R.C.S.A. § 19-13-B27a
Youth camps (Repealed)
Cite as Conn. Agencies Regs. § 19-13-B27a
(a) Water supply. A water supply of sanitary quality shall be provided for each youth camp in ample
quantity to meet all requirements of the maximum number of persons using such a camp
at any time. Whenever water is obtained from other than an approved public water supply,
it shall be of safe, sanitary quality approved by the state department of health.
Any well shall conform with the requirements of sections 19-13-B51a to 19-13-B51l, inclusive. Such water supply shall be easily obtainable from its source or from
a distributing system within a distance of not more than three hundred feet of any
camping spot within such tract. In cases where it can be shown that the approved water
supply is not adequate to satisfy all demands of the camp, chlorinated lake water
may be used for toilets and showers but shall not be supplied to the kitchen or to
any sinks.
(b) Drinking facilities. Drinking fountains shall be sanitary as prescribed in section 19-13-B35 and no common
drinking utensils shall be provided or used.
(c) Toilet facilities. Chemical toilets, fly tight privy pits or water flushed toilets shall be provided
and shall be maintained in a clean and sanitary condition. Separate toilets for men
and women shall be provided. In a residential camp at least one toilet seat for each
fifteen persons or fraction thereof shall be provided. At least one toilet seat for
each twenty persons or fraction thereof shall be provided in each day camp. Urinals
may be substituted for not more than one-half of the total requirement for male campers.
No unit site within a camp shall be at a greater distance than three hundred feet
from the toilets. The location of all toilets shall be plainly indicated by signs.
Privies shall be located at least two hundred feet from a kitchen or food service
area.
(d) Disposal of sewage and refuse. The method of final sewage or refuse disposal utilized in connection with the operation
of a camp shall be such as to create no nuisance and shall conform with the requirements
of sections 19-13-B20a to 19-13-B20r, inclusive, and plans for such disposal shall
be approved by the state department of health.
(e) Plumbing. The plumbing facilities within each camp shall conform with requirements of section
19-13-B45.
(f) Washing facilities. Adequate hand washing facilities shall be provided with at least one facility for
each twenty persons or fraction thereof. Wash basins and water shall be readily accessible
to the toilet rooms. In a residential camp at least one shower house shall be provided
with one shower head for each twenty persons or fraction thereof.
(g) Control of refuse litter. Supervision and equipment sufficient to prevent littering of the grounds with rubbish,
garbage or other refuse shall be provided and maintained. Fly tight depositories for
such material shall be provided and conspicuously located. Each unit site within a
camp shall be within a distance of not over two hundred feet of such depository. Such
depositories shall not be permitted to become foul smelling or unsightly or a breeding
place for flies.
(h) Facilities for dispensing foods or beverages. Facilities for dispensing foods or beverages shall meet the requirements of section
19-13-B42. Day camps shall collect and store potentially hazardous food in appropriate
refrigeration facilities.
(i) Swimming and bathing facilities. Swimming and bathing facilities when provided shall comply with the provisions of
sections 19-13-B33a, 19-13-B34 and 19-13-B36.
(j) Health care. A physician shall be on call and responsible for all health care including first
aid. Annually the physician shall sign and date standing orders to be carried out
in his absence by the camp nurse or by a person over age twenty-one having American
Red Cross Standard First Aid and Personal Safety Training certification, or the equivalent.
Physicians and nurses employed in camps shall hold current Connecticut licenses and
registrations. Additional aides under age twenty-one may be employed if they possess
American Red Cross Standard First Aid and Personal Safety Training certification or
its equivalent but shall not be in charge of health care. All camp health care personnel
shall present current proficiency certification in cardiopulmonary resuscitation as
evidenced by examination by the American Red Cross or American Heart Association.
For residential camps having two hundred fifty or more campers or staff in residence
a registered nurse shall be required to be in charge of first aid and emergency medical
care activities. First aid equipment and supplies shall be specified by the camp physician
in his standing orders. Only nonprescription drugs shall be available in stock containers
in camps. Prescription drugs shall be available only on individual prescription unless
locked and in the sole custody of a physician. Proof of use records as required under
section 19-461 of the general statutes shall be kept by the physician.
(k) Communicable disease control requirements. Communicable disease control shall meet the requirements of sections 19-13-A2 to
19-13-A24, inclusive.
