Chapter 07. Health and Medication Requirements for Youth Camps

“Acute illness” means an abnormal condition of the body with rapid onset associated with recognizable symptoms and signs, such as chicken pox, gastroenteritis, influenza, or streptococcal sore throat, which has a short course of duration, as opposed to a chronic illness of long duration lasting 30 calendar days or more.

Administer Medication.

“Adult” has the meaning stated in COMAR 10.16.06.02.

“Agent” means an individual who:

“Anaphylaxis” means a sudden, severe, and potentially life-threatening allergic reaction that occurs when an individual is exposed to an allergen.

“Applicant” means an individual applying for a Certificate for Emergency Epinephrine.

“Camp” means a youth camp as defined in COMAR 10.16.06.02.

“Camper” has the meaning stated in COMAR 10.16.06.02.

“Certificate” means a document showing the authority to operate a youth camp, issued by the Maryland Department of Health pursuant to COMAR 10.16.06 and Health-General Article, §14-403, Annotated Code of Maryland, which displays the name of the person granted the authority.

“Certificate for emergency epinephrine” means a certificate or an endorsement on the operating certificate of a youth camp issued by the Maryland Department of Health to an individual who operates a youth camp under COMAR 10.16.06 to obtain, store, and administer emergency use epinephrine.

“Certificate for emergency epinephrine holder” means an individual who is authorized by the Maryland Department of Health to obtain, store, and administer emergency use epinephrine to be used in an emergency situation.

“Day” has the meaning stated in COMAR 10.16.06.02.

“Department” has the meaning stated in COMAR 10.16.06.02.

“Director” has the meaning stated in COMAR 10.16.06.02.

“Emergency medication” means a medication, identified by a camper’s plan of action for use in case of a medical emergency, for a camper with an identified medical problem.

“Emergency use epinephrine” means a portable, disposable drug delivery device or product approved by the federal Food and Drug Administration that contains a premeasured single dose of epinephrine that is used to treat anaphylaxis in an emergency situation.

“Health supervisor” means an individual who:

Identified Medical Problem.

“Medication” means any nonprescription or prescription medication present at camp.

“Operate” means to supervise, control, conduct, or manage a youth camp as:

“Operator” has the meaning stated in COMAR 10.16.06.02.

“Person” has the meaning stated in COMAR 10.16.06.02.

“Secretary” has the meaning stated in COMAR 10.16.06.02.

“Self-administer medication” means the act of an individual’s ingesting, injecting, or applying the individual’s own medication when the individual:

“Successfully completed” means to pass a written examination with a grade of 75 percent or higher.

Is approved annually, in writing, by a physician, certified nurse practitioner, or registered nurse licensed to practice in the State;

Is on file in the headquarters or office of the camp and is available to the camp staff members;

Includes the name, title, and license number of the health supervisor;

Includes procedures for the camp staff members to:

Includes procedures for handling medication at camp in accordance with Regulation .14 of this chapter; and

If using electronic records, includes procedures for, in the event that a power or server outage prevents access to the electronic record:

Is trained in the health program;

Demonstrates knowledge of the health program procedures; and

Is provided with the opportunity to discuss the procedures and have any questions answered by a supervisor.

Available for consultation at all times when campers are present at a camp; and

On site at all times when campers are present in a camp where 50 percent or more of the campers have identified medical problems;

With the trip; and

At the camp;

With the trip; and

At the camp.

Date;

Name of individual;

Ailment;

Treatment prescribed; and

Name of the individual administering care or initials of the individual administering care if a list of names and initials is provided at the front of the health log;

Written on lined paper;

Maintained in a confidential manner;

Stored in a locked compartment;

Available at all times for review by the Department; and

Retained for a period of 3 years;

Recorded in ink and no lines are skipped, providing a permanent record that is not easily modified; and

Legibly signed by the individual administering care at the camp; and

Bound volume, such as a composition notebook;

Spiral book with sequentially numbered pages; or

Dedicated paper record per individual.

