ADA Accommodations
One area that all youth-serving organizations must address is how to accommodate children with disabilities. It can be a complicated question, such as when a child’s disability harms other children or when your program simply cannot accommodate a disability without completely changing the program. Youth programs must find a way to balance and care for the needs of all of the children in the program.
The first step is to know what the law requires. Americans with Disabilities Act (ADA) is the best known of the federal statutes. An earlier statute, Section 504 of the Rehabilitation of Act of 1973 (Sec. 504), has overlapping requirements, and both create a web of requirements for child care centers, camps, and similar organizations. A third statute, Individual Disabilities Education Act (IDEA), creates another layer of regulations for programs connected with public education. You can find a good chart comparing the three laws here.
Which Statutes Govern Which Organizations?
The ADA is the broadest statute, governing all places of public accommodation including camps, child care centers, mentoring groups, and other organizations that serve the public. The main exception is for activities controlled by religious entities. Church schools, for example, generally are exempt. Programs that merely use religious facilities, such as a child care center that leases space from a synagogue, are subject to the ADA.
Organizations that do not have their own space, such as mentoring programs that consist largely of field trips, also may not be subject to the ADA in some jurisdictions. Various federal courts have widely varying decisions on this question, so you need to check with a lawyer in your area for specific advice. The most common ruling is that the ADA does apply.
You also need to check your state and local anti-discrimination laws and licensing regulations. Even if the ADA itself does not apply, state and local governments are free to adopt their own more restrictive rules. Voluntary standards organizations, such at the National Association for the Education of Young Children or the American Camping Association incorporate the ADA into their accreditation standards.
Section 504 governs all organizations that receive federal funds. The flow of money can be direct, such as block grants administered by states (e.g., lunch programs), or indirect, such as tuition assistance. Section 504 has no exception for religious groups.
The IDEA applies to all public education agencies that receive federal funds, and any groups with which those agencies contract to provide education. Thus, IDEA covers charter schools, private special education schools and residential placements receiving education funds. IDEA also makes available grants for preschool and kindergarten programs. Anyone receiving such funds, generally through a block grant to states or a Head Start program, must follow specific federal regulations. Most other child care centers, camps, or mentoring organizations do not receive education funds and have to deal only with the ADA and Section 504.
General Standards for ADA/504
The ADA and Sec. 504 prohibit discrimination against a child with a physical or mental impairment that “limits one or more major life activities.” In general, a facility must make “reasonable modifications” to their programs to accommodate a child’s disability. There are three important exceptions. A program (1) can exclude children who pose a direct threat to the health or safety of others, (2) need not make accommodations that would fundamentally alter the program, and (3) need not take steps that place an undue burden on the program.
How the general rule and exceptions play out depends entirely on the specifics of the program and the disability. Furthermore, your program must individually assess each situation and cannot consider hypothetical concerns such as “what if everyone asks for this” or “the other parents will be upset.” Be certain that you are viewing each case on its unique facts and individual merits. Furthermore, as with all matters involving legal questions, keep thorough documentation of all of your communications, fact situations, and decisions about a given child’s disability and accommodations.
At one end of the spectrum are the easy exclusions. A youth program can expel a violent child, and an adventure camp need not accommodate wheelchairs. At the other end are the clear accommodations. A camp cannot exclude children with HIV or epilepsy, and a child care center must accommodate a child’s anxiety disorder. The vexing problems are the ones in between.
Physical Disabilities
In this post, I’ll consider physical disabilities, and next week I’ll discuss developmental, behavioral, and mental health disabilities.
Chronic Illnesses
Children with chronic medical conditions require a nuanced calculation. Most organizations can accommodate allergies, for example, with moderate changes in their programs. Children with compromised immune systems will need more proactive plans, such as added protection from children with colds or flu symptoms.
Juvenile diabetes is another common situation that caregivers face. Because the treatment involves sharp, pointy objects, most youth programs are not comfortable dealing with it. Lay people, however, are perfectly capable of learning to monitor blood sugar for and dispense medicine (even insulin), so the ADA requires that you provide those services. Note that the American Diabetes Association encourages older children to learn self-care and urges programs to allow them to do so.
Other illnesses may require more specialized medical care. The law does not require you to perform medical procedures, or to hire a nurse to provide advanced care. If a lay person cannot be trained to safely provide a service, then your program generally need not provide it.
Communicable Diseases
You can exclude children who pose a direct threat of passing on a communicable disease, such as measles. Some communicable diseases, however, you can accommodate. For example, Methicillin Resistant Staphylococcus Aureus (MRSA) is contagious, but the CDC counsels against excluding children from day care or schools if you can keep the infected area clean and covered.
Service & Emotional Support Animals
A very contentious area currently is whether programs must accommodate service animals and emotional service animals. Media often (even usually) confuses the two categories, but the law treats them very differently. A service animal is a dog (only dogs are covered currently) trained to do a specific task related to the child’s disability. The task can be as simple as reminding them to take medication, or as complicated as detecting an oncoming seizure and protecting the child during the seizure. The dog can be trained either professionally or by the family.
Your program must make accommodations for service animals consistent with the principles set out above. For example, if a service dog poses a danger to the other children or is not housebroken, you can exclude it. If other children are allergic to dogs, then you must make an effort to segregate them and care for everyone. If your program is too small for that accommodation to work, then the presence of the service animal might fundamentally alter your program, possibly allowing you to exclude it. In a camping program, a blind child with a guide dog might able to participate in a hike, but not a ropes course. You can require that a service animal be leashed, as long as it can perform the tasks that the child needs and the child’s disability does not preclude restraint.
Emotional support animals, by contrast, are not trained for a task and have no legal status under federal disability law. You can exclude these animals without running afoul of the ADA. As always, local or state laws vary, so check with your local attorney about those requirements.
Conclusion
Every program that serves young people wants to do the right thing for them. Both morality and the law require that attitude. But even federal law must bow to the laws of physics and economics and only require that your program do what it reasonably can to accommodate disabilities. Consider each case individually and thoroughly document each step of your process, doing all that you can to balance the needs of each child in your care.