CAP and EMT's

[CadetProgramGuy]

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team.

CAP however doesn't want FR's or higher to advertise their certifications.

Also as a FR or higher certification, who would you fall under for your medical direction?

Thoughts?

[RiverAux]

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team

citation?

[isuhawkeye]

Wile the original post is not 100% correct her you go.
http://www.fema.gov/emergency/usr/wilderness_search_team.htm

My question would be, why do you need to mobalize as a type one team. 

If each wing or group could develop some good reliable type III teams my state would benefit

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

[CadetProgramGuy]

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

We have??

This topis relates to CAP and EMT's on the teams.  Is there a time where we can deliver aid in the field to our targets, or are we opening our selves to lawsuits?

Does Good Sam laws relate to EMT's?

Also I don't understand where I was in-correct.  My statement was about needing EMT's or FR or higher to be type I certified.  Thats what NIMS states in your link as well.  Can you elaborate where I am wrong?

[arajca]

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

We have??

This topis relates to CAP and EMT's on the teams.  Is there a time where we can deliver aid in the field to our targets, or are we opening our selves to lawsuits?

That is the major reason there is not a program for HSOs to progress through. Read CAPR 160-1 for more details.

Does Good Sam laws relate to EMT's?

Varies from state to state. Check with your wing HSO or Legal Officer.

Also I don't understand where I was in-correct.  My statement was about needing EMT's or FR or higher to be type I certified.  Thats what NIMS states in your link as well.  Can you elaborate where I am wrong?

A Type I team requires EMT, ACLS, BTLS, not FR. A Type II team requires EMT or Wilderness First Responder. which is a specific skill set not covered in the generic First Responder certification.

As for elaboration,

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team.

FR doesn't cut it for Type I teams.

[CadetProgramGuy]

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

We have??

This topis relates to CAP and EMT's on the teams.  Is there a time where we can deliver aid in the field to our targets, or are we opening our selves to lawsuits?

That is the major reason there is not a program for HSOs to progress through. Read CAPR 160-1 for more details.

Does Good Sam laws relate to EMT's?

Varies from state to state. Check with your wing HSO or Legal Officer.

Also I don't understand where I was in-correct.  My statement was about needing EMT's or FR or higher to be type I certified.  Thats what NIMS states in your link as well.  Can you elaborate where I am wrong?

A Type I team requires EMT, ACLS, BTLS, not FR. A Type II team requires EMT or Wilderness First Responder. which is a specific skill set not covered in the generic First Responder certification.

As for elaboration,

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team.

FR doesn't cut it for Type I teams.

Thanks for the clarification, I thought I had that covered.  OK On with the discussion.

[DNall]

Right now we're at a roadblock. We aren't supposed to provide care (per CAP because of liability issues. But, many states require you to render aid to the extent of your training/ability; with penalties like license, criminal liability, and certainly civil suit.

So... we're screwed if we do & screwed if we don't.

CAP currently provides incentives (initial & ongoing promotions) to recruit & retain medical professionals (EMTs, Drs, nurses, PAs).

Right now there is little for them to do. There's health & wellness, and limited care at encampments kind of stuff, but that's secondary missions that don't warrant the current incentives versus our other hard working members or the skills they bring to the table.

As I understand it, those incentives are there to build & retain a pool of medical folks, so that when the legal issues are fixed, we'll be able to put it into execution within the force structure.

The way I understand, we'd have a medical director/SOPs on the Air Force side & on call thru AFRCC. We also need doctors/PAs at the Wg/Reg level to oversee qualifications & execution of those SOPs in training.

Sorting out qualifications on a state-by-state basis, making that comply with NIMS typing, and work within a national EMS structure overseen by an active/reserve AF doctor... that's just a little bit of a headache.

My feel for the situation is it'll ultimately require congressional action to fix the problem. The issue is congress doesn't have a plan for that either. The plan needs to be worked out between CAP & AF, then taken to congress for some policy changes to be voted into effect.

[RiverAux]

Unfortunately, FEMA has conflated the presence of a medical professional of some time with the ability of a team to stay in the field. 

CAP should be capable of having a Type 2 team, except for the medical professional requirement.  Although, it would probably be difficult for any individual squadron to come up with a 28-person ground team with 4 team leaders.  With that one real exception and one challenge we could do it.  Otherwise, having us as a Type 3 team is just fine. 

I don't think our current CAP training would provide us with the man-tracking skills to claim Type 1 status even if we do manage to meet the medical specialist requirements. 

I'm not too terribly worried about these rankings cause the locals aren't really going to pay much attention to them.  Most aren't going to have ANY trained SAR personnel at all in their jurisdiction and will be happy with whatever they can get, while those with a super-high-speed type 1 team probably wouldn't turn away the help of a type 3 team in any case.   

[lordmonar]

While we are talking about NIMS requirments.....we need to be complaint...but who says we have to field a type I team?

We are talking about 52 team members (6 GLS, 6 EMTs, 42 GTMs) and a mission base staff to support them.  (say 2 GBDs, 2LSC, 2CUL, 8 MROs, and maybe 2-4 PSC just to round them out).

Anyone got 68 people sitting around fully qualified ready to deploy as a team?


More then likely we are only looking at type III and IV teams....we still need to get proactive to make the necessary contacts with our local EMS organisations, get the needed MOA in place and do some training to get everyone on the same page.

[isuhawkeye]

I could see groups and wings building type III and IV teams.  an aggressive region ES officer, or national could coordinate the formation and movement of type I and II teams.  You could deploy a type I team on very large scale events like Katrina, etc

[lordmonar]

But that would require organic EMTs...which per CAP policy is not possilbe.

So let's focus on what we can do and do the best that we can.

[isuhawkeye]

very true

[RiverAux]

But that would require organic EMTs...which per CAP policy is not possilbe.

CAPR 160-1

a. Medical care within CAP is limited to emergency care, only (i.e., first aid and stabilization) within the training and qualifications of the person rendering such care, until such time that private professional or authorized military care can be obtained.

CAPR 60-3 1-21

f. First Aid and Emergency Medical Care. CAP is not an emergency medical care or paramedic organization and should not advertise itself as such. CAP will not be the primary provider of medical support on missions or training events though qualified personnel can be used to support such activities. The only type of medical aid that should be administered by CAP personnel or by any other person at CAP's request is reasonable first aid deemed necessary to save a life or prevent human suffering and executed by a person qualified to attempt such medical care within their skill level

Seems to me that a CAP EMT would be able to provide emergency care to the level of their qualifications as part of a CAP ground team. 

[lordmonar]

But that would require organic EMTs...which per CAP policy is not possilbe.

CAPR 160-1

a. Medical care within CAP is limited to emergency care, only (i.e., first aid and stabilization) within the training and qualifications of the person rendering such care, until such time that private professional or authorized military care can be obtained.

CAPR 60-3 1-21

f. First Aid and Emergency Medical Care. CAP is not an emergency medical care or paramedic organization and should not advertise itself as such. CAP will not be the primary provider of medical support on missions or training events though qualified personnel can be used to support such activities. The only type of medical aid that should be administered by CAP personnel or by any other person at CAP's request is reasonable first aid deemed necessary to save a life or prevent human suffering and executed by a person qualified to attempt such medical care within their skill level

Seems to me that a CAP EMT would be able to provide emergency care to the level of their qualifications as part of a CAP ground team. 

It is right ther in para F.  CAP is not a Emergency medical care or paramedic organization........but a type I, II or III ground team IS a paramedic organization....ergo CAP as the rules stand now....cannot ever legally field a Type I, II or III wilderness search and rescure team.

We can sorty  a whole but load of type IV and V  teams and a full cadre of support personell....but it would never get signed into the Staging Area as a type I team because we lack organic EMTs.

[RiverAux]

I think you are misunderstanding what is meant by that phrase.  To me that says we don't sell ourselves as an emergency ambulance service that will come to your house when you have a heart attack or go to motor vehicle accidents. 

It specifically allows for care to be given within the skill level of the person giving it.  It doesn't restrict that skill level in any way.  If they didn't want a CAP member who was an EMT giving an EMT level of care to someone that needed it in order to survive, they could have easily said so by specifically restricting CAP from doing anything beyond the level of basic first aid. 

Having an EMT or first responder on your ground team doesn't somehow magically transform it into some sort of rogue team not sanctioned by CAP. 

Telling the county sheriff that you have an EMT on your team doesn't make you a paramedic organization.  What it means is that if we find the target and they need care to save their life, we have an EMT that could provide that care up to the level of their training if no other medical care is available. 

[DNall]

It specifically allows for care to be given within the skill level of the person giving it.  It doesn't restrict that skill level in any way.  If they didn't want a CAP member who was an EMT giving an EMT level of care to someone that needed it in order to survive, they could have easily said so by specifically restricting CAP from doing anything beyond the level of basic first aid. 

Actually, the reg says level of training, but the current legal policy says nothing beyond basic first aid for life saving purposes only regardless of training, and they're serious about that.

But that would require organic EMTs...which per CAP policy is not possilbe.

So let's focus on what we can do and do the best that we can.

Granted we should be forming up as Type III/IV teams right now, but CAP doesn't even have a plan right now. I can train my people, but I can't certify them & even if I could I couldn't deploy them cause CAP has a whole lot of HUA syndrome going on.

I'm not too terribly worried about these rankings cause the locals aren't really going to pay much attention to them.  Most aren't going to have ANY trained SAR personnel at all in their jurisdiction and will be happy with whatever they can get, while those with a super-high-speed type 1 team probably wouldn't turn away the help of a type 3 team in any case. 

You're completely missing the point. The guy below is not...

I could see groups and wings building type III and IV teams.  an aggressive region ES officer, or national could coordinate the formation and movement of type I and II teams.  You could deploy a type I team on very large scale events like Katrina, etc

[DNall]

My vision for a type I team would be 4-man GT w/ EMT x 4-6 teams. One RV or trailer based mobile command center w/ full up comms, sat internet, generators, etc; manned by on-scene commander (IC3 or OSC), IT, MROx4. And 1 organic aircraft w/ SDIS capability (upgrade the transmit capability).

So, think back to the MS setup after Katrina. Centralized Air Ops & ICP up north a bit, with three FOBs up in the damage zone.

Same kind of deal, functioning airfield up closer to the impact area with ICP & central air ops - after Ike over here that would have been Ellington Field (versus we operated out of IWS, which is further from the action & away from all the other players).

That mobile command center deploys up into the area, co-located with field customers. For example, I'd have put those next to county EOCs for the hardest hit areas. Just roll up & set up, and that should be as soon as winds are low enough to move the assets, not days later.

At this point I can liaise with that county EOC. I can put their comms back on the air via P25 highbird. I can give them near real-time imagery on my laptop in my command trailer. I can put my GTs into their area with supplies. They can take damage pics, hand out supplies, and help people that need it - and lots do at this point. I got air to support those those GTs not getting into areas they can't deal with.

That all make sense? That's type-I. I got lots & lots of experienced people around here that are more than qualified to do that kind of work, and have done it for CAP in the past. Every bit of that is well within our existing capability. It'd take some work to scale it up around the country, but it's not beyond us at all. That's what we want/need to be doing. That's why we're in CAP.

What I got after this hurricane crashed thru my neck of the woods though was wait a week, then toss some food for a couple days, then run some ELTs that were obviously not distress anymore, while an air mission flew around taking lots of pictures but nothing I'd call emergency related.

[flyerthom]

While we are talking about NIMS requirments.....we need to be complaint...but who says we have to field a type I team?

We are talking about 52 team members (6 GLS, 6 EMTs, 42 GTMs) and a mission base staff to support them.  (say 2 GBDs, 2LSC, 2CUL, 8 MROs, and maybe 2-4 PSC just to round them out).

Anyone got 68 people sitting around fully qualified ready to deploy as a team?


More then likely we are only looking at type III and IV teams....we still need to get proactive to make the necessary contacts with our local EMS organisations, get the needed MOA in place and do some training to get everyone on the same page.

Two unexplored options are DMAT and local MRC's. Our area has both and few contacts have been made.

[Eclipse]

This is another easy one.

Don't worry about EMT's or medical professionals operating officially or with anymore sanction than exists today anytime soon.

Its not going to happen.

Period.

NIMS is not a prescription, it is a national, flexible, framework for standardization.

CAP is a special beast with special rules, functions, obligations, and limitations, we are not your neighborhood SAR team, we're "other", and as such, we'll continue to work as we have, NIMS or not.

NIMS does not change an organization's mission, capabilities, or limitations, its simply a way to categorize and standardize resources as they are sent.  NIMS does not change PD into FD, or non-medical responders into Squad 51.

What is likely going to happen is that we will simply type individuals based on how our training fits into the framework, and not categorize what we call a Ground Team today into the SARTech nomenclature.

This idea that NIMS is going to force CAP, or any other agency, to radically change their core mission or capabilities is silly, and blatantly agenda driven by the (understandably) frustrated medical professionals who are handcuffed during CAP operations.

CAP is not a first-responder agency, is not tasked or capable today of providing anything more than basic, community-level first aid, most for team safety, and that's fine with the majority of members.

[RiverAux]

Actually, the reg says level of training, but the current legal policy says nothing beyond basic first aid for life saving purposes only regardless of training, and they're serious about that.

No "policy" supercedes our regulations (or ICLs) so if such a policy exists (please provide citation) it is irrelevant. 

[lordmonar]

Granted we should be forming up as Type III/IV teams right now, but CAP doesn't even have a plan right now. I can train my people, but I can't certify them & even if I could I couldn't deploy them cause CAP has a whole lot of HUA syndrome going on.

I don't understand what you are talking about....we have a whole program on how to train our ground teams...as far as I know FEMA has yet to define what the required training is.  It leaves it up to the Agency with Jurisdiction to determine.

[lordmonar]

Actually, the reg says level of training, but the current legal policy says nothing beyond basic first aid for life saving purposes only regardless of training, and they're serious about that.

No "policy" supercedes our regulations (or ICLs) so if such a policy exists (please provide citation) it is irrelevant. 

Beg to differ....when you corporation legal says don't do it...that is it....if you do it and you get sued.....CAP will just say "he was not following our policy" and you would be on your own.

And that is the core of the argument.

