Today's webinar will discuss the importance
of using essential eligibility criteria in adaptive sport
programs.
Having a robust EEC ensures your program has objective criteria
to determine who can safely participate in an activity,
and helps you avoid the legal pitfalls
of stereotyping and subjective determination
by staff and volunteers.
The webinar was created by Crystal Skahan, Director
of Education and Training at Northeast Passage.
Crystal oversees training and continuing education
opportunities for staff and volunteers
at Northeast Passage.
She also teaches within the University of New Hampshire's
Recreation Management and Policy graduate program
on the topic of adapted sport and recreation facilitation.
Crystal is a recreation therapist, certified brain
injury specialist, and adaptive paddling instructor trainer
through the American Canoe Association,
and maintains additional instructor certifications
available through USA Archery and USA Water Ski.
Thank you for having me here today
to talk about essential eligibility criteria.
I was first introduced to EEC early in my professional career
as I began teaching adaptive paddling workshops.
The Adaptive Paddling Committee within the American Canoe
Association has been providing education
on essential eligibility criteria for many years.
In my professional career, as I have
acquired professional certifications
to support my programming responsibilities with Northeast
Passage, I've developed a deep appreciation
for risk management, something I'm sure that you all
are equally passionate about.
And an important aspect of providing safe programming
is evaluating how we're managing and training our staff,
how we are facilitating our programs, what
types of accommodations or adaptations
are we prepared with and qualified to provide,
and who is qualified to safely participate.
I am not a subject matter expert,
nor am I familiar with the unique aspects of all types
of programs or activities.
But I hope the information that we cover today provides you
with a baseline of information and resources
to evaluate the EEC your programs are presently
utilizing or striving to develop.
As we outline and define EEC, we will
discuss how your risk management analysis and strategies
are relevant to developing EEC.
Knowing your industry and your activity
will help you identify the functional skills that anyone
needs to be able to perform to participate safely
in an activity.
We will review the integration mandate of the Americans
with Disabilities Act and the purpose of EEC.
We will discuss how to develop EEC, and review
a few samples of published EEC, which
can be used as a starting point when
you are seeking to adopt EEC for your own programs
and activities.
Then we'll wrap up with a quick review
to create seamless integration in your programs,
encouraging program staff to assess management
and facilitation strategies in relation to your program
goals that may enhance reasonable accommodations
and modification and facilitation strategies.
As recreation professionals, we recognize
that risk is an inherent and often desirable
component of recreation participation.
It is our duty to identify and anticipate as many
of these risks as possible, to continually evaluate our risk
management strategies, to be purposeful in our therapeutic
use of risk, and to understand that embracing risk
as a necessary component of an activity
does not mean that all risks in the activity are acceptable.
Consider a roller coaster ride.
While riding a roller coaster has a high perceived
risk for many people, the real or actual risk
of riding a roller coaster is statistically low,
pending you meet the baseline criteria
for safe participation.
What is the essential functional threshold
for riding a roller coaster safely?
To determine this, you need to know your industry
and your activity.
You need to know the forces at play,
the effects on the human body, and the thresholds
of your equipment, your staff, and participants themselves.
You may have seen signage such as this at your visit
to an amusement park.
This sign is part of the amusement park's notification
of risk and safety thresholds.
It's posted for patrons to review and determine
if riding a roller coaster would be safe.
An individual can view this information
and decide for themselves, or self-select,
if it would be safe to ride.
In addition to individuals being informed,
staff and ride operators are informed.
And in the event a roller coaster operator
denies a ride to an individual who
is wearing a neck brace, for example, the risk management
decision is objectively and publicly spelled out.
Notice that the signage is not labeled essential eligibility
criteria, though it clearly highlights that participation
may be unsafe or restricted under certain circumstances.
The Americans with Disabilities Act
is civil rights legislation that prohibits discrimination
based upon disability, providing equal access to employment,
transportation, and programs.
As a provider of recreation programs,
the integration mandate of the Americans with Disabilities Act
is important legislation to be familiar with.
It reads as such.
"No qualified individual with a disability
shall, by reason of such disability,
be excluded from participation in
or be denied the benefits of the services, programs,
or activities of a public entity,
or be subjected to discrimination
by any such entity."
The integration mandate goes on to further clarify
that programs must be provided in the most integrated setting
possible.
While many adaptive sport and recreation organizations
offer programs exclusively targeting participants
with disabilities, in essence we offer segregated programming.
It is not the most integrated setting possible.
All public or everyday programs fall within the jurisdiction
of the integration mandate, and must
allow qualified individuals with disabilities
the choice to participate.
There is great value in the barrier-free access
to adaptive recreation and sport opportunities, the access
to adaptive equipment, disability-specific knowledge
and expertise, in addition to peer-to-peer mentoring
opportunities that our programs provide.
The list of benefits our programs provide
and the opportunities we create goes on and on.
The integration mandate is not stating
that we need to stop providing adaptive-specific programming.
It simply states that a qualified individual
with a disability may not be denied the opportunity
to participate in an everyday program.
For example, a qualified individual with an intellectual
or developmental disability cannot be denied
the opportunity to join a community bowling league
as a result of a local Special Olympics organization also
running a bowling league within the community.
That individual has the choice to participate
in either league.
I've been mentioning qualified individual.
And as you may be asking yourself,
don't all individuals with disabilities
qualify for adaptive sport programs?
The answer to that question is no.
Having a disability does not automatically
qualify an individual for safe participation
in all adaptive programs or activities.
The single purpose of essential eligibility criteria
is to define qualified individual
under the integration mandate.
Jurisdictional threshold on the integration mandate
only applies to individuals who can safely
participate in the service, program,
or activity, referenced as qualified individuals.
The integration mandate does not protect those individuals who
cannot safely participate.
Therefore, we may and must discriminate
for safety in cases where participants do not meet EEC.
Let's take a quick example.
We'll take a quick look at an example of discrimination
based upon safety.
You may have seen signage such as this posted at a carnival
or amusement park, requiring that you demonstrate
you are at least this tall but no taller
than this to ride this roller coaster.
This is not discriminating against individuals
with gigantism or dwarfism.
This criteria is discriminating based
upon safety due to the configuration of the safety
restraint system.
Essential eligibility criteria are the essential functional
thresholds for anyone to safely participate
in a program, service, or activity.
EEC must be applied to all potential participants,
volunteers, and staff.
If you are subjectively applying EEC only
to individuals with disabilities,
you are inherently utilizing EEC to discriminate
based upon disability, which is precisely what EEC
is designed to protect against.
Having EEC documented helps avoid
subjectivity and stereotyping.
Subjectivity is demonstrated when
EEC are applied inconsistently, and stereotyping
is demonstrated when quick assumptions are
made about an individual's ability,
with the risk of unfair or inaccurate assessments.
We want to publish and adopt EEC for two reasons.
First, potential participants can review the EEC
and self-select a program they are
qualified to participate in.
And second, when we need to tell someone they cannot
participate, when we say no, we are helping safeguard ourselves
and our organization from discrimination claims.
EEC protect us only from discrimination suits
arising when we deny someone the right
to participate in a program, a service or activity.
If we publish properly formed EEC, then whenever we
deny an individual's participation,
we can point to a published standard
and demonstrate a safety-based rationale for the decision.
If someone meets all other program prerequisites,
we can legally deny someone's participation
only if the individual does not meet the EEC.
And the EEC are essential functional thresholds
for safe participation.
We will talk about the difference between EEC
and prerequisites and their importance in a bit.
Right now, let's take a look at an example of EEC
posted by the American Canoe Association,
as it is written for the activity of paddle sports.
I apologize for the small print, but please
know you will receive a handout with this information,
and it is available on the American Canoe Association
website for your reference.
