Health Services Officers

[keenanw1]

Does anyone know what's happening with CAP's Health Services Program? I am a licensed healthcare provider and yet CAP doesn't seem to recognize any of us. We are supposed to be exempt from Level II on, but the wings don't understand because NHQ has not provided guidance. My specialties lie in pharmacy and Emergency Medical Care instruction. We aren't permitted to wear any specialty insignia and our scope of practice is currently so restrictive, we may as well not practice. I end up teaching first aid courses and making sure everyone's paperwork is in order. Sometimes, I'll teach a nutrition course or conduct a safety briefing. My squadron commander lets me do pretty much what I want and I have had to create protocols for my subordinates. Sometimes, I have medical emergencies that I treat on base, but I have no idea what CAP really wants us to do. I simply follow my state's EMS protocols and the Air Force Medical Services manual. Does anyone have any tips or tools that they use at your squadrons?

I read a recent publication by NHQ that prohibits any health professional from handling cadets' medications. Granted, some are not licensed to do so, but those of us who are should be entrusted with the monitoring of drugs. CAP is trying, it seems, to restrict medical professionals from being able to treat patients too. So, what are we supposed to do if someone has a minor injury or maybe something more serious like needing CPR? Are we supposed to stand by and refuse to treat them because we are healthcare professionals and are not covered under the Good Sam Law? I personally refuse to let a patient of mine suffer. Granted, I won't start ALS procedures, but I will provide basic care.

[Hawk200]

CAP personnel don't practice medicine as a part of the program. Yes, doctors and nurses are recognized with insignia, but they don't perform any medical duties while in the uniform. What you have been doing so far is pretty much the limit on what medical personnel are permitted to do. Insurance issues are the biggest obstacle for CAP, the costs associated with it are prohibitive.

The cadets and medication issue has been going on for a while, and it has been said that a directive is forthcoming (don't know the validity of that, just something I've heard.) There have been too many issues with people handling medications, and a "dispensary" would most likely be a problem. From the issues I've seen, I don't think we need to start such a thing.

[DakRadz]

The cadets and medication issue has been going on for a while, and it has been said that a directive is forthcoming (don't know the validity of that, just something I've heard.) There have been too many issues with people handling medications, and a "dispensary" would most likely be a problem. From the issues I've seen, I don't think we need to start such a thing.

Sir,
The new Draft 52-16 has a change to this effect. The following is from the Summary and Rationale on the updates

3.. Prescription Medicine. 2-5b
Rule: States that all members are responsible for
self-administering their prescription medication.
Rationale: This language incorporates a policy
change approved by the National Board in the
summer of 2009.

Emphasis mine.

[RiverAux]

You don't have a scope of practice in CAP.  Don't ask me why we have the program in the first place given the restrictions on actually doing anything. 

[arajca]

From the CAP HSO Yahoo! Group:

Greetings to all HSO's,

We are making steady progress on finalizing the drafts of CAPR 160-1 and CAPR 160-2 (Cadet meds) and the CAPF 160-1 series forms and have incorporated commander comments. The results, I hope, will be much clearer for all. It has been a project over 5 years in the making involving many policy discussions with attorneys, cadet programs and many other stakeholders.

Now that our policy has been solidified, we are proceeding with compiling tranining materials for the HSO specialty track courses. I know many of you have some excellent documents that you have used for instructions and protocols for encampments, position descriptions and other documents. I would be interested in having you send me copies of what you have prepared. I would love to be able to use some of these proven materials in our National curriculum.

Our first modules for the Technician Level HSO will focus on the following areas:
1. General HSO knowlege- History, HSO program organization, HSO registration, HSO duties, and regulations, etc
2. Basic (Individual and Leader) Field Sanitation; Operational Fatigue, Hot weather, cold weather, hydration, UV courntermeasures, footcare, personal illness prevention, etc...
3. Basic Preplanning: ICS Form 206, Collecting emergency information and resources for an emergency response at a unit meeting or other 1 day activity in a low risk or urban setting with readily available medical care. Unit/vehicle first aid kit, etc...
4. Cadet issues in CAP: Cadet medications, Cadet physical fitness program, HSO contributions to DDR program, etc...
5. Core Values, legal issues in CAP, scope of practice, state laws, HIPPA, confidentiality, medical records and information, etc...
6. First Aid, Bloodborne Pathogens, and CPR issues for CAP. Resources.
7. Introduction to CISM- Basic concepts, CISM in CAP, activating CISM resources, CAPR 60-5, etc...
8. Principles of Health and Wellness: nutrition, physical activity, occupational heatlh, mental health issues, etc...

Subsequent efforts will focus on the Senior and Master HSO courses.

Please send your materials to me at: kaymclaughlin@voyager.net

Thanks for all you do!

