Aquatic Safety for Populations with Special Healthcare Needs


Nine million US children under the age of 18 (13% of that age group) have some form of special healthcare need. The Americans with Disabilities Act was amended in 2008 to provide easier access to the protections afforded to people with disabilities. In general, recreational facilities are subject to the act and must implement reasonable considerations for people protected by it. Further amendments in 2010 provide specific physical access requirements for swimming pools. However, studies show that children with developmental, physical, psychological, and emotional disabilities have higher rates of injury, a fact which can create an imbalance between being inclusive and accommodating and remaining safe for all who wish to use high risk areas like the pool.

Individuals with special healthcare needs are like everyone else in wanting to participate both in recreational swimming and structured programming. Safety for and inclusion of all individuals begins at the membership desk. The JCC should ask every member, program participant, and guest if there are any medical conditions such as seizures, autism, insulin-dependent diabetes, cerebral palsy, severe hypertension, or asthma of which the staff should be aware. (The wording used is important – you can use a reminder using such as but you cannot specifically ask if someone has a disability). The form should ask each participant what, if any, special accommodations are needed. Everyone should be offered a tour of the facility to familiarize them with access and offerings.

The creation of an accommodation plan, if necessary, should include the appropriate departmental staff. All staff should be trained to understand and assist individuals with special healthcare requirements. About 80% of the youth who have disabilities in our country want to participate in normal programming. The JCC should provide choices that allow for each individual’s preference without any stigma, including the 20% who wish not to be in general programming,

JCCs should regularly educate both membership and staff regarding accommodations necessary for individuals with special healthcare needs. Such communications should highlight a person’s uniqueness and abilities while encouraging an atmosphere of acceptance and personal communication with program staff. Lifeguards should remain vigilant for all swimmers but should take note of any who display a lack of skill, appear to have healthcare challenges, or inform them of special limitations. Lifeguard ratios should increase even during regularly-scheduled times when the number of high-risk individuals (including those with special healthcare needs) rises. Aquatic staff may need to re-enforce pool rules with certain individuals and may need to train some to stand up when they find themselves in trouble. All members and program participants need to learn to “Stop, Look, Listen” when a lifeguard blows a whistle.

Other entities that use JCC facilities to serve this population should be required to provide certificates of insurance, hold-harmless waivers, indemnity agreements, and a facility agreement that contains:

  • Specific day, starting time, and duration of event
  • Area of pool desired and whether the space must be separated or if it can be shared
  • Average and maximum number of participants
  • Ratio of partners to participants; distinction should be made between water watchers on the pool deck and swim buddies in the water
  • Annual health form updates; these should be reviewed by the JCC to determine potential adjustments in lifeguards or instructional staff
  • Partner staff should communicate to the JCC lifeguards on the day of the activity if there have been changes in any patient’s health conditions

One in five Americans has a disability so preparing your JCC and lifeguarding staff to provide a safe and inviting environment is a needful way to serve your membership and community.

Please call us at 800-463-8546 to discuss this or any other risk management safety tip, or visit our web site at to learn more about JCC risk management issues.


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