RSV+ But Mom Keeps It From Me!!!

[sahm2three]

OP - what did you decide to do?

I am giving a stern warning. I am going to have a conversation with her today to tell her how wrong what she did was, tell her that it was a complete breech in trust, and I will have a hard time trusting her again. And I am giving her a written warning telling her that this is her one and only warning. If she breeches a policy again, she is gone immediately. My head wants to term, my heart wants to keep my little guy. He is one of the good ones! LOL!

[jen]

Let us know how it goes!!

[sahm2three]

Where is it in the OP's post where she said the parent took the kid to an informed of the situation MD?

Are you suggesting the parent told the MD that she had an infant special needs child in the house? Did the parent know and tell the MD that there are children in the home this week that weren't in the home last week? Did the parent know if any new children were to start care this week?

This idea that everyone has already been exposed so it's okay to do future daily exposures is rediculous and shows that the average person and Doctor doesn't have a clue of how group care works.

The "kids have already been exposed" sells. It makes Doctors money because the parents keep coming back if they get that one. There is no possible way a Dr can know if the kids have already been exposed without contacting the provider and getting specific health info on the current kids, attendance during the contagious period, and info on any incoming kids to care.

There's also the issue of repeated exposures. Having a kid day after day who is contagious increases the liklihood of exposure. Nobody wants to talk about that.

Thanks, nannyde! I don't buy the "already exposed" deal either! Why continually expose, or expose the kids that are not here every day? No need. Be responsible as a parent for petes sake!

[Unregistered]

Good luck with your dcm. While it's true RSV is usually mild for most kids, why did she feel the need to lie about it?

There are preventative shots for RSV--but a lot of insurance companies won't pay for them.

[Unregistered]

RE: Nanny DE

With no further comment on the present situation - I am assuming the RSV DCK is home and the ICDCK is in care and all moms have been warned- It is my opinion that if the FCP is going to mainstream an IC child in her care, she has a responsibility to inform everyone, MDs included.

SO - forward from this point, they should be informed. It is part of what she needs to do to offer a safe environment for an IC child.

Further, HIPPA does apply, the MD's opinion should be both final and in many cases must be accepted. FMLA does not kick in on a FCP's opinion.

If I were the parent of either of these kids, I would be frustrated, but I would be more likely to keep my IC kid home or take my RSV+, treated, returned to care child looking for new providers while we are out of care.

Even if you run a very clean house you cannot prevent every exposure. OP also can't prove the RSV wasn't contracted at her home.

If you or your child are immune compromised, the onus is on you to avoid exposures.

[sahm2three]

With no further comment on the present situation - I am assuming the RSV DCK is home and the ICDCK is in care and all moms have been warned- It is my opinion that if the FCP is going to mainstream an IC child in her care, she has a responsibility to inform everyone, MDs included.

SO - forward from this point, they should be informed. It is part of what she needs to do to offer a safe environment for an IC child.

Further, HIPPA does apply, the MD's opinion should be both final and in many cases must be accepted. FMLA does not kick in on a FCP's opinion.

If I were the parent of either of these kids, I would be frustrated, but I would be more likely to keep my IC kid home or take my RSV+, treated, returned to care child looking for new providers while we are out of care.

Even if you run a very clean house you cannot prevent every exposure. OP also can't prove the RSV wasn't contracted at her home.

If you or your child are immune compromised, the onus is on you to avoid exposures.

Well, the infected child was out of town from Wednesday last week until Sunday. He returned to care on Monday and fell ill that day. I would assume that he was indeed infected somewhere else. Regardless of WHERE he contracted it, if the child has it, STAY HOME. I should have at the VERY LEAST been TOLD about it by the mom. As soon as I knew about the diagnosis I did contact all of the other parents and informed them. The poor little guy with RSV is still not well enough to get up off the couch, so look for other care, no daycare would have allowed this sick child to stay in their care.

Sorry, HIPAA does NOT apply. I am asking the parent for the note from the doctor, not asking the doctor directly. The parent can choose to not comply with my policy, but will be denied a return to care. I checked with my licensor today. Thanks for attempting to stir the pot though!

[sahm2three]

With no further comment on the present situation - I am assuming the RSV DCK is home and the ICDCK is in care and all moms have been warned- It is my opinion that if the FCP is going to mainstream an IC child in her care, she has a responsibility to inform everyone, MDs included.

SO - forward from this point, they should be informed. It is part of what she needs to do to offer a safe environment for an IC child.

Further, HIPPA does apply, the MD's opinion should be both final and in many cases must be accepted. FMLA does not kick in on a FCP's opinion.