These EEC are activity-specific, safety-based
essential functional thresholds well-written
in nondiscriminatory language.
Let's read through these, as there
is a bit of language I would like to clarify
at the bottom of the document.
So these EEC are written for participation in ACA courses.
One, breathe independently and not require medical devices
to sustain breathing.
EEC number two, independently maintain sealed airway passages
while underwater.
The ability to independently hold your head upright
without head or neck support, manage personal care
independently or with the assistance of a companion,
manage personal mobility independently
with a reasonable amount of assistance.
Following instructions and effectively
communicate independently or with the assistance
of a companion.
To independently turn from facedown to face-up
and remain floating face-up while wearing
a properly fitted life jacket.
Getting in and out of a paddlecraft independently
or with a reasonable amount of assistance.
Independently getting out from under a capsized paddlecraft.
To re-enter a paddlecraft following a deep-water capsize
independently or with a reasonable amount
of assistance.
And maintaining a safe body position
while attempting skills, activities,
and rescues listed in the appropriate course outline,
and have the ability to recognize and identify
to others when such efforts would be unsafe
given your personal situation.
Notice items seven through 11 have an asterisk at the end.
And the notation at the bottom, which I would like to clarify,
states, to participate in adaptive programs,
participants must acknowledge only the first six
EEC listed above.
Entry-level adaptive programs will
involve teaching and practicing EEC number seven through 11.
I want to take this opportunity to clarify
that this statement is not generic to all adaptive
programs, and should by no means be interpreted as such.
The adaptive programs this notation is referencing
are ACA adaptive paddling courses,
in which individuals have an opportunity
to practice the EEC number seven through 11
in a controlled environment of a pool session
under the close supervision of a qualified staff,
and must successfully demonstrate these skills prior
to participation in an open water program or paddling
opportunity.
The ACA recognizes that an individual
with a disability who is new to paddle sports
or may have sustained a recent injury
may benefit from time to learn and practice these skills.
And they've worked this into providing opportunities
to develop that skill mastery and continue to participate
in additional paddling courses once those skills have
been demonstrated.
Water-based programming adds another element
of risk and safety thresholds.
Let's take a look at another example of EEC.
As an organization that offers waterski programming,
we at Northeast Passage have an obligation
to provide safe programming under appropriate weather
and water conditions with qualified staff and volunteers.
We've established the following EEC for participation
in our water ski programming.
This criteria is derived from instruction guidelines
in the level one adaptive instructor's manual created
and published by the Water Skiers With Disabilities
Association and USA Water Ski.
You may recognize some of the language.
For EEC one through six, similar to what you saw in the ACA EEC,
you've got the ability to breathe independently and not
require medical devices to sustain breathing.
Independently maintain sealed airway passages
while underwater.
To independently hold head upright
without head and neck support.
To independently turn from facedown to face-up
and remain floating face-up while wearing
a properly fitted life jacket.
To get out of a capsized water ski
independently when floating in deep water.
And manage personal care independently
or with the assistance of a companion.
If an individual is unable to demonstrate each of EEC one
through five, the ski lesson will be discontinued,
and we will spend some time working with an individual
to develop these skills.
An individual who is new to the sport
or has recently acquired a disability
again may benefit from time to practice these skills, time
to practice turning from facedown to face-up
in the water.
We may try different styles of PFDs.
Different PFDs where buoyancy is placed differently
among the jacket can be a make or break in someone
being able to meet that EEC.
We may try a type one PFD.
Not all PFDs are created alike, and finding the right fit
can be the key to meeting that EEC.
If immersion in cold water is causing spasticity
that may be inhibiting someone from demonstrating those EEC,
we may recommend an individual practice this skill
in a heated pool with a water safety instructor,
or try again later in the season when the water is warmer.
Just because an individual is not presently
able to meet the EEC does not mean
they wouldn't develop the skill over time.