(l) Records. Records of both staff and campers shall be kept on file at camp and shall include
the personal data concerning each member of the staff and camper kept in any reasonable
form the camp director may choose, including therein the name, age and address of
the individual, the name, address and telephone number including the business telephone
number of the parent, guardian, or in the case of an adult next of kin, who shall
be notified in an emergency, the date of first attendance at camp and the date of
leaving camp permanently in the case of residence camps, or the last date of attendance
at camp in the case of day camps, and a physical examination or health status certification
by a physician, an advanced practice registered nurse or registered nurse licensed
pursuant to chapter 378 or a physician assistant licensed pursuant to chapter 370
dated within thirty-six months prior to the date of arrival at camp. A physical examination,
including a complete immunization history, that is required for school purposes may
also be used to satisfy this requirement provided it is dated within thirty-six months
prior to the date the camper arrives at camp. The physical examination requirement
may be waived where such procedure is contrary to the religious beliefs of the camper.
A statement requesting such exemption shall be submitted annually and shall be kept
on file at the camp. This statement shall be signed by a parent or guardian, shall
include affirmation of church membership by an appropriate church authority, and shall
grant permission to camp authorities to authorize physical examination or other appropriate
measures when medical emergencies occur. The parent or guardian shall certify that
he/she accepts complete responsibility for the health of the camper and that to the
best of his/her knowledge the camper is in good health. All staff and campers shall
be adequately immunized as specified in Sections 10-204a-1-4 of the Regulations of
Connecticut State agencies against diphtheria, tetanus, pertussis, polio, measles,
rubella, and any other diseases specified in Section 10-204a. The physical examination
or health status certification shall include a complete immunization history. Where
the individual because of medical or religious reasons does not have such immunizations
these reasons shall be so specified in writing in accordance with Section 10-204a(a)
of the General Statutes.
(m) Emergency medical care. (1) For resident camps there shall be on file a memorandum of understanding between
the camp director and the nearest hospital with regard to arrangements for emergency
medical care. (2) There shall be on file a memorandum of understanding with the on-call
or resident physician concerning the provision of medical care for emergencies and
of routine care to be carried out at camp, including standing orders for the nurse,
if there is one, and instructions for the director of first aid in lieu of a resident
physician or nurse, for both day and residential camps. (3) There shall be a telephone
line available to the first aid area for the use of the first aid staff, with posting
of the telephone numbers of the camp physician, camp director, camp nurse, nearest
hospital, local director of health in whose jurisdiction the camp falls, local fire
department in whose jurisdiction the camp falls, local police department in whose
jurisdiction the camp falls, the poison control center, the nearest state police barracks
which is the source of snake anti-venom or other emergency assistance, and of ambulance
services. (4) An abstract record of all cases treated at camp shall be kept in a bound
volume noting the date, the condition, the disposal and the persons responsible for
the care. At least once a week these cases shall be reviewed by the camp physician
who shall sign and date the bound volume indicating his review of cases. (5) There
shall be available a defined area where ill or injured individuals may rest and receive
care until they are either removed to their homes or recovered. This area shall be
adequate to provide for the temporary isolation of any suspected communicable diseases
and shall have its own toilet facilities not used for other purposes within the camp.
(n) Qualifications of management and staff. (1) No person shall establish, conduct or maintain a youth camp without adequate
and competent staff. (2) The camp director shall be over the age of twenty-one and
of good character, shall not have been convicted of any offense involving moral turpitude,
shall be certified as mentally competent by a physician, shall not use improperly
any narcotic or controlled drug, and shall uphold and maintain the standards required
under the Youth Camping Act. Except for those persons who have already served at least
one summer as a camp director, a camp director shall have had at least sixteen weeks
administrative or supervisory experience, in an organized camp or in lieu thereof
equivalent training or experience in camping satisfactory to the commissioner. (3)
(a) The director of each individual waterfront or swimming area, including areas devoted
to the practice of aquatics, shall be over age twenty and shall possess an American
Red Cross Lifeguard Training current rating or its equivalent. (b) The director of
each small craft waterfront area shall possess current certification in American Red
Cross Lifeguard Training or its equivalent and current certification in the small
craft safety program of the American Red Cross or its equivalent for the type of small
craft used in the camp. Each such director shall comply with the provisions of the
Connecticut boating safety laws and laws relating to scuba diving. (4) the director
of the Rifle Range shall be at least twenty-one years of age and shall possess a current
National Rifle Association Instructor's card or equivalent. (5) The director of the
archery range shall be over age eighteen and possess evidence satisfactory to the
State Department of Public Health of appropriate training and experience in archery.
(6) The director of horseback riding activities shall be over age eighteen and possess
evidence satisfactory to the State Department of Public Health of appropriate training
and experience. (7) The camp director provided he meets the requirement Section 1,
subsection (n) (5) and (n) (6) may serve as director of archery or horseback riding
activities in addition to his duties as camp director. Counselors shall be over age
sixteen. Counselors in training shall be over age fourteen. (8) In resident camps
the ratio of staff, exclusive of cooks, clerical and maintenance personnel, to campers
shall be at least one person over age sixteen to six campers under age eight and to
eight campers eight years and older. In day camps the ratio shall be at least one
person age sixteen or older to each nine children under age six, and to each twelve
children over six years.
