Daycare.com Forum Daycare Forum

Go Back   Daycare.com Forum > Main Category > Daycare Center and Family Home Forum

Daycare Center and Family Home Forum Daycare Center and Family Home owners, Directors, Operators and Assistants should post and ask questions here.

Reply
 
Thread Tools Display Modes
  #1  
Old 06-03-2012, 07:15 AM
CheekyChick's Avatar
CheekyChick CheekyChick is offline
Daycare.com Member
 
Join Date: Dec 2009
Location: USA
Posts: 811
Default Extra Charge For High Needs Child???

I have a little girl (almost 2 years) who is diabetic. She requires a LOT more care than the other children in her age group. We have to test her blood throughout the day (even while she's sleeping), give her insulin at times, monitor her eating, and stay in constant contact with her parents throughout the day.

Is it legal to charge a bit more for her care? I've read at traditional preschools that it is not legal to charge more - but I run a daycare which is different.

Anyway, she will be moving to a new class soon and I would like to give a small wage increase to her teacher as she is taking on TONS more work and responsibility.

What are your thoughts?
Reply With Quote
  #2  
Old 06-03-2012, 07:22 AM
snbauser's Avatar
snbauser snbauser is offline
Daycare.com Member
 
Join Date: Jan 2011
Location: North Carolina
Posts: 1,385
Default

In the past I have been told that it is against the Americans with Disabilities Act to charge more for a child with special needs.
Reply With Quote
  #3  
Old 06-03-2012, 08:25 AM
Former Teacher's Avatar
Former Teacher Former Teacher is offline
Advanced Daycare.com Member
 
Join Date: Apr 2009
Location: USA
Posts: 1,305
Default

Quote:
Originally Posted by snbauser View Post
In the past I have been told that it is against the Americans with Disabilities Act to charge more for a child with special needs.
I have heard this as well.

If my memory serves me right, once at my former center we had a family whose daughter was in a wheelchair. It would have required that we had to redo the WHOLE building to accommodate this family plus add ramps etc.

The director just told the family that we were full. Sad yes I know. But she didn't want to go through the hassle (and the expense!) for a family that may or may not stay.
Reply With Quote
  #4  
Old 06-03-2012, 08:30 AM
CheekyChick's Avatar
CheekyChick CheekyChick is offline
Daycare.com Member
 
Join Date: Dec 2009
Location: USA
Posts: 811
Default

Thank you for your input...

I have been googling whether or not it is legal to charge more at an at home daycare, which is completely different than a traditional preschool. We decide what we charge, so I assumed I could charge more for special needs children. Also, the Department of Human Services even pays more for special needs children, but it doesn't specify what is considered "special needs."
Reply With Quote
  #5  
Old 06-03-2012, 09:18 AM
Blackcat31's Avatar
Blackcat31 Blackcat31 is offline
 
Join Date: Oct 2010
Posts: 19,760
Default

My state actually pays more for children with special needs. So I don't think it is against the ADA...or atleast some cases aren't.

I have received a higher rate reimbursement for children who have diabetes and for children with other issues that require more care then regular kids.

I don't have any idea what the rules are and had no idea I could charge a higher rate until my licensor told me I could and the state subsidy program sent me the paperwork saying how I should go about applying for the higher rate reimbursement.
Reply With Quote
  #6  
Old 06-03-2012, 09:37 AM
Willow Willow is offline
Advanced Daycare.com Member
 
Join Date: May 2012
Posts: 2,607
Default

It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.


I'm sorry but IMHO you need to suck it up. Some kids need almost no care at all, they are smart and play well, are well behaved, eat well, clean up after themselves...then there are those who need loads of extra supervision because they can't play independently, are into and onto everything, are picky or messy eaters and buck clean up every single time. There are also those with long hair that need tending to throughout the day. Those who wear glasses or hearing aids that need special attention. Those with eczema that need creams put on daily. Those with allergies who need medications administered and reactions monitored etc. etc. etc.

If you start nit picky charging for everything that adds a bit more to your plate you better start doing that for all AND be willing to discount the parents of the easy streeters to boot.




DHS in MN has instituted DOC rates for special needs kids in foster care. Is that what you're talking about? Children that become wards of the state are assessed, given a number and that number corresponds with a reimbursement rate beyond the regular daily rate. Sure, if I've got a drug addicted detoxing newborn who doesn't sleep but two hours a day, needs to eat a specially prepared formula every one to two hours, baths several times a day to keep their bottom clear of the feces that literally burn their skin, doctors appointments several times a week and specialists coming into my home almost daily then that child will have a higher DOC number and I'll be reimbursed for the "extra" care I need to provide.

Not that it's necessary, I certainly didn't need or expect to make more money off the backs of sicker kids as opposed to healthy ones.

I don't know how that would relate to daycare though. Unless perhaps that child's rates are paid via county assistance?


K-12 teachers don't make more for kids in their classes that are more "difficult" to teach or handle. I'm not sure why preschool teachers should be able to.




When you talk about "giving" a wage increase to the next teacher just because she was a bit more work for you....frankly, I'd sue if I was the girl's parents and I was ever presented such a notion.
Reply With Quote
  #7  
Old 06-03-2012, 09:50 AM
Blackcat31's Avatar
Blackcat31 Blackcat31 is offline
 
Join Date: Oct 2010
Posts: 19,760
Default

Quote:
Originally Posted by Willow View Post
It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.
This has nothing to do with this thread really, but please don't say it like that.

My DH is a Type 1 insulin diabetic. He is NOT sick or ill. He does not have an illness that is going to go away some day like having strep throat or an ear infection.

I know that is really not what you meant and I respect the fact that you feel like a higher rate is unfair and such and I also admire the fact that you feel charging more is not morally or ethically right but saying diabetes is an illness or sickness just sits wrong with me.

