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CampLine: 2009 Fall Issue
2009 Fall CampLine
Lessons Learned, Case Studies, and Preparation Tips for Your Camp
In 2009, we experienced the busiest year ever with the American Camp Association (ACA) Camp Crisis Hotline. Calls to the hotline were up almost 10 percent over last year's record breaking year — and as a comparison, we received 100 percent more calls than we did just five years ago. Why all the growth? We attribute this phenomenal growth in the number of calls to several factors, including: more members know of this service, the media hype around medical issues caused more people to question what they know, a number of camps had health-care staff who were unfamiliar with the camp setting, and finally many camps had first-time camp directors who needed support with issues unfamiliar to them.
Annually, we provide you with an analysis of the kinds of calls we received. In addition, we create case studies for you to use with your staff. Additionally, we share resources and links to the most common references we used to assist callers. We hope you will learn from the lessons of other camps and discuss these case studies as you prepare your camp for future campers, camp families, and user groups.
Health/medical issues monopolized our calls this year (47 percent of all calls!). Questions and clarification about the H1N1 virus were by far the most frequent calls. ACA partnered with the Centers for Disease Control and Prevention (CDC) and the Association of Camp Nurses to provide the latest information online 24/7. However, camps often called us to help them sort through all of the mixed messages being sent by the media, by parents, and their local health departments. Some lessons we learned:
- Prevention of the spread of disease starts before anyone even enters your camp. Camps should provide advice to parents to not send sick children to camp. Camps should perform detailed health screenings (taking temperatures, etc.) on all incoming campers, educate campers and staff on protective behaviors (sneeze/cough into an elbow, etc.), and initiate stringent hand-washing and camp sanitation procedures. For camps that discovered someone was ill, the most successful camps immediately followed the guidelines from the CDC about how to prevent an outbreak.
- Communication with parents was the number one factor in determining how camp families reacted to outbreaks of illness, concerns about potential outbreaks, and rumors about what "might" be happening. Camps that took a proactive approach by telling families before camp exactly what they had been doing to prevent an outbreak and what they would do if there was an outbreak had the most success in partnering with parents.
- Knowledge about the facts of how this type of flu is contracted, what to do to help prevent outbreaks, and what to do if an outbreak occurs was absolutely necessary this summer. The CDC Web site was packed with excellent information. However, there were situations where local health departments' requirements were not the same as the CDC. Camps called to discuss the challenge. The bottom line? Camps must partner with their local health departments. If their requirements are more stringent than the CDC, you must work with them. At times this was frustrating to some camps who felt that their local health department was overreacting; however, the CDC does not have authoritative control over these health departments. A positive partnership with your health department is vital.
In addition to the calls about H1N1, we received calls about a variety of other illnesses and incidents, including: chicken pox, lice infestation, the MRSA virus, a potentially pregnant camper, and questions about who can distribute medication. The ACA Camp Crisis Hotline is not a medical hotline, but we did assist camps in finding the information they needed, in identifying challenges with their health-care set-up, and in finding outside resources. Lessons we learned:
Other Medical/Health Issues Lessons
- Nursing licenses are not necessarily valid across state lines. Just because someone has their R.N. license in one state, it does not mean that they are licensed in your state. Nurses should know this information, and you should know your state's license requirements as well if you are considering hiring an out-of-state nurse. To find your state's Nursing Board, visit: www.healthguideusa.org/state_nursing_ boards.htm.
- Nursing competencies should be evaluated when you are making your hiring decisions. Many health/medical calls to the Hotline concerned common childhood illnesses (such as chicken pox); however, in many cases the camp nursing staff were not familiar with these issues. Camp nursing has its own set of skills and competencies, and most importantly, familiarity with working with children and their common issues is critical. When hiring, you should be talking to your applicants about their experience working with children and their familiarity with common childhood illnesses. The Association of Camp Nurses is an excellent resource: www.acn.org.
- Distribution of medication laws vary by state. Often a caller will ask us something such as "Can my counselors distribute medication if they are out on a night hike with campers?" We cannot provide the definitive answer, but we can direct you to your state/local resource. It is important that you know this information prior to the camp session and have set up appropriate procedures. Helpful resources.
Preparation and Readiness Tips
- Partner with your health department. Work to develop a positive, supportive relationship with your local health department officials. The more they understand about the camp experience and your commitment to the health and safety of your campers and staff, the more helpful and supportive they can be in times of crisis. Reach out now.
- Verify with your state licensing authority whether they have any regulations concerning medication administration.
- Bookmark the Center for Disease Control and Prevention (CDC) Web site on your computer. The CDC (www.CDC.gov) offers the very best information available on virtually every disease and illness you may encounter. Among the diseases, illnesses, and afflictions we were asked about this year were: H1N1, Norovirus, MRSA, Scabies, Head Lice, Pinworm, Chicken Pox, and Pink Eye.
