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  #1  
Old 10-05-2011, 08:37 PM
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Default Med Policy Change... Need Feedback Please!

After reading the thread on the over medicated baby, I have reconsidered my policy on meds and have decided to no longer give meds at all. I don't want the liability. This is the notice I plan to give out:

Notice of Policy Change:

Effective immediately, no medications of any kind will be given at *** daycare. This includes all prescription and over the counter medications.
This change is due to increased risks involved in giving medications and increased liability which we are unable to accept. Please respect this policy and do not ask for an exception.*
Please note: the ONLY exception to this policy will be for children who require the use of an inhaler for breathing issues.*

Should I add anything? Remove anything?
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  #2  
Old 10-05-2011, 08:48 PM
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I think it is reasonable to allow prescription meds. Do you really want to rule out caring for any medical or special need condition?

I do agree with refusing to dispense any over-the-counter meds without a written prescription.
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Old 10-05-2011, 08:58 PM
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Quote:
Originally Posted by Crystal View Post
I think it is reasonable to allow prescription meds. Do you really want to rule out caring for any medical or special need condition?

I do agree with refusing to dispense any over-the-counter meds without a written prescription.
Hmmm, can you give an example where providers dispensing prescription would be necessary (other than the inhaler, which I stated would be allowed)?
I'm thinking if a child is ill they shouldn't be here anyway. The only thing I can come up with is maybe ADHD meds that require a midday dose.
What about maybe adding a clause that the parent is welcome to come and give the meds themselves? I just don't want the liability. If I don't give it, then I'm not liable, right? Maybe have them sign when they give the meds and a date? What do you think?

Last edited by 3kidzmama; 10-05-2011 at 08:59 PM. Reason: Misspelling
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Old 10-05-2011, 09:27 PM
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I would state in you PHB that if a child is on medication, the parent MUST personally hand you the meds, along with doctors diagnosis, treatment plan and all parents must sign permission to administer form each and every time their child gets put on a new medication. Also NO over the counter medications will be given at daycare without a doctor’s diagnosis and treatment plan plus all of the above.

Works for me always
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Old 10-05-2011, 10:16 PM
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A child would need to be on antibiotics for something long past the point they are contagious. That might be another time you would need to consider giving meds...
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Old 10-05-2011, 10:24 PM
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I have an illness which has always required me to take medication 3x a day. So therefore if I were a child I could not attend your daycare.

However, I understand your desire. It is a big liability.
It's your business and your choice how you want to run it.
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Old 10-06-2011, 03:29 AM
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so are you not going to allow children to come if they are on medication, because children can be on meds anywhere from 3 days to 10 days (which is now the norm) I think I would allow prescribed medication only.
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Old 10-06-2011, 04:23 AM
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My med policy states that we rarely ever give medication.

I do keep tylenol or advil on hand in case a child spikes a high fever here. I want to be able to give them a fever reducer to prevent a febrile seizure. I've had to do that a couple of times in the last decade.

I don't give antibiotics. I would only give that if it was ordered four times a day or more and that never happens.

I don't do respiratory therapy treatments.

I do give benadryl cream or spray for my two little girls with mosquito bite allergies with a dr's order. Their allergies are very severe.

I never administer teething medication or cold medication.

I don't have medical or behavioral special needs children in my day care and most likely won't for the rest of my career.
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Old 10-06-2011, 04:46 AM
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I give antibiotics if they are 3 times a day or more. I'll give one dose. I will also give Benadryl liquid and apply cream for the same reasons as Nannyde. I have one DCG with an allergy and a doctors note. She is just a mess if a bug bite goes too long without some cream.

Other than that I have a waiver to administer tylenol or advil with a same day permission email from the parents.

I think in general if they need meds they should be home.

