Sec. 7-2.25. Additional requirements for camps enrolling campers with disabilities

(a) Effective October 1, 2016, the following requirements shall apply to all camps enrolling a child with a physical or developmental disability, except that any camp for children with developmental disabilities as defined in section 7-2.2 of this Subpart shall comply with this section upon the effective date of this Subpart:

(1) Personnel and supervision.

(i) The ratio of counselors to campers who use a wheelchair, adaptive equipment or bracing to achieve ambulation, but who do not possess, for whatever reason, the ability to fit, secure or independently manipulate such devices satisfactorily to achieve ambulation, shall be 1:2.

(ii) Camp staff providing direct care of a camper with a disability shall be trained on the specific needs of the campers in their charge.

(2) Medical requirements.

(i) A camp operator shall obtain existing individual treatment, care, and behavioral plans for campers with a disability. Camp staff shall implement adequate procedures to protect the health and safety of a camper based on the plan provided and, when necessary, in consultation with an individual’s parent, guardian and/or clinical team.

(ii) The confidential medical history for a camper with a disability shall, in addition to the requirements of section 7-2.8(c)(1) of this Subpart, include:

(a) any restrictions, allergies, medications, special dietary needs, and other pre-existing medical, physical or psychological conditions and illnesses;

(b) the camper’s physician’s name, address and telephone number.

(iii) Modified diets and other special needs related to a camper’s disability shall be identified for each camper prior to arrival at camp, planned for, provided for in accordance with supplied directions, and reviewed by the designated camp health director.

(3) Recreational safety.

(i) The minimum counselor-to-camper ratio during swimming pool and bathing beach activities shall be one counselor for each camper who is non-ambulatory or has a disability identified by the camper's parents, guardian, physician or residential care provider that may result in an increased risk of an emergency in the water, such as uncontrolled epilepsy.

(ii) The minimum counselor-to-camper ratio during swimming pool and bathing beach activities shall be one staff member for every five campers with a developmental disability not designated in subparagraph (i) of this paragraph.

(iii) No camper with a developmental disability can participate in swimming activities unless a written permission statement signed by the camper’s parent, guardian or residential care provider is on file at the camp.

(iv) The camp safety plan approved under section 7-2.5(n) of this Subpart shall contain a procedure to address the handling of seizures and aspiration of water for campers with developmental disabilities. All bathing beach and swimming pool staff shall be trained to implement the procedure prior to the date the camp begins operation. In-service training using this procedure shall be conducted and documented every two weeks after the commencement of the camp’s operation or as otherwise approved by the permit-issuing official in the camp’s safety plan.

(4)

Toilets, privies, lavatories, showers. All lavatories and showers used by a camper with a physical disability shall be equipped with specialized fixtures, grab bars or other controls appropriate for the camper’s disability. Lavatories and showers used by campers with physical, intellectual or developmental disabilities, who are unable to moderate water temperature safely, shall have a water temperature not greater than 110°F.

(5) Sleeping quarters.

(i) Buildings housing campers who are non-ambulatory or use a wheelchair shall have ramps constructed in accordance with the Uniform Code to facilitate access and egress.

(ii) Non-ambulatory campers shall not have their sleeping accommodations above the ground floor.

(6) Location; grounds. Exterior paths of travel shall be free of encumbrances and provide an appropriate surface for movement during inclement weather as appropriate for the camp population being served.

(b) Children’s camps for children with developmental disabilities. In addition to the requirements listed in subdivision (a) of this section, the following requirements shall apply to all children’s camps for children with developmental disabilities, as defined as defined in section 7-2.2 of this Subpart:

(1) Definitions. The following definitions apply to this subdivision:

(i) Camp staff shall mean a director, operator, employee or volunteer of a children's camp; or a consultant, employee or volunteer of a corporation, partnership, organization or government entity which provides good or services to a children's camp pursuant to contract or other arrangement that permits such person to have regular or substantial contact with individuals who are cared for by the children's camp.

(ii) Department shall mean the New York State Department of Health.

(iii) Justice Center shall mean the Justice Center for the Protection of People with Special Needs, as established pursuant to section 551 of the Executive Law.