- Select your health/medical team carefully. Ask about direct experiences working with children and their common illnesses and injuries when you are interviewing potential team members.
- Have a health/medical support system in place. Before camp ever starts, identify health and medical resources you can call at a moment's notice to assist you in whatever challenges come your way. This plan includes not just your on-site health- care staff, but the list of contacts you would phone in the event of the unexpected (e.g., mental health professionals, dentists, etc.).
Case Studies on Health/Medical Issues
- H1N1: Whether your camp experienced this or not, a surprise outbreak of influenza-like symptoms and what you would do about it is an excellent case study. What would you do if suddenly a number of campers or staff were experiencing influenza-like symptoms? Consider not only what you would do to protect the health and safety of those in your care, but how would you communicate with families, and how would you work with the media if they were suddenly pursuing you about the issue?
- Camp nurse license: Upon hiring your camp nurse, you simply assumed that she was licensed to provide nursing care in your state. You suddenly find out that nurses licensed in her state are not automatically licensed to work in your state. There are two weeks of camp left. What do you do? To whom do you turn for help? What hiring procedures will you put in place to ensure that this does not happen again?
- Lice: Your camp nurse finds lice in a camper's hair. What do you do?
- Camps don't get head lice — people do. Head lice are human parasites and require human blood to survive. Plan ahead. Put policies in place now about what you will do if you find lice in a camper's hair at check in or any other time during camp. The National Pediculosis Association, www.headlice.org, has excellent resources.
- Centers for Disease Control and Prevention
- Association of Camp Nurses
- State Boards of Nursing
- Preventing Injuries and Illnesses online courses from ACA
- Management and administration of medication
- Food-borne illness
- Teen pregnancy issues and support
Personnel issues were the next most frequent category of calls (17 percent). Most questions were about hiring practices with the remaining being about staff behavior and potential firing procedures. Now is the time for you to be considering your staff policies — before you begin hiring staff for next season. (If you are a year-round operation, it is still a great time to consider lessons learned over the past year.) We noticed that most issues resulted from a camp not having crystal clear written policies about staff behavior.
Featured Case Study: It's two weeks before camp training week and you find out from the "head office" that the results of the criminal background check of a new staff member have come back with a conviction from 1986. You don't yet know the actual detail, and the individual did not disclose anything on the voluntary disclosure form. You're wondering what to do. You don't have any written guidelines about what would be "acceptable" in someone's past criminal history. You really like this staff person and want to wait until you find out what the conviction was for before you make a decision about what to do.
This case study is an excellent example of the importance of creating your "thresholds" for acceptable past criminal history before you begin your hiring process. The decision should not be based on whether you "like" someone or not — in fact that can cause all kinds of legal headaches for you. Instead, your organization should sit down and consider what types of past criminal history would be acceptable to you — for each different type of job. For example, you might find it acceptable that someone applying for an activities director job had a petty theft conviction 20 years ago, but would that be an acceptable background for your accounting position? There are no definitive right-and-wrong answers (except in some states that tell you who cannot work with children), you need to set your thresholds based on the culture of your camp. It is very important that you work with your legal advisors as you develop these thresholds because you must comply with hiring laws while you protect the safety of those in your care. It is critical that you be consistent and follow your own thresholds and not treat people who are interviewing for the same job differently (e.g., "I like her so she'll be fine."). Only you know your program and what is acceptable.
Preparation and Readiness Tips
- Background check result thresholds: See the above case study. Work with your legal advisors now. (See Key Resources for this section.)
- Staff policies: Be as inclusive as possible in your employment agreements and your personnel policies. Learn from other camps about what they wished they had included in their policies. Here's a short list of things camps called about and did not have clear policies regarding:
- Expectation of a staff member's literacy in English (that is, if you expect the staff person to be able to read and write in the English language at a certain ability, you need to make that clear — and this applies not just to international staff who obviously speak a different language — but to all staff).
- Staff profiles on social networking sites (e.g., Facebook).
- Unacceptable relationships between staff, between staff and CITs, between staff and campers.
- Cell phone and Internet usage by staff.
- Time-off activities and expectations of staff when they return to camp after that time off.
- Acceptable/unacceptable topics of discussion between staff and campers.
- Acceptable/unacceptable physical contact between staff and campers (for example, in your camp are hugs, pats on back, sitting on laps, etc., acceptable?).
- Acceptable/unacceptable picture taking and picture posting by staff.
- Termination procedures: Plan ahead. Many camps have termination policies, but no accompanying procedures. That is, if you terminate an employee, what are your procedures for physically getting them out of camp? Many staff do not have their own transportation. Plan now for what you will do in the future.
