Medication Management FAQ

Frequently Asked Questions regarding medication management.

May 20, 2025 - Initial Posting and FAQs

• Q: Insurance policies are designed to protect against liability, and this should cover situations where medication administration goes wrong. However, policies may have exclusions for certain actions, such as using unlicensed personnel or neglecting to follow prescription instructions. Insurance coverage is important. Does CAP have appropriate liability coverage to protect against potential claims related to medication administration errors? What is our coverage?

  • A: CAP does not maintain liability coverage for this incident.   Since CAP HSOs and HS Designees do not prescribe, dispense, or administer medications, but solely secure, store, and retrieve medications for self-medication by the cadet, and then return the remaining medication to safe storage, documenting the self-administration, there is no cause for liability.   The cadet and his/her parents and health care provider are solely responsible for providing prescription and non-prescription medications, and ensuring that prescription instructions are supplied to HS (preferably through CAP Health) for documentation only.

• Q: Refrigerated medications: Medication that needs refrigeration should not be stored in a food refrigerator; they need to be stored separately. The fridge's temperature needs to be monitored, and it should be locked. You could put a locked box in the fridge, but you would still want a locked door as well. What provisions are in place to ensure appropriate storage?

  • A: Provisions for securing and storing refrigerated medications would need to be worked out before check-in for the Activity.   Pre-activity communications with parents/guardians need to be made very clear.   Refrigeration is not a “given” without prior arrangements.   Ideally, the refrigerator used by HS for this purpose would be kept secure.

• Q: Medication Policy: 79-10 covers procedures for non-compliance/refusal, but what about right patient (cadet), right med, right time, right dose etc.) – What is CAP policy for verification of identity – should be two identifiers?

  • A: The activity leadership would be responsible for that. Ideally, each cadet would have a CAP ID available (with a photo).

• Q: Parents are responsible for providing all necessary medications and ensuring they are labeled correctly and given to the camp staff upon arrival. Should pills be counted to ensure, especially with Class II medications? This will greatly impact check-in at the encampment. Also, upon dismissal from the encampment, those Class II meds should be counted and verified so that they do not come back on us at a later date?

  • A: CAP is not responsible for counting medications but for secure storage and witnessed self-medication. CAP is NOT administering or dispensing medications; it is only responsible for providing secure storage.

• Q: If licensed medical staff are not overseeing directly, but a UAP (unlicensed assistive personnel) is – according to the Nurse Practice act for the state of Missouri, UAP staff should be trained on proper medication handling, storage, and administration procedures, and should be familiar with the specific needs of cadets with medications.  How are we going to document this?  Are we certifying people to do EPIPens? Inhalers?  Good Samaritan law covers only so much for UAP.  Technically, they would be acting under the medical person’s (HSO) license. How are the HSO and UAP being protected?

  • A: Since CAP is NOT administering, dispensing or prescribing medications, but only providing secure storage and witnessed/documented self-medication, none of this should apply.

• Q: Per the call on 4/27/25, records are to be destroyed immediately upon the end of encampment. How does this protect HSOs in the event that a parent comes forward later and states that there were errors in administration, medications not handed back, an incorrect number of medications given back, etc.…

  • A: If CAP Health is used for the medication administration program, the record would not be destroyed following the activity.   Second, CAP HS personnel, whether HSOs (MD, RN, or other) or HS Designees, are not handling the medication at any point, but only securing and retrieving the medication in the original containers.  The dosage, correct medication, administration time, and route of administration are entirely the responsibility of the parent/guardian to provide.   HS personnel will not handle the medications at any time, only the labeled ”baggie” in which the medication bottles are stored.

• Q: MAR form attached to 79-10 – are we filling these out, or will they self-populate? How are we verifying accuracy? Transcription errors?

  • A: The MAR is an example of a form that might be used if CAP Health is unavailable (or the choice is made to use the MAR).   It is not intended to be anything other than documenting a cadet’s self-medication.

• Q: E-services/CAP Health—There needs to be an N/A button or something that indicates no medications. You can just hit next on meds and not enter anything. If you don’t enter anything, it just says no medications entered. How do we know that they didn’t overlook it?

  • A: Just like when they don’t put N/A when sending the written list of medications, which then necessitates a call to the parent.

• Q: Entering of medications in e-services health:  instructions for medications should be the same as on the pill bottle.  Some meds are dose-adjusted according to various parameters (PT/INR, for example). How is that communicated in e-health? 

  • A: This is an excellent example of why health records must be provided to the Activity HSO at least 6 weeks before the Activity for review. Specific needs for dosage adjustment would require prior arrangements and would not be the responsibility of the Activity HSO or HS Staff.

• Q: Right to privacy: According to the right to privacy, no more than one person should be seen at a time. How are we accomplishing this, especially at check-in? Parents cannot leave prior to medications being reviewed and counted.

  • A: CAP is not responsible for the cadet/parent/guardian providing the correct medication or quantities. The HS staff will not touch the medication containers at any time but ONLY receive and secure the provided medications (placed by the parent/cadet in a labeled baggie or other container). Issues of right to privacy will need to be addressed by the Activity leadership.

• Q: Cadets 18 and over: they are recognized as adults; parents should not be called on medication issues unless there is a specific reason, such as diminished capacity. 

  • A: Cadets over 18 are subject to all of the exact requirements and regulations as cadets under age 18.

• Q: 79-10 states that we are acting in loco parentis: Do these parents administer all the medications at home?  Do the kids take their medications on their own at home?  The rooms, if I remember correctly, have the ability to have a locked drawer (cadets would have to provide a lock).  Why do we feel the need to change that?  Have there been issues “CAP Wide”?

  • A: Yes, there have been incidents that could have resulted in a serious health injury due to poor choices on the part of cadets.   “In loco parentis” does not necessarily mean that parents administer all medications at home, but they are fully responsible for their children properly receiving and taking prescribed and OTC medications.  CAP is reflecting that responsibility in this program.