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Daycare Center and Family Home Forum>Can I Require Epi-Pen?
LLLdle 12:25 PM 08-19-2016
Hi all,

Ive been an early childhood educator at private schools and this is my first year running my in-home center. I have a child starting next week who has an epi-pen. At the schools I worked at we required the parents to supply us with an extra epi-pen to keep on hand in case of an emergency. This epi-pen stayed in the main office or in the teachers emergency back-pack.

My question is....can i have the same policy here at my home daycare or is there anything that has worked for you all in the past? My fear is that the parents would forget it one day OR Id have to go digging in a diaper bag if their were an emergency instead of a known spot OR Id have to keep constant tabs when he arrives on if the epi pen is there and in site. I also think the parents might have a fit if I require it to stay here. :/

Open to any suggestions
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Blackcat31 12:28 PM 08-19-2016
Originally Posted by LLLdle:
Hi all,

Ive been an early childhood educator at private schools and this is my first year running my in-home center. I have a child starting next week who has an epi-pen. At the schools I worked at we required the parents to supply us with an extra epi-pen to keep on hand in case of an emergency. This epi-pen stayed in the main office or in the teachers emergency back-pack.

My question is....can i have the same policy here at my home daycare or is there anything that has worked for you all in the past? My fear is that the parents would forget it one day OR Id have to go digging in a diaper bag if their were an emergency instead of a known spot OR Id have to keep constant tabs when he arrives on if the epi pen is there and in site. I also think the parents might have a fit if I require it to stay here. :/

Open to any suggestions
Absolutely! I would NOT allow the child to be in care at all without one. Way too risky and like you mentioned what if the parent forgot?

I would insist they leave one with you.

Welcome to the forum too!
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Second Home 12:36 PM 08-19-2016
Here in MD we must have a allergy or asthma treatment plan ( forms are from the state ) filled out by the child's doctor and the medication in original packaging when accepting a child into care .
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Leigh 12:40 PM 08-19-2016
Originally Posted by Blackcat31:
Absolutely! I would NOT allow the child to be in care at all without one. Way too risky and like you mentioned what if the parent forgot?

I would insist they leave one with you.

Welcome to the forum too!
Also, you do NOT want one in a diaper bag where other kids could access it! Get one that YOU can lock up and keep safe.
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Mom2Two 01:04 PM 08-19-2016
Epi-pens have a problem with exposure to heat. I'll have to read the pkg again. But being dragged around in the diaper bag might mean that it's been left in the car.

I would also ask parents to do the trainer with you (one comes in each double pkg) or leave it with you at least for a time. Also to leave a sheet with instructions about what to admin for each reaction. Only severe reactions (vomit or anaphylaxis) warrant the epi. Other reactions should be treated with benedryl.

If I find the good sheet I've seen, I'll post it here.
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Mom2Two 01:04 PM 08-19-2016
Just so you know, unless the parents have it covered by insurance, Epis cost like $500 each.
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LysesKids 01:11 PM 08-19-2016
Originally Posted by LLLdle:
Hi all,

Ive been an early childhood educator at private schools and this is my first year running my in-home center. I have a child starting next week who has an epi-pen. At the schools I worked at we required the parents to supply us with an extra epi-pen to keep on hand in case of an emergency. This epi-pen stayed in the main office or in the teachers emergency back-pack.

My question is....can i have the same policy here at my home daycare or is there anything that has worked for you all in the past? My fear is that the parents would forget it one day OR Id have to go digging in a diaper bag if their were an emergency instead of a known spot OR Id have to keep constant tabs when he arrives on if the epi pen is there and in site. I also think the parents might have a fit if I require it to stay here. :/

Open to any suggestions
Just be ready to hear that the parents may not be able to afford more than one even with insurance... I know for a fact I can't because they cost $500-1000 a pop now and I pay out of pocket for mine; that and the epic pen literally has to be replaced yearly. Believe me I would want an extra in daycare if a child needed it, but it could actually be a budget breaker if a family is living paycheck to paycheck.