EMTs...RNs....LPNs....and Dr all have professional liability issues they have to be worried about.  You can't ask a professional EMT to "volunteer" his time and training to CAP and then cover him in the event of a law suit.

[DNall]

NIMS is not a prescription, it is a national, flexible, framework for standardization.

Okay, this is another frame of reference issue like river had a second ago. Yes, from the national level talking to local depts it is a framework of suggested training they'd like for you to have at the local level. However, going the other direction, with local depts responding across the country & then being piecemealed out with other agencies in an expeditionary force structure, in that situation the training standards get enforced.

People are nice about it, but if your agency has a reputation for not being qualified to industry standards, or having lose check standards, then you get A) not invited/activated, or b) assigned crap work way after the fact that isn't changing anyone's life. Any of that sound familiar?

Your local fire or sheriff's dept may not care much about that stuff, especially when they need ground and/or air search capabilities & they got no one else to turn to, but FEMA, CG, 1AF, 5th Army, National Guard.... all those kinds of folks do very much care.

CAP is a special beast with special rules, functions, obligations, and limitations, we are not your neighborhood SAR team, we're "other", and as such, we'll continue to work as we have, NIMS or not.

Let me tell you about "work as we have." 10 years ago we ran full-on joint coastal SaRExs with Coast Guard. We were treated as equals with them. We had officers in their command center & vice versa. We joint planned & attacked an overall joint mission together sharing resources & playing off each other's strengths & weaknesses. We went on to execute that same dynamic in several major real world searches. That went on for about 4-5 years straight.

Then ICS came along. CAP was slow to adapt & got dropped. Now we don't meet industry training standards, and we don't have a strong qualification verification system - and we have a reputation for all of that.

So, Ike rolls thru here. We get a state mission to take pictures. Okay, that's fine, but it's not emergency response & not really being used for emergency response. We do a little tiny bit of photo work for FEMA & NWS, fly a few politicians, hand out supplies at PODs alongside little kids, church groups, and basically anyone that feels like showing up, and we're not even in charge of the sites. A week later we started turning off ELTs. I talked to the CG Dist 8 & the local SaR controller. they couldn't give a crap less about EPIRBs that far after the storm. They were just letting them die off & he didn't even care what we were working or understand why we were wasting resources on it. There was a federal ICP in clear lake. We didn't have a liaison there, we didn't even know it existed till a more than a week after the storm. We were not part of the overall air operations plan. We weren't considered for any ground role. A quarter of my state was in massive distress & needed every bit of help it could get. CAP had no role of any consequence in that situation. We did some nice stuff, and some academic research was probably advanced a little bit from our photos, but not one person was saved & no response by anyone was sped up or assisted in any significant way because of our activity.

So... what the hell am I spending all this time & money training for? If I can't answer that question for myself, how the hell do I answer it in a way that inspires confidence & commitment in my troops?

I have a lot of trained, experienced, and capable people; and, I got a lot of worthless and/or untrained/unqualified/incapable people. I got no system to tell the two apart on paper. I got no system to verify that the squared away guys are squared away, at least not that anyone outside CAP would accept. And I got no support system that'll get these folks called out & assigned any real work.

NIMS does not change an organization's mission, capabilities, or limitations, its simply a way to categorize and standardize resources as they are sent.

That's right. It doesn't change organizations. What it does is seperate posers from operators. And, in doing so it sets standards, which organizations then look at & choose to change their internal training/standards in order to be categorized as operators in the future rather than posers.

There was a time - actually the whole history of CAP till this system was adopted about five or six years ago... yeah look CAP has always had a bunch of people that didn't meet the mark, and then a stronger core group that could do ES at a high level. Our reputation used to be based on that tip of the spear group. Now, we're instilling a least common denominator system & averaging those front end operators down with 12yo cadets & 68yo grandmothers doing admin. What we aren't doing is changing our standards & adapting to the state of industry standards that our major customers are demanding of us in order to make any contribution of significance.

This idea that NIMS is going to force CAP, or any other agency, to radically change their core mission or capabilities is silly, and blatantly agenda driven by the (understandably) frustrated medical professionals who are handcuffed during CAP operations.

CAP is not a first-responder agency, is not tasked or capable today of providing anything more than basic, community-level first aid, most for team safety, and that's fine with the majority of members.

CAP does not NOW consider itself a a first responder agency. However, a plane goes missing & CAP is lead agency on that search, first on scene... that's the definition of first responder.

I'm not at all arguing that we should change our core missions/capabilities. We've always had & executed these capabilities. It's only within the last decade that we've let legal issues change that, and in doing so have given up significant capabilities, that because of major changes in the larger SaR sector (mostly NIMS driven) that's lost us significant reputation & mission taskings.

I don't propose we have PJ-type field medical operators out there providing massive EMS services on the types of missions we have now, much less responding to new medical missions because we have these folks with us. I'm telling you first aid for team/community care is fine on a UDF mission in a van on surface streets. It's less than optimal walking around a leveled city where you need to be wearing a mask, require tetanus shots if you get a scratch, the hospital is destroyed, there are no services, and it's going to take me 2-4hrs to get you any outside medical help and that's only if you're critical & I can get a helo in to take you out - that's what Galveston Island was & for the most part still is right now.

Actually, the reg says level of training, but the current legal policy says nothing beyond basic first aid for life saving purposes only regardless of training, and they're serious about that.

No "policy" supercedes our regulations (or ICLs) so if such a policy exists (please provide citation) it is irrelevant. 

Beg to differ....when you corporation legal says don't do it...that is it....if you do it and you get sued.....CAP will just say "he was not following our policy" and you would be on your own.

Policy ALWAYS supersedes regs. Policy is the interpretation of regs according to advice (in this case legal & medical) and IAW commander's intent. Regs are one of several authoritative sources from which commanders develop SOPs. Troops operate according to SOPs, they don't read regs to determine the source or argue the interpretation. That's above your paygrade. When you're a wing commander you can have that conversation. Until then, the best you can hope for is effecting that interpretation that makes it into SOP at the sub-wing level.

[Dragoon]

Gotta chime in here - it has been two years since the threads started on "The Sky is Falling!  We're not NIMS certified!  We aren't going to get our National Mandated ID cards!  And we'll never get another mission ever again!"

So far, the mission tempo nationwide hasn't changed.  And I've yet to find one credible story of us being excluded because we aren't on the bleeding edge of NIMS.

So here's the challenge - if anyone knows, for a FACT, that CAP was excluded from a major mission because we aren't the sterling example of NIMS/ICS compliance, please PM me with the following:

1.  Description and dates of the incident
2.  A description of what CAP did and didn't get to do.
3.  The name and contact info for the decison maker who chose to exclude CAP.

I will happily call the guy and verify the veracity of the story, and post the results here.

What I've seen being the major problem with getting called out is that CAP doesn't keep the lines of commo active with all the myriad folks who can run missions, so we only get involved when USAF gets asked for assistance, and they pass it down to us.   In other words, a failure of marketing rather than a failure in compliance.  And that's been a problem for at least 25 years.  We're just not well wired on the local level, and many missions are local.

[isuhawkeye]

could the argument be made that NIMS compliancy (and an active movemant towards those standards) is a major part of any organizations external marketing effort.

I do not know of any organization at any level is a "sterling example of NIMS compliance".  even the coast guard had to make its own course as a stop gep towards nims compliance.

sent from my treo phone

[Eclipse]

could the argument be made that NIMS compliancy (and an active movement towards those standards) is a major part of any organizations external marketing effort.

NIMS is the Sarbanes-Oxley of ES.

Important to people its important to, uninteresting the to "real" world.  We might as well add ISO 9000 and PCI-DSS to the marketing sheets for all that it would mean to recruiting.

[RiverAux]

Actually, the reg says level of training, but the current legal policy says nothing beyond basic first aid for life saving purposes only regardless of training, and they're serious about that.

No "policy" supercedes our regulations (or ICLs) so if such a policy exists (please provide citation) it is irrelevant. 

Beg to differ....when you corporation legal says don't do it...that is it....if you do it and you get sued.....CAP will just say "he was not following our policy" and you would be on your own.

Please provide a citation for such a policy.  The CAP knowledgebase has an answer on the subject with a note from legal that basically re-states the wording of the regulation.   

[Dragoon]

could the argument be made that NIMS compliancy (and an active movemant towards those standards) is a major part of any organizations external marketing effort.

I do not know of any organization at any level is a "sterling example of NIMS compliance".  even the coast guard had to make its own course as a stop gep towards nims compliance.

sent from my treo phone

Exactly.  Everyone is struggling with this.  And as far as I can tell, lack of compliance is not only the norm anywhere right now. It's also not losing us missions.

Marketing us to Sheriff's Departments, State Emergency Management Agencies, National Guard Adjutant Generals as "NIMS compliant" matters if and only if they care.

What it more important is to let these folks know "hey, these are the capabilities we have, and here's how to get ahold of us."  And keep reminding them constantly, because people turn over and phone numbers change.  NIMS or not, if they need airplanes and they know we got 'em AND they know how to get ahold of us, they'll call.

One reason CAP isn't very good at this is because we work on weekends, and these folks work during weekdays.  If you want to got see them to discuss CAP, you need to do it during business hours.  When they have DR exercises, they tend to have them during the week.  And the most logical CAP liaison to contact them or participate in the exercise may very well not be able to get off work.  This has been a constant problem for many, many years.

The big reason is that we're aligned as a federal force, and only secondarily as a state force.  This is why I wish CAP was aligned under the National Guard Bureau, to bring us closer to the TAGs who get the state calls for DR assistance.


Someday, maybe, NIMS will actually be required.  We'll all be entered in some central registry.  And those without registration will not be able to play.  This will probably be a good thing.    But two years after this topic was first breached, it's still a long, long way off.

[DNall]

Gotta chime in here - it has been two years since the threads started on "The Sky is Falling!  We're not NIMS certified!  We aren't going to get our National Mandated ID cards!  And we'll never get another mission ever again!"

So far, the mission tempo nationwide hasn't changed.  And I've yet to find one credible story of us being excluded because we aren't on the bleeding edge of NIMS.

So here's the challenge - if anyone knows, for a FACT, that CAP was excluded from a major mission because we aren't the sterling example of NIMS/ICS compliance, please PM me with the following:

1.  Description and dates of the incident
2.  A description of what CAP did and didn't get to do.
3.  The name and contact info for the decison maker who chose to exclude CAP.

I will happily call the guy and verify the veracity of the story, and post the results here.

What I've seen being the major problem with getting called out is that CAP doesn't keep the lines of commo active with all the myriad folks who can run missions, so we only get involved when USAF gets asked for assistance, and they pass it down to us.   In other words, a failure of marketing rather than a failure in compliance.  And that's been a problem for at least 25 years.  We're just not well wired on the local level, and many missions are local.

I believe I stated that already.

1) Ike came thru here.

2) What we did:

a) There was a federal ICP in clear lake. CAP was not invited to even have a liaison present. There was a massive federal mission going on, and no place in it for CAP.

b) We flew a couple sorties for FEMA, which honestly were taking picture of their relief effort to go in power point presentations to their bosses about what they were doing. It had nothing to do with damage assessment or anyone's response.

c) We flew a couple sightseeing flights for NWS forecasters, not assessment or even academic documentation.

d) we ran an ELT mission. There were thousands going off. They were all obviously bogus. Coast Guard didn't care, waiting for them to die, didn't care what we were responding to, and wouldn't respond to any themselves unless they thought they were legit emergencies. AFRCC wanted to close the mission after a couple days, but we kept it open to keep turning stuff off as training, but it was more sightseeing than accomplishing anything meaningful.

e) We flew a massive air photo mission for the state. However, none of that was really about assessment for the purposes of disaster response. It was more for academic study of the damage, state insurance board, etc. I'm not at all against us doing that, secondary to our federal and/or emergency response missions. It may well help make decisions about how they rebuild so it won't be so bad, or help to plan for future disasters.

f) we also sent volunteers our to PODs to hand out supplies. That started out with a small city out of the major damage area complaining on teh news they weren't getting federal support, and getting supplies from the houston food bank thru a local church, and CAP got asked by a former member to help out. When FEMA got pressured into sending over supplies, we helped out at their location along side little kids, church groups, and anyone else that felt like showing up.

What we didn't do:
- any meaningful disaster response activity at all
- any actual SaR mission
- any ground mission other than non-distress UDF & look good on the news
- much of anything on behalf of the federal govt.

3) The decision makers involved were FEMA primarily on the civilian side, TAG & SOC on the state side.

My point is we have capabilities and are not allowed to do anything of consequence cause we're mere volunteers. It has nothing to do with some online courses or not. I agree that no one really cares about that crap.

It does have a lot to do with actual training/qualifications/capabilities/standards though. What we have is a huge joke by comparison to industry standards & really doesn't put us in a position to do anything meaningful.

FEMA has other standards. Are they black & white do exactly this or don't show up? Of course not, but we're no where even remotely close to those standards, and that's our reputation, which in turn defines the missions we get or don't get.

On the air side, those guys want to fly. If they get that done & feel like they're doing something for someone in the process then all the better. On the ground we're a lot more limited. It has to actually be disaster response/SaR type stuff. You can't survey birds or environmental conditions with a GT - at least you can't get people to train for GT so they can do that worthless stuff.

[RiverAux]

My point is we have capabilities and are not allowed to do anything of consequence cause we're mere volunteers.

Disagree.  The Red Cross is made up of volunteers but it has a very prominent role and is integral to disaster response at all levels of government.  Heck, didn't congress just give them 100 million or something like that? 

The reason CAP's ground capabilities are not utilized more in major disasters are that 1) CAP doesn't really advertise that we've got them to any great extent -- we focus on getting air missions and 2) we have not yet developed any clear role for ourselves in these situations. 

[arajca]

and 3) too many of our members lack a professional attitude.

[RiverAux]

Disagree with that as well.  If poor professional attitude was a problem we wouldn't get as many requests as we do for aviation-missions from other agencies.  I'm not aware of any specific bias against using CAP ground teams because they're not perceived as being professional. 

[RADIOMAN015]

Regarding the Red Cross, that was REIMBURSEMENT they requested/received under the Stafford Disaster Relief & Emergency Assistance Act See: http://en.wikipedia.org/wiki/Stafford_Disaster_Relief_and_Emergency_Assistance_Act.   (funny I can't seem to find a press release on the ARC website that they got that reimbursement).