(iv) Reportable incidents shall include the following:

(a) Abuse and neglect shall mean those actions by camp staff that satisfies the definitions of “physical abuse”, “sexual abuse”, “psychological abuse”, “deliberate use of restraints”, “use of aversive conditioning”, “obstruction of reports of reportable incidents”, “unlawful use or administration of controlled substance” and “neglect” all as defined in section 488 of Social Services Law.

(b) Significant incident shall mean an incident, other than an incident of abuse or neglect as defined by clause (a) of this subparagraph that because of its severity or the sensitivity of the situation may result in, or has the reasonably foreseeable potential to result in, harm to the health, safety, or welfare of a camper with a developmental disability. A significant incident shall include but not limited to:

(1) conduct between campers with developmental disabilities that would constitute abuse, as defined in this section, if it had been conducted by a camp staff member; or

(2) conduct by a camp staff member which is inconsistent with the individual treatment plan for a camper with a developmental disability, generally accepted treatment practices and/or applicable Federal or State laws, regulations or policies, and impairs or creates a reasonably foreseeable potential to impair the health, safety or welfare of a camper with a developmental disability. Such conduct shall include but is not limited to: actions incorporated within the definitions of “unauthorized seclusion,” “unauthorized use of time-out,” “administration of a prescribed or over-the-counter medication, which is inconsistent with a prescription or order issued by a licensed, qualified health care practitioner, and which has an adverse effect,” and “inappropriate use of restraints,” as defined in section 488 of the Social Services Law.

(v) Personal representative shall mean a camper’s parent, guardian, or person authorized under State, tribal, military or other applicable law to act on behalf of a camper with a developmental disability in making health care decisions.

(2) Personnel and supervision.

(i) The camp director, who may also be the camp operator, shall possess a bachelor's degree from an accredited program in the field of physical education, recreation, education, social work, psychology, rehabilitation or related human services fields and shall present evidence of specialized training or one year of experience in treating or working with individuals with a developmental disability.

(ii) A camp director does not have to meet the minimum requirements of subparagraph (i) of this paragraph if:

(a) the individual was a camp director for a camp for children with developmental disabilities during each of the three camping seasons preceding the 1986 camping season;

(b) conditions at the camp did not threaten the health or safety of campers during that person's tenure as camp director; and

(c) the individual otherwise meets the minimum qualifications for a camp director, as set forth in section 7-2.5 of this Subpart.

(iii) The camp director shall not be on the Justice Center staff exclusion list (SEL) consistent with paragraph (6) of this subdivision.

(iv) The camp director shall develop a written staff training program appropriate to the specific needs of the campers with developmental disabilities enrolled in the camp.

(v) There shall be at least one counselor in addition to the driver in any vehicle transporting campers with developmental disabilities or as provided in the camp safety plan approved under section 7-2.5(n) of this Subpart.

(3) Medical requirements. The camp health director shall be a physician, physician's assistant, registered nurse or licensed practical nurse and shall be on-site for the period the camp is in operation.

(4) Reporting. In addition to reporting incidents as required by Part 5 of this Title and by sections 7-2.8(d), 7-2.5(n)(3) and 7-2.6(f)(4) of this Subpart, all camp staff shall immediately report any reportable incident, as defined in subparagraph (1)(iv) of this subdivision, involving a camper with a developmental disability, to the permit-issuing official and to the Justice Center's vulnerable person's central register (VPCR). Such report shall be provided in a form and manner as required by the department and Justice Center.

(5) Immediate protections and notifications.

(i) Immediately upon notification of abuse, neglect or significant incident as defined by subparagraph (1)(iv) of this subdivision, the camp operator or designee shall ensure appropriate actions are taken to address the immediate physical and psychological needs of the camper(s), implement protections to ensure the safety and mitigate further risk to campers, and document such actions and implementations.