(o) Safety of grounds and program practices. (1) Fields intended for athletic activities or use shall be maintained free of hazards.
(2) The waterfront and aquatic activities shall be laid out and conducted in accordance
with the American Red Cross Water Safety Aquatics and Small Craft Activities Standards
or equivalent. (3) The rifle range shall be laid out and operated in accordance with
standards of the National Rifle Association or its equivalent. (4) Vehicles used for
the transport of campers both on and off the camping premises shall have a motor vehicles
safety sticker for the current year and shall be licensed including, if necessary,
licensure for their specific use. (5) Boats and small crafts shall be licensed or
registered under the boating laws, if so required, and this information shall be available
upon request to agents of the state department of health. Water safety equipment shall
meet United States Coast Guard standards where applicable. (6) When any out of camp
outings or trips are planned, advance information shall be kept on file which will
include permission of the campers to participate, signed by the parent or guardian,
the purpose of the trip and the itinerary, the names of the campers, trip director
and staff. The trip director shall be an adult who shall have had experience or hold
certification in the activity in which the trip is being conducted, if this is applicable,
e.g. Maine Guide's license, Red Cross Water Safety Instructor, etc.
(p) Arrangements for camp inspection. The camp director shall make arrangements either personally or through one of the
members of the senior camp staff to conduct the state inspector around the camp premises
and to supply him with any information, documents or materials necessary in order
to comply with the inspection process.
(q) General sanitation requirements. The camp site shall be owned by the operator or the operator shall have a written
lease giving permission to use the site for a youth camp. The location of the camp
shall be such as to provide for adequate drainage of all areas occupied by campers,
the food preparation and service area and other activity areas. Buildings shall be
maintained in a safe and sanitary condition. When the state department of health or
the local director of health so directs, a certificate of approval shall be obtained
from the local or state fire marshal. All hot water and space heaters shall be properly
located and vented.
(r) Trailer coaches. In every camp where space for trailer coaches is rented or offered for rent or on
which free occupancy or camping of trailers is permitted to trailer owners or users,
sanitary facilities shall be provided for the disposal of wastes from trailer sinks
and toilets. Trailer facilities and parking shall comply with the provisions of section
19-14-B44.
(s) Responsibility of management. The camp director shall be responsible at all times for the health, comfort and safety
of campers and staff and shall have responsibility for maintaining in good repair
all sanitary appliances on the camp ground. He shall promptly prosecute or cause to
be ejected from such ground any person who willfully or maliciously damages such appliances.
(t) Exceptions. Exceptions to the requirements of subsection (a), (c) and (f) may be made by the
commissioner of health at his discretion in the case of primitive or pioneer camps.
Exceptions to the requirements of subsection (l) may be made by the commissioner of health at his discretion in the case of day camps
where the requirements of a physical examination or health memorandum for campers
would impose a hardship on the administration of such a camp. Application for such
exemptions shall be made in writing by the camp director thirty days before the opening
of camp.
(u) Accident or illness. Any fatality which occurs at camp or which results from camping activities or any
injury or illness which occurs at camp or which results from camping activities and
which is attended by a physician, nurse, or person in charge of health care at the
camp, and as a result of which the person (1) is sent home, or (2) is admitted to
a hospital, or (3) has a clinical report, laboratory analysis, or x-rays performed
which result in a positive diagnosis, shall be reported to the state department of
health services within twenty-four hours by telephone by the camp director. This verbal
report shall be confirmed in writing within seventy-two hours of the verbal report
on a form provided by the state department of health services. The original report
form shall be maintained at the camp or sponsoring organization for a minimum of two
years. A copy shall be forwarded to the state department of health services upon completion
of the form. For day camps, such reports are not required for any injury or illness
where the individual as a result of such injury or illness is sent home and for which
there is no hospital admission or positive diagnosis by clinical report, laboratory
analysis, or x-ray.