I would be open to give any doctor's prescription that can't be worked around DC hours though.
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Old 10-06-2011, 06:25 AM
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Ok so... Would any of you mind posting or pm'ing me how your policy actually reads? I'm looking for the least liability, but at the same time I don't want to be unreasonable. Also, I do not accept special needs children (I'm a former Special Ed teacher - been there, done that, no desire to do it again). But I do understand that there are going to be those that require meds past the time of contagious period.
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Old 10-06-2011, 06:43 AM
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make sure you state that you have benedryl on hand, this summer, I had a kid who wrapped himself in a blanket that the kids where playing with outside and he broke out in hives, totally weird, but a shot of benedryl fixed it.
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Old 10-06-2011, 06:53 AM
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I would not limit to just asthma medication. Some children are on a maintenance medication such as those with diabetes. What about Epi pens do plan on excluding those as well? I understand the need to limit what meds you give but as a parent and provider I would be a little leery of such a narrow policy.
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Old 10-06-2011, 06:56 AM
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Quote:
Originally Posted by daycare View Post
I would state in you PHB that if a child is on medication, the parent MUST personally hand you the meds, along with doctors diagnosis, treatment plan and all parents must sign permission to administer form each and every time their child gets put on a new medication. Also NO over the counter medications will be given at daycare without a doctor’s diagnosis and treatment plan plus all of the above.

Works for me always

This is what is required for our public school as well. If we want our child to have tylonol at school I have to send a drs note with the bottle of medication "I" hand to the nurse. No note means I have to go to the school to administer myself.
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Old 10-06-2011, 06:58 AM
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I will apply Baby Anbesol for teething children with a note and I will administer Tylenol at the written request of the parent if they supply it and there must be a reason for it.


For example: I will not give Tylenol to a 3 year old just because they are going in for a flu shot.
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  #15  
Old 10-06-2011, 07:07 AM
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My handbook reads:

"NO medication will be given to any child while on the child care premisis. This includes over the counter medications such as Tylenol and Advil and their generic forms. I will also NOT give prescription medication to any child while in care. If your child needs prescription meds, please make arrangements for their dosage requirements to not interfere with child care attendance."

This has been my policy for several years. I have yet to have a parent try to negotiate or ask for exceptions. I have had several children needing prescription meds for various reasons such as an ear infection or something similar and they have all either gotten an antibiotic that is dispensed twice daily or only once. I know there are a few meds that need to be given three or four times daily but the parents have either picked up before their child needed the next dose or used alternate care arrangements with family members.

I also have a section in my policy stating that parents must inform me when their child is on medication (OTC and prescription) and failure to notify me is grounds for immediate termination.

I have refused to take on the liability connected with children and medications and make absolutely no exceptions. It has worked fine for several years so I don't find this policy to be impossible and is very do-able. I also require all imms to be given on a Friday or prior to the child having 2 days off from care.
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  #16  
Old 10-06-2011, 07:08 AM
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I have a medication authorization form that is required for parents to fill out, in full, and return before any meds can be given here.

It has Childs full name, name of medication, Prescription number, Physicians name/phone number, start and end dates, times to be given, how medication is to be stored, and dosage for the specific child as per signing physician. I then document each dosage and time, at the end of treatment we both keep a copy.

So, technically, Yes, I give meds...but they have to do their part first. Nobody has for anything other than longterm/chronic cardiac/renal/respiratory meds (have not given meds for over a year now). I also do not have the meds going back and forth (exhausting policing), I have them ask the pharmacist to split it into two bottles for childcare, never been an issue.

Turns out it is easier to give a 3x per day med (every 8 hours) just before drop-off, right after pick-up and before the adults go to bed for the evening than to go through the trouble of having the ped fill out a dosing schedule for childcare (other than longterm).

I do not feel guilty for having "inconvenienced" them at all. It is their child. I have followed many a difficult dosing schedule for my kids. Honestly, though, not many antibiotics are dosed 3-4 times a day anymore. Peds know non-compliance is HUGE with those....they breed superbugs.
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  #17  
Old 10-06-2011, 07:16 AM
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what about an infant on reflux meds? don't those have to be given more frequently? My DD didn't need them but I heard of a lot of babies who did
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Old 10-06-2011, 07:23 AM
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Quote:
Originally Posted by Unregistered View Post
what about an infant on reflux meds? don't those have to be given more frequently? My DD didn't need them but I heard of a lot of babies who did
For me, Sure

Reflux would be considered a chronic/longterm condition.

I would still be required to have the form filled out, though. I have to keep them on file for two years because of the rate drugs are being put out on the market and then being recalled now.
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Old 10-06-2011, 08:44 AM
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I'm also going to change my policy to no meds. I will keep Tylenol on hand, but will NOT give it for teething. That mother wanted me to give Tylenol EVERY day, plus she was giving it at home but didn't tell me when he last had it. How was I ever supposed to know if he had a fever?!

If parent wants child on decongestant or whatever for a cold or allergies, they can do that at home. If it is that bad that the child can't function without it, they can stay at home for the day.

I've never had a parent even ask me to give antibiotics or prescriptions, besides that mom...but technically she never told me about the prescriptions, I just found them in the bag.
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Old 10-06-2011, 09:28 AM
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Here is mine,... I think it covers almost everything...


Illness and Medication Policies
~If you know they are ill - DO NOT BRING THEM. If your child becomes ill COME TO GET THEM. If there is vomiting, diarrhea, fever, green or yellow runny nose, or an undiagnosed rash they cant come to daycare. Child can return to daycare when:
Fever free without medication for 24 hours (teething does not cause fever)
Free of vomiting, fever or diarrhea without medication for 24 hours, this means 24 hours from last episode. If they last vomited at daycare at 330 pm, they cant return to daycare until 330 pm the following day, even if they do not vomit again at home. They must be out of daycare for 24 hours following illness. If they vomit at home after leaving daycare then they can’t return until 24 hours has passed from that episode. I know this sounds ridiculous and that most parents would never willingly expose another child to illness. Over the years we have had many bouts with preventable illness’s because parents brought their child back to daycare while they are still contagious. If your child is ill and has a fever, even when you give meds to alleviate fever, the child is STILL contagious even if fever comes down with medication. They must be FEVER free, SYMPTOM FREE for 24 hours without medication . They must also wait 24 hours AFTER the start of any antibiotic.
~ Please do not attempt to ‘mask’ illness with medications. I know your child well enough to that I can tell when they are medicated. This also becomes a safety issue should an accident occur and paramedics ask if they have had medication. If you feel the need to medicate your child then they need to be absent from daycare that day. My priority is to keep the children in my care SAFE, HEALTHY and HAPPY. I am unable to do that if I allow ill children to attend. While I know it is an inconvenience, your child’s health and the health of his/her playmates is worth more than you may lose by missing work. If it is crucial you do not miss work, then you must find alternate care for your ill child, maybe a friend or family member.
~ I would appreciate all medications to be given at home and not daycare. This includes antibiotics and allergy medications. I prefer medications be handled by parents or guardians. There are times when this is unavoidable and in this case ALL medication must be brought in daily with a detailed signed note giving permission to administer including time and dosage instructions. I am referring to medications for asthma, heart medications, etc. A doctors prescription and detailed administration directions from physician are needed and they are the only instructions I will follow. The medication must be for the child who is getting it. Ex: Billy cant have Sally’s meds even if they have the same illness. I will also only give medications 4-6 hours after arrival. If they need an initial daily dose, give it to them at home. I will NOT administer meds until I can ensure there will be NO chance for accidental overdose.
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Old 10-06-2011, 09:30 AM
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Quote:
Originally Posted by Blackcat31 View Post
My handbook reads:

"NO medication will be given to any child while on the child care premisis. This includes over the counter medications such as Tylenol and Advil and their generic forms. I will also NOT give prescription medication to any child while in care. If your child needs prescription meds, please make arrangements for their dosage requirements to not interfere with child care attendance."

This has been my policy for several years. I have yet to have a parent try to negotiate or ask for exceptions. I have had several children needing prescription meds for various reasons such as an ear infection or something similar and they have all either gotten an antibiotic that is dispensed twice daily or only once. I know there are a few meds that need to be given three or four times daily but the parents have either picked up before their child needed the next dose or used alternate care arrangements with family members.

I also have a section in my policy stating that parents must inform me when their child is on medication (OTC and prescription) and failure to notify me is grounds for immediate termination.

I have refused to take on the liability connected with children and medications and make absolutely no exceptions. It has worked fine for several years so I don't find this policy to be impossible and is very do-able. I also require all imms to be given on a Friday or prior to the child having 2 days off from care.
This is exactly what I was thinking originally. Do you mind if I use your wording in my new
policy?
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Old 10-06-2011, 10:10 AM
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Count me in the group that does not want the liability. I don't give ANY meds either and this is my policy:

"****** Daycare does not administer any prescription or non-prescription medications. If your child requires medication, we recommend that you set up a dosing schedule that does not include the hours that your child is in care. Should your child require medication during daycare hours, you will be required to come and give him/her the scheduled dosage."



In my state you have to have MAT training in order to administer even over the counter meds and we need a consent form for topical products. So, I have the parents fill out a consent form for topical products like sunscreen, diaper cream, insect repellant, etc. saying they must be in the original container and will only be applied only according to the manufacturer’s directions. They have to have a dr.'s note for any exceptions.
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  #23  
Old 10-06-2011, 11:38 AM
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Default Medication policy

I don't like to administer meeds to my dcks but I will if I need to. I have the parents fill out a detailed medication form no matter what medication it's for. I don't use baby oragel or baby ambesol be use it just makes teething babies that much madder in my experience! I keep liquid benedryl here in case of allergic reactions that have to be addressed right away. I have infants ibuprofen drops and infants acetaminophen drops as well as children's ibuprofen and acetaminophen that I have on hand. Since I rarely have to use them, I don't mind providing them. It's less of a hassle for me.

With prescription medications, I will do antibiotics only if it's prescribed to take 3 or 4 times a day. I won't do neb treatments but I don't mind inhalers (with spacers). I don't have any kids with an epi-pen right now. I don't mind eye drops unless I have to fight with a child to get them in. Let the parents deal with that fight!
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Old 10-06-2011, 12:04 PM
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Quote:
Originally Posted by 3kidzmama View Post
This is exactly what I was thinking originally. Do you mind if I use your wording in my new
policy?
It's yours to use. Hope it helps.
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  #25  
Old 10-15-2013, 06:42 AM
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Quote:
Originally Posted by 3kidzmama View Post
Hmmm, can you give an example where providers dispensing prescription would be necessary (other than the inhaler, which I stated would be allowed)?
I'm thinking if a child is ill they shouldn't be here anyway. The only thing I can come up with is maybe ADHD meds that require a midday dose.
What about maybe adding a clause that the parent is welcome to come and give the meds themselves? I just don't want the liability. If I don't give it, then I'm not liable, right? Maybe have them sign when they give the meds and a date? What do you think?
A child who needs insulin, epilepsy medications, inhalers in some circumstances, basically any medications used to treat a condition that could be considered a disability. In my understanding, a provider may not refuse to give medications used to manage a disability, nor refuse to care for a child that requires them if the decision is based on the need for meds.
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Old 10-15-2013, 06:59 AM
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Quote:
Originally Posted by Leigh View Post
A child who needs insulin, epilepsy medications, inhalers in some circumstances, basically any medications used to treat a condition that could be considered a disability. In my understanding, a provider may not refuse to give medications used to manage a disability, nor refuse to care for a child that requires them if the decision is based on the need for meds.
Yep. I have a daycare child on Zantac, Amiodorone (heart condition), breathing treatments (lung damage from heart failure at birth), antibiotics occasionally (she has to be on them for WEEKS sometimes). Not to mention constant topically.

Her little infant brother is on Zantac also.