(ii) The camp director or designee shall notify a camper with a developmental disability and the camper’s personal representative that the camper is an alleged victim or potential witness of an incident of abuse or neglect. Alleged victims shall be notified within 24 hours and potential witnesses shall be notified within 48 hours of the permit-issuing official reporting, to the camp director or designee, that an incident of abuse or neglect has been accepted by the Justice Center for investigation. There shall be no notification of a personal representative if the alleged victim or potential witness objects to such notification or if providing such notification would compromise the investigation, violate relevant confidentiality laws, be contrary to court order, or otherwise contrary to the best interests of the alleged victim or the potential witness.

(iii) Camp staff shall document in writing that notice was given or that a diligent effort to make such notification was made for each camper.

(6) Camp staff screening, training, and code of conduct.

(i) Prior to hiring anyone who will or may have direct contact with campers, or approving credentials for any camp staff, the operator shall follow the procedures established by the Justice Center in regulations or policy, to verify that such person is not on the Justice Center’s staff exclusion list (SEL) established pursuant to section 495 of the Social Services Law. If such person is not on the Justice Center's staff exclusion list (SEL), the operator shall also consult the Office of Children and Family Services State Central Registry of Child Abuse and Maltreatment as required by section 424-a of the Social Services Law. Such screening is in addition to the requirement that the operator similarly verify that a prospective camp staff is not on the sexual abuse registry, as required by section 7-2.5(l) of this Subpart.

(ii) A camp operator shall ensure that camp staff receive training regarding mandated reporting and their obligations as mandated reporters as defined by article 11 of Social Services Law. A camp operator shall ensure that the telephone number for the Justice Center's VPCR hotline for the reporting of reportable incidents is conspicuously displayed in areas accessible to mandated reporters and campers.

(iii) The camp operator shall ensure that all camp staff are provided with a copy of the code of conduct established by the Justice Center pursuant to section 554 of Executive Law. Such code of conduct shall be provided at the time of initial employment, and at least annually thereafter during the term of employment. Receipt of the code of conduct shall be acknowledged and the recipient shall further acknowledge that he or she has read and understands such code of conduct.

(7) Disclosure of information.

(i) Except to the extent otherwise prohibited by law, the camp operator shall be obliged to share information relevant to the investigation of any incident subject to the reporting requirements of this Subpart with the permit-issuing official, the department, and the Justice Center. The permit-issuing official, the department and the Justice Center shall, when required by law, or when so directed by the department or the Justice Center and except as otherwise prohibited by law, be permitted to share information obtained in their respective investigations of incidents subject to the reporting requirements of paragraph (4) of this subdivision.

(ii) Except as otherwise prohibited by law, the operator of a camp not otherwise subject to article 6 of the Public Officers Law shall make records available for public inspection and copying to the extent required by subdivision 6 of section 490 of the Social Services Law.

(8) Incident management.

(i) The camp operator shall cooperate fully with the investigation of reportable incidents involving campers with developmental disabilities and shall provide all necessary information and access to conduct the investigation. The camp operator shall promptly obtain an appropriate medical examination of a physically injured camper with a developmental disability. The camp operator shall provide information, whether obtained pursuant to the investigation or otherwise, to the Justice Center and permit-issuing official upon request, in the form and manner requested. Such information shall be provided in a timely manner so as to support completion of the investigation subject to the time limits set forth in this subdivision.

(ii) Unless delegated by the Justice Center to the department, an allegation of abuse or neglect as defined in clause (1)(iv)(a) of this subdivision, shall be investigated by the Justice Center. With regard to an alleged significant incident, as defined in clause (1)(iv)(b) of this subdivision, the permit-issuing official shall initiate a prompt investigation of the allegation, unless the Justice Center agrees that it will undertake such investigation. An investigation conducted by the permit-issuing official shall commence no later than five business days after notification of such an incident. Additional time for completion of the investigation may be allowed, subject to the approval of the department, upon a showing of good cause for such extension. At a minimum, the investigation of any reportable incident shall comply with the following:

(a) Investigations shall include a review of medical records and reports, witness interviews and statements, expert assessments, and the collection of physical evidence, observations and information from care providers and any other information that is relevant to the incident. Interviews should be conducted by qualified, objective individuals in a private area which does not allow those not participating in the interview to overhear. Interviews must be conducted of each party or witness individually, not in the presence of other parties or witnesses or under circumstances in which other parties or witnesses may perceive any aspect of the interview. The person alleging the incident, or who is the subject of the incident, must be offered the opportunity to give his/her version of the event. At least one of the persons conducting the interview must have an understanding of, and be able to accommodate, the unique needs or capabilities of the person being interviewed. The procedures required by this clause may be altered if, and only to the extent necessary to, comply with an applicable collective bargaining agreement.

