Medical Forms

[Owl62]

Does anyone know if there is an official BSA policy on the handling, storage, and security of the medical forms that members of the BSA are required to submit?

 

These forms are very similar to medical history forms that are maintained by regular healthcare providers and organizations which are required to comply with very specific procedures for the handling, storage and security of them.

 

From what I can tell, BSA health forms are not handled in any standard or secure way and this concerns me and others.

 

 

[Bob White]

The BSA and scout units (and similar organizations)are not required to comply with the new HIPAA regulations.

 

That does not mean the information should not be treated with confidentiality by the unit leader. The best thing to do is to follow the recommendation of the BSA and that is to have the current health record or physical on hand (depending on the event) but to make the youth and parent responsible for storage and taking of all prescription medications.

 

That way the medical form can be stored in a sealed envelope unless needed to be accessed for emergency medical treatment by a trained and licensed medical professional.

 

There are those who will argue that the leader needs to know the content of the health form, but that is simply not true. The leader needs to know those health needs for a scout that the parents want to divulge. While I agree the parents have a responsibility to inform the leader of activities and conditions that could negatively affect the scout, they have a right to privacy and confidentiality when it comes to their child's specific health records and conditions.

 

Insist on current information and strongly recommend that parents keep you informed as to activities or conditions that could be harmfull to the scouts health, but stem your curiosity about an individual's private health information until it is required for emergency medical treatment.

 

Bob White

 

 

[Fat Old Guy]

HIPPO (or GIRRAFFE) doesn't apply to BSA.

 

This question has come up here in the past. Who do you want to have access to the records? Who needs access to the records? Most units don't have the luxury of having a doctor or nurse who tags along with the records under lock and key.

 

If you or a Scout is diabetic, shouldn't anyone who is a leader on an outing know? If not, how are people supposed to respond properly if something happens?

 

 

[Fat Old Guy]

Sorry Bob, gotta disagree with you there. The right to privacy ends when there is the potential for someone's health or safety being endangered.

 

I can see a situation in Bob White's troop now. Johnny Jones is diabetic but his parents are embarassed to tell anyone. On an outing, Johnny goes into "insulin shock" and keels over. The SM says, "Hey, what's wrong with Johnny?" but no one knows and Johnny doesn't respond. The SM says, "Hey, let's look at the medical form!" but Bob White blocks his path saying, "You are not a properly trained and licensed health care professional! You may not look at that form." They are out of cell phone range and Johnny goes into convulsions and dies before they can carry him out.

 

If the SM had been allowed to look at the records before hand, he'd have known that Johnny's pancreas had crapped out and he could have asked the parents what to do if Johnny keeled over.

 

There's another issue, if someone from the unit doesn't check the medical forms for completness before you leave for summer camp, you risk having a Scout being turned away at the gate.

 

 

[Bob White]

I have a friend who is diabetic. He has been responsible for his own medication since he was of cub scout age. I have known him for over two years and never new he was diabetic and yet it never had an effect on his condition.

 

Now that I work in the same office with him he told me, and showed me where he keeps his snacks if he has a problem. And yet, I have never seen his personal health history or medical form.

 

I had a scout who was diabetic and took his own insulin, and I knew what to do because his parents gave me the info I needed and yet in five years I never needed to look at his medical form. But I had it with me in a sealed envelope in case I needed it.

 

The bottom line is the question that was first asked was about what security is required, technically, none. That fact that the forms are similar is irrelevant. HIPPA is not about the forms but the transfer of information on the forms.

 

By the way FOG, I fnd your story innane and personally offensive. I have never acted in such a manner and have never seen any leader act in such a manner. I give you a C- in creativity and an F in truth telling.

 

Bob White(This message has been edited by Bob White)

[KoreaScouter]

Bob;

 

Time for a reality check. Your personal knowledge of your friend's situation is probably not a representative example of what unit leaders have to contend with. I don't have one "friend" -- I have 45. And, many have allergies, medications, or some other health issue that we need to know immediately if something comes up. Not when somebody else remembers where the sealed envelope is. Or worse, when you open the envelope and see that the parent forgot to sign it, in effect not authorizing treatment.

 

Everything you argue for, that is, parents divulging health information a leader needs to know, insisting parents keep you informed on activities their sons shouldn't participate in, are all listed in one place -- the Health History form. I destroy a number of applications when I rip the Class I off the back for parents to re-accomplish when health history changes or the Class I's over a year old.

