Camp Fever: Injuries, illnesses missing from Indiana state records

The Media School Report • June 29, 2017

Editors: These stories may be copied and published free of charge. Please credit the student reporters whose bylines appear with each story, and the Indiana University Media School.

PART 1

Camp fever: Injuries, illnesses missing from Indiana state records

By Andrew Maciejewski, Alyson Malinger, Joshua Margolis, Jackie Melichar, Nikos Potamousis, Kacey Ross and Jenna Wilen

Bradford Woods. (Andrew Maciejewski | The Media School)

When 11-year-old Jadyn Larky was killed by a falling tree at Camp Livingston in Switzerland County in 2016, the camp was supposed to immediately file a report with the Indiana State Department of Health.

Three years earlier, when three campers were seriously injured in a lightning strike at Goldman Union Camp Institute in Zionsville, a report should have been filed as well.

But, despite mandatory reporting rules for such incidents, the state health department has no records of either one.

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Under state law intended to help ensure the safety of children at summer programs, overnight youth camps are required to file injury and illness reports soon after any event that results in hospitalization, a positive X-ray or lab result or a child being sent home.

Unreported deaths and injuries like those at Camp Livingston and Goldman Union Camp Institute, however, indicate the state’s records are far from complete. Those omissions and other problems, including a lack of enforcement by the state, are among the revelations of a three-month investigation by an Indiana University Media School student reporting team.

The investigation raises concerns about how much the state – and parents – really know about summer camp safety.

After the team questioned the completeness of the safety records and the state’s enforcement of the requirements, however, the health department indicated it is working to remind summer camp operators of their obligations under the law.

Camp rules and regulations

The Youth Camp Inspection and Approval Program, part of the health department’s environmental public health division, is charged with keeping track of residential camps in Indiana.

Division director Mike Mettler said the 133 camps on the roster are inspected annually or biannually to ensure they  follow Rule 410 of Indiana’s Administrative Code. The rule provides guidelines for maintaining youth camps, from on-site water sampling to how many smoke detectors a building must have. Section 17 specifies how youth camps must report camper illnesses, injuries or deaths.

Camps have 10 days to report injuries or illnesses that result in a camper being sent home or hospitalized. A positive X-ray or laboratory analysis also falls within these requirements. If a camper or staff member dies, the deadline for filing a report is shortened to 24 hours. Incidents must be reported on State Form 51866, or an equivalent.

For this report, the Media School reporting team requested all the forms on file. Although health department officials initially said they would provide safety reports going back to the 1990s, they provided records only from 2006 through 2016. Since April 21, no additional reports have been released, and no explanation has been provided for the lapse in complying with the records request.

An incomplete paper trail and a lack of enforcement

A review of the reports the state did release indicates a wide range of injuries and illnesses occurring at summer camps. Last year’s reports, for instance, covered problems including dehydration, a medication error, aches and bruises, fractured bones and vomiting.

But only seven of the 133 youth camps registered with the health department – about 5 percent – filed reports in 2016. And that year is not atypical in the official records. Over the entire period, there are only 145 injury and illness reports from only 21 – or about 16 percent – of the registered camps.

That doesn’t mean the other camps are incident-free, however. The Media School investigation found several apparent lapses in reporting:

  • First, incidents such as those at Camp Livingston and Goldman Union Camp Institute should have been reported.
  • Second, a spot check of ambulance runs to some camps revealed emergencies that may have been reportable incidents if they involved campers. For instance, Epworth Forest Conference Center in Kosciusko County had four emergency runs during the summer camping seasons in 2014 and 2015 for incidents involving an injured person, head trauma and two separate cases of difficulty breathing.
  • And third, officials at some camps indicated they were not even aware of the requirement to file reports with the state.

“There’s nothing state-level that we report to,” said Scott Helmkamp, director of leadership development for the YMCA of Greater Fort Wayne, which operates YMCA Camp Potawotami in South Milford.

YMCA camps are among those registered with the state health department that did not file any safety reports during the time frame examined. According to Helmkamp, Camp Potawotami uses an outside insurance agency to report illnesses and injuries.

