Medicating the Scouts Your Role, Responsibility and Liability Golden Arrow Roundtable December2013 "The taking of prescription medication is the responsibility of the individual taking the medication and/or that individual’s parent or guardian. A leader, after obtaining all the necessary information, can agree to accept the responsibility of making sure a youth takes the necessary medication at the appropriate time, but BSA does not mandate or necessarily encourage the leader to do so." - Guide to Safe Scouting

Scouters Role and Risks If your Troop is aiding in the dispensing of medications - or just reminding Scouts to do so – does the Troop or individual adult have a liability if the Scout errors in taking his medication, or fails to do so - even if he says he did? What is the Scouters role and risks regarding medication on campouts? How can you keep your adult volunteers out of trouble?

No Legal Advice There will be no legal advice tonight. Nor is there a claim to present an acceptable solution for every troop. The Guide to Safe Scouting is pretty much the beginning and end of the advice you will receive. ◦No one wishes to venture further interpretation or opinion.

Example of the Problem Following a campout, a parent removed a Scout from the troop after objecting to the explanation given by the troop regarding medication which: ◦May have been taken or not taken by a Scout on his own, and ◦the same Scout's application of both sun screen and the first of the Scout Laws (trustworthy).

Example of the Problem Said Scout was responsible for taking their prescription medication (as stated in the Guide to Safe Scouting) and ◦Was reminded to do so by the troop. ◦Scout reportedly said he did so, but it is unlikely that he did actually take the medication. ◦Further, same Scout was told to apply sun screen, said he did so, even multiple times, but ended the campout with a significant sunburn. Parent believes the failure to take the medication contributed to the Scout failing to apply sun screen and/or his resulting sunburn - not to mention the failure to tell the whole story when asked about both incidents.

Questions & Concerns Does the parent have cause for complaint, let alone further action? Did the Troop do anything "wrong?" How much responsibility can we put on a young Scout in regards to his well being - especially when this may be a new behavior for them (responsible for taking their own medication)? Where does a reminder end and a responsibility begin for the Troop?

Clear Policy and Procedures These are all issues we can debate endlessly. ◦No clear answers, only opinions and interpretations. To help prevent such a case from developing among any of our Troops: ◦Establish a clear and comprehensive policy regarding medications taken by the Scouts on outings and overnights.

Clear Policy and Procedures Troops have many safety oriented policies for everything from use of knives to trailer pulling. Prescription (and OTC) medication should be considered an issue worthy of a formal policy, properly and well communicated to the parents and Scouts, and adhered to without exception. However, no such policy should be in conflict with the Guide to Safe Scouting - and herein lies the concern for Troops and individual Scouters.

Clear Policy and Procedures IF a Troop takes the responsibility for taking such prescription medications away from the Scouts and parents ◦by way of reminders, medication distributions, or checklists, etc. The troop takes on the possibility of limited responsibility, if not liability in the minds of the parents - even if not the courts. So, communication of both the Troop policy/program regarding prescription medications as well as the overriding Guide to Safe Scouting should be clearly communicated.

Clear Policy and Procedures Equally, if not more important to each Scouter: ◦A volunteer cannot be assigned the task of medication reminder or dispenser without his or her permission and they should be apprised of not only their right to refuse such a role, but that the BSA does not encourage them to take on this responsibility.

Policies & Procedures Most units follow one of two methods for managing medications. The first, and most common method, is the Unit Designated Adult (UDA). ◦Here a unit will designate an adult that will take the responsibility of distributing medications to all the scouts that need them. The second method is individual responsibility method (IR). ◦In this method, the individual, parent or guardian is responsible to ensure the scout receives his/her medications.

Policies & Procedures Assuming there is a willing volunteer among the Troop's adults and he or she is present at an outing or campout, this is where a clear policy and/or procedure must be followed by all involved - even if that policy is to simply state the BSA line - Prescription medications are the responsibility of the Parent and Scout.

Example Policy Medication Policy Troop Boy Scouts of America It is recognized that Boy Scouts may need to have medications (prescription and/or over the counter) administered during Troop outings and Troop 804 feels it is in the Scouts, his parents' and the Troop's best interest for the medications to be administered. The Scoutmaster may, at his discretion, agree to administer medications as directed by the parents. If the Scoutmaster agrees, any Scout requiring medications during an outing shall provide them to the Scoutmaster at the start of the outing, usually in the parking lot at Baldwin Hall before departure. They shall be in an original pharmacy printed label medication container clearly marked with the Scout's name, medication type and dosage frequency. It is intended that this means the usual small plastic cylindrical container provided by pharmacies. While over the counter medications won't have a pharmacy label, a similar container clearly marked with the same information will suffice. The quantity provided shall be only for the frequency for the duration of the outing. It is also requested that the administration times be set for morning around breakfast, evening before going to bed or both, if possible, as frequently, Scout activities can be wide ranging geographically and getting to the Scout may be impossible at times other than when Troop adult leaders are present. A written Troop 804 Medication Administration Form will accompany the medication, delineating medication dosage, time of administration and giving permission for the Scoutmaster (or designee - a registered adult Scouter over 21 years of age) to administer. The Troop 804 Medication Administration Form and medication will be sealed in a ziplock bag and the Scoutmaster should place all provided medications in a waterproof container. The only exceptions to the policy for adult administration of medication shall be for asthma inhalers and EpiPen ® Auto-Injectors type devices for allergic reactions. These devices shall be carried by the Scouts themselves and the Scout shall be capable of administering it to themselves, as adult leaders may not be able to. If a Scout is not capable of self- administration, he needs to be taught to do so, or he will be unable to participate in Troop outings. Rev. Apr 2011 (Cosgrove)

Policies & Procedures Summer camps have forms and processes for dispensing medications. ◦A good starting point for any Troop's efforts to establish medication dispensing procedures for outings and overnights. ◦Such a form, filled out by parents, and a process clearly spelling out how the medications are dispensed, may be sufficient. However, many Troops have gone beyond this to establish their own policies and procedures, including the permissions needed for OTC medications and other medical related releases.

Policies & Procedures Your Troop may already have a per-event permission slip providing authorization for medical treatment ◦You may wish to add medications and other policy elements. ◦Some troops may wish to handle medication authorization or distribution on a once-a-year basis. Packet includes examples of forms and procedures prepared by Troops and Councils for the purpose of providing a policy and/or procedure for the taking of or dispensing or medication. Hopefully one or more of these will help you to develop your own policies and procedures.

Final Thought “In Scouting safety is our primary concern in all that we do. When it comes to medication, the responsibility for safety must fall on the person most familiar with the situation.”