CAPR 52-16 CADET PROGRAM MANAGEMENT EFFECTIVE 1 FEBRUARY 2011

[A.Member]

Extremely poor wording of 2-5b.  It should simply read that "no CAP member may not administer prescription or nonprescription medication to another member".  Of course, exceptions are not addressed...or maybe there are none? (the way I read it there are none).

Non-concur.

This portion of the new regulation simply implements the basic policy directed by the NEC, and more completely described in the draft CAR 160-2 (see our previous discussion here on CT).

The new 160-2 will have all the necessary details, exceptions, etc. and provides essential guidance for members, leaders, and parents.

How about most the people that haven't seen your discussion on CT (myself included)?  The reg makes no reference to 160-2.  If that is the intent, then it should be stated.  You can "non-concur" but it doesn't change the fact that it's poorly worded.

[Eclipse]

^ This isn't a change in anything - CAP members were never allowed to administer meds to anyone, and the new 52-16 does not preclude
activity CC's from vetting cadet medical status, nor tracking that they take their meds.

As to the other stuff, talk about nit-picking - make sure you understand the term "should" in a CAP regulatory context.  That indicates a preferred situation, not a requirement.  I am a staunch advocate of TLC, and anything that brings more members to that table gets my support, but like most things in CAP that require adult initiative beyond the minimums, all we can do is "strongly suggest".

As to the weekend activities - if between unit/group/wing you can't find at least one non-meeting activity a week to offer your cadets, you do need some program adjustment.

As to O-Rides, Wings have always been the final delimiter on scheduling and coordination, since they have to approve the funding.  This may put some more pressure on the Wing O-Ride coordinators to be more proactive, but its not like the majority of effort still won't be in the unit CC's, who will still need to make sure the cadets actually show up.  I think the biggest problem with the 90 days is that this is an unfunded mandate for cadets who join in the late summer / early Fall, when the issue is not lack of interest or initiative, but lack of funding.

Military O-Rides are nearly non-existent in most parts of the country outside encampments, and it will be real interesting to see who wins the argument when a unit CC in mid-state nowhere with one new cadet says the wing has to ferry a plane for a single ride.  Have the ferry ratios been relaxed or eliminated?

The only thing in the new rev which is causing much concern in my wing is the removal of the ability to waive Part 1 of RST.  It doesn't affect the encampment I run, but does some other activities in the wing which have transient staff, which may need to run it almost daily, and for the full 2-sessions.

[Sleepwalker]

  I think what is being referred to regarding meds are the cases where Senior Members have control of the Cadets' prescription meds during certain activities, and make sure that they take their proper dosages on time.  Appearently this practice will end in February.         

[cap235629]

So, what if this parent is a nonmember? Do we really allow a non screened person to just "chill" around other children during an activity?

You cannot exclude a parent. Bad JUJU.

[Eclipse]

So, what if this parent is a nonmember? Do we really allow a non screened person to just "chill" around other children during an activity?

You cannot exclude a parent. Bad JUJU.

Non members are non-participants.  They don't "hang around", juju or no.

Period.

[NCRblues]

So, what if this parent is a nonmember? Do we really allow a non screened person to just "chill" around other children during an activity?

You cannot exclude a parent. Bad JUJU.

So lets say this activity is a NCSA, heck for giggles ill say its one you all love  NBB.

Now a cadet puts in his application, get accepted, but the parents do not feel he is ready to handle his own medication. So with E.O. and the law suit happy world we live in, we must allow this cadet to attend. What about the parent though? I refuse to let a non screened person around children.

It's all good that they have a child in CAP, but just because you have a kid in CAP does not mean that the parent is an angel.

So for the whole 2 weeks beret is going on, do we allow the parent to just "come and go" and give medication, or do we allow them to be on compound with the cadets?

I don't see a win/win here....at best I see a minor hassle with scheduling around medication time...at worst well, i don't know....

So, do we say no to the cadet, no to the parent, or let it happen and pray the parent is a nice person?

[MICT1362]

/\
I can see that already. Person walks up to the gate guard.

**The following is a dramatization, not every parent is like this, but I have seen similar.**

Parent: "Uh, hello, I need you to open the gate, I have to give snuffy his medication."
Gate Guard: "Uh, what, huh, who are you again? Who are you looking for?"
Parent: Not that its any of your business, but I'm his/her parent, now open the gate please."
Gate Guard: "Do you have an ID badge?"
Parent: "I don't need one, I have his medication."
Gate Guard: "I'm going to have to contact the Activity Director and see what they want to do."

Parent then gets frustrated and tells the AD that the gate guard was rude and yelled at them causing the cadet to get into trouble for doing their job.

