PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:
Proposed Action:
Amendment of Subpart 7-2 of Title 10 NYCRR.
Statutory authority:
Public Health Law, section 225
Subject:
Children’s Camps.
Purpose:
To include camps for children with developmental disabilities as a type of facility within the oversight of the Justice Center.
Substance of proposed rule (Full text is posted at the following State website:www.health.ny.gov):
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.
Text of proposed rule and any required statements and analyses may be obtained from:
Katherine Ceroalo, DOH, Bureau of House Counsel, Reg. Affairs Unit, Room 2438, ESP Tower Building, Albany, NY 12237, (518) 473-7488, email: regsqna@health.state.ny.us
Data, views or arguments may be submitted to:
Same as above.
Public comment will be received until:
45 days after publication of this notice.
Summary of Regulatory Impact Statement
Statutory Authority:
The Public Health and Health Planning Council (PHHPC) is authorized by section 225(4) of the Public Health Law (PHL) to establish, amend and repeal sanitary regulations known as the State Sanitary Code (SSC), subject to the approval of the Commissioner of Health. Article 13-B of the PHL authorizes the PHHPC to prescribe standards and establish regulations for children’s camps. PHL sections 225 and 201(1)(m) authorize SSC regulation of the sanitary aspects of businesses and activities affecting public health including children’s camps.
Legislative Objectives:
In enacting Chapter 501 of the Laws of 2012, the Legislature established the New York State Justice Center for the Protection of People with Special Needs (Justice Center). This legislation amended Article 11 of Social Service Law to include children’s camps for children with developmental disabilities, and it required the Department of Health to promulgate regulations pertaining to incident management.
Needs and Benefits:
The following requirements, which previously pertained only to camps with 20 percent or more campers with a developmental disability, will now apply to any camper with a disability, as of October 1, 2016:
• For campers who cannot independently manipulate a wheelchair or adaptive equipment, camps must provide at least 1:2 supervision;
• Staff providing direct care of campers with disabilities must be trained on the needs of the campers in their charge;
• Camps must obtain health information and existing care/treatment plans and implement adequate procedures to protect the safety and health of camper with disabilities;
• During swimming activities, camps must provide one counselor for each camper who is non-ambulatory or has a disability that might result in unusual emergencies in the water. For campers with developmental disabilities, camps must provide one counselor for every five campers and obtain parent/guardian’s written permission to allow for swimming participation;
• Non-ambulatory campers cannot have housing above ground level;
• Provisions for adaptive equipment, ramps and accessible design are included for lavatories, showers, and buildings. A maximum water temperature is established lavatories and showers.
To implement Article 11, the Department of Health proposes these amendments to 10 NYCRR Subpart 7-2, relating to “Children’s Camp for Children with Developmental Disabilities”. The amendments define a Children’s Camp for the Developmentally Disabled as a children’s camp with camper enrollments of 20 percent or more campers with a developmental disability. In addition to immediately complying with the requirements above, the amended regulations would immediately require these camps to comply with the following:
• Reportable incidents are defined and required to be reported by camp staff to the Justice Center and permit-issuing official;
• Camps must implement immediate protections following an incident to prevent further risk or harm to campers;
• Camps must notify the victim, potential witnesses, and each camper’s personnel representative that the camper may be interviewed as part of an abuse or neglect investigation;
• Camps must verify staff are not on the Justice Center’s Staff Exclusion List (SEL) prior to hiring. After this verification, the operator must consult the Office of Children and Family Services (OFCS) State Central Registry of Child Abuse and Maltreatment (SCR);
• Camp staff must receive mandated reporter training and acknowledge an understanding of the Justice Center’s code of conduct;
• Camps need to cooperate with investigations, including providing access and disclosing necessary information;
• Camps must convene a Facility Incident Review Committee to review the camp's response to a reportable incident and make recommendations to reduce reportable incidents.
Compliance Costs:
Cost to Regulated Parties:
Costs to Camps for Children with Developmental Disabilities:
Costs to regulated parties are difficult to estimate due to variation in staff salaries and time needed to investigate incidents. Reporting incidents should take less than half an hour; assisting with investigations will range from several hours to two staff days. The Department estimates that the total staff costs range from $120 to $1600 for each investigation. Expenses should be minimal statewide as less than 55 Camps for Children with Developmental Disabilities operate each year, with an average of six camps reporting a total of 18 incidents per year.