I again think primarily CAP role nationwide is Disaster Relief is airborne/aircraft related, versus ground ops (and probably will remain this way for years to come).   It is easier to put together a team for this air missions/activity than the ground operations side (you can fly into & out of many disaster situations the same day, etc).  Granted that in very local circumstances, press releases seem to indcate that some CAP units may provide some limited support, e.g. food distribution, sand bag filling, shelter/feeding assistance etc.   I don't think that national hdqs wants to advertising capabilities that aren't a sure thing.  Also for those members that are EMT's/Paramedics etc, CAP's policy is "first aid" training/assistance nothing more.  Those with advanced medical skills, probably a good group to volunteer with FEMA's Disaster Medical Assistance Team (DMAT) see: http://www.dmat.org/, http://en.wikipedia.org/wiki/Disaster_Medical_Assistance_Team and I think you actually will get paid (GS 9 level and above) if you are deployed into a disaster area.   Also there's probably other Search/Rescue organizations in your specific geographic area, that could probably better utilize EMT/paramedic skills.  
RADIOMAN

My point is we have capabilities and are not allowed to do anything of consequence cause we're mere volunteers.

Disagree.  The Red Cross is made up of volunteers but it has a very prominent role and is integral to disaster response at all levels of government.  Heck, didn't congress just give them 100 million or something like that? 

The reason CAP's ground capabilities are not utilized more in major disasters are that 1) CAP doesn't really advertise that we've got them to any great extent -- we focus on getting air missions and 2) we have not yet developed any clear role for ourselves in these situations. 

[RiverAux]

Also for those members that are EMT's/Paramedics etc, CAP's policy is "first aid" training/assistance nothing more.

For the second time in this thread I will ask for a citation limiting CAP members to doing no more than providing basic first aid. 

I have already provided CAP regulation citations showing that CAP EMTs could perform any medical aid within the realm of their training if it was needed to save a life. 

[CadetProgramGuy]

From Knowledgebase.....

What is the level of care a licensed health-care provider (EMT, nurse, physician, etc) can provide while acting as a CAP member?

  Answer
  From the CAP General Counsel:

CAP Policy is that CAP is not an emergency medical care or paramedic organization and should not advertise itself as such. CAP will not be the primary provider of medical support on missions or training events though qualified personnel can be used to support such activities. The only type of medical aid that should be administered by CAP personnel or by any other person at CAP's request is reasonable first aid deemed necessary to save a life or prevent human suffering and executed by a person qualified to attempt such medical care within their skill level. See CAP REGULATION 60-3 (E) CAP EMERGENCY SERVICES TRAINING AND OPERATIONAL MISSIONS Paragraph 1-21f below.

Civil Air Patrol does not provide professional liability or malpractice insurance for members. A state's good Samaritan law may provide some protection for members administering medical care consistent with their training and license, and the wing legal officer should be consulted for state specific information.

CAP General Counsel

1-21f. First Aid and Emergency Medical Care. CAP is not an emergency medical care or paramedic organization and should not advertise itself as such. CAP will not be the primary provider of medical support on missions or training events though qualified personnel can be used to support such activities. The only type of medical aid that should be administered by CAP personnel or by any other person at CAP's request is reasonable first aid deemed necessary to save a life or prevent human suffering and executed by a person qualified to attempt such medical care within their skill level

[RiverAux]

Yes, that is basically a re-statement of the regulations which would allow a CAP EMT to do anything they are trained to do to save a life. 

[PHall]

River, you're reading into this what you want to see.

The General Counsel's statemeant is pretty clear to me. If you treat some one and they or their family decides to sue, you better hope your state has a Good Samaritan law because CAP will not cover you legally.

So, are your malpractice insurance payments current?

[DNall]

My point is we have capabilities and are not allowed to do anything of consequence cause we're mere volunteers.

Disagree.  The Red Cross is made up of volunteers but it has a very prominent role and is integral to disaster response at all levels of government.  Heck, didn't congress just give them 100 million or something like that? 

The reason CAP's ground capabilities are not utilized more in major disasters are that 1) CAP doesn't really advertise that we've got them to any great extent -- we focus on getting air missions and 2) we have not yet developed any clear role for ourselves in these situations. 

I disagree with that. A good portion of the Red Cross is NOT volunteer. It is a non-profit with a lot of paid staff who are supported by volunteer manpower under the supervision of trained mgmt. The paid versus not paid doesn't mean anything to anyone. The level of training/competence/documented standards/quals means the world. Red Cross does a good job with that, heck many of their courses are the industry standard.

CAP doesn't need to be well known by the public, just the operational directors. In general, they DO know about us. More specifically, the AF liaisons that are always in those decision making centers do absolutely know about CAP. I can guarantee you in this last situation that they knew we existed and our full range of capabilities, and they chose not to use those cause we weren't up to the tasks.

10-15 years ago, long before 9/11 or NIMS, those same people used us all the time & treated us as equals with agencies like Coast Guard & National Guard - I cited examples of operations. That was because, at the time, they assumed (incorrectly) that we met the same kind of standards. Since the rise of NIMS, a lot more light has been shown on agencies & we're now exposed for our actual qualification levels, which are not up to par. States - well I can only speak for mine - still make some of those incorrect assumptions &/or don't care at times, but the feds, specifically FEMA & 1AF, use people they trust with the taskings, and that isn't us at least not for anything meaningful.

It's not that our members don't behave professionally, though at times that's a bit of an issue. It's that they are incompetent. I know that's not true of everyone, but big picture... if I assemble a GTM3 level team by picking names off a list & no knowledge of the people, their experience, etc, just on a qual list, can I guarantee to a customer agency exactly the min level capability their getting? Absolutely not. And that's using an internal CAP rating system that no one else remotely understands. The purpose of NIMS is to fix both aspects of that issue.

[wingnut55]

Excellent Thread

We do need more ELTs but only to support our mission, I think it is silly to think a ground team can go out without an EMT. but that EMT should support our mission. We are not a rescue organization, maybe at one time. that function is carried out much better at the State and local level. In Calif. the county Sheriff Departments field some excellent volunteers who if I might add do not bellyache at the training requirements.

[arajca]

Something to consider about EMT's on GT's:
Unless they're carrying a full jump kit, an EMT is only going to be able to perform the same tasks as a first responder or first aid'er. EMT's are trained to use various peices of equipment and drugs well beyond first responders and first aid'ers. Without the equipment and drugs, they are no different than the others.

The jump kit is in adition to everything else carried in the field, not instead of it. Also, drugs have shelf lives, which, given the frequency that a CAP EMT would need them make that a waste of money because you'd be throwing them out before you can use them. When I was running with the FD, we regularly (read monthly) moved drugs to 'training' status (iv solutions for example) or just threw them out because they had expired.

[RiverAux]

River, you're reading into this what you want to see.

The General Counsel's statemeant is pretty clear to me. If you treat some one and they or their family decides to sue, you better hope your state has a Good Samaritan law because CAP will not cover you legally.

So, are your malpractice insurance payments current?

As long as what the EMT is doing is covered under the good samitarian law for that state, then it shouldn't matter any more than it would if someone that has done basic first aid messes up and someone dies as a result. 

The General Counsel statement is about 95% identical to the regulations and no where in it does it say that you can only do BASIC first aid.  It throws in the term "reasonable", but again links that back to the level of training of the CAP member providing the aid. 

[RiverAux]

if I assemble a GTM3 level team by picking names off a list & no knowledge of the people, their experience, etc, just on a qual list, can I guarantee to a customer agency exactly the min level capability their getting? Absolutely not. And that's using an internal CAP rating system that no one else remotely understands. The purpose of NIMS is to fix both aspects of that issue.

Theres nothing in NIMS that is going to fix that sort of thing.  CAP has a standard ground team training program that is more or less perfectly suited to what we do and just as good as the alternative and if it is not being tested the way it is supposed to be now, that is a problem for you and your fellow Wing members to fix.  We've got a firm national standard that you are saying is not being met in your area.  Another national standard ain't going to change that. 

[DNall]

Theres nothing in NIMS that is going to fix that sort of thing.  CAP has a standard ground team training program that is more or less perfectly suited to what we do and just as good as the alternative and if it is not being tested the way it is supposed to be now, that is a problem for you and your fellow Wing members to fix.  We've got a firm national standard that you are saying is not being met in your area.  Another national standard ain't going to change that. 

Actually there is no standardization of training or enforcement. I can go on eServices & put in dates/CAPID #s. That associated SET/trainer is never consulted to verify they actually viewed or approved the task. There is no structured academic work followed by practical testing. Those SET/trainers are not held to any high or standardized bar on the quals. What is passing to one person may not meet the standard to another individual; even with the same grader, those standards are not normally enforced the same against a 14yo cadet as they are a 50yo adult... if you think there's any serious standardization nationally, you're out of your mind.

Even if we were 100% squared away, those standards are unrecognizable to anyone outside CAP. If you cross-ref the FEMA standards, we're missing out big time on some key things. Even if you put courses & ratings aside for a second, how many people can pass a PT test? Don't you think that might be kind of important if you intend to strap up & hike into rough terrain for a few days?

Right now we're doing UDF & search line. We really can't do much more then that. That's a long way from WSAR, not to mention urban SaR. There is really no use for UDF/search line beyond missing aircraft & maybe the very rare light terrain no-overnight missing person type search.

What many many of our members are actually trained for & capable of is far beyond that. I personally have no desire to do another UDF mission as long as I live. I'd rather run ops & at least have a little challenge. If we're going to do real deal stuff though, I'll hump it out there with serious operators & save people's lives. That's why ground folks are actually in CAP, not to turn off non-distress ELTs.

Moving from UDF to real GSaR missions necessitates (per NIMS) EMTs once you get to a certain level of mission/team capability. That's the exact kind of capability we're needing in a post hurricane disaster response.

River, you're reading into this what you want to see.

The General Counsel's statemeant is pretty clear to me. If you treat some one and they or their family decides to sue, you better hope your state has a Good Samaritan law because CAP will not cover you legally.

So, are your malpractice insurance payments current?

As long as what the EMT is doing is covered under the good samitarian law for that state, then it shouldn't matter any more than it would if someone that has done basic first aid messes up and someone dies as a result. 

You're placing a lot more faith in good Samaritan laws than you should. It's one thing when you're a non-medical person performing CPR/first-aid within the limits of your training. It's quite another when you're placing your license & livelihood at risk to perform within the limits of your training, a level of care which is much more likely to result in legal action than bandaging a wound.

Those laws are different in every state with dif levels of protection & dif penalties for refusing aid.

What we actually need is a federal good samaritan law that covers federal responders & volunteer responders under federal orders for liability issues. That was worked on a couple years ago, but hasn't gone anywhere yet.

[RiverAux]

You're placing a lot more faith in good Samaritan laws than you should. It's one thing when you're a non-medical person performing CPR/first-aid within the limits of your training. It's quite another when you're placing your license & livelihood at risk to perform within the limits of your training, a level of care which is much more likely to result in legal action than bandaging a wound.

Those laws are different in every state with dif levels of protection & dif penalties for refusing aid.

Which is why the knowledgebase said this:

A state's good Samaritan law may provide some protection for members administering medical care consistent with their training and license, and the wing legal officer should be consulted for state specific information.

Obviously, if your state's good sam law has restrictions on how much protection is afforded trained medical professionals that would affect an individuals decision on how much of their skills to use while on CAP time. 

Incidentally, while I do believe EMTs can act within their training while in CAP service, I agree with you on a federal good sam law and would go even further in saying that CAP and the AF should work something out to cover CAP EMTs in some form or fashion. 

[DNall]

Obviously, if your state's good sam law has restrictions on how much protection is afforded trained medical professionals that would affect an individuals decision on how much of their skills to use while on CAP time. 

The issue is most of those laws also require medical professionals to render aid to the full extent of their training/ability, with penalties from losing license to going to jail, and most certainly includes civil suits which any private malpractice coverage they have would not cover.

The choice a CAP member would have, and this is what the court would find, is to put themselves in the position of being on a GT where they know they might encounter that situation. If they had the choice not to be there then they could have avoided the liability. Once there, they don't have a choice not to treat.

Incidentally, while I do believe EMTs can act within their training while in CAP service, I agree with you on a federal good sam law and would go even further in saying that CAP and the AF should work something out to cover CAP EMTs in some form or fashion. 

The concept I saw a while back was tied in with DMAT for the same issue. Obviously we'd like to get employment protections added as well.

[Eclipse]

The good Samaritan law is not a blanket protection from malpractice or other liability, especially for professionals.

It may well protect me if I make a bad decision about moving a victim versus letting him burn up and he becomes either charcoal or paralyzed, but I don't believe its going to mean much if an EMT administers an IV and the drug is expired or causes some sort of shock, etc.

Also, in order to invoke GoodSam as a defense, you have to defend yourself, which requires lawyers and money.
And CAP is always going to be enjoined in the initial suit, just like any other agency, and they will always have to show
cause as to why the corporation itself is not liable.

As it stands, CAP can sit back, knowing full well that most responders when faced with a real life or death situation, will do what the movies tell them to do, make the "right choice" and run into the burning building, while at the same time, actively seeking to avoid most cases where those situations would come up, and taking the stand of "we said 'no', so you're on your own".

Even in that environment, we have national activities, where NHQ commanders and staff participate, with seniors and cadets running around with stethoscopes, running triage rooms, and whole "medical detachments" - we have one major training activity which openly solicits and "trains" medical responders.

This in an environment where the official regs say "knock it off".

So imagine where we end up when the line is moved or changed.

No.  Either CAP changes things whole-scale, gets into the medical SAR business and starts seeking out related missions, coverage, and providing standardized qualification (note, I did not say training, as that can be garnered outside, just like the pilots), or things are fine the way they are.

We just need to stop recruiting EMT's with tales of them playing Dr. for CAP.

[Eclipse]

The issue is most of those laws also require medical professionals to render aid to the full extent of their training/ability, with penalties from losing license to going to jail, and most certainly includes civil suits which any private malpractice coverage they have would not cover.

The choice a CAP member would have, and this is what the court would find, is to put themselves in the position of being on a GT where they know they might encounter that situation. If they had the choice not to be there then they could have avoided the liability. Once there, they don't have a choice not to treat.