WONDERFUL!

-Paramedic

[SamFranklin]

You guys over-complicate things.

(1)  Encampment CC or NCSA CC sends the usual welcome letter to cadets / parents.  It includes a few words about the self-medication policy.  "Hey mom, this activity is for young adults, so you'll want to make sure your kid can self-medicate. Please call Capt Jones if you have concerns."

(2)  If mom insists on attending, fine, but I bet that won't happen for more than 1 cadet in a thousand. We've got nothing to hide, so parents being involved is a good thing.

-- Mom can come during the day and per CAPR 52-10 can interact with cadets even without being screened if a screened senior is present. One senior would of course be present anyway.

-- Encampment CC or NCSA CC also tells mom that the DoD facility won't let her thru the gate unless she is a CAP member, so she'll want to become a CSM if she's intent on attending even part-time.

(3)  The NBB example above is a red herring because cadets need to complete encapment before going to NCSAs. If the cadet made it through encampment, I bet he's ok for NBB.

It's common sense. The self-med policy isn't the end of the world. Moreover, I dunno about you, but I'm confident that I have enough leadership skill to calm a worrisome mom and make her feel good about our great activities.

[Eclipse]

Now a cadet puts in his application, get accepted, but the parents do not feel he is ready to handle his own medication. So with E.O. and the law suit happy world we live in, we must allow this cadet to attend. What about the parent though? I refuse to let a non screened person around children.

EO is not applicable here because refusal to allow participation would not be based on the cadet's status in a protected class.

[Eclipse]

-- Mom can come during the day and per CAPR 52-10 can interact with cadets even without being screened if a screened senior is present. One senior would of course be present anyway.

How do you figure?  Past the CPPT issues, non members aren't allowed to just "hang around", for starters it is a disruption of the
training environment.

Encampments and large activities are not unit meetings, either you're on staff or you're not there.

[NCRblues]

You guys over-complicate things.

(1)  Encampment CC or NCSA CC sends the usual welcome letter to cadets / parents.  It includes a few words about the self-medication policy.  "Hey mom, this activity is for young adults, so you'll want to make sure your kid can self-medicate. Please call Capt Jones if you have concerns."

(2)  If mom insists on attending, fine, but I bet that won't happen for more than 1 cadet in a thousand. We've got nothing to hide, so parents being involved is a good thing.

-- Mom can come during the day and per CAPR 52-10 can interact with cadets even without being screened if a screened senior is present. One senior would of course be present anyway.

-- Encampment CC or NCSA CC also tells mom that the DoD facility won't let her thru the gate unless she is a CAP member, so she'll want to become a CSM if she's intent on attending even part-time.

(3)  The NBB example above is a red herring because cadets need to complete encapment before going to NCSAs. If the cadet made it through encampment, I bet he's ok for NBB.

It's common sense. The self-med policy isn't the end of the world. Moreover, I dunno about you, but I'm confident that I have enough leadership skill to calm a worrisome mom and make her feel good about our great activities.

1. Yes, they do send out the letter. Lets all be honest here. Most of the parents don't read them, and I would say 45% of parents use CAP as a baby sitting tool. Its (sometimes) cheaper than an actual babysitter.

2. Once again, 1 in a whole NCSA. That seems like a small number, but (using my NBB example) we barley have enough staff on hand (because of budget restraints and sleeping area's at a minimum) and sometimes (well most of the time) the cadets are unsupervised (by a SM, cadet staff is present) in the barricks and around compound. So mom would have to follow her sons tac around ALL day....then we get into the actual mission week of NBB. (I'm just using NBB as an example, insert your own here if you feel you need to). Only CAP members can be on AF mission's. We have had cadets need to take medication once an hour before, so, conceivable mom would then have to follow the flight around ELT hunting? I'm 100% sure the AF is not going to allow that one to go down. (mom slips and falls, is not covered under insurance...BAM lawsuit)

2a. 52-10 says that people instructing cadets are allowed to come while being supervised. It makes no mention of mom or dad in the provision you are talking about. A member is screened, mom and dad are not. Its that simple. I will not allow mom or dad to just "chill" around the rest of the kids.

3. Encampments are for a large majority of time, classroom marching and inspections. Most NCSA are more than that, and (using my example again) NBB is far....very far from that. Just because you make it through an encampment does not mean in anyway shape or form you are ready for NCSA.

We can be the best speakers in the world, we can move mountains with words, but find the one mom who wont let her "baby go play soldier" without her presence well....good luck.

I do not believe this "self medication" idea was really thought about. I think the legal eagles said this is good, it will keep us from getting in trouble and BAM it was done.