Likewise, Bradford Woods in Martinsville – operated by Indiana University – has an internal system for documenting injuries and illnesses.

“It’s a full page, front-and-back sheet that’s got all of the pertinent information that all of our staff have, that all of our staff are trained on,” said Nicholas Hunter-Shields, the recreation therapy administrative assistant at Bradford Woods.

He said the camp fills out the forms for incidents ranging from tripping and falling on a branch to golf cart accidents.

Such methods of incident reporting do not meet the requirements of Indiana’s health code, according to Mike Mettler, director of the state health department’s environmental public health division.

“It is not a violation for a youth camp to keep its own records, but camps are still required to submit the information to ISDH on the prescribed form,” Mettler said.

If the department becomes aware of an injury or illness that should have been reported to the state, the camp in question could be cited with violating state law. But over the past decade, the department has not issued any citations.

When the Media School reporting team sought comment on the apparent lack of enforcement, health department spokesman Ken Severson provided a statement saying the department “is issuing reminders about these requirements to all youth camps, and inspectors will conduct follow-up discussions of the reporting requirements with youth camp operators during their next inspection.”

Injuries large and small

In the safety reports that camps submitted since 2006, the most common health concerns for campers by far have been common colds, hay fever and stomach aches — listed with varying degrees of details on the state forms. One camper was listed as suffering from homesickness, and another was hit by a truck. The latter incident was among 32 that reported broken bones or sprains.

There also were two deaths – one from drowning, and one from an unexplained collapse. Specific cases included:

  • A 5-year-old girl taken to IU Health Bloomington Hospital after fracturing her leg at Jellystone Park at Lake Monroe in 2012. The girl had been playing with friends on the camp’s jumping pillow, an inflatable trampoline, when another camper fell on her, twisting her leg.
  • A girl taken to Goshen Health Hospital after pulling a muscle at Kosciusko County’s Camp Alexander Mack in 2009. The girl heard and felt a “pop” in her back on the right side and was in severe pain until the ambulance arrived. She had been playing a game of blob tag, a variation of the classic game, when the pop occurred.
  • A boy who died in 2009 at Camp Ray Bird in South Bend after using a water slide. According to the report, the boy walked about 15 feet before collapsing and later died.

Camp Ray Bird, operated by Ray Bird Ministries, stands out as a prolific filer of safety reports – 78 from 2006 through 2016. A distant second was Spring Hill Camps in Seymour, which filed 14 reports in the same time span.

But given the fact that some camps are not filing reports, it is impossible to assess whether any particular camp is more prone to problems than others.

Incidents not reported

As noted above, some high-profile cases of death and injuries don’t show up in the state’s records at all.

Last June, Jadyn Larky, of Columbus, Ohio, was sleeping in the east village at Camp Livingston when a bolt of lightning hit a tree next to her cabin around 3 a.m. Larky and two other campers were trapped after the tree collapsed into the building. She was pronounced dead at the scene by the Switzerland County Sheriff’s Department.

Camp Livingston did not report the death to the state health department, nor has it filed any other injury or illness reports since at least 2006.

That also is the case with Goldman Union Camp Institute in Zionsville, which has reported no injuries or illnesses since 2006. Yet on June 29, 2013, three summer campers were struck by lightning in a field northeast of the camp while playing Frisbee on a clear blue day. One, a 9-year-old boy from Columbus, Ohio, required 209 days of hospitalization.

Media reports indicated it would have been almost impossible to avoid the injuries since there were only a few clouds in the sky that day. And police praised camp staff for immediately performing CPR on the three children.

In any case, the incident did not make it onto the state-required injury and illness form.

The forms are public records, but they are not easily accessible for parents who might wish to do research about a prospective camp for their children. The forms are mailed in hard copy form to the health department, which maintains them as paper records. Neither the forms nor any data from them are available online.

At the request of the Media School reporting team, the department released scanned forms in PDF format with some personal information about individual campers redacted.

