Current through Register Vol. 51, No. 19, September 20, 2024
A. An operator
shall ensure that:
(1) Except for medication
covered by standing orders as described in § 1 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;
(2)
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;
(3) A
prescription medication is kept in the original container bearing a pharmacy
label that includes the:
(a) Prescription
number;
(b) Date filled;
(c) Authorized prescriber's name;
(d) Patient's name;
(e) Name of the medication;
(f) Dose of the medication;
(g) Route of administration for the
medication;
(h) Time or frequency
of administration for the medication; and
(i) Expiration date;
(4) A nonprescription medication is kept in
the original container that includes the directions for use;
(5) Medication is given to the camper from
the original container;
(6) The
directions provided in the prescriptive order for the medication found on the
Medication Administration Authorization Form or the standing order is
followed;
(7) 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;
(8) Medication is
kept in a secure manner;
(9)
Emergency medications are handled according to §D of this
regulation;
(10) Medication is
stored according to the manufacturer's directions;
(11) A staff member or designated volunteer
documents medication administration on a Medication Administration Form meeting
the requirements of §G of this regulation;
(12) 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;
(13) 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:
(a) Returned to:
(i) The parent;
(ii) The guardian; or
(iii) An individual designated by the parent
or guardian who has authorization to pick-up the camper and the medication;
or
(b) Destroyed;
and
(14) If authorized
by the parent or guardian, a camper may take their medication with them at the
end of the camping session.
B. Staff Administration - Routine Medication.
Except as allowed in §E of this regulation, an operator shall ensure that
a routine medication, other than insulin, is administered by:
(1) A licensed or certified professional:
(a) Who is authorized to practice in
Maryland; and
(b) Whose scope of
practice includes medication administration; or
(2) An adult staff member or a volunteer who:
(a) Is designated by the operator;
and
(b) On an annual basis
successfully completes a training course approved annually by the
Department.
C. Staff Administration - Insulin. Except as
allowed in §E of this regulation, an operator shall ensure that insulin is
administered by a licensed or certified professional:
(1) Who is authorized to practice in
Maryland; and
(2) Whose scope of
practice includes medication administration.
D. Staff Administration -Emergency
Medication.
(1) Except as allowed in
Regulation .15 of this chapter, an operator shall ensure that:
(a) Emergency medication is:
(i) Carried by the camper needing the
medication if authorized according to §E(2) of this regulation;
(ii) Carried by an adult staff member or
volunteer directly supervising the camper; or
(iii) Stored at a designated easily
accessible location; and
(b) Emergency medication is administered by:
(i) The camper so long as the camper is
capable and authorized to self-administer according to §E of this
regulation;
(ii) An adult staff
member or volunteer meeting the requirements of §B of this regulation;
or
(iii) An adult staff member or
volunteer trained by a health supervisor.
(2) 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.
E. Self-Administration. An operator may allow
a camper to self-administer medication, including insulin, if:
(1) Both the parent or guardian and a
licensed or authorized prescriber have provided written consent for the camper
to self-administer the medication;
(2) The health supervisor has designated an
adult staff member or volunteer to supervise the camper while the camper is
self-administering medication; and
(3) The designated adult staff member or
volunteer supervises the camper while the camper is self-administering
medication.
F.