There will be minimal expense for determining if potential employees are on the SEL and SCR. An entry level staff person earning the minimum wage of $8.75/hour should be able to compile the information for 100 employees within six to eight hours. OCFS requires a $25.00 screening fee for new or prospective employees and no fee for volunteers.
Camps will be required to: disclose certain information to the Justice Center and to the permit issuing official charged with investigating reportable incidents; ensure immediate protections are in place for victims; and notify the victims and any witnesses that they may be interviewed as part of an investigation. Costs associated with these activities include staff time for locating information, contacting camper’s parent/guardians and expenses for copying materials. The typical cost should be under $100 per incident.
Costs associated with mandated reporting training are minimal as training materials will be provided to the camps and will take about one hour to review during routine staff training. The telephone number for the Justice Center reporting hotline must be conspicuously posted for campers and staff. Costs associated with posting is limited to making and posting copies in appropriate locations.
Camp operators must provide each camp staff member or volunteer with the code of conduct established by the Justice Center. The code must be provided at the time of initial employment and annually thereafter. The employee must acknowledge they received, read, and understand the code. The cost of providing the code, and obtaining and filing the required employee acknowledgment should be minimal. Staff should need less than 30 minutes to review the code.
Camps will be required to establish and maintain a facility incident review committee to review the camp's responses to reportable incidents. The cost to maintain a facility incident review committee is difficult to estimate due to the variations in salaries and the amount of time needed for the committee to meet. An incident review committee will be required to meet to fulfill its duties if any reportable incidents occur. Because most camps only operate during the summer season, it is expected that the incident review committee will meet no more than once a year. The cost is estimated to be $450.00 dollars per meeting. The regulations provide opportunity for a camp to seek an exemption, which may be granted based on the duration of the camp season and other factors.
Camps are now required to obtain a medical examination of any camper physically injured during a reportable incident. Because a medical examination is an expected standard of care in response to such injuries, there will be no additional cost.
Costs to camps enrolling campers with a disability:
Certain regulations, which previously pertained only to camps with 20 percent or more campers with a developmental disability, will now apply to any camp that enrolls one or more campers with a disability. The cost to affected parties is difficult to estimate due to variation in salaries and the unknown number of campers with a disability attending camps.
Camps will be required to provide at least: 1:2 supervision for campers who cannot independently manipulate a wheelchair or other adaptive equipment; 1:1 supervision during swimming for each camper who is non-ambulatory or has a disability that may result in an increased risk of an emergency in the water; and 1:5 supervision for campers with a developmental disability during swimming. Entry level staff person earning the minimum wage of $8.75/hour should be able to comply with the supervision requirements. The expense for camps will vary depending on the number of campers with these disabilities and the length of time the campers are in attendance.
Camps will be required to obtain and follow existing care/treatment plans and other available information relevant to the care of a camper with disabilities, such as pre-existing medical conditions, allergies, modified diets, and activity restrictions. Staff providing direct care of these campers must be trained on the specific needs of each camper. Costs to obtain existing health and care information are expect to be minimal, since camps currently collect health information. Costs to provide staff training will vary based on needs of individual campers, but are expected to be a minimal as they currently provide staff training in other areas.
Camps will need to obtain parent or guardian’s written permission to allow campers with developmental disabilities to participate in swimming activities. The cost of obtaining permission slips should be minimal, as it is limited to copying, distributing, and filing with other materials from parents/guardians.
Cost to State and Local Government:
State agencies and local governments operating camps will have the same costs described in the section entitled “Cost to Regulated Parties.”
The regulation imposes requirements on local health departments (LHDs) for receiving incident reports, investigating incidents, and oversight of corrective actions. The total cost for these services is difficult to estimate because of the variation in the number of incidents and amount of time to investigate an incident. The cost to investigate an incident, including report completion, is estimated to range from $400 to $1600.
Cost to the Department of Health:
There will be costs associated with printing and distributing the amended Code. There will be minimal costs for printing and distributing training materials, as most information will be distributed electronically. LHDs will likely include copies of training materials in routine correspondence to camps.
Local Government Mandates:
Camps operated by local governments must comply with the requirements imposed on camps operated by other entities, as described in the section entitled “Cost to Regulated Parties.” Local governments serving as permit issuing officials will face additional reporting and investigation requirements, as described in the section entitled “Cost to State and Local Government.” The proposed amendments otherwise do not impose new responsibilities on local governments.