Complicating the effort to analyze camp safety, the forms often are filled out improperly, with sections occasionally left blank. In three of 17 forms from 2012, for instance, the only boxes checked were those asking for the sex of the camper. Forms also were often completed days, weeks and sometimes months after an injury or illness. In one case, Camp Ray Bird filled out a form two years after the injury was reported.

Parental concerns

Parents who send their kids to summer camp each year say they are looking for experiences that will provide fun, friendship and, in some cases, religious and moral training for their children.

“When you send your kid off to camp, even for the day, you want to know that they are going to have fun and be with their friends,” said Donna Kaufman, who sends her daughter, Gabby, to Still Waters Camp in Lexington, Indiana.

But Kaufman and others said safety is also a key factor. Still Waters has filed six injury/illness reports with the state, all in 2011 and 2012.

“No one wants to send their kid to the care of someone who could actually care less,” said Juliana Henkel, who sends her two young daughters to Camp Rancho Framasa in Nashville. “It is vital that the camp operates at a high rate so parents can be confident that their child is being looked after correctly.”

The camp is not among those that have submitted reports to the health department.

Justin Morseth, whose 8- and 11-year-olds attend a YMCA camp, said he has not had any problems with his kids’ safety there. But he did express concern when informed about the problem of missing safety reports.

“There is no accountability there,” Morseth said. “These camps need to be more accountable with their actions and do the right thing.”

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PART 2

FYI for parents: Camp rules vary depending on state and accrediting body

By Alyson Malinger, Andrew Maciejewski, Josh Margolis, Jackie Melichar, Nikos Potamousis, Kacey Ross and Jenna Wilen

Read more »

Under Indiana law, a regulated youth camp is defined as one that provides more than 72 continuous hours of outdoor living experiences to 10 or more children not accompanied by a parent or guardian.

There are 133 such camps currently operating in the state, and they are licensed by the Indiana State Department of Health. Day camps are not required to have a license.

In addition to mandatory reporting of injuries and illnesses, Indiana requires a youth camp to have a health supervisor who has completed the Red Cross standard first aid course or an equivalent.

The rules for camps vary greatly from state to state.

For instance, although Indiana requires a license for residential camps to operate, South Dakota, Georgia, Missouri and Washington, D.C., do not require licensing of either day or residential camps.

But some other states have stricter requirements. While most states require criminal background checks for employees, Indiana is one of 17 that does not. (See related story here.)

While Indiana requires at least one nationally certified lifeguard for every 30 campers, the New York State Department of Health requires each camp to have an aquatics director who meets age, work experience and lifeguard certification requirements. That person must be certified for lifeguard supervision or management by taking a course from an approved list.

Unlike Indiana, New York has specific requirements camps must meet for campers with physical and mental disabilities. For example, camps that serve children with mental disabilities must have an incident review committee, and staff must follow mandatory reporting procedures for abuse, neglect and suicide.

Safety reports online in New York but not in Indiana

New York maintains a more robust website with resources for camp directors, parents and the public regarding codes, regulations, information, certification and state forms.

Notably, New York makes incident summary reports available online. Indiana’s safety reports are available only by request.

New York also has a State Camp Safety Advisory Council that meets throughout the year to coordinate discussions on issues surrounding camp regulations, with updated meeting minutes maintained online for the public.

The council includes non-profit and for-profit camp directors and organization leaders, and officials from the health department sit in on the meetings.

Indiana has no similar council in place.

Accreditation another way to judge camp quality

The American Camp Association is a national nonprofit organization that has its own set of guidelines for accrediting camps.

Private accreditation is not required under Indiana law, and the ACA states on its website that its accreditation is not “intended to circumvent the licensure required to operate your primary business.”

However, the ACA requirements can provide useful guidance to parents about the safety procedures followed at specific camps.

Under the ACA guidelines for residential camps:

  • A camp must have a licensed physician or registered nurse on site daily.
  • A staff member with CPR and first aid training must be on duty at all times.
  • Parents/guardians must know when they will be notified of illness/injury of their camper.
    Healthcare staff must follow written treatment procedures for reasonably anticipated injury/illness.
  • The camp must keep a health log and reports of all incidents requiring professional medical treatment.