If I were the parent of either of these kids, I would be frustrated, but I would be more likely to keep my IC kid home or take my RSV+, treated, returned to care child looking for new providers while we are out of care.

Even if you run a very clean house you cannot prevent every exposure. OP also can't prove the RSV wasn't contracted at her home.

If you or your child are immune compromised, the onus is on you to avoid exposures.

ALSO, all parents are aware of the infants and the special needs kiddo in my daycare. They all think it is wonderful that I have agreed to take him. I warned the special needs foster mom and told her that I would feel better if he stayed home this week (he only comes 2 times a week). I have completely sanitized all the toys and anything else I can think of that he may have come in direct or indirect contact with.

I have done all that I can do.

[nannyde]

With no further comment on the present situation - I am assuming the RSV DCK is home and the ICDCK is in care and all moms have been warned- It is my opinion that if the FCP is going to mainstream an IC child in her care, she has a responsibility to inform everyone, MDs included.

SO - forward from this point, they should be informed. It is part of what she needs to do to offer a safe environment for an IC child.

Further, HIPPA does apply, the MD's opinion should be both final and in many cases must be accepted. FMLA does not kick in on a FCP's opinion.

If I were the parent of either of these kids, I would be frustrated, but I would be more likely to keep my IC kid home or take my RSV+, treated, returned to care child looking for new providers while we are out of care.

Even if you run a very clean house you cannot prevent every exposure. OP also can't prove the RSV wasn't contracted at her home.

If you or your child are immune compromised, the onus is on you to avoid exposures.

So we are responsible to notify every emergeny room, acute care clinic, walk in clinic, etc. that could possibly SEE one of our day care kids that WE have a day care kid that is immunocomprimised thus ANYTIME they HAPPEN to see one of our day care kids they ALREADY know there is an imunocomprimised kid in our care?

That's what you are saying? It's up to US to notify any possible MD that the sick kid could go to?

Sure... .that's doable.

The MD's word is his OPINION of whether or not the kid can return to care. They can't possibly know our population. They can not possibly know whether or not the other children have already been exposed. Last week I had five kids gone on spring break. On Monday I had a newborn start his very first day. If this kid came back to my house he would have exposed five kids who hadn't seen him for nine days and a brand new seven week old infant he had never met. How in the world would his Doctor know that he hadn't been around my kids or even met one of my kids? Do you think the Mother of my newborn would have been okay with him exposing her brand new baby?

Tell me specifically WHAT cases a home day care provider MUST accept a child with a definite contagious illness because of the final word of a doctor? Where is it written that WE must accomodate a FMLA law?

I decide what I will accept and what I won't. If the parent and doctor feel the child can go to daycare with the illness then the two of them can find another daycare. It doesn't have to be MY daycare.

If you have done daycare for any length of time you have been burnt on doc notes. You figure out really quickly that some parents will lie directly to a doctor to get the note. They will mask fevers with advil and tylenol to prove the kid doesn't have a fever. They will give a history that doesn't resemble in any way the child's condition in your home.

Whenever there is money attached to the note you are going to have some people cheat to save their money. Dr's notes are just one avenue for that in child care. It's just real life and in the end I am responsible for what I allow in my home.

The OP's dcp LIED to her. Do you think that same parent wouldn't lie to the Doctor?

[Unregistered]

must is a strong word

A parent must accept a Dr.s recommendation. A parent's employer must also respect that. No one can tell you what you must accept in your home, but not many working parents would accept a contract written on your personal opinion. Having parents fired from their jobs will not increase your business. CDC guidelines are a safe home base. Many FCPs and Centers have a clear policy on illness that keeping this RSV+ child home would violate. The conditions necessary for providing perfectly safe care for a immune compromised child can't be met in most group care settings. I don't feel, based on the OP, that this mom intentionally deceived this provider. I feel that she acted on her interpretation of the common knowledge of RSV, that it is just a cough, that it is very common, will likely make its round of every member of the community and that all of the kids are exposed.

It is practical to require contact information from all parents about pediatricians, if they frequent urgent treatment centers instead, yes, I would require that contact. If I made the decision to accept an immune compromised child into my care, I would make changes to my contracts, notify all other parents and MDs and give parents a choice as to whether they could accept a possible week home even after the MD had returned the child based on my feelings. I would also send home a note with the sick child stating that there is an immune compromised child in care and that the MD must include a statement of no risk to the other children upon returning a child to care. We caught NORO virus at our pediatrician's office on a well child visit. The world is imperfect. Germs are out there.

I do feel that many of the opinions here are hitting an extreme, and whether you choose to consider mine is really your choice, but I am stating it.

I read that you are very lucky to have perfectly well behaved and healthy children in your care. I don't think that represents the entire population of providers or children.