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Oklahoma EMS Board Handbook July 2010 Oklahoma EMS Board Handbook Prepared as a joint project: Oklahoma State Department of Health Emergency Systems and Oklahoma Cooperative Extension Service Oklahoma State University For additional information, contact: Lee Martin Trauma and Systems Director Emergency Systems Oklahoma State Department of Health (405) 271-4027 or Dr. Gerald A. Doeksen Extension Economist & Regents Professor Oklahoma Cooperative Extension Service Oklahoma State University (405) 744-6083 July 2010 Oklahoma EMS Board Handbook Introduction One method of funding emergency medical services in Oklahoma is through Article X of the Oklahoma Constitution. This article allows Oklahoma residents to vote for a special taxation district to fund emergency medical services. Currently, the legislation allows up to three mills for operating expenses and up to three mills for capital equipment expenditures. Once a special taxation district is successfully voted in, the County Commissioners will appoint a Board of Directors to operate the District as a business. The appointed Board of Directors are volunteers. The Board of Directors of Emergency Medical Services (EMS) Districts are dedicated, hard-working, community leaders who are successful in their chosen occupations. However, the members of the Board of Directors often lack information and experience on directing an EMS system. The purpose of this Handbook is to provide the Board members with information to aid them in their decisions regarding the provision of Emergency Medical Services. Section 1 is an overview of EMS budget studies available through Oklahoma Cooperative Extension Service. The County Commissioners’ duties are illustrated in Section 2. The Board duties are covered in Section 3, with the duties of the EMS Director in Section 4. Examples of EMS Contracts are in Section 5. The EMS Rules and Regulations from the Oklahoma State Department of Health are included in Section 6, with EMS legislation in Section 7. Legal opinions regarding EMS are in Section 8. Section 9 contains information on Occupational Safety and Health. Section 10 includes EMS forms. Trauma legislation is included in Section 11 and EMS data in Section 12. Recently, HB 1888 was passed and is included under Section 7 EMS Legislation. County Commissioners will be receiving information on how to implement this new legislation in the near future. The Oklahoma State Department of Health and the Oklahoma Cooperative Extension Service, Oklahoma State University, have collaborated to provide the Oklahoma EMS Board Handbook for EMS Board members. Any suggestions or ideas on how to make this Handbook more useful to your Board are welcome. Contacts for both organizations are included. Good luck with your EMS District! Oklahoma EMS Board Handbook Table of Contents Introduction 1. Services Available 2. Commissioner’s Duties 3. EMS Board Duties 4. Duties of the EMS Director 5. EMS Contracts 6. Emergency Medical Service Regulations (Chapter 641) 7. EMS Legislation 8. Legal Opinions 9. Occupational Safety and Health 10. Forms 11. Trauma 12. EMS Data December 2009 Oklahoma Cooperative Extension Service Dr. Gerald A. Doeksen Extension Economist and Regents Professor Email: gad@okstate.edu Cheryl F. St. Clair Associate State Extension Specialist Email: cheryl@okstate.edu Oklahoma Cooperative Extension Service Oklahoma State University 513 Ag Hall Stillwater, OK 74078 Phone: 405-744-6083 Fax: 405-744-9835 Website: www.okruralhealthworks.org Stan Ralstin Area Extension Rural Development Specialist (Western half of Oklahoma) Email: stan.ralstin@okstate.edu Oklahoma Cooperative Extension Service Northwest District Office 316 E. Oxford Enid, OK 73701-1335 Phone: 580-237-7677 Fax: 580-242-1955 Jack Frye Area Extension Rural Development Specialist (Eastern half of Oklahoma) Email: jack.frye@okstate.edu Oklahoma Cooperative Extension Service Southeast District Office 1700 N. Broadway Ada, OK 74820-1406 Phone: 580-332-7011 Fax: 580-332-9234 December 2009 Oklahoma State Department of Health Lee Martin Trauma and Systems Director Email: LeeM@health.ok.gov Dale Adkerson Emergency Systems Administrator Email: DaleA@health.ok.gov Theresa Hope Emergency Systems Administrator Email: TheresaH@health.ok.gov Robert Irby Emergency Systems Administrator Email: RobertI@health.ok.gov Jackie Whitten Emergency Systems Administrator Email: JackieW@health.ok.gov Dr. Timothy Cathie Interim EMS Director Oklahoma State Department of Health Emergency Systems 1000 Northeast Tenth Street Oklahoma City, OK 73117-1299 Phone: 405-271-4027 Fax: 405-271-4240 Website: http://www.ok.gov/health/ July2010 522 EMS DISTRICTS COUNTY WIDE DISTRICTS AREA SERVICE & ADDRESS LEVY Alfalfa County Alfalfa County EMS 3 mills P O Box 36 Helena OK 73741 Phone: 580-852-3258 Atoka County Atoka County EMS 2 mills 700 W. Cedar Atoka OK 74525 Phone: 580-364-0777 Beaver County Beaver County EMS 1 mill P O Box 640 Beaver OK 73932 Phone: 580-625-4551 Bryan County Bryan County EMS 3 mills P O Box 1 Durant OK 74702 Phone: 580-924-4687 Choctaw County Choctaw County Ambulance Authority 3 mills P O Box 567 Hugo OK 74743 Phone: 580-326-2634 Cimarron County Cimarron County EMS 2.5 mills P O Box 367 Boise City OK 73933 Phone: 580-544-3021 Coal County Coalgate Fire Dept / EMS 3 mills P O Box 475 Coalgate OK 74538 Phone: 580-927-3913 Cotton County Walters Volunteer Ambulance 3 mills P.O. Box 394 Walters OK 73572 Phone: 580-875-2400 July2010 COUNTY WIDE DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Creek County Creek County Emergency Ambulance 3 mills (Excludes Mannford Service Dist School District) 123 E. Hobson Sapulpa OK 74066 Phone: 918-227-4111 Ellis County Ellis County EMS 3 mills P O Box 591 Shattuck OK 73858 Phone: 580-938-5267 Grady County Chickasha Fire Dept EMS 3 mills (Except Independent 1700 Harly Day Drive Districts 1, 2, and 29) Chickasha OK 73018 Phone: 405-222-6033 Harmon County Southwest Oklahoma Ambulance Authority 3 mills P.O. Box 88 Hollis OK 73550 Phone: 580-688-3363 Hughes County Hughes County EMS 3 mills P.O. Box 671 Holdenville OK 74848 Phone: 405-379-7046 Jackson County Jackson County EMS 3 mills 1309 N. Park Lane Altus OK 73521 Phone: 580-477-4112 Johnston County Johnston County EMS 3 mills 604 E. 24th Street Tishomingo OK 73460 Phone: 580-371-0569 LeFlore County EMS of LeFlore County 3 mills P O Box 1025 Poteau OK 74953 Phone: 918-647-9270 July2010 COUNTY WIDE DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Love County Love County EMS 3 mills Mercy Health – Love County 300 Wanda Street Marietta OK 73448 Phone: 580-276-3347 Major County Major County EMS 3 mills P O Box 511 Fairview OK 73737 Phone: 580-227-2322 Marshall County Marshall County EMS District 3 mills P O Box 707 Madill OK 73446 Phone: 580-795-7541 McCurtain County McCurtain County EMS 3 mills 827 Lincoln Road Idabel OK 74745 Phone: 580-286-7585 Murray County Murray County EMS 3 mills P O Box 545 Sulphur OK 73086 Phone: 580-622-6630 Muskogee County Muskogee County EMS 3 mills 200 Callahan Muskogee OK 74403 Phone: 918-683-0130 Pushmataha County City of Antlers EMS 3 mills 100 S.E. 2nd Antlers OK 74523 Phone: 580-298-0288 Roger Mills County Roger Mills County Ambulance Service 3 mills PO Box 219 Cheyenne OK 73628 Phone: 580-497-3336 July2010 COUNTY WIDE DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Tillman County Tillman County EMS District 2 mills P O Box 122 Frederick OK 73542 Phone: 580-335-5877 Woodward County Woodward County EMS 3 mills P O Box 771 Woodward OK 73802 Phone: 580-254-3341 July2010 522 EMS DISTRICTS SCHOOL DISTRICTS AREA SERVICE & ADDRESS LEVY Ardmore Southern Oklahoma Ambulance Service 3 mills Po Box 1387 Ardmore OK 73402 Phone: 580-223-1226 Buffalo Buffalo EMS District 3 mills P O Box 676 Buffalo OK 73834 Phone: 580-727-5421 Butler Butler EMS 3 mills HC 66 Box 94-2F Foss, OK 73647 Phone: 580-664-3915 Caddo Cashion Fire Department EMS 3 mills P.O. Box 27 Cashion OK 73016 Phone: 405-433-2243 Canton-Longdale Canton-Longdale EMS District 3 mills P.O. Box 39 Canton OK 73724 Phone: 580-886-2515 Cleora Cleora EMS District Trust 3 mills 32922 Pebble Creek Afton OK 74331 Phone: 918-782-9434 Crescent Crescent Ambulance District 3 mills P O Box 233 Crescent OK 73028 Phone: 405-969-2000 Geary Park View Ambulance -Geary 3 mills 2115 Parkview Drive El Reno OK 73036 Phone: 405-262-2640 July2010 SCHOOL DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Glenpool EMS Plus, LLC 3 mills 1408 W. Detroit Street Broken Arrow, OK 74012 Phone: 918-258-6671 Greer Greer County Special Ambulance 3 mills P.O. Box 308 Mangum OK 73554 Phone: 580-782-5314 Grove Grove EMS 3 mills 1310 S. Main Grove OK 74344 Phone: 918-787-3457 Guthrie Guthrie EMS 3 mills 209 E. Springer Guthrie OK 73044 Phone: 405-282-4433 Hinton Park View Ambulance - Hinton 3 mills 2115 Parkview Drive El Reno OK 73036 Phone:405-262-2640 Jefferson Waurika Ambulance 3 mills 122 N. Main Waurika OK 73573 Phone: 580-228-2713 Kingfisher Kingfisher Fire/EMS 3 mills 415 S Main Kingfisher