(v) Administration of Medications and the Monitoring of Diabetes in Youth Camps
(1) Definitions as used in this subsection:
(A) "Administration of medication" means the direct application of a medication by inhalation,
ingestion or any other means to the body of a person;
(B) "Advanced practice registered nurse" means an individual licensed pursuant to section
20-94a of the Connecticut General Statutes;
(C) "Authorized prescriber" means a physician, dentist, advanced practice registered nurse,
physician assistant, optometrist, or podiatrist;
(D) "Commissioner" means the Commissioner of Public Health or the commissioner's designated
representative;
(E) "Department" means the Connecticut Department of Public Health or any duly authorized
representative thereof;
(F) "Medication" means any medicinal preparation including controlled substances, as defined
in section 21a-240 of the Connecticut General Statutes;
(G) "Medication error" means failure to administer medication to a child, or failure to
administer medication within one (1) hour of the time designated by the authorized
prescriber, or failure to administer the specific medication prescribed for a child,
or failure to administer the medication by the correct route, or failure to administer
the medication according to generally accepted standards of practice, or failure to
administer the correct dosage of medication;
(H) "Optometrist" means an individual licensed pursuant to section 20-127 of the Connecticut
General Statutes;
(I) "Parent(s)" means the person(s) responsible for the child and may include the legally
designated guardian(s) of such child;
(J) "Pharmacist" means a person with a license to practice as a pharmacist in Connecticut
in accordance with section 20-590 of the Connecticut General Statutes;
(K) "Physician" means a doctor of medicine or osteopathy licensed to practice medicine
in this or another state;
(L) "Physician assistant" means an individual who has two (2) years of pediatric experience
and functions under the direction of the consulting physician for the youth camp and
meets the requirements of sections 20-12b of the Connecticut General Statutes;
(M) "Podiatrist" means an individual licensed pursuant to chapter 375 of the Connecticut
General Statutes;
(N) "Program staff" means those persons responsible for the direct care of children;
(O) "Registered nurse" means a person with a license to practice as a registered nurse
in Connecticut in accordance with chapter 378 of the Connecticut General Statutes;
(P) "Self administration of medication" means that the child is able to identify and select
the appropriate medication by size, color, amount, or other label identification;
knows the frequency and time of day for which the medication is ordered; and consumes
the medication appropriately;
(Q) "Significant medication error" means a medication error, which is potentially serious
or has serious consequences for a child, such as, but not limited to, the administration
of medication by the wrong route; for which the resident has a known allergy; which
was given in a lethal or toxic dosage; or which causes serious medical problems resulting
from the error. Refusal of a medication is not considered a significant medication
error if appropriate follow up action is taken; and
(R) "Staff" means personnel, including volunteers, who provide a service to a youth camp.
(2) Administration of Medications
Youth camps are not required by this subsection to administer medications to children.
If a youth camp permits the administration of medications of any kind by unlicensed
program staff, the youth camp shall comply with all requirements of this subsection
and shall have a written policy and procedures at the youth camp governing the administration
of medications which shall include, but not be limited to, the types of medication
that will be administered, parental responsibilities, staff responsibilities, proper
storage of medication and record keeping. Said policies and procedures shall be available
for review by the department during inspections or upon demand and shall reflect current
best practice. No program staff member under eighteen (18) years of age shall administer
any medication at a youth camp.
Children enrolled at youth camps may self administer medications with documented parental
and authorized prescriber's permission. Children may request and receive assistance
from staff in opening containers or packages or replacing lids.
(A) Administration of Nonprescription Topical Medications Only
(i) Description
For the purposes of this subparagraph, nonprescription topical medications shall include:
(I) diaper changing or other ointments free of antibiotic, antifungal, or steroidal components;
(II) medicated powders; and
(III) gum or lip medications available without a prescription;
(ii) Nonprescription Topical Medications Administration/Parent Permission Records
The written permission of the parent shall be required prior to the administration
of the nonprescription topical medication and a medication administration record shall
be written in ink and kept on file at the youth camp for each child administered a
nonprescription topical medication. The medication administration record and parent
permission shall become part of the child's health record when the course of medication
has ended. Any medication error shall be documented in the record. This information
shall include:
(I) the name, address, and date of birth of the child;
(II) the name of the medication;
(III) the schedule and site of administration of the medication, as applicable, according
to the manufacturer's directions;
(IV) the name, address, telephone number, signature and relationship to the child of the
parent(s) authorizing the administration of the medication;
(V) the date and time the medication is started and ended;
(VI) the name of the person who administered the nonprescription topical medication; and
(VII) the signature of the camp director or the camp director's designee receiving the parent
permission form.
(iii) Nonprescription Topical Medications, Labeling and Storage
(I) The medication shall be stored in the original container and shall contain the following
information on the container or packaging indicating:
(a) the individual child's name;
(b) the name of the medication; and
(c) directions for the medication's administration.
(II) The medication shall be stored away from food and inaccessible to children and unauthorized
persons. External and internal medications shall be stored separately from each other.
(III) Any unused portion of the medication shall be returned to the parent. Any expired
medication shall be destroyed by the program staff member in a safe manner or returned
to the parent.