This is not really a "problem", so to speak, and can be managed by anyone willing to do so.

The laws involved, including outside licensing, are outside CAP's control, however that doesn't change our internal rules.

If you find yourself in a situation where a "duty to rescue" law conflicts with CAP's mandates, you simply are no longer operating under CAP control or protection and revert to whatever civilian or professional protections you would be afforded in that case were you to come upon the scene without CAP involved.

In a lot of cases I'd say its better for all parties to try and avoid those situations - its pretty hard to give CPR from an airplane, but if people insist on getting involved, then they accept the consequences.

Where it'd get real "courtroom muddy", is when the question of how the member could have been involved at all were it not for his CAP involvement to start with is raised.

[DNall]

In a lot of cases I'd say its better for all parties to try and avoid those situations - its pretty hard to give CPR from an airplane, but if people insist on getting involved, then they accept the consequences.

Where it'd get real "courtroom muddy", is when the question of how the member could have been involved at all were it not for his CAP involvement to start with is raised.

The member had a choice to be in CAP, and on a GT, where they have a reasonable expectation of encountering airplane crashes, etc. They made the choice to be in that situation when they fully knew the legal ramification if they did/did not provide care.

Sure you can fly around w/o much liability, and pilots love all the hours, but it doesn't do anything for anyone else in the org. W/o that strong combined arms (air, grd, cmd & ctrl) team really none of the parts get to do anything very worthwhile.

[RiverAux]

And even if you believe CAP's regs prohibit a CAP EMT from going beyond basic first aid (which I don't), if that EMT did decide to use his skills while on a AFAM, there isn't any "taking off his CAP hat" clause that would keep CAP from being sued if he did something wrong. 

Too many organizations let fear of getting sued paralyze them into not doing what they're supposed to be doing. 

[DNall]

Too many organizations let fear of getting sued paralyze them into not doing what they're supposed to be doing. 

CAP has had bad problems with that for about a decade now. Some of that is/was prompted by AF not wanting the liability on them, some is just lawyers looking for a way not to do things verses getting the job done.

[Ned]

Some of that is/was prompted by AF not wanting the liability on them, some is just lawyers looking for a way not to do things verses getting the job done.

Yup, it's just those lazy lawyers at it again. . . 

Come on. LT, you know better than that.  The Army is full of JAGs whose primary interest is protecting commanders, soldiers, and Uncle Sam from unnecessary problems. 

CAP JAGs all have the same client -- CAP, Inc.  And they have a fiduciary duty to watch out for their client.

I'm a former CAP lawyer and I'll let you in on a little secret.  "All" CAP needs to do is buy errors and omissions liability coverage (aka medical malpractice insurance) to cover our medical folks and we would be off to the races and doing everything you guys want to do.

The teensy little fly in the ointment is that the insurance would cost hundreds of thousands (or more) a year to cover our state licensed docs, nurses, medics, therapists, etc. in all 50 states, DC and Puerto Rico.

Let's say we get a bargain and get the coverage for only $500k a year.  Heck, that would only increase dues by $10 a member a year!  Do you think the membership would mind if we raised dues by roughly 25%?

But more importantly, if I had an extra half million dollars a year to play with in CAP, I might very well choose to spend it somewhere else.  Like say, airplanes or cadet scholarships that will be used every day rather than malpractice insurance for our HSOs that will be used very, very rarely.

But that's just me.


CAP is not trained or equipped to be a medical care provider.  If members happen across a genuine bona-fide emergency they can and should provide first aid up to their competence level.

Ned Lee
Former Legal Officer

[DNall]

Some of that is/was prompted by AF not wanting the liability on them, some is just lawyers looking for a way not to do things verses getting the job done.

Yup, it's just those lazy lawyers at it again. . . 

Come on. LT, you know better than that.  The Army is full of JAGs whose primary interest is protecting commanders, soldiers, and Uncle Sam from unnecessary problems. 

Since you're addressing me in my Army rank, I take it you want an Army officer response to that.

My job is to accomplish my mission at the cost of my own life & the lives of my troops if necessary, and it will be necessary at times. The lawyer's job is to give me advice (not instructions) on how to do that without ending up in jail after the fact. And then, regardless of how I do it, to defend me by threatening others with legal action or whatever else he needs to do to keep them off my back. Unless and until I break the faith, his job is to protect that faith on his field of battle as I do on mine.

I'll tell you what I very regularly use JAG officers for is threatening civilian employers on behalf of my troops by knowingly feeding them a complete misinterpretation of USERRA.

Their job is to use the law to further our mission. It is not to reinterpret the law in a way that prevents us from doing it.

I'm a former CAP lawyer and I'll let you in on a little secret.  "All" CAP needs to do is buy errors and omissions liability coverage (aka medical malpractice insurance) to cover our medical folks and we would be off to the races and doing everything you guys want to do.

The teensy little fly in the ointment is that the insurance would cost hundreds of thousands (or more) a year to cover our state licensed docs, nurses, medics, therapists, etc. in all 50 states, DC and Puerto Rico.

Let's say we get a bargain and get the coverage for only $500k a year.  Heck, that would only increase dues by $10 a member a year!  Do you think the membership would mind if we raised dues by roughly 25%?

But more importantly, if I had an extra half million dollars a year to play with in CAP, I might very well choose to spend it somewhere else.  Like say, airplanes or cadet scholarships that will be used every day rather than malpractice insurance for our HSOs that will be used very, very rarely.

But that's just me.


CAP is not trained or equipped to be a medical care provider.  If members happen across a genuine bona-fide emergency they can and should provide first aid up to their competence level.

Well first, no one here is proposing we start running an ambulance service. We're looking for something more like combat medic services for teams that are going to be in the worst possible circumstances.

For example: in terrain where an ambulance can't get remotely close to, or in post-disaster areas where there isn't a lot of established medical facilities in operation & response times are long.

Into those circumstances we would NOT be doing any kind of medical mission. We are sending in SaR, eval, and response teams. They are there for a completely different reason, but if one of them or a civilian is seriously hurt, we need to be able to stabilize them till a specialized medical team can get there to evac them.

FEMA says that's the standard. They say if you can't do that then you're no better than the church youth group over there. So you're going to go pass out water cause that's all your good for, and stay out our way while the real professionals save people's lives.

So 500k? That's buy us 1.5 more planes. Big freakin deal. Hell, by fixing this alone you'd be able to ramp up ES ops in a way that'd bring increased membership more than adequate to cover that low cost.

I think what we're all saying here is CAP's response capability has fallen away significantly since pre-9/11 because of tightening industry standards & related legal issues. That needs to get fixed or we might as well cease to exist - which you certainly see played out in our retention numbers.

I think the proposed solution we all agree on calls for congressional action to provide that coverage, at least while in AFAM status.

[RiverAux]

Let's say we get a bargain and get the coverage for only $500k a year.  Heck, that would only increase dues by $10 a member a year!  Do you think the membership would mind if we raised dues by roughly 25%?

You're assuming that CAP would pay all the costs and that the AF wouldn't kick in anything, which I don't think would be the case.

Heck, we're already paying 1.8 million in liability insurance costs right now.  An additional 500K would increase CAP's Ops and Maintenance budget by  about 5-10% and would only be half the cost of all the paid wing administrators that have been hired (who we got along without for 95% of our history)

[Ned]

[In my Army role, ]  the lawyer's job is to give me advice (not instructions) on how to do that without ending up in jail after the fact. And then, regardless of how I do it, to defend me by threatening others with legal action or whatever else he needs to do to keep them off my back. Unless and until I break the faith, his job is to protect that faith on his field of battle as I do on mine.

[ . . .]

Their job is to use the law to further our mission. It is not to reinterpret the law in a way that prevents us from doing it.

Exactly.

Now how's that any different than CAP?

As long as you follow your CAP orders and regulations (including the prohibition on HSOs rendering non-emergency care), the CAP JAGs will back you.

Well first, no one here is proposing we start running an ambulance service. We're looking for something more like combat medic services for teams that are going to be in the worst possible circumstances.

I guess that's the point.  "Combat medic services" is not our mission.

It never has been.  And unless there are unimaginable changes in our training, resources, and utilization, it's not gonna be.

FEMA says that's the standard. They say if you can't do that then you're no better than the church youth group over there. So you're going to go pass out water cause that's all your good for, and stay out our way while the real professionals save people's lives.

So, if we don't meet FEMA standards for activities that we don't do, then we aren't "real professionals."   

I daresay we don't meet FEMA's standards for swift-water rescue, either.  Or heavy urban SAR.  Or a whole bunch of things that might be necessary in any conceivable disaster or man-made calamity.

We just aren't "combat medic services" providers.  No matter how much we wish we might be.

So 500k? That's buy us 1.5 more planes. Big freakin deal. Hell, by fixing this alone you'd be able to ramp up ES ops in a way that'd bring increased membership more than adequate to cover that low cost.

That's quite a world view to be able to state that a half million dollars isn't a big deal for CAP, Inc.  If you don't think a couple of extra airplanes is enough to be concerned about, how about hiring another half-dozen folks for CP?  (The part of CAP that actually involves the majority of our members.)

I think what we're all saying here is CAP's response capability has fallen away significantly since pre-9/11 because of tightening industry standards & related legal issues. That needs to get fixed or we might as well cease to exist - which you certainly see played out in our retention numbers.

Our retention numbers have not changed significantly in the last 20 years.  CAP has always cycled up and down.  We are in no danger of "ceasing to exist".

Unless of course, an HSO decides to blow off the regulations and provide medical care outside of a bona-fide emergency.

For which we have no insurance.

That's a danger which could cause us to "cease to exist" very quickly.

I think the proposed solution we all agree on calls for congressional action to provide that coverage, at least while in AFAM status.

I don't disagree that the best fix would be legislative.  But I think it is far easier to talk about such legislation than it is to draft a version and get it passed.  It would have to be a wonderfully complex bit of legislation, and would inevitably come with a great deal of nationally mandated training  and record-keeping.

[MIKE]

This whole thread, and every EMT and HSO thread is just [peeing] into the wind.

[RiverAux]

I guess that's the point.  "Combat medic services" is not our mission.

You know that was just an analogy. 

I don't think it is unreasonable for an organization that does promote itself as a search and rescue force to be able to provide more than bandaids to the people that we're looking for. 

[Ned]

I don't think it is unreasonable for an organization that does promote itself as a search and rescue force to be able to provide more than bandaids to the people that we're looking for. 

Except that we don't promote ourselves as any sort of rescue force.  We have ground teams that composed of highly flexible folks that have trained to provide a multitude of services.  But rescue in the sense of victim extraction from aircraft, ruined structures, or debris and provision of subsequent medical treatment is not what we do.

We are not equipped to do it.  We are not trained to do it.

I'd like to think that our members who encounter a life-or-death situation will do their best to save the victims and provide first aid.  That can only be a good thing, and our regulations already permit first aid in such situations.

But that is a far cry from the new mission that some members are proposing we undertake -- provision of medical services in an emergency.

[DNall]

[In my Army role, ]  the lawyer's job is to give me advice (not instructions) on how to do that without ending up in jail after the fact. And then, regardless of how I do it, to defend me by threatening others with legal action or whatever else he needs to do to keep them off my back. Unless and until I break the faith, his job is to protect that faith on his field of battle as I do on mine. [ . . .]

Their job is to use the law to further our mission. It is not to reinterpret the law in a way that prevents us from doing it.

Exactly.

Now how's that any different than CAP?

As long as you follow your CAP orders and regulations (including the prohibition on HSOs rendering non-emergency care), the CAP JAGs will back you.

That prohibition on care has been added in the last few years, in many people's opinions due to over active lawyers allowing fears of liability to restrict the capability rather than finding a way, thru the law, to protect us while we drive forward with that care.

Well first, no one here is proposing we start running an ambulance service. We're looking for something more like combat medic services for teams that are going to be in the worst possible circumstances.

I guess that's the point.  "Combat medic services" is not our mission.

It never has been.  And unless there are unimaginable changes in our training, resources, and utilization, it's not gonna be.

I'm not sure you understand what a combat medic does. They are never the mission. They don't go out to provide care. They are not part of a medical unit (well they could be, but not for the purposes of this discussion). They go along with operators on normal missions - in this case a SaR mission - and are there to provide stabilizing care first of all to the operators, and secondarily to other folks you may come across.

It is no different than first aid. The difference is we're talking about a higher risk SaR/DR mission where basic first aid is not going to be adequate because there isn't accessible civilian EMS in a reasonable time after injury.

Let me give you a real world example. Galveston Island here a couple weeks ago. I had ground teams down there running ELTs. There were no EMS services available on the island for a long time, and they're still limited. The only medical evacuation available was via helicopter - there were no ambulances & no hospital. Yet, we're walking around in some serious debris fields with all kinds of nasty stuff around. Early on we did encounter some people that needed help too. A bandaid & some peroxide isn't going to fix those problems till I can get them to specialized medical care. I need to stabilize seriously hurt people till EMS can get there. In that circumstance it could be a few hours, not call 911 (there was no cell service) or jump in the van & lets drive down to the hospital.

I need someone qualified & capable of taking care of us so that we can operate in that environment. That's just sound risk mgmt, which is why it's in the FEMA standards. You don't need it for UDF & you don't need it for 90% of missions. When you do need it though, you really need it.

FEMA says that's the standard. They say if you can't do that then you're no better than the church youth group over there. So you're going to go pass out water cause that's all your good for, and stay out our way while the real professionals save people's lives.

So, if we don't meet FEMA standards for activities that we don't do, then we aren't "real professionals."   

I daresay we don't meet FEMA's standards for swift-water rescue, either.  Or heavy urban SAR.  Or a whole bunch of things that might be necessary in any conceivable disaster or man-made calamity.

We just aren't "combat medic services" providers.  No matter how much we wish we might be.

Swift water is on the WSAR list too even for type III/IV teams. That would/will have to be added to the training as we move toward compliance.

Urban SaR means collapsed structure, mountain means over 14k ft. We don't do either of those missions. Right now we don't meet the standards to do AFAM search for missing aircraft or persons in any circumstance. Almost everyone agrees that has to change (movement to type III/IV teams). The debate about adding EMTs is if we should also be able to do type I/II activities. The very strong opinion from the field is that we have that capability & need to get there, the debate is legal/financial to make it happen & a timeline.