OK 73750 Phone: 405-375-4070 Laverne Laverne EMS 3 mills P O Box 902 Laverne OK 73848 Phone: 580-921-3930 July2010 SCHOOL DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Leedey Leedey Emergency Ambulance 3 mills P.O. Box 232 Leedey OK 73654 Phone: 580-488-2101 McClain/Grady Counties McClain/Grady County EMS Dist #1 3 mills (Newcastle, Blanchard and P O Box 430 Dibble School Districts) Blanchard OK 73010 Phone: 405-485-2000 Miami Integris Baptist Regional EMS 3 mills 200 2nd SW Street Miami OK 74354 Phone: 918-542-5171 Mountain View/Gotebo Mountain View/Gotebo Ambulance Service 3 mills P O Box 294 Mountain View OK 73062 Phone: 580-347-2268 Okeene Okeene Ambulance 2 mills P.O. Box 508 Okeene OK 73763 Phone: 580-822-4031 Oologah – Talala Oologah – Talala EMS District 3 mills P.O. Box 165 Oologah OK 74053 Phone: 918-443-2350 Seiling Community Ambulance Service 3 mills P O Box 811 Seiling OK 73663 Phone: 580-922-4241 Vici – Camargo Vici – Camargo EMS 3 mills 619 Main Street Vici OK 73859 Phone: 580-995-3350 July2010 SCHOOL DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Weleeka/Graham Weleeka-Graham EMS 3 mills P O Box 445 Weleeka OK 74880 Chair: John Anglin Meets: 1st Mon @ 7:00 PM July2010 522 EMS DISTRICTS CITY DISTRICTS AREA SERVICE & ADDRESS LEVY Noble Noble Fire Department EMS 3 mills P.O. Box 557 Noble OK 73068 Phone: 405-872-3030 Pauls Valley Pauls Valley Gen. Hospital EMS 3 mills P.O. Box 368 Pauls Valley OK 73075 Phone: 405-238-5501 Section 1 Financing Alternatives for EMS Systems Financing Alternatives for EMS Systems The Oklahoma Cooperative Extension Service, in cooperation with the Oklahoma State Department of Health Emergency Systems Division, is available to provide EMS call analysis and/or EMS budget and revenue alternatives. These are available on a “first-come, first-serve” basis and will be available as long as funding is available to support them. To begin a study, contact the Extension Service or your EMS Field Coordinator (details below). To do a call analysis, your reports will need to be up-to-date in the OSDH Emergency Systems Division. An analysis of a year’s call reports will provide data for your EMS service. The call data will assist the Oklahoma Cooperative Extension Service in providing a report on alternative financing for your EMS service. To develop EMS budget and revenue alternatives, the EMS service will need to provide the call data (above), as well as cost and revenue data. The study will include at least two alternatives. The total capital costs, annual capital costs, and annual operating costs (building expenses, vehicle expenses, labor expenses, etc.) will be itemized. The total annual capital and operating expenses will be summarized and include the average cost per call. The revenue tables will include different options, and may include fee per call, mileage fees, special taxation district millage levies, sales tax, and fees per utility bill (when appropriate). These studies do not recommend a particular action or option, rather they are intended to provide information to the local EMS service to utilize in their decision-making process. To request this service, contact: Cheryl F. St. Clair Oklahoma Cooperative Extension Service Oklahoma State University 513 Ag Hall Stillwater, OK 74078 Phone: 405-744-6083 or 9824 OR Oklahoma State Department of Health Emergency Systems 1000 NE 10th St. Oklahoma City, OK 73124 Phone: 405-271-4027 Section 2 Commissioner’s Duties COMMISSIONER’S DUTIES This section contains a brief list of the County Commissioner’s main responsibilities. Also included is a memorandum from the Oklahoma State Attorney General describing who may appoint, and who may be appointed to, the EMS Board of Directors. For more detail on County Commissioner’s duties and responsibilities, see the sections titled “EMS Laws” and “Attorney General.” RESPONSIBILITIES OF COUNTY COMMISSIONERS I. Call for election. II. Appoint the EMS Board Members. Those members should live within the District, and may not hold another office. III. Instruct the EMS Board to operate the District as a business. IV. After this, your only requirement is to appoint new Board members. The law states that County Commissioners shall not act as Board members, but allow the Board to make decisions. §51-6. Officers and deputies not to hold other offices - Exemptions. A. Except as may be otherwise provided, no person holding an office under the laws of the state and no deputy of any officer so holding any office shall, during the person's term of office, hold any other office or be the deputy of any officer holding any office, under the laws of the state. The provisions of this section shall not apply to: 1. Notaries public; 2. Members of the State Textbook Committee; 3. County free fair board members; 4. Municipal and county law enforcement officers serving in positions as law enforcement officers of both such governmental entities upon such terms and conditions as are mutually approved by resolutions adopted by the board of county commissioners and governing body of the municipality employing such officers; 5. Any person holding a county or municipal office or position, or membership on any public trust authority, who is a member of a board or commission that relates to federal, state, county or municipal government and is created by the United States Government, the State of Oklahoma or a political subdivision of the state, except where the duties of the offices or positions conflict; 6. Any elected municipal officers and school board members who are appointed to a state board, commission, or similar entity if there is no compensation for such services other than reimbursement for necessary travel expenses pursuant to the provisions of the State Travel Reimbursement Act, Section 500.1 et seq. of Title 74 of the Oklahoma Statutes; 7. Any trustee of a public trust, who is appointed as a trustee of a different public trust or any trustee of the Tulsa County Public Facilities Authority who may also be employed by the Department of Transportation; 8. Law enforcement officers employed by municipal or county law enforcement departments or agencies, other than those law enforcement officers elected or appointed as sheriff, chief of police or some similar position in which they are the head of a county or municipal law enforcement agency, who are elected to local boards of education; provided, the provisions of this paragraph shall not prohibit any law enforcement officer employed by a municipality having a population of ten thousand (10,000) or fewer people from serving as a member of a local board of education; 9. Any member of the Oklahoma Highway Patrol Division of the Department of Public Safety who is elected to a local board of education; 10. Any District Supervisor, Assistant District Supervisor, Team Supervisor, Parole Officer 1 or Parole Officer 2 of the Department of Corrections who is elected or appointed to a city council; 11. Any trustee or director of a rural electric cooperative, or port authority who is appointed or elected to a state, county or municipal board, commission or similar entity; 12. County employees who are elected as members of town or city councils; 13. Municipal, county, state or tribal law enforcement or peace officers operating under cross-deputization agreements with an Indian tribe or branch of the federal government; 14. Municipal or county law enforcement or peace officers serving in positions as campus police officers or campus public safety officers pursuant to the provisions of the Oklahoma Campus Security Act, upon such terms and conditions as are mutually approved by resolution adopted by the governing body of the municipality or county and the governing board of the institution of higher education; 15. State law enforcement or peace officers serving in positions as campus police officers or campus public safety officers pursuant to the provisions of the Oklahoma Campus Security Act, upon such terms and conditions as are mutually approved by written agreement between the Commissioner of Public Safety and the governing board of the institution of higher education; 16. Municipal and county law enforcement officers serving in positions as part-time rangers under the Oklahoma Tourism and Recreation Department; 17. The Administrator of a Scenic Rivers Commission serving in the position of a park ranger under the Oklahoma Tourism and Recreation Department; 18. Members of the University Hospitals Authority; 19. Any person holding a state office or position who is a reserve force deputy sheriff or a reserve municipal police officer; 20. Any person holding a state office or position who serves as a special assistant district attorney without compensation; 21. Any elected or appointed member of a local school board who is a member of a municipal planning commission; 22. Any elected or appointed member of a local school board who is a member or an officer of a volunteer fire department; 23. Directors or officers of a rural water district and chiefs of municipal fire departments or rural fire