SETTLEMENT AGREEMENT BETWEEN
THE UNITED STATES OF AMERICA
PINE HILLS KIDDIE GARDEN,
FORT WAYNE, INDIANA
I.BACKGROUND AND PARTIES
II.TERMS OF AGREEMENT
III.MONETARY RELIEF FOR COMPLAINANTS
Pine Hills agrees to pay to the United States the sum of TEN THOUSAND DOLLARS ($10,000.00 in civil penalties pursuant to 42 U.S.C. § 12188(b)(2)(C)(i), by delivering a check in that amount made payable to the United States Treasury. The check of TEN THOUSAND DOLLARS ($10,000.00) shall be provided to the United States no later than thirty (30) days prior to the expiration of this Agreement.
V.ENFORCEMENT AND IMPLEMENTATION
For notices to the United States:
John L. Wodatch, Chief
Attention: Robert Mather
Disability Rights Section
Civil Rights Division
U.S. Department of Justice
1425 New York Avenue, NW
Washington, D.C. 20005
(202) 307-2236 (telephone)
(202) 616-6862 (facsimile)
For notices to Pine Hills:
Nelson and Beverly Eagle
5755 South Depew Circle
Littleton, Colorado 80123
(303) 932-7682 (telephone)
(303) 932-8398 (facsimile)
|FOR PINE HILLS KIDDIE GARDEN:||FOR THE UNITED STATES OF AMERICA|
THOMAS E. PEREZ
JOHN L. WODATCH, Chief
|Dated:||Dated: October 19,2009|
Pine Hills Kiddie Garden
Policy on Diabetes Management
Pine Hills Kiddie Garden (“Pine Hills”) is committed to complying fully with the Americans with Disabilities Act (“ADA”) and any other applicable laws and regulations pertaining to children with disabilities.
Children with diabetes Type I or Type II who attend Pine Hills may require assistance with diabetes management. The management regime of every child with diabetes may be different and, for this reason, it is the view of Pine Hills that one Policy cannot dictate the particular protocol followed by Pine Hills for all individuals. Pine Hills will make an individual assessment of the special needs of each child with diabetes on a case-by-case basis and will work with families to provide reasonable accommodations to children with diabetes in accordance with applicable laws. Successful participation and accommodation of the children depends on an actively cooperative relationship and ongoing communication between the parents or guardians of the children and Pine Hills.
Parents or guardians who wish to enroll a prospective child with diabetes should submit a complete application for the child at least one month ahead of the scheduled start date for daycare, camp, or other activity or two weeks for daily events such as field trips, to permit adequate time for the staff to meet with the parents or guardians of the child to examine the individual needs of the child on a case-by-case basis and to take appropriate steps to comply with pertinent laws.
Within two weeks of the child’s admission to a particular session or program, Pine Hills will send to the parents or guardians a copy of this Policy, a Diabetes Management Plan Form, and a Physical Examination Form. A reasonable time (i.e., twenty (20) business days) prior to the beginning of any session or program, the parents or guardians of a child with diabetes will send the Director at Pine Hills a completed Diabetes Management Plan Form, typewritten in easy to understand terms, detailing care necessary for the child’s safety; a completed Physical Exam Form; and a signed general release, if the same release is required of all other children regardless of disability.
For current children who should require treatment for diabetes for the first time during any session, parents or guardians of these children should immediately notify Pine Hills, submit the completed Management Plan Form as set forth above, and comply with the remaining aspects of this Policy with sufficient time to allow Pine Hills to make good faith efforts for continuation of the session consistent with this Policy.
Because each child’s care is different and the activity levels of each child may be different, this policy should not be construed to prevent Pine Hills from working with health care professionals and the child’s guardians or parents in an effort to expedite the child’s admission or improve the child’s experience.
Parents or guardians will be available at Pine Hills’s request to attend and participate on the first day of a session with the child and, if deemed necessary by either party, to attend a prior run through of the first day, and to continue to meet with and advise the staff working with the child about proper diabetes care. Parents will be available by phone or have other emergency contacts (which may include the child’s health care provider) available by phone each day that the child is participating in a session to answer questions from Pine Hills or the child regarding the child’s management of diabetes care and to approve particular actions related to proper care when necessary.
Parents or guardians will provide specific information and training about the child’s diabetes and particular needs related to diabetes care to Pine Hills, and will permit the child’s personal health care providers to share information with Pine Hills staff and other health care personnel when necessary to assure the child’s safety and compliance with the child’s Diabetes Management Plan. The information should include all equipment, food, and substances to be provided by the parents/guardians that are not regularly provided by Pine Hills; and containers for proper disposal and maintenance of all materials including, but not limited to, keeping the child’s blood glucose meter and insulin pump in good working order.
Parents or guardians will promptly inform Pine Hills of relevant changes in the child’s health status. The parents or guardians will provide, along with instructions about proper maintenance or use of all items, all supplies and equipment necessary for the child’s safe participation in all activities.