Paperwork:
The paperwork associated with the amendment includes the completion and submission of incident report forms to the LHD and Justice Center. Camps will be required to provide records necessary for LHD investigation of incidents, and to retain documentation regarding whether prospective employees were found on the SEL or SCR. Camps enrolling campers with a disability will be required to obtain health care related documents/information and permission slips for swimming and document in-service training for aquatic staff.
Duplication:
This regulation does not duplicate any existing federal, state, or local regulation.
Alternatives Considered:
The amendments to the code that relate to Camps for Children with Developmental Disabilities are mandated by law. No alternatives were considered for these requirements.
The Department considered not imposing additional requirements on camps that enroll less than 20% of campers with a disability; however, this option was rejected because the requirements are viewed as necessary to protect campers with disabilities attending camp.
The Department also considered imposing all of the requirements for Camps for Children with Development Disabilities on all children’s camps with one or more qualifying campers; however, this option was rejected due to the burdensome costs associated with implementing the requirements. The State Camp Safety Advisory Council also expressed concern that applying the regulations to all camps enrolling a child with a developmental disability could be burdensome and have unintended consequences. The Department received correspondences from two State Senators, who expressed concern that expanding the regulations to all children’s camps would have unintended financial consequences that could impact access.
Public comments were delivered by municipal organizations, children’s camps and camp organizations, all of which argued in favor of keeping the 20 percent threshold. The Justice Center conveyed agreement with the Department’s application of the additional requirements to camps serving a population of 20 percent or more children with developmental disabilities.
Federal Standards:
No current federal law governs the operation of children’s camps.
Compliance Schedule:
The proposed amendments will be effective upon publication of the Notice of Adoption in the State Register. For Camps for Children with Developmental Disabilities, compliance with all requirements will be immediately required. For camps serving a population of less than 20 percent of children with developmental disabilities, the requirements pertaining to such camps will be effective October 1, 2016.
Regulatory Flexibility Analysis
Types and Estimated Number of Small Businesses and Local Governments:
There are approximately 2,510 regulated children’s camps (533 overnight and 1977 summer day camps) operating in New York State. Any such camp that enrolls a camper with a disability will be affected by the proposed rule. Municipalities (towns, villages, cities and school districts) operate approximately 295 summer day camps and no overnight camp. Most of the remaining camps are believed to be small businesses.
Of the estimated 49 Children’s Camps for Children with Development Disabilities (21 overnight camps and 28 summer day camps) that will be affected by the proposed rule, approximately nine summer day camps and none of the overnight camps are operated by municipalities (towns, villages, and cities). Most of the remaining Children’s Camps for Children with Development Disabilities are believed to be small businesses.
Regulated children’s camps representing small business include those owned or operated by corporations, hotels, motels and bungalow colonies, non-profit organizations (e.g., Girl/Boy Scouts of America, Cooperative Extension, YMCA) and others. The proposed amendments would affect these camps if they enroll children with disabilities. None of the proposed amendments will apply solely to camps operated by small businesses or local governments.
Compliance Requirements:
Reporting and Recordkeeping:
The obligations imposed on small business and local government as camp operators are no different from those imposed on camps generally, as described in “Cost to Regulated Parties,” “Local Government Mandates,” and “Paperwork” sections of the Regulatory Impact Statement. The obligations imposed on local government as the permit issuing official is described in “Cost to State and Local Government” and “Local Government Mandates” portions of the Regulatory Impact Statement.
Other Affirmative Acts:
The obligations imposed on small business and local government as camp operators are no different from those imposed on camps generally, as described in “Cost to Regulated Parties”, “Local Government Mandates,” and “Paperwork” sections of the Regulatory Impact Statement.
Professional Services:
Camps for Children with Developmental Disabilities are now explicitly required to obtain an appropriate medical examination of a camper physically injured from a reportable incident; however, a medical examination has always been expected for such injuries, so this is not a new required service.
Compliance Costs:
Cost to Regulated Parties:
The obligations imposed on small business and local government as camp operators are no different from those imposed on camps generally, as described in “Cost to Regulated Parties” and “Paperwork” sections of the Regulatory Impact Statement.
Cost to Small Businesses and State and Local Government:
The obligations imposed on small business and local government as camp operators are no different from those imposed on camps generally, as described in the “Cost to Regulated Parties” and “Paperwork” section of the Regulatory Impact Statement. The obligations imposed on local government as the permit issuing official is described in “Cost to State and Local Government” and “Local Government Mandates” portions of the Regulatory Impact Statement.