I go a few years in between & pray a lot that a bee doesn't sting me, but since the cost skyrocketed it's out of my range - the IRS gives me a waiver on medical each year ( I'm in a state that didn't expand healthcare for working poor) and I'm still too young to qualify for senior benefits thru DHS
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LysesKids 01:13 PM 08-19-2016
Originally Posted by Mom2Two:
Just so you know, unless the parents have it covered by insurance, Epis cost like $500 each.
More than that sometimes & if they haven't used their deductible it may come out of pocket like mine does
Reply
Blackcat31 01:49 PM 08-19-2016
Originally Posted by Mom2Two:
Just so you know, unless the parents have it covered by insurance, Epis cost like $500 each.
accidental death, failure to provide medical provisions and possible loss of business and person assets far exceeds $500.
Reply
Mike 02:26 PM 08-19-2016
Even with the cost, if I was to watch a child who needed an epi-pen, parents would have 2 options. Get one for me to keep, or hand it to me personally each morning. If they choose the 2nd option and ever forget to bring it, child can't be dropped off.

I've seen what happens when one is needed and not around. Luckily the ambulance was fast enough.
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lblanke 05:57 AM 08-20-2016
Yes absolutely. Parents should provide an epi pen and clear written instructions from a doctor as to when to give it. Do not accept a child without one if that child has one prescribed. It comes as a twin pack (2 pens). Keep it out of reach of the children but not locked (you don't want to fumble around for a key in the unlikely event you have to use it).
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Mike 06:28 AM 08-20-2016
Originally Posted by lblanke:
Yes absolutely. Parents should provide an epi pen and clear written instructions from a doctor as to when to give it. Do not accept a child without one if that child has one prescribed. It comes as a twin pack (2 pens). Keep it out of reach of the children but not locked (you don't want to fumble around for a key in the unlikely event you have to use it).

That's a very good point.
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Pestle 04:45 PM 08-20-2016
The EpiPen brand only comes in a two-pack, so your parents should have a second one that stays with you. That's how we do it with our daughter.

The cost is extraordinary, yes, and most insurance only covers a small portion of it, yes. We had the Auvi-Q, which the allergist gave us a manufacturer's coupon for, and I think the upfront cost was much less. But then GENCO had a recall on the Auvi-Q, so now we have the EpiPen again.

I have read that it's possible for parents to have a compounding pharmacy create a generic epinephrine solution for you and give you a syringe for it. You could see if your family's allergist would consider that.

Apparently, there's a third competing brand called Adrenaclick. We'll be looking into that when our current EpiPens expire.
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sahm1225 08:01 PM 08-21-2016
Originally Posted by Pestle:
The EpiPen brand only comes in a two-pack, so your parents should have a second one that stays with you. That's how we do it with our daughter.

The cost is extraordinary, yes, and most insurance only covers a small portion of it, yes. We had the Auvi-Q, which the allergist gave us a manufacturer's coupon for, and I think the upfront cost was much less. But then GENCO had a recall on the Auvi-Q, so now we have the EpiPen again.

I have read that it's possible for parents to have a compounding pharmacy create a generic epinephrine solution for you and give you a syringe for it. You could see if your family's allergist would consider that.