districts who are appointed or elected to an unsalaried office in a state, county, municipal, school, or technology center school board, commission, or similar entity, except where the duties of the office would create a conflict of interest; 24. Any person who is a dispatcher or confinement officer at a municipal jail who is a noncompensated reserve municipal police officer; and 25. Any person who is an assistant district attorney serving as a municipal judge or prosecutor. The provisions of this section shall not prohibit any person holding an office under the laws of the state or any deputy of any officer so holding any office from serving upon the board of Oklahoma Futures or upon the board of directors of the Oklahoma Center for the Advancement of Science and Technology. The provisions of this section shall not prohibit a member of the board of directors of the Oklahoma Center for the Advancement of Science and Technology from serving upon the board of Oklahoma Futures. B. Any salaries, emoluments or benefits that would otherwise be paid by the agency or political subdivision to a loaned employee or officer shall instead be paid to the regular employer of such employee. The loaned employee shall in turn be paid regular salary and benefits the same as if continuing regular employment with the permanent employer. R.L.1910, § 4274. Amended by Laws 1929, c. 255, p. 363, § 1; Laws 1939, p. 22, § 1, emerg. eff. April 27, 1939; Laws 1981, c. 47, § 1, emerg. eff. April 13, 1981; Laws 1986, c. 207, § 54, operative July 1, 1986; Laws 1987, c. 222, § 116, operative July 1, 1987; Laws 1987, c. 236, § 128, emerg. eff. July 20, 1987; Laws 1989, c. 357, § 1, emerg. eff. June 3, 1989; Laws 1990, c. 230, § 1, eff. Sept. 1, 1990; Laws 1991, c. 202, § 1, emerg. eff. May 17, 1991; Laws 1991, c. 298, § 9, operative July 1, 1991; Laws 1992, c. 43, § 1, eff. Sept. 1, 1992; Laws 1992, c. 373, § 11, eff. July 1, 1992; Laws 1993, c. 331, § 3, eff. July 1, 1993; Laws 1994, c. 2, § 18, emerg. eff. March 2, 1994; Laws 1995, c. 127, § 1, emerg. eff. April 27, 1995; Laws 1996, c. 24, § 5, emerg. eff. April 3, 1996; Laws 1997, c. 317, § 1, emerg. eff. May 29, 1997; Laws 1998, c. 184, § 1, eff. July 1, 1998; Laws 2000, c. 162, § 1, eff. Nov. 1, 2000; Laws 2001, c. 33, § 39, eff. July 1, 2001; Laws 2001, c. 414, § 6, eff. Nov. 1, 2001; Laws 2002, c. 389, § 2, emerg. eff. June 4, 2002. NOTE: Laws 1992, c. 2, § 2 repealed by Laws 1992, c. 373, § 22, eff. July 1, 1992. Laws 1993, c. 330, § 22 repealed by Laws 1994, c. 2, § 34, emerg. eff. March 2, 1994. Laws 2001, c. 19, § 1 repealed by Laws 2001, c. 414, § 16, eff. Nov. 1, 2001. Section 3 EMS Board Duties EMS BOARD DUTIES This section has five parts. The first section is a brief description of the duties and responsibilities of the Board. Examples of the EMS District by-laws are provided. The second section contains an outline of Board responsibilities after they have selected one of the three alternative methods of providing EMS to their constituents. The first alternative is for the Board to oversee the day-to-day operation of the EMS with the aid of a paid EMS administrator. Secondly, the Board may contract with a hospital, city, county, fire department, an individual, or some other entity to provide EMS, but hire an EMS administrator to report to the Board. The third alternative is for the Board to contract with one of the above entities to provide all EMS functions, including that of the administrator, with the main duty of the Board to oversee the contractual agreement. The third part of this section is a set of common questions about EMS Districts and how they operate. It will help answer some of the questions about your duties, responsibilities, opportunities, and limitations. Next, we have included a synopsis of the EMS Agenda for the Future to help you understand how the functions of your district are important to the overall mission of delivering emergency medical service to the entire State of Oklahoma, and to the nation. Finally, we have included a publication of the Small Business Administration on how to prepare a business plan. For more information on EMS Board duties and responsibilities, Board members should familiarize themselves with the entire Handbook. DUTIES OF THE BOARD OF TRUSTEES The operation of an EMS District is constantly under the authority and diligent surveillance of the appointed Board of Trustees. The Board shall enact and maintain an approved set of By- Laws, which shall define the parameters of operations and oversight of the 522 EMS District in accordance with Article X of the Oklahoma Constitution. The Board becomes more than merely a “pass through” agency for funding. It is, in essence, the responsible body for operational functions and business administration of the EMS District. The Board has the duty and the power to make rules applying to such details as vehicle specifications, patient care equipment, level of care to be delivered to the constituents of the District, stations locations, and other functions necessary to the operation of a high-quality EMS District. They are also responsible to ensure that necessary patient care equipment which is lacking or needing replacement is purchased when funds become available. The purchases should be made with advice from the service providers, EMTs, and the medical control physician. The board may also establish procedures for the operation of the District, typically referred to as Standard Operating Procedures (SOP). It is recommended they hire an EMS administrator, who will be responsible for day-to-day operations, quality assurance, collection of accounts, and future planning. It is recognized that EMS Board Members have their own affairs to conduct, and may not be fully knowledgeable of the technical aspects of EMS operations and management. The Board may contract with service providers necessary for the operation of the District. The Board of Trustees may issue bonds, if approved by a majority vote at a special election called for such purpose. The bonds may be issued for purchase of vehicles and stations. A special ad valorem tax will be levied not to exceed three mills per dollar annually for the payment of principal and interest until the outstanding bonds have been paid. Detailed information on the issuance of bonds and manner of payment is contained in Sections 9C(b) through (n) of Article X of the Oklahoma Constitution. The District, under the jurisdiction of the Board of Trustees, is empowered to charge fees for service and accept gifts, funds or grants from sources other than the mill levy to be used for the provision of emergency medical services. RESPONSIBILITIES OF THE BOARD OR AUTHORITY WHERE THEY PROVIDE SERVICE I. Be knowledgeable and responsible for compliance of State EMS statutes, rules and regulations. II. Hire a good administrator A. Administrator should be, at least, EMT-Basic, but role should primarily be administrative. B. Salary and benefits package should be sufficient to attract and retain qualified professionals. III. Responsible for operating a business. Some responsibilities include: A. Review annual budget prepared by administrator; B. Adopt an annual budget; C. Approve monthly dispensation of tax funds; D. Approve salaries and benefits of personnel; E. Approve capital expenditures; and F. Insure system stays economically solvent. IV. Responsible for policy decisions. Some examples include: A. Setting ambulance service fees (inside and outside district); B. Deciding on station location(s); C. Deciding on number and types of crews (paid versus volunteer); and D. Deciding on level of care (basic versus paramedic). V. Responsible for public relations A. Assist in promotion of district through the media; and B. Assist in resolving complaints. RESPONSIBILITIES OF BOARD OR AUTHORITY WHERE THEY HIRE ADMINISTRATOR AND CONTRACT FOR SERVICE I. Be knowledgeable of State EMS statutes, rules and regulations. II. Hire a good administrator. III. Assure adequate and accurate record keeping. IV. Approve monthly expenditures and annual budget. V. Approve and adopt Standard Operating Procedures. VI. Maintain compliance with State EMS statutes, rules and regulations. RESPONSIBILITIES OF BOARD OR AUTHORITY WHERE THEY CONTRACT FOR SERVICE I. Be knowledgeable of State EMS statutes, rules and regulations. II. Develop contract specifications.1 A. Specify who owns vehicles. B. Specify desired level of service. III. Review the bids (specify such things as insurance, personnel, level of service, response times, quality assurance, etc.) IV. Write contract.2 V. Monitor performance of contract. VI. Keep records according to established accounting principles. 1 An example bidding specification document is presented in Appendix A. 2 An example contract is presented in Appendix B. It is only an example and your contract needs to be reviewed by your attorney before you sign the document. FREQUENTLY ASKED QUESTIONS 1. Question: What is a “522” EMS District? Answer: “522” refers to State Question 522 which was a constitutional amendment which allows a district to be formed following the boundaries of a county, school district or an incorporated city or town and to establish an annual recurring ad valorem tax levy of not more than three (3) mills per dollar of assessed valuation of all taxable property in the district. 