Medication Administration Authorization Form. A Medication Administration
Authorization Form shall include:
(1) The
written prescriptive order for the medication that includes:
(a) The child's name;
(b) The child's date of birth;
(c) The condition for which the medication is
being administered;
(d) Whether or
not the medication is an emergency medication;
(e) The name of the medication;
(f) The dose of the medication;
(g) The route of administration for the
medication;
(h) The time or
frequency of administration for the medication;
(i) If PRN, the frequency and for what
symptoms the medication should be administered;
(j) The known side effects of the medication
specific to the camper;
(k) The
date medication administration shall begin;
(I) The date medication administration shall
end, not to exceed 1 year from the beginning date;
(m) The authorized prescriber's
name;
(n) The authorized
prescriber's title;
(o) The
authorized prescriber's telephone number;
(p) The authorized prescriber's fax
number;
(q) The authorized
prescriber's address;
(r) The
authorized prescriber's signature; and
(s) The date the form is signed by the
authorized prescriber;
(2) 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 ";
(3) The parent's or guardian's
signature;
(4) The date the parent
or guardian signed the form;
(5)
The parent's or guardian's primary phone number;
(6) The parent's or guardian's alternative
phone number;
(7) If a camp allows
a camper to self-administer medication, authorization to self-administer
medication that includes:
(a) The following
statement: "I authorize self-administration of the above listed medication for
the child named above under the supervision of the youth camp operator, a
designated staff member or volunteer";
(b) The signature of the authorized
prescriber and the date the form is signed under the statement in §F(7)(a)
of this regulation; and
(c) The
signature of the parent or guardian and the date the form is signed under the
statement in §F(7)(a) of this regulation; and
(8) If a camp allows a camper to self-carry
emergency medication, authorization to self-carry emergency medication that
includes whether the:
(a) Authorized
prescriber gives permission for the child to self-carry emergency medication;
and
(b) Parent or guardian gives
permission for the child to self-carry emergency medication.
G. Medication
Administration Form. A Medication Administration Form shall include the:
(1) Child's name;
(2) Child's date of birth;
(3) Name of the medication;
(4) Dose of the medication;
(5) Route of administration for the
medication;
(6) Time or frequency
of administration for the medication;
(7) Amount of medication
administered;
(8) Date and time of
administration; and
(9) Name of the
individual who:
(a) Administered the
medication to the child; or
(b)
Supervised self-administration if the child self-administered the
medication.
H. Medication Final Disposition Form. A
Medication Final Disposition Form shall include:
(1) The child's name;
(2) The child's date of birth;
(3) The name of the medication;
(4) The final disposition of the
medication;
(5) Documentation that
the medication is returned to the parent or guardian, or authorized individual,
including the:
(a) Name of the individual to
whom the medication was returned; and
(b) Signature of the staff member or
volunteer who returned the medication; and
(6) A section for documenting that the
medication was destroyed that includes the:
(a) Signature of the individual responsible
for destroying the medication;
(b)
Signature of the individual witnessing the destruction of the medication;
and
(c) Dates each individual
signed the form.
I. Standing Orders. When standing orders from
a licensed or certified professional authorized to prescribe medication are
used in place of the Medication Administration Authorization Form required in
§A(1) of this regulation, an operator shall ensure that:
(1) Written permission is obtained from the
child's parent or guardian to administer the medication; and
(2) The medication is administered by a staff
member or volunteer who meets the requirements in §B of this
regulation.
J.
Medications at Primitive Camps. Except for emergency medication that the camper
is authorized to self-carry according to §E(2) of this regulation, in a
primitive camp as defined in COMAR
10.16.06.02, medication is kept
inaccessible to the camper.
K.
Staff Member or Volunteer Medication.
(1) An
operator shall:
(a) Provide a means to secure
medication for a staff member or volunteer when a medication is brought to
camp; and
(b) Ensure that all staff
member or volunteer medications are maintained in a secure manner at all
times.
(2) Except when a
staff member or volunteer is self-administering a medication, an operator
shall:
(a) Ensure that a staff member or
volunteer:
(i) Provides written authorization
on a Medication Administration Authorization Form meeting the requirements of
§F of this regulation for each medication brought to camp; and
(ii) Who is an adult, signs the Medication
Administration Authorization Form in lieu of a parent or guardian;
and
(b) For a staff
member or volunteer taking medication, have on file for each medication:
(i) A Medication Administration Authorization
Form;
(ii) A Medication
Administration Form; and
(iii) A
Medication Final Disposition Form.
L. Form Retention. An operator shall retain
for 3 years and make available to the Department the completed:
(1) Medication Administration Authorization
Form;
(2) Medication Administration
Form;
(3) Medication Final
Disposition Form; and
(4) Record of
successful training for each staff member or volunteer who is trained to
administer medication under §B(2) of this regulation.