So 500k? That's buy us 1.5 more planes. Big freakin deal. Hell, by fixing this alone you'd be able to ramp up ES ops in a way that'd bring increased membership more than adequate to cover that low cost.

That's quite a world view to be able to state that a half million dollars isn't a big deal for CAP, Inc.  If you don't think a couple of extra airplanes is enough to be concerned about, how about hiring another half-dozen folks for CP?  (The part of CAP that actually involves the majority of our members.)

I've been a cadet programs officer almost my whole career, and I'll tell you flat out that half a dozen employees, scholarships, additional NCSAs, etc are all very very low priorities next to getting our act together on the ES side. If we're able to respond into major disaster areas immediately after an incident & provide SaR/DR services on par with industry standards, then there's suddenly a whole lot more for CAP to do, and a whole lot more reason for our members to train & specialize. That brings excitement to the ranks. It retains people versus dumping them like happened when we couldn't deliver after 9/11. People come here to make a difference, and we need to give them the opportunity to do that.

I think what we're all saying here is CAP's response capability has fallen away significantly since pre-9/11 because of tightening industry standards & related legal issues. That needs to get fixed or we might as well cease to exist - which you certainly see played out in our retention numbers.

Our retention numbers have not changed significantly in the last 20 years.  CAP has always cycled up and down.  We are in no danger of "ceasing to exist".

Unless of course, an HSO decides to blow off the regulations and provide medical care outside of a bona-fide emergency.

For which we have no insurance.

That's a danger which could cause us to "cease to exist" very quickly.

That's a misleading statement about retention. It's leveled back out now to where it was prior to 9/11. We took on a lot of people after that & lost most of them when they realized CAP doesn't do nearly as much as the charter says. And leveled out to absolutely unacceptable percentages. CAP's retention has always been horrible. That's chiefly because we over sell & under deliver. The over-sell part of that is a recruiting education issue. The under-deliver part is not. We need to start delivering.

I think the proposed solution we all agree on calls for congressional action to provide that coverage, at least while in AFAM status.

I don't disagree that the best fix would be legislative.  But I think it is far easier to talk about such legislation than it is to draft a version and get it passed.  It would have to be a wonderfully complex bit of legislation, and would inevitably come with a great deal of nationally mandated training  and record-keeping.

Yeah it would come with a lot of training & record keeping. Actually, I think it would spin the HSO career field under the governance of DMAT & utilize much of their system. I might just have seen a couple drafts over the last couple years, and I'll let you know when it looks like we can take it to cmte. In the meantime, it'd be a lot more useful if CAP would work with AF, FEMA, and DMAT to propose the solution they want legislated, cause it's pretty darn difficult to get congressmen to mandate things down on those parties when they don't see the orgs complaining about the problem.

[PHall]

DNall, Ned Lee is a Retired Major (Inf) from the California National Guard.
He may have an idea or two on what a Combat Medic does...

[Dragoon]

You missed a key point in your diatribe below.  You did not give us a single name of a person we can use to verify your claims.

In other words it's still rumor.

If you have concrete knowlege that someone at FEMA or someone at your TAG who decided to exclude CAP because of a lack of NIMS compliance, just give me a name, a job title and a phone number.  I'll call 'em and have a chat.

If you can't do it, it's just rumor.  Sorry.  There are many possible reasons that your wing didn't get to do more.  The most common reason is that the decision maker didn't know what CAP could provide, not that they know CAP and decided that because of a lack of NIMS, they'd exclude us.

By the way, so far not a single person has provided a credible example of CAP being excluded for this reason.  And without evidence.......

Gotta chime in here - it has been two years since the threads started on "The Sky is Falling!  We're not NIMS certified!  We aren't going to get our National Mandated ID cards!  And we'll never get another mission ever again!"

So far, the mission tempo nationwide hasn't changed.  And I've yet to find one credible story of us being excluded because we aren't on the bleeding edge of NIMS.

So here's the challenge - if anyone knows, for a FACT, that CAP was excluded from a major mission because we aren't the sterling example of NIMS/ICS compliance, please PM me with the following:

1.  Description and dates of the incident
2.  A description of what CAP did and didn't get to do.
3.  The name and contact info for the decison maker who chose to exclude CAP.

I will happily call the guy and verify the veracity of the story, and post the results here.

What I've seen being the major problem with getting called out is that CAP doesn't keep the lines of commo active with all the myriad folks who can run missions, so we only get involved when USAF gets asked for assistance, and they pass it down to us.   In other words, a failure of marketing rather than a failure in compliance.  And that's been a problem for at least 25 years.  We're just not well wired on the local level, and many missions are local.

I believe I stated that already.

1) Ike came thru here.

2) What we did:

a) There was a federal ICP in clear lake. CAP was not invited to even have a liaison present. There was a massive federal mission going on, and no place in it for CAP.

b) We flew a couple sorties for FEMA, which honestly were taking picture of their relief effort to go in power point presentations to their bosses about what they were doing. It had nothing to do with damage assessment or anyone's response.

c) We flew a couple sightseeing flights for NWS forecasters, not assessment or even academic documentation.

d) we ran an ELT mission. There were thousands going off. They were all obviously bogus. Coast Guard didn't care, waiting for them to die, didn't care what we were responding to, and wouldn't respond to any themselves unless they thought they were legit emergencies. AFRCC wanted to close the mission after a couple days, but we kept it open to keep turning stuff off as training, but it was more sightseeing than accomplishing anything meaningful.

e) We flew a massive air photo mission for the state. However, none of that was really about assessment for the purposes of disaster response. It was more for academic study of the damage, state insurance board, etc. I'm not at all against us doing that, secondary to our federal and/or emergency response missions. It may well help make decisions about how they rebuild so it won't be so bad, or help to plan for future disasters.

f) we also sent volunteers our to PODs to hand out supplies. That started out with a small city out of the major damage area complaining on teh news they weren't getting federal support, and getting supplies from the houston food bank thru a local church, and CAP got asked by a former member to help out. When FEMA got pressured into sending over supplies, we helped out at their location along side little kids, church groups, and anyone else that felt like showing up.

What we didn't do:
- any meaningful disaster response activity at all
- any actual SaR mission
- any ground mission other than non-distress UDF & look good on the news
- much of anything on behalf of the federal govt.

3) The decision makers involved were FEMA primarily on the civilian side, TAG & SOC on the state side.

My point is we have capabilities and are not allowed to do anything of consequence cause we're mere volunteers. It has nothing to do with some online courses or not. I agree that no one really cares about that crap.

It does have a lot to do with actual training/qualifications/capabilities/standards though. What we have is a huge joke by comparison to industry standards & really doesn't put us in a position to do anything meaningful.

FEMA has other standards. Are they black & white do exactly this or don't show up? Of course not, but we're no where even remotely close to those standards, and that's our reputation, which in turn defines the missions we get or don't get.

On the air side, those guys want to fly. If they get that done & feel like they're doing something for someone in the process then all the better. On the ground we're a lot more limited. It has to actually be disaster response/SaR type stuff. You can't survey birds or environmental conditions with a GT - at least you can't get people to train for GT so they can do that worthless stuff.

[Ned]

I'm not sure you understand what a combat medic does. They are never the mission. They don't go out to provide care.

As a former mech infantry battalion XO, I have a vague idea of what all those guys in the medical platoon were doing.

Maybe it's perspective, but I'd say that the only reason they go out is to provide care.  That's kinda their whole reason to exist.  They lived, breathed, and ate combat medicine.  Trained incessently, and went out of their way to put what they learned into practice.  They were not just cross-trained infantry soldiers (like combat lifesavers), they were a stand-alone MOS.  IOW, medical stuff is pretty much all they do.

(Tip:  Never, ever, complain about being a little dizzy when standing up quickly during a hot summer FTX.  At least not near the medics who are desparate to practice their IV skills.  )

And they lugged a whole lot of equipment around the battlefield.  Not counting the battalion aid station, the medics assigned to the line companies had hundreds of pounds of gear.

So, I'm thinking that combat medic paradigm is a pretty poor fit for CAP, unless you are suggesting that we have dedicated medical personnel equipped and trained for major trauma.

[For example, in a Galveston-type environment] I need someone qualified & capable of taking care of us so that we can operate in that environment. That's just sound risk mgmt, which is why it's in the FEMA standards. You don't need it for UDF & you don't need it for 90% of missions. When you do need it though, you really need it.

In these types of scenarios, CAP is not operating in a vacuum.  The Galveston cops do not have organic medics.  They relied on the fire department or other providers.

Why are we different?  We can and should give first aid in emergencies while expecting the victim to be treated subsequently by a medical professional.

I've been a cadet programs officer almost my whole career, and I'll tell you flat out that half a dozen employees, scholarships, additional NCSAs, etc are all very very low priorities next to getting our act together on the ES side.

Strong statement of personal opinion noted.  But given that over half of our members work almost exclusively in CP, I'm not sure that your opinion is held by most members.

That's a misleading statement about retention. It's leveled back out now to where it was prior to 9/11. We took on a lot of people after that & lost most of them when they realized CAP doesn't do nearly as much as the charter says. And leveled out to absolutely unacceptable percentages. CAP's retention has always been horrible. That's chiefly because we over sell & under deliver. The over-sell part of that is a recruiting education issue. The under-deliver part is not. We need to start delivering.

Honestly, don't you think that conversations like this are part of the "over-sell."?

We really don't sell ourselves as a rescue force.  If rogue squadron members do that at the local level, then we deserve crappy retention figures.

Maybe the answer is not to over-sell in the first place rather than engage in mission creep to allow us to catch up to our sales pitch. Spacing - MIKE

[DNall]

You missed a key point in your diatribe below.  You did not give us a single name of a person we can use to verify your claims.

In other words it's still rumor.

If you have concrete knowlege that someone at FEMA or someone at your TAG who decided to exclude CAP because of a lack of NIMS compliance, just give me a name, a job title and a phone number.  I'll call 'em and have a chat.

If you can't do it, it's just rumor.  Sorry.  There are many possible reasons that your wing didn't get to do more.  The most common reason is that the decision maker didn't know what CAP could provide, not that they know CAP and decided that because of a lack of NIMS, they'd exclude us.

By the way, so far not a single person has provided a credible example of CAP being excluded for this reason.  And without evidence.......

The issue is not quote unquote NIMS compliance, it's not being qualified for the work, which is judged by FEMA resource typing standards, which are part of NIMS. It's not IC100-800 or lack thereof.

And who do you want to talk to?

I don't know who the overall federal (FEMA) IC in clear lake was. That was way above my pay grade. We weren't even informed that the place existed till the mission was 1/2 - 3/4ths over with. I found that out from CG when the guy at dist 8 tried to call back there looking for me on a referral we passed them. We weren't assigned any federal mission of consequence. The one major state mission we did was not life saving or critical response shaping. That stuff is supposed to be our bread & butter.

[DNall]

I'm not sure you understand what a combat medic does. They are never the mission. They don't go out to provide care.

As a former mech infantry battalion XO, I have a vague idea of what all those guys in the medical platoon were doing.

Maybe it's perspective, but I'd say that the only reason they go out is to provide care.  That's kinda their whole reason to exist.  They lived, breathed, and ate combat medicine.  Trained incessently, and went out of their way to put what they learned into practice.  They were not just cross-trained infantry soldiers (like combat lifesavers), they were a stand-alone MOS.  IOW, medical stuff is pretty much all they do.

So, I'm thinking that combat medic paradigm is a pretty poor fit for CAP, unless you are suggesting that we have dedicated medical personnel equipped and trained for major trauma.

And I'm not trying to insult your intelligence here, but I'm not remotely talking about a medical platoon either. I'm talking about a single light infantry squad or platoon medic. (Mech guys got a whole freakin medic track & all kinds of junk)

When that infantry Sqd/Plt goes outside the wire, it's not to support the combat medic (well in theory it could be, but again that's not what we're talking about). The mission is the infantry objective. Certainly the medic is there to provide care IF the need arises, which is exactly what I'm talking about. Just like the RTO is there for comm, but the mission isn't comm.

A type I/II team by definition is responding to incidents where it's not safe for them to go with just basic first aid. There is no (or very limited) existing EMS system that can back them up. They aren't going into areas to rescue anyone. They're in there turning off an ELT, taking damage photos, or rucking into the woods looking for missing a missing person or plane. BUT, if someone gets hurt or they encounter hurt people, and there's a good chance that'll happen, then there's no one else to turn to for help.

CAP's response in the past has been that we just won't do those missions, that we don't want to put volunteers at risk. No one in the field is happy with that answer.

You have to be able to stabilize - not field surgery or anything insane, just stabilize -  that person till you can get them help. That is exactly what first aid is. However, the level of medical care required to accomplish the same thing in that environment is higher - FEMA says EMT-B. I'm not sure if I absolutely agree with them, but I don't make that call, and they do decide who gets missions & who doesn't.

[For example, in a Galveston-type environment] I need someone qualified & capable of taking care of us so that we can operate in that environment. That's just sound risk mgmt, which is why it's in the FEMA standards. You don't need it for UDF & you don't need it for 90% of missions. When you do need it though, you really need it.

In these types of scenarios, CAP is not operating in a vacuum.  The Galveston cops do not have organic medics.  They relied on the fire department or other providers.

Why are we different?  We can and should give first aid in emergencies while expecting the victim to be treated subsequently by a medical professional.

What Galveston Cops? What fire dept? The local depts were wiped off the earth. DPS held the bridge. There was no fire or EMS service on the island for quite a while. It was a 90min trip on/off the island at times. Literally the only medical service would have been getting our highbird to call DPS & request a lifeflight or Coast Guard helo. That would be at least an hour delay & require us to move the patient to an LZ.

After about a week I could put them in the van & move them to the airport on the island where there was a guard security detachment that sometimes had a medic with them. By that time though we were into more of a type III or maybe low type II environment. Type I is operating in a vacuum.

Yes we can & should give first aid while relying on EMS providers to provide subsequent care. I'm in absolute agreement with that. The issue is, in certain environments like my couple examples, the level of care necessary to bridge to that subsequent care is greater than first aid. Again, FEMA says it rises to EMT-B. That may or may not be slightly overkill, but it's not my call.

