(1) CAMP WELLNESS.
(a)
Physician on staff or consulting
physician.Before a camp opens for the first time, and at least
annually thereafter, the camp operator shall make written arrangements for
medical care of campers and camp staff by a staff physician, consulting
physician or the consulting physician's practice.
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(b)
Staff physician or consulting
physician standing orders. Health services staff shall work under the
delegation of a physician licensed pursuant to ch. 448, Stats., who is
available on-site during the camping season or for consultation services.
1. The staff physician or consulting
physician, in cooperation with the camp operator, shall develop standing
orders, signed by the physician, for the administration of medications, routine
health care and emergency medical care at the camp.
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Note: Wisconsin is identified in a high
incidence category for Lyme disease, therefore it is recommended that a written
protocol should include tick bite identification and removal techniques, such
the following resource provided by the United States centers for disease
control and prevention:
https://www.cdc.gov/lyme/resources/FS-Guidance-for-Clinicians-Patients-after-TickBite-508.pdf.
Note: Bats are the leading rabies vector in
Wisconsin. It is recommended that camp staff are trained in bat education and
that a written protocol be developed that includes: how to prevent and
recognize a bat exposure, safe capture of a bat and what to do in the event a
bat is found in a room with sleeping campers. A copy of the rabies algorithm
can be found at the Wisconsin department of health services website at:
https://www.dhs.wisconsin.gov/rabies/algorithm/index.htm.
2. The physician shall review,
sign and date the standing orders annually.
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(c)
Camp vehicle. A camp
shall have a vehicle available at all times to transport a camper or staff
member requiring urgent medical services to a hospital or clinic when the camp
cannot provide the needed services or as approved by the department or its
agent.
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(d)
Camper health history.
1. Each camper upon arrival at the camp,
shall present to the health services staff or to the rental groups health
services staff as required pursuant to s. ATCP 78.16, an up-to-date written
health history.
P Health histories shall include all
of the following:
a. Any physical condition
or limitations.
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b. Medications.
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c. Allergies.
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d. Immunization status or a signed document
by the legal guardian presented to the camp objecting to the immunization
requirements for a camper for reasons of health, religion or personal
conviction that meets the requirements pursuant to s.
252.04(3),
Stats.
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e. Any special health and behavioral
considerations, including mental, emotional, social and developmental needs or
restrictions of the camper.
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f. Permission from the family that allows for
a camper to self-carry and administer emergency medication, such as
epinephrine, inhalers, or insulin, if applicable.
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2. For a camper under 18 years of age, the
written health history shall be prepared and signed by a parent or legal
guardian.
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3. Parent or legal guardian's written consent
to treat camper in case of an emergency.
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4. Signed permission by the parent or legal
guardian for camp health services staff to provide routine healthcare
treatment, identifying over-the-counter medications that can be administered.
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Note: It is recommended that each camper upon
arrival at the camp, also present to the health services staff a written report
of a physical examination performed within the preceding 24 months by a
physician, a physician assistant, or a nurse practitioner.
(e)
Camp staff
health history.
1. Each camp staff
member, upon arrival at the camp, shall present to the health services staff or
to the rental groups health services staff, as required pursuant to s. ATCP 78.16, an up-to-date written health history.
P Health histories shall include all
of the following:
a. Any physical condition
or limitations.
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b. Medications.
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c. Allergies.
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d. Based on the staff member's job
description, clarification of any camp activities from which the staff member
should be exempted or limited for health reasons as indicated by qualified
medical personnel.
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e. A statement indicating if the staff member
requires any medication that might impair their ability to perform the
essential functions of their position.
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f. Who to contact in case of
emergency.
g. Immunization status
as determined by the consulting physician and camp health supervisor.
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2. For camp staff under 18 years of age, the
written health history shall be provided as required pursuant to par. (d).
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(f)
Health center. A camp
shall have written procedures and space for the temporary isolation of sick or
injured campers and staff members.
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Note: Reportable communicable diseases are
listed in appendix A to ch. DHS 145. Cases are to be reported to the local
health officer or the department pursuant to s.
252.05, Stats., and ch. DHS
145.
(g)
First-aid
supplies. A camp shall have first-aid supplies as determined by the
staff physician or consulting physician standing orders.
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(h)
Emergency Phone.
1. A telephone capable of connecting with 911
or emergency dispatch services shall be accessible at all times during camp
operation.
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2. Other telephone technology may be used
that has continuous power backup and a reliable service connection.
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3. The installation and location of the
telephone shall be in close proximity to the camp buildings or lodging units
and the telephone shall be available to camp staff and campers.
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4. A current list of emergency numbers,
including 911, and the facility's location shall be attached to or posted near
the telephone.
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(i)
AED. If provided, the
camp shall ensure the AED meets all of the following:
1. Maintained in operational condition in
accordance with manufacturer guidelines.
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2. Tested in accordance with any operational
guidelines of the manufacturer.
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3. Continually available on camp premises
when camp is in session.
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Note: Camp administration is encouraged to
consider placement of multiple AED(s) based on the population served and
activities conducted.
