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Finding reliable, quality child care can be a difficult and stressful task for any parent -- especially those who have children with special healthcare needs.
Finding quality child care is a difficult process for anyone. Finding quality and inclusive child care for children with disabilities can be extremely difficult.
A child that has special needs is one who, because of physical, emotional or health reasons, requires some special attention and care. Regardless of individual needs, all children have the right to belong, be active and play.
In 1990, the Americans with Disabilities Act (ADA) was signed into law. This law established protections for people with both physical and mental disabilities against discrimination in employment; public accommodations (including child care programs); state and local public services; telecommunications; and public transportation.
The ADA clearly requires child care programs of all sizes to care for and accommodate the needs of children with disabilities, whenever they are reasonably able to do so. Reasonable modifications must be made in child care programs' policies, procedures and practices in order to accommodate individuals with disabilities, unless those modifications would fundamentally alter the service or operation of the child care program.
Child care centers and family day care homes are specifically included as public accommodations. However, child care programs operated by religious organizations might be exempt from ADA public accommodation requirements (although not exempt from employment requirements).
The Complex Care Center at Cincinnati Children's provides information on finding day care and respite programs.
Chronically Ill Day Care facilities provide for children with chronic medical and / or mental health conditions. Care for these children includes:
Chronically Ill Day Care is mostly needed before and after school, on weekends, holidays and during the summer months. Therapies such as occupational, physical and speech therapies and / or counseling can often be provided. In addition, respiratory therapies, medication and feedings could also be administered.
They are usually separate for mental health versus medical health and various age groups. Occasionally, these facilities are also limited by the severity of the condition and / or level of care.
Acutely Ill Day Care facilities care for children with acute infectious illnesses who are otherwise well or chronically ill. There are usually some limitations to which infectious diseases each facility will care for.
They are mostly needed during weekday school hours since September through June is when infectious illnesses are most common.
Respite Care is usually periodic, overnight care to:
Respite Care is needed year-round to cover family illnesses, special events, vacations and stressful times when families need a break. Respite care should be able to provide the same services as Chronically Ill Day Cares.
It is not uncommon for a child to have multiple conditions that include all three of these categories.
Prescribed Pediatric Extended Care (PPEC) centers provide medical care for children with complex medical needs in a day care setting. PPECs complement home care by combining medical care along with the benefits of socialization, activities and therapies. They are staffed by registered nurses who provide the acute medical care needed for children to attend. PPECs receive reimbursement by Medicaid for services that are determined to be medically necessary. They are not available in every state and guidelines vary. Ohio does not support PPECs which makes it challenging for children with a range of chronic conditions to find day care. Organizations in Ohio are lobbying to change this.
The Ohio Department of Medicaid has added in-home respite services to their five Medicaid Managed Care Plans:
Some key points of the new service include:
Care coordinators from each plan will help families access respite services. You can request a care coordinator from your plan if you do not have one.
Medicaid Waivers can also fund respite services:
4C for Children, Cincinnati and Northern Kentucky local resource for child care referrals, information for families on how to choose quality child care, free publications, links, resources and child care eSearch feature. They provide free referrals to child care centers and family home providers and are able to search for providers that care for children with special needs.
Care.com provides an online directory of respite providers for special needs, organized by zip code. However, Cincinnati Children's cannot endorse or recommend any specific providers.
Home of the Innocents, Kosair Charities Pediatric Convalescent Center, Louisville, Kentucky, serves medically fragile children, ages birth to 21. The skilled nursing facility provides short-term, long-term and respite care for children with severe developmental and/or physical disabilities, as well as ventilator dependency.
We want to hear from you. Email us with your feedback or suggestions for additional resources. Call our Family Resource Center at 513-636-7606 with your questions.
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New to Cincinnati Children’s or live outside of the Tristate area? 1-877-881-8479
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