- Plan for temporary replacements: Prior to the camp season, consider what you will do if shorter-term staff (like a nurse who will work for just one week) do not show up at the last minute. What network of ready-to-call volunteers might you call upon at the last minute to assure supervision ratios and the safety of campers?
Case Studies on Personnel Issues
- Inappropriate picture posting: You hear from one of your staff that another staff person is posting inappropriate (perhaps even pornographic) photos on a social networking site. You discover that it is true. You phone the police, and they come to camp and discreetly take a computer, a camera, and the alleged perpetrator off property. What do you do now? Is there something you should have done prior to phoning the authorities? What do you tell staff, your campers, your camp families, and the media? Who do you need to make sure is in the loop — legal advisor, insurance company, others? Who will be your spokesperson? What else do you need to consider?
- Staff-camper relationships off season: Two adult staff contact you off season and express concern that another staff person is having an "inappropriate" relationship with a fifteen-year-old camper. They tell you that this is based on the staff member's interaction on Facebook with the camper. You visit the Facebook page of the staff person as you are a "friend." You agree that what you see is inappropriate communication between the two. What do you do? Does your camp have a written policy about staff communications with campers in the off season? What is your role here?
- Staff contracts
- Staff hiring and screening
- Best practices with international staff
- Background check resources:
- ACA's Buyers Guide; Select the Background Checks category
- ACA's e-Institute course
- ACA's Camp Administrator Course
- Employment laws: Understand the employment laws in your state.
Allegations of Abuse — At Home and at Camp
Issues of allegations of sexual and nonsexual physical abuse are always the most difficult for the hotline caller to discuss. Thirteen percent of the calls to the hotline were related to issues of abuse. The majority of those calls concerned a camper revealing that they had been abused at home. Twenty-nine percent of those calls concerned camper-to-camper abuse and two calls concerned staff shoving or pushing campers.
Trends and Questions
- Mandated reporting: Most often, ACA is asked to help clarify the laws of "mandated reporting" when a camper reveals that they have been abused somewhere other than camp (home, school, etc.) More information about mandated reporting.
- Camper-to-camper abuse: It is absolutely critical that your staff be vigilant about identifying situations where campers could be alone and potentially abuse each other. All of the calls to the hotline about this issue allegedly occurred in those brief moments when staff were not directly in contact with campers. Sleeping time, overnights in tents, trips to the bathroom, and times when campers are changing clothes for the pool are clearly the times when camps need to be ever more attuned for the possibilities of camper-to-camper inappropriate activities. Provide training and policies that do not allow campers to be alone without staff supervision — ever. An excellent new resource on abuse among children is listed in the Key Resources for this section.
- Allegations of abuse outside of camp: It is not unusual for abused children to reveal at camp that they have been abused elsewhere. Many children feel safe at camp because they feel that people there care — thus what they might not have revealed at home is sometimes more easily revealed at camp. In these situations, children often say "Please don't tell anyone." You cannot promise them that. Instead, you need to assure them that you care and that you must tell the people who can help.
- Allegations of staff abuse of campers: We received two calls this year concerning interaction between staff and campers. The first concerned a staff member shoving a camper so forcefully that he fell to the ground. The other alleged that a sixteen-year-old CIT was being too "tough" and "aggressive" with campers. Staff training is crucial. Staff need to understand that there can be no physical contact between campers and staff (if you allow such contact as hugging and high-fiving, you need to be very clear about what is acceptable). Be sure your procedures do not allow for one staff to be alone with a camper.
Case Studies on Abuse Issues
- Rental group: You observe that the adults in the rental group on your property are behaving in a way you believe is abusive to the children they have brought with them. You observe shoving, pushing, verbal abuse, and other behaviors you believe to be inappropriate. What do you do? Are you a "mandated reporter" in this situation? If you are not, what is your obligation here? What is in the best interest of the children?
- Staff-to-staff relationship: You discover that an eighteenyear- old counselor and a sixteen-year-old CIT have been "mutually consenting and having sex." You're wondering if you need to report it to the authorities as a mandated reporter. You're wondering how to find out what the "age of consent" is in your state. The age of consent does vary by state so you would need to find out your state laws. Furthermore, whether legal or not . . . what are your camp's policies about relationships among staff? What about the family of the sixteen-year-old, and what is your obligation since the sixteen-year-old is a minor whether of consenting age or not?
- Allegation of long-ago abuse: You find out that your camp is being sued because a former camper is alleging that he was abused by another camper four years ago. What do you do? What documentation have you saved that shows your staff training, your policies and procedures, etc.? Do you have legal counsel identified?