Apparently, there's a third competing brand called Adrenaclick. We'll be looking into that when our current EpiPens expire.
I was actually just talking about this with one of my daycare moms. Her son needs one for home, daycare AND school. They would only cover one epipen pack. She called the insurance and explained that this was a life saving medicine. They told her they would cover one pack a month since it was medically required and the school required it. The insurance ended up covering 100% of the cost and she was able to get three sets. Maybe you could call your insurance and ask? It just seems unfair that insurance wouldn't cover something that is necessary! The cost of an epipen being covered would be cheaper than a hospital visit for the insurance to pay out!
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Pestle 08:12 PM 08-21-2016
Originally Posted by sahm1225:
I was actually just talking about this with one of my daycare moms. Her son needs one for home, daycare AND school. They would only cover one epipen pack. She called the insurance and explained that this was a life saving medicine. They told her they would cover one pack a month since it was medically required and the school required it. The insurance ended up covering 100% of the cost and she was able to get three sets. Maybe you could call your insurance and ask? It just seems unfair that insurance wouldn't cover something that is necessary! The cost of an epipen being covered would be cheaper than a hospital visit for the insurance to pay out!
I accidentally burst into tears (at the office, in front of my manager) while on the phone with the insurance company, and the agent felt bad enough to cover part of the prescription that time.
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MrsSteinel'sHouse 09:13 AM 08-22-2016
Originally Posted by Pestle:
The EpiPen brand only comes in a two-pack, so your parents should have a second one that stays with you. That's how we do it with our daughter.
They come as a 2 pack because in most places it will take longer than the 15 minutes that the 1st shot lasts for, for an ambulance to arrive and for them to be transported. Keep the 2 pack together!! You may need both!
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Mike 09:26 AM 08-22-2016
Originally Posted by MrsSteinel'sHouse:
They come as a 2 pack because in most places it will take longer than the 15 minutes that the 1st shot lasts for, for an ambulance to arrive and for them to be transported. Keep the 2 pack together!! You may need both!
That's good to know. Can get expensive having to have 2 at each location, but then, how much is your child worth?
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Pestle 09:43 AM 08-22-2016
Yes, that is good to know! Fortunately, both my daughter's school and my house are within 3 blocks of a hospital.
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laundrymom 09:49 AM 08-22-2016
I require one to be left here as its a basic medical need. I understand they're expensive, but what price would a parent out on a child's life? It's an issue I won't waiver on. No pen. No care.
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MrsSteinel'sHouse 10:40 AM 08-22-2016
and my daughter's doc wrote out the prescription for 2 sets as the prescribed amount and my insurance covered it. So she had one at school (teacher) and one at home.
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KSDC 12:12 PM 08-23-2016
I have a child with an epi. Her family keeps it in a small bag that is handed to me when she walks in the door. No epi, no stay. The bag is then hung on a high hook in my office behind a child safety gate. Easy for me to reach, near on impossible for any of my munchkins.
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Leigh 02:19 PM 08-23-2016
Originally Posted by Pestle:
The EpiPen brand only comes in a two-pack, so your parents should have a second one that stays with you. That's how we do it with our daughter.

The cost is extraordinary, yes, and most insurance only covers a small portion of it, yes. We had the Auvi-Q, which the allergist gave us a manufacturer's coupon for, and I think the upfront cost was much less. But then GENCO had a recall on the Auvi-Q, so now we have the EpiPen again.

I have read that it's possible for parents to have a compounding pharmacy create a generic epinephrine solution for you and give you a syringe for it. You could see if your family's allergist would consider that.

Apparently, there's a third competing brand called Adrenaclick. We'll be looking into that when our current EpiPens expire.
Actually, a provider should have both pens from a pack-they come in pairs so that there is a spare in case of failure, and because if you can't get to emergency personnel within 15 minutes, you're supposed to administer the 2nd dose.

But, YES, there is at least one alternative auto-injector that is much cheaper, and epinephrine + syringe is another option (I'd require the auto injector for daycare and let the parents deal with syringe, though, because of liability-you don't want to inject a vein!).
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Leigh 02:20 PM 08-23-2016
Originally Posted by Leigh:
Actually, a provider should have both pens from a pack-they come in pairs so that there is a spare in case of failure, and because if you can't get to emergency personnel within 15 minutes, you're supposed to administer the 2nd dose.

But, YES, there is at least one alternative auto-injector that is much cheaper, and epinephrine + syringe is another option (I'd require the auto injector for daycare and let the parents deal with syringe, though, because of liability-you don't want to inject a vein!).
And, I see that others have already said what I did.
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galaxy 02:28 PM 08-23-2016
Yes. I follow army childcare guidelines and if a child has an allergy map and it says they need an epi it must be kept in care. Emergency rescue meds are kept in a red backpack and go with us every where including outside even if we are just going to be in the yard.
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Blackcat31 06:42 AM 08-24-2016
A little off topic from original post but still interesting info about cost of EpiPens

http://usuncut.com/class-war/pharma-ceo-epipen/

"The pharmaceutical company that cornered the market on the life-saving EpiPen and dramatically increased its price also jacked up the pay of top executives.

