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Mr. SARASIN. Thank you, Doctor.

Mr. DANIELS. With reference to the day camp or troop camp, I believe this morning you were here when a representative of the Girl Scouts of America testified where it was suggested by the witness that an exemption be given to day camps. In view of your experience in this type of work, what would be your thoughts and views on that subject!

Dr. Kirk. As far as troop camps, we worked out something with the Boy Scouts. They have a vast number of troop camps going out.

Mr. DANIELS. How does a troop camp differ from the ordinary day camp?

Dr. KĪRK. A scout leader joins two assistants and takes 20 to 25 boys off. They would set up a camp in Farmer Brown's pasture somewhere. They may stay there 1 week, 10 days or maybe a weekend.

In Michigan, if they were there 5 days or longer, they were listed. They get a permit to do this from the council. The council knows they are going out.

We have such a vast number of such programs going on that, again from an economic point of view, it would have been impossible without tripling or quadrupling the cost. So, we worked with the counselors so the individual going out had to sign an affidavit. They would sign this statement, stamped by the council when received in the council office, then sent to the listing office.

A troop camp list which is different in size and everything elsethis was sent to that camp leader. The different inspector would take half a day and spot-check any that were there, any in violation.

We only had one during the years I was with the program. We only found one in flagrant violation. Any professional working in the camping field is interested in the welfare of children.

Mr. SARASIN. When you refer to council, what council are you talking about?

Dr. KIRK. They are geographic units.
Mr. SARASIN. You are talking about Boy Scouts?
Dr. KIRK. Or Girl Scouts or what have you.

Mr. DANIELS. So, you do not recommend any specific exemption be given?

Dr. KIRK. No. I think it can be worked out within the promulgation of the regulation.

Mr. DANIELS. On behalf of the committee, I want to express our sincere thanks.

The next meeting of the committee will be tomorrow morning in room 2175.

The committee will stand adjourned until tomorrow morning.

[Whereupon, at 2 p.m. the subcommittee recessed, to reconvene the following day.]

YOUTH CAMP SAFETY ACT

THURSDAY, JUNE 13, 1974

HOUSE OF REPRESENTATIVES,

SELECT SUBCOMMITTEE ON LABOR
OF THE COMMITTEE ON EDUCATION AND LABOR,

Washington, D.C. The subcommittee met at 10 a.m., pursuant to recess, in room 2175, Rayburn House Office Building, Hon. Dominick V. Daniels (chairman of the subcommittee) preşiding.

Present: Representatives Daniels, Esch, Peyser, and Sarasin.

Staff members present: Daniel H. Krivit, counsel; Joseph Alviani, counsel; Alexandra Kisla, clerk; and Denniese Medlin, legislative assistant.

Mr. DANIELS. The Select Subcommittee on Labor will come to order.

This morning we continue with the hearings on youth camp safety, and I wish to announce we have with us today representatives of the Department of Health, Education, and Welfare who were mandated in 1972 by Congress to make a full and complete investigation of the situation surrounding youth camps in this country.

And so this morning we have with us Dr. Theodore Cooper, Deputy Secretary of HÈW, who is accompanied by Frank Samuels, Deputy Assistant Secretary of Health Legislation, HEW; Dr. Bruce Dull, Assistant Director for the Program, Center for Disease Control; and Dr. J. Michael Lane, Center for Disease Control, HEW.

I might state the following. We have this panel of witnesses, and the other witnesses who will appear are the contractor and subcontractor to whom HEW awarded the contract for a study and investigation.

You may proceed.

STATEMENT OF THEODORE COOPER, M.D., DEPUTY ASSISANT SEC

RETARY OF HEALTH, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, ACCOMPANIED BY FRANK E. SAMUEL, JR., DEPUTY ASSISTANT SECRETARY FOR LEGISLATION (HEALTH); BRUCE DULL, M.D., ASSISTANT DIRECTOR FOR PROGRAM, CENTER FOR DISEASE CONTROL; AND J. MICHAEL LANE, M.D., CENTER FOR DISEASE CONTROL, HEW, ATLANTA, GA.

Dr. COOPER. Thank you, Mr. Chairman and members of the subcommittee. I am here today to testify on summer youth camp safety, a matter which has been of congressional concern since hearings were first conducted by the 90th Congress. This subject raises issues in which the Department has a vital interest.

For example, one of the six Public Health Service agencies within the Department-namely, the Center for Disease Control-devotes much of its effort to the prevention of avoidable disease and illness, and this includes injury and death among summer youth campers.

Public Health Service physicians and technical personnel have provided disease prevention services for several Boy Scout jamborees. And so we share your interest in understanding and preventing unnecessary illness, injury, and death among young people as well as in the entire population.

HISTORICAL BACKGROUND

During the earlier congressional hearings on summer youth camp safety, testimony was presented to this committee which suggested that there simply was no comprehensive information available on serious and preventable adverse health incidents affecting summer youth campers and on laws pertaining to such camps.

More particularly, the information available apparently did not permit the Congress to arrive at an informed conclusion concerning the necessity or suitability of Federal legislation on this matter.