(B) Administration of Medications Other Than Nonprescription Topical Medications
(i) Training Requirements
(I) Prior to the administration of any medication by program staff members, the program
staff members who are responsible for administering the medications shall first be
trained by a pharmacist, physician, physician assistant, advanced practice registered
nurse or registered nurse in the methods of administration of medications and shall
receive written approval from the trainer indicating that the trainee has successfully
completed a training program as required herein. A program staff member trained and
approved to administer medication shall be present whenever a child who has orders
to receive medication is enrolled and present at the youth camp, and the youth camp
permits the administration of medication by unlicensed program staff.
(II) The training in the administration of medications shall be documented and shall include,
but not be limited to, the following:
(a) statement of objectives;
(b) a description of methods of administration including principles and techniques,
application and installation of oral, topical, and inhalant medication, including
the use of nebulization machines, with respect to specific age groups;
(c) techniques to encourage children who are reluctant or noncompliant to take their
medication and the importance of communicating the noncompliance to the child's parent
and to the authorized prescriber;
(d) demonstration of techniques by the trainer and return demonstration by participants,
assuring that the trainee can accurately understand and interpret orders and carry
them out correctly;
(e) recognition of side effects and appropriate follow up action;
(f) avoidance of medication errors and the action to take if a medication error or
a significant medication error occurs, or if a dosage is missed or refused;
(g) abbreviations commonly used;
(h) required documentation including parent permission, written orders from the authorized
prescriber, and the record of administration;
(i) safe handling, including receiving medication from a parent, safe disposal, and
universal precautions; and
(j) proper storage including controlled substances, in accordance with Section 21a-262-10
of the Regulations of Connecticut State Agencies.
(III) Injectable Medications
In addition to the above training, before program staff members may administer injectable
medications, they shall have successfully completed a training program on the administration
of injectable medications by a premeasured, commercially prepared syringe. The certifying
trainer who shall be a pharmacist, physician, physician assistant, advanced practice
registered nurse or registered nurse, shall assure that the program staff member understands
the indications, side effects, handling and methods of administration for injectable
medication. Thereafter, on a yearly basis, the program staff members shall have their
skills and competency in the administration of injectable medication validated by
a pharmacist, physician, physician assistant, advanced practice registered nurse or
registered nurse. Injectable medications shall only be given in emergency situations,
by a premeasured commercially prepared syringe, unless a petition for special medication
authorization is granted by the department as specified in section 19-13-B27a(v)(2)(B)(vi).
(IV) A program staff member currently certified by the State of Connecticut Department
of Mental Retardation to administer medications shall be considered qualified to administer
medications at youth camps.
(ii) Training Approval Documents and Training Outline
(I) Upon completion of the required training program, the pharmacist, physician, physician
assistant, advanced practice registered nurse or registered nurse who conducted the
training shall issue a written approval to each program staff member who has demonstrated
successful completion of the required training. Approval for the administration of
oral, topical, inhalant medications shall remain valid for three (3) years.
Approval for the administration of injectable medications shall be valid for one (1)
year. A copy of the approval shall be on file at the youth camp where the program
staff member is employed and shall be available to the department upon request.
(II) The written approval shall include:
(a) the full name, signature, title, license number, address and telephone number
of the pharmacist, physician, physician assistant, advanced practice registered nurse
or registered nurse who gave the training;
(b) the location and date(s) the training was given;
(c) a statement that the required curriculum areas listed in Sec.19-13-B27a (v)(2)
(B)(i)(II) and Sec. 19-13-B27a(v)(2)(B)(i)(III) when applicable were successfully
mastered, and indicating the route(s) of administration the trainee has been approved
to administer;
(d) the name, date of birth, address and telephone number of the program staff member
who completed the training successfully; and
(e) the expiration date of the approval.
(III) The trainer shall provide the trainee with an outline of the curriculum content which
verifies that all mandated requirements have been included in the training program.
A copy of said outline shall be on file at the youth camp where the trainee is employed
for department review. The department may require at any time that the youth camp
licensee obtain the full curriculum from the trainer for review by the department.
(iii) Order From An Authorized Prescriber and Parent's Permission
(I) Except for nonprescription topical medications described in Section 19-13-B27a(v)(2)(A)(i),
no medication, prescription or nonprescription, shall be administered to a child without
the written order of an authorized prescriber and the written permission of the child's
parent which shall be on file at the youth camp. Such medications may include:
(a) oral medications;
(b) topical medications, including eye and ear preparations;
(c) inhalant medications; and
(d) injectable medications, by a premeasured, commercially prepared syringe, to a
child with a medically diagnosed condition who may require emergency treatment.
