Comments
Tami Gamble wrote:
I am a Parent Advocate with the American Diabetes Association. I had a family referred to me by FSN. Apparently a child care provider will no longer allow a child who was recently diagnosed with Type I Diabetes to attend her establishment. They are unwilling to accommodate the child. I understand federal law in regards to daycares, preschools and school accommodations but what about a child care center that accepts money from the state. Would it be subject to federal law?
The Michigan Disabilities Act requires the centers to provide reasonable accommodations for disabled children. The OCR has ruled that diabetes care tasks are not unreasonable, yet in the settlement with KinderCare, insulin was not required to be provided as a reasonable accommodation. The failure to provide insulin would render the accommodation useless in that these children must have insulin to live. Am I to understand that there is not access to child care for a child with Type I Diabetes unless it is run by the school? Thank you in advance for your response.
The Michigan Disabilities Act requires the centers to provide reasonable accommodations for disabled children. The OCR has ruled that diabetes care tasks are not unreasonable, yet in the settlement with KinderCare, insulin was not required to be provided as a reasonable accommodation. The failure to provide insulin would render the accommodation useless in that these children must have insulin to live. Am I to understand that there is not access to child care for a child with Type I Diabetes unless it is run by the school? Thank you in advance for your response.
27/02 20:26:06
refadmin wrote:
A child care center is subject to both state and federal law. A state can provide greater rights to its citizens but cannot limit the rights provided to them under the federal law. A state cannot limit rights provided under the federal law an must follow the federal law mandate at the minimum with regard to rights provided to citizens.
Keep in mind that the fact that insulin was not provided for in the settlement agreement makes no difference as to what is binding law. The settlement agreement was just that an agreement between the parties to settle the matter and is not caselaw establishing precedent to be followed.
Under the Michigan Public Health Code, only a physician can order the administration of medication. Upon the physician's order, none other than the parent, a licensed nurse or someone acting under nursing supervision, may administer the medication ordered by the physician. Insulin is a medication. To do so would constitute the practice of nursing.
Under Michigan Compiled Law, MCL 333.17211, a person shall not engage in the practice of nursing unless licensed. MCL 333.17201 defines the practice of nursing to include the systematic application of substantial specialized knowledge and skill, derived from the biological, physical, and behavioral sciences, to the care, treatment, counsel, and health teaching of individuals who are experiencing changes in the normal health processes or who require assistance in the maintenance of health and the prevention or management of illness, injury, or disability.
KinderCare unlikely would have settled had they been required to provide insulin. Their argument would be that the accommodation is unreasonable. Doing the testing and perhaps assisting in the utilization of an insulin pump would be as far as they would go because to require the administration of insulin would force KinderCare to keep a licensed nurse on staff to administer the insulin. The settlement appears to have contemplated that monitoring of the glucose levels along with modifications in diet and close contact with emergency services and parents according to the parents' directives, should go a long way to keeping these children healthy and happy.
Note well though, this was a settlement. The issue has not been litigated and is up for grabs for willing participants. There may be child care centers for which providing insulin would not be an unreasonable accommodation. The analysis is case specific.
Keep in mind that the fact that insulin was not provided for in the settlement agreement makes no difference as to what is binding law. The settlement agreement was just that an agreement between the parties to settle the matter and is not caselaw establishing precedent to be followed.
Under the Michigan Public Health Code, only a physician can order the administration of medication. Upon the physician's order, none other than the parent, a licensed nurse or someone acting under nursing supervision, may administer the medication ordered by the physician. Insulin is a medication. To do so would constitute the practice of nursing.
Under Michigan Compiled Law, MCL 333.17211, a person shall not engage in the practice of nursing unless licensed. MCL 333.17201 defines the practice of nursing to include the systematic application of substantial specialized knowledge and skill, derived from the biological, physical, and behavioral sciences, to the care, treatment, counsel, and health teaching of individuals who are experiencing changes in the normal health processes or who require assistance in the maintenance of health and the prevention or management of illness, injury, or disability.
KinderCare unlikely would have settled had they been required to provide insulin. Their argument would be that the accommodation is unreasonable. Doing the testing and perhaps assisting in the utilization of an insulin pump would be as far as they would go because to require the administration of insulin would force KinderCare to keep a licensed nurse on staff to administer the insulin. The settlement appears to have contemplated that monitoring of the glucose levels along with modifications in diet and close contact with emergency services and parents according to the parents' directives, should go a long way to keeping these children healthy and happy.
Note well though, this was a settlement. The issue has not been litigated and is up for grabs for willing participants. There may be child care centers for which providing insulin would not be an unreasonable accommodation. The analysis is case specific.
29/02 01:09:16
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29/10: Michigan Child Care
Finding the right day care for your child is a grueling process so this blog item is dedicated to those who need assistance / guidance through the process. Thankfully, a Google search of"Michigan child care providers" brings up on top of the list of links, "DHS Finding Child Care in Your Neighborhood" - http://www.michigan.gov/dhs/0,1607,7-124-5453_5529_7143-20904--,00.html
From there, one can access a link "Find Licensed Child Care Centers and Homes", which then brings up "Statewide Search for Child Day Care Centers and Homes". From this point, search criteria is entered with the option to search child care in any desired city.
A list of providers can then be elicited and a click on the link of any specific provider provides detailed information including: Facility Information, Licensee Information, License Information, Days Open, Services Offered, and Reports Available. The latter detail is the most significant in that various reports are available as for example the most recent inspection report and any special investigation reports with the current status of the investigation. A client was recently was considering a provider until I found from the referenced links / information that the provider was investigated and violations were confirmed involving an infant turning gray while sleeping with CPR being administered by a provider who was not current with CPR testing. Another candidate had an adult residing in the home who had been using ecstasy while at the home and whose friend had hidden marijuana in one of the dresser drawers.
A parent should also be familiar with the licensing rules for the child care centers. These rules can be found at: http://www.michigan.gov/documents/dhs/DHS_OCAL_PUB_0008_199925_7.pdf
One suitable candidates are found, visit the location and assess whether the candidate is in compliance with the rules at that time. It could be that the Department of Human Services has not caught up with them yet, and while they appear to comply on paper, practically speaking they do not.
There is no substitute for Mom and Dad, but an arduous search will find the right person, and this search can begin with the links provided.