The following summarizes the proposed regulations pertaining to children with disabilities attending a children’s camp.

Pursuant to the proposed amendments, the following requirements, which previously pertained only to camps with 20 percent or more campers with a developmental disability, will now apply to any camp enrolling campers with a disability, beginning October 1, 2016:

• For campers who cannot independently manipulate a wheelchair or adaptive equipment, camps must provide at least 1:2 supervision;

• Staff that have direct care responsibilities of campers with disabilities must receive training relevant to the specific needs of the campers in their charge;

• Camps must obtain and implement, as appropriate, care and treatment plans for campers with disabilities that have such plans as well as obtain other available information relevant to the care and specific needs of a camper with disabilities including pre-existing medical conditions, allergies, modified diets, and activity restrictions;

• During swimming activities, camps must provide one counselor for each camper who is non-ambulatory or has a disability that may result in an increased risk for an emergency in the water;

• For campers with developmental disabilities, camps must provide one counselor for every five campers during swimming activities;

• Camps must obtain parent/guardian’s written permission to allow campers with developmentally disabilities to participate in swimming activities;

• Camps must develop procedures and training for handling seizures or aspiration of water by campers with developmental disabilities that may occur during swimming activities;

• All lavatories and showers used by campers with physical disabilities must be equipped with specialized features and grab bars;

• Lavatories and showers used by campers with a disability, who are unable to moderate water temperature safely, shall have a water temperature not greater than 110 degrees Fahrenheit;

• Buildings housing non-ambulatory campers shall have ramps to facilitate access.

• Non-ambulatory campers may not have housing above ground level; and

• Exterior paths must be constructed and maintained, as appropriate for the camp population served, to provide for safe travel during inclement weather.

The amendments also define a “Camp for Children with Developmental Disabilities.” Such camps would be immediately required to adhere to the following additional requirements, pursuant to the legislation that established the Justice Center, in addition to immediately complying with the provisions above:

• Reportable incident is defined to include abuse, neglect and other significant incidents specified in section 488 of Social Services Law. Camp staff must report all reportable incidents to the Justice Center Vulnerable Persons’ Central Registry and the permit-issuing official;

• A definition of a personal representative was added to be consistent with section 488 of Social Services Law;

• Prior to hiring camp staff, camps must verify that candidates are not on the Justice Center’s staff exclusion list or on the Office of Children and Family Services State Central Registry of Child Abuse and Maltreatment;

• All camp staff must obtain mandated reporter training and review and acknowledge an understanding of the Justice Center’s code of conduct;

• Camps must ensure that immediate protections are in place following an incident to prevent further risk or harm to campers;

• Camps must notify the victim, any potential witnesses, and each camper’s personnel representative (as appropriate) that the camper may be interviewed as part an abuse or neglect investigation;

• Camps must cooperate fully with reportable incident investigations and provide/disclose all necessary information and access to conduct investigations;

• Reportable incident investigations procedures are established;

• Camps must promptly obtain an appropriate medical examination of a physically injured camper with a developmental disability;

• Unless a waiver is granted, camps must convene a Facility Incident Review Committee to review the camp's responses to a reportable incident including making recommendations for improvement, reviewing incident trends, and making recommendations to reduce reportable incidents;

• Camps must implement any corrective actions identified as the result of a reportable incident investigation.

Note that, for organizational reasons, these amendments repeal section 7-2.25 in its entirety, and replace it with a new section 7-2.25. Although reorganized, some provisions have been left substantially unchanged, including certain provisions relating to camp directors and health directors.

Changes made to the last published rule do not necessitate revision to the previously published RIS, RFA, RAFA and JIS.

A total of six written comments were received during the comment period. Written comments were received from: three local health departments (Chemung County, Livingston County, and Niagara County), the Conference of Environmental Health Directors, New York State Association of County Health Officials, and Town of Hyde Park.

The following summarizes the concerns expressed by those who commented and the Department of Health’s (DOH) response to the comments:

Increased Cost for Camps:

Comments:

All six commenters included concerns that the proposed amendments would place financial hardships on camps that are not designated as a Camp for Children with Developmental Disabilities and that the hardships may result in camps closing.

