By Stephanie Hasbrouck

Choosing a daycare for your child can be fraught with questions and concerns — cleanliness, student-teacher ratio, licensing and other factors weigh in as parents decide who will help care for their children.

The tragedy of one Alabama family highlighted the need for stricter reform when it comes to medication in a childcare setting. Ten-week-old Douglas died Aug. 30, 2002 from a suspected fatal dose of medication administered by a home-operated daycare. His parents, Robert and Mary Hernandez of Mobile, claim they never gave consent for their infant son to have medication. Their heartbreak stirred them to call upon state legislators to create a new law that provides criminal penalties for daycares that medicate infants without parental consent.

The Baby Douglas Law went into effect Nov. 1, 2004, making it a crime for an employee, owner or operator of any childcare facility, be it public or private, licensed or unlicensed, to administer medication to a child with the intent to drug the child or alter the child’s behavior, beyond what is medically prescribed. Failure to comply with the law is a felony, and punishment includes fines and imprisonment.

The law further states that parental instructions are not sufficient unless accompanied by a doctor’s written prescription or precise over-the-counter instructions. As a result, the Baby Douglas Law has caused much confusion among childcare providers and parents across the state.

According to Sophia Bracy Harris, executive director of FOCAL (Federation of Child Care Centers of Alabama, Inc.), the law was passed in May 2004. Implementation of the law was delayed six months to give childcare facilities time to adjust their medication policies, training and procedures.

A lack of public awareness and media attention to the new law led FOCAL to initiate a statewide campaign, Mind the Meds. “The campaign is intended to bring attention to Alabama Act 2004-538 (the Baby Douglas Law) and alert parents, childcare providers, pharmacists, physicians and community members about the existence and implications of the law,” Harris says. “The intent of the law was to protect children, but without widespread knowledge of the law, it is useless for children and potentially harmful for those who care for children.” The Mind the Meds campaign was developed and launched by FOCAL in conjunction with the Birmingham Advisory Committee, a group that comprises representatives from a variety of backgrounds related to childcare.

FOCAL also produced an informational video about the new law, including sections of an interview with Attorney James Long of the Department of Human Resources. In addition, FOCAL initiated informational sessions with childcare providers and parents across the state. And in December, FOCAL received funding from the Robert R. Meyer Foundation in Birmingham to begin a more extensive campaign in the Birmingham area, which has the highest concentration of childcare facilities in the state.

Harris said in its endeavors to address concerns about the new law, FOCAL found that initially most parents and childcare providers were unaware of the Baby Douglas Law.
“ The vast majority of those who had heard of the law had no idea about the implications and complexities of the law. As our Child Care Services Coordinator Deborah Thomas has said, ‘Their eyes were opened when they watched the video. They suddenly sat up and took notice,’” Harris says.

She says parents and childcare providers have been surprised, confused and sometimes angered by the new law. “Parents are sometimes surprised that their childcare provider cannot always follow the medication instructions that the parent gives.”

And, Harris says, some childcare providers have become more hesitant to administer medication to children. “Some feel that the risks involved are too great. Others have become so demoralized by the over-regulation and criminalization of childcare that they have closed their facilities entirely.”

Robbie Roberts, director of teacher training at Harris Early Learning Center in Birmingham, says the new law does not affect the way in which his childcare facility administers medication.

“I feel the Mind the Meds program is trying to provide public awareness of a law that many may not truly be aware of, but could be held accountable should they not follow it. Therefore, I feel it has helped to educate those providers that have had an opportunity to attend a meeting or receive any of their written materials,” Roberts adds.

Roberts says the term “medication” as used in the new law could refer to all drugs, powders, ointments, drops, creams and other health products and puts an additional burden on childcare facilities when administering such things as baby diaper creams or sunscreen.

The tight restrictions now in place under the Baby Douglas Law may be confusing and unnecessary in the minds of some and may offer additional peace of mind for others.
Harris says existing laws provided for the prosecution of licensed childcare providers who endanger the lives of children, but Alabama Act 2004-538 provides further implications — and further responsibility on the part of the childcare provider. The key, Harris says, is for both parents and childcare providers to be informed. “Uninformed reactions can increase legal liability for childcare operators,” she says.

Stephanie Hasbrouck is a Birmingham freelance writer and mother.

FAST FACTS
• FOCAL and the Birmingham Advisory Committee are developing a resource pool of attorneys, physicians and pharmacists who can advise childcare providers and parents. The list will be distributed later this summer.
• The FOCAL informational video about Alabama Act 2004-538 is available for purchase and on the Department of Human Resources Web site, www.DHR.state.al.us.
• Those with questions are encouraged to contact the Alabama Department of Human Resources and the Alabama Department of Public Health.
• The Alabama Department of Public Health is providing training on child medication.