My DH (and our whole family) have had to deal with biases and mis-information associated with having diabetes so I am aways quick to jump in to correct the wrong wording or wrong ideas about it...so forgive my haste, but I just get upset when people say illness or sickness...kwim?

I know it is just words...but he isn't sick and he isn't ill. He has a disease and one that he can and does live with to the best of his abilities but it isn't going to go away or get better.

Last edited by Blackcat31; 06-03-2012 at 09:52 AM.
Reply With Quote
  #8  
Old 06-03-2012, 10:00 AM
Former Teacher's Avatar
Former Teacher Former Teacher is offline
Advanced Daycare.com Member
 
Join Date: Apr 2009
Location: USA
Posts: 1,305
Default

Quote:
Originally Posted by Willow View Post
It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.

I'm sorry but IMHO you need to suck it up. Some kids need almost no care at all, they are smart and play well, are well behaved, eat well, clean up after themselves...then there are those who need loads of extra supervision because they can't play independently, are into and onto everything, are picky or messy eaters and buck clean up every single time. There are also those with long hair that need tending to throughout the day. Those who wear glasses or hearing aids that need special attention. Those with eczema that need creams put on daily. Those with allergies who need medications administered and reactions monitored etc. etc. etc.

If you start nit picky charging for everything that adds a bit more to your plate you better start doing that for all AND be willing to discount the parents of the easy streeters to boot.

DHS in MN has instituted DOC rates for special needs kids in foster care. Is that what you're talking about? Children that become wards of the state are assessed, given a number and that number corresponds with a reimbursement rate beyond the regular daily rate. Sure, if I've got a drug addicted detoxing newborn who doesn't sleep but two hours a day, needs to eat a specially prepared formula every one to two hours, baths several times a day to keep their bottom clear of the feces that literally burn their skin, doctors appointments several times a week and specialists coming into my home almost daily then that child will have a higher DOC number and I'll be reimbursed for the "extra" care I need to provide.

Not that it's necessary, I certainly didn't need or expect to make more money off the backs of sicker kids as opposed to healthy ones.

I don't know how that would relate to daycare though. Unless perhaps that child's rates are paid via county assistance?

K-12 teachers don't make more for kids in their classes that are more "difficult" to teach or handle. I'm not sure why preschool teachers should be able to.

When you talk about "giving" a wage increase to the next teacher just because she was a bit more work for you....frankly, I'd sue if I was the girl's parents and I was ever presented such a notion.
Not to hijack this thread by any means, but I am reminded of someone/something. This person will remain anonymous because she no longer posts. However she remains highly respected and well loved here.

If I am remembering and reading her posts right, this is EXACTLY how she does business. She charges the parents for every little thing that requires extra work for her and/or assistant. I don't remember all the little details however it does stick in my mind that she has made the comment, if the parents want special, they have to pay for it.

I do not blame the providers who want to charge extra. Nor do I blame them if they want complete control of the children they take care of. I do however blame the parents that allow such things like this to happen.

Ok off my soap box
Reply With Quote
  #9  
Old 06-03-2012, 10:46 AM
Willow Willow is offline
Advanced Daycare.com Member
 
Join Date: May 2012
Posts: 2,607
Default

Quote:
Originally Posted by Blackcat31 View Post
This has nothing to do with this thread really, but please don't say it like that.

My DH is a Type 1 insulin diabetic. He is NOT sick or ill. He does not have an illness that is going to go away some day like having strep throat or an ear infection.

I know that is really not what you meant and I respect the fact that you feel like a higher rate is unfair and such and I also admire the fact that you feel charging more is not morally or ethically right but saying diabetes is an illness or sickness just sits wrong with me.

My DH (and our whole family) have had to deal with biases and mis-information associated with having diabetes so I am aways quick to jump in to correct the wrong wording or wrong ideas about it...so forgive my haste, but I just get upset when people say illness or sickness...kwim?

I know it is just words...but he isn't sick and he isn't ill. He has a disease and one that he can and does live with to the best of his abilities but it isn't going to go away or get better.

My sincere apologies.

I knew when I typed the word it wasn't quite right, but could not think of the right way to convey it with what I was trying to say. I considered calling it a disease but actually that seemed to have even more of a negative connotation in my mind than the word illness did. Although it's a tough thing to live with undoubtedly I can imagine there is enough of a stigma surrounding any permanent affliction in a persons life as it is that that makes it even tougher.

Was trying not to add to that and failed, please know that wasn't my intention
Reply With Quote
  #10  
Old 06-03-2012, 11:24 AM
jokalima's Avatar
jokalima jokalima is offline
Daycare.com Member
 
Join Date: May 2012
Location: Connecticut
Posts: 474
Default

Here is not legal to do that, but I am going to have different rates for different families after I renew the contract, so I think you could do the same thing, have different rates. I know it sounds bad, but it is understandable that it is more work and if someone thinks they need to get paid more for doing it I can't judge them.
Reply With Quote
  #11  
Old 06-03-2012, 11:49 AM
CheekyChick's Avatar
CheekyChick CheekyChick is offline
Daycare.com Member
 
Join Date: Dec 2009
Location: USA
Posts: 811
Default

Quote:
Originally Posted by Willow View Post
It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.


I'm sorry but IMHO you need to suck it up. Some kids need almost no care at all, they are smart and play well, are well behaved, eat well, clean up after themselves...then there are those who need loads of extra supervision because they can't play independently, are into and onto everything, are picky or messy eaters and buck clean up every single time. There are also those with long hair that need tending to throughout the day. Those who wear glasses or hearing aids that need special attention. Those with eczema that need creams put on daily. Those with allergies who need medications administered and reactions monitored etc. etc. etc.

If you start nit picky charging for everything that adds a bit more to your plate you better start doing that for all AND be willing to discount the parents of the easy streeters to boot.




DHS in MN has instituted DOC rates for special needs kids in foster care. Is that what you're talking about? Children that become wards of the state are assessed, given a number and that number corresponds with a reimbursement rate beyond the regular daily rate. Sure, if I've got a drug addicted detoxing newborn who doesn't sleep but two hours a day, needs to eat a specially prepared formula every one to two hours, baths several times a day to keep their bottom clear of the feces that literally burn their skin, doctors appointments several times a week and specialists coming into my home almost daily then that child will have a higher DOC number and I'll be reimbursed for the "extra" care I need to provide.

Not that it's necessary, I certainly didn't need or expect to make more money off the backs of sicker kids as opposed to healthy ones.

I don't know how that would relate to daycare though. Unless perhaps that child's rates are paid via county assistance?


K-12 teachers don't make more for kids in their classes that are more "difficult" to teach or handle. I'm not sure why preschool teachers should be able to.




When you talk about "giving" a wage increase to the next teacher just because she was a bit more work for you....frankly, I'd sue if I was the girl's parents and I was ever presented such a notion.

You don't know me or the way I run my business. I cater to and pamper each and every one of my families. I ALWAYS go the extra mile. I have watched children for free, I have given huge discounts when parents are going through tough times, I've never charged a late fee, and I will stay open for a parent who is running late with a smile on my face. I give gifts throughout the year to the children, their parents, and even a few grandparents. I hold baby showers for expectant mothers, I feed parents if they happen to be here during meal time, and I buy shoes, coats, and gloves for children that don't have them. Oh, and when this little girl was diagnosed, I spent hours upon hours of my OWN time meeting with her parents on Saturday(s) to learn to care for her.

Do NOT make me out to be a greedy, uncaring person. I am the furthest thing from that. I love this little girl, but she is the work of two children. She is moving to a different class and I feel it's fair to compensate her new teacher for the extra work she has in store - on top of her regular duties. Oh, and this family is doing well. One is a teacher and the other is a pharmacist. I do believe they can afford an extra 25 cents per hour.
Reply With Quote
  #12  
Old 06-03-2012, 01:45 PM
Willow Willow is offline
Advanced Daycare.com Member
 
Join Date: May 2012
Posts: 2,607
Default

Why do you think it should be up to you to raise the rates of a family you're not even going to be caring for any longer?

Why not let the new teacher decide if it's too much work on her own. Just because the girl was a lot for you to deal with doesn't mean the new teacher will feel the same way.


Using the excuse that the family is financially stable so who cares if you hike the rate....there just aren't words for a thought process like that......
Reply With Quote
  #13  
Old 06-03-2012, 02:26 PM
CheekyChick's Avatar
CheekyChick CheekyChick is offline
Daycare.com Member
 
Join Date: Dec 2009
Location: USA
Posts: 811
Default

Quote:
Originally Posted by Willow View Post
Why do you think it should be up to you to raise the rates of a family you're not even going to be caring for any longer?

Why not let the new teacher decide if it's too much work on her own. Just because the girl was a lot for you to deal with doesn't mean the new teacher will feel the same way.


Using the excuse that the family is financially stable so who cares if you hike the rate....there just aren't words for a thought process like that......
Why do I think it's up to me? Because I own and run MY daycare.

I never said she was "a lot to deal with," I said she requires a lot more work than the other children. Even though she is moving classes, I will STILL be caring for her. I just can't be in four different class rooms at one time - that is why I have assistants.

I've already spoke to the assistant in the toddler room and she feels a bit overwhelmed by the task at hand. I was hoping a slight wage increase would encourage her to take on this enormous task. I don't want to lose her OR the family.

"There just aren't words for a thought process like that." LOL!!! Once you run a successful business with 16 children per day and a waiting list a mile long, I might just listen to your input.

Have a great day.
Reply With Quote
  #14  
Old 06-03-2012, 02:58 PM
itlw8's Avatar
itlw8 itlw8 is offline
Daycare.com Member
 
Join Date: Jan 2012
Location: Missouri
Posts: 2,199
Default

You may not refuse care for a child with a disability and you may not charge more for a child with a disability.

so the question is by law is diabetes a disability?

Ask Tom he would know the correct legal answer.
Reply With Quote
  #15  
Old 06-03-2012, 03:19 PM
Former Teacher's Avatar
Former Teacher Former Teacher is offline
Advanced Daycare.com Member
 
Join Date: Apr 2009
Location: USA
Posts: 1,305
Default

Quote:
Originally Posted by itlw8 View Post
so the question is by law is diabetes a disability?
When is diabetes a disability under the ADA? Diabetes is a disability when it substantially limits one or more of a person's major life activities
Reply With Quote
  #16  
Old 06-03-2012, 05:15 PM
Blackcat31's Avatar
Blackcat31 Blackcat31 is offline
 
Join Date: Oct 2010
Posts: 19,760
Default

Quote:
Originally Posted by itlw8 View Post
You may not refuse care for a child with a disability and you may not charge more for a child with a disability.

so the question is by law is diabetes a disability?

Ask Tom he would know the correct legal answer.
My DH has diabetes (Type 1) and he does NOT qualify for any type of special services and is not recognized as disabled by the ADA.

He takes several insulin shots per day along with the other things a diabetic must do but is in no way considered disabled or eligible to receive any type of payment or reimbursement from social security or any other type of monetary payments.

Same goes for my nephew (age 18) who has been type 1 since he was 6 and for my late BIL who passed away from complications of diabetes at 36 years old. He was on dialysis, had one leg amputated and was partially blind and recieved not one dime of any type of disability during his short life....despite applying several times in the later part of his life but he never qualified as disabled.

Like Former Teacher said, "It is not simply having diabetes that qualifies a person as being disabled, but how diabetes has impacted their life" http://www.isletsofhope.com/civil-ri...-disabled.html

Last edited by Blackcat31; 06-03-2012 at 05:17 PM.
Reply With Quote
  #17  
Old 06-03-2012, 05:19 PM
Blackcat31's Avatar
Blackcat31 Blackcat31 is offline
 
Join Date: Oct 2010
Posts: 19,760
Default

Quote:
Originally Posted by Willow View Post
My sincere apologies.

I knew when I typed the word it wasn't quite right, but could not think of the right way to convey it with what I was trying to say. I considered calling it a disease but actually that seemed to have even more of a negative connotation in my mind than the word illness did. Although it's a tough thing to live with undoubtedly I can imagine there is enough of a stigma surrounding any permanent affliction in a persons life as it is that that makes it even tougher.

Was trying not to add to that and failed, please know that wasn't my intention
Apology acepted. As I said, I know that wasn't your intention. I just wanted to make it clear that diabetes is NOT an illness.
Reply With Quote
  #18  
Old 06-03-2012, 05:21 PM
itlw8's Avatar
itlw8 itlw8 is offline
Daycare.com Member
 
Join Date: Jan 2012
Location: Missouri
Posts: 2,199
Default

Then I guess the answer is yes you can charge more.... maybe?

The teacher would still be overwhelmed with more money. Can another staff member come in a test or take over while the main teacher is testing.

In school the child would go to the nurse. so in a center the director?? family childcare would be as anything else just another hat to wear.
Reply With Quote
  #19  
Old 06-03-2012, 05:54 PM
Blackcat31's Avatar
Blackcat31 Blackcat31 is offline
 
Join Date: Oct 2010
Posts: 19,760
Default

Apparently diabetes doesn't necessarily only fall under the ADA rules as much as it follows rules/laws set under IDEA and Section 504 of the Rehabilitation Act of 1973

The law states "This law prohibits all schools and day care centers, except those run by religious organizations, from discriminating against children with disabilities, including diabetes. Protection under is this law is the same as that for Section 504" but doesn't clarify anything about charging higher rates based on accomodation for the higher needs.

It also says "Any educational facility, school or daycare center, which receives federal funding cannot discriminate in the admission, educational process, or treatment of a student who has diabetes".

Privately-run child care centers - like other public accommodations such as private schools, recreation centers, restaurants, hotels, movie theaters, and banks must comply with title III of the Americans with Disabilities Act (ADA).

Child care services provided by State and local government agencies, such as Head Start, summer programs, and extended school day programs, must comply with title II of the ADA. Both titles apply to a child care center's interactions with the children, parents, guardians, and potential customers that it serves.

http://www.childrenwithdiabetes.com/d_0q_600.htm

http://www.childrenwithdiabetes.com/d_0q_100.htm

Here is a wonderful site for child care providers in regards to the law about this subject and other special needs issues: http://www.childcare.gov/xhtml/links/g_3/t_33.html
Reply With Quote
  #20  
Old 06-03-2012, 05:59 PM
Blackcat31's Avatar
Blackcat31 Blackcat31 is offline
 
Join Date: Oct 2010
Posts: 19,760
Default

Quote:
Originally Posted by CheekyChick View Post
I have a little girl (almost 2 years) who is diabetic. She requires a LOT more care than the other children in her age group. We have to test her blood throughout the day (even while she's sleeping), give her insulin at times, monitor her eating, and stay in constant contact with her parents throughout the day.

Is it legal to charge a bit more for her care? I've read at traditional preschools that it is not legal to charge more - but I run a daycare which is different.

Anyway, she will be moving to a new class soon and I would like to give a small wage increase to her teacher as she is taking on TONS more work and responsibility.

What are your thoughts?
Yah!

I am pretty sure I found the answer to your question. It is found in the answers to question #13 and #20. (in the link below)

From what I read and understand, you cannot charge this family more.

http://www.ada.gov/childq%26a.htm
Reply With Quote
  #21  
Old 06-03-2012, 06:17 PM
sharlan's Avatar
sharlan sharlan is offline
Advanced Daycare.com Member
 
Join Date: May 2011
Location: Chino, California
Posts: 6,040
Default

OT - but in CA, we cannot administer insulin. We may monitor blood only.
Reply With Quote
  #22  
Old 06-03-2012, 06:34 PM
Heidi's Avatar
Heidi Heidi is offline
Advanced Daycare.com Member
 
Join Date: Sep 2011
Location: Wisconsin
Posts: 6,858
Default

Quote:
Originally Posted by Blackcat31 View Post
Yah!

I am pretty sure I found the answer to your question. It is found in the answers to question #13 and #20. (in the link below)

From what I read and understand, you cannot charge this family more.

http://www.ada.gov/childq%26a.htm
Wow! That is awesome! I just took a "children with differering abilities" course, and we never came accross this link. I think I will send it to the instructor for her next class. Thanks!
Reply With Quote
  #23  
Old 06-03-2012, 07:09 PM
Blackcat31's Avatar
Blackcat31 Blackcat31 is offline
 
Join Date: Oct 2010
Posts: 19,760
Default

Quote:
Originally Posted by sharlan View Post
OT - but in CA, we cannot administer insulin. We may monitor blood only.
States definitely differ in whether they allow insulin and/or glucagon administration to be delegated to someone other than a medical representative or medically trained person.

Here is a handy little chart that shows whether or not your state allows the child care provider or other delegated person to administer insulin and/or glucagon.

http://www.diabetes.org/assets/pdfs/...nistration.pdf
Reply With Quote
  #24  
Old 06-03-2012, 07:38 PM
CheekyChick's Avatar
CheekyChick CheekyChick is offline
Daycare.com Member
 
Join Date: Dec 2009
Location: USA
Posts: 811
Default

Quote:
Originally Posted by Blackcat31 View Post
Yah!

I am pretty sure I found the answer to your question. It is found in the answers to question #13 and #20. (in the link below)

From what I read and understand, you cannot charge this family more.

http://www.ada.gov/childq%26a.htm
You are awesome, Blackcat. Thank you for taking the time to do some research.

The only thing I'm questioning, is that it seems this was written for child care centers - not in-home daycares. I could be wrong though.
Reply With Quote
  #25  
Old 06-03-2012, 07:58 PM
CheekyChick's Avatar
CheekyChick CheekyChick is offline
Daycare.com Member
 
Join Date: Dec 2009
Location: USA
Posts: 811
Default

Quote:
Originally Posted by itlw8 View Post
Then I guess the answer is yes you can charge more.... maybe?

The teacher would still be overwhelmed with more money. Can another staff member come in a test or take over while the main teacher is testing.

In school the child would go to the nurse. so in a center the director?? family childcare would be as anything else just another hat to wear.
She is not overwhelmed or afraid to care for her, she is overwhelmed by the time and responsibility it would take to care for her AND 9 other children. For example: She has to be tested in the morning, tested before morning snack, tested before she plays outside, tested after she plays outside, tested before lunch, tested during naps, tested before afternoon snack. Oh, and tested it it is too cold outside or if she's acting different in any way.

It is not only the testing, it is watching her like a hawk for signs of going low, agitation, stomach upset, sweating, etc. It is also responding to the parents who call or text throughout the ENTIRE day with questions/concerns. It is also sitting with her at every meal, encouraging her to eat enough because she has to be full enough to last until the next meal/snack which HAS to be spread 3 hours apart, and then calculating the carbs. It is making sure she doesn't eat anything from someone else's plate (not easy for a 23 month old). The list goes on and on...

Those are the reasons it would be fair to my Assistant to get a small wage increase for the additional work. It truly is a HUGE job.
Reply With Quote
  #26  
Old 06-03-2012, 08:00 PM
CheekyChick's Avatar
CheekyChick CheekyChick is offline
Daycare.com Member
 
Join Date: Dec 2009
Location: USA
Posts: 811
Default

Quote:
Originally Posted by Blackcat31 View Post
States definitely differ in whether they allow insulin and/or glucagon administration to be delegated to someone other than a medical representative or medically trained person.

Here is a handy little chart that shows whether or not your state allows the child care provider or other delegated person to administer insulin and/or glucagon.

http://www.diabetes.org/assets/pdfs/...nistration.pdf
You should be a detective - GREAT work.
Reply With Quote
  #27  
Old 06-04-2012, 06:57 AM
texascare's Avatar
texascare texascare is offline
Daycare.com Member
 
Join Date: Mar 2011
Location: Texas
Posts: 203
Default

wow. My son is type 1 Diabetic and I am just floored...........
Reply With Quote
  #28  
Old 06-04-2012, 09:48 AM
MarinaVanessa's Avatar
MarinaVanessa MarinaVanessa is offline
Family Childcare Home
 
Join Date: Jan 2010
Location: Ventura County, CA
Posts: 7,200
Default

The Americans with Disabilities Act doesn't differentiate between a "center" or "FCC". Whenever federal law says "daycare center" they are including centers, FCC, after school programs, etc. "The ADA prohibits family child care providers and child care centers from discriminating against a child, parent, or employee based solely on his/her disability (such as denying admission into a child care program). The ADA requires child care providers to make reasonable accommodations for all children." Here's that sheet from the Public Counsel Law Center, THE AMERICANS WITH DISABILITIES ACT & CHILD CARE PDF

Charging a family more because a child has a condition or disability is opening yourself up for a potential lawsuit unless you have to hire extra staff specifically for that child. Should this family decide to fight you in court it will be your responsibility to show that this child's diabetes doesn't fall under the Americans with Disabilities Act and that could be a tough fight. The Americans with Disabilities Act doesn't list specific conditions "Because each child is unique and has unique needs, no single approach to caring for children with disabilities can be applied to all children, or even to those with the same disability". So in other words, it's based on a case by case basis but courts don't typically side with the person going against this Act.

"The Americans with Disabilities Act (ADA) defines a child with a disability more specifically as one who has a physical or mental impairment that substantially limits the child’s ability to care for herself or himself, perform manual tasks, or engage in any other “major life activity,” such as walking, seeing, hearing, speaking, breathing, or learning, in an age-appropriate manner."

The sheet that I have goes on to say "]The kind of disability a child might have can vary greatly — allergies, moderate retardation, diabetes, cerebral palsy, or even a terminal illness may each be considered a disability under the ADA." When dealing with the ADA it's best to tread the waters very carefully. From Childcarelaw.org Caring for Children with Special Needs: THE AMERICANS WITH DISABILITIES ACT AND CHILD CARE

The only way that you can safely charge more without risk of a lawsuit is if you for example, feel like the staff member that cares for this child will be overwhelmed so you hire an extra assistant for this child and either bill the parents for this extra help or you can raise their rates a bit to cover a portion of the extra assistant and "eat" the other part of the cost.

On a side note, I can just imagine how intimidating this task and responsibility can seem to someone that has never had to deal with it. Are you open to the option of personally training and observing your staff member until she feels comfortable? Or of having your staff member trained by either attending a class or by scheduling an appointment with the child's physician so that she can learn the ins and outs (at the expense of the parents)?
Reply With Quote
  #29  
Old 06-04-2012, 09:54 AM
countrymom's Avatar
countrymom countrymom is offline
Advanced Daycare.com Member
 
Join Date: Aug 2010
Location: ontario canada
Posts: 4,756
Default

this has nothing to do about disability, its obvious that this child needs 2 people to care for her. Sometimes you can't be everywhere and monitor this childs diabetes, so this is where a second person is required. Just like people who get a "helper" to help them out during the day, so I would ask for maybe a couple dollars more considering you need a helper. Now maybe when she is about 5 and has it under control and the parents feel comfortable you can drop their rate, but for now, its fine to ask.
Reply With Quote
  #30  
Old 06-04-2012, 10:01 AM
Blackcat31's Avatar
Blackcat31 Blackcat31 is offline
 
Join Date: Oct 2010
Posts: 19,760
Default

Quote:
Originally Posted by MarinaVanessa View Post
The Americans with Disabilities Act doesn't differentiate between a "center" or "FCC". Whenever federal law says "daycare center" they are including centers, FCC, after school programs, etc.

Charging a family more because a child has a condition or disability is opening yourself up for a potential lawsuit unless you have to hire extra staff specifically for that child. Should this family decide to fight you in court it will be your responsibility to show that this child's diabetes doesn't fall under the Americans with Disabilities Act and that could be a tough fight. The Americans with Disabilities Act doesn't list specific conditions "Because each child is unique and has unique needs, no single approach to caring for children with disabilities can be applied to all children, or even to those with the same disability". So in other words, it's based on a case by case basis but courts don't typically side with the person going against this Act.

"The Americans with Disabilities Act (ADA) defines a child with a disability more specifically as one who has a physical or mental impairment that substantially limits the child’s ability to care for herself or himself, perform manual tasks, or engage in any other “major life activity,” such as walking, seeing, hearing, speaking, breathing, or learning, in an age-appropriate manner."

The sheet that I have goes on to say "]The kind of disability a child might have can vary greatly — allergies, moderate retardation, diabetes, cerebral palsy, or even a terminal illness may each be considered a disability under the ADA." When dealing with the ADA it's best to tread the waters very carefully. From Childcarelaw.org Caring for Children with Special Needs: THE AMERICANS WITH DISABILITIES ACT AND CHILD CARE

The only way that you can safely charge more without risk of a lawsuit is if you for example, feel like the staff member that cares for this child will be overwhelmed so you hire an extra assistant for this child and either bill the parents for this extra help or you can raise their rates a bit to cover a portion of the extra assistant and "eat" the other part of the cost.

On a side note, I can just imagine how intimidating this task and responsibility can seem to someone that has never had to deal with it. Are you open to the option of personally training and observing your staff member until she feels comfortable? Or of having your staff member trained by either attending a class or by scheduling an appointment with the child's physician so that she can learn the ins and outs (at the expense of the parents)?
Actually the ADA separate FCC from center care in two groups:

Privately-run child care centers/homes - like other public accommodations such as private schools, recreation centers, restaurants, hotels, movie theaters, and banks must comply with title III of the Americans with Disabilities Act (ADA).

Child care services provided by State and local government agencies, such as Head Start, summer programs, and extended school day programs, must comply with title II of the ADA. Both titles apply to a child care center's interactions with the children, parents, guardians, and potential customers that it serves.

See my post above (post # 19) for links that define each of the areas (Title II and Title III)
Reply With Quote
  #31  
Old 06-04-2012, 10:03 AM
MN Day Mom's Avatar
MN Day Mom MN Day Mom is offline
Daycare.com Member
 
Join Date: Mar 2011
Location: New Jersey
Posts: 246
Default

Quote:
Originally Posted by CheekyChick View Post
You are awesome, Blackcat. Thank you for taking the time to do some research.

The only thing I'm questioning, is that it seems this was written for child care centers - not in-home daycares. I could be wrong though.
Here is what I found....http://www.mnchildcare.org/issues/ada.php
Reply With Quote
  #32  
Old 06-04-2012, 10:11 AM
Blackcat31's Avatar
Blackcat31 Blackcat31 is offline
 
Join Date: Oct 2010
Posts: 19,760
Default

Quote:
Originally Posted by MN Day Mom View Post
Since diabetes can be either Type 1 or Type II, there are certain requirments that each provider must follow in each state and EVERY single state differs in those rules and regulations.

As Sharlan mentioned, California does NOT allow child care providers to administer insulin or glucagon injections where as Minnesota does allow it.

I also think that having diabetes, as ohters have stated, doesn't automatically mean someone is disabled therefore, not always having to follow the rules and guidelines of the ADA.

I know from experience that having Type I diabetes is a whole different ballgame than having Type II. Each requires a completely different type of care. Then if you add having an automated pump, the rules again would be different. So I would automatically assume that different rules/regulations would apply in almost every situation.
Reply With Quote
  #33  
Old 06-04-2012, 10:13 AM
Kelly's Avatar
Kelly Kelly is offline
Daycare.com member
 
Join Date: Dec 2011
Location: Illinois
Posts: 151
Default

How much time does it take to deal with this child's diabetes? My son has Type 1 diabetes and I have never found it to take an excessive amount of my time.
Reply With Quote
  #34  
Old 06-04-2012, 10:40 AM
MarinaVanessa's Avatar
MarinaVanessa MarinaVanessa is offline
Family Childcare Home
 
Join Date: Jan 2010
Location: Ventura County, CA
Posts: 7,200
Default

Quote:
Originally Posted by Blackcat31 View Post
Actually the ADA separate FCC from center care in two groups:
Right. Each have their own conditions but either way they are both covered under the ADA. That's the point that I was trying to make since you had already covered the differences.

Quote:
Originally Posted by countrymom View Post
this has nothing to do about disability, its obvious that this child needs 2 people to care for her. Sometimes you can't be everywhere and monitor this childs diabetes, so this is where a second person is required.
Yes, she can always hire another staff member and bill the parents for the extra money that this will cost or she can bill them just a portion. The only problems that I can think of with going this route is that the parent's may not be able to afford to pay the tuition and the full amount of money for the other staff member. Also if the parent's are billed for the full amount of the new staff member then this staff member's responsibilities need to be with only this one child. If the parent only pays for a portion of the cost then the staff member can be given other duties to do when she's not assisting this child.

If a new staff member is not hired then she won't be able to charge more without risk of a potential lawsuit because the staff member is already employed and so asking an already employed staff member to take on more duties to care for this child would constitute "reasonable accomodations" to me. Giving one staff member more duties does not itself cost more even though the staff member may not like it. Paying the staff member more may keep her happier but it in itself is not necessary, it;s something extra that the provider can offer to help keep her employee happy. If her employee quits because she doesn't like the added duties another employee can be hired and told from the beginning that this child will be a part of the duties and still be paid the same wages as the previous employee. I've worked at centers and administering medication while getting paid minimum wage is typical, it's not special (although of course here in CA only a nurse can administer a shot).

I'm thinking about this from a subjective viewpoint because if something like this goes to court then I see something like this happening:
Judge: Why did you charge them more?
Provider: Because I had to give my staff member more duties so I gave her a raise so she wouldn't quit.
Judge: Why didn't you just hire someone else willing to do the work for the same price if your staff member quit?
KWIM?

Oh and I wanted to add ... could you see this as a selling perk? If you employ someone that familiar with administering shots and medication or train one of your employees to be really familiar with administrating shots and handling medications and treatments you can potentially attract more parents that have these needs. You can have a special niche so to speak. It sounds like a lot of responsibility but if your staff is properly trained then it's not so scary. I had never had a DC kid with any type of medical condition until I recenty took on a child with a peanut allergy. Everyone told me about the liability and I took this very seriously. I went as far as to speak with the child's physicial to get a run-down of how to prevent an allergic reaction and I took a small class through Rainbow Connections (our local special needs parent's group) which covered peanut allergies specifically. I paid a small $45 fee for the training but I now feel that I know more about it and how to prevent and react to reactions and that makes me feel ALOT better. SOmetimes just not knowing is scarier than actually doing it KWIM?
Reply With Quote
  #35  
Old 06-04-2012, 10:48 AM
texascare's Avatar
texascare texascare is offline
Daycare.com Member
 
Join Date: Mar 2011
Location: Texas
Posts: 203
Default

Quote:
Originally Posted by Kelly View Post
How much time does it take to deal with this child's diabetes? My son has Type 1 diabetes and I have never found it to take an excessive amount of my time.
It isn't that difficult. Did the OP know this child had Diabetes before accepting them into care? I lost the name of the OP in all the posts....sorry.
Reply With Quote
  #36  
Old 06-04-2012, 12:59 PM
SilverSabre25's Avatar
SilverSabre25 SilverSabre25 is offline
Senior Member
 
Join Date: Aug 2010
Location: Where I am legally unlicensed ;), USA
Posts: 7,625
Default

Quote:
Originally Posted by texascare View Post
It isn't that difficult. Did the OP know this child had Diabetes before accepting them into care? I lost the name of the OP in all the posts....sorry.
From the sounds of it, this child needs quite a bit of care and watching--this is by the OP, who btw is CheekyChick and this is from post #25

Quote:
She is not overwhelmed or afraid to care for her, she is overwhelmed by the time and responsibility it would take to care for her AND 9 other children. For example: She has to be tested in the morning, tested before morning snack, tested before she plays outside, tested after she plays outside, tested before lunch, tested during naps, tested before afternoon snack. Oh, and tested it it is too cold outside or if she's acting different in any way.

It is not only the testing, it is watching her like a hawk for signs of going low, agitation, stomach upset, sweating, etc. It is also responding to the parents who call or text throughout the ENTIRE day with questions/concerns. It is also sitting with her at every meal, encouraging her to eat enough because she has to be full enough to last until the next meal/snack which HAS to be spread 3 hours apart, and then calculating the carbs. It is making sure she doesn't eat anything from someone else's plate (not easy for a 23 month old). The list goes on and on...

Those are the reasons it would be fair to my Assistant to get a small wage increase for the additional work. It truly is a HUGE job.
Reply With Quote
  #37  
Old 06-04-2012, 01:55 PM
texascare's Avatar
texascare texascare is offline
Daycare.com Member
 
Join Date: Mar 2011
Location: Texas
Posts: 203
Default

Thank you SilverSabre25...my thought was did she know about the medical condition before she accepted the child into care? I was wondering what the parent would think if the provider came back after knowing all this and raised the rates? No dealing with a type 1 is not that difficult as my son is type 1. Do we then raise rates on a child who has asthma and needs breathing treatments or a child who has an allergy to certain foods? Just thinking.
Reply With Quote
  #38  
Old 06-04-2012, 06:11 PM
MrsB's Avatar
MrsB MrsB is offline
Daycare.com Member
 
Join Date: Jan 2012
Location: Maryland
Posts: 590
Default

Over the years I have had several children with special needs. In fact I pride myself in always trying to have one or two children with special needs enrolled, usually Aspergers or Autism. Along time ago when I ran my contract by my lawyer, he suggested I word my contract, that my rates are based on the needs of each child/family. Same as the contract has custom hours to meet the families daycare needs, the rate is a custom rate based on the hours/days/ and needs of the child. Also in my contract, I have that at anytime the rates are subject to change based on me meeting the needs of the child, if the parents dont agree then they have the option to give two weeks notice and find other care. My rates are not based on the disability itself, but the needs of the child. I am totally up front with my parents about this. In my experience when you are up front with parents and communicative with parents who have children that have special needs whether it be a disability or not, they are very receptive as long as they dont see you as just trying to nickle and dime them. To justify the rate increase you have to provide examples of the extra time spent.

I have charged more on screaming infant, a child that isn't potty trained, and a child that increased their time at daycare because they required more attention than my base rate, same as I might consider raising the rate for someone that required special monitoring whether they had a qualified "disability". But you can't just have a "disability rate".

My opinion for this case is either you do as a previous poster suggested and get an additional assistant and charge the parents more, just let it go, or change everyones rates to those based on needs.
Reply With Quote
  #39  
Old 06-05-2012, 07:03 AM
countrymom's Avatar
countrymom countrymom is offline
Advanced Daycare.com Member
 
Join Date: Aug 2010
Location: ontario canada
Posts: 4,756
Default

Quote:
Originally Posted by SilverSabre25 View Post
From the sounds of it, this child needs quite a bit of care and watching--this is by the OP, who btw is CheekyChick and this is from post #25
thats ALOT of care for a child. By the sounds of it, you truly need another helper just to deal with her diabetes. For those whose kids are diabetic, is this normal to do so much testing and such, I've only worked with older adults (when I was a nurse) and we never did that much testing. And why test if its cold outside.
Reply With Quote
  #40  
Old 06-05-2012, 07:16 AM
SilverSabre25's Avatar
SilverSabre25 SilverSabre25 is offline
Senior Member
 
Join Date: Aug 2010
Location: Where I am legally unlicensed ;), USA
Posts: 7,625
Default

Quote:
Originally Posted by countrymom View Post
thats ALOT of care for a child. By the sounds of it, you truly need another helper just to deal with her diabetes. For those whose kids are diabetic, is this normal to do so much testing and such, I've only worked with older adults (when I was a nurse) and we never did that much testing. And why test if its cold outside.
I was also wondering how much of it is medically necessary and how much of it is her parents being overcautious and over-protective.

OP, I think that if you were to word your rates as one poster suggested--that they are based on family/child's needs, then you could probably manage to levy the charge a bit higher to compensate for the much higher level of attention and care that their daughter needs. You might want to consult a lawyer though, to be on the safe side.

Are there any other things you could do that would help ease the strain on her teacher? What about moving kids around so that the teacher has 1 or 2 fewer kids in her class, or could you go in and take care of the testing and some of the other care?
Reply With Quote
  #41  
Old 06-05-2012, 08:46 AM
wahmof3's Avatar
wahmof3 wahmof3 is offline
Daycare.com Member
 
Join Date: Oct 2011
Location: Ohio
Posts: 803
Default

In my state (Ohio): My state assistance program pays 5% more for special needs. A form signed by a doctor stating the special need is required.
Reply With Quote
  #42  
Old 06-05-2012, 11:48 AM
Unregistered
Guest
 
Posts: n/a
Default

Quote:
Originally Posted by Willow View Post
It wouldn't matter if it was legal or not, charging a sicker child's parents a higher rate wouldn't sit right with me.

It's not their fault she's sick, and the price their child pays in life enduring her illness is infinitely high enough.


I'm sorry but IMHO you need to suck it up. Some kids need almost no care at all, they are smart and play well, are well behaved, eat well, clean up after themselves...then there are those who need loads of extra supervision because they can't play independently, are into and onto everything, are picky or messy eaters and buck clean up every single time. There are also those with long hair that need tending to throughout the day. Those who wear glasses or hearing aids that need special attention. Those with eczema that need creams put on daily. Those with allergies who need medications administered and reactions monitored etc. etc. etc.

If you start nit picky charging for everything that adds a bit more to your plate you better start doing that for all AND be willing to discount the parents of the easy streeters to boot.




DHS in MN has instituted DOC rates for special needs kids in foster care. Is that what you're talking about? Children that become wards of the state are assessed, given a number and that number corresponds with a reimbursement rate beyond the regular daily rate. Sure, if I've got a drug addicted detoxing newborn who doesn't sleep but two hours a day, needs to eat a specially prepared formula every one to two hours, baths several times a day to keep their bottom clear of the feces that literally burn their skin, doctors appointments several times a week and specialists coming into my home almost daily then that child will have a higher DOC number and I'll be reimbursed for the "extra" care I need to provide.

Not that it's necessary, I certainly didn't need or expect to make more money off the backs of sicker kids as opposed to healthy ones.

I don't know how that would relate to daycare though. Unless perhaps that child's rates are paid via county assistance?


K-12 teachers don't make more for kids in their classes that are more "difficult" to teach or handle. I'm not sure why preschool teachers should be able to.




When you talk about "giving" a wage increase to the next teacher just because she was a bit more work for you....frankly, I'd sue if I was the girl's parents and I was ever presented such a notion.
AMEN I completely agree with you and glad there are daycare providers like you. As a parent of a special needs child I would NOT be happy to find out I had to pay a higher rate because my child was more work.
Reply With Quote
  #43  
Old 06-10-2012, 05:57 PM
thatdivalady's Avatar
thatdivalady thatdivalady is offline
Daycare.com Member
 
Join Date: Oct 2011
Location: Pennsylvania
Posts: 155
Default

As one poster above stated, my rates are based on individual/family situation and needs of the child. I charge more for a preemie infant because they usually require more care. I charge more for an infant who is under 6 weeks old for the same reason. It's all based on what that particular child's needs are. I think if you word it that way and make it a common practice to apply those principles across the board it is not discriminatory.
Reply With Quote
Reply

Tags
ada, ada laws, diabetes in child care, diabetes-daycare, idea, insulin, section 504, special needs

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
Charging on Holidays Interested Parents and Guardians Forum 343 12-26-2019 07:28 AM
Do Your Daycare Kids Act Out at Pickup? jenh171 Daycare Center and Family Home Forum 72 12-13-2018 05:57 PM
Daycare Child Telling Parents Things That Have Them Question Me Constantly E Daycare Daycare Center and Family Home Forum 25 01-08-2018 03:32 PM
Plastic Slides Danger in Hot Weather nannyde Daycare Center and Family Home Forum 33 06-01-2010 12:10 PM
Payment When Provider Is Out Sick Unregistered Parents and Guardians Forum 18 02-16-2009 02:07 PM


All times are GMT -7. The time now is 08:49 AM.



Daycare.com         Find A Daycare         List Your Daycare         Toys & Products                 About Us

Daycare.com
Please read our Disclaimer before continuing.

Topics pertain mainly to the following States:

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming