willray

So, off the topic of Linked Troops and committees, I am curious how other units with "Linked Troops", or potentially even "just" two troops out of the same CO, are conceptualizing the division of resources. In our case, if the "batch of new scouts that joined on Feb 1" had been boys, they simply would have gone into another couple patrols in the boy's troop, and there would be no question about equal access to CO-owned (read original boy's troop) resources. If BSA National had said "girls can join boys troops as separate single-gender patrols", the exact same thing would have happened and they'd still have equal access to all of the boys-troop/CO resources. However, since we were forced to start a separate unit to accommodate the girls, for some reason we're thinking of their finances and resources as separate . I'm not sure why we're thinking that way. I'm not sure it's the wrong way to think of things, but I don't believe we've actually thought deeply about what model might actually be right, or about how we've chosen to think about this. So - has anyone else who's in this situation of two troops under one CO, given much thought to exactly why you're tightly coordinated or not tightly coordinated, and how this plays into questions of access to resources/funds/etc? I think that for my part, I see our girls' troop eventually heading in the direction of significant independence, and so I expect that colors my thinking regarding "their" resources vs "our" resources, but I'm not really sure I wouldn't see a reason for distinct resources even if our girls' troop was primarily a legal fiction to enable having girls patrols that could participate alongside the boys patrols.

With the proviso that even for a Linked Troops model, BSA still requires that the committee members submit a separate Adult application to be a member of the 2nd troop's committee (even though it's the same committee). As a result, there appears to be no actual paperwork difference between two "Linked Troops that share a committee", and two "not Linked Troops that have separate committees with all the same individuals on them". Somehow, to me, this seems daft.

Which works great, until it's not updated, or not available when it's needed. Not keeping the data at all, would be even simpler, and also would work great, right up until someone decided to sue the organization because they didn't have it. I'm not sure where others have difficulty "chasing down" the BSA forms. We've got an adult leader who's responsible for the forms-binder. We don't accept permission-slips for campouts/activities unless there's a current medical form in the binder. End of chase.

I suppose it comes down to whether you're more concerned about a targeted attack against you as an individual, or general leakage of your data "to the public" in a bulk sense. I agree completely, if someone close to you wanted the data on your medical form, the social-engineering/physical route would almost certainly be far easier than breaching a "secure" database. On the other hand, in aggregate, I guarantee that your EMR data is not protected in any meaningful way. I do computing research in the life sciences. I do my utmost to insulate my lab from Personal Health Information, and we kick anyone who even looks like they might have PHI back out the door before they even get the chance to introduce themselves. Even so, I'll probably see anywhere between a half-dozen, and a few hundred records hemorrhaged from protected databases go floating by on any given day, and this is with both all the "protections" built into the system, and us trying desperately not to look. I'm curious - I've been approaching the discussion from the point of view of general leakage, rather than a targeted attack, so I haven't thought the targeted attack possibility through. Under what circumstances would you envision someone close to you wanting to specific access to your health data, who didn't already know what they were going to find? It's a serious question - the only thing that comes immediately to mind for me, is someone who's actually intending to do you harm and wants to know allergy information. I'm sure there must be other scenarios.

My point was that in the end, this probably generates as much, or more paper use than BSA's paper forms, and done ad-hoc rather than in a principled regular fashion, has all manner of failure modes, from failing to have printed a form for some scout, to greater lossage and leakage of the ad-hoc printed forms. "Give us your form at the beginning of the year, we store it in a binder that goes on every campout" may be primitive, but it actually provides a simple solution to a lot of problems.

Yeah, I thought about trying to be more precise, but decided it wouldn't actually help. Anyone who thinks HIPAA, or any other legislation or technological system actually prevents their data from being accessed inappropriately is living in a fantasy world. The truly silly thing about all of the hullabaloo over data privacy and security (all the way down to website cookies) is that everyone should have learned all that that they need to know about this by the time they were done with Kindergarten: If you want something to stay secret, don't tell anyone. If you tell someone something, then everyone is going to know that something, and the best that you can do is go crying to mommy afterwards. Jimmy dropped a frog in Tina's back pack, you take medication X, or that underwear you bought the missus was less than scout appropriate, if somebody knows (and if you did it online/electronically, at least one other person knows), then you can pretty much bet that everybody knows. Sure would be nice if that wasn't the case, but getting all bent out of shape because someone else didn't treat your stuff the way you wanted it treated, is pretty silly. Don't want them to mistreat/lose/sell/give-away your data, don't let them have it. It's the only actually reliable solution.

You might want to look at the frequency of reported data breaches for the electronic systems before you trust them too much. And that's just the reported ones. Living on the side of the fence that has access to those databases, and can watch who else has access and what they're doing, I can assure you that there are an order of magnitude more unreported breaches than reported ones.

I dunno - I have a number of modern tools with laser-engraved information that is already completely unreadable due to minor surface wear, and a lot of century-old tools where the stampings can still be read. There are certainly advantages to laser engraving - like density of the information that could be provided, and the fact that the tags could easily be double-sided if they were laser engraved, but, I'm not sold on its durability.

I'm not big on the tree-killing aspect of paper, but GSUSA pretty much relies on the girls never being much further than across the street from a starbucks where someone can access the required information electronically. This doesn't work so well for BSA troops that can be several days' hike from the nearest cell or wifi signal. Additionally, as has been pointed out, paper is fundamentally more secure than online databases. This is part of why the Security portion of HIPAA rules only apply to electronic records. Finally, and whether this is appropriate could be argued, it seems like BSA organizationally thinks that "starting over" every year is actually useful to the mission. It appears that they believe that regularly reviewing one's health information, helps promote introspection about that "physically strong, mentally awake" health part of scouting.

While ERs cannot deny service, or provide different service for the uninsured, it's not unheard of for the admitting process to spend time trying to determine insurance carrier/etc status when this is not immediately clear.

GDPR is absolutely going to be a show worth stocking up on popcorn for. I'll bet folding money that they'll find a way to back themselves into a regulatory corner such that it's impossible to fix the problems with the law, without violating the law. None of which is to say that I'm not a staunch supporter of individual privacy - I simply believe that a person needs to take responsibility for their own privacy, and that only a fool would think that they can actually achieve privacy by legislatively mandating someone else to maintain it.

I guess you're right about the insurance policy information - that's probably overreach, since it's not really necessary for risk mitigation. Of course, if you'd prefer to go in the slow-line at the ER if you actually need medical assistance, it appears that the form is perfectly happy to accept "None" as an answer. The emergency contact information perhaps might count as overreach as well, though at least to me, that's less obvious, and I suspect any reasonably responsible entity would insist on collecting that as a condition of participation even if they didn't collect health information. The rest of the information is pretty much required by YPT - I don't think you're going to find many units willing to risk letting someone participate with youth on an activity, if they don't know your name, age, and in today's world, declared gender.

There is no need, other than perhaps wanting to improve your chances for survival in an emergency, to provide any information on the forms that would only be useful once you made it to an ER. If you feel a need to have that ER-relevant information with you on a scouting activity, I assume you also feel a need to have it with you when you're doing things other than scouting activities, so something like the suggested medical dog-tags makes sense: They're carried on the person, so they're actually on-site when needed, rather than locked up in a car back at the trail-head, they're not exposed to scrutiny unless necessary, etc. Other than in compliance with any state or federal laws that might mandate its acquisition and maintenance by units/camps, there's simply no reason to record any of that information on BSA forms period. The BSA forms exist so that the unit can manage risk to you, and to the rest of the participants in an activity. If the information happens to help at the ER, should an emergency occur, that's great, but, that's certainly not their primary reason for existing. If there's something you'd like to keep between you and your doctor, and it doesn't affect your risk or the rest of the unit then by all means, feel free to omit that information. If whatever it is, does affect your risk, or puts others at increased risk, and you're more worried about whether you can trust your fellow scouts and scouters than those risks, please, don't attend.

And if someone had answered "Yes", your proposed ad-hoc procedure would have either resulted in a probably-fruitless attempt to memorize the person's details and share them with enough people so that someone remembered in the case of a problem, or the generation of un-standardized and untracked paperwork that probably would have failed to capture all the relevant information, both possibilities generating enhanced risk, and decreasing the likelihood that the information would actually be "kept private". On the other hand, given that everyone answered "no" and the procedure that they followed, the paper records that you're concerned about being abused should contain, by definition, no information that could be abused!