DOH Response:

The amendments are necessary to protect children with disabilities attending any camp. The amendments impose additional requirements on camps enrolling campers with physical or developmental disabilities, to further protect this vulnerable population.

Comments:

Comments received expressed concern that higher staff supervision ratios for children with disabilities will result in the hiring of additional staff.

DOH Response:

The supervision and staffing requirements in these amendments apply to campers with severe disabilities and who are unable to care for themselves. In most cases, the new staffing requirements are anticipated to be implemented through existing staffing levels with minor changes to current camp policies and procedures.

Comments:

Comments were received that expressed concern that the new staff training and qualifications were unspecified and there were no guidelines for adequate training.

DOH Response:

The cost for additional staff training on the needs of campers with disabilities is expected to be minimal, as camps are currently required to provide staff training in other areas. Therefore, only staff with direct care responsibilities are required to be trained on the needs of the campers with disabilities in their charge. The amendments do not mandate hiring specially trained or certified staff or provide training guidelines because each training will be camp specific depending on the disabilities of the children who are enrolled.

Comments:

Comments were received that expressed concern about the costs associated with new structural accessibility requirements for campers with physical disabilities.

DOH Response:

Accessibility standards have been mandated by NYS Uniform Building and Construction Code since 1984 and by American’s with Disabilities Act since 1986. Prior to the amendment, accessibility requirements only pertained to camps with 20 percent or more campers with a developmental disability. The regulation is amended to correctly apply accessibility requirements to all children’s camps.

Comments:

Comments received expressed concerns about additional unspecified procedural requirements.

DOH Response:

Commenters stated that procedural requirements of the amendments would increase expenses for camps, but did not explain what requirements were of concern. Therefore, the Department believes no change is necessary.

Comments:

Comments received expressed concern about the cost associated with the establishment of Facility Incident Review Committees.

DOH Response:

Chapter 501 of the Laws of 2012 which established the NYS Justice Center for the Protection of People with Special Needs, requires each facility within the oversight of the Justice Center to have a Facility Incident Review Committee. Accordingly, this requirement applies to Camps for Children with Developmental Disabilities. In certain circumstances, however, a camp operator may seek an exemption from the requirement pursuant to 10 NYCRR Section 7-2.25(b)(8)(iv)(b).

Comment:

One commenter suggested that if a camper requires 1 to 1 supervision that the child’s parents should provide the caregiver.

DOH Response:

The amendments do not prohibit camps from making individual arrangements with parents for a caregiver. However, the Department declines to make this a requirement.

Comment:

Another commenter included a suggestion that a provision should be included for low cost or no interest loan to camp operators to assist with compliance.

DOH Response:

Low interest loans to camp operators is outside of the scope of these regulations.

Comment:

One commenter suggested that a provision should be included that gives camps advanced notice to allow for adequate training preparation.

DOH Response:

The requirements for Children's Camps for Children with Developmental Disabilities are consistent with past emergency regulations and guidance that have been implemented since June of 2013. Requirements for other camps are not effective until October 1, 2016, which gives camps time to prepare.

Increased Costs for Local Health Departments:

Comments:

Comments received expressed concern that the amendments would result in additional expenses and place a burden on local health departments (LHDs). One commenter specifically listed the costs associated with incident investigation and other training required in the Justice Center regulations for Camps for Children with Developmental Disabilities. There were also comments which mentioned the inability for LHDs to increase children’s camp permit fee to cover costs associated with the amendments.

DOH Response:

Additional expenses associated with LHDs complying with these amendments is expected to be minimal. LHDs will assess camps for compliance with the amendments during currently required routine on-site inspections of a camp. The additional requirements are not expected to add a significant amount of time to an inspection. Furthermore, amendments for incident investigation and additional staff training at Camps for Children with Developmental Disabilities are required by the Justice Center legislation and cannot be amended by the Department of Health. The Department of Health will be providing training to LHDs about the amendments at no charge. Children’s camp permit fees are set in Public Health Law § 1406 and therefore cannot be increased through regulation.

Expanding the applicability of the regulations:

Comments:

Commenters questioned the need for amendments that go beyond the Justice Center regulations.

DOH Response:

The Department evaluated the regulations and determined the amendments are necessary to protect children with disabilities attending all camps, not just camps designated as a Camp for Children with Developmental Disabilities.