2. Question: How is the election called? Answer: By the board of county commissioners or by petition of 10% of registered voters in the region affected. 3. Question: What is the time frame involved in calling the election? Answer: Elections shall be conducted by the county election board or boards upon receipt of an election proclamation issued by a majority of the board or boards of county commissioners of the proposed district. The proclamation setting forth the purpose and date of the election shall be published in one issue of a newspaper of general circulation in each county involved at least ten (10) days prior to the election. 4. Question: When can the district be organized following the election? Answer: The board can be appointed immediately. Funds will not be available until the following collection period. The board may borrow from anticipated tax funds for operating expense if service is begun before funds are actually available. 5. Question: Who serves as administrators of the district? Answer: A board of trustees of not less than five (5) members shall be chosen jointly by the board or boards of county commissioners following the election establishing the district. One individual from each county or part thereof must be appointed to the board. 6. Question: Does the board operate the emergency medical service? Answer: The board may hire a manager, contract, organize, maintain and otherwise operate the district. 7. Question: What is the term of office for board members? Answer: The first board draws lots for length of office ranging from one to five years, after which the appointment is for five years. 8. Question: What duties do board members have? Answer: The have the power and duty to promulgate and adopt rules, procedures and contract provisions necessary to carry out purposes and objectives of the legislation and such additional powers as authorized by the legislature. 9. Question: Must board members be bonded? Answer: Yes. All board members must be able to be bonded. The minimum is $10,000. 10. Question: May the board members serve on another public board or hold public office? Answer: No. 11. Question: Is the board required to follow the procedures of the open meeting law? Answer: Yes. It is a public body administering public funds. 12. Question: May additional tax revenues be raised through “522”? Answer: Yes. The trustees may issue bonds if approved by a majority vote in a special election to acquire emergency vehicles, other equipment and maintain the same. 13. Question: Can the three mills for the operation of the service and the bond issue be voted on at the same time? Answer: Yes. The bond issue can be contingent to the passing of the question establishing an EMS district. 14. Question: How are the bonds repaid? Answer: By an additional annual three mill ad valorem levy until the bonds are repaid. 15. Question: Who conducts audits for the district? Answer: The State Examiner and Inspector shall conduct an annual audit of the operations of such districts. 16. Question: Are there other sources of revenue for the district? Answer: Yes. The board of trustees are empowered to charge fees for service, accept gifts and funds or grants from other sources. 17. Question: What agency of government is pecuniarily liable? Answer: The board of trustees of the district has jurisdiction over funds received and disbursed. The board of trustees have the capacity to sue and be sued. They have the same immunity from civil suits for actions arising from the operation of the district as municipalities and counties. 18. Question: What happens to the existing service and equipment when an EMS District is established? Answer: The existing service, if one exists, can be donated to the district, purchased, leased, or contracted to provide services for the district. 19. Question: May the district be expanded? Answer: Yes, by a majority vote of both the existing district and the area of expansion. 20. Question: May the district be dissolved? Answer: Yes, by a majority vote at an election called for that purpose. The election may be called by three-fifths of the EMS District trustees or upon petition of not less than 20% of all registered voters in the district. 21. Question: Are these districts a part of county government? Answer: No. They are special government entities which may constitute a part of a county or part of more than one county, a county or more than one county. 22. Question: Will the district provide free ambulance service? Answer: Probably not, though this is entirely up to the board. The tax revenue is designed to help with the cost of financing the availability of an emergency medical service. However, some districts have been able to provide service with funds from tax revenues and reimbursements through Medicare, Medicaid and private insurance policies. 23. Question: What are advantages of EMS Districts? Answer: 1. Some funding is available on recurring basis. 2. Quality of service is overseen by a board representing the interests of the constituents of the region. 3. Cost to consumer can be lower than it would be otherwise. 4. Funds can be generated for capital investment. 5. Wide variety of options available for operation of EMS. 6. Work toward development of EMS system for pre-hospital care. 24. Question: What will three mill ad valorem levy cost average homeowner? Answer: 1. $ 40,000 x .09 x .003 = $10.80 per year 2. $ 60,000 x .09 x .003 = $16.20 per year 3. $ 80,000 x .09 x .003 = $21.60 per year 4. $120,000 x .09 x .003 = $32.40 per year 5. $200,000 x .09 x .003 = $54.00 per year §51-6. Officers and deputies not to hold other offices - Exemptions. A. Except as may be otherwise provided, no person holding an office under the laws of the state and no deputy of any officer so holding any office shall, during the person's term of office, hold any other office or be the deputy of any officer holding any office, under the laws of the state. The provisions of this section shall not apply to: 1. Notaries public; 2. Members of the State Textbook Committee; 3. County free fair board members; 4. Municipal and county law enforcement officers serving in positions as law enforcement officers of both such governmental entities upon such terms and conditions as are mutually approved by resolutions adopted by the board of county commissioners and governing body of the municipality employing such officers; 5. Any person holding a county or municipal office or position, or membership on any public trust authority, who is a member of a board or commission that relates to federal, state, county or municipal government and is created by the United States Government, the State of Oklahoma or a political subdivision of the state, except where the duties of the offices or positions conflict; 6. Any elected municipal officers and school board members who are appointed to a state board, commission, or similar entity if there is no compensation for such services other than reimbursement for necessary travel expenses pursuant to the provisions of the State Travel Reimbursement Act, Section 500.1 et seq. of Title 74 of the Oklahoma Statutes; 7. Any trustee of a public trust, who is appointed as a trustee of a different public trust or any trustee of the Tulsa County Public Facilities Authority who may also be employed by the Department of Transportation; 8. Law enforcement officers employed by municipal or county law enforcement departments or agencies, other than those law enforcement officers elected or appointed as sheriff, chief of police or some similar position in which they are the head of a county or municipal law enforcement agency, who are elected to local boards of education; provided, the provisions of this paragraph shall not prohibit any law enforcement officer employed by a municipality having a population of ten thousand (10,000) or fewer people from serving as a member of a local board of education; 9. Any member of the Oklahoma Highway Patrol Division of the Department of Public Safety who is elected to a local board of education; 10. Any District Supervisor, Assistant District Supervisor, Team Supervisor, Parole Officer 1 or Parole Officer 2 of the Department of Corrections who is elected or appointed to a city council; 11. Any trustee or director of a rural electric cooperative, or port authority who is appointed or elected to a state, county or municipal board, commission or similar entity; 12. County employees who are elected as members of town or city councils; 13. Municipal, county, state or tribal law enforcement or peace officers operating under cross-deputization agreements with an Indian tribe or branch of the federal government; 14. Municipal or county law enforcement or peace officers serving in positions as campus police officers