Some religiously-affiliated camps belong to alternate organizations such as the Christian Camp and Conference Association.

Of the 21 camps that have filed illness and injury reports with the state department of health since 2006, only four are accredited by the ACA. The ACA has 51 accredited camps in Indiana, both day and overnight.

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PART 3

A parent’s view: relying on word of mouth when choosing camps

By Andrew Maciejewski

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Every summer, parents across Indiana send their kids to camp to make memories, eat s’mores and tell ghost stories around bonfires.              

Most children return from camp with new friends and experiences they cannot get at home. But sometimes kids get injured or sick while at camp. Accidents can happen even when safety procedures are in place. Either way, camps are required by Indiana law to report all injuries and illnesses.

But an IU Media School investigation raises questions about whether camps are following the rules. Only a small percentage of camps have filed reports over the past decade. And some high-profile accidents, including hospitalizations and at least one death, were not among the cases in the Indiana State Department of Health’s records.

The ISDH requires camps to report injuries that result in hospitalization within 10 days, and deaths must be reported within 24 hours.

“If there’s any kind of injury that requires them to get medical treatment, I feel like that should be reported,” said Kathleen Mills, a parent and co-chair of the English department at Bloomington High School South. “Certainly, if a child died at a camp, parents should know about that so they can evaluate what happened in that situation.”

Mills has an 11-year-old daughter and 14-year-old son who attend summer camp regularly. Her daughter attended Girl Scout Camp at Camp Gallahue until last year, when she became a camper at Camp Palawopec.

At Camp Gallahue in Morgantown, parents were invited to an open house to meet the staff, ask questions and walk around the property.

“They do a run-down of all their rules and let you know how things work there,” Mills said. “So, that’s reassuring.”

Last year, her daughter went to Camp Palawopec in Nashville. Mills said the camp allows the kids more freedom than at other camps. On its website, the camp describes itself as “outdoor-oriented” and “good old-fashioned summer fun in a non-competitive, relaxed setting.”

“My daughter went to Palawopec last summer, when she was 10, and one night, she and a friend just camped in the woods by themselves,” Mills said.

She said they were on the camp property, and counselors were nearby.

“It’s not like they were in the Alaskan wilderness, but still, I feel like at other camps it would be really more controlled.”

Mills said her daughter will return to Palawopec this summer.

While Camp Palawopec has filed one safety report since 2006, Camp Gallahue has not filed any.

There are more than 100 overnight youth camps in Indiana, each with varying programs for summer. Some offer high ropes and zip-lines, while others take children out on the lake for watersports. Each has different risks associated with the types of activities offered.

But for parents, it is difficult to find out about the risks from state records, which are not available online.

Mills said she had been unaware of the lapses in safety report filing revealed by the Media School investigation.

“It doesn’t seem like it would be that hard to have a database of summer camps where you can type in and see if they’ve had any incidents reported,” Mills said. “As a parent, I would find that very useful and something I would want to look into.”

Mills’ friend has a neighbor who runs a day camp on his property, and she said she doesn’t think anyone from the state oversees it. In fact, Indiana is one of 11 states that doesn’t require state licensing for day camps.

“I mean, he seems like a nice guy, but I don’t know – there’s no background check… there’s no one who would visit his camp and say, ‘Yes, this meets safety standards.’ So, that seems a little strange to me that you can just kind of set up your own camp like that.”

In Indiana, someone who wants to open a home daycare for more than six children who are not immediate relatives must get a license from the Indiana Family and Social Services Administration.

“They set up something to inspect those situations, so why not camps?” Mill said. “Tons of Indiana kids go to camps. It just seems like that would be a no-brainer.”

Indiana is also one of 17 states that does not require background checks on camp staff. Mills said while statistics show a child is less likely to be sexually assaulted by a stranger than someone close to the family, she would like to see Indiana require background checks for camp employees.

She pointed out that even parents who want to eat lunch with their students at school must undergo background checks.

As things stand, parents looking for a good, safe summer camp are dependent on camps’ advertising and others’ recommendations.