I've been a cadet programs officer almost my whole career, and I'll tell you flat out that half a dozen employees, scholarships, additional NCSAs, etc are all very very low priorities next to getting our act together on the ES side.

Strong statement of personal opinion noted.  But given that over half of our members work almost exclusively in CP, I'm not sure that your opinion is held by most members.

While I appreciate the hard work our staffers at NHQ do, I doubt VERY seriously most members have any idea how many work in CP, what impact 1 or 6 or 20 more in that shop would make, and I can about assure you that they'd vote for any of a hundred other priorities before additional staff. Obviously any unit out here in the field could do huge things with just a few grand. And the total national budget for CAP is a whole lot of millions every year.

That's a misleading statement about retention. It's leveled back out now to where it was prior to 9/11. We took on a lot of people after that & lost most of them when they realized CAP doesn't do nearly as much as the charter says. And leveled out to absolutely unacceptable percentages. CAP's retention has always been horrible. That's chiefly because we over sell & under deliver. The over-sell part of that is a recruiting education issue. The under-deliver part is not. We need to start delivering.

Honestly, don't you think that conversations like this are part of the "over-sell."?

We really don't sell ourselves as a rescue force.  If rogue squadron members do that at the local level, then we deserve crappy retention figures.

Maybe the answer is not to over-sell in the first place rather than engage in mission creep to allow us to catch up to our sales pitch.

We've ALWAYS sold ourselves as a SaR organization. And for a really long pert of our history we did actually attempt to make good on the rescue part of that too. I don't think we were ever qualified to do that, but it did happen. Now, standards are more tightly controlled & all we do is search.

Look, I don't care about finding non-distress ELTs. I don't care very much about finding downed planes with dead people in them. I don't care about taking pictures of damage for some academic study down the road. I don't care about running shelters or filling sand bags or handing out food/water. I train for ES so I can maybe someday save someone's life. Anybody that has anything to do with ES is here for that reason. Saving lives involves more than search.

[Dragoon]

You missed a key point in your diatribe below.  You did not give us a single name of a person we can use to verify your claims.

In other words it's still rumor.

If you have concrete knowlege that someone at FEMA or someone at your TAG who decided to exclude CAP because of a lack of NIMS compliance, just give me a name, a job title and a phone number.  I'll call 'em and have a chat.

If you can't do it, it's just rumor.  Sorry.  There are many possible reasons that your wing didn't get to do more.  The most common reason is that the decision maker didn't know what CAP could provide, not that they know CAP and decided that because of a lack of NIMS, they'd exclude us.

By the way, so far not a single person has provided a credible example of CAP being excluded for this reason.  And without evidence.......

The issue is not quote unquote NIMS compliance, it's not being qualified for the work, which is judged by FEMA resource typing standards, which are part of NIMS. It's not IC100-800 or lack thereof.

And who do you want to talk to?

I don't know who the overall federal (FEMA) IC in clear lake was. That was way above my pay grade. We weren't even informed that the place existed till the mission was 1/2 - 3/4ths over with. I found that out from CG when the guy at dist 8 tried to call back there looking for me on a referral we passed them. We weren't assigned any federal mission of consequence. The one major state mission we did was not life saving or critical response shaping. That stuff is supposed to be our bread & butter.

In other words, you know that you didn't get called out  but you have no first hand knowledge as to why.

This makes the rest just conjecture.

Again, it may be as simple as the guys doing the call outs didn't have a current phone roster.  Or never had a CAP guy explain what CAP could do for them.  In fact, these are the two most common reasons we don't get called for DR work.

Unless you know why, it's hard to know what needs fixing.

Here's your quote

It's only within the last decade that we've let legal issues change that, and in doing so have given up significant capabilities, that because of major changes in the larger SaR sector (mostly NIMS driven) that's lost us significant reputation & mission taskings.

All I'm asking for is for you to back up this bold assertion with facts.  Tell me how lack of NIMS has lost us missions.  Give me a name of someone who you  know for a fact could have called us out but didn't  because of lack of NIMS.

I know you THINK that this is why, but I really don't see any hard evidence to back this up.

[RiverAux]

Incidentally, up until very recently you had to have "Advanced First Aid" to be a Ground Team Leader.  They never really defined that in the regulations, but there was some sort of handout from NHQ saying that it meant a 40 hour first aid course --- which would basically mean the First Responder course.  We've dropped that now and I tend to agree that it is asking a bit much for every GTL to be a First Responder, but that certification, or something similar should be part of the program. 

[Ned]

And I'm not trying to insult your intelligence here, but I'm not remotely talking about a medical platoon either. I'm talking about a single light infantry squad or platoon medic. (Mech guys got a whole freakin medic track & all kinds of junk)

As I said I suspect this is just a matter of perspective.

I can only agree that the infantry unit's objective is normally some warfighting task.

But I suspect you'd agree that the medic's sole supporting mission is to render aid as needed.

A type I/II team by definition is responding to incidents where it's not safe for them to go with just basic first aid. There is no (or very limited) existing EMS system that can back them up. They aren't going into areas to rescue anyone. They're in there turning off an ELT, taking damage photos, or rucking into the woods looking for missing a missing person or plane. BUT, if someone gets hurt or they encounter hurt people, and there's a good chance that'll happen, then there's no one else to turn to for help.

Dennis, the whole point of the OP was that FEMA wants a FR or better on teams. 

As others have pointed out, there is no CAP regulation that would prohibit or even discourage us from having a FR or better on our teams.

The only restriction is that CAP HSOs are restricted in the kind of care they can give.

But they can certainly be on the teams.  As a practical matter, I suspect they should be cross trained in other specialties.  Kinda like SF guys.

CAP's response in the past has been that we just won't do those missions, that we don't want to put volunteers at risk. No one in the field is happy with that answer.

CAP is clearly always going to decline missions that are too risky for our teams after consideration of the team's experience, training, and equipment. 

That's just common sense and ORM.

And good leadership.

Look, I don't care about finding non-distress ELTs. I don't care very much about finding downed planes with dead people in them. I don't care about taking pictures of damage for some academic study down the road. I don't care about running shelters or filling sand bags or handing out food/water. I train for ES so I can maybe someday save someone's life. Anybody that has anything to do with ES is here for that reason. Saving lives involves more than search.

Absolutely.  But contrary to your assertiions, sometimes saving lives does indeed involve running shelters, filling sand bags, and handing out food/water.

It is important and worthy work.  We are privileged to perform it when needed and requested.


But that critically important work isn't as flashy or fun as pulling victims out of collapsed buildings.

[PHall]

Look, I don't care about finding non-distress ELTs. I don't care very much about finding downed planes with dead people in them. I don't care about taking pictures of damage for some academic study down the road. I don't care about running shelters or filling sand bags or handing out food/water. I train for ES so I can maybe someday save someone's life. Anybody that has anything to do with ES is here for that reason. Saving lives involves more than search.

Then I think you may be in the wrong organization. You want to do RESCUE, then you may want to join a SEARCH and RESCUE TEAM.
Because CAP is neither trained or equipped for that mission.

[isuhawkeye]

Maybe he was recruited into cap based upon the idea that CAP does Search and Rescue


http://www.cap.gov/visitors/about/our_programs/operations.cfm
http://level2.cap.gov/index.cfm?nodeID=5243
http://www.af.mil/news/story.asp?id=123116954
http://www.pawingcap.com/hawk/

If CAP doesnt do search and rescue, then someone should tell these people ^^^

[sarmed1]

As we have hashed out in many (many) previous discussions.  It doesnt matter if you are an EMT (B, I or P) it depends how your state defines your scope of practice at your certification level, more specifically what you are allowed to do at that level of certification and more over under whose license you are performing that skill. 

For example: as a paramedic I dont carry a drug box and cardiac monitor in my car, I just cant stop on the side of the road and start and  IV and intubate someone just because I am a paramedic.  I have to be operating under the direction (off line or on line) of a medical command physician, more specifically the Medical Director of the service I am working for.  Even as a volunteer firefighter, my department provides first responder level care only, I cant operate as a paramedic (performing ALS skills) because we are not licensed to or have the equipment or the insurance to cover that.  Now that is specifically how Pennsylvania works currently, most other states are some what similar.  The EMT level here is pretty much the same (though the skill set is smaller)

How does this relate to CAP SAR capability and NIMS?
It may be assumed that there is a certain "skill set" that is expected of an EMT (remember that this too varies from state to state so a "Federal" document assumes the DOT standard I guess) but no where in the original or revised FEMA standard does it state what equipment or skill set it expects the EMT/ WFR to have/perform. Might say BLS equipment which is: splinting, bandaging and basic airway,  Oxygen and AED may fall into that but remeber in most states AED use is a lay persone skill and so is oxygen in some places (honestly you cant carry enough oxygen to be effective for the length of time it takes to do a wilderness rescue anyway nor is the AED going to be commonly effective in the same enviropnment....CPR for 2 plus hours is going to be counterproductive)

So really, you can have an EMT/WFR on your team and meet the standard, the only "problem" is that they may not be able to perform to the full extent of their level of trianig due to CAP's restrictions....(which I have even had as an ALS provider....I was a paramedic at a FD in Texas that the medical directer limited our range of drugs because we were only a first responder service) but you still meet the standard of an EMT/WFR on your team.  Either way the real restriction applies to "routine" care; providing EMT level care in an emergency is within the letter of CAP's "restrictive" regulation.
(as quoted above)

personally I think that solves the FEMA/NIMS issue.   
Now on a seperate issue, the area I would like to see clarification on is if CAP HS personnel are covered under by the USAF on AFM.  Since it seems that most other liability issues fall under USAF for AFM why wouldnt medical liability and malpractice?  The issues I see with that are multifold: 2ish really stand out: 
Firstly as a USAF enlisted medical guy I have a folder of like what seems like 1000 tasks that I have to demonstrate knowledge and competency in (some 1 time some 20 month re-occuring) to be current an qualified and I know that RN's, PA's and MD's have similar requirements.  I see that (or something similar)  being a core requirement of the AF if they are going to assume the risk of CAP's HSO acting on the USAF behalf to render medical care (routine or emergency), and I see that as a difficult one (my current and every reserve unit I have been in always gets dinged on their inspections for these folders being messed up, out of date or not there entirely) 
Secondly, similar to the NG this protection would only apply to CAP while on AFM status...(when I was in the NG, we could only perform medic skills...IV, drugs etc....if we were on Federal Status...ie annual tour or activation) So all of the weekly meetings, weekend activites, NCSA, encampments etc that HSO's support would still be not covered.  So like Ned pointed out the benefit would only apply to a small percentage of CAP's folks....and I am sure the other 2/3 of the folks would still be upset because their "hands are tied"

mk

[Dragoon]

Maybe he was recruited into cap based upon the idea that CAP does Search and Rescue


http://www.cap.gov/visitors/about/our_programs/operations.cfm
http://level2.cap.gov/index.cfm?nodeID=5243
http://www.af.mil/news/story.asp?id=123116954
http://www.pawingcap.com/hawk/

If CAP doesnt do search and rescue, then someone should tell these people ^^^

It's true - we do primarily "S" not "SAR."  It's been that way for some time, and by that I mean a whole bunch of decades.

We CONTRIBUTE to "SAR" by doing "S".  I'd agree that more straightforward advertising would make mroe sense.

[RiverAux]

Folks, "Rescue" does not always equal "provide medical care". 

[Eclipse]

Folks, "Rescue" does not always equal "provide medical care". 

Double ditto - just one part of the team.

[Dragoon]

Folks, "Rescue" does not always equal "provide medical care". 

Absolutly true - but we also don't do a heck of a lot of rescue either.  Not only are we lacking medical assets, we also don't invest in extraction stuff.  Not that there's anything wrong with that - but when you say "We do Search and Rescue" to someone you know that the image you just put in their head doesn't match what CAP really does.

[RiverAux]

Yeah, we really wasted our time looking for and finding those 90 people last fiscal year.  Why even bother.

[DNall]

Again, it may be as simple as the guys doing the call outs didn't have a current phone roster.  Or never had a CAP guy explain what CAP could do for them.  In fact, these are the two most common reasons we don't get called for DR work.

There is ALWAYS an AFRes liaison from 1AF (not CAP-USAF) in that ICP. Always has been since well before there was a 1AF or anything remotely like NIMS. That person is very knowledgeable about CAP & our full capabilities, as well as everything the AF has to offer. They advise that IC staff of those capabilities, and coordinate requests to 1AF (who is the overall air commander for federal response anyway).

Could we do a better job of selling those officers on selling CAP in those situations? Sure, and we should. But, their job is plug the right resource into the right job, regardless of cost.

Now, no I'm certainly not in a position to be a fly on the wall during that process. I can't tell you if 1AF believes we are not qualified to do the kind of response needed on the ground, or if 1AF is offering & FEMA isn't buying because they don't believe we're either capable at all or at least the most capable resource they have in the tool box. I would guess it's a healthy combination of the two.

If you want to say the answer is marketing... well, okay to a certain extent that's true, but that's really just hype. I think it's reasonable to also say we can & should bump up our capabilities to become a more competitive resource - to make ourselves more marketable.

I don't think we can hide our head in the sand & say we're good enough, that we don't need to train to these higher standards cause it's too hard; and that the answer is all on the national marketing level. To me that's just passing the buck. If we do that & it turns out very successful, aren't we just going to find ourselves in situations we're not prepared for?

What I got taught was dress for the job you want - train to the industry standard for the level of work you want to do, THEN market that capability. When billions of dollars are being spent on a response, the difference between 150/hr and 1,000 isn't a factor. Being the cheapest way to get a passable job done on limited things isn't going to be enough.

I don't think the sky is falling by any means. But, I do very strongly believe in "excellence in all we do." Resting on our laurels isn't acceptable. Seeing in this situation a challenge we can overcome & become great by that process... that's where the vision of this org needs to be.

It's only within the last decade that we've let legal issues change that, and in doing so have given up significant capabilities, that because of major changes in the larger SaR sector (mostly NIMS driven) that's lost us significant reputation & mission taskings.

All I'm asking for is for you to back up this bold assertion with facts.  Tell me how lack of NIMS has lost us missions.  Give me a name of someone who you  know for a fact could have called us out but didn't  because of lack of NIMS.

I know you THINK that this is why, but I really don't see any hard evidence to back this up.

