Scouters giving meds to Scouts

[spitfidgetx]

This is my first post to this forum. I'm a Scouter of ten years, but five away from Scouts (dipped back down to Cubs). I've got five weeks of summer camp under my belt, and in the past four weeks (1999 to 2003), only had to give daily ADD meds to one child at one camp. This summer, as the second in command, I ended up in charge of meds for five boys, and four were ADD and of those, two took multiple meds (for depression, ADD, and I don't know what else all the pills were for). This was my worst week as a Scouter ever, in that an inordinate amount of the time of the two leaders (another and myself) went towards putting out fires caused by the two most heavily medicated boys.

 

After the fact, reading a blog posted by the assistant camp director (an MD as I've been told), his helpful advice was "When I was a scoutmaster, if the scout had to take meds, the parents either came, or the scouts didn't".

 

This seems harsh, given the realities of single families, families with parents who can't come the whole week, and etc., but frankly, I'd personally prefer it from a liability standpoint. Had we not been leaving that morning from camp, the two heavily medicated scouts would have been sent home given issues with knives (poking through cabin holes) and etc.

 

Our committee is strongly divided on all this (thank goodness, I get to be 'just a parent', but was a former Committee Chair). Needless to say, the parents of all but one of the medicated scouts come to camp. The parents of the most heavily medicated do not. At all.

 

Any words of wisdom and guidance/suggestions? I know I will not hand out meds to any more scouts (especially when I was verbally attacked by one of the med'd scout's guardians at the end of camp that the other med'd scout had 'assaulted' the first. Of course, this was the first word I'd heard of this )(1/2 hour before pulling out of a week long camp). However, as an attorney in my 'real life', I've been sued enough to know that even when I win (100% now), it is not fun to be sued.

 

Again, any pointers, or advice? Short of telling my wife: 'Honey, I got the first Eagle through, you get the next!'?

 

Yours in Scouting

 

Spitfidgetx

[scoutldr]

Welcome. counsellor. Interesting handle. This topic has been discussed here ad nauseam...just do a search on "meds" or "medication". Sounds like your camp has pushed the responsibility back to the units. In our camp, ALL medications, youth and adult, are to be turned in to the camp medical person during check-in, and must be in their original containers with name and dosage thereon. In recent years, they even required a SEPARATE permission slip for EACH dose, signed by the parent. The unit leader's responsibility is to ensure the scout reports to medical for each dose. NO medications were to be kept by the scout or the unit, except for rescue inhalers or epi-pens. My wife is a school nurse, and her day used to be nothing but handing out doses of Ritalin. With the new long-acting drugs, it's not as much as a problem, since they only take one dose before coming to school.

 

Our previous discussions here drew the consensus that it's up to you to choose whether to accept the responsibility or not. You are certainly under no obligation. If the behavior of the scout is not acceptable, then address it accordingly without regard to medications. I hate it when ADD/ADHD is used as an excuse to get away with bad behavior.(This message has been edited by scoutldr)

[mistysmere]

I am the mom of a medicated Wolf Cub and a new committee member of a small Pack that is heavily medicated. By this, I mean that more boys in our Pack take medication than boys that don't. Reading your concerns really bothers me. Being on medication does not mean that the child will be a discipline problem, and that seems to be a connection that you are making.

 

You really need to deal with two separate issues. At camp, you had two boys that needed constant supervision. As a committee, you need to look at all the things these two boys attend. Are they ALWAYS in need to constant supervision? Are the choices that they are making always just this side of "you are going to get yourself banned for life"? If so, then you probably need to make a choice that these boys probably need to have an adult assigned to them at all events. Meaning that if you would normally send two adults to camp, these boys can only attend if the parents find an adult to attend with them. Stating the situation this way would allow for a single parent family finding a way to still keep their child in Scouts.

 

In our Pack, three different therapists have recommended Scouts to 4 different families. ADD/ADHD children can only be helped so far with medication. Then, the child needs structure and discipline to take them the rest of the way. Scouts was recommended to us as another place that had structure and discipline while also giving my child the bling/carrots in the form of patches, badges, belt loops and pins he needs for his self confidence. Once you realize that therapists and other parents are recommending Scouts to this specific population, you need to accept that handing out medication may become a norm, but you need to remember that the medication and the issue that is being medicated do not CAUSE a child to do stupid things. Human beings make stupid choices. ALL human beings.

 

Please take the time to separate the two issues, medication and misbehavior. You may find that your Troop will be in a stronger place once you do. I would also recommend separating the two discipline problems as much as possible. Even if they are great friends, I bet that everyone will breathe a sigh of relief if they happen to be put in different tents.

 

mistysmere

[kbandit]

You stated that you were "second in command" does that mean that you are an assistant scoutmaster(?).

 

It would be a good idea to go to the committee and give a first hand accout of what transpired at summer camp even as "just a parent."