Parents or guardians will provide and properly maintain all supplies and equipment for the child’s diabetes and assist with proper disposal of equipment and supplies. Parents or guardians will provide written permission to undertake the steps indicated on the child’s Diabetes Management Plan and Physical Exam Form, and will provide all applicable releases in writing two weeks before a child joins any session or program at Pine Hills.
Training of Personnel
In accordance with applicable law, including those regulations enforced by the applicable Department of Public Health, if a child with diabetes applies for any session or program, Pine Hills will arrange for a qualified health care professional to provide basic training to the appropriate personnel at Pine Hills. That basic training will include a general overview of diabetes and typical health care needs of individuals with disabilities, recognition of common symptoms of hypoglycemia and hyperglycemia, and ways to get help quickly. The person
assigned to do the training will also provide assistance and respond to inquiries from parents about any matter or concern related to the care or treatment for a child with diabetes.
Primary teachers and any other teacher or staff member who has primary responsibility for a child with diabetes for more than 60 minutes in any one day will have received training that enables Pine Hills to provide all care required to comply with applicable law. Such training includes (but may not be limited to) an overview of diabetes, general information on how to recognize signs and symptoms of hypoglycemia and hyperglycemia, diabetic care practices related to glucose monitoring and regulating glucagon and insulin administration, including by insulin pump. In addition, depending on the unique needs of the child, training may include information about dietary requirements for individuals with diabetes in general and particular information about dietary requirements for particular children, and training and guidance from parents or guardians of children about any reasonable accommodations needed by a child as identified in each child’s Diabetes Management Plan (which is to be provided by the parent or guardian to Pine Hills at least twenty (20) business days prior to any session) and related documents. Parents or guardians must provide information and training necessary for staff to be trained with regard to any unique needs of their child.
Monitoring Blood Sugar Levels
Parents or guardians will check the child’s blood sugar levels each morning before the child arrives at Pine Hills to ensure they are within the established “target range” in the child’s diabetes Medical Management Plan. Parents or guardians agree to be available to be contacted as deemed necessary to provide information, assistance, or guidance so that Pine Hills satisfies each child’s Diabetes Management Plan. If the child self-identifies, or staff recognizes symptoms of hyperglycemia or hypoglycemia, the staff will assist the child to check blood sugar and treat the symptoms. Pine Hills will assess the level of assistance or supervision that is reasonable depending on the individual needs of the child in the particular situation and provide whatever assistance is appropriate in the situation consistent with the Plan and applicable law.
Further, parents or guardians will furnish all appropriate meals and snacks that are not regularly provided by Pine Hills and that are necessary to meet the child’s needs. The parents or guardians will also ensure that the carbohydrate content falls within the proper amounts set forth in the Diabetes Management Plan so that the totals will be predetermined and calculated by the parents. Carbohydrate values will be calculated and provided on labels on each food item provided by the parents so that the staff may monitor the appropriate use of insulin and insulin pumps or other equipment to administer insulin.
At the onset of any symptom of hyperglycemia or hypoglycemia, the child will notify the staff that the child needs to have a glucose test. Should the staff or nurse notice any symptom(s) of hyperglycemia or hypoglycemia, the staff or nurse will take steps reasonably consistent with the Diabetes Management Plan.
Insulin and Insulin Pumps
Children with diabetes are responsible for arriving at Pine Hills with all necessary supplies. Children may carry their own medical supplies and snacks in a safe fashion that meets local code or safety standards for the care and disposal of medical supplies so that these supplies are in close proximity to the child. To that end, children with insulin pumps are expected to come to Pine Hills with a fully functional pump, back-up insulin and syringes, and glucose tablets for low sugar episodes, and any other equipment necessary for that child. When the child cannot hold these supplies, the supplies will be held at the administrative office, health office, or by a staff member.
Nothing in this process shall prevent Pine Hills from exercising its discretion for the benefit of the child. This policy is not intended to provide fixed rules for dealing with all care involving diabetes; however, the policy sets a minimum standard for ADA compliance. This policy is not intended to serve as a contract with any individual child. The policy may be modified or updated at any time following prior approval by the Department of Justice during the pendency of the Agreement in the case identified below. Absent written notice from Pine Hills, no representative of Pine Hills, other than the Administrator, is authorized to make written or oral representations regarding the statements contained in this Policy. Should you have any questions, the Administrator will be happy to answer your questions or help you get the information you need.
DIABETES MANAGEMENT PLAN
This plan should be completed by the child’s personal health provider/physician and parents/guardian and immediately updated by these persons with any new information in the future.
Contact Information: Circle the primary contact person and phone number Mother/Guardian:
Child’s Doctor/Health Care Provider:
Notify parents/guardian or emergency contact in the following situations:
Specify any medical time requirements: ____________________________________
Can child perform own monitoring? ❑ Yes ❑ No
Identify the type of any meter, monitor, nebulizer, applicator, needle, pump, or any other
devices necessary for the child’s Medical Management Plan (include model and instruction booklet):
What signs does the child demonstrate when child is symptomatic?