Economic and Technological Feasibility:
There are no changes requiring the use of technology.
The proposal is believed to be economically feasible for impacted parties. The amendments impose additional reporting and investigation requirements that will use existing staff that already have similar job responsibilities. There are no requirements that that involve capital improvements.
Minimizing Adverse Economic Impact:
The amendments for Camps for Children with Developmental Disabilities are mandated by law. No alternatives were considered.
Amendments for camps that have less than 20 percent of the campers with developmental disabilities are believed to be what is minimally necessary to protect this vulnerable population. Requirements for camps serving a population of less than 20 percent of children with developmental disabilities will be effective October 1, 2016. This will allow camps to adequately prepare for and implement these requirements.
Small Business and Local Government Participation:
The regulations were discussed at several State Camp Safety Advisory Council meetings which are open to the public and attended by camp operators, local health department staff and other local government officials. However, due to the need to have regulations in place by the 2016 camping season with adequate time for camps to prepare for the new requirements, no formal outreach was conducted.
Rural Area Flexibility Analysis
Types and Estimated Number of Rural Areas:
There are approximately 2,510 regulated children’s camps (533 overnight and 1,977 summer day camps) operating in New York State. Any of these camps that enrolls a camper with a disability will be affected by the proposed rule. There are an estimated 412 day camps and 402 overnight camps operating in the 44 counties that have population less than 200,000. There are an additional 395 day camps and 97 overnight camps in the nine counties identified to have townships with a population density of 150 persons or less per square mile.
Of the approximate 814 camps operating in the 44 counties that have populations less than 200,000, there are 9 summer day and 13 overnight Camps for Children with Development Disabilities. There are an additional 5 day camps and 4 overnight camps in the 9 counties identified as having townships with a population density of 150 persons or less per square mile.
Reporting and Recordkeeping and Other Compliance Requirements:
Reporting and Recordkeeping:
The obligations imposed on camps operators in rural areas are no different from those imposed on camps generally, as described in “Cost to Regulated Parties” and “Paperwork” sections of the Regulatory Impact Statement.
Other Compliance Requirements:
The obligations imposed on camps in rural areas are no different from those imposed on camps generally, as described in “Cost to Regulated Parties” and “Paperwork” sections of the Regulatory Impact Statement.
Professional Services:
Camps for the Children with Development Disabilities are now explicitly required to obtain an appropriate medical examination of a camper physically injured from a reportable incident; however a medical examination has always been expected for such injuries, so this is not an additional service.
Compliance Costs:
Cost to Regulated Parties:
The costs imposed on camps in rural areas are no different from those imposed on camps generally, as described in “Cost to Regulated Parties” and “Paperwork” sections of the Regulatory Impact Statement.
Economic and Technological Feasibility:
There are no changes requiring the use of technology.
The proposal is believed to be economically feasible for impacted parties. The amendments impose additional reporting and investigation requirements that will use existing staff that already have similar job responsibilities. There are no requirements that involve capital improvements beyond requirements already imposed by the Americans with Disabilities Act.
Minimizing Adverse Economic Impact on Rural Area:
The amendments for Camps for Children with Developmental Disabilities are mandated by law. No alternatives were considered. No impacts are expected to be unique to rural areas.
Amendments for camps that have less than 20 percent of the campers with developmental disabilities are necessary to protect this vulnerable population. The Department has sought to strike a balance between protecting this vulnerable population and ensuring that costs are feasible. Amendments for camps that have less than 20 percent of the campers with developmental disabilities are believed to be what is minimally necessary to protect this vulnerable population.
Requirements for camps serving a population of less than 20 percent of children with developmental disabilities will be effective October 1, 2016. This will allow camps to adequately prepare for and implement these requirements.
Rural Area Participation:
The regulations were discussed at several State Camp Safety Advisory Council meetings which are open to the public and attended by camp operators from rural areas However, due to the need to have regulations in place by the 2016 camping season with adequate time for camps to prepare for the new requirements, no formal outreach was conducted.
Job Impact Statement
No Job Impact Statement is required pursuant to section 201-a (2)(a) of the State Administrative Procedure Act. It is apparent, from the nature of the proposed amendment that it will have no adverse impact on the number of jobs and employment opportunities at children’s camps, because it does not result in a decrease in current staffing level requirements.