[Ned]

I do not believe this "self medication" idea was really thought about. I think the legal eagles said this is good, it will keep us from getting in trouble and BAM it was done.

Oh come on, don't be silly.

The orignial committee work was done with multiple Spaatz cadets(one of whom has an MD), including the National Cadet Advisor, on board.  It was only AFTER this committee did their work that the legal guys got to take a look.  (And they unanimously approved, BTW).  It had extensive input from the corporate CP staff, most of whom also have Spaatz awards.

Then it went to the NEC, the majority of whom are keenly familiar with the CP, as well as the operational aspects of large CAP activities.  After close examination and public input from all the stakeholders (including, BTW, extensive discussions here on CT and on CS), the NEC established the policy on medications, and directed that it be incorporated into our regulations.

Which includes the 52-16 and the upcoming CAPR 160-2, Cadet Medications, which is in final coordination.

You may agree or disagree with some or all of our CAP policies (which is fine, of course), but it would be a grave error to suggest that the policy on cadet medications was done with little or no thought or study; or that this is somehow driven by "legal beagles" instead of it being a reasoned response to concerns raised by experienced CP leaders in the field.

Just saying . . .

[BGNightfall]

I fully think that NHQ is right to draw a line on this particular issue.  It may seem like common sense that senior members should be able to provide a cadet with a pill and a glass of water, but how many senior members are comfortable with measuring out a shot of insulin and injecting a cadet before every meal?  Or with giving a cadet a suppository?  Not to be morbid or obscene, but these are very real possibilities.

When it comes to cadets, the burden is on us as the leaders of the cadets to educate the parents (especially parents of cadets that require special attention) on the nature of our regulations in this or any regard.  Preferably before they sign on the application to send their cadets to encampment, to an NCSA or even to an overnight squadron activity. 

Why wait for a letter from the encampment commander when the senior members at the local squadron can discuss the issue in person? 

[MICT1362]

Ned,

As a Health Care Professional, and after ten years in CAP, I still don't think that cadet self medication is 100% smart.  With the amount and variety of medications being prescribed today, this can become a huge problem.  Can some cadets handle it, sure, but others can't, and that is where the problem will start.  I don't mind cadets physically taking their own medications, but they don't need to keep them.

I saw absolutely no problem with having the medications collected at inprocessing and being held for the cadet.  The Medical Officer would simply note when a cadet needed to take medications and check boxes that they came and took them as appropriate.  This kept medications from being passed around the barracks like candy.  I am not saying that this happens all the time, but it only takes one time of a cadet getting ahold of something that they didn't know they were allergic too.  The Medical Officer is not administering medication, they are simply safe guarding the property of one cadet from another. 

How far behind are we in processing input from the field?  If I suggested that something needed to be changed today, it would take a while to get to the field.  I would say that some items even take years of deliberation in the office before the field hears again.  Admittedly my numbers are probably off, but what I'm trying to say is that the problem today wont get solved tomorrow.  So are the Spaatzen and Dr's working off of what they saw 10 years ago, because as a CP leader at the squadron level, I don't know that our input makes it that far.  I fear that we get lost in the shuffle.

It is impossible, IMO, to find a perfect solution to this problem, but I still do not know that our current stance is the best answer. 

As always, I respect your position in the organization and the experience that you as well as the rest of the NHQ team have.  It is impossible to please everyone and I will follow the regulation as set forth by NHQ, but you are correct in saying that I do not have to like or agree with it.  As such I will not utilize my professional background and serve as a Medical Officer at activities other than in a life or death situation.  I fear that if something happens, the entire thing would end up thrown in my lap, and that isn't something that I can afford to do. 

So, such is life that we continue to have something to discuss on CT.  What would we all do if we had nothing to discuss?

-Paramedic

[manfredvonrichthofen]

As a Health Care Professional, and after ten years in CAP, I still don't think that cadet self medication is 100% smart.  With the amount and variety of medications being prescribed today, this can become a huge problem.  Can some cadets handle it, sure, but others can't, and that is where the problem will start.

Read the regulation again, as well as the previous posts. If a cadet's parents don't think that their cadet is ready or capable of self medication then it is their responsibility to ensure that there is a method of administering the medication that they deem safe. If that means the cadet's parents attend in order to administer the medication then that is what needs to be done. It should not be the responsibility of a SM to shoot a cadet in the arm with insulin. The problem with a SM administering insulin and other such medications is that even though we may know the cadet very well, we still might not know the proper dosage for this or that situation, and we may accidentally make things worse for the cadet. Do you want to accidentally give a cadet too much insulin do you? Doesn't matter what, there is the possibility that you could medicate wrong. Admittedly there is the possibility that a cadet could do the same thing to them self, but it is less likely to happen.

