Sec. 10.16.07.14. Medications

A. An operator shall ensure that:

(1) 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;

(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;

(l) 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.