Annual Health and Medical Record/Medical Form - policy against digital ?

[Harold123]

Hello

I have a scenario where I feel we need to move into the modern world with the BSA "Medical Form".    One of our scout Parents, who is in charge of maintaining physical copies of all the forms, recently had a family emergency which prompted her to depart the state for extended time frame.   For all intents and purposes, she is not a "Unit Leader" (important to note, please see attached image).   She is a volunteer parent, and merit badge counselor.

With that said, we recently had a camping event in which the physical Form C was required to be presented at Camp check-in, in accordance with past practices.   However the only person "holding" this form was the above parent volunteer, who was now out of town.   the Troop had a mini panic attack and quasi emergency as a result.  We realized having one adult as the "keeper" of the forms was single point of failure.

Ideas:

1.  When scouts get their Form C signed by their doctor/medical provider, have TWO forms signed.   One form (call it "Scout copy") is kept at the scouts house, by the scout, and one form is kept at the "Form Keepers" location ("master copy").   However the form keeper/adult volunteer is to MAINTAIN these master copies and NOT open up the file to retrieve forms each time a camp occurs.   For camps and other activity, the youth HIMSELF brings the "Scout Copy" (indeed, with the doctors original signature).  This also builds a sense responsibility and accountability for the youth.   The adult volunteer "form keeper" will continue to review forms for expiration and remind youth members to keep things up to date.

2.  Scan the Form C into a PDF and email them to the "Form Keeper" adult volunteer.   The original remains with the youth, which he brings to camps/activities as outlined in #1.  This "digitizing" of Form C appears to be in conflict with the BSA guidance that Records are NOT to be digitized, scanned, sent by email, or stored electronically by unit leaders.  However is a parent volunteer considered a "Unit Leader."  If not, then I see no issue here, as no "unit leader" is digitizing the records.  Sure, is this a "loophole" ?  Maybe.  Maybe not.  We are complying with the guidance (versus rules) pushed out by BSA.

The form keeper, now with PDF copies, can continue to review and check expiration dates and remind scouts to keep things up to date.

Thoughts, ideas ?

Thank you

* Note:  BSA themselves says the Medical Form is not subject to HIPAA.

Moderator Edit: Adding the source link to content below. ~ RS

https://www.scouting.org/health-and-safety/ahmr/medical-formfaqs/

 

Edited September 17, 2020 by RememberSchiff
Added source link -RS

[RememberSchiff]

@Harold123  on behalf of moderators of scouter.com welcome.

[CynicalScouter]

First, welcome.

Second, BSA practice is for the committee to have two registered adults for this.

The Committee Secretary is to keep the unit versions of the form. ("Work with the outdoor/activities coordinator to assemble the medical and insurance binder for the Scoutmaster to take on each outing.") and the outdoor/activities coordinator ("Work with the secretary to assemble the medical and insurance binder for the Scoutmaster to take on each outing.")

Unregistered adults should NOT be in charge of this. This is just bad practice.

Third, HIPPA aside (and if there's one law that has been grossly misunderstood in the last 6 months, it is HIPPA and who it covers) do NOT scan it. Don't. Don't. Don't. It is just too fraught with peril and panic on the part of parents who will misinterpret HIPPA to think you are doing something wrong. Just. Don't.

Fourth, as for "loopholes" ask yourself this: if it is wrong for you as an adult leader to do something, does it make it any better to direct a non-registered adult to do the wrong thing for you? Answer: No.

What my unit does is this. There is an event binder that is made up of copies of the A/B/C for those scouts and leaders who are going. This is in the hands of the Adult Leader/Scoutmaster. There is also a Troop binder with copies of the A/B/C for all registered adults and scouts. This is held by our Medical Forms person who is a registered adult leader/committee member.

We do NOT scan unless it is an absolute emergency (read: the event will be cancelled or a scout will be forced to go home). The Medical Forms person back home could, in that emergency, scan and email. We've never had to do this.

 

Edited September 17, 2020 by CynicalScouter

[Cleveland Rocks]

The BSA's guidance on whether you should or shouldn't store the AHMR electronically (you shouldn't):

• The forms should be maintained by a designated leader. To assure privacy, the forms should be carefully stored and used only as needed to provide for planning and rendering care. The AHMR should not be scanned, stored, or sent electronically except as specifically directed for a BSA national event such as the national jamboree or NOAC.

[yknot]

This is interesting because I think it's one of the things needs to change.  I've had to scan in and submit health records for other youth activities. Not sure why BSA is continuing with paper. 

How our troop handles it now though is to require parents to submit two copies of all forms at registration. One set always remains in the master binder kept at the CO. The second set is pulled out and put into a trip binder for each trip and then returned. In the event that copy is ever lost, though, a master set remains in the unit's possession. 

I also think one of the things that has to be considered is what makes the most sense from a volunteer sense. Requiring a scout to bring their own form to each trip, and then requiring someone to keep track of that for each trip, seems like a whole lot more work than just asking for two copies of the form. 

Finally, the BSA policy on health forms predates some of the issues that are becoming common today and can require frequent consultation of these forms. I'm thinking of food allergies, behaviorial meds, diabetes management, etc. Ideally in most cases a parent is along or a child is capable of overseeing his or her own care, but any adult in charge of the trip would need to be aware or monitoring just in case. This has been a problem in our unit because whipping paper documents in and out of a binder under weather conditions on the trail has not always been effective.

 

[CynicalScouter]

3 minutes ago, yknot said:

This is interesting because I think it's one of the things needs to change.  I've had to scan in and submit health records for other youth activities. Not sure why BSA is continuing with paper.

Same reason why adult applications and 90% of the registration process is paper: institutional inertia and (most recently) the mass layoff at National crippled their ability to anything new.

[T2Eagle]

I'm not sure how long you've been at this game known as scouts, but hard earned experience is that if you do this: "One form (call it "Scout copy") is kept at the scouts house, by the scout, and one form is kept at the "Form Keepers" location ("master copy"). "  you will spend a lot of time every Friday before pulling out of the parking lot ensuring that each scout has a form, and then you'll spend some more time as one or two scramble because they forgot it.  If you're just going to have the scouts responsible for their form what is the point of having a master file that never gets used?

In our troop we keep a master file of all forms in a sturdy, water resistant, zippered binder.  That binder stays at our Chartered Organization with all our other equipment, and it goes on every outing.  One committee person is responsible for maintaining it and ensuring everybody's forms are up to date. 

We do not try to put together a folder that has just the forms for those attending an event,  we just take the "medical binder" with us everywhere.  On the rare occasion that we have to turn a physical copy in at check-in, which for us happens only at summer camp and one other camporee type event, we make a copy of those attending ahead of time, turn it in, and then when we get them back either shred them or give them to the parent.  

We urge everybody to make and keep a copy of their form before they turn it in, just in case something happens.  In practice that means the scout or parent brings it to the meeting and we make a copy for them.  Generally the big push for this is the run up to summer camp and so everyone is pretty much on the same renewal cycle.

The forms are important, but what is important about them is that they alert the leaders to any underlying conditions a scout might have.  I have been at this game a while now, and in many trips to the ER and one serious air medi-evac, no medical professional has ever asked to see a health form.  They do ask if we know of any conditions they should know about, but with rare exception folks don't wander this world with their own medical form in their back pocket, and every emergency protocol just assumes that dearth of information.

I have mixed feelings about the prohibition on digitizing forms.  It would make things easier, but it is also true that whenever you make a digital copy of something that copy lasts forever on every computer, server, phone, etc. that ever accesses it.  There is actually no such thing as deleting. 

Lastly, what you refer to as a loop hole isn't one.  If the unit leaders are deciding to have someone digitize the forms then the unit leaders are digitizing the forms, it doesn't matter who actually is running the scanner.

 

[yknot]

26 minutes ago, T2Eagle said:

We do not try to put together a folder that has just the forms for those attending an event,  we just take the "medical binder" with us everywhere.  On the rare occasion that we have to turn a physical copy in at check-in, which for us happens only at summer camp and one other camporee type event, we make a copy of those attending ahead of time, turn it in, and then when we get them back either shred them or give them to the parent.  

We urge everybody to make and keep a copy of their form before they turn it in, just in case something happens.  In practice that means the scout or parent brings it to the meeting and we make a copy for them.  Generally the big push for this is the run up to summer camp and so everyone is pretty much on the same renewal cycle.

 

 

Agree with all you said except for one thing: We don't send the whole medical binder anywhere. The set of  "to go" forms for each scout are in their own clear plastic, largely water proof closed file. These can either go in the traveling binder for a camp site location or just clipped together on a ring for a backpacking trip.  The medical binder has been lost once in a tip over so we never leave the unit without a master set. It is also a lot of volunteer hassle to have to recreate it. Also, it might be silly, but it feels like a privacy thing. No reason why med forms for 40 kids should go on a trip for 10.

[InquisitiveScouter]

We instruct parents to make and keep a copy (e-copy is their choice), keep their original, and provide the Troop with one paper copy.  A registered Committee Member, the "Medical Forms Grand Poobah" (or MFGP) holds and manages our forms, including inputting dates into Scoutbook, and sending out reminder notices when forms are expiring.  (It is almost a full time job for our unit.)

Prior to every outing, the unit leader designated for that outing procures the binder for all attendees (only), and reviews that binder prior to the outing (sometimes this happens at the very last minute.)

If anyone's form is missing or outdated, the designated leader takes steps to resolve with the parents or adult attendee.

Personally, I make every Scout/Scouter with an epi-pen or rescue inhaler show those to me upon arrival at any outing.  No meds is a no go...  He must also show everyone in his patrol where he keeps those items in his pack/gear.  (One of them may be the Scout who saves his life.)

Before I give any OTC meds to a Scout, I review the form and, if possible, call the parent.  This has proven wise on several occasions as we have Scouts who are allergic to ibuprofen, pepto-bismol, benadryl, aspirin, certain topical antibiotics, etc.

You have to set your own policies on prescription meds, and whether unit leaders will keep or administer those...to each his own...

Highly recommend you set a deadline of one week before Scout camp as the due date for medical forms.  Even so, you will always have "the usual suspect" parents scrambling at the last minute to get Johnny's physical done.

When I came to this unit, they kept e-copies on a thumb drive to give to the unit leader.  Of course, the unit leader could rarely access them if needed.  Not really that smart... And as @T2Eagle notes, no medical pro has ever asked for a form...

Finally, pro tip...if you ever even remotely plan to do a SCUBA event during the year (many SCUBA shops offer an orientation program that meets SCUBA BSA and Snorkeling BSA requirements), instruct parents to print out and take the SCUBA form with them during their provider visit.  It will save you beaucoup headaches down the road...  Keep them with the medical forms.

 

 

[InquisitiveScouter]

3 hours ago, Cleveland Rocks said:

The AHMR should not be scanned, stored, or sent electronically except as specifically directed for a BSA national event such as the national jamboree or NOAC.

Do as I say, and not as I do???

[MattR]

My understanding of the do not scan rule is that this is a HIPPA requirement, not a BSA requirement. I heard this from a guy that works IT for the city.

However, I haven't read it in a more aauthoritative source.

[InquisitiveScouter]

2 minutes ago, MattR said:

HIPPA requirement

HIPAA only applies to providers/insurers/etc...

https://www.hhs.gov/hipaa/for-professionals/faq/190/who-must-comply-with-hipaa-privacy-standards/index.html

The BSA no-scan guideline exists to protect you from identity theft and fraud, as well as safeguarding personal and private health information that you don't want plastered all over the internet...

[CynicalScouter]

18 minutes ago, MattR said:

My understanding of the do not scan rule is that this is a HIPPA requirement, not a BSA requirement. I heard this from a guy that works IT for the city.

As I said previously: HIPAA is the most misunderstood law and it has gotten worse since COVID.

The HIPAA Rules apply to covered entities and business associates. 

What is defined as covered entities and business associates? Only three entities

1. A Health Care Provider     
2. A Health Plan     
3. A Health Care Clearinghouse

Are you a health care provider? Are you a health plan? Are you a health care clearinghouse? Here's a handy chart to walk you through it.

No?

Are you the business associate of any of the above 3?

No?

Then

Quote

If an entity does not meet the definition of a covered entity or business associate, it does not have to comply with the HIPAA Rules.

So, your IT guy MIGHT MAYBE be covered if he is providing IT support services to a doctor, hospital, or a health plan.

But if Boy Scouts of America and/or your local Council and/or your local Troop decided to broadcast your medical records, it does NOT violate HIPAA. Might violate other state/local laws and might also be the basis for lawsuit (breach of duty to keep private) but it is NOT a HIPAA issue.

Edited September 17, 2020 by CynicalScouter

[Chisos]

I'd concur with what most others have said.  For the Part C, I have the parents keep the original and give us a photocopy.  I've never had a camp say they required the original.

We keep one binder with all forms.  The whole thing goes on each event.  We used to pull out only the needed forms for an event, but that just created more confusion, especially if someone decided to attend last-minute (or not).  I keep them alphabetized by name so any given form is easy to find if needed.

[InquisitiveScouter]

2 minutes ago, Chisos said:

We used to pull out only the needed forms for an event, but that just created more confusion, especially if someone decided to attend last-minute (or not).  I keep them alphabetized by name so any given form is easy to find if needed.

Agreed, but we often do Patrol camping where each Patrol selects their own destination...so two or three books going out is not unusual for us.  It keeps the Medical Forms Grand Poobah on her toes

Edited September 17, 2020 by InquisitiveScouter