We've established EEC number six,
managing personal care independently
or with the assistance of a companion,
as our staff is not qualified with the proper training
to safely assist an individual with this task.
But it is more than reasonable to have a companion attend
a water ski event to assist with personal care,
such as feeding, changing clothing, or toileting.
These EEC are posted on our water program description
on our website, and participants acknowledge that they
meet the EEC upon registration.
This EEC is included again in our electronic registration
confirmations, and printed in our water ski
fitting forms that are completed as individuals are receiving
their dry land instruction prior to getting
on the water at an event.
This ensures that all staff have the EEC in hand,
are familiar with it, and are able to apply it
consistently and in a standardized format
at each program.
We ask that individuals redemonstrate EEC one
through five at the beginning of every ski season,
if they've modified their ski or are
trying a new piece of equipment, or if they've
experienced a change in their medical status
since their previous successful water test.
As you begin your activity analysis
to determine what functional thresholds are
essential for safety, consider what it takes to participate.
Getting into and out, what does it
take to get into and out of a paddlecraft?
Is there a particular distance, elevation, or temperature
an individual would need to withstand or tolerate?
Making quick safety judgments, properly wearing the industry
standard safety gear.
Can adaptive equipment or accommodations be used?
What resources do you have available within your program?
What is outside the threshold of what
you are able to accommodate?
And are there height and weight minimums or restrictions
based upon what your volunteers and staff can safely
assist in transferring, or the manufacturer specifications
on your adaptive equipment resources?
Question what cognitive or physical skills, abilities,
or attributes are necessary for an individual to perform.
Consider whether an individual must perform a task
independently, or whether a companion, a staff member,
or a volunteer could safely assist an individual
in the completion of a task.
And utilize resources for additional information,
such as Coast Guard reports or publications
by professional organizations to research
the most likely causes of death or injury involved
in an activity.
For an organization facilitating paddle sport programming,
a review of the 2016 recreational boating statistics
will report the most common causes of fatality
in paddle sport use is drowning, reporting victims who
were and were not wearing PFDs.
The most common cause of injuries, paddle sport
injuries, being hypothermia, with additional reporting
of dislocation, concussion, cuts, bruises,
broken bones, et cetera.
This report also highlights the most
common contributing factors to paddle sport accidents,
including operator inexperience and inattention, weather,
hazardous waters, and alcohol use.
Becoming a certified paddle sport instructor
will help develop your awareness and management strategies
to minimize these risks.
Analyzing the inherent activity risk
and the statistical likelihood and impact of an incident,
should it occur, will help you evaluate your risk management
strategies and determine the essential functional skills
someone needs to participate safely.
Consider the heuristics, or what you know
from training and experience.
Contact Disabled Sports USA or another governing organization
to inquire about incident trending.
Research what other similar organizations are utilizing
for EEC and risk management.
Activities that take place on water and activities
that involve speed, terrain, and exposure
have a higher probability and severity of consequences
in the event of an incident.
Wearing a seat belt does nothing to prevent a collision.
Wearing a helmet does nothing to prevent a fall.
Wearing a PFD does nothing to prevent a capsize,
does not get you out of the boat,
and is not guaranteed to turn you face-up in the water.
There is a high probability of capsize in paddle sports.
As long as the paddler meets all 11 established
EEC for this activity and can perform
functional skills such as independently getting
themselves out from under the capsized paddlecraft,
maintaining a safe body position when floating in the water
while wearing a properly fitted PFD,
and re-enter the paddlecraft either independently
or with the assistance of a safety boater,
the consequences will likely be minor.
An individual who does not have the capacity
to form these functional safety skills
would likely experience severe consequences,
such as aspiration or drowning.
The ability to wear properly fitted industry standard safety
equipment, such as a cycling helmet, a seat belt, a climbing
harness, a personal flotation device designed
to help minimize the severity of consequences
in the event of an incident is essential safety.
As are the necessary cognitive and physical skills,
abilities, and attributes.