Unless BSA decides on a policy such that they bar persons from any activity where any pre-existing medical condition could possibly affect their safety, or the safety of others around them, then the answer is unequivocally yes. Plenty of people are fit to participate in activities where they are nonetheless either at an enhanced risk to themselves, or pose a risk to those around them if appropriate precautions aren't taken. It is the height of irresponsibility to ask that the unit deal with the consequences of those risks without providing them adequate information with which to mitigate the risks. And yeah, that's un-scoutlike. If the forms contain information that is necessary to help mitigate risks, or deal with emergency medical issues should they arise, then also, unequivocally yes. If the forms contain something other than that information, I would argue that whatever that content is, it is irrelevant and ought to be omitted.

Ummm... ... Per HIPAA, if BSA was a covered entity, Awanatech reviewing medical forms prior to an activity would be permissible, and your son/daughter telling someone in another patrol about their patrol-member's food allergy would be a sue-able, mandatory-consequences-inducing act. That's what a legislated solution will get you, so be careful what you wish for. More interestingly, what I believe I'm seeing is a greater need for safeguards for units, so that they can protect themselves and their scouts against medical-safety issues induced by paranoid scouters who would rather endanger youth and other unit leaders, than disclose medical information that is important to the unit's safety and ability to operate.

The medical history information is not about whether someone is fit or not. It's about whether the unit is prepared for whatever medical complications the person may bring to the activity with them. If you believe that it's fine for you to come on activities with my unit without informing us that you have a communicable disease that requires extra attention to personal-protective equipment if someone must assist you medically, while you are allergic to things that we need to know in advance for planning or for maintaining your safety during the activity, or any number of other medical issues that impact whether we can conduct a safe activity for everybody including you, then I'll invite you to not participate. The medical information forms are for information that we need to know. If we don't need to know it, because it can't affect your care, or our safety we don't need to know it. If it can affect your care, or our safety, then because we will be the ones administering first aid, we need to know it, and a doctor's permission slip is not adequate.

I certainly try to be! I've made no assumption that Awanatech is a qualified medical professional. HIPAA contains no requirement that only qualified medical professionals have access to a person's medical data. That's simply not what the law is about, what it does, or how it works. Now, what HIPAA would do, is make it a finable offense subject to mandatory reporting to the federal government and a defined punishment and sanction program, if your child told a member of another patrol, that a member of his or her own patrol had a food allergy. It's not clear to me how a "qualified/not-qualified" checkbox provides the information necessary for a unit to make well-informed decisions about how to deal with a person's medical status in the context of an activity, unless you're proposing that BSA bar anyone from participating in any activity unless a Dr. is willing to certify that there is no possibility that any medical conditions that person may suffer, will have zero effect on the activity. People will encounter situations during activities where their medical conditions have bearing on their treatment. That shouldn't bar them from the activity, but it would be exceptionally un-scout-like to insist that the unit should suffer the burden of trying to assist them in the absence of information that would be helpful in improving their care. I certainly don't have a good answer to the problem, HIPAA certainly isn't it.

Again, I believe someone without knowledge of what HIPAA actually is or does, is advocating for something they don't understand. What you are advocating for, does not prevent what you want it to prevent: assuming Awanatech is the cognizant individual with responsibility for the health information and medical-preparedness of the unit on an activity, he or she would be allowed by HIPAA to review the medical forms. Personally, I kind of like the idea of having everyone carry their necessary medical information on their person, but I am not sure whether that addresses whatever legal requirements/regulations regarding camping, to which BSA feels they're required to adhere.

The fact that all GPS units you have used include navigation features, really doesn't change what a GPS is, or, alter the fact that there actually are GPS units that provide nothing other than the unit's current coordinates. YOU ARE HERE is all that GPS provides. The rest is add-on features of whatever device you're using. That being said, I would argue that if the scout is finding, and following the route, using the GPS (that is, figuring out the route, entering the waypoints, and then following the route based on GPS direction-to-next-waypoint functionality), the would be meeting the expectations of the requirement. If the scout asked the navigation system to find the route and create the waypoints, and then simply "went along for the ride", following the instructions from the navigation system, I would not consider that meeting the requirement. At some point one's got to ask oneself what the point of the requirement is. I'll argue that it's probably about asking the scout to do something or learn something that will help them be a more functional member of society, with life-skills that are probably a bit above what they would be required to achieve if they weren't scouts. Tapping their ear-bud and saying "Hey Siri, take me to Chick Fil-A", and then following the voice directions, wouldn't appear to qualify. Other analogs of the same process that equally do not involve the scout finding and following the route, would seem similarly inadequate.

To my thinking, it comes down to whether either bystander-first-aid providers, or first-responders could use the information on the form, or on dog-tags, to more appropriately provide care. I see absolutely no reason to provide any medical-history information that doesn't impact caregiving decisions in the field or in an ER. In the case of our incident, I think everyone was grateful that we had information that allowed us to not go into full panic mode. Certainly the scouter could have omitted all information from their medical form and would still have received adequate care, but I think it's questionably loyal, helpful or friendly to omit medical details from your form that would serve to modulate the rest of the troop's panic if you suffer from some lesser malady that persons with only basic first-aid training could reasonably mistake for something more serious in an emergency situation. It sounds like your epilepsy doesn't fall into that category.

That seems like a responsible way to arrive at the right conclusion. Hopefully if they ever start to diverge from that, you can nudge them back in the right direction with some well-placed questions! GPS units tell you where you are. Compasses tell you what direction you are facing. Both require maps, and being able to use the information regarding where you are, or what direction you are facing, to find and follow routes. It seems disingenuous to ask a computer built into navigation system, to use the maps built into a navigation system to find and follow a route, and to then call that "the scout" finding and following the route. If asking a device to complete a requirement for you constitutes completing the requirement, then handing in a Better Homes and Gardens illustrated cookbook, satisfies the 2c "Show which pans, utensils, and other gear will be needed to cook and serve these meals" requirement.

No, that's a different sentence. The first sentence requires demonstration of how to use a handheld GPS unit, GPS app, or other navigation system. The second sentence requires using a GPS to find your location, a destination, and a route, and then following the route. A GPS is not a navigation system. Many integrated navigation systems include GPS units, and many GPS units now include navigation systems, but they are _not_ the same thing. Words mean things. Just like if the first sentence said "use a GPS system, compass and map, or navigation system to do X", and the second sentence said "Use a compass to do Y", they'd really mean specifically compass, and not GPS or navigation system for the requirement in the 2nd sentence, in this case they said GPS. A GPS tells you where it is physically located. Period. Ummm... "Find your location, a destination, and the route you will take..." sure sounds like finding a route to me. Through all of history, "finding a route" has meant sitting down with a map, and planning out the path on that map that will take you from point A to point B. I see no reason to assume that the meaning of the language has suddenly changed.

I would suggest that it's appropriate to note that the requirement says to "Use GPS" - not an embedded GPS-enabled navigation system. The requirement says to use the GPS to find and follow the route. It does not say to use the embedded navigation system in a TomTom navigation system, or in Google/Apple's Maps/etc, to find the route. Clicking the "directions to..." button on a GPS-enabled navigation system is to "Use a GPS to find and follow a route", as "phoning in an order for takeout" is to "planning and preparing a meal"...

We're a bit far afield, but I'm going to guess that you use EPIC in a "normal" practice or hospital setting? If you're managing to make it even remotely useful for clinical trials/research data retrieval, you've managed to do something that's eluded Nationwide Children's and OSU's medical centers! If we hadn't had access to medical history information, we probably would have felt obliged to hit the panic button on our Garmin InReach and called in a life-flight. Having a few details from the medical history helped us decide that we could responsibly go with getting the individual to personal vehicle and bugging out in the direction of an ER. To be sure, we rolled the dice on this one. Having been dead before, I take cardiac symptoms rather seriously. If we hadn't had someone saying "look here at this, it's plausibly X instead", I would not have been comfortable with that risk. I don't know enough about epilepsy, and particularly your variety, to know whether there's something different that should be done for first aid for it, compared to other medical emergencies that might look the same to someone giving first aid. If there's absolutely no difference in what should be done for you, and anyone else who happens to have a non-epileptic seizure, and whatever information that would help EMTs is on your dog-tags, then I don't see how sharing information about your condition would be helpful on your medical history. Dog-tags might be a good solution. I'm not well-educated on what information can be encoded on them, what is required to access it, and whether there are any impediments to retrieving that information in areas without cell-phone/wireless coverage. It's also not clear whether they satisfy the requirements of whatever state laws that BSA apparently feels they need to satisfy, regarding camping regulations. Certainly, if they carry all the necessary information and satisfy legal requirements, having the person's medical history on the person would be a lot more helpful than having it in a binder of forms locked back in the troop van at the trailhead!