“I think parents pretty much have to rely on word-of-mouth from other people,” she said. “It seems like it would be prudent for the state to put something more formal in place.”

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PART 4

Price of summer camps tied to accreditation, program offerings

By Alyson Malinger

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Cost is always an important factor for parents choosing a summer camp.

But while charges vary greatly by location and program options, accreditation seems to play a major role in price differences, at least among the camps that have filed safety reports with the Indiana State Department of Health.

Of the 21 camps that filed reports from 2006 to 2016, four hold American Camp Association (ACA) accreditation, and those four are significantly more expensive for a week of camp.

A session at Camp Tecumseh YMCA in Brookston, for instance, costs about $665. A week at Camp Ray Bird, a non-accredited camp two counties away, costs about $300.

“A lot of factors go into the price, like food service, counseling, staff, good amenities and nurses, but safety is always a large part of this,” said Camp Tecumseh CEO Scott Brosman. “A lot of people are looking for that traditional summer camp experience. Rock climbing and horses and archery and rifling – these are the things that people associate with this experience, all required to have special safety instruction.”

Brosman estimated about a third of the parents who choose Tecumseh do so because of the accreditation.

“There is a cost for accreditation,” he said, “but it is usually not a large factor in our price because safety is the highest concern of parents.”

The ACA is a collective of camp professionals, owners and others interested in summer camps and similar camp programs. Founded to create a model and standardizing influence for organized youth camps, it has a voluntary accreditation process involving about 300 health and safety standards.

“Just keeping up with the same standards allows us to cover all of our bases,” said Jessica Kreider, program director at Camp Alexander Mack. “It is pretty easy to keep up with it once you have the initial accreditation.”

Camp Alexander Mack, in Kosciusko County, has been accredited by the ACA since the early 1980s. Kreider said her staff turns to the accreditation when answering any questions from parents regarding safety procedures at the camp.

“I don’t know how much the accreditation factors into our price, but I know it keeps us accountable,” she said.

Overnight camps such as Tecumseh and Alexander Mack often are among the more costly summer camp options because care is being provided to campers 24 hours a day. The average weekly cost of an overnight camp is $690, but could go as high as $2,000 per week, according to the ACA.

An average price per week session at Camp Alexander Mack is $400, while shorter sessions fall into the $150 range.

“We see us as right in the middle of the line,” Kreider said. “We have a climbing tower and boats but we don’t have jet skis or dirt bikes. You pay for the experience you are looking for.”

Parents looking for less costly options might consider day camps, which have an average cost of $304 per week, according to the ACA. Those hosted by non-profit organizations such as Boy Scouts and Girl Scouts of America and YMCA often fall into the lower range of prices, whereas for-profit camps can cost $500 or more per week.

In addition to day camps, specialty and private camps are also common choices for children during the summer. Specializations include activities such as basketball or performing arts.

Because these camps typically offer more one-on-one attention and instruction for campers, prices will typically be higher than those of day camps, ranging from $500 to $1,000 per week, according to the ACA.

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PART 5

Criminal background checks optional at Indiana camps

By Jackie Melichar

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Criminal background checks are not required for camp counselors in 17 states, including Indiana, according to the American Camp Association.

In Indiana, a camp can request what is called a Limited Criminal History report from the Indiana State Police, which costs $7 by mail and $15 online.

Camps including Girl Scouts of Central Indiana, Boy Scout Summer Camp, Camp Crosley and Indiana University’s Camp Brosius and Bradford Woods all require background checks for their staff.

Not all camps follow such procedures, however. Camp Ray Bird in northern Indiana, for instance, does not require criminal background checks. Instead, it relies on an extensive list of application questions, including:

  • What do you think is the best way to redirect a child who is not listening?
  • When you are unhappy, angry or emotional about a person or circumstance, what do you do?
  • Do you consider yourself to have been physically or sexually abused as a child? (This information will be kept entirely confidential. We realize it can be very hard to process abuse, especially on your own, and we would like to offer ourselves in any way we can, even if just to listen or talk.)
  • Have you ever physically or sexually abused a child?
  • Has someone ever accused you of abusing a child?