Col. (Dr.) Kay McLaughlin, DO
Chief, CAP National Health Services Program

[Eclipse]

We are supposed to be exempt from Level II on...

Why would you expect to be "exempt" from anything?  Depending on qualifications you may be eligible for an advanced promotion, and/or
you may receive a specialty qualification.  Neither makes you exempt from the other parts of professional development levels and in most cases your grade is frozen until you "train up" to the level you received because of outside quals.

but the wings don't understand because NHQ has not provided guidance.

There's nothing to "understand".  Until such time as NHQ provides a framework, members can't complete the HSO levels.

My specialties lie in pharmacy and Emergency Medical Care instruction. We aren't permitted to wear any specialty insignia and our scope of practice is currently so restrictive, we may as well not practice.

No.  You may not practice.  Period.  Emergency medicine has some potential connectivity, but I can't begin to guess where a pharmacy
background would be useful, other than possibly in DDR.

I end up teaching first aid courses and making sure everyone's paperwork is in order. Sometimes, I'll teach a nutrition course or conduct a safety briefing.

Sounds like you are already doing all you're allowed to do.

My squadron commander lets me do pretty much what I want and I have had to create protocols for my subordinates.

You are not allowed to create "protocols" if you're referring to anything regarding medical procedures or treatment in a CAP context.
If your CC is allowing this he is putting everyone involved at risk.

Sometimes, I have medical emergencies that I treat on base, but I have no idea what CAP really wants us to do.

They want you to call 9-1-1.

I simply follow my state's EMS protocols and the Air Force Medical Services manual. Does anyone have any tips or tools that they use at your squadrons?

Neither has much weight internal to CAP.

I read a recent publication by NHQ that prohibits any health professional from handling cadets' medications. Granted, some are not licensed to do so, but those of us who are should be entrusted with the monitoring of drugs.

Activity staff may monitor the taking of medications, they simply can't secure them any more.

CAP is trying, it seems, to restrict medical professionals from being able to treat patients too.

No, they are not "trying" to do it, CAP specifically prohibits "treating" patients by medical professionals.

So, what are we supposed to do if someone has a minor injury or maybe something more serious like needing CPR? Are we supposed to stand by and refuse to treat them because we are healthcare professionals and are not covered under the Good Sam Law?

You are to contact professional (separate) EMS immediately and provide the same treatment as anyone else trained in basic first aid, etc.
Start an IV or cur a trach and you are on your own, no longer wearing the uniform.

I personally refuse to let a patient of mine suffer. Granted, I won't start ALS procedures, but I will provide basic care.

Then you need to reconsider placing yourself in situations where you would be tempted to violate CAP regulations.

[arajca]

HSO's are exempt from any PD requirements after Level I per CAPR 35-5, para. 5-4 (a) 1

Health service personnel and legal officers are exempt from senior member professional development requirements after Level I.

[Eclipse]

HSO's are exempt from any PD requirements after Level I per CAPR 35-5, para. 5-4 (a) 1

Health service personnel and legal officers are exempt from senior member professional development requirements after Level I.

Is that appointed HSO staff or those pursuing the HSO track?

I can't begin to understand why an HSO staffer is any different than any other member in this regard, especially considering they aren't even allowed to practice.  One more reason to simply not appoint them.

[AirAux]

Wouldn't it just be easier to say, "Excuse me, I was wrong, I humbly apologize."??  The Reg's are the Reg's and you denying it doesn't make it any different and just confuses new members that have read the Reg's..  Geeesh, there is a difference between personal opinion and what is Regulation..  If you don't like, start trying to change the Reg's..   

[Eclipse]

I'm not "denying" anything.  I'm asking a follow-up.

Which is it?  The HSO track or appointed HSO's?

[AirAux]

It's appointed HSO's and assistant HSO's since there is no official HSO track at this time..  I believe that you know that.

[FW]

The regs currently state who can be an HSO.  There is somewhat of an HSO program which can be followed however, I think it is a very sketchy program at present.  To me, it's kind of like a "safety program" for the body.  Reminding us to keep a healthy lifestyle, taking our meds, exercising, sponsoring "health walks" at conferences, etc.  The  HSO program is also a good recruiting tool for senior members with such training.  Once in, we can gently  "persuade' them into other areas of interest.
I know quite a few former HSO's who ended up in command of squadrons, groups, wings and, regions.

[Eclipse]

The  HSO program is also a good recruiting tool for senior members with such training.

I disagree.  Recruiting members with any specific skill which they are not allowed to use is the root of the problem, not an advantage.

CAP needs to look at the real needs of a fully-functional squadron and reassess the entire 20-1 suggestions.  The majority of the org charts are either redundant, unnecessary, or obsolete.  Giving someone a title, grade, and a business card, and then telling them to sit quietly and not do their jobs is why a lot of people quit.