(II) The written order from an authorized prescriber shall contain the following information
which may be on the prescription label or on supplemental information provided by
the authorized prescriber or pharmacist;
(a) the name, address and date of birth of the child;
(b) the date the medication order was written;
(c) the medication or drug name, dose and method of administration;
(d) the time of the day the medication is to be administered;
(e) the date(s) the medication is to be started and ended as applicable;
(f) relevant side effects and the authorized prescriber's plan for management should
they occur;
(g) notation if the medication is a controlled drug;
(h) a listing of any allergies, reactions to, or negative interactions with foods
or drugs;
(i) specific instructions from the authorized prescriber who orders the medication
regarding how the medication is to be given;
(j) the name, address and telephone number of the parent;
(k) the name, address and telephone number of the authorized prescriber ordering the
drug; and
(l) the authorized prescriber's signature.
(III) If the authorized prescriber determines that the training of the program staff member
is inadequate to safely administer medication to a particular child, or that the means
of administration of medication is not permitted under this subsection, that authorized
prescriber may order that such administration be performed by licensed medical staff
with the statutory authority to administer medications.
(IV) The program staff member shall administer medication only in accordance with the written
order of the authorized prescriber. The parent shall be notified of any medication
errors immediately by telephone and in writing within seventy-two (72) hours, and
the error shall be documented in the medication administration record.
(iv) Required Records
(I) Except for nonprescription topical medications described in Section 19-13-B27a(v)(2)(A)(i),
individual written medication administration records for each child shall be written
in ink, reviewed prior to administering each dose of medication and kept on file at
the youth camp. The medication administration record shall become part of the child's
health record when the course of medication has ended.
(II) The individual written medication administration record for each child shall include:
(a) the name, address, and date of birth of the child;
(b) the name, address, telephone number, signature and relationship to the child of
the parent(s) giving permission for the administration of the drug by the program
staff member;
(c) the name of the medication or drug;
(d) the dosage ordered and method of administration;
(e) the date, time, and dosage at each administration;
(f) the signature in ink of the program staff member giving the medication at the
time of each administration; and
(g) any refusal by the child in accepting the medication, and any follow-up action
taken as a result of the refusal.
(III) Medication errors shall be logged and recorded in the individual written medication
administration record of the child. Significant medication errors, identified by the
camp director or the camp director's designee, shall be reported in writing within
seventy-two hours to the department, by the camp director or the camp director's designee.
The camp physician shall review all logs of medication errors on a weekly basis, and
a record of the review shall be kept on file at the youth camp.
(v) Storage and Labeling
(I) Medication shall be stored in the original child-resistant safety container. The container
or packaging shall have a label which includes the following information:
(a) the child's name;
(b) the name of the medication;
(c) directions for the medication's administration; and
(d) the date of the prescription.
(II) Except for nonprescription topical medications described in Section 19-13-B27a(v)(2)(A)(i),
medication shall be stored in a locked area or a locked container, in a refrigerator
in keeping with the label or manufacturer's directions, away from food and inaccessible
to children and unauthorized personnel. External and internal medications shall be
stored separately from each other. Keys to the locked area or container shall be accessible
only to personnel authorized to administer medication. Controlled drugs shall be stored
in accordance with Section 21a-262-10 of the Regulations of Connecticut State Agencies.
(III) All unused or expired medication, except for controlled drugs, shall be returned to
the parent or destroyed by the camp director or the camp director's designee if it
is not picked up within one (1) week following the camper's departure at the end of
camp. Medications that need to be destroyed shall be flushed into sewerage or a septic
system in the presence of at least one witness. The youth camp shall contact the CT
Department of Consumer Protection for direction on the proper method of disposing
of a controlled drug, and shall carry out the direction as required. The youth camp
shall keep a written record of the medications destroyed which shall be signed by
the person destroying the medication and the witness to the destruction.
(vi) Petition For Special Medication Authorization
(I) The youth camp licensee may petition the department to administer medications to a
child cared for at the youth camp by a modality that is not specifically permitted
under this subsection by submitting a written application to the department including
the following information:
(a) a written order from an authorized prescriber containing the information for the
specific child set forth in Section 19-13-B27a(v)(2)(B)(iii) and a statement that
the administration by the requested modality is the only reasonable means of providing
medication and that the administration must occur during hours of the child's attendance
at the youth camp;
(b) a written training plan including the full name, signature, title, license number,
address and telephone number of the physician, advanced practice registered nurse,
physician assistant, registered nurse, or pharmacist who will provide the training,
a detailed outline of the curriculum areas to be covered in training, and a written
statement by the authorized prescriber that the proposed training is adequate to assure
that the medication will be administered safely and appropriately to the particular
child;
(c) the name, date of birth, address and telephone number of the person(s) who shall
participate in the training;
(d) written permission from the child's parent; and
(e) such other information that the department deems necessary to evaluate the petition
request.