Between 2007, when Mylan acquired the patent for the EpiPen, to 2015, the wholesale price had skyrocketed from $56.64 to $317.82 — a price increase of 461 percent. Similarly, compensation for Mylan CEO Heather Bresch increased astronomically over the same time period. According to NBC News, Bresch went from making $2.453,456 in 2007 to $18,931,068 in 2015, amounting to a 671 percent raise over eight years.

But Bresch wasn’t alone in the windfall resulting from the rising price of the EpiPen. Mylan’s president, Rajiv Malik, saw his base pay increase by 11 percent to $1 million annually as of 2015, while Mylan Chief Commercial Officer Anthony Mauro got a 13.6 percent raise, amounting to $625,000 per year.

Millions of people with life-threatening allergies, particularly food allergies, depend on the EpiPen for survival. When used, the EpiPen provides an emergency dosage of epinephrine to the user, inhibiting a potentially fatal allergic reaction, known as anaphylaxis, from occurring.

The rising cost of the EpiPen also mirrored Mylan’s stock price increase over the same time period. In the two years after Mylan acquired the EpiPen patent, the price increased by a 5 percent rate. In 2009, the price of the EpiPen increased by a whopping 19 percent. And in 2010, 2011, 2012, and 2013, the price went up by another ten percent each year. The price then shot up rapidly from the fourth quarter of 2013 to the second quarter of 2016, skyrocketing by 15 percent twice a year.

Conversely, between 2007 and 2015, Mylan’s stock price tripled, going from $13.29 per share in 2007 to a high of $47.59 in 2016. As of this writing, Mylan’s stock is hovering around $45.68 per share on the NASDAQ index, with MarketWatch rating Mylan’s stock as “Bullish.” According to Bloomberg, the EpiPen now accounts for roughly 40 percent of Mylan’s profits.

Mylan’s greedy business practices are attracting the rancor of parents and politicians alike. On Monday afternoon, a coalition of U.S. Senators, led by Amy Klobuchar (D-Minn.), the ranking member of the Senate Judiciary Committee, penned a letter to Mylan CEO Heather Bresch demanding she justify her company’s dramatic price increase of the life-saving device.

“This outrageous increase in the price of EpiPens is occurring at the same time that Mylan Pharmaceutical is exploiting a monopoly market advantage that has fallen into its lap,” Sen. Klobuchar said in a public statement. “Patients all over the U.S. rely on these products, including my own daughter. Not only should the Judiciary Committee hold a hearing, the Federal Trade Commission should investigate these price increases immediately.”

As of Tuesday evening, Mylan had not responded to the request for a Senate hearing. The Other 98%, a progressive action group, has launched a petition calling on Mylan to make the EpiPen affordable for everyone"


If you are interested in signing the petition, use this link:

https://actionnetwork.org/petitions/...g-medicine-now
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Mike 07:42 AM 08-24-2016
I signed.

I hate when companies use monopoly to their advantage. For a product people don't need, charge whatever you want. For a product that saves lives, give it to a non profit organization.
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MarinaVanessa 09:03 AM 08-24-2016
Originally Posted by Blackcat31:
accidental death, failure to provide medical provisions and possible loss of business and person assets far exceeds $500.
Agree completely.

I require one. If a parent couldn't afford an Epi pen then I'd be genuinely sorry for the family but I wouldn't take on that risk in liability.

I have to remind myself constantly that their issues are not my issues and not to make them my issues at the risk of my business.
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laundrymom 09:23 AM 08-24-2016
This. Exactly.
I'm a childcare provider.
I'm not the parent.
It's not my responsibility to figure out "how THEY provide" only that they provide it.
I know it's expensive but it's part of being a parent. Especially when a child has special needs. It's not
Fair. It isn't fun. And it's no ones fault. But it still is part of being a parent.

Originally Posted by MarinaVanessa:
Agree completely.

I require one. If a parent couldn't afford an Epi pen then I'd be genuinely sorry for the family but I wouldn't take on that risk in liability.

I have to remind myself constantly that their issues are not my issues and not to make them my issues at the risk of my business.

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Tags:allergies, epi pen
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