or campus public safety officers pursuant to the provisions of the Oklahoma Campus Security Act, upon such terms and conditions as are mutually approved by resolution adopted by the governing body of the municipality or county and the governing board of the institution of higher education; 15. State law enforcement or peace officers serving in positions as campus police officers or campus public safety officers pursuant to the provisions of the Oklahoma Campus Security Act, upon such terms and conditions as are mutually approved by written agreement between the Commissioner of Public Safety and the governing board of the institution of higher education; 16. Municipal and county law enforcement officers serving in positions as part-time rangers under the Oklahoma Tourism and Recreation Department; 17. The Administrator of a Scenic Rivers Commission serving in the position of a park ranger under the Oklahoma Tourism and Recreation Department; 18. Members of the University Hospitals Authority; 19. Any person holding a state office or position who is a reserve force deputy sheriff or a reserve municipal police officer; 20. Any person holding a state office or position who serves as a special assistant district attorney without compensation; 21. Any elected or appointed member of a local school board who is a member of a municipal planning commission; 22. Any elected or appointed member of a local school board who is a member or an officer of a volunteer fire department; 23. Directors or officers of a rural water district and chiefs of municipal fire departments or rural fire districts who are appointed or elected to an unsalaried office in a state, county, municipal, school, or technology center school board, commission, or similar entity, except where the duties of the office would create a conflict of interest; 24. Any person who is a dispatcher or confinement officer at a municipal jail who is a noncompensated reserve municipal police officer; and 25. Any person who is an assistant district attorney serving as a municipal judge or prosecutor. The provisions of this section shall not prohibit any person holding an office under the laws of the state or any deputy of any officer so holding any office from serving upon the board of Oklahoma Futures or upon the board of directors of the Oklahoma Center for the Advancement of Science and Technology. The provisions of this section shall not prohibit a member of the board of directors of the Oklahoma Center for the Advancement of Science and Technology from serving upon the board of Oklahoma Futures. B. Any salaries, emoluments or benefits that would otherwise be paid by the agency or political subdivision to a loaned employee or officer shall instead be paid to the regular employer of such employee. The loaned employee shall in turn be paid regular salary and benefits the same as if continuing regular employment with the permanent employer. R.L.1910, § 4274. Amended by Laws 1929, c. 255, p. 363, § 1; Laws 1939, p. 22, § 1, emerg. eff. April 27, 1939; Laws 1981, c. 47, § 1, emerg. eff. April 13, 1981; Laws 1986, c. 207, § 54, operative July 1, 1986; Laws 1987, c. 222, § 116, operative July 1, 1987; Laws 1987, c. 236, § 128, emerg. eff. July 20, 1987; Laws 1989, c. 357, § 1, emerg. eff. June 3, 1989; Laws 1990, c. 230, § 1, eff. Sept. 1, 1990; Laws 1991, c. 202, § 1, emerg. eff. May 17, 1991; Laws 1991, c. 298, § 9, operative July 1, 1991; Laws 1992, c. 43, § 1, eff. Sept. 1, 1992; Laws 1992, c. 373, § 11, eff. July 1, 1992; Laws 1993, c. 331, § 3, eff. July 1, 1993; Laws 1994, c. 2, § 18, emerg. eff. March 2, 1994; Laws 1995, c. 127, § 1, emerg. eff. April 27, 1995; Laws 1996, c. 24, § 5, emerg. eff. April 3, 1996; Laws 1997, c. 317, § 1, emerg. eff. May 29, 1997; Laws 1998, c. 184, § 1, eff. July 1, 1998; Laws 2000, c. 162, § 1, eff. Nov. 1, 2000; Laws 2001, c. 33, § 39, eff. July 1, 2001; Laws 2001, c. 414, § 6, eff. Nov. 1, 2001; Laws 2002, c. 389, § 2, emerg. eff. June 4, 2002. NOTE: Laws 1992, c. 2, § 2 repealed by Laws 1992, c. 373, § 22, eff. July 1, 1992. Laws 1993, c. 330, § 22 repealed by Laws 1994, c. 2, § 34, emerg. eff. March 2, 1994. Laws 2001, c. 19, § 1 repealed by Laws 2001, c. 414, § 16, eff. Nov. 1, 2001. 15 COMPONENTS OF AN EMS SYSTEM 1. MANPOWER 2. TRAINING 3. COMMUNICATIONS 4. TRANSPORTATION 5. FACILITIES 6. ACCESS TO CRITICAL CARE UNITS 7. UTILIZATION OF PUBLIC SAFETY AGENCIES 8. CONSUMER PARTICIPATION 9. ACCESSIBILITY TO CARE 10. TRANSFER OF PATIENTS 11. STANDARD MEDICAL RECORD-KEEPING 12. MEDICAL DIRECTION A. QUALITY ASSURANCE B. MEDICAL PROTOCOLS 13. CONSUMER INFORMATION - PUBLIC EDUCATION 14. REVIEW AND EVALUATION 15. MUTUAL AID AGREEMENTS 16. TRIAGE TRANSPORT TRANSFER 17. PATIENT CARE EMS Agenda for the Future During the past 30 years, emergency medical services (EMS) in the Untied States have experienced explosive development and growth. Yet initiatives to create a system to provide emergency medical care for the nation’s population began with limited knowledge about what constituted the most efficient processes for delivering ideal resources to the spectrum of situations encountered by contemporary EMS. The “15 Components of an EMS System” on the previous page were a part of the genesis of the EMS we know today. In 1996, a multi-disciplinary group, under the leadership of the National Highway Traffic Safety Administration, developed the EMS Agenda for the Future. The Vision Emergency medical services (EMS) of the future will be community-based health management that is fully integrated with the overall health care system. It will have the ability to identify and modify illness and injury risks, provide acute illness and injury care and follow-up, and contribute to treatment of chronic conditions and community health monitoring. This new entity will be developed from redistribution of existing health care resources and will be integrated with other health care providers and public health and public safety agencies. It will improve community health and result in more appropriate use of acute health care resources. EMS will remain the public’s emergency medical safety net. To realize this vision, the EMS Agenda for the Future proposes continued development of 14 EMS attributes. You will note that this list is similar to the 15 Components of an EMS system listed previously. These attributes are a modernized expansion. They are: ◊ Integration of Health Services ◊ EMS Research ◊ Legislation and Regulation ◊ System Finance ◊ Human Resources ◊ Medical Direction ◊ Education Systems ◊ Public Education ◊ Prevention ◊ Public Access ◊ Communication Systems ◊ Clinical Care ◊ Information Systems ◊ Evaluation The EMS Agenda for the Future provides a vision for pre-hospital EMS. Achieving such a vision will require deliberate action and application of the knowledge gained during the past 30 year EMS experience. You will see that the EMS of the future will be more than merely an emergency transportation service. The EMS Division of the State Department of Health and the local EMS Districts are the workhorses of the national agenda. An understanding of the Agenda will help the local EMS Board of Trustees understand the reasoning behind some of the EMS legislation and regulation. If pursued conscientiously, the Agenda will be an achievement with great benefits for all of society. The goals associated with these 14 attributes follow. Integration of Health Services ◊ Expand the role of EMS in public health ◊ Involve EMS in community health monitoring ◊ Integrate EMS with other health care providers and provider networks ◊ Incorporate EMS within health care networks’ structure to deliver quality care ◊ Be cognizant of the special needs of the entire population ◊ Incorporate health systems within EMS that address the special needs of all segments of the population EMS Research ◊ Allocate federal and state funds for major EMS systems research ◊ Develop information systems that provide linkage between various public safety services and other health care providers ◊ Develop academic institutional commitments to EMS-related research ◊ Interpret informed consent rules to allow for clinical and environmental circumstances inherent in conducting credible EMS research ◊ Develop involvement and/or support of EMS research by all those responsible for EMS structure, processes, and/or outcomes ◊ Designate EMS as a physician subspecialty, and a subspecialty for other health professions ◊ Include research related objectives in the education processes of EMS providers and managers ◊ Enhance the quality of published EMS research ◊ Develop collaborative relationships between EMS systems, medical schools, other academic institutions, and private foundations Legislation and Regulation ◊ Authorize and sufficiently fund a lead federal EMS agency ◊ Pass and periodically review EMS enabling legislation in all states that supports innovation and integration, and establishes and sufficiently funds an EMS lead agency ◊ Enhance the abilities of state EMS lead agencies to provide technical assistance ◊ Establish