NIMS as a black & white standard isn't the key. Being competent, and seen as competent, is.

I came into CAP in 94. For the first 5 years, we were heavily involved in multi-agency large scale operations where we were treated and tasked as equals by agencies like Coast Guard & FEMA. I deployed out as a GTL & MO on many many of those missions doing all the sorts of things you now see professional agencies out there doing.

Since becoming active again in ES things have been significantly different. Since about 2003/4 in particular, CAP ES has been a very small shadow of what we were previously being tasked with.

I have worked with CG & FEMA since that time, and it's not remotely the same. I don't think we've changed significantly, but I do think they have. And they're the big players that we have to adapt to. We haven't been doing that. In some respects for legal reasons, but for the large part it's because it'd be hard & leadership didn't have a vision or drive to do it. I don't think that works. I don't think that's acceptable going into the future. I think we have to drive forward and set an example, not wait it out & lemming along behind hoping to pick up some bread crumbs here & there.

PS - I can slide in some more cliches if you think it'd help.

[DNall]

I can only agree that the infantry unit's objective is normally some warfighting task.

But I suspect you'd agree that the medic's sole supporting mission is to render aid as needed.

Absolutely.... and the role of an MRO on a GT is what? To run the radio right? Is that the GT mission, to go out into the field & run comms? Absolutely not. It's a support task necessary to complete the overall objective.

So what role does a GTM with first aid have on a GT? Be a GTM & render aid as needed, right?

So what if you're putting that GT out to do the same GT missions we do now (mostly find ELTs & take damage pictures), but you're putting them in an environment where first aid isn't going to be adequate medical support for them to accomplish the mission & there are NOT available outside resources to back them up?

That is what a type I incident is. That was the situation on Galveston Island for over a week, and longer then that on Bolivar Peninsula.

As I said, no one is arguing to operate EMS or set up some kind of field hospital. That's first of all nuts, and second of all what DMAT is there for. What I am saying is our very tip of the spear units, organized on a wing or even region level, should be able to respond into those more challenging circumstances. Right now that is not the case.

Dennis, the whole point of the OP was that FEMA wants a FR or better on teams. 

As others have pointed out, there is no CAP regulation that would prohibit or even discourage us from having a FR or better on our teams.

The only restriction is that CAP HSOs are restricted in the kind of care they can give.

But they can certainly be on the teams.  As a practical matter, I suspect they should be cross trained in other specialties.  Kinda like SF guys.

If you defer the liability to the responder, and don't provide them a designated or required role, why are they going to put themselves in that situation? If we don't have them but by chance & against the odds, then we can't field teams that meet the standard, so we don't have the capability.

CAP's response in the past has been that we just won't do those missions, that we don't want to put volunteers at risk. No one in the field is happy with that answer.

CAP is clearly always going to decline missions that are too risky for our teams after consideration of the team's experience, training, and equipment. 

That's just common sense and ORM.

And good leadership.[/quote]
Yes it is good ORM/leadership. However, if you change the experience, training, equipment factors prior to the engagement, don't you then change the decision to engage or not?

Look, I don't care about finding non-distress ELTs. I don't care very much about finding downed planes with dead people in them. I don't care about taking pictures of damage for some academic study down the road. I don't care about running shelters or filling sand bags or handing out food/water. I train for ES so I can maybe someday save someone's life. Anybody that has anything to do with ES is here for that reason. Saving lives involves more than search.

Absolutely.  But contrary to your assertiions, sometimes saving lives does indeed involve running shelters, filling sand bags, and handing out food/water.

It is important and worthy work.  We are privileged to perform it when needed and requested.

But that critically important work isn't as flashy or fun as pulling victims out of collapsed buildings.

It is important and worthy in the same way the finance guy back here at home makes sure I get paid when I'm downrange in contact. It's not what you engage highly trained, experienced, line personnel to do. That's a huge waste of resources.

You were an infantry officer with PL & CO time. I don't know if you ever had to do a rotation as S1 or 4 or anything like that, but I'm sure you know fellow officers that did. When that's a quality line officer in that role. You know darn well how they feel about it.

That's how I and a lot of my experienced operators feel about the state of high level ES in CAP right now. It's frustrating, and it drives those best people away, which just hurts our capability even more.

I'm not saying a 13yo cadet needs to be able to go into hell with me, they certainly do not need to be there. But, there's some people around here that can & should be there, and CAP as an org should be there doing what we've always done, and what we say we can do.

I'm sorry if people see that as pessimism. It's not! It's an optimistic vision about what we can and should be if we're willing to earn it. I want to be part of that solution, my operators want to be part of that solution, what we need is the national organization to take up that challenge and drive forward.

[RiverAux]

I think some good points have been made in regards to varying standards for EMTs across the country and their licensing requirements and incorporating them into CAP's GSAR mission may not be feasible. 

Instead, I believe that the First Responder training might be more appropriate to have for our teams.  I'm familiar with the regular Red Cross First Responder course (actually called Emergency Response), which is 40-50 hours, but not the Wildnerness First Responder course referenced earlier on in this thread. 

According to the web, there are several organizations that teach this course, which is about 80 hours and conforms to standards of the Wilderness Medical Society.  I've looked at the topics covered and am not seeing a lot of bang for the buck in terms of comparing what you learn in the regular course vs the wilderness course, so I'm not convinced that the trade-off in terms ofa 2-week vs 1-week course is worth it. 

[SARMedTech]

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

We have??

This topis relates to CAP and EMT's on the teams.  Is there a time where we can deliver aid in the field to our targets, or are we opening our selves to lawsuits?

That is the major reason there is not a program for HSOs to progress through. Read CAPR 160-1 for more details.

Does Good Sam laws relate to EMT's?

Varies from state to state. Check with your wing HSO or Legal Officer.

Also I don't understand where I was in-correct.  My statement was about needing EMT's or FR or higher to be type I certified.  Thats what NIMS states in your link as well.  Can you elaborate where I am wrong?

A Type I team requires EMT, ACLS, BTLS, not FR. A Type II team requires EMT or Wilderness First Responder. which is a specific skill set not covered in the generic First Responder certification.

As for elaboration,

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team.

FR doesn't cut it for Type I teams.

Couple of problems here:

1. BTLS is no longer called BTLS. It has been changed to ITLS or International Trauma Life Support. Its semantics by the company that basically holds the monopoly but it behooves us in such conversations to get our terminology straight.

2. If an EMT (meaning an EMT-B) is required for a Type I team, the ACLS does not come into play. ACLS involves the use of not only synchronized defibrilation (a technique not generally allowed for use by Basics), it also involves the use of cardio-verting drugs, which are definitely out of bounds for basics, unless your state considers ASA a cardioverter and allows its administration by Basics.

[SARMedTech]

I think you are misunderstanding what is meant by that phrase.  To me that says we don't sell ourselves as an emergency ambulance service that will come to your house when you have a heart attack or go to motor vehicle accidents. 

It specifically allows for care to be given within the skill level of the person giving it.  It doesn't restrict that skill level in any way.  If they didn't want a CAP member who was an EMT giving an EMT level of care to someone that needed it in order to survive, they could have easily said so by specifically restricting CAP from doing anything beyond the level of basic first aid. 

Having an EMT or first responder on your ground team doesn't somehow magically transform it into some sort of rogue team not sanctioned by CAP. 

Telling the county sheriff that you have an EMT on your team doesn't make you a paramedic organization.  What it means is that if we find the target and they need care to save their life, we have an EMT that could provide that care up to the level of their training if no other medical care is available. 

WRONG, WRONG, WRONGITY WRONG!

You do not understand, apparently, regardless of how many times this conversation is had, that EMT-Bs or Paramedics cannot, under CAP regulations (not to mention insurance and medical direction issues) operate to their full level of training. I'll give you some examples:

I can, in the state of IL, as an EMT place a combitube to maintain a patent airway. Given that all EMTs operate as surrogates under the medical license of a medical director/physician, absent that regulated medical director being part of CAP and providing either direct (on scene) or indirect (off scene by phone, radio, etc) medical control, I as an EMT cannot drop that combi into an airway.

An EMT-B is allowed to administer oxygen under standing medical orders. Medical oxygen is considered a drug. Given that CAP has no standing medical orders or medical control, no CAP EMT can give oxygen. Sounds silly, but its the law. The standing order must be in place. There is a tendency to think that because its air, no medical control or orders, standing or otherwise, are needed. That assumption is incorrect.

An EMT-P can perform a crycho-thyrotomoy (surgical airway).  Wanna see what would happen if a CAP paramedic did this? Wanna try for decompression of a tensioned lung?

The fact remains that i have seen CAP Basics and Paramedics hauling around STOMP packs with oxygen cylinders, syringes, airways of all sorts, scalpels, etc. What exactly are you going to do with that stuff?  You'd be better off to throw it to a non EMS CAPster and let them do something under good samaritan laws than you would be to do it yourself. Seriously. Just because you are an EMT or Paramedic and good samaritan laws do, to an extent, cover EMS personnel off duty (which they are when they are in the field with CAP...an on duty EMT of any level is only "on duty" when on the clock with the service that pays him/her or with which he/she volunteers) a CAP EMT of any level doing the things that they could do in the field or in the ambulance of the agency they work for (ie non-CAP) on a CAP mission or SAR-X is going to be sued until they dont have two nickels to rub together and will never hold a medical license anywhere ever again. I have seen CAP EMTs carrying around oral and nasal pharyngeal airways?  What are you going to do with that?  That is an invasive medical procedure.

No, having an EMT of any level doesnt make your team a rogue. But having an EMT performing up to his/her level of skill and license without direct or indirect medical control makes that EMT a rogue and you can bet your brass buttons that he will get his head handed to him when the spit hits the spam, and so will the CC, National and just about everyone associated with CAP or at least that CAP team.

RiverAux-

it surprises me after all this time that A) you misread these regulations so severely and B) that you dont know that what CAP wants is EMTs and paramedics to be taking risks with their licenses and livelihoods in the field with absolutely no backup (legally) of any kind at the wing, region or national level.

[SARMedTech]

I think some good points have been made in regards to varying standards for EMTs across the country and their licensing requirements and incorporating them into CAP's GSAR mission may not be feasible. 

Instead, I believe that the First Responder training might be more appropriate to have for our teams.  I'm familiar with the regular Red Cross First Responder course (actually called Emergency Response), which is 40-50 hours, but not the Wildnerness First Responder course referenced earlier on in this thread. 

According to the web, there are several organizations that teach this course, which is about 80 hours and conforms to standards of the Wilderness Medical Society.  I've looked at the topics covered and am not seeing a lot of bang for the buck in terms of comparing what you learn in the regular course vs the wilderness course, so I'm not convinced that the trade-off in terms ofa 2-week vs 1-week course is worth it. 

The difference between MFRs and WMFRs lies not so much in what they are taught, but where they are taught to do it. Wildnerness Medical First Responders are trained to provide stabilizing first aide and evacuation in austere, remote and wilderness environments.

[SJFedor]

So, is this a NIMS resource typing question, or a thread about medical directors for EMS providers.  Either way we have hashed both issues to death many many times

We have??

This topis relates to CAP and EMT's on the teams.  Is there a time where we can deliver aid in the field to our targets, or are we opening our selves to lawsuits?

That is the major reason there is not a program for HSOs to progress through. Read CAPR 160-1 for more details.

Does Good Sam laws relate to EMT's?

Varies from state to state. Check with your wing HSO or Legal Officer.

Also I don't understand where I was in-correct.  My statement was about needing EMT's or FR or higher to be type I certified.  Thats what NIMS states in your link as well.  Can you elaborate where I am wrong?

A Type I team requires EMT, ACLS, BTLS, not FR. A Type II team requires EMT or Wilderness First Responder. which is a specific skill set not covered in the generic First Responder certification.

As for elaboration,

So in the world of NIMS and MINS compliance we need a FR or higher on our ground teams to act as a Type I Team.

FR doesn't cut it for Type I teams.

Couple of problems here:

1. BTLS is no longer called BTLS. It has been changed to ITLS or International Trauma Life Support. Its semantics by the company that basically holds the monopoly but it behooves us in such conversations to get our terminology straight.

2. If an EMT (meaning an EMT-B) is required for a Type I team, the ACLS does not come into play. ACLS involves the use of not only synchronized defibrilation (a technique not generally allowed for use by Basics), it also involves the use of cardio-verting drugs, which are definitely out of bounds for basics, unless your state considers ASA a cardioverter and allows its administration by Basics.

BTLS, ITLS, PHTLS, they all work. 

And to my knowledge, no state in the union allows their Basics to provide ACLS care. Heck, there's a lot of states that don't even let their basics start IVs (PA, unless it's changed since I moved).  Just for gits and shiggles, where does it say in the FEMA/NIMS stuff that a Type I team needs an EMT with BTLS and ACLS skillsets? Cuz if it does, they probably need to rewrite their verbage to have it say EMT-P.


And, just a moment of zen for you medical professionals out there....

[cap235629]

Just for gits and shiggles, where does it say in the FEMA/NIMS stuff that a Type I team needs an EMT with BTLS and ACLS skillsets? Cuz if it does, they probably need to rewrite their verbage to have it say EMT-P.

http://www.fema.gov/pdf/emergency/nims/508-8_search_and_rescue_resources.pdf

pay particular attention to pages 24-27 (mountain SAR) and 39-41 (wilderness SAR)

[SJFedor]

Just for gits and shiggles, where does it say in the FEMA/NIMS stuff that a Type I team needs an EMT with BTLS and ACLS skillsets? Cuz if it does, they probably need to rewrite their verbage to have it say EMT-P.

http://www.fema.gov/pdf/emergency/nims/508-8_search_and_rescue_resources.pdf

pay particular attention to pages 24-27 (mountain SAR) and 39-41 (wilderness SAR)

Hm. Ok then. I'm guessing they're alluding to this person being an EMT-P since they do make the differential between an EMT-B and an EMT-P on Page 31, simply by saying that ACLS is required = EMT-P, not just a Basic.

[sarmed1]

There is technically nothing that prevents an EMT from taking ACLS.....they just are not allowed to perform ACLS level care in most situations.  The military is the one example I can think of, the 3 services only require their medics to hold an NRMET-B basic certification, but can be allowed to delivers ACLS meds in certain situations...


mk

[sarmed1]

we also don't invest in extraction stuff.  Not that there's anything wrong with that - but when you say "We do Search and Rescue" to someone you know that the image you just put in their head doesn't match what CAP really does.