With assumption of risk, the aspect of challenge by choice,
we've determined that an individual meets
the EEC for that program, and now the decision to participate
is theirs, that challenge by choice decision.
We have an obligation to inform of the additional risks that
are involved through the inherent participation
in that activity.
So although an individual may meet the EEC,
they may still sustain an injury by participating
due to the inherent risk of that activity.
Your liability waiver likely has language outlining
all the atrocities that may occur through participation
in that activity, but in my experience,
very few folks sit down and read through it completely.
So taking the time to become knowledgeable
of the most common injuries that occur
and the unique consideration of an individual's disability
can help ensure that you're providing
comprehensive information to participants
and preventive risk management strategies within your program.
There is one aspect of EEC that we have not yet discussed.
If an individual does not meet your EEC and is therefore not
qualified to participate, but is allowed to participate
regardless-- in other words, if you say yes when you should say
no, if an individual who is not qualified is allowed
to participate in your program and there is an incident
or harm, an individual may--
an investigation may result in evaluating your organization's
compliance with industry standard best practices,
reviewing aspects of program management, training, adherence
to policy, procedure, and EEC.
The four elements of negligence are duty, breach, harm,
and causation between the breach and the harm.
If we say yes to someone who does not meet the EEC
and they get hurt, then we have proven
two of the four elements of negligence for that person.
EEC are a self-published list of duty,
and saying yes to someone who does not meet the EEC
is per se breach of that duty.
People with disabilities who meet the essential eligibility
criteria may not be denied the right
to participate in an activity.
You must inform of risks involved,
and enable someone to make an informed challenge by choice
decision, having equal opportunity to reach the goal,
to try to circumnavigate the island, summit the mountain,
or achieve certification.
However, meeting the EEC does not automatically
guarantee that an individual would
be able to successfully complete a program,
or complete a certification to reach the intended
outcome of that program.
For example, an individual who meets the EEC to participate
in a kayak instructor certification program
is not guaranteed to successfully complete
all components of the program, and may not achieve the desired
certification.
EEC is about equalizing opportunity,
not about standardizing outcomes.
Equal opportunity does not guarantee equal outcome.
In working to develop EEC, take an opportunity
to review the published EEC that is available to you,
and see what you can utilize and build from.
There are a number of organizations
that have published EEC on their websites, the American Canoe
Association being one of them.
REI Outdoor School has an extensive list of criteria
that they have available.
You may find that there is some content around EEC or program
prerequisites that you could build from.
Appalachian Mountain Club has a list of criteria.
And other adaptive sports programs,
such as DCR's Universal Access Program in Massachusetts
all have posted criteria on their websites
that you can search and review.
Obtaining professional organization membership
is a great way to get to know the industry
and stay up-to-date on risk management
and essential eligibility criteria.
And continuing your education around attending conferences,
taking a course, listening to a webinar,
and acquiring certification training are all really good
places to start when you're determining
what essential functional thresholds are
important to participate safely in an activity.
All properly formed EEC must be safety-based,
functional thresholds, and essential.
They're generally written to be activity-specific.
So the ACA has written theirs regarding paddle sports.
The same EEC is applicable for participation,
whether it's a kayaking class, a stand-up paddleboarding,
canoeing, whitewater rafting.
The same base of EEC is applied across programs.
Editing for simplicity and being mindful that the language
you use is written in nondiscriminatory terms.
So using language like traverse uneven terrain versus
walk over uneven terrain.
Ascend instead of climb, to be able to identify versus see.
Using nondiscriminatory language and being--
again, making sure that everything is safety-based,
is functional threshold, and essential.
So think for a moment.
Can we legally include this EEC for kayak programs
where the only option is to launch off of a floating dock?
Participants must be able to transfer
to a seated position on floating dock
and move from dock into a floating
kayak with minimal assistance from others.
Can we legally include this EEC for this program?
The answer is yes.
The EEC excludes from participation
based upon the unique environmental factors and staff
and participant safety.