and fund the position of State EMS Medical Director in each state ◊ Authorize state and local EMS lead agencies to act on the public’s behalf in cases of threats to the availability of quality EMS to the entire population ◊ Implement laws that provide protection from liability for EMS field and medical direction personnel when dealing with unusual situations System Finance ◊ Collaborate with other health care providers and insurers to enhance patient care efficiency ◊ Develop proactive financial relationships between EMS, other health care providers, and health care insurers / provider organizations ◊ Compensate EMS on the basis of a preparedness-based model, reducing volume-related incentives and realizing the cost of an emergency safety net ◊ Provide immediate access to EMS for emergency medical conditions ◊ Address EMS relevant issues within governmental health care finance policy ◊ Commit local, state, and federal attention and funds to continued EMS infrastructure Human Resources ◊ Ensure that alterations in expectations of EMS personnel to provide health care services are preceded by adequate preparation ◊ Adopt the principles of the National EMS Education and Practice Blueprint ◊ Develop a system for reciprocity of EMS provider credentials ◊ Develop collaborative relationships between EMS systems and academic institutions ◊ Conduct EMS occupational health research ◊ Provide a system for critical incident stress management Medical Direction ◊ Formalize relationships between all EMS systems and medical directors ◊ Appropriate sufficient resources for EMS medical direction ◊ Require appropriate credentials for all those who provide on-line medical direction ◊ Develop collaborative relationships between EMS systems and academic institutions ◊ Develop EMS as a physician and nurse subspecialty certification ◊ Appoint state EMS medical directors Education Systems ◊ Ensure adequacy of EMS education programs ◊ Update education core content objectives frequently enough so that they reflect EMS patient health care needs ◊ Incorporate research, quality improvement, and management learning objectives in higher level EMS education ◊ Commission the development of national core contents to replace EMS program curricula ◊ Conduct EMS education with medical direction ◊ Seek accreditation for EMS education programs ◊ Establish innovative and collaborative relationships between EMS education programs and academic institutions ◊ Recognize EMS education as an academic achievement ◊ Develop bridging and transition programs ◊ Include EMS-related objectives in all health professions’ education Public Education ◊ Acknowledge public education as a critical activity for EMS ◊ Collaborate with other community resources and agencies to determine public education needs ◊ Engage in continuous public education programs ◊ Educate the public as consumers ◊ Explore new techniques and technologies for implementing public education ◊ Evaluate public education incentives Public Access ◊ Implement 9-1-1 nationwide ◊ Provide emergency telephone service for those who cannot otherwise afford routine telephone services ◊ Ensure that all calls to a Public Safety Answering Point (PSAP), regardless of their origins, are automatically accompanied by unique location-identifying information ◊ Develop uniform cellular 9-1-1 service that reliably routes calls to the appropriate PSAP ◊ Evaluate and employ technologies that attenuate potential barriers to EMS access ◊ Enhance the ability of EMS systems to triage calls, and provide resource allocation that is tailored to patient���s needs Communications Systems ◊ Assess the effectiveness of various personnel and resource attributes for EMS dispatching ◊ Receive all calls for EMS using personnel with the requisite combination of education, experience, and resources to optimally query the caller, make determination of the most appropriate resources to be mobilized, and implement an effective course of action ◊ Promulgate and update standards for EMS dispatching ◊ Develop cooperative ventures between communications centers and health providers to integrate communications processes and enable rapid patient-related information exchange ◊ Determine the benefits of real-time patient data transfer ◊ Appropriate federal, state, and regional funds to further develop and update geographically integrated and functionally-based EMS communications networks ◊ Facilitate exploration of potential uses of advancing communications technology by EMS ◊ Collaboration with private interests to effect shared purchasing of communication technology Prevention ◊ Collaborate with community agencies and health care providers with expertise and interest in illness and injury prevention ◊ Support the Safe Communities concept ◊ Advocate for legislation that potentially results in injury and illness prevention ◊ Develop and maintain a prevention-oriented atmosphere within EMS systems ◊ Include the principles of prevention and its role in improving community health as part of EMS education core contents ◊ Improve the ability of EMS to document injury and illness circumstances Clinical Care ◊ Commit to a common definition of what constitutes baseline community EMS care ◊ Subject EMS clinical care to ongoing evaluation to determine its impact on patient outcomes ◊ Employ new care techniques and technology only after shown to be effective ◊ Conduct task analyses to determine appropriate staff configurations during secondary patient transfers ◊ Eliminate patient transports as a criterion for compensating EMS systems ◊ Establish proactive relationships between EMS and other health care providers Information Systems ◊ Adopt uniform data elements and definitions and incorporate them into information systems ◊ Develop mechanisms to generate and transmit data that are valid, reliable, and accurate ◊ Develop information systems that are able to describe an entire EMS event ◊ Develop integrated information systems with other health care providers, public safety agencies, and community resources ◊ Provide feedback to those who generate data Evaluation ◊ Develop valid models for EMS evaluations ◊ Evaluate EMS effects for multiple outcome categories ◊ Determine EMS cost-effectiveness ◊ Incorporate consumer input in evaluation processes Write a Business Plan Essential Elements of a Good Business Plan for Growing Companies A business plan should be a work-in-progress. Even successful, growing businesses should maintain a current business plan. As any good salesperson knows, you have to know everything you can about your products or services in order to persuade someone to buy them. In this discussion, you are the salesperson and your products represent your business. Your customers are potential investors and employees. Since you want your customers to believe in you, you must be able to convince them that you know what you are talking about when it comes to your business. To become an expert (or to fine-tune your knowledge if you already believe you are one), you must be willing to roll up your sleeves and begin digging through information. Since not all information that you gather will be relevant to the development of your business plan, it will help you to know what you are looking for before you get started. In order to help you with this process, we have developed an outline of the essential elements a good business plan. Every successful business plan should include something about each of the following areas, since these are what make up the essentials of a good business plan: • Executive Summary • Market Analysis • Company Description • Organization & Management • Marketing & Sales Management • Service or Product Line • Funding Request • Financials • Appendix Writing The Plan What goes in a business plan? The body can be divided into four distinct sections: 1) Description of the business 2) Marketing 3) Finances 4) Management Agenda should include an executive summary, supporting documents, and financial projections. Although there is no single formula for developing a business plan, some elements are common to all business plans. They are summarized in the following outline: Elements of a Business Plan 1. Cover sheet 2. Statement of purpose 3. Table of contents I. The Business A. Description of business B. Marketing C. Competition D. Operating procedures E. Personnel F. Business insurance II. Financial Data A. Loan applications B. Capital equipment and supply list C. Balance sheet D. Breakeven analysis E. Pro-forma income projections (profit & loss statements) F. Three-year summary G. Detail by month, first year H. Detail by quarters, second and third years I. Assumptions upon which projections were based J. Pro-forma cash flow III. Supporting Documents A. Tax returns of principals for last three years Personal financial statement (all banks have these forms) B. For franchised businesses, a copy of franchise contract and all supporting documents provided by the franchisor C. Copy of proposed lease or purchase agreement for building space D. Copy of licenses and other legal