In an attempt to mend this deficiency, the Congress enacted Public Law 92–318, the Education Amendments of 1972, which called for the further study of summer youth camp safety and instructed the Secretary of the Department of Health, Education, and Welfare to make "a full and complete investigation and study to determine:

1. The extent of preventable accidents and illnesses currently occurring in youth camps throughout the Nation.

2. The contribution to youth camp safety now being made by State and local public agencies and private groups.

3. Whether existing State and local laws adequately deal with the safety of campers in youth camps.

4. Whether existing State and local laws relating to youth camp safety are being effectively enforced.

5. The need for Federal laws in this field.

The legislation was enacted on June 23, 1972. It required a report from the Department, including answers responding to the questions noted above, by March 1, 1973. Such a report could only meet this deadline if the data required were already in existence somewhere, and they were not. The summer camping season was already well underway by June 23 and no study of illness, injury, and death among campers could be mounted during the 1972 camping season.

The Public Health Service undertook its investigation of this matter upon the passage of the legislation. HEW staff did a thorough review of the literature and undertook discussions with State and local officials and with national organizations having knowledge of these matters.

The result of this review by the Department was consistent with the findings of the subcommittee-namely, that data currently available were incomplete. Further study was essential.

Accordingly, a report was made to the Congress by the date specified, March 1, 1973. This report addressed the nonavailability of data on preventable injuries and illnesses, reviewed existing literature on earlier studies pertaining to youth camp health and safety, summarized information obtained from State and local officials and public and private national organizations, and presented a plan for obtaining the information required in the legislation.

Since in the late summer of 1972 it was already evident that the Department could not answer Congress questions with existing data, the Public Health Service took appropriate steps at that time to make all necessary arrangements for a study of illness, injury, and death among summer youth campers during the 1973 camping season.

Furthermore, it moved to collect all laws and regulations pertaining either directly or indirectly to youth campers or the operation of such camps. The planning for this further study was carried out during the winter of 1972 and the spring of 1973.

During the summer of that year, two contractors and a subcontractor carried out the investigations. While the information gathering went smoothly, two circumstances delayed the prompt completion of the report:

1. The body of law and regulation gathered by the contractor required a more painstaking analysis than had been envisioned in the original contract. Accordingly, the contractor was requested to undertake this additional analysis—thus delaying a final report on law and regulation until early February of this year.

2. The injury and illness data emanating from the survey presented more analysis difficulties than had been anticipated. This contractor's report was also provided to the Department on about February 1.

The Department analyzed the data and prepared the report which was transmitted to Congress April 29.

FINDINGS, YOUTH CAMP SAFETY STUDY

Now I would like to recapitulate the findings produced by this study:

1. The rates of severe injury and illness among campers attending the approximately 200 camps were low—0.1 per 1,000 and 0.3 per 1,000 camper days, respectively. No deaths were reported in these camps. Moreover, severe injuries, illnesses, and deaths occurred with lower frequency among youngsters attending these 200 camps than occurs among this age group in the national population at large.

2. A mail survey and other sources of information identified 25 deaths among campers attending camps which were not part of the survey.

3. Undoubtedly, some of the severe injuries or illnesses and deaths noted above were preventable.

4. No systematic reporting mechanism presently exists which provides reasonably complete information on occurrence of severe injuries or illnesse and death associated with youth camps.

5. Twenty-eight States have laws and regulations specific to youth camps. Of these, only four were judged to have adequate legislation and regulation coupled with a regulatory requirements for the annual inspection of summer youth camps.

6. The enforcement of existing laws and regulations on summer youth camps is deficient.

We recognize that the results of the survey of illness and injury may not be entirely representative of all camps. Of the 200 camps constituting the initially selected sample, only 128 actually participated.

Some of those not participating indicated a simple unwillingness to participate while others lacked the required time or staff to do so. Still others had to be dropped because of early closing dates and others did not meet the specifications established for residential youth camps,

While replacement camps were drawn in a statistically random fashion, the total sample is, in fact, a selection of voluntary participants. Thus the statistical design does not allow us to conclude that findings are necessarily applicable to all camps.

I mentioned earlier that the illness and injury rate among the campers studied was very low-namely, 0.1 and 0.3 per 1,000 camper days. It is also true that the 25 deaths identified during the past season clearly indicate that camping is sometimes accompanied by tragedies for campers and their families. Those deaths must be evaluated with two facts in mind:

1. The information on camper deaths came from sources which might be expected to report all camp deaths but may have missed

2. The number of deaths reported, 25, is about one-half the number which would have been expected, given normal mortality rates for this age group in the national population at large.

The Department recognizes that the nature and extent of serious and preventable illness and injury and also death among campers is not fully understood since there is no monitoring system which reliably identifies these events. Nonetheless, the facts which are now available suggest that some action should be taken; even one camping death or serious injury is too many.

We believe that the States, camping organizations, parents and youth groups, and the Federal Government should devote their respective efforts to promoting the health and safety of our youth campers.

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BRIEF DESCRIPTION OF THE BILL

The Youth Camp Safety Act, H.R. 1486, directs the Secretary of Health, Education, and Welfare to develop and promulgate youth camp safety standards. It provides for departmental review of such plans and approval of State plans which are at least equal to Federal standards and which provide for the enforcement of such standards.

Grants, up to 80% of eligible costs, are authorized to be made to States with approved plans. The Secretary would be responsible for enforcement of youth camp safety standards in States without approved plans. Camps would be required to report annually to the Secretary all accidents resulting in death and serious injury and illness.

The Secretary would be responsible for the enforcement of Federal standards in travel camps. The legislation also directs the

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