[NCRblues]

As a Health Care Professional, and after ten years in CAP, I still don't think that cadet self medication is 100% smart.  With the amount and variety of medications being prescribed today, this can become a huge problem.  Can some cadets handle it, sure, but others can't, and that is where the problem will start.

Read the regulation again, as well as the previous posts. If a cadet's parents don't think that their cadet is ready or capable of self medication then it is their responsibility to ensure that there is a method of administering the medication that they deem safe. If that means the cadet's parents attend in order to administer the medication then that is what needs to be done. It should not be the responsibility of a SM to shoot a cadet in the arm with insulin. The problem with a SM administering insulin and other such medications is that even though we may know the cadet very well, we still might not know the proper dosage for this or that situation, and we may accidentally make things worse for the cadet. Do you want to accidentally give a cadet too much insulin do you? Doesn't matter what, there is the possibility that you could medicate wrong. Admittedly there is the possibility that a cadet could do the same thing to them self, but it is less likely to happen.

It is less likely a minor child, being rushed to get back to training and not miss anything with his friends will give him/herself a little to much, compared to a certified paramedic or nurse or doctor, which most of the medical officers are in cap?

So your saying a paramedic will mess up a simple insulin injection more than a child?
Just wanted to make sure that's what you are saying.

Also when do we draw the line? How many parents are we going to allow to come to an activity before it is to many and the activity cannot proceed?

Once again, i stress that most activity's struggle to provide the minimum amount of SM staff, let alone, ones to watch non members mommys and daddy's when they are around other cadets. Nonmembers don't get to come and play. They are not cleared to work with other kids, sorry but that's a no go, not only in my book, but the regs as well. Noncleared don't get to play.


Ned, I really appreciated your answers and have a great repsect for you sir, but i think on this issue you are....for lack of a better term "towing the party line" a little to much here.

The input from the field you speak of....i was never asked (been in or around CP for 11 years as of last October). I have asked almost every DCC in the wing and they were never asked on this issue. I have also asked a lot of the medical officers in the wing and they were never asked, so...where was the public input? I guess they asked everyone in other wings except mine then?

I'm not trying to be a smart *&^ but, can anyone cite one instance where a SM holding the medication for a MINOR child resulted in something bad?

[Ned]

'm not trying to be a smart *&^ but, can anyone cite one instance where a SM holding the medication for a MINOR child resulted in something bad?

Easy to do.

I have  personally seen such things.

I have read the investigation of an incident concerning a cadet who took ADD/ADHD drugs "as needed."  At an encampment, his drugs were seized at inprocessing, and passed along to his tac for "safekeeping."  The cadet decided that it was some sort of a sign of weakness to ask his tac for his meds, since it would suggest that he wasn't tough enough to make it through encampment like his team mates.  The unmedicated cadert experienced an "acute incident" and experienced a complete breakdown, resulting in his parents having to drive hours to pick him up mid week.  The parents very reasonably asked why their 16 year old cadet was not allowed to keep his own medications instead of having the tac serve as a gatekeeper.  The parents felt that if the cadet had had his own medication, he would not have been intimidated, and would likely have taken the meds when he needed them.  Just like he did at home and school.

I have read the investigation concerning a squadron weekend camp out where the parents delivered their child and his medication to the senior checking troops in at the squadron headquarters.  The senior took possession of the ADD/ADHD meds (there is a bit of a trend here), but as it turned out this particular senior was only checking the troops in and was not actually going out into the field.  The senior inadvertantly did not pass the meds along to the seniors going into the field.  The unmedicated cadet misbehaved and acted out sexually on Saturday night.

I have served as a tactical officer at a large wing's encampment that often has 20-25 cadets per flight.  As the tac, it was not unusual  for me to tote around two dozen different medications for 10-15 different cadets.  Each with a different dose and schedule.  I like to think of myself as a conscientious officer, and I bet I got the dosages at least 95% correct.  Of course, that is still 5% wrong.

On the other hand, even after carefully checking we could not find a single documented incident of inappropriate drug sharing by cadets.  Lots of anecdotal accounts ("I heard from a friend who heard from the DCP that in 1998 in XXwg, there were these cadets selling Ritalin in the latrine . . . "), but no verified incidents.  In the thousands of CAP encampments held since WWII, it may well have happened, but there is absolutely no evidence to suggest that it is a real problem.

And yes, it is my job to "tow the company line," especially when the "company line" is not only correct, but the actual mandatory policy ordered by the NEC.