documents E. Copy of resumes of all principals F. Copies of letters of intent from suppliers, etc. Sample Plans One of the best ways to learn about writing a business plan is to study the plans of established businesses in your industry. Check out available Business Plan Workshops and review examples of real business plans on the U. S. Small Business Administration’s website at: http://www.sba.gov/smallbusinessplanner/plan/writeabusinessplan/SERV_WRRITINGBUSPLA N.html Detailed information on Writing a Business Plan is available through the U. S. Small Business Administration at http://www.sba.gov/smallbusinessplanner/plan/ 1 | P a g e BY-LAWS OF EMERGENCY MEDICAL SERVICES OF _________ COUNTY 1. THE BOARD OF COUNTY COMMISSIONERS OF ____________ COUNTY, COMPLYING TO STATE LAWS OF CONSTITUTION OF STATE OF OKLAHOMA (ARTICLE 10-SECTION 9 B), PLACED THE QUESTION BEFORE THE PEOPLE ON SAID DAY OF _____________ _____. _____, WHEREUPON THE COUNTY OF ____________ APPROVED THE FORMATION OF AN AMBULANCE DISTRICT UNDER THE EMERGENCY MEDICAL SERVICES DISTRICT ACT OF AUGUST, 1976, TO FORM ____________ COUNTY EMERGENCY MEDICAL SERVICES. TO COMPLY WITH SAID ELECTION, THE BOARD OF COUNTY COMMISSIONERS HAVE APPOINTED SAID MEMBERS TO THE BOARD OF TRUSTEES OF ____________ COUNTY EMERGENCY MEDICAL SERVICES: 1. __________________________ 2. __________________________ 3. __________________________ 4. __________________________ 5. __________________________ 6. __________________________ 7. __________________________ 8. __________________________ 9. __________________________ 2. APPOINTMENT OF BOARD MEMBERS THE ORIGINAL BOARD OF TRUSTEES FOR THE ____________ COUNTY EMS SHALL BE COMPOSED OF NINE (9) MEMBERS, THREE (3) FROM EACH COUNTY COMMISSION DISTRICT. THE MEMBERS OF SAID BOARD SHALL ELECT BY ORAL VOTE THE FOLLOWING OFFICES: ONE (1) CHAIRPERSON, ONE (1) VICE-CHAIRPERSON, ONE (1) SECRETARY. SUCH BOARD OF TRUSTEES SHALL HAVE THE POWER AND DUTY TO PROMULGATE AND ADOPT SUCH RULES, PROCEDURES, AND CONTRACT PROVISIONS TO CARRY OUT THE PURPOSE AND OBJECTIVES OF THESE PROVISIONS AND SHALL POST SUCH BOND AS REQUIRED BY THE COUNTY COMMISSIONERS. 3. TERM OF OFFICE THE ORIGINAL MEMBERS OF THE BOARD OF TRUSTEES SHALL HOLD OFFICE AS FOLLOWS: 2 | P a g e AT FIRST MEETING OF SAID BOARD, BOARD MEMBERS SHALL DRAW LOTS TO DETERMINE EACH TRUSTEE’S ORIGINAL LENGTH OF TERM OF OFFICE. THE NUMBER OF LOTS TO BE PROVIDED SHALL BE EQUAL TO THE NUMBER OF ORIGINAL MEMBERS OF THE BOARD. LOTS SHALL BE NUMBERED SEQUENTIALLY FROM ONE (1) THROUGH FIVE (5), WITH LOTS IN EXCESS OF THE FIFTH LOT BEING ALSO NUMBERED SEQUENTIALLY FROM ONE THROUGH FIVE (5) UNTIL ALL LOTS ARE NUMBERED. EACH ORIGINAL MEMBER OR MEMBERS ADDED BY AN EXPANSION AREA OF THE BOARD SHALL HOLD OFFICE FOR THE NUMBER OF YEARS INDICATED ON SAID PARTY’S LOT. EACH YEAR AS NECESSARY THE BOARD OF BOARDS OF COUNTY COMMISSIONERS SHALL APPOINT SUCCESSORS TO SUCH MEMBERS OF THE BOARD OF TRUSTEES WHOSE TERM HAS EXPIRED, AND SUCH APPOINTMENTS SHALL BE FOR TERMS OF FIVE (5) YEARS. THE ORIGINAL MEMBERS OF THE BOARD OF TRUSTEES OF ____________ COUNTY EMS WILL SERVE A TERM OF OFFICE AS TO THE FOLLOWING TERMS: FROM TIME OF APPOINTMENT IN CALENDAR YEAR _____, TO THE END OF FISCAL YEAR ____. IN THE CALENDAR YEAR ____, MONTH OF ______, THE BOARD OF COUNTY COMMISSIONERS WILL APPOINT SUCCESSORS TO SUCH MEMBERS WHOSE TERMS HAVE EXPIRED, AND SUCH SUBSEQUENT APPOINTMENTS SHALL BE FORE TERMS OF FIVE (5) YEARS. EACH YEAR THEREAFTER, IN THE MONTH OF ____, THE BOARD OF BOARDS OF COUNTY COMMISSIONERS SHALL APPOINT SUCCESSORS TO SUCH MEMBERS WHOSE TERMS HAVE EXPIRED, AND SUCH SUBSEQUENT APPOINTMENTS SHALL BE FOR FIVE (5) YEARS. FOLLOWING HIS APPOINTMENT EACH NEW MEMBER WILL BE SWORN IN AT THE NEXT REGULAR MEETING IN THE MONTH OF _______, AND WILL ASSUME THE DUTIES OF A MEMBER OF THE ____________ COUNTY EMS BOARD OF TRUSTEES. THE MEMBERS OF THE BOARD OF TRUSTEES SHALL, ANNUALLY IN THE MONTH OF _______, ELECT BY ORAL VOTE THE FOLLOWING OFFICES: ONE (1) CHAIRPERSON, ONE (1) VICE-CHAIRPERSON, ONE (1) SECRETARY. AT ANY TIME A MEMBER OF THE ____________ COUNTY EMS BOARD OF TRUSTEES SHOULD SUBMIT A LETTER OF RESIGNATION TO THE BOARD OF TRUSTEES, SAID LETTER OF RESIGNATION SHALL BE REVIEWED AND VOTED ON AT THE NEXT REGULAR MEETING OF THE BOARD OF TRUSTEES, WITH A MAJORITY OF THE REMAINING BOARD MEMBERS OF THE ____________ COUNTY EMS TRUSTEES IN AGREEMENT. THE BOARD OF COUNTY COMMISSIONERS SHALL THEN APPOINT A MEMBER TO REPLACE THE ABSENT MEMBER, WHO SHALL THEN SERVE THE REMAINING TERM OF SAID DISCHARGED MEMBER. 3 | P a g e 4. DUTIES OF THE BOARD THE BOARD OF TRUSTEES SHALL HAVE THE ADDITIONAL POWERS TO HIRE OR DISMISS AN ADMINISTRATOR AND TO CONTRACT, ORGANIZE, MONITOR, OR OTHERWISE OPERATE THE EMERGENCY MEDICAL SERVICE IN SAID DISTRICT, AND SUCH ADDITIONAL POWERS AS MAY BE AUTHORIZED, INCLUDING THE REVIEW OF SUCH PERSONNEL THE ADMINISTRATOR MAY UTILIZE IN THE PROVISION OF SERVICES. THE BOARD OF TRUSTEES OF THE ____________ COUNTY EMERGENCY MEDICAL SERVICES WILL APPROVE PAYMENT OF ALL BILLS AND LIABILITIES MADE BY SAID AMBULANCE SERVICE OR ITS REPRESENTATIVES. THE BOARD OF TRUSTEES OF THE ____________ COUNTY EMS WILL NOT BE SALARIED OR PAID FOR SERVICES RENDERED FOR THEIR DUTIES AS MEMBERS OF SAID BOARD UNTIL AT SUCH TIME A RESOLUTION IS MADE BY SAID BOARD, AND LEGALLY VOTED ON, AND PASSED BY A MAJORITY OF THE SAID BOARD MEMBERS. THE ____________ COUNTY EMS BOARD WILL CONDUCT A MONTHLY MEETING THE ________ _________ EACH CALENDAR MONTH, UNLESS OTHERWISE ANNOUNCED AT THE PRECEDING MONTH MEETING, AT WHICH TIME THE CHAIRPERSON, OR PERSONS IN CHARGE SHALL MAKE SUCH ANNOUNCEMENT. TIME AND PLACE OF SAID MEETINGS SHALL BE AT _________. IN THE ____________ COUNTY COURT HOUSE UNLESS A CHANGE OF DATE, TIME, AND/OR PLACE IS DULY AGREED UPON AND ANNOUNCED TO THE PUBLIC AT LEAST FORTY-EIGHT (48) HOURS PRIOR TO THE MEETING. TIME, DATE, AND PLACE OF EACH REGULAR MEETING SHALL BE FILED WITH THE COUNTY CLERK FOR THE ENTIRE CALENDAR YEAR BY _____________ ANNUALLY. NO MEMBER OF THE BOARD OR PERSON HOLDING A HIRED OR OTHER APPOINTED POSITION SHALL HAVE PECUNIARY INTEREST EITHER DIRECTLY OR INDIRECTLY FOR PURCHASE FOR SAID EMS UNLESS THE SAME ARE PURCHASED ON COMPETITIVE BIDS. THE BOARD SHALL HAVE THE EXCLUSIVE CONTROL OF THE EXPENDITURES OF ALL MONIES COLLECTED OR DEPOSITED TO THE CREDIT OF THE EMS FUND, THE AMBULANCES, AND ALL OTHER EQUIPMENT LEASED, PURCHASED, OR SET APART FOR THE PURPOSE. ALL MONEY DRAWN FROM THE COUNTY TREASURY MEMBERS ON A REGULAR OR MONTHLY BASIS MUST HAVE BEEN AUTHORIZED BY THE CHAIRPERSON AND MEMBERS OF THE GOVERNING BOARD. NO PERSON SHALL BE ALLOWED TO SPEND OVER ________ WITHOUT FIRST BRINGING THE MATTER BEFORE A MEETING OF THE BOARD AND RECEIVING ITS APPROVAL. ALL PURCHASES OR CONTRACTS IN EXCESS OF ________ WILL BE SUBMITTED FOR COMPETITIVE BIDDING, WITH THE BOARD OF TRUSTEES RESERVING THE 4 | P a g e RIGHT TO REJECT ANY OR ALL BIDS. BIDDING PROCEDURES WILL COMPLY WITH THE STANDARDS SET FORTH BY THE BOARD OF COUNTY COMMISSIONERS. ALL PAYMENT VOUCHERS OR CHECKS WILL BE ENDORSED BY CHAIRMAN OF BOARD OF COUNTY COMMISSIONERS AND COUNTY CLERK. THIS MEMBER SHALL BE DESIGNATED THE REQUISITIONING OFFICIAL, AND SHALL HAVE THE AUTHORITY TO MAKE PURCHASES, NOT EXCEEDING THE AMOUNT OF ________, SUCH PURCHASES TO BE USED ON AN EMERGENCY BASIS ONLY. IN THE ABSENCE OF THE REQUISITIONING OFFICIAL, THE REQUISITION PURCHASE ORDERS SHALL BE SIGNED BY THE CHAIRPERSON. 5. QUORUM EXCEPT AS HEREIN OTHERWISE, SPECIFICALLY PROVIDED A MAJORITY OF FIVE OF THE AUTHORIZED NUMBER OF TRUSTEES SHALL CONSTITUTE A QUORUM OF THE BOARD, FOR TRANSACTION OF BUSINESS. EVERY ACT OR DECISION DONE OR MADE BY A MAJORITY OF THE TRUSTEES PRESENT AT A MEETING DULY HELD, AT WHICH A QUORUM IS PRESENT, SHALL BE THE ACT OF THE BOARD OF TRUSTEES. PROVIDED, HOWEVER, THAT A MINORITY OF THE BOARD OF TRUSTEES, FROM DAY TO DAY, BUT MAY NOT TRANSACT ANY BUSINESS. SHOULD A PERIOD OF THREE MONTHS PASS DURING WHICH NO BUSINESS MAY BE CONDUCTED FOR LACK OF A QUORUM, THE MATTER SHALL BE REMANDED TO THE COUNTY COMMISSIONERS AT THEIR NEXT STATED MEETING AND THEY MAY TAKE SUCH ACTION AS MAY BE NECESSARY TO CORRECT THE MATTER. ANY MEMBER OF THE ____________ COUNTY EMS BOARD WHO IS ABSENT FROM THREE (3) CONSECUTIVE REGULAR MEETINGS SHALL BE HELD IN VIOLATION AND SHALL BE DISMISSED AUTOMATICALLY FROM HIS POSITION ON THE BOARD. THE VIOLATOR SHALL BE NOTIFIED OF SAID DISMISSAL BY REGISTERED LETTER, A COPY OF WHICH SHALL BE SENT TO THE COUNTY COMMISSIONER. THE COUNTY COMMISSIONER SHALL THEN APPOINT A NEW MEMBER WHO SHALL SERVE THE REMAINDER OF THAT TERM OF OFFICE. 6. SPECIAL MEETINGS SPECIAL MEETINGS OF THE BOARD OF TRUSTEES MAY BE CALLED AT ANY TIME, BY ORDER OF THE CHAIRPERSON, OR FIVE (5) OR MORE OF THE BOARD OF TRUSTEES. NOTICE OF THE TIME AND PLACE OF ALL SPECIAL MEETINGS OF THE BOARD OF TRUSTEES SHALL BE GIVEN TO EACH TRUSTEE BY THE DELIVERY PERSONALLY, OR BY MAIL, OR BY TELEPHONE CONTACT, AT LEAST TWENTY-FOUR (24) HOURS BEFORE THE TIME FIXED FOR HOLDING SAID MEETING. EACH TRUSTEE SHALL REGISTER HIS OR HER ADDRESS WITH THE SECRETARY OF THE BOARD OF TRUSTEES. THE NOTICE OF MEETING SENT OR GIVEN BY MAIL, OR TELEPHONE TO SUCH ADDRESS, AS HEREIN ABOVE PROVIDED, AND SUCH ADDRESS SHALL BE VALID NOTICE OF SUCH MEETING. 