You want to develop EEC for your programs
that account for the type of venue
that you are using, operating within the essential functional
safety thresholds of what your staff can accommodate
on a consistent basis, the thresholds of your equipment.
And you can tailor these.
You may have two different sets of EEC
within your paddle sport program.
At this one venue, you may have an extra set
of criteria for this venue.
As you are reviewing published EEC and developing your own,
I encourage you to be mindful of the difference between EEC
prerequisites and program descriptions and goals.
You may find these are intermixed at times.
And if you start doing an internet search,
you'll see that there's a lot of information intermixed.
While prerequisites are important,
they are not EEC, and should be kept separate.
Prerequisites are defined as skills, attributes, or training
that exceed the essential functional threshold
necessary for safe participation.
Examples include setting a minimum age requirement,
requiring a payment of a fee, or having successfully completed
a previous training.
An individual who meets the EEC for paddle sports cannot
participate in a level four class unless they have
successfully completed the prerequisite skills from
a level three class.
Payment of a fee has no impact on an individual's ability
to meet the functional safety thresholds.
You may decide to waive a participation fee to alleviate
financial hardship.
EEC cannot be waived.
Age, in and of itself, is not an essential functional threshold,
but a measure of time in which we assume an individual
will have developed a level of maturity, judgment,
or physical development.
While age is a commonly used prerequisite,
and for valid reasons, it is not EEC.
A volunteer instructor within your programs must meet the EEC
and be at least 18 years of age.
This is a requirement of your insurance company
that assumes an instructor who is at least 18 years of age
has the maturity of judgment to be able to perform that job
task with success.
Other examples.
The United States Power Soccer Association
has set a prerequisite minimum age of five years
to participate or compete in power soccer.
The assumption here is that an individual who
is at least five years of age will
have developed a certain level of control
in driving their powerchair.
You may have activities in your program that have no need,
or no EEC that you are able to identify
due to the inherent safety of the activity.
In this instance, it is tempting for folks to write things
like, the only EEC for this program
is the desire to participate, or to have fun.
And this is not safety-based and should not be labeled as EEC.
For example, one does not need to know--
one does not need to want to mow their lawn
or enjoy moving their lawn to perform the activity safely.
Regarding seamless integration, once someone
has confirmed that they meet the EEC when they register
for your program, you want to have
a system of gathering medical information and a means
of identifying what participants would
benefit from accommodations or outfitting.
What disability-specific considerations
do you want to be prepared for?
Being mindful of what medication side effects,
is there a sensitivity to sunlight
that would affect participation in an outdoor program, seizure
risk, allergy, heat or cold sensitivity.
Being mindful that this information is confidential,
and you don't want to disclose this information
without an individual's permission,
but making sure you have enough information
to make the adjustments in your facilitation and your risk
management plans, and leaving yourself enough time
to prepare for adaptations, taking into account
the equipment you have available and the what ifs of your risk
management plans.
You can restructure an activity and still
meet the needs of the group and the goals
that you had anticipated and wanted to accomplish
as an organization.
In summary, EEC enables objective assessment
about who can participate safely on the basis
of functional abilities, reduces case-by-case subjective
determinations, and thereby helps protect you
from discrimination claims.
If an individual does not meet EEC,
then the risk management decision
is objectively spelled out and documented
if you have posted this EEC in all of your program materials,
on your website, in your conformations,
and made it part of your staff training
so everyone is using it consistently.
If a participant does not meet EEC--
or excuse me, if they do meet the EEC, that individual
gets to decide whether to participate in your program
or not, that challenge by choice decision.
And you want to make sure to inform of risks involved,
and enable that participant to make an informed decision.
I've listed a number of references here
that will be available in your presentation materials.
I encourage you to look through any of them
if you are developing your own EEC for your programs,
and continue to research the types of resources
that people are utilizing within their programs.
If anyone has additional questions following up
this opportunity, I encourage you to reach out.
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