Foods to avoid, if any ________________________________________________
Instructions for when food is provided to the child (e.g., as part of a party or food sampling event): ___________________________________________________________________
Exercise and Sports Limitations
Treatment Supplies to be kept at the School site and provided by parent/guardian are
For children with medical concerns, please complete the supplemental form.
This Medical Management Plan has been approved by:
I give permission to the school to perform and carry out the care tasks as outlined in the Medical Management Plan. I also consent to the release of the information contained in this Medical Management Plan to all staff members and other adults who have custodial care of my child such as those persons on the emergency list and who may need to know this information to maintain my child’s health and safety. A written revocation or amendment to this document must be delivered to the school director by the child’s Parent/Guardian in order to effectuate a revocation of the same. The school reserves the right to request additional documentation after review of the within document.
Acknowledged and received by:
PHYSICAL EXAM FORM
To be completed and approved by the child’s diabetes nurse educator, endocrinologist, or primary care provider/physician.
Dear Diabetes Team:
Your cooperation in supplying the following information about an applicant for Pine Hills Kiddie Garden is greatly appreciated. The child will not be accepted without your approval on this form.
To Parent/Guardian: Please complete boxed information BEFORE submitting to Physician.
Date of most recent exam: _____________________
I have read the Diabetes Management Plan, attached to this form, and certify that it provides an easy to understand, complete regime of care for this child’s safety at Pine Hills Kiddie Garden, I recognize that the child will be active at this camp and represent that this plan accounts for applicable varying activity levels.
Have any complications of health or disabilities been detected? Yes/No (circle one)
Is the child emotionally and physically mature or responsible enough to independently manage his/her health concerns? Yes______; No_____. If not, please explain the minimum level of medical licensure and training required for the child’s safety (unless fully described in the Medical Management Plan): ______________________________
Do you have any specific concerns regarding the management of this child’s health or health at school not fully described in the Medical Management Plan? Yes____, No____.
Do you recommend any limitation on child’s activity while at camp beyond those described in the Medical Management Plan? Yes _______ No ______ If yes, please describe:_______________________________________________________________
Primary Care Physician/Endocrinologist’s Name (typed or printed)
Primary Care Physician/Endocrinologist’s Signature:
Parents/Guardians name (typed or printed)
Legal Guardian: ____________________________
RELEASE AND WAIVER OF LIABILITY
THIS IS A RELEASE AND WAIVER OF LIABILITY (hereinafter referred to as “Release”) made this ______ day of _____________, 20___, by and between Pine Hills Kiddie Garden (“Pine Hills”) and _____________________ and ______________________ residing at _______________________________________, who are the parent(s) or guardians(s) of ________________(the “Child”).
WHEREAS, the parent(s) or Guardian(s) has engaged Pine Hills to provide a program for the child.
NOW, THEREFORE, in consideration of the agreements and covenants contained herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto hereby agree as follows:
1. The Parent(s) and/or Guardian(s) hereby fully and forever release and discharge the School from any and all liability, claims, demands, injuries, actions or causes of action, including attorneys’ fees and costs, as a result of any action or failure to take action by Pine Hills. The parent(s) and/or guardian(s) expressly agree that the Child’s use of the Pine Hills or attendance at Pine Hills and any activities associated with Pine Hills are undertaken at the sole risk of the Child and/or Parent(s) and/or Guardians and that Pine Hills, its agents and employees shall not be liable for any damages or injuries to the Child or the property of the Child or be subject to any claim, demand, injury, action or causes of action, including but not limited to any injury or damage resulting from the negligence of Pine Hills, guests and/or other children and/or third parties.
2. This Release shall be governed by the laws of the State of Indiana, without regard to conflict of law principles.
3. This Release supersedes and replaces all prior negotiations and all agreements proposed or otherwise, whether written or oral, concerning all subject matters covered herein. This Release constitutes the entire agreement among the parties with respect to the subject matters discussed herein.
4. The reference in this Release to the term “Pine Hills” shall include Pine Hills Kiddie Garden, and all of its affiliates, subsidiaries, successor corporations, parent corporations and any and all of their directors, officers, employees, agents and representatives. The terms Parent(s)/Guardian(s) shall include the Child and the dependents, heirs, executors, administrators, assigns and successors of the parent, guardian and/or child.
5. The Guardians and/or Parents and/or Child recognize that the failure of any guardians, parents, and or child to comply with Pine Hills policies, guidelines, directions, regulations and or other applicable law may result in nonadmision or removal of the child from Pine Hills. I give permission to Staff at Pine Hillspersonnel to seek emergency assistance when deemed necessary.
6. If one or more of the provisions of this Release shall for any reason be held invalid, illegal or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect or impair any other provision of this Release. This Release shall be construed as if such invalid, illegal or unenforceable provisions had not been contained herein.
Pine Hills Kiddie Garden
All Custodial Parent(s) and Guardian(s)
October 20, 2009