One need only look at the currently mandated "big-4" jobs to see where the focus should be.  CC,SE,AE,FM.  Add CP and ES and let everyone else be subordinate to those staffers in a functional role without pretending we are allowed to offer or have a need for internal professional medical or counseling services.

As it stands today, an EMT on duty at the firehouse next door to the airport is more valuable to CAP than one on unit staff.

[FW]

^I agree with you.  I was just stretching out a reason for HSO's to exist in CAP.  I guess I just over stretched and now need an HSO to fix the (mental) strain......

[RiverAux]

Can we have a firefighters track and associated badge?  It would help us recruit people who could provide fire safety talks to our units and who could give excellent training in the use of fire extinguisghers.  Obviously we would need several levels in the track to represent firefighters, engineers, and Captains/Chiefs along with associated badges and stars.  And, it goes without saying that they would immediately be kicked out should they ever try to actually extinguish a fire..... 

[AirAux]

From a historical perspective, in the old days of yesteryear, doctors brought personal aircraft and money and some prestige to the service.  Now, they still bring some aircraft, money, prestige and influence.  They also bring a level of education unprecedented by most members.  If there is a large disaster requiring medical services from CAP, it wouldn't take much to broaden the scope of the Reg's and you would have a medical service on line.  As has been said, in most units they fulfill multiple roles and do an excellent job.  Most them have actually been trained to think and analyse a situation and consequences prior to acting.  Something I wish I could say for all members.. But I digress.. 

[Eclipse]

If there is a large disaster requiring medical services from CAP, it wouldn't take much to broaden the scope of the Reg's and you would have a medical service on line.

You can stop right there - becoming a medical responder service is not just changing a few regs, and it is not going to happen in anything less than a National-level Armageddon scenario, in which case those same medical professionals will have plenty to do.

Times change and we don't look to members to bring their own planes anymore.  Indicating that one member's outside qualifications somehow make their skills more "valuable" than another's is degrading to everyone in the conversation.  Either your skillset and experience are relevant to CAP's current operations, or they aren't.  Currently, medical professionals don't have all that much to offer CAP from a day-to-day unit operational perspective, beyond the responder mentality and the assumption of enough education to fill out forms.

Something else no one has mentioned, but is certainly an issue in my AOR - medical professionals, especially EMT's, tend toward shift work, and the younger ones inclined to join CAP or similar are usually stuck with 2nd/3rd shift and weekends, which is exactly when
we need them with us.

I've had more than a few EMT's or similar join, get advanced grade and other credit, only to never be around when you need them.

Consider this - technicians, meaning anyone who specializes, medical, comms, IT, whatever, are not what CAP is in desperate need of.

What we desperately need are good managers, educators, and leaders.

[Short Field]

I need people to enroll in the tracks that trains them to help run the squadron:  Admin, Cadet Programs, Professional Development, Personnel, Finance, Logistics, IT, etc.  I also need people who can help train, man, and lead Ground Teams, Air Crews, and Mission Bases:  ICs, AOBDs, GBDs, CULs, MPs, and GTLs.  I need to have MPs who are CFIs so I can get Fm 5 and Fm 91 checkrides for my new pilots before they give up and stop coming.  Everything else is just "nice to have".

[MICT1362]

Consider this - technicians, meaning anyone who specializes, medical, comms, IT, whatever, are not what CAP is in desperate need of.

What we desperately need are good managers, educators, and leaders.

Good thought, but nowhere close to accurate.  These technicians that you say you don't need are infact exactly what you say you do need.  EMT's, FF, Police Officers, Comm Specialists are a huge part of what we do.  Don't missunderstand me, because I don't think that their specialty skills are always useful.  As a Paramedic, I know my limitations in CAP, and yes I wish from time to time that they weren't so constrictive.  However, what you fail to realize is that my training goes far beyond caring for the injured.  We spend countless hours learning the best ways to control situations that are far more difficult that what the everyday CAP'er would ever deal with.  Our conflict resolution and reasoning skills are far more developed than you give us credit for. 

EMT's/Paramedics frequently control scenes involving multiple patients and numerous First Responders and Coworkers.  What better training could I get for controlling a Ground Team, Mission Base, or even a Squadron?  The Continuing Education time that we spend every year keeping up with our physical as well as mental skills would probably exceed the amount of time that some squadrons actually spend in the field.  Not to mention that we spend time teaching the public as well as other professionals the skills that they need to perform tasks as lay responders.

So, you say you need managers, educators and leaders, well guess what, that's exactly what these people are.

I hope you reconsider your thought that we aren't needed...

-Paramedic

On a side note; CAP got me started in EMS, and EMS has taught me so much more to use in CAP.  Kind of go hand in hand.

[Eclipse]

You should spend some more time here and read the thread(s) completely before making assumptions...