[BGNightfall]

It is less likely a minor child, being rushed to get back to training and not miss anything with his friends will give him/herself a little to much, compared to a certified paramedic or nurse or doctor, which most of the medical officers are in cap?

So your saying a paramedic will mess up a simple insulin injection more than a child?
Just wanted to make sure that's what you are saying.

How many medical officers do we actually have in CAP?  Does every wing have one?  Not trying to be accusatory, but these are relevant questions.  Do we have enough to require them on every overnight or all day activity? 

Having said that, I also agree with you that non-cleared don't get to come play, and that senior members have enough on their plate without watching the parents too. 

What I would say instead is that issues like this should be discussed with the parents or guardians by the squadron/flight level leadership long before we have uncleared parents traipsing around our encampments.  If the parent does not feel confident that their child can self-administer, then ideas such as cadet sponsor membership can be discussed.

Honestly, I'm okay with deciding with a parent that their child should wait before going to encampment, if the parent doesn't want their child self-administering and they don't wish to join for their own reasons.  If that means that Cadet Snuffy misses out on overnight activities, or encampment, until he's 16, or even 18, I can live with that. 

[Eclipse]

'm not trying to be a smart *&^ but, can anyone cite one instance where a SM holding the medication for a MINOR child resulted in something bad?

Easy to do.

I have  personally seen such things.

I have read the investigation of an incident concerning a cadet who took ADD/ADHD drugs "as needed."  At an encampment, his drugs were seized at inprocessing, and passed along to his tac for "safekeeping."  The cadet decided that it was some sort of a sign of weakness to ask his tac for his meds, since it would suggest that he wasn't tough enough to make it through encampment like his team mates.  The unmedicated cadert experienced an "acute incident" and experienced a complete breakdown, resulting in his parents having to drive hours to pick him up mid week.  The parents very reasonably asked why their 16 year old cadet was not allowed to keep his own medications instead of having the tac serve as a gatekeeper.  The parents felt that if the cadet had had his own medication, he would not have been intimidated, and would likely have taken the meds when he needed them.  Just like he did at home and school.

I have read the investigation concerning a squadron weekend camp out where the parents delivered their child and his medication to the senior checking troops in at the squadron headquarters.  The senior took possession of the ADD/ADHD meds (there is a bit of a trend here), but as it turned out this particular senior was only checking the troops in and was not actually going out into the field.  The senior inadvertantly did not pass the meds along to the seniors going into the field.  The unmedicated cadet misbehaved and acted out sexually on Saturday night.

I have served as a tactical officer at a large wing's encampment that often has 20-25 cadets per flight.  As the tac, it was not unusual  for me to tote around two dozen different medications for 10-15 different cadets.  Each with a different dose and schedule.  I like to think of myself as a conscientious officer, and I bet I got the dosages at least 95% correct.  Of course, that is still 5% wrong.

On the other hand, even after carefully checking we could not find a single documented incident of inappropriate drug sharing by cadets.  Lots of anecdotal accounts ("I heard from a friend who heard from the DCP that in 1998 in XXwg, there were these cadets selling Ritalin in the latrine . . . "), but no verified incidents.  In the thousands of CAP encampments held since WWII, it may well have happened, but there is absolutely no evidence to suggest that it is a real problem.

And yes, it is my job to "tow the company line," especially when the "company line" is not only correct, but the actual mandatory policy ordered by the NEC.

So...

Three incidents of inappropriate staffing and behavior changes the system?

Drug sharing is not the issue - not taking them is.  I have several personal, hands-on examples.

IMHO TAC officers have no business handling meds, if it is going to be done, it needs to be a dedicated person or staff with no other duties for exactly the reasons indicated above.

[Ned]

So...

Three incidents of inappropriate staffing and behavior changes the system?

Drug sharing is not the issue - not taking them is.  I have several personal, hands-on examples.

Bob,

You're normally a little better at following these threads and responding responsibly than this would indicate.

I was asked to "cite one instance", so I did.  I was not asked to cite "all incidents" (or whatever you were gleefully refuting here.)

And if you take a moment and re-read this thread, you will see a lot of folks who were specifically concerned with drug sharing, which is what I was responding to.

As it turns out, I agree with you.  Based on my research, drug-sharing is not an issue.  And I also agree that "not taking them" is the primary issue.

The difference between us is that you believe that seizing and reissuing the drugs prevents the non-taking, and the NEC believes that seizing and reissuing causes at least some of the non-taking.

I've cited at least a couple of incidents where "seize and reissue" has caused the problem.  Perhaps you would care to share your evidence that "seize and reissue" has prevented some non-taking.