It is interesting how CAP seems to have eliminated most references to "rescue" in relation to GT operations.  Given the old 101 trainnig program just had a broad training catagory covering "rescue training" but even in the past couple of years, litter tie-in has been removed as well as knot tying.

Facilitating rescue (ie I'll call the Fire Department and tell them where to come to) is good enough it seems.....I have to agree CAP is seemingly mis-represeting its capabilities.

mk

[Eclipse]

Facilitating rescue (ie I'll call the Fire Department and tell them where to come to) is good enough it seems.....I have to agree CAP is seemingly mis-representing its capabilities.

Where, specifically?

I think you may be confusing the actions of members with the corporate policy.

[isuhawkeye]

THe "EMT" in the verbiage was written as a generic place holder.  in many states an EMT-I (99) can function at the ALS (ACLS) level.  Some states have special certs for WIlderness (ALS) Other states have cardiac technicians that can fill the ALS component.

I dont read it to mean that an EMT-B needs ACLS.  

[JayT]

THe "EMT" in the verbiage was written as a generic place holder.  in many states an EMT-I (99) can function at the ALS (ACLS) level.  Some states have special certs for WIlderness (ALS) Other states have cardiac technicians that can fill the ALS component.

I dont read it to mean that an EMT-B needs ACLS.  

New York actually has a level of care above EMT-I but below full EMT-P that can do ACLS and almost all other Paramedic skills (I have that class tonight!)

[NC Hokie]

Facilitating rescue (ie I'll call the Fire Department and tell them where to come to) is good enough it seems.....I have to agree CAP is seemingly mis-representing its capabilities.

Where, specifically?

I think you may be confusing the actions of members with the corporate policy.

This might be an appropriate example:
http://www.cap.gov/visitors/about/our_programs/operations.cfm

[Eclipse]

Facilitating rescue (ie I'll call the Fire Department and tell them where to come to) is good enough it seems.....I have to agree CAP is seemingly mis-representing its capabilities.

Where, specifically?

I think you may be confusing the actions of members with the corporate policy.

This might be an appropriate example:
http://www.cap.gov/visitors/about/our_programs/operations.cfm

The only thing on the line would be the litter, otherwise,


its just SDIS and a member picking up "stuff".




Nothing in the text even hints at a paramedic capability.

Helping move a victim is still well within our capabilities and operational authorization.  The problem is that a lot of members carry enough equipment to transplant a kidney or do dialysis on the poor guy between the place he got hurt and the ambulance, and get all bent when we say "no".

I'll grant that someone seeing CAP for the first time, might get the impression we render emergency medical care as part of the mission, however seeing some of our press releases and other web sites, potential members might also think we're an active component, drive hummers and C-130's, and have an SF component that does nighttime combat ops (look hard enough and you can find plenty of members in cap uniform wearing face paint with weapons in their hands).

Once they actually shake hands with someone at the unit-level, they should be receiving the right idea.  If a "bill-of-goods" is being presented, that's the local Unit CC's fault, Not CAP, Inc.

Regardless, emergency medical care is not something CAP, Inc. is "selling" to anyone officially, and to believe that it is requires filling in the gaps using incomplete information because you want to believe that we do.

[NC Hokie]

Eclipse,

I agree that CAP is not and should not position itself as an emergency medical provider, but I don't think that's what sarmed was talking about.  My understanding of his post is that CAP, Inc. seems to be distancing itself from the rescue side of Search and Rescue.  With that being the case, it is misrepresentation to advertise CAP's search and rescue capabilities, as half of those capabilities are simply no longer supported.

To be blunt, it's much more accurate to label CAP emergency services as any of the following:

Fly and Find
Drive and Disable
Aid and Comfort

There's nothing wrong with any of those missions, but the fact remains that none of them are remotely close to the common understanding of Search and Rescue.

[Ned]

Absolutely.  But contrary to your assertiions, sometimes saving lives does indeed involve running shelters, filling sand bags, and handing out food/water.

It is important and worthy work.  We are privileged to perform it when needed and requested.

But that critically important work isn't as flashy or fun as pulling victims out of collapsed buildings.

It is important and worthy in the same way the finance guy back here at home makes sure I get paid when I'm downrange in contact. It's not what you engage highly trained, experienced, line personnel to do. That's a huge waste of resources.

Non-concur.

I spent a lot of years in the Guard, arguably as a "highly experienced line person" (MOS qual infantry and military police), and my troops and I personally were called upon to:

1.  Fill thousands of sandbags and patrol levees in severe floods.

2.  Drive trucks while supporting firefighters in major wildfires.

3.  Support a homeless shelter being run out of my armory.

4.  Transport and pass out pallets of water and food to persons displaced by earthquakes.

(Sure, we also did some MOS-appropriate tasks like suppress major riots.)

And while watching people suffer, I don't ever remember any of my soldiers say that our deployments were a "huge waste of resources."  Even though we were highly trained and equipped for other possible state and federal missions.

How is CAP any different?


(OK, in the interest of full disclosure, we were never really in love with the homeless shelter mission.  But we did what we were told.)

You were an infantry officer with PL & CO time. I don't know if you ever had to do a rotation as S1 or 4 or anything like that, but I'm sure you know fellow officers that did. When that's a quality line officer in that role. You know darn well how they feel about it.

I was both a Bn 1 and a 4.  And as a former company commander I can tell you that there is a reason we use line officers in those roles at the battalion level.  And that's because the line guys understand how their work impacts the companies in ways a non-line guy never could.  I also learned a whole lot more about logistics and personnel than I ever would have if I had just done PL and CO time.  And that made me a much better field grade officer, I believe.


Again, how is CAP any different in this respect?

[sarmed1]

Where, specifically?

I think you may be confusing the actions of members with the corporate policy.

RESCUE:  Definition:
 
1. transitive verb remove somebody from danger: to save somebody or something from a dangerous or harmful situation

Given an aircradft that spots a downed aircraft or a ground team that finds the distress ELT is an integral part of the SAR process, but that would be like saying I saw the bank robbers getaway car and claiming I was part of the arrest of wanted felons.

I agree that you are not going to land the aircraft nearby and hike to the crash site with a load of medical gear and extrication equipment PJ style and pull out the crew.  But a ground team that hikes overland to do the same and is unable to at least provide rudimentery emergency medical care or limited extrication/evacuation capability is a toothless animal.

but i digress, rescue capability of CAP SAR units would be a cause for a differant topic....this is about medical capability.

mk

[DNall]

Absolutely.  But contrary to your assertiions, sometimes saving lives does indeed involve running shelters, filling sand bags, and handing out food/water.

It is important and worthy work.  We are privileged to perform it when needed and requested.

But that critically important work isn't as flashy or fun as pulling victims out of collapsed buildings.

It is important and worthy in the same way the finance guy back here at home makes sure I get paid when I'm downrange in contact. It's not what you engage highly trained, experienced, line personnel to do. That's a huge waste of resources.

Non-concur.

I spent a lot of years in the Guard, arguably as a "highly experienced line person" (MOS qual infantry and military police), and my troops and I personally were called upon to:

1.  Fill thousands of sandbags and patrol levees in severe floods.

2.  Drive trucks while supporting firefighters in major wildfires.

3.  Support a homeless shelter being run out of my armory.

4.  Transport and pass out pallets of water and food to persons displaced by earthquakes.

(Sure, we also did some MOS-appropriate tasks like suppress major riots.)

And while watching people suffer, I don't ever remember any of my soldiers say that our deployments were a "huge waste of resources."  Even though we were highly trained and equipped for other possible state and federal missions.

How is CAP any different?


(OK, in the interest of full disclosure, we were never really in love with the homeless shelter mission.  But we did what we were told.)

Your full unit did those things. What was the lowest or even average qualification level of all personnel assigned? MP & Infantry units are going to do just those kind of tasks, as well as security details.

I'm in an apache unit BN. It's even called an "Attack Reconnaissance BN," but we have no meaningful role in disaster response. We send out an enlisted task force for the same sort of security/grunt work, and many of our staff officers move up to Bde to support overall aviation ops, but a lot of people just stay home.

I wasn't talking about the whole unit though, or MOS related work.

CAP in the big picture does and will continue to do all those lesser but still worthy/important tasks - shelter mgmt, hand out supplies, etc, etc. That's what cadets do. That's what type III/IV qualified GTM/Ls do when the environment calls for type I/II teams. I'm not saying at all that those tasks are below our very best front line operators, but neither do you assign an SF unit to manage a homeless shelter unless things are REALLY desperate. If/when you do that, you can expect to piss off those folks (be it CAP, guard, or civilian) who train their ever-lovin-butts off to be qualified for more significant missions, and then they walk away at the first opportunity.

You were an infantry officer with PL & CO time. I don't know if you ever had to do a rotation as S1 or 4 or anything like that, but I'm sure you know fellow officers that did. When that's a quality line officer in that role. You know darn well how they feel about it.

I was both a Bn 1 and a 4.  And as a former company commander I can tell you that there is a reason we use line officers in those roles at the battalion level.  And that's because the line guys understand how their work impacts the companies in ways a non-line guy never could.  I also learned a whole lot more about logistics and personnel than I ever would have if I had just done PL and CO time.  And that made me a much better field grade officer, I believe.

Again, how is CAP any different in this respect?

While you can use an AG or QM officer in those roles, of course it's better to put a line officer there that actually understands the mission. It does develop that line officer for higher command, and it does deliver better support to the line companies.

That said, you can fill those posts with your best up & coming guys that you want to groom for future BN cmd with that short-term broadening experience, or your taking the guys that you don't want to ever command a BN & stuffing them into a staff billet, preferably out of a line BN.

You understand my example though. You don't willingly put your very best front line operators on BS work, or you don't for long have front line operators.

Which again... how do I retain my best operators, and keep them dedicated to ES, when they see a massive disaster & don't get to do what they joined CAP to do. They're spending a lot of time & money to build up & maintain those skills. If they think it's a waste of time, they're gone.

^ that being an issue, cause these FEMA standards say we need medics to field top end teams, which puts my better operators out of business till we solve that issue.

Facilitating rescue (ie I'll call the Fire Department and tell them where to come to) is good enough it seems.....I have to agree CAP is seemingly mis-representing its capabilities.

Where, specifically?

I think you may be confusing the actions of members with the corporate policy.

Try this picture gallery: http://ngsar.homestead.com/home.html
Or this one: http://www.pawingcap.com/hawk/

I'd say we're misrepresenting to our own members, and I don't mean potential recruits. While at the same time having national policy that runs contrary to all of that.

[Eclipse]

Try this picture gallery: http://ngsar.homestead.com/home.html
Or this one: http://www.pawingcap.com/hawk/

I'd say we're misrepresenting to our own members, and I don't mean potential recruits. While at the same time having national policy that runs contrary to all of that.

You wouldn't get any argument from me on that, both are part of the problem, namely we're purporting to train our own people for missions we're not allowed to execute.

But that's got nothing to do with what we sell externally, nor should it muddy the understanding of members who attend.
By the time you are capable and eligible to go to Hawk or NESA, you know the score.

[SARMedTech]

Try this picture gallery: http://ngsar.homestead.com/home.html
Or this one: http://www.pawingcap.com/hawk/

I'd say we're misrepresenting to our own members, and I don't mean potential recruits. While at the same time having national policy that runs contrary to all of that.

You wouldn't get any argument from me on that, both are part of the problem, namely we're purporting to train our own people for missions we're not allowed to execute.

But that's got nothing to do with what we sell externally, nor should it muddy the understanding of members who attend.
By the time you are capable and eligible to go to Hawk or NESA, you know the score.

One should not have to wait to "know the score" until a given amount of blingage is earned. This is emergency services (ostensibly), not the friggin boy scouts. Members, new or otherwise, should know the score the first time they strap on the BDUs cause the friggin score should be posted at the beginning of the game.

Oh, and in IL, its illegal for anyone who is not directly involved (as a provider, supervisor, dispatcher, etc) in emergency medical services to  display or wear the star of life. Im sure this is true in other states. Should we all be taking the "blue star and wings" off our shirts?  Probably.  Being an EMT in CAP entitles you to clutter up your uniform with another patch or pin. It is NOT an actual function as defined under any accepted definition.  So for your GTLs...next time you say to a crash victim or lost person "I'm going to have my EMT take care of you" stop and think exactly what that means. EMS is more than "aide and comfort" and regardless of what anyone things, CAP, Inc is trying to say without really saying that it has EMS personnel who can function within the full scope of that occupation in its ranks. Its trying to give them an "MOS" that looks good to the public and draws membership.

Here in IL, we have a disaster medical team, an urban search and rescue team, a technical rescue team, etc. All seperate organizations run by the state. The only common denominator is medical care. The medical team I am a part of here provides the medical personnel for all those seperate teams. And we operate with a medical director with standing orders, etc and we never deploy without that MD medical director with us. CAP needs to stop selling what it cant provide. Its beyond semantics at this point. These are peoples lives in disaster situations we are talking about. CAP does not, nor can it, provide more medical care than the average boy scout and shouldnt even hint that it can. Given the nature of what it claims to do, it should have a fully functioning and supervised medical component, but it doesnt and  never will.

As for the definition of rescue...so you remove someone from a dangerous situation. Then what do you do with them. So you take them out of the mess that used to be a plane. They should never be moved without a c-collar. Do you have one? Probably not and if you did you have no standing orders for its use.

SAR is a complex and highly skilled avenue of endevour. It is highly different from point to the bad thing and get out of the way. CAP is sort of like a hunting dog: it points to what is being looked for and then stays out of the way of the guys with the big guns. Ive worked on SAR teams that have a full medical component. CAP just isnt one of them and doesnt have the training or the assets or the liability coverage to be. We need to move on from this discussion and back to important ones...like where to get BBDUs because those seem to be the things important to National.

[Eclipse]

So for your GTLs...next time you say to a crash victim or lost person "I'm going to have my EMT take care of you" stop and think exactly what that means.

What it would "mean" in this case, is that the GTL is violating CAP regs.

[MIKE]

5 pages going nowhere because it can't go anywhere.