(b) All evidence must be adequately protected and preserved.

(c) Any information, including but not limited to documents and other materials, obtained during or resulting from any investigation shall be kept confidential, except as otherwise permissible under law or regulation, including but not limited to article 11 of the Social Services Law.

(d) Upon completion of the investigation, a written report shall be prepared which shall include all relevant findings and information obtained in the investigation and details of steps taken to investigate the incident. The results of the investigation shall be promptly reported to the department, if the investigation was not performed by the department.

(e) If any remedial action is necessary, the permit-issuing official shall establish a plan in writing with the camp operator. The plan shall indicate the camp operator’s agreement to the remediation and identify a follow-up date and person responsible for monitoring the remedial action. The plan shall be provided, and any measures taken in response to such plan shall be reported to the department.

(f) The investigation and written report shall be completed and provided to the department within 45 days of when the incident was first reported to the Justice Center.

(iii) At the conclusion of an investigation of an alleged reportable incident, the camp operator shall:

(a) assess the need for corrective actions;

(b) report corrective actions plans to the permit-issuing official within 45 days of the conclusion of an investigation from the Justice Center or permit-issuing official; and

(c) implement corrective actions identified by the camp, or required by the permit issuing official or the Justice Center. Corrective action plans shall be implemented as soon as possible but within 90 days of the completion of an investigation unless the camp has closed for the season. If closed for the season, corrective action plans shall be implemented when the camp reopens.

(iv) Incident review committee.

(a) The camp shall maintain a facility incident review committee, in accordance with 14 NYCRR Part 704. The incident review committee shall be composed of members of the governing body of the children’s camp and other persons identified by the camp operator, including some members of the following: camp administrative staff, direct support staff, licensed health care practitioners, service recipients, the permit-issuing official or designee and representatives of family, consumer and other advocacy organizations, but not the camp director. The camp operator shall convene a facility incident review committee to review the timeliness, thoroughness and appropriateness of the camp's responses to reportable incidents; recommend additional opportunities for improvement to the camp operator, if appropriate; review incident trends and patterns concerning reportable incidents; and make recommendations to the camp operator to assist in reducing reportable incidents. The facility incident review committee shall meet each year in which there is a reportable incident. When the incident review committee is responsible for approving or developing corrective action plans, the committee shall meet within 45 days of the conclusion of an investigation, unless an extension for such plans has been granted by the Justice Center.

(b) Pursuant to paragraph (f) of subdivision (1) of section 490 of the Social Services Law and 14 NYCRR Part 704, a camp operator may seek an exemption from the requirement to establish and maintain an incident review committee. In order to obtain an exemption, the camp operator shall file an application with the permit-issuing official and provide sufficient documentation and information to demonstrate that compliance would present undue hardship, that granting an exemption would not create an undue risk of harm to campers' health and safety and specify an alternative process to ensure appropriate review and evaluation of reportable incidents. The permit-issuing official shall consult with the department and shall not grant or deny an application for an exemption unless it first obtains department approval for the proposed decision. An operator shall meet all terms of an approved exemption(s). An exemption shall remain in effect until revoked by the permit-issuing official. A camp operator shall immediately notify the permit-issuing official when conditions, upon which the incident review committee exemption was granted, have changed.

(9) In addition to the requirements specified by section 7-2.4(d) and (g) of this Subpart, a permit may be denied, revoked, or suspended if the children's camp fails to comply with regulations, policies, or other requirements of the Justice Center. In considering whether to issue a permit to a children's camp, the permit-issuing official shall consider the children's camp's past and current compliance with the regulations, policies, or other requirements of the Justice Center.