(II) After reviewing the submitted information, if the department determines that the proposed
administration of medication for the particular child can be provided in a manner
to assure the health, welfare and safety of the child, it may grant the petition.
The department may grant the petition with any conditions or corrective measures the
department deems necessary to assure the health, safety and welfare of the child.
The department will specify the curriculum that the training program shall cover and
the expiration date of the authorization provided in granting the petition. If the
department grants the petition, no medication may be administered until after the
proposed training program has been successfully completed and a written approval from
the physician, advanced practice registered nurse, physician assistant, registered
nurse or pharmacist who provided the training is submitted to the department. The
approval shall include:
(a) the full name, signature, title, license number, address and telephone number
of the physician, advanced practice registered nurse, physician assistant, registered
nurse or pharmacist who provided the training;
(b) the location and date(s) the training was given;
(c) a statement that the curriculum approved by the department was successfully mastered
by the participant. The statement shall also include the modality of administration
of medication that the participant has been approved to administer; and
(d) the name, date of birth, address and telephone number of the person(s) who successfully
completed the training.
(III) Copies of all documentation required under this subsection shall be maintained at
the facility. The requirements of Sections 19-13-B27a(v)(2)(B)(iv) and 19-13-B27a(v)(2)(B)(v)
shall apply to the administration of medication authorized by petition.
(3) The Monitoring of Diabetes in Youth Camps.
(A) Policy and Procedures
(i) All youth camps at which designated program staff members will be administering finger
stick blood glucose tests shall have written policies and procedures governing the
administration of finger stick blood glucose tests to children diagnosed with diabetes
mellitus. The policies and procedures shall address at least the following areas:
(I) parental responsibilities;
(II) staff training and responsibilities;
(III) proper storage, maintenance, and disposal of test materials and supplies;
(IV) record keeping;
(V) reporting test results, incidents, and emergencies to the child's parent and the child's
physician, physician assistant, or advanced practice registered nurse; and
(VI) a location where the tests occur that is respectful of the child's privacy and safety
needs.
(ii) Said policies and procedures shall be available for review by the department during
inspections or upon demand.
(B) Training
(i) Prior to the administration of finger stick blood glucose tests, the program staff
member(s) shall have completed the following training requirements:
(I) a course approved by the department in first aid, as verified by a valid first aid
certificate on file at the youth camp; and
(II) additional training given by a physician, physician assistant, advanced practice registered
nurse, registered nurse, certified emergency medical technician, or the child's parent
according to written guidelines provided by the child's physician, physician assistant,
or advanced practice registered nurse. The additional training shall include, but
not be limited to:
(a) the proper use, storage and maintenance of the child's individual monitoring equipment;
(b) reading and correctly interpreting test results; and
(c) appropriate actions to take when test results fail to fall within specified ranges
indicated in the written order from the child's physician, physician assistant, or
advanced practice registered nurse.
(ii) The training shall be updated at least every three years when a child with diabetes
mellitus who requires finger stick blood glucose testing is present at the youth camp.
(iii) Documentation that program staff member(s) have been trained to administer finger
stick blood glucose tests shall be in writing and kept at the facility for review
by the department. Such documentation shall indicate:
(I) the subjects covered in training;
(II) the signature and title of the instructor;
(III) the signature and title of the trainee; and
(IV) the date the training was given.
(C) Administration of Finger Stick Blood Glucose Test
(i) Except as provided in subclause (iii) of this subparagraph, only program staff members
trained in accordance with subparagraph (B) of this subdivision may administer the
finger stick blood glucose test in youth camps. No program staff member under eighteen
(18) years of age shall administer finger stick blood glucose tests to another person
at a youth camp.
(ii) Whenever a child diagnosed with diabetes mellitus who has orders to receive finger
stick blood glucose monitoring is enrolled and present at the facility, a program
staff member designated and trained to administer finger stick blood glucose tests
shall be present at the youth camp.
(iii) Upon the written authorization of the child's physician, physician assistant or advanced
practice registered nurse, and the child's parent, a child may self administer the
finger stick blood glucose test under the direct supervision of the designated staff
member who has met the training requirements in subparagraph (B) of this subdivision.
(iv) Only those staff trained to administer injectable medications as described in section
19-13-B27a(v)(2)(B)(i)(III) of the Regulations of Connecticut State Agencies and authorized
to do so in writing by the child's parent and physician, physician assistant, or advanced
practice registered nurse may administer glucagon in a pre-filled syringe in emergency
situations only.