Immediately to the health supervisor and, in the case of a minor, to the minor’s parent or guardian;

Verbally to the Department within 24 hours; and

To the Department within 1 week of the incident, on a form that meets the requirements of Regulation .07 of this chapter;

Immediately to the health supervisor and, in the case of a minor, to the minor’s parent or guardian; and

To the Department within 4 weeks of the end of camp on a form that meets the requirements of Regulation .07 of this chapter;

An illness or injury that is not included in §A or B of this regulation; or

An accident with no apparent injury, such as:

Immediately to the health supervisor and in the case of a minor, to the minor’s parent or guardian;

Verbally to the Department within 24 hours; and

To the Department within 1 week of the incident on a form that meets the requirements of Regulation .07 of this chapter;

Immediately to the health supervisor and, in the case of a minor, to the minor’s parent or guardian; and

To the Department within 4 weeks of the end of camp on a form that meets the requirements of Regulation .07 of this chapter; and

Annually review all health log records and identify opportunities to reduce incidents, accidents, injuries, and medication errors; and

Make available to the Department for review written documentation of the findings of the review of health log records.

Completed in duplicate; and

Signed and dated by the person completing the form;

Within the United States, a United States territory, or the District of Columbia, documentation of:

Outside the United States, a United States territory, or the District of Columbia, documentation of:

Within the United States, a United States territory, or the District of Columbia, documentation of:

Outside the United States, a United States territory, or the District of Columbia, documentation of:

A health log;

A camper health record;

A staff or volunteer health record;

A Medication Administration Authorization Form;

A Medication Administration Form;

A Medication Final Disposition Form; or

When an operator uses standing orders for medication administration, a parent or guardian consent form.

Capturing the same required information as the paper record being replaced;

Password protected;

Accessed only by authorized staff members;

Permanent and will not be deleted;

Capable of tracking staff member use of the system and producing an auditable record;

Maintained in a confidential manner;

Available at all times for review by the Department upon request; and

Retained for a period of 3 years.

Provide a paper health log that meets the requirements of Regulation .05 of this chapter;

Record all injuries, illnesses, medication errors, and reportable diseases and conditions as defined in COMAR 10.06.01 in the paper health log until access to the electronic record is restored;

Transcribe all information recorded in the paper health log into the electronic record once access to the electronic record is restored;

Annotate the paper health log to indicate that transcription has occurred;

Retain the paper health log according to the time frame specified in Regulation .05 of this chapter; and

Provide an alternative means to access the electronic record.

Monitor a camper for signs and symptoms of acute illness such as vomiting, diarrhea, or a fever;

Arrange for first aid or medical treatment upon observing a sign or symptom of acute illness;

Restrict an affected camper from participating in camp activities so that the camper’s illness is not communicated to another individual;

Provide supervision for an affected camper so that the camper is within sight and hearing of the supervising staff member; and

Upon observing a sign or symptom of acute illness:

Provide medical consultation or treatment; and

Report the situation to the local health department in accordance with COMAR 10.06.01.

Admit an individual to a camp; or

Except for a residential camp as defined in COMAR 10.16.06.02, allow a camper to remain in a camp.

The individual is under the care of a licensed health care practitioner; and

A licensed health care practitioner or local health officer as applicable approves, in writing, the individual’s attendance.

Is maintained within the camp for the temporary isolation and treatment of sick or injured campers;

Affords privacy, quiet, continual supervision, and protection from the elements;

Is equipped with:

In the case of a residential camp as defined in COMAR 10.16.06.02, except for a primitive camp as defined in COMAR 10.16.06.02, provides:

Except for medication covered by standing orders as described in §I of this regulation, before administration of a medication, written authorization is provided on a Medication Administration Authorization Form meeting the requirements of §F of this regulation;

Except for a primitive camp as defined in COMAR 10.16.06.02, emergency medication, or while a medication is being administered, medication is kept in a locked storage compartment;

A prescription medication is kept in the original container bearing a pharmacy label that includes the:

A nonprescription medication is kept in the original container that includes the directions for use;

Medication is given to the camper from the original container;

The directions provided in the prescriptive order for the medication found on the Medication Administration Authorization Form or the standing order is followed;

The staff member or designated volunteer administering the medication or supervising a camper who is self-administering medication knows the side effects and toxic effects of the medication;

Medication is kept in a secure manner;

Emergency medications are handled according to §D of this regulation;

Medication is stored according to the manufacturer’s directions;

A staff member or designated volunteer documents medication administration on a Medication Administration Form meeting the requirements of §G of this regulation;

A staff member or designated volunteer documents the final disposition of the medication on a Medication Final Disposition Form meeting the requirements of §H of this regulation;

Except as allowed in §A(14) of this regulation, within 2 weeks after the end of the camping session or when the medication is discontinued, medication is:

If authorized by the parent or guardian, a camper may take their medication with them at the end of the camping session.