5 | P a g e 7. SPECIAL APPOINTMENTS NON-VOTING A PHYSICIAN (MD) MAY BE APPOINTED AS MEDIAL DIRECTOR TO THE ____________ COUNTY EMS DISTRICT TO SERVE AS ADVISORY PERSONNEL IN THE DIRECT PROVISION OF EMERGENCY CARE IN THE FIELD AND TO ESTABLISH AND MAINTAIN CURRENT PATIENT CARE PROTOCOLS IN ACCORDANCE WITH THE GUIDELINES ESTABLISHED BY THE TECHNICAL MEDICAL DIRECTIONS COMMITTEE OF THE STATE OF OKLAHOMA. THE MEDICAL DIRECTOR MAY AND SHOULD ACT IN CONJUNCTION WITH THE ADMINISTRATOR AS LIAISON TO THE RECEIVING HOSPITALS. OTHER PERSONS MAY BE APPOINTED FOR SPECIFIC SERVICES AND FOR SPECIFIC TERMS OF TENURE AS REQUIRED TO ASSIST THE BOARD IN THE TRANSACTION OF ITS BUSINESS AND THE DISCHARGE OF ITS DUTIES. SUCH APPOINTEES WILL NOT BE SALARIED OR PAID FOR SERVICES RENDERED FOR THEIR DUTIES AS APPOINTEES UNTIL AT SUCH TIME A RESOLUTION IS MADE BY SAID BOARD, AND LEGALLY VOTED ON, AND PASSED BY A MAJORITY OF THE BOARD MEMBERS ON EACH SPECIFIC INSTANCE. 8. DUTIES OF THE ADMINISTRATOR ADMINISTRATION OF THE ____________ COUNTY EMERGENCY MEDICAL SERVICE SHALL BE HELD BY A PERSON WHO IS AN EMERGENCY MEDICAL TECHNICIAN (EMT) OR BECOMES AN EMT WITHIN ONE YEAR OF ASSUMING THE OFFICE OF ADMINISTRATOR TO THE SERVICE. THIS ADMINISTRATOR SHALL BE GIVEN THE NECESSARY AUTHORITY TO HOLD RESPONSIBLE FOR THE ADMINISTRATION OF THE EMS IN ALL ITS ACTIVITIES. THIS PERSON SHALL ACT AS THE DULY AUTHORIZED REPRESENTATIVE OF THE BOARD OF TRUSTEES IN ALL MATTERS. THE AUTHORITY AND DUTIES OF THE ADMINISTRATOR SHALL BE: A. To perfect and submit to the Board of Trustees for approval a plan of organization of the personnel and others connected with the operation of the EMS, and to maintain other such records on service utilization and effectiveness to provide necessary data for continuing evaluation of the service. B. To prepare an annual budget showing the expected receipts and expenditures. C. To select, employ, control and discharge all employees authorized by the Board of Trustees. D. To see that all physical properties and equipment are kept in a good state of repair and operating condition. E. To supervise all business affairs, such as records of financial transactions, collections of accounts, and the purchase of supplies in issuance of them, and to insure that all funds are collected and expended to the best possible advantage. F. To submit at each regular meeting reports showing the Professional Services, the Financial Activities of EMT and to propose and submit such special reports as may be required by the Board of Trustees. G. To attend all meetings of the Board of Trustees. 6 | P a g e H. To perform any of the duties that may be necessary to maintain constant provision of services. I. TO serve as the Liaison Officer in conjunction with the Medical Director for the provision of communications between the Board of Trustees and the Governing Boards of the receiving hospitals. J. Co-ordinate a continuing public information program. K. Provide for the training and continuing education of all ambulance personnel including the administrator. L. Disburse such equipment and supplies as may be purchased to the appropriate ambulance and/or personnel. 9. Service Area SPECIFICALLY THE GEOGRAPHIC AREA LYING WITHIN THE CONFINES OF THE LINES OF BOUNDARY DEFINED AND DESIGNATED BY THE STATE OF OKLAHOMA AS ____________ COUNTY. THIS AREA SHALL, UNLESS SUBSEQUENTLY REDEFINED BY THE BOARD, CONSIST OF ONE DISTRICT KNOWN AS ____________ COUNTY EMERGENCY MEDICAL SERVICES. THE UNIT, HEREINAFTER REFERRED TO AS COUNTY UNIT EIGHTEEN (18) SHALL BE HEADQUARTERED AT ________, OKLAHOMA. THE UNIT HEREINAFTER REFERRED TO AS COUNTY UNIT NINETEEN (19) SHALL BE HEADQUARTERED EITHER AT ___________, ___________, _______________, OKLAHOMA AS SPECIFIED BY THE GUIDELINES. THE UNIT HEREINAFTER REFERRED TO AS COUNTY UNIT SEVENTEEN (17) MAY BE HELD IN THE RESERVE FOR BACK-UP DUTY OR FOR USE IN SUCH CAPACITY AS IS REQUIRED BY THE SERVICE. IT OR ITS FUNCTION MAY BE RETIRED FROM SERVICE WHEN AND IF THE BOARD OF TRUSTEES MAKES SUCH AN AGREEMENT. THE UNITS SHALL SERVE IN CONJUNCTION WITH EACH OTHER AND MAY AND SHALL PROVIDE ASSISTANCE TO EACH OTHER AND TO REGIONAL JURISDICTIONS OUTSIDE THE BOUNDARIES OF THE DISTRICT AS DELINEATED IN WRITTEN AND VERBAL MUTUAL AID AGREEMENTS WITH OTHER EMERGENCY MEDICAL SERVICES AND/OR RECEIVING FACILITIES. ALL UNITS SHALL, UNLESS OTHER WRITTEN ARRANGEMENTS ARE MADE WITH A PROVIDER AND AGREED TO BY THE BOARD OF TRUSTEES, BE QUARTERED IN COUNTY BUILDINGS AT COUNTY EXPENSE. ALL UNITS ARE DEEMED THE PROPERTY OF THE COUNTY AND MAY BE BARTERED, TRADED, OR SOLD BY THE BOARD OF TRUSTEES UNLESS OWNERSHIP BY ANOTHER ENTITY CAN BE PROVEN. 1 CONSTITUTION AND BY-LAWS OF THE GOVERNING BOARD, LATIMER COUNTY EMERGENCY MEDICAL SERVICES ARTICLE I. OFFICERS. Section 1. The membership of the Governing Board shall consist of five (5) qualified members appointed by the Board of County Commissioners, and the Officers of the Governing Board shall be a chairman, a Vice-Chairman, a Secretary and a Treasurer, and such other officers as the Board of Control may authorize. All of them shall be elected or appointed by the board from among its own membership at the first regular meeting after it has been appointed, and shall hold office for a period of one (1) year or until their successors shall have been selected and duly qualified. Members of the Governing Board shall draw lots to determine each members original length of term in office. The number of lots to be provided shall be equal to the number of original members of the board, and lots shall be numbered sequentially from one through five. Each year as necessary, the board or boards of county commissioners shall appoint successors to such members whose terms have expired, and such subsequent appointments shall be for terms of five (5) years. Members of the Board as such, shall receive no salary or compensation for their services. Section 2. The chairman shall call and preside at all meetings. The Vice-Chairman shall act as chairman in the absence of the chairman, and when acting, shall have all power and authority of the chairman. The Secretary shall be responsible for taking of the minutes of all meetings of the Governing Board. ARTICLE II. REGULAR AND SPECIAL MEETINGS. A. The annual meeting of the Governing Board shall be the first meeting after the close of the Fiscal year (month of July). B. Regular meetings will be held every three (3) months. C. Special meetings can be called by the chairman of the Board or executive director of EMS. D. The time, date, and place of each meeting will be filed with the County Clerk at the court house for the whole calendar year by December 15 of each year. It will also be published in the local paper. ARTICLE III. COMMITTEES. A. Finance Committee. The finance committee shall be the responsibility of the Governing Board as a whole. This committee is responsible for Policy, Review of Budget, Financial Statements and related problems. Section 1. Building, Grounds, and Maintenance Committee. This committee shall be the responsibility of the Governing Board as a whole. This committee will inspect the premises every three months, and report on the up-keep of the grounds, building, ambulance, and all other items which are essential to the operation of the EMS. 2 ARTICLE IV. No member of the Board shall have pecuniary interest either directly or indirectly for purchase for said EMS unless the same are purchased on competitive bids. The Governing Board shall have the exclusive control of the expenditures of all monies collected or deposited to the credit of the EMS Fund, the ambulance, building, and all other equipment leased or set apart for the purpose. All money drawn from the County Treasurers must have been authorized by the Chairman and Secretary of the Governing Board. No person shall be allowed to spend over ______ without first bringing the matter before the Governing Board. ARTICLE V. ADMINISTRATION. Section 1. Administrator of __________________________________ shall be the Administrator of EMS. This administrator shall be given the necessary authority and held responsible for the administration of the EMS in all its activities. He shall act as the duly authorized representative of the Governing Board in all matters. Section 2. The authority and duties of the Administrator shall be: A. To perfect and submit to the Governing Board for approval a plan of organization of the personnel and others connected with the operation of the EMS. B. To prepare an annual budget showing the expected receipts and expenditures by the Governing Board. C. To select, employ, control, and discharge all employees authorized by the Governing Board. D. To see that all physical properties and equipment are kept in a good state of repair and operating condition. E. To supervise all business affairs, such as records of financial transaction, collