WWYD About This Dcg And Increasing Pay?

[lvt77]

The child has very bad breathing problems and doesn't respond well to being treated with the nebulizer. She needs the one to one care of a specialist trained in respiratory therapy. A home day care setting is not the right place for a child with this level of care unless a trained staff person is available for her medical needs at all times.

The Disability Act does not force providers to provide care they are not capable of safely doing.

I'm not aware of the Department of Justice ever taking a home day care provider to court for not complying with the disability act. If anyone knows of any case PLEASE post a link. I know about CENTERS being sued under the ADA but not a single case of a Home Day Care provider.

You CAN charge for any services you provide for children who are acutely ill. You CAN charge medication administration fees for acutely ill children. The ADA does not protect children with illnesses that are normal childhood illness and are resolved over short durations. It also doesn't force providers to care for children when the provider feels she is incompetent and unable to safely care for that child.

wow you have some knowledge under your belt. very impressive. Thank you for taking the time to explain that to me as I did not know that. CA is a sue happy state.... I am always afraid of getting sued.....YOu would be shocked over the things that people sue for here its unreal..... Glad I now know this information for future.

Thanks so much

[Mrs.Ky]

The child has very bad breathing problems and doesn't respond well to being treated with the nebulizer. She needs the one to one care of a specialist trained in respiratory therapy. A home day care setting is not the right place for a child with this level of care unless a trained staff person is available for her medical needs at all times.

The Disability Act does not force providers to provide care they are not capable of safely doing.

I'm not aware of the Department of Justice ever taking a home day care provider to court for not complying with the disability act. If anyone knows of any case PLEASE post a link. I know about CENTERS being sued under the ADA but not a single case of a Home Day Care provider.

You CAN charge for any services you provide for children who are acutely ill. You CAN charge medication administration fees for acutely ill children. The ADA does not protect children with illnesses that are normal childhood illness and are resolved over short durations. It also doesn't force providers to care for children when the provider feels she is incompetent and unable to safely care for that child.

You can NOT charge more for a child who has special needs or deny a child care its against the law

Ex A: My middle child has ADHD combined type he is special needs if I went to find daycare for him and provider said she was charging higer rate because he is more work THIS IS AGAINST THE law he is cover under ADA

Ex B: I take my ADHD child and try to get him in a center who recieves Subsidy care they decide they will charge me more because he is more work they would lose any goverment assitants they recieve because of section 504

As you see she could be in a heap of trouble for charging more for a special needs child as the law states children with disabilities has a right to be treated, edcuated, etc. as all others maybe not in those words. No it doesnt FORCE her to care for this child but it says this child should be treated the same as others and she can get rid of said child for other reasons but she can not use the reason based on the childs special need.

[E Daycare]

I would call your licensing and ask what you need to do in order to administer a nebulizer treatment. (I had this as a child because I was born with asthma. Also had to take it during elementary school in the nurse's office too.) If it is considered medication, does your handbook have anything about you NOT giving any forms of medications? Mine does with a parent consent and they must fill out a form. If you don't though, I would ask if you are required to give the treatment when you call.

If you just had everyone turn in a new contract today, I wouldn't want to have them sign another one. Did you raise your rates too? If you are going to term down the road, I would wait a bit as you are advertising and let others know you might have a spot opening soon. Then, term once you have documentation of one more late pickup or early drop off or late payment. You obviously have records of these from the past, if not, create them.

I wish you the best of luck. You should also ask the mom for the dr's name and number because you "have a few questions to ask him" that you will not share with the mom because.....you will call and mention you are the child's provider and want to know if they really get reimbursed for daycare costs and when or whatever other questions you may have.

Also, if you honestly feel you cannot provide the proper care this child now requires, that is okay to term with that being said and a two week notice. I read it somewhere and it is NOT discrimination. It's honesty and caring and if you're unable to provide the proper care for this child's newly aquired needs then it is best to let them know. You could even try it for a week or two and then decide.

Im not licensed so I dont really know what to do with that .

I wouldnt be asking for more (persay) as I charge all the others in my care MORE but because they argued they couldnt afford the $175.00 so I charge $150.00 and now they come 4 days a week its down to $120.00. I normally charge daily of $35.00 and only get the $30.00 a day from them. With the constant crap I get from this family this was my last straw. And since now the state would be paying wouldnt they be able to afford my regular rate? Or is it just bad that since I have to do added care the extra 5$ a day just seems too harsh?

Today the dcg stayed 45min late because the parent insisted on bringing her here during the ice storm and the dcm ran into a ditch. My husband had to walk dcg down the driveway in her pumpkin seat and there was no base in the car he put her in and they drove away unsecured. I keep a complete log notebook on this dcg of every day happenings because this is just insane to me. Shes the reason why I started logging all my kids.

I didnt raise my rates, kept them the same because they are pretty "up there" I think to begin with and its a lot to get the 30$ a day I can get from some people.

The medication fee is a good idea. I like it but right now they are getting to not be worth my time, effort, and stress. Today was it for me.

Thanks for all the input guys!! You cant cover your butts too much in this job.

[lvt77]

Great now I am confused...

I am just going to stick with what I thought I learned in college many moons ago which is what Ms. Ky posted....

[momofboys]

Im not sure if its a nebulizer or not but Im sure it is. She was vague on that and just wanted to inform me the state would give her money back. I do like the idea about re-writing her contract. The only thing is I JUST did this and require the newly signed forms to be given to me today. Would it look crazy for me to tell her that I need to do this again?

Nebs are a piece of cake, particularly if the child can sit on their own. You can even put them in a high chair to do it. She can ask for a mask that goes around his head so you wouldn't even have to hold it for the child. Easy! But I do understand your concerns about the payment. It would be hard for me to know what to do.

[momatheart]

So in your state if you watch more than one family can you still watch more families if one of the families is recieveing free care from the state? I think there is a law against this in my state... Just saying you may want to check that out. Who knows this may be your out.

[momofboys]

I guess my issue is she was already giving them special deals/discounts & now she has to do additional work, would it now be for less $$$ since the state would pay or will the parent still pay her & get reimbursed? What if she was to do an across-the-board raising of fees? It is no one's business if she raises her fees for everyone. No state can mandate how much you charge. Maybe that is what you could do if you are already on the low end.

[nannyde]

You can NOT charge more for a child who has special needs or deny a child care its against the law

Ex A: My middle child has ADHD combined type he is special needs if I went to find daycare for him and provider said she was charging higer rate because he is more work THIS IS AGAINST THE law he is cover under ADA

Ex B: I take my ADHD child and try to get him in a center who recieves Subsidy care they decide they will charge me more because he is more work they would lose any goverment assitants they recieve because of section 504

As you see she could be in a heap of trouble for charging more for a special needs child as the law states children with disabilities has a right to be treated, edcuated, etc. as all others maybe not in those words. No it doesnt FORCE her to care for this child but it says this child should be treated the same as others and she can get rid of said child for other reasons but she can not use the reason based on the childs special need.

There's so much misunderstanding about the care of children with disabilities.

The child care provider HAS to be paid for the care of the child. She HAS to have a client base that can support the care of a special needs child or additional govermental/grant funding accessable. She doesn't have to work for free because the child is disabled.

The support for the care of a special needs child can include personal one to one time above and beyond "regular" care, the INSURANCE to cover the providers "treatment" of the child, the physical alterations to accomodate the child etc.

When you have a very small client base... two/three/four/six/eight clients you have to have enough income from each of the clients to support the care of the special needs child. It takes very little to consume such a small business.

In order to decide whether or not your business can sustain the cost of care for the child you have to be knowledgeable about each aspect of care and the hard cost of providing that care.

If the provider is questioned regarding her inability or unwillingness to care for a child who she is refusing care then she needs to be able to back up the actual cost, her attempts to access funding within her client base and any community funds available, and the affect it will have on her business to provide that care.

Because I'm a RN, I have had many many requests to provide care for special needs kids. Because of this life experience I have been very fastidious about documenting the hard cost of providing any care to children beyond the "average" care over the five years of care I usually provide per child. If I am certain that the care of a child would overwhelm my business and my client base is unable to support the hard costs of the additional care the child needs then I will decline to care for the child.

I'm perfectly aware that I may be challenged one day and I would be willing to undergo whatever govermental involvement is necessary to prove that I can not do what I say I can not do. I will not be bullied.

I will be happy to take a child with special needs and go through the process of documenting the cost of that child's care and evaluating whether or not the cost of the care is feasable. With such a small client base it really doesn't take very much at all to prove the costs of additional one to one care, insurance for any medical care, etc. will consume a business very quickly. Even the cost of two/three dollars per day per client could wreck a small business like a home child care. With a small client base there really isn't much of a window of fee increases that would devestate the business in pretty short order.

Providers should understand THEIR rights to operate, be finacially viable, and provide services they are comfortable with.

[E Daycare]

My rates are $175.00 weekly/$35.00 Daily. At the time they wanted care they said they couldnt afford the $175.00 a week so I charge them $30.00 a day or the $150.00 a week. The other non-discounted children are at $35.00 a day. This family is also taking away a day so its down to 4 days a week at $120.00 a week. Basically Ive discounted them $220 a month now that shes part time. Would it seem that bad if I told her she now has to go to the actual full time rate at the $35.00 a day? I guess when it comes down to it, its really ONLY $25.00 a week but still.

I guess Im just annoyed at the fact she seemed overly happy to have to put her kid on a breathing machine and get paid by the state for it. The extra work is besides the point. Its just one thing after another with this family and its always something for nothing.

[nannyde]

Nebs are a piece of cake, particularly if the child can sit on their own. You can even put them in a high chair to do it. She can ask for a mask that goes around his head so you wouldn't even have to hold it for the child. Easy! But I do understand your concerns about the payment. It would be hard for me to know what to do.

Sure they are easy if nothing goes wrong. It's the day something goes wrong when it's not so easy after all.

Medication given by inhalation are VERY serious medications. The provider needs to understand the medication, the importance of properly adminstering them as ordered, the knowledge of when to administer the medication if there is a window of time and an "as needed" decision, AND the very serious side effects of each medication.

I don't feel comfortable doing them in my setting. If a provider feels they are easy peasy and doesn't have a lick of problems with them then the kids who need them need to go to that provider. That's not me I don't have the luxury of not knowing the seriousness of these medications.

[E Daycare]

Im not trying to be an insensitive caregiver who cares all about pay but with this family I have to hit them in their wallets to get them to hear me. I know children have changing needs but I feel as if some things were hidden from me when we first interviewed in September. The snotty nose issue was a "allergy issue" at the time. Then it was a "cold issue from being in a new environment" at my house. Now its turned into a actual medical need. She also need PT but Im never aware of when the PT will come to my home or what they do with her if they come while not at my house.

My nephew was a preemie so Im aware of some developmental delays preemies pose but Im really starting to wonder if a caregiver who actually specializes in disabled children would be better for her. Im always waiting for the other shoe to fall with her. Shes currently on a bunch of medications for this recurring cold, an inhaler, special formula mixtures and the family hasnt been following through with feeding her actual baby food so Ive been teaching her how to eat baby food too. Shes becoming a special needs child. I have some very active toddlers to tend to and where the dcg isnt much of a problem really its just a lot more then Im comfortable with. Beggars cant be choosers but Im waiting for them to bring in special walkers and things because thatll be next to aid in her walking development or something to that nature.

[E Daycare]

Sure they are easy if nothing goes wrong. It's the day something goes wrong when it's not so easy after all.

Medication given by inhalation are VERY serious medications. The provider needs to understand the medication, the importance of properly adminstering them as ordered, the knowledge of when to administer the medication if there is a window of time and an "as needed" decision, AND the very serious side effects of each medication.

I don't feel comfortable doing them in my setting. If a provider feels they are easy peasy and doesn't have a lick of problems with them then the kids who need them need to go to that provider. That's not me I don't have the luxury of not knowing the seriousness of these medications.

I dont know much about them and have never worked with them at all. The dcm has already informed me dcg does not like them and she has to hold her down to do them and wait for dcg to fall asleep to do a session properly. So Im kinda iffy about it from that standpoint too. I dont want to have to hold down a baby to give meds for a period of time, especially when I have active toddlers running around. If she needs a dose every 4 hrs and shes here 10hrs a day (typical if not more of this child) then I will have to "wrestle" with her at least 2 times a day (well, maybe "wrestle" with her once a day if shes napping for the other dose).

I dont know all the details on it really as shes supposed to be on these treatments since last Friday but the mom hasnt brought in the machine to show me so Im also wondering if its really a big concern to her or if its a matter of the state paying her back as well. I know this, I wont write off on anything I dont do.

Homey dont play that.

[nannyde]

My rates are $175.00 weekly/$35.00 Daily. At the time they wanted care they said they couldnt afford the $175.00 a week so I charge them $30.00 a day or the $150.00 a week. The other non-discounted children are at $35.00 a day. This family is also taking away a day so its down to 4 days a week at $120.00 a week. Basically Ive discounted them $220 a month now that shes part time. Would it seem that bad if I told her she now has to go to the actual full time rate at the $35.00 a day? I guess when it comes down to it, its really ONLY $25.00 a week but still.

I guess Im just annoyed at the fact she seemed overly happy to have to put her kid on a breathing machine and get paid by the state for it. The extra work is besides the point. Its just one thing after another with this family and its always something for nothing.

Are you saying that because the child is now deemed an asthmatic that the state will pay for the child's day care? I guess I don't get how the breathing machine makes her qualify for free day care???? If the parent was able to get a diagnosis that qualifies her for special needs fuding then are you sure it's not to be given in ADDITION to the fee they pay and the Mom is just SAYING that the money they give is to BE the fee? In other words the Mom is saying the money that you get from the State is to go to the regular day care fee instead of it going to the provider for the special needs care?

The Mom may WANT it to go for the regular day care rate but that doesn't mean that is what the money is intended for. I would find out directly from the State if they are paying the fees for the special needs care and whether or not the parents are to continue to pay their regular fee. If you got extra State monies on TOP of their fee it may be more worth it.

Think of it like this: If it's a big enough deal that it enables the parent to get special funding because of it then it's a big enough deal for YOU to get special funding because of it. It works both ways. It doesn't make sense that the State recognizes the child is entitled to funding but none of the "special" of it actually goes to the provider who is doing it?

[E Daycare]

Are you saying that because the child is now deemed an asthmatic that the state will pay for the child's day care? I guess I don't get how the breathing machine makes her qualify for free day care???? If the parent was able to get a diagnosis that qualifies her for special needs fuding then are you sure it's not to be given in ADDITION to the fee they pay and the Mom is just SAYING that the money they give is to BE the fee? In other words the Mom is saying the money that you get from the State is to go to the regular day care fee instead of it going to the provider for the special needs care?

The Mom may WANT it to go for the regular day care rate but that doesn't mean that is what the money is intended for. I would find out directly from the State if they are paying the fees for the special needs care and whether or not the parents are to continue to pay their regular fee. If you got extra State monies on TOP of their fee it may be more worth it.

Think of it like this: If it's a big enough deal that it enables the parent to get special funding because of it then it's a big enough deal for YOU to get special funding because of it. It works both ways. It doesn't make sense that the State recognizes the child is entitled to funding but none of the "special" of it actually goes to the provider who is doing it?

Hmmmm good points! Dcm mentioned that if I was to administer these treatments in while dcg was in my care then im no longer considered a regular caregiver but something else. Cant remember actually what she called it. She said then the state will write off the days of care I administer the treatments. If/when the dcm says I need to start doing this, Im going to require a doctors note with the doctors information.

[nannyde]

I dont know much about them and have never worked with them at all. The dcm has already informed me dcg does not like them and she has to hold her down to do them and wait for dcg to fall asleep to do a session properly. So Im kinda iffy about it from that standpoint too. I dont want to have to hold down a baby to give meds for a period of time, especially when I have active toddlers running around. If she needs a dose every 4 hrs and shes here 10hrs a day (typical if not more of this child) then I will have to "wrestle" with her at least 2 times a day (well, maybe "wrestle" with her once a day if shes napping for the other dose).

I dont know all the details on it really as shes supposed to be on these treatments since last Friday but the mom hasnt brought in the machine to show me so Im also wondering if its really a big concern to her or if its a matter of the state paying her back as well. I know this, I wont write off on anything I dont do.

Homey dont play that.

Word of advice: never allow a parent to med train you. Get the training from someone who is a trained trainor.

I can't imagine giving an infant this while they are napping. She may be talking about doing the "wand" where you point the wand at the kids nose. I've never had that work out too well.

The machine is noisy... the mist going in their face is annoying. Even if she WAS sleeping she would wake right up.

You won't be doing it twice a day. You will be giving one right at arrival, four hours after that, and four hours after that. You will find that they will tell you that the kid had it four hours ago when they arrive so that they can have one right when they get there. This puts you into the window of having to do it three times.

A very common scenario is that the parents want you to do ALL the treatments for the day while the kid is on your clock. All they have to do is SAY that they coudn't give it before day care because they HAD to give it in the middle of the night and the next one is due fifteen minutes after they get to your house.

If you pass the medicine back and forth with the machine count the doses. You may find out that you have the same number of them in the box that you had when you sent the kid home the day before. When the kid fights a treatment that takes fifteen minutes it's really easy for the parent if you just do it all at your house.