The application also requests information about any criminal charges.

Juliana Henkel, who sends her daughters to a camp in Nashville, said it is inconceivable that Indiana does not require background checks for summer camp workers.

“I’m a single mom of two small girls,” she said. “As if I wasn’t worried enough for their safety and as if it wasn’t hard enough for me to send them to camp … I just want to know they will be in good hands.”

Henkel said it is imperative for parents to check reviews and ratings of camps when they are deciding where to send their kids.

“No one wants criminals or people with bad intentions watching their daughters,” she said.

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PART 6

Food safety also a concern at camp

By Jenna Wilen

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Parents concerned about the safety of their kids at summer camp shouldn’t forget to check out prospective camps’ practices when it comes to food service.

The Centers for Disease Control estimates that 48 million people each year become sick from foodborne illnesses.

Residential camps in Indiana are among the facilities that are subject to inspections by health officials looking to prevent such illness.

Some counties maintain inspection reports online so the public can easily check compliance with health rules at camps.

Online records in Brown County, for example, detail a 2015 inspection at Camp Gallahue that reported the chemical concentration being used to sanitize counters and silverware was too strong. The health department noted that the kitchen must check the cleaning solution with a test kit each time to ensure safety and health in the cooking facility.

Camp Ray Bird in South Bend is among 21 camps that have filed illness and injury reports with the Indiana State Department of Health from 2006 through 2016. While the reports included illnesses such as fever, nausea and vomiting, none of them mentioned foodborne causes.

“I haven’t heard of anyone getting food poisoning,” said Executive Director David Mui.

Mui said the camp takes precautions such as using accurate thermometers in refrigerators, providing hot water at hand-washing sinks, and ensuring a steady supply of hand cleaning soap and sanitary towels.

“We encourage the campers to wash their hands,” he said. “Especially because they are often playing outside, washing their hands is important.”

Sandy Wallace of the Monroe County Health Department said summer camps are typically inspected right before they open each year. She said when camps are found in violation of any regulations, the problems are corrected immediately and the department follows up to ensure compliance.   

The inspections look at food handling and delivery procedures, food storage, chemical identification and storage and employee hygienic practices. One of the main priorities is kitchen sanitation, especially food contact surfaces.

“Inspectors look to prevent physical, bacterial and chemical contamination of foods,” Wallace said.

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PART 7

For camp counselors, fun makes up for low pay

By Joshua Margolis

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According to the American Camping Association, in nearly all 50 states, overnight summer camps are not required to pay their counselors minimum wage. This means that counselors, many of whom are at the camps for days on end, receive pay far below that of traditional jobs.

Seth Tow, a sophomore at Indiana University, earns a base salary of $1,300 for eight weeks as a counselor at Camp Airy, a Jewish overnight camp in Maryland. In addition, tips from parents are divided among counselors, amounting to an additional $200 each.

Lodging and food is provided free to counselors, but Tow said the lack of pay can be frustrating.

“It’s kind of annoying, but I put up with it,” Tow said. “It’s something I know is not really going to change. I’m willing to deal with it.”

Over the course of a summer, Tow gets only five breaks of 24 consecutive hours and five breaks of 12 consecutive hours.

A recent study by the ACA found that those working at summer day camps earn a higher median wage ($306 per week) than those working overnight camps ($230 per week).

Of course, pay varies depending on location and qualifications. Having a lifeguard certification usually leads to a counselor earning more, as does status. Returning counselors often make several hundred dollars more than someone working their first summer.

Even though Tow knows he could earn more working a different summer job, he’s more than content spending his time at Camp Airy, which he attended as a kid. He enjoyed his time there so much he applied to be a counselor when he grew too old to be a camper.

“It’s incredible. It’s so much fun,” Tow said. “I have a blast, even on staff. I’m doing a lot of the same stuff I did as a camper. It’s work and it can get tedious and tiring at times dealing with kids all day, but it’s fun. There are so many times where I feel like I’m getting paid to have fun.”

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PART 8

Summer camps that filed safety reports

By Alyson Malinger