- Mandated reporter laws
- Child abuse reporting telephone numbers by state, under Child Abuse Reporting Numbers, click on View Publication
- Camper-to-camper issues: Do Children Sexually Abuse Other Children? Stop It Now
- Preventing Child Sexual Abuse Within Youth Serving Organizations, U.S. Department of Health and Human Services
Camper Behavior Issues
Questions about dealing with camper behaviors (non-abusive) significantly decreased this year. While we did not receive a single call this year about bullying, research shows that harassment (both sexual and otherwise) is happening at younger and younger ages. What are your camp's policies and consequences for camper-to camper harassment? Almost every case of campers being inappropriate with each other happens when there is little or no direct supervision from staff. Examine the times when campers are not directly supervised such as when using the restroom, changing for programs, resting, and when staff are sleeping, etc.? Provide training and policies that do not allow campers to be alone without staff supervision — ever.
Case Studies on Camper Behavior Issues
- Drugs: A bag of something that appears to be marijuana is found by one of the campers and is handed over to staff. You suspect that there may be other illegal drugs on the camp property. What do you do? Can you search camper and staff belongings? (Yes — see the Key Resources for this section.)
- Speaking about suicide: A nine-year-old male camper has been making random comments about suicide to a counselor. The counselor feels that the child is "serious." Where would you turn for help? Are there any mental health professionals close by that can assist you?
- Searching camper's belongings: "Privacy vs. Protection — Can You Search Camper and Staff Belongings?"
- Bullying: www.ACAcamps.org/campmag/0601bullying.php and www.stopbullyingnow.org
- Suicide prevention
- Suicide resources
- Preventing Child Sexual Abuse Within Youth Serving Organizations, U.S. Department of Health and Human Services
A small number of calls were related to requests for special accommodations for campers. When camps receive requests related to accommodation for those with physical disabilities, there are excellent resources available (see the Key Resources for this section). This year however, we handled a few calls concerning the sexual identity of a camper. We had one call of this nature last year, so we'd like to spotlight a case study for your camp to consider.
Transgendered Camper — Case Study
You receive a call from the family of a camper who has been with you for three years. The family tells you that their twelve-year-old biologically female camper has self-identified as a male. The camper's parents have asked you to place the camper in the male cabin group. What would you do? What do you need to consider? What is in the best interest of the camper and your other campers? Who would need to know about the decision? What resources are available to help you understand this issue?
- American Psychological Association: "Answers to Your Questions about Transgender Individuals and Gender Identity
- Americans With Disabilities Act
- Special needs issues: www.childrensdisabilities.info
Every year, a large number of calls get placed in the "miscellaneous" category because there is just one call of that nature. Much can be learned from these situations, even if they were not a trend. The following case studies are important to review with your staff:
- Death of a parent: You receive a call from a family member that the father of one of your campers has died, and the family is coming to pick up the camper in the morning. What do you need to consider? Some suggestions . . . Who tells the camper? Should the camper talk on the phone to the family member? If so, who should be with the camper at that time? How do you get the camper ready to leave? What do you tell the other campers and staff, etc.?
- Derogatory video on YouTube®: You discover that there is a video on YouTube® that is extremely derogatory about your camp and you in particular. You want to know if you can have it removed. You need legal counsel in this area. Find out who the poster of the video is and work from there. If it is a former staff member, did you have an employment agreement that expressly restricted them from posting video/pictures about your camp? If it is not, work with your legal counsel to identify options. YouTube® has occasionally removed videos, but get your facts in order and discuss with legal counsel.
Sadly, we were informed of one death at camp this summer. It was the death of a staff member who drowned during his time off.
Preparation and Readiness Tips
- Pre-planning: Review your crisis management and risk management plans every year. Train your staff so they know what to do in any conceivable situation. Be clear about staff use of camp facilities on their time off. If they are allowed to use camp facilities, make it clear that the usual procedures and policies apply.
- In case of emergency: If an accident occurs, there are excellent resources available to help your camp and the family of any victims. One helpful reference that is used frequently by the ACA Hotline staff is a manual prepared by Grief Recovery, Inc. (www.griefrecovery.ws/index.htm).
- Crisis communications: www.ACAcamps.org/members/toolkit/ and www.ACAcamps.org/books/crisiscommunication/
- Crisis response
- Aquatics and water-related resources
The ACA Camp Crisis Hotline
The ACA Camp Crisis Hotline is available twentyfour hours a day. We encourage you to use this service when you need help in a crisis. If you have any questions about the resources and case studies in this article, please contact Hotline Team Leader Susan E. Yoder, syoder@ACAcamps.org, at the ACA National Office. For additional case studies, review every Fall issue of The Campline online at www.ACAcamps.org/campline/; click on "Archived Issues." The Hotline phone number is 800-573-9019.