A licensed or certified professional:

An adult staff member or a volunteer who:

Who is authorized to practice in Maryland; and

Whose scope of practice includes medication administration.

Except as allowed in Regulation .15 of this chapter, an operator shall ensure that:

An operator may allow a camper to self-carry an emergency medication if both the parent or guardian and a licensed or authorized prescriber have provided written consent for the camper to self-carry the emergency medication.

Both the parent or guardian and a licensed or authorized prescriber have provided written consent for the camper to self-administer the medication;

The health supervisor has designated an adult staff member or volunteer to supervise the camper while the camper is self-administering medication; and

The designated adult staff member or volunteer supervises the camper while the camper is self-administering medication.

The written prescriptive order for the medication that includes:

The following statement: “I request the authorized youth camp operator, staff member or volunteer to administer the medication or to supervise the camper in self-administration as prescribed by the above authorized prescriber. I certify that I have legal authority to consent to medical treatment for the child named above, including the administration of medication at the facility. I understand that at the end of the authorized period an authorized individual must pick up the medication; otherwise, it will be discarded. I authorize camp personnel and the authorized prescriber indicated on this form to communicate in compliance with HIPAA”;

The parent’s or guardian’s signature;

The date the parent or guardian signed the form;

The parent’s or guardian’s primary phone number;

The parent’s or guardian’s alternative phone number;

If a camp allows a camper to self-administer medication, authorization to self-administer medication that includes:

If a camp allows a camper to self-carry emergency medication, authorization to self-carry emergency medication that includes whether the:

Child’s name;

Child’s date of birth;

Name of the medication;

Dose of the medication;

Route of administration for the medication;

Time or frequency of administration for the medication;

Amount of medication administered;

Date and time of administration; and

Name of the individual who:

The child’s name;

The child’s date of birth;

The name of the medication;

The final disposition of the medication;

Documentation that the medication is returned to the parent or guardian, or authorized individual, including the:

A section for documenting that the medication was destroyed that includes the:

Written permission is obtained from the child’s parent or guardian to administer the medication; and

The medication is administered by a staff member or volunteer who meets the requirements in §B of this regulation.

An operator shall:

Except when a staff member or volunteer is self-administering a medication, an operator shall:

Medication Administration Authorization Form;

Medication Administration Form;

Medication Final Disposition Form; and

Record of successful training for each staff member or volunteer who is trained to administer medication under §B(2) of this regulation.

Is an operator of a youth camp;

Is at least 18 years old; and

Has successfully completed, at the applicant’s expense, an emergency epinephrine educational training program approved by the Department.

Designation of agents;

The name of the approved emergency epinephrine educational training program; and

Procedures to:

An application form prescribed by the Department;

A copy of all training program materials, including but not limited to handouts, presentations, and exams; and

The following credentials of the instructor:

The signs and symptoms of anaphylaxis;

Use of an emergency use epinephrine pen;

Follow-up procedures with a parent or guardian after an emergency use epinephrine is administered;

A skills demonstration; and

A written examination.

Issue a certificate for emergency epinephrine to an applicant who meets the requirements in §§A and B of this regulation;

Deny, revoke or suspend a certificate for emergency epinephrine from an applicant who does not meet the requirements in §§A and B of this regulation;

Approve an emergency epinephrine educational training program if the training program meets the requirements of §C of this regulation;

Disapprove an emergency epinephrine educational training program if the training program does not meet the requirement of §C of this regulation; and

On or before January 31 of each year, publish a report summarizing the information obtained from the Reportable Incident Report Forms submitted to the Department related to the use of emergency use epinephrine at youth camps.

On presentment of a certificate for emergency epinephrine, receive from any physician licensed to practice medicine in the State a prescription for auto-injectable epinephrine; and

Possess and store prescribed auto-injectable epinephrine.

Written notice of the denial, suspension, or revocation of the certificate for emergency epinephrine;

The reasons for the denial, suspension, or revocation; and

In accordance with §A of this regulation, an opportunity for a hearing.