I have a very detailed physician form to be filled out every time a medication is dispensed and if a dr recommends an OTC med he fills that out or the pharmacist can fill it out with detailed instructions, dosages, reasons for administration etc and side effects to be expected.

Living down here with allergies and asthma so very high, if I refused to keep kids who were on meds I would be in the poor house.

But I don't just give meds for the heck of it though.
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Old 10-15-2013, 08:50 AM
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I refuse to give medications of any kind, if child needs meds they need to stay home, I don't want to take chances with the children's health and then be on the evening news.
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Old 10-15-2013, 09:42 AM
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We are also not allowed (starting this year) to give meds of any kind. In theory it makes sense, but in practice sometimes healthy kids DO need to be on medication that can't be timed outside of daycare. For example my baby came home on medication to regulate his heart rate after open heart surgery. He was able to be weaned off it as an infant thank G/d, but he could have been on it for years. It needed to be given every 6 hours, because that is how long it is effective for. He was in my daycare at the time so I could legally give it to him, but if I had worked outside the house no idea what I would have done. He was FINE to be in daycare, it was simply an effect of scarring doing the surgery that thankfully went away with time.
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Old 10-15-2013, 10:37 AM
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Quote:
Originally Posted by Crystal View Post
I think it is reasonable to allow prescription meds. Do you really want to rule out caring for any medical or special need condition?

I do agree with refusing to dispense any over-the-counter meds without a written prescription.
I just sent out a memo to make parents aware that as of now, I no longer administer over the counter meds to children under 2yr
I wish I could say I don't want to administer any but as you said if I did that my daycare would be empty more times than not
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Old 10-15-2013, 01:32 PM
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I don't administer medications either. other than topical products I don't have anything in my policies about exceptions. I do this because I don't want clients to start asking me for a bunch of reasons why I should make an exception for them when it's not necessary (one example, I had a client with a little boy that believed whole hearted that everything required antibiotics. DCB was given so much since so little that they stopped working on him and later he repeatedly got chronic earaches and DCM wanted me to administer antibiotics when she could just as easily give them at home) but if a client has a need due to some type of special need I can make the decision to make an exception if I like (I do have a DCG with allergies to ALOT and asthma so I made an exception for an inhaler and epi pen)

Here is what I have:

Medication
The childcare provider will not administer any type of medication at daycare. This includes prescription and non-prescription medication. If a child needs medication of any kind a dosage schedule must be set up that does not include the hours that the child is in care. Clients are required to notify the childcare provider any time that their child is on any type of medication so that we can look out for possible reactions to the medication.

Keep in mind that fever reducers and pain relievers do not cure illnesses, they simply mask symptoms. If a child is given any form of fever reducer or pain reliever then this means that the child is not well enough to attend daycare and is required to be kept home for a minimum of 24 hours from the time that the last dosage was given.

Do not send a sick child to daycare by giving a fever/pain reducer to mask the symptom. The effects of the medication will eventually wear off (usually between 12:00 p.m. and 2:00 p.m. if given in the morning) and it will be apparent to the childcare provider that the child was given medication. In the day care field this is commonly known as the "dope and drop". Giving a child fever/pain reducer and bringing a child to daycare are immediate grounds for termination.

Topical products such as lotion, diaper rash ointment, sunscreen, children’s toothpaste, etc. are the only exception but require written consent. Topical products must be provided by the client in unopened and original containers and labeled with the child’s name and must remain at the daycare at all times.
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  #31  
Old 10-15-2013, 01:56 PM
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Quote:
Originally Posted by Jenniferdawn View Post
A child would need to be on antibiotics for something long past the point they are contagious. That might be another time you would need to consider giving meds...
Yeah, some meds need to be given 3-4x a day for 7-10 days which is well beyond the point of contagiousness or symptoms. I personally don't mind giving Rx meds if its during my hours of care and with a dr's note and appropriate forms signed. OTC meds I can see refusing and it's not something I typically do anyway.

Another thought, what about Epi-Pens? Are you going to refuse those too? Those are life-saving and a lot of kids need them.
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