 

One thing our troop has done in the past with "problem" scouts was have every scout and parent sign a reminder that all would be on scout behavior at all times or the parent will be called to pick up the scout from where ever we happened to be. The only time we used it was 6 hrs. away from home and an out of control scout on heavy meds that weren't working as they were supposed to. If the parent couldn't/wouldn't do this don't send them.

 

At this point in time we no longer have to have the reminders signed. Life is good. LOL

 

Safety is every adult's concern and must be a priority. If these scouts cannot behave in a safe manner then .....

 

Improper use of knives at least confiscate the knives until they redo totem chit. Not allowed to have a knife until this is completed.

 

 

[Mike F]

spitfidgetx,

 

Welcome to our virtual campfire! I'm sure many more pulling their morning coffee up to the circle soon.

 

In Boy Scouting, were striving toward eventual independence of the boys. Its sometimes rough getting started. It sounds to me like you were dealing with an out of control discipline issue and meds are not an excuse.

 

As leaders with challenging conditions like what you just faced, we have to balance two needs: The need for an individual boy to have an opportunity to overcome his challenges and grow versus the need for the overall group to function without undue disruption.

All boys need to adhere to the discipline expectations of the group and parents must understand this is one of the requirements for being part of the group.

 

Its not fair to either the leaders or the other boys when some are unable to control themselves. The presence of underlying medical problems makes it imperative your SM team has a very frank discussion with the parents to understand exactly what youre dealing with. The parents may have some suggestions about how you can help the boys cope. The youth leadership also needs to understand the basics, because they are really the ones who should be doing the hands-on leadership.

 

Occasionally we reach the point where it becomes obvious a boy is not a good fit for an individual troop or for Boy Scouting, but its pretty rare that something cant be worked out. In the troop I serve, our patrols do a lot of activities on their own without adults - including camping remotely. Weve had a couple of boys who couldnt handle that, transferred to other troops, and are doing fine.

 

It sounds like perhaps your troop needs to refresh their internal training to get everyone on board with the chain of command and discipline. Brief example: The Patrol Leader should be the one working the discipline challenges in his patrol. When he needs help, he gets the SPL. When they need more help, they get the SM. The second time the SM has to get involved with an individual scout concerning discipline, he notifies the Troop Committee they are working a challenge and has a talk with the parents. At this point, I would also say that the scout is on probation and any more significant problems within the next 6-months will result in parents getting a call to come and get their son without regard to time or distance.

 

Having a parent attend all activities and campouts is not a good answer and may be part of the problem if the parent is always working with their own son and he never gets used to working independently within his patrol.

 

Good luck!

 

[Twocubdad]

Guide to Safe Scouting, page 48:

 

"The taking of prescription medication is the responsibility of the individual taking the medication and/or that individual's parent or guardian. A scout leader, after obtainging all he necessary information, can agree to accept responsibility of making sure a Scout takes the necessary medication at the appropriate time, but BSA does not mandate nor necessarily encourage the Scout leader to do so. Also, if your state laws are more limiting, they must be followed."

 

 

In our troop, per the above policy we choose not to get involved with a Scout's medications. Early on in the Webelos transistion process we let parents and new Scouts know that they will be responsible for medications, not the troop. Usually, that means before summer camp the parents need to teach their sons to be responsible for taking their medications on time.

 

Yes, some of the parents wig out. But do they plan to go to college with their son to make sure he takes his medicine? Assuming no, that means at some time he is going to have to learn to be responsible for himself. Why not now?

 

Like everything else in Scouting, it's not a totally black and white issue. The adults leaders know what meds are being taken and when and will informally ask the Scouts if they've taken them. We do NOT chase a kid around the campsite with a pill bottle. Thinking about it, this is the same approach we take to showers, changing underwear and brushing teeth. We may ask/remind, but it's up to each Scout to be responsible for themselves.

 

At summer camp we are required by the camp for an adult to keep the meds in a locked tackle box in their tent. The scouts are still responsible for coming to the adult with the meds and getting their prescriptions as needed. On troop campouts the Scouts take full responsibility.

 

So far this system has worked just fine for us (other than causing some heartburn for a few of the parents). And we do have two boys with serious health problems which require regular medications. As you may expect, these boys take their medications very seriously and are quite diligent about taking them on time. If they can do it anyone can.

 

Spit, my advice to you would be to cite BSA policy and decline to be responsible for the medications, regardless of what the rest of the troop wants to do. Take a copy of the Guide to Safe Scouting to your committee meeting. If others want to be responsible, they should do so. But they need to commit to going to camp for a week, too.

 

I'll also second the suggestion to separate medication from behavioral issues. Even if here is a 1:1 correlation between the two, the Scouts need to behave like Scouts, on or off medication.

 

[nldscout]

unless you are licensed and trained to handle meds, what you did is a federal crime and most likely a state crime also.

 

I can only speak of NY's laws, but most states are the same. Handling controlled drugs without being licensed is a class A Misd. and depending on circumstances a felony.

 

Is it worth screwing your life up if a mistake is made and someone is hurt or dies over a wrong med you dispensed.

 

The boy needs to keep his own meds and you can track to see that they take them, thats it.

 

 

[scoutldr]

With all due respect, state laws must be different. When my wife, the school nurse, takes a sick day and a sub cannot be found (a frequent occurrence), the office staff dispenses the meds. It's apparently legal in this state.

[Greaves]

Our council has a special needs district, and they are available to any Scouter who has a question. You don't have to prove a disability, or even be sure there is one, for them to advise. In your shoes, I'd call them in for help. They can observe the boys, make recommendation to the leaders, facilitate a parent-SM-scout conference, where everyone can work towards resolution, all sorts of helpful things for making things better. Sometimes they recommend other units.

 

Does your council have a special needs person/district/hotline?

[nldscout]

Scoutldr,

 

depending on the state it may be legal for school personnel, I know its not in NY, but I don't think its legal under federal law.

 

Same problem would be if one of those office people screwed up.

 

Un untrained scout leader should not be handling controlled drugs

[John-in-KC]

We are talking about children here. We want them to grow up to be great adults, but they are children.

 

I'm OK with a Troop telling Moms and Dads to teach their kids how to medicate themselves. If the Patrol Leader can keep a confidence, I'm OK with a Troop having the first check and balance be the youth member telling his PL what he's taken.

 

If the PL cannot keep a confidence, then I'm not OK with him knowing.

 

I'm really not OK with a Troop not having an adult check/balance that the youth member is indeed taking his medications.

 

It's an Adult Association thing ...

[TAHAWK]

"I can only speak of NY's laws, but most states are the same. Handling controlled drugs without being licensed is a class A Misd. and depending on circumstances a felony."

 

Not sure if by "controlled drugs" you mean "controlled substances," "prescription substances," or both.

 

Those who buy drugs prescribed by ther physician possess them without a license. That's millions and millions of folks. So there must be an exception for possessing drugs prescribed to them.

 

Parents who possess drugs prescibed for their children?

Is there an exception for parents possessing drugs for their children?

 

Exception for those acting in loco parentis? "The phrase person in loco parentis in R.C. 2907.03(A)(5) applies to a person who has assumed the dominant parental role and is relied upon by the child for support. This statutory provision was not designed for teachers, coaches, scout leaders, or any other persons who might temporarily have some disciplinary control over a child. Simply put, the statute applies to the people the child goes home to."

 

Can you give us the NY language to assist in Google searches for similar law in other states?(This message has been edited by TAHAWK)

[ASM59]

Well, I'm not a Doctor or a Lawyer, nor have I ever played one on TV. My wife however is a nurse and we've had many discussions regarding this topic. My wife can dispense medication, but only under the direction of a Doctor. In other words, if she is working at a nursing home or hospital or even school, she can dispense meds according to the orders for an individual patient. We have both worked many childrens and youth camps. When she works (volunteers is more accurate) she is camp nurse and is responsible for holding all medication. The camp's policy is that all medication is to be held by the nurse in a locked (or otherwise controlled) container. As she does not specifically have a doctor's written order for dispensing medication, she reads the container, and discusses with the camper what they are supposed to take. She then hands the container to the camper, who opens the container and takes out the pill(s) and takes their own medication while she watches.

 

Now, as for Scout Camp...

First, let's discuss this year's summer camp at our local council. All medications had to be stored and dispensed by the medical staff member who was a paramedic. Adult members of the individual units were prohibited from keeping or dispensing medication; including their own. The previous year we went to a neighboring council's camp. Their policy is that all medication is kept in the unit campsite and it was the unit leader's responsibilty to give the medication to the Scouts. In our unit, the medication was kept locked in the adult leader's cabinet in the trailer. When the Scout(s) needed to take their medication, it was made available to them so that they could take it.

 

I don't know for sure all the legalities, but my wife is convinced that there is a difference between giving a pill from the container to a person and letting them take the pill out of the container themselves. She has been told that the person opening and taking the pill from the container is considered the person dispensing the medication. If that person is the person on the container, then all is OK.

 

Just my two cents...

 

ASM59

[shortridge]

I don't think the handling-controlled-drugs-without-a-license-is-illegal notion is quite accurate. Following that line of thinking, many a BSA camp across the country is violating federal law if they require camp health officers to hand out meds. After all, American Red Cross First Responders and EMTs can be camp health officers - but something tells me that even EMT training doesn't qualify someone for whatever kind of dispensing license nldscout is talking about. After all, how many camps are really lucky enough to have an actual M.D. on duty, on site 24/7?

 

Regardless of of the administering medications issue - personally, I simply would not feel comfortable providing security for a camper's medications in my tent! I've had too many experiences with sticky fingers over the years. A locked tackle box, as Twocubdad says his camp requires unit leaders to use, can be busted open with a rock. IMHO, unless you're doing something in the backcountry away from the main camp, all non-emergency medications should be in the custody of the camp health officer, under lock & key 24/7. (A mini-fridge or wooden cabinet takes more effort to break into than a tackle box.)

[DeanRx]

While not licensed to practice in NY, I am a doctor of pharmacy in real life...

 

There is a HUGE difference between dispensing medications (either directly from a practitioner's office or persuant to a legal prescription written by a legally licensed provider) and "passing meds" on behalf of a patient persuant to the prescription label as provided by the dispensing pharmacy.

 

Now - if a scout leader takes it upon themself to dispense (i.e. Johnny is acting up, so I think I'll give him one of Jimmy's pills - they seem to work for Jimmy...) then yes, they are committing a crime if said drug is either a controlled substance or even just a legend drug (i.e. requires a prescription / non over-the-counter). If its an OTC drug and they have the parent's permission (i.e. give them Benadryl if they have bad allergies), then you can use some of Johnny's for Jimmy, but you better have the permission slip and know what the heck you are doing with regards to OTC dosing.

 

This is a HUGE difference than an adult agreeing to make sure a minor scout takes their medication at the right dose, at the right time presuant to a legal prescription (in a legally labelled pharmacy bottle) while said scout is at a unit or council overnight / resident camp. Yes, you are assuming some legal responsibility, mostly that you will only give it as labelled on the prescription bottle, but as far as I'm aware, you are not breaking any laws in any state that I've ever practiced (5 states now).

 

If you alter the dose or give scout A's meds to scout B, well then we can talk about breaking laws.

 

All this being said, it is a big responsiblity and I think BSA has it right. Unit adult scouter's may assume responsiblity for passing out meds (but should not feel forced to). I don't know WHY a council ran camp would want to centralize this practice for several reasons...

 

1) With a camp of 300-400 kids (the one I just got back from on Wednesday) - the camp would need at least ONE full time staff (in addition to the medical officer) to do nothing but keep track of and administer the meds for the scouts at camp. Most camps are doing good to get ONE qualified medical officer on staff and they are kept busy with health forms and tending to minor 1st aid and illness issues (barf, poop, and cuts as I refer to them).

 

2) If a camp expects a scout to report for meds at the medical hut, then who accompanies said scout each day (or multiple times per day). Seems like a good amount of camp time would be spent standing in line to get your meds at an average sized scout camp. You must send an adult or at least the scout's buddy with them, so there is a big chunk of time away from program time. Not alot of down time at the camps I've been to... gee want to miss your range time to stand in line for 1 kid's Ritalin? Didn't think so.

 

3) If you centralize the process, you greatly increase the likihood of med handling errors occuring. If I have two ADD scouts in my group, I have to worry about keeping two scout's meds seperate. If you have 50 scout's ADD meds together and they all show up in the morning for their daily dose, what are the chances that someone is going to get someone else's drug by mistake?

 

4) If you centralize the process (and everyone in camp knows this)... Hmmm makes an easy target for a dishonest person to hit and score a decent amount of medications or controlled substances with very little resistence. However, if the meds are in camp with the units, then everyone in camp doesn't know where they are kept and it makes it harder to steal them.

 

Bottom line - you are NOT breaking the law if you agree to take on medication administration duties for scouts in your care. You ARE assuming some responsibilities above and beyond the normal leadership role and because of this, you should 1) feel comfortable and knowledgable about what you are doing, what the med is for, what the dose is, what its storage and handling requirements are, etc... 2) not feel like this is an expectation. Med passing is a FAVOR you are willing to do to facilitate a scout coming to camp that might otherwise have a barrier to attending / participating. You do so as a volunteer and on your own terms.

 

Its just like giving a scout a ride to scout camp. Yes, you CAN do it. Yes, there are procedures that you best follow to mitigate liability God forbid something goes wrong. No, you are not required to let a kid ride with you if you are not comfortable with it. You need not give a reason, if you are not comfortable with it, then don't volunteer to do it. Med passing is no different.

 

One more pearl of wisdom. Advise your parents of scouts needing to bring medicaitons to camp to go to there pharmacy in advance and request a "school labelled" bottle for the med. This is an 'extra' bottle labelled the same as the orginal prescription bottle. Then the PARENT should place just enough of the med needed for the # of days at camp into the "school bottle", so that the unit leaders can have correctly labelled medicaions at camp in quantities adequate for camp without taking Jr's month long supply of controlled substance to a 3 night or one week long camp.

 

Good luck - use common sense - only volunteer to take on reasonable responsibilities you feel comfortable doing and you'll be just fine.