Finding Child Care for Kids with Extra Support Needs

If your child is a Regional Center client, your Regional Center likely works with respite care agencies that can help you find a respite worker. Here’s what you need to know:

• Respite must be requested through the Individual Program Plan (IPP) or the Individual Family Service Program Plan (IFSP) process. Talk to your service coordinator about access to this service.
• Agency respite workers are bound to an in-home only service and paid minimum wage. If you need care outside your home, you may ask for an exemption.
• Each Regional Center holds different rules for children with medical conditions. Lisa Concoff Kronbeck advises that if your child has a specialized medical condition, it’s important to find out what type of intervention is allowed by the respite worker. For example, some centers require respite workers to have licensed vocational nurse (LVN) training to be allowed to change a G-tube or intervene during a seizure. Other Regional Centers dictate that their respite workers cannot practice these interventions while some allow parents to train workers in this area.
• Remember that if you don’t find a respite care worker to be a good fit, you can request different care providers at any time.

Parent conversion

Another option for respite care is parent conversion, also known as parent/family choice. What this means is that the parent finds their own caregiver and then helps that caregiver register with a respite agency in order to bring them on through Regional Center.

• Lisa Carey suggests that parents “go about this the same way they would finding a babysitter. They can use their family members, friends, parents’ groups on social media, or real-life connections.” Carey adds that she prefers parent conversion over agency-assigned as it allows the parents to be in more of a supervisor role, dictating what respite care workers can and cannot do.
• As veteran respite care finders know all too well, finding a qualified and trustworthy person to care for your child can be a major task. Searching for someone willing to work for the state respite care standard of $15 per hour presents an additional challenge. Several Undivided parents shared with us that to offset this low pay, they make up the difference in rate by privately hiring the caregiver for extra work outside respite care hours and paying their own determined (much higher) rate. (Please note that this is only possible when hiring through the parent conversion method. If you choose to have an agency provide you with a respite worker, you cannot privately hire or offer to offset low wages.)

Self-Determination

Regional Center’s Self-Determination Program (SDP) allows parents to create an individualized plan that’s personalized to their child’s strengths and needs, and it can be particularly useful for families who don’t live near Regional Center vendors or who don’t have local agencies that can provide care specific to their child’s needs.

SDP is a voluntary route that Independent Facilitator Carla Lehmann describes as offering more flexibility, freedom of control, and better quality of services. Lehmann assures us that it will not cost more money, but it will initially involve more work. With this approach, you have control over your budget and can put money toward services and resources that are more effective for you and your child. Under Self-Determination, the respite care provider of your choice is not bound to the in-home-only, minimum-wage rules of the traditional respite agency.

Since you are creating the budget, you are allowed to choose the type of home service and dictate the rate you pay, giving you the option to pay more or receive more respite hours for the same price that Regional Center would have paid a respite agency. (Lehmann explains that SDP eliminates going through the respite agency, which takes a cut of the budget.) By eliminating the respite agency, this removes rules and restrictions that Regional Center abides by. Your respite provider is able to drive your child to different locations, such as a socialization class, which allows you to have respite time while your child is busy and entertained.

If your child is not a Regional Center client, or you find respite services inadequate for your needs, you can look for a private agency to help you hire a child care provider, or you can screen for a provider yourself on a job board site. Here are some potential nationwide resources:

• Nanny League
• Care.com
• Sittercity
• UrbanSitter

Note that each agency or site has its own requirements for who is qualified to provide care, the costs, the background check and matching process, and experience providing care to children with disabilities, so you will need to do your research as far as the best fit for your family. You can also ask the Undivided Research Team for help narrowing down your options.

Even if you’re going through an agency, it’s helpful to have a list of questions to ask a caregiver to help you find the right fit and set expectations for their responsibilities. One parent recommends setting up a list of “must-haves, flexible-to-haves, and nice-to-haves” that you can reference as you interview a candidate.

Think about your child’s specific needs as you come up with questions to ask during a phone and/or in-person interview. Here are some general ideas to get you started:

• What are your qualifications? What areas of training or certification have you received?
• What experience do you have caring for children with extra support needs [or your child’s specific disability]?
• How familiar are you with [medical equipment or other assistive tech, such as AAC your child uses]?
• How comfortable would you be helping my child with [toileting, dressing, mealtimes, other important needs]?
• Can you tell me about a time you handled a particularly challenging behavior or medical need?
• What is your process for documenting your caregiving activities and progress reports?
• What would be your process for building a trusting relationship with my child?

Wherever possible, ask for references from any candidate you’re seriously considering. Calling previous clients and speaking with them about their children’s needs can help you assess whether a potential caregiver has the skills necessary to look after your child’s well-being. This guide from kitsit.com has a great list of questions you can ask when calling references.

How to run a background check

Most agencies and some sitter websites will take care of the background check as part of their service, but if you’re hiring a provider yourself, you may want to run a background check before committing to your preferred candidate.

In California, background checks that assess criminal or credit history for employers are regulated by the Fair Credit Reporting Act. As a potential employer, you must obtain written consent from the candidate before you run the background check.

You can manually check public records, or you can use a third-party service such as Checkr, BeenVerified, or eVerify to process the background check for you for a fee. Some aspects that a background check can verify include:

• Identity
• Eligibility to work in the United States
• Criminal history
• Sex offender registry entry
• Driving records

We know it can seem daunting to find a child care provider who will meet your kid’s needs when you’re not available, but we hope these resources will be helpful in finding a great fit for your family. If you have other suggestions or tips to add, please get in touch so we can share them with other parents!