 

Having the families seal the forms in envelopes is a technique. It's not a technique we use. Our Health History forms are stored in a flourescent-colored 3-ring binder, inside clear sleeves, filed alphabetically. The leaders at an outing are always aware of the location of the book -- also contains our insurance policy.

 

Guide to Safe Scouting, Section XI, Medical Information, Class 1. (Bold type, denoting BSA policy): "Den leaders, Scoutmasters, team coaches, and crew Advisors should review these and become knowledgeable about the medical needs of the youth members in their unit. Forms must be updated annually. They are filled out by participants and kept on file for easy reference."

 

Owl62; if you don't have a copy of the latest GTSS (orange cover), recommend you get one. Section XI starts on page 48.

 

KS

[Fat Old Guy]

Wow! I must have jumped to another quantum reality! Bob White actually expressed an opinion in conflict with published BSA policy. The Second Coming is just around the corner!

 

BTW, you may give me bad grades but that story reflects what you recommended and I see that the Scout Law doesn't apply to you.

[Bob White]

Nothing I said was in violation of any BSA policy or guideline. Adult leaders can know the needs and characteristics of a scout without having access to the confidential medical information contained in a personal physical. The BSa has made it clear in the G2SS that a scout and his parents are responsible for medications. that being the case unless a problem arises there is no need to even know what the scout is taking. That is private information unles the scout or his parents choose to release it.

 

There is nothing inthe recomendations or policies of the BSA that require the leader to read the personal medical information until medical aid is required. Whether or not a scout takes Adderall for an ADHD condition is nobody'd business unless the parents choose to share it. Seeing that the scout takes his medication is the parent's responsibility not the scout leader's. If the parent chooses to inform you of his condition so that you can adapt teaching techniques to better serve him is a parent's choice not a mandate.

 

As a leader you might have a curiosity about each scouts personal medical condition but that does not give you a right or priviledge to invade his privacy.

 

All the BSA reqires is that you have current health information on hand.

 

A leader can ask the parents direct questions such as, "is there anything on this health form that I should know about in advance in order to keep Mark healthy?" but if the parent says that there is not, then there is no need anyone to read the form. You can ask the parents if it would be okay for you to read it. But if they say it is only for medical treatment then you really have no authority to invade their privacy.

 

A good example is at Philmont Training center where Faculty used to collect the medical forms. That is now done by a licensed nurse for reasons of confidentiality.

 

4 scouts of 45 personal info is just that, personal, and it should be treated as such.

 

Bob White

 

This was written, as was my first response, without the need to include any other poster or criticize anyone. I would hope that responses to this post would follow the same example.

 

 

[NeilLup]

A far more likely problem is that the medical form IS available but the parent didn't list a medical condition or didn't want it known.

 

On an adult leader training course a long time ago, we had prepared patrols based on geography, diversity, medical conditions, etc. One married couple showed up and the husband demanded that he and his wife be in the same patrol. He said that his wife was essentially blind. When I looked at her medical form and showed him where it said nothing about her vision, he said "You have no need to know that!"

 

I think that we all know of boys who have ADD or ADHD and may be on meds for it where the boy or parents choose not to list it on the form.

 

It's a tricky problem. The book of medical forms properly safeguarded is a good approach, but in a real emergency, it can be 10-15 minutes away or more. Similarly, limiting it to adults can be wise, but it is permitted to have a patrol take a patrol hike or even a patrol camp with no adults present. In that case, the boy leader needs to have information. But how do you account for the possibility that the boy leader may be the one hurt?

 

Probably the wisest course of action is to identify well in advance any really serious medical conditions (like a bee sting or peanut allergy) which can cause acute, rapid problems and make awareness of them a general thing together with how to treat them should it be necessary. This can be explained to parents and to the boy as a safety measure. In the case above, an epi pen may be appropriate. A Boy Scout may be able to handle this and treat himself but is that a reasonable expectation for a Cub Scout? Perhaps a parent may be required to be present. More chronic conditions can be handled with the book of forms, etc.

 

But it also is wise to have a unit first aider who has reviewed the forms in advance (adult forms too) to identify in his or her own mind people who might have problems to be prepared in a non-intrusive manner. On a recent Wood Badge, among participants and staff, there were eight people with diabetes. So we were prepared.

 

And then a serious discourse on "A Scout is Courteous" and "A Scout is Kind" and on the obligations which knowing private information like this places on the persons (adults and boys) who have access to the information.

[Fat Old Guy]

" Adult leaders can know the needs and characteristics of a scout without having access to the confidential medical information contained in a personal physical."

 

Let's see . . . G2SS says to review the forms but Bob White says that we don't need to actually see the forms.

 

Stop making up the rules as you go Bob White. Follow the program, that's the only way to deliver Scouting.

[Bob White]

So addressing the question without taking shots at other posters is not possible?

[FScouter]

On the health history form, parents are asked to disclose any condition that may affect the participation of their boy. When they complete the form and hand it over to the unit leadership, certainly they expect that the leadership is going to read the form and thus be informed. Were breaching our responsibility if we dont read those forms and keep informed and up-to-date. I see liability issues if Mom provides information about her sons medical needs and the unit leadership chooses to ignore it, claiming confidentiality.

 

Medical information shouldnt be public knowledge, and should be kept reasonably confidential, but that doesnt mean the unit leadership needs to be kept in the dark too.

 

[Bob White]

Nowhere have I said that the leader should be kept in the dark or that parents did not have a responsibility to share information that might be needed to insure their childrens well being.

 

But a parents responsibilities are different than a parent's or individuals rights. There is no such thing as a scoutleaders right to personal medical information. The things you need to know are only those things that a parent chooses to share. Not everything in a medical form is life threatening but it certainly could be personal, the only reason for the form is for emergency treatment.

 

You want to see it only because you have always looked, but that doesn't make it right.

 

Bob White

[NeilLup]

Whoa, fellow Bob White,

 

There's a line in your post which really bothers me.

 

"The things you need to know are only those things a parent chooses to share."

 

I know of a case where a parent chose not to share that

 

1)Their child was on serious medication for ADD/ADHD

2) For the weekend of a Scout campout, the child was being put on "vacation" from the medication

3) The parent chose not to tell this "because then you wouldn't have taken my son."

 

The Troop was going to a remote camp involving a 10 mile hike in. The boy went bonkers at the remote camp due to the lack of medication combined with long, hard physical exertion and needed to be physically restrained until he could be returned to the base camp and home. The Scout leader had no idea what had happened to the gentle, respectful boy whom he knew from meetings and other campouts.

 

If a Scout leader is expected to assume parental responsibilities, then that I would suggest that the Scout leader needs to know what the parent knows about acute conditions which might affect mood and behavior and/or emergency treatment. There certainly is no need to know everything about the boy but there is a need to provide reasonable first aid information.

 

If I'm a volunteer, I have no desire at all to deal with parents playing "I've got a secret" where their son is involved. Or for that matter for themselves.

 

Privacy is one thing and should be appropriately guarded. But keeping information secret from trip leaders is something else.

 

By the way, there is an area where I understand that HIPPA can impact with Scouting. Our medical forms should include not just permission to treat but also permission to receive medical information. I heard of a recent case where a Scout was brought into an emergency room with an injury with appropriate permission to treat forms. The ER people went right to work. However, when the SM asked "What is happening?" he was told "We can't tell you. You have permission to treat forms and we are treating him. But you aren't his parent and your forms don't give permission to receive information. So under HIPPA, we can only give information to the parents."

 

Never a dull moment.

[saltheart]

"There is no such thing as a scoutleaders right to personal medical information."

 

If that were the case, in today's litigious society, in an environment wherein the adult leader is, indeed, responsible for the care of, wellbeing of, and health and safety of each and every Scout in his charge, just how many of us would want that liability rested upon our shoulders? That's got to be one of the more outrageous notions put forward that I've ever heard in Scouting.

 

While we may very well enjoy the Scouting environment in which we can hike and fish and camp with the boys, and help them to grow into responsible, thinking young men, part of that charge is the responsibility we each take upon ourselves to maintain the child's health and wellbeing, wherever we are, under whatever circumstances, at any time. This job, volunteer though it may be, does not come without liability. And for an adult volunteer, in any organization serving others, children or not, knowing exactly what he or she is dealing with in those in his care is of the utmost importance, doctor, nurse, or not.

 

Would I take upon myself the challenge of being an adult leader in Scouting and the liability that comes with the territory if I did not have access to knowledge of what I'm dealing with? Absolutely not. None should be placed in that situation. Medical forms provided by the BSA for use in Scouting provide far more than just medical information. They provide emergency phone, names, and addresses. They are not separated. While I may not understand that exact parameters and circumstances of a given medical condition, I do feel I'm deserving of the knowledge that it exists among my charge...just in case. The entire Scouting world within my immediate vicinity does not need to know. But if I'm responsible for the care of the child as the adult leader in the absence of the parent, I do deserve to know.

 

Otherwise, the liability in this world is just too great. That's the reality. And I wouldn't want the job.