Section 144-208-5 - HEALTH SUPERVISION5.A. INFIRMARY. A residential youth camp shall provide an infirmary building screened and protected from flies and other insects that meets the following minimum requirements:
5.A.1. A treatment area with a handwash lavatory equipped with hot and cold running water, soap and paper towels. C 5.A.2. Lockable storage areas for medications. C5.A.3. A bathroom facility equipped with a toilet, lavatory and shower shall be located in or readily available to the infirmary. Hot and cold running water from mixing faucets shall be provided to the lavatory and shower. The hot water temperature shall not exceed 120oF. C 5.A.4. Not less than 1 bed shall be provided for every 50 persons in camp. NC5.A.5. Beds shall be provided with clean sheets and pillowcases and shall be changed whenever soiled or patient is discharged. C 5.A.6. An isolation area shall be provided for patients with suspect or confirmed cases of communicable diseases. C 5.A.7. All floors and walls shall be kept clean and in good repair. Ceilings shall be kept clean and free from dust and cobwebs. NC5.A.8. Day Camps shall provide an infirmary facility protected from flies and other insects to be used for the temporary isolation of the sick or injured. Screens shall be maintained in good repair. Sections 5.A.1 through 5.A.7 shall not apply to day camps. S 5.A.9. There shall be a communication system capable of communicating with outside medical services. Emergency contact information shall be clearly posted. C 5.A.10. A stretcher or backboard, and other first aid equipment and supplies in accordance with the health care plan shall be available on site. C 5.A.11. All first aid kits shall be marked as such, stocked with the items deemed appropriate and placed at activity locations deemed appropriate and accessible by the health supervisor or directing physician. C 5.B. HEALTH SERVICES. 5.B.1. There shall be standing orders that include provision for emergency first aid and medical care. These standing orders shall be reviewed, signed and dated annually by the physician or nurse practitioner. C5.B.2. There shall be on site an adult health supervisor who is one of the following: C Physician,
Physician Assistant,
Registered Nurse,
Licensed Practical Nurse,
Emergency Medical Technician
A person holding a Wilderness First Responder Certificate,
An athletic trainer certified by the National Athletic Trainers' Association Board of Certification (NATABOC), with the appropriate level of training provided by the National Safety Council, or an equivalent certification approved by the Department.
5.B.2.a. If the only "on site" health supervisor is a Licensed Practical Nurse, then there shall be an arrangement with an off site Registered Nurse for consultation on a 24 hour basis and a documented site visit at least once a week. C 5.B.2.b. The health care supervisor shall be qualified to provide services in the State of Maine or have proof of reciprocity with another state. C5.B.2.c. An adult or adults with current certification from a NRCB in first aid, including training on bloodborne pathogens and certification from a NRCB in age-appropriate cardiopulmonary resuscitation (CPR) that includes the use of breathing devices shall be readily accessible to all activity areas. C 5.B.3. Except as provided in 5.B.4. , all prescription medications brought to camp by campers and staff housed with campers shall be kept under lockC5.B.3.a. Schedule II drugs shall be kept under double lock or in the immediate possession of the health supervisor or the person specifically designated by such supervisor. The double lock should be a locked compartment inside of a locked cabinet C5.B.4.. The youth camp shall have a written policy authorizing those campers who are required to self-administer emergency medication, including, but not limited to, an asthma inhaler or an epinephrine pen to self administer such medication provided the following requirements are met: C 5.B.4.a. A camper who self-administers emergency medication shall have the prior written approval of the camper's primary health care provider and the camper's parent or guardian;5.B.4.b. The camper's parent or guardian shall submit written verification to the camp from the camper's primary health care provider confirming that the camper has the knowledge and the skills to safely self-administer the emergency medication in camp; 5.B.4.c. The documentation referred to in 5.B.4.a and 5.B.4.b above shall be kept with the health history of the individual and be available for review by the Department upon request. 5.B.4.d. The camp health staff shall evaluate the camper's technique to ensure proper and effective use of the emergency medication in camp.5.B.5. A treatment log for all campers and staff shall be kept and made available to the Department upon request. C 5.B.5.a. The log shall contain: 5.B.5.a.1. The name of each person receiving treatment. C5.B.5.a.2. The ailment being treated. C5.B.5.a.3 The medication and dosage administered. C5.B.5.a.4. The name of the person providing treatment. C 5.B.5.a.5. The date and time of treatment. C5.B.5.b. A written record of medical treatment including medications dispensed to campers or staff while away from camp shall be submitted to the health care supervisor by the trip leader upon return to camp. Information from this record shall be transferred to the treatment log and be made available for review by the Department upon request. The original record shall be kept by the health care supervisor and be made available for review by the Department upon request. C 5.B.6. The health histories of each camper and staff member shall be kept and made available for review by the Department upon request. In addition, camps shall comply with the Department of Health and Human Services immunization rules relating to youth camps. C 5.B.6.a. Health histories shall include: 5.B.6.a.1. Description of any current health conditions requiring medication, treatment, or special restrictions while at camp. C 5.B.6.a.2. A record of past medical treatment. C5.B.6.a.3. A record of immunizations, including the date of last tetanus shot, and available information concerning age specific vaccinations consistent with the sample immunization form in Appendix D. C5.B.6.a.4. A list of known allergies. C5.B.6.a.5. A consent and information form for preventative health care and treatment signed by the parent or guardian.5.B.7. First aid kits shall be taken on all out-of-camp trips. C 5.B.8. Emergency transportation shall be available at all times. C5.B.9. Sections 5B.1 to 5.B.7 shall not apply to a youth camp or an individual whose religious beliefs prohibit or restrict medical attention, nor shall any part of these rules be construed to compel any person, either on behalf of himself or his child or ward, to submit to any physical examination, or immunization if such person, parent, or guardian relies in good faith on spiritual means alone through prayer to prevent or cure disease or suffering and objects to the same in writing. 5.C. CONDITIONS REPORTABLE/NOTIFIABLE. 5.C.1. The camp operator shall report directly to the Maine Center for Disease Control and Prevention within 72 hours any of the following reportable conditions: NC 5.C.1.a. Injuries causing unconsciousness, causing fracture of a bone, necessitating hospitalization, for 12 hours or more, requiring suturing or head, neck, spinal cord injuries or injuries of equivalent severity; and an explanation of how the injury occurred. NC 5.C.1.b. Carnivorous animal bite wounds. NC 5.C.1.c. (Food poisoning) Epidemic illnesses involving 3 or more persons including suspect food infection, or food intoxication. NC5.C.1.d. Any illness causing muscle paralysis or weakness, unconsciousness, loss of hearing. NC 5.C.1.e. Any illness or injury resulting in the death or near death of any camper, employee or visitor to the camp. NC 5.C.2. In addition, the camp operator shall report to the Maine Center for Disease Control and Prevention any "Notifiable Condition" listed in Rules for Control of Notifiable Conditions, 10-144 C.M.R. Ch. 258 in the timeframe specified in the Notifiable Conditions list found in Appendix B of these rules. C5.C.3. All reports made to the Department shall include a description of how and under what circumstances the reportable condition occurred. NC10-144 C.M.R. ch. 208, § 5