(2) HEALTH STAFF REQUIREMENTS FOR A CAMP OR
RENTAL GROUP OPERATING FOR 3 NIGHTS OR MORE.
(a)
Camp health services
supervisor.1. Except as provided
pursuant to sub. (3), a camp shall have an adult camp health supervisor who
shall be responsible for routine and urgent health care supervision at the camp
and meet the requirements pursuant to par. (b) 1.to 5.
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2. The camp health supervisor shall inform
appropriate camp staff of any specific needs, as identified in the camper
health history, of a camper whom they are responsible.
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(b)
Health services
qualifications.
1. The health staff
shall include at least one of the following:
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a.
A physician licensed in Wisconsin pursuant to s.
448.033, Stats.
b. A registered nurse licensed in Wisconsin
pursuant to s. 441.115(3),
Stats.
c. A physician assistant
licensed in Wisconsin.
d. A
practical nurse licensed in Wisconsin.
e. A national athletic trainers association
certified trainer and meeting subd. 4.
f. An emergency medical services practitioner
as defined in s. 256.01(5),
Stats., and meeting subd. 4.
g. A
person currently certified as completing the American Red Cross responding to
emergencies course or equivalent and meeting subd. 4.
h. A person currently certified as completing
a wilderness first aid course as approved by the department and meeting subd.
4.
2. Health services
staff at a camp shall hold current certification from the American Red Cross or
American Heart Association for basic CPR and AED.
P A camp shall follow the staffing
requirement for CPR and AED as follows:
a. If
the local ambulance service provider or emergency medical services states in
writing that there is a target response time of 30 minutes or less to the camp,
the camp shall meet the requirements pursuant to s. ATCP Table 78.27, for all
programs going to a physical location.
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b. If the local ambulance service provider or
emergency medical service response is greater than 30 minutes, the camp shall
meet the requirements pursuant to s. ATCP Table 78.27.
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3. Health services staff at a camp shall hold
a current certificate for the completion of the American Red Cross or American
Heart Association first-aid course or equivalent.
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4. Health services staff administering
medication and only meeting the requirements pursuant to subds. 2. and 3.,
shall annually take the Wisconsin department of public instruction online
course, Medication Administration Principles and shall maintain documentation
of the assessment test and passing grade.
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Note: The Wisconsin department of public
instruction course Medication Administration Principles can be found at the
following link.
https://media.dpi.wi.gov/sspw/av/bmap/story_html5.html.
5. If a camp is prescribed an
epinephrine auto-injector or pre-filled syringe as an authorized entity that is
not patient-specific or the camp plans to have health services staff help
administer epinephrine to a camper, health services staff shall complete an
anaphylaxis training program required pursuant to s.
255.07(5),
Stats., and meet all of the following:
a. The
health services staff member shall complete a training program conducted by a
nationally recognized organization experienced in training laypersons in
emergency health treatment or an organization approved by the Wisconsin
department of health services.
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b. The training certificate shall be
maintained on the camp premises.
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c. The training certificate shall be made
available to the department or its agent upon
request.
(c)
Health services coverage. A camp shall meet the requirements
pursuant to s. ATCP Table 78.27, for health service staff coverage at the camp
at all times during camp operations.
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(d)
Health services staff coverage
for off-premises trips and primitive camping.
1. If the local ambulance service provider or
emergency medical services states in writing that there is a target response
time of 30 minutes or less to the camp, the camp shall meet the requirements
pursuant to s. ATCP Table 78.27, for all off-premises trips and primitive
camping.
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2. If the local ambulance service provider or
emergency medical service response time is greater than 30 minutes, the camp
shall meet the requirements pursuant to s. ATCP Table 78.27, for all
off-premises trips and primitive camping.
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(3) ALTERNATIVE HEALTH SERVICES REQUIREMENTS
FOR A RENTAL GROUP THAT OPERATES FOR A PERIOD OF 3 NIGHTS OR LESS. A rental
group, such as a school class, a church group, or a scout troop that provides
their own health services staff shall meet the requirements pursuant to s. ATCP
Table 78.27.
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ATCP Table 78.27 Health Staff Coverage and Training
Requirements -
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Recreational and educational
camp
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Minimum number of health services staff
available at all times during camp operations, for given EMS response
time
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Health services staff - minimum training
requirements
|
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Ambulance service provider or EMS provides
written documentation that response time is 30 minutes or less.
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Ambulance service provider or EMS response time
is greater than 30 minutes.
|
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More than 3 nights
|
1
|
2
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A health services supervisor as required pursuant
to sub. 2 (a). Additional health services staff providing coverage shall at
least meet the requirements pursuant to sub. (2) (b) 2. and 3. and if they are
administering medication or epi-nephrine they shall also meet sub. (2) (b) 4.
and 5.
|
|
Rental Group - 3 nights or less
|
1
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2
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Adult leader - Meet requirements nights or less
pursuant to sub. (2) (b) 2. and 3. and if they are administering medication or
epinephrine they shall also meet sub. (2) (b) 4. and 5.
|
|
Off-premises and primitive camping
|
1
|
2
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Health services staff - Meet requirements
pursuant to sub. (2) (b) 2. and 3. and if they are administering medication or
epinephrine they shall also meet sub. (2) (b) 4. and 5.
|
(4)
MEDICATIONS BROUGHT TO CAMP.
(a)
Prescription medication.
1.
Except as specified in subd. 2., all medications brought to camp by a camper or
staff member shall be properly labeled with all of the following:
a. The name of the camper or staff member.
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b. The name of the medication.
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c. The dosage.
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d. The frequency of administration.
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e. The route of administration.
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f. Name of the prescribing physician.
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g. The prescription number.
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h. The date prescribed.
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2. A prepackaged pill pack provided by a
pharmacy service accompanied by paperwork meeting the requirements as specified
pursuant to subd. 1.
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(b)
Additional information.
Information regarding possible adverse reactions, the specific conditions when
contact should be made with the physician and other special instructions shall
be documented in the camper health history.
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(c)
OTC medications including
vitamins, supplements and natural remedies. All OTC medications
brought to camp by a camper or staff member shall meet all of the following:
1. Clearly labeled with the name of the
camper.
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2. In a container labeled with the name of
the medication and directions for use.
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(d)
Medication administration and
storage. Except as allowed in pars. (e) and (f), all medication
brought to camp by a camper or staff member under 18 years of age shall meet
all of the following:
1. Kept in a locked
unit.
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2. Administered by health services staff
qualified pursuant to sub. (2) (b), except that epinephrine auto-injector,
pre-filled syringe, inhaler, and insulin or other medication or device used in
the event of life-threatening situations may be carried by a camper or staff
member. Each camper or staff member 18 years of age or older may take
responsibility for the security of their personal medication.
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3. Administered by a parent or legal guardian
who is serving as camp staff member that:
a.
Retains and administers their own child's medications as long as this
information is included in the camps medication record.
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b. Takes responsibility for the security of
their child's personal medication.
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(e)
Delegation for administration of
medication. For a camp that lasts longer than 3 days, the department
shall allow qualified health services staff to designate an individual at the
camp to administer, to a camper or staff member who is under 18 years of age,
medications brought to the camp by that camper or staff member, other than
medications that a camper or staff member may carry themselves pursuant to s.
97.67(5m) (b),
Stats. Any individual designated by health services staff to administer
medication brought to camp by campers, not meeting the qualifications pursuant
to sub. (2) (b) 1., shall meet the requirement pursuant to sub. (2) (b) 4., for
completion of the Wisconsin department of public instruction course, Medication
Administration Principles.
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Note: The Wisconsin department of public
instruction course Medication Administration Principles can be found at the
following link.
https://media.dpi.wi.gov/sspw/av/bmap/story_html5.html.
(f)
Rental group
administration of medication. When a camp's facilities are used by a
rental group for 3 nights or less, an adult leader of the group shall meet all
of the following:
1. Keep all medications
brought to camp by a camper or staff member under 18 years of age in a locked
unit.
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2. Meet the requirements pursuant to s. ATCP
Table 78.27.
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3. Administered by a parent or legal guardian
who is serving as camp staff pursuant to par. (d) 3.
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(5) HEALTH AND TREATMENT RECORDS.
(a)
Health history records.
A camp's health services supervisor shall keep available, the health history
required pursuant to sub. (1) (d) and (e), for each camper and staff member.
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(b)
Medication and treatment
log. When a medication is administered or treatment provided to a
camper or staff member, health services staff shall, as soon as possible, make
a record of the action using any one of the following:
1. In a bound book with preprinted page
numbers.
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2. By electronic entry into a software
program that documents each change to the health record and that does not allow
previous changes to the health record to be edited or deleted.
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3. By making an electronic medication
administration record, printed with the date and time stamp, from a health
software program pursuant to subd. 2., to be used for manual recording with a
signature on the form of the individual making entries.
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(c)
Medication and treatment record
requirements. The record shall indicate all of the following
information:
1. Legal name of the person
receiving the medication or treatment.
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2. Ailment.
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3. Name of the medication or treatment.
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4. Quantity given.
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5. Date and time administered.
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6. Initials of the person administering the
medication or providing treatment.
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7. Comments.
(d)
Medication and treatment record
storage.1. The logging of medication
and other treatment administered shall support accurate medication and
treatment administration in a clear, complete and organized manner.
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2. Health history and treatment records shall
be accessible, upon request, to the department or its
agent.
(e)
Record
retention. The camp shall retain health history and treatment records
for at least 3 calendar years.
(f)
Rental group health history, medication and treatment records.
1. The rental group using a camp's facilities
and providing their own health services staff shall maintain the health
histories and treatment records for their campers and staff.
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2. The health history and treatment records
shall be accessible, upon request from the department or its
agent.
(g)
Rental
group record retention.1. The rental
group, if providing health supervision, shall maintain all camper health
histories, medication and treatment records for a minimum of 3 calendar years
and make the records available upon request to the department or agent within 2
business days of the request.
2.
The rental group shall keep a register and a method of tracking individuals
entering and leaving the camp during operation, pursuant to s. ATCP 78.28, and
make the register and tracking document available upon request to the
department or agent within 2 business days of the
request.
This section is created eff. 9-24-23 by CR
21-109.