(D) Equipment
(i) The child's parent shall supply the youth camp licensee with the necessary equipment
and supplies to meet the child's individual needs. Such equipment and supplies shall
include at least the following items:
(I) the child's blood glucose meter and strips;
(II) an appropriate retracting lancing device used in accordance with infection control
procedures;
(III) tissues or cotton balls; and
(IV) fast acting carbohydrates to be given to the child as indicated in the written order
from the child's physician, physician assistant, or advanced practice registered nurse
for hypoglycemia.
(ii) Such equipment and supplies shall be labeled with the child's name and shall remain
in a locked storage area when not in use.
(iii) The youth camp licensee shall obtain a signed agreement from the child's parent that
the parent agrees to check and maintain the child's equipment in accordance with manufacturer's
instructions, restock supplies, and remove material to be discarded from the facility.
All materials to be discarded shall be kept locked until it is given to the child's
parent for disposal. The youth camp may dispose of medical waste if it has a contract
with a medical waste disposal contractor, in accordance with local, state, and federal
laws.
(E) Record Keeping
The youth camp licensee shall keep the following records at the facility as part of
the child's medical record, and shall update them annually or when there is any change
in the information:
(i) A current, written order signed and dated by the child's physician, physician assistant,
or advanced practice registered nurse indicating:
(I) the child's name;
(II) the diagnosis of diabetes mellitus;
(III) the type of blood glucose monitoring test required;
(IV) the test schedule;
(V) the target ranges for test results;
(VI) specific actions to be taken and carbohydrates to be given when test results fall
outside specified ranges;
(VII) diet requirements and restrictions;
(VIII) any requirements for monitoring the child's recreational activities; and
(IX) conditions requiring immediate notification of the child's parent, emergency contact,
the child's physician, physician assistant, or advanced practice registered nurse.
(ii) An authorization form signed by the child's parent which includes the following information:
(I) the child's name;
(II) the parent's name;
(III) the parent's address;
(IV) the parent's telephone numbers at home and at work;
(V) two adult, emergency contact people including names, addresses and telephone numbers;
(VI) the names of the program staff member(s) designated to administer finger stick blood
glucose tests and provide care to the child during testing;
(VII) additional comments relative to the care of the child, as needed;
(VIII) the signature of the parent;
(IX) the date the authorization is signed; and
(X) the name, address and telephone number of the child's physician, physician assistant
or advanced practice registered nurse.
(iii) The youth camp director or the youth camp director's designee shall notify the child's
parent in writing of the results of all blood glucose tests and any action taken based
on the test results, and shall document the test results and any action taken in the
child's medical record.
(w) Emergency Distribution of Potassium Iodide. Notwithstanding any other provisions of the Regulations of Connecticut State Agencies,
during a public health emergency declared by the Governor pursuant to section 2 of
public act 03-236 and if authorized by the Commissioner of Public Health via the emergency
alert system or other communication system, a youth camp licensed in accordance with
section 19a-421 of the Connecticut General Statutes and located within a 10-mile radius
of the Millstone Power Station in Waterford, Connecticut shall permit designated staff
members to distribute and administer potassium iodide tablets to adults present or
to a child in attendance at the youth camp during such emergency, provided that:
(1) Prior written consent has been obtained by the youth camp for such provision. Written
consent forms shall be provided by the youth camp to the parent(s) or guardian(s)
of each child currently enrolled or employees currently employed at the youth camp
promptly upon the effective date of this subdivision. Thereafter, written consent
forms shall be provided by the youth camp to the parent(s) or guardian(s) of each
minor child upon enrollment and to each new employee upon hire. Such documentation
shall be kept at the facility;
(2) Each person providing consent has been advised in writing by the youth camp that the
ingestion of potassium iodide is voluntary;
(3) Each person providing consent has been advised in writing by the youth camp about
the contraindications and the potential side effects of taking potassium iodide, which
include:
(A) persons who are allergic to iodine should not take potassium iodide;
(B) persons with chronic hives, lupus, or other conditions with hypocomplementemic vasculitis
should not take potassium iodide;
(C) persons with Graves disease or people taking certain heart medications should talk
to their physician before there is an emergency to decide whether or not to take potassium
iodide; and,
(D) side effects may include minor upset stomach or rash.
(4) Youth camps shall have designated staff members to distribute and administer potassium
iodide to those individuals and minor children for whom prior written consent has
been obtained. Such designated staff members shall be eighteen (18) years of age or
older and shall have been instructed by the youth camp in the administration of potassium
iodide. Such instruction shall include, but not be limited to the following:
(A) the proper use and storage of potassium iodide;
(B) the recommended dosages of potassium iodide to be administered to children and adults
as prescribed by the Food and Drug Administration.
(5) Potassium iodide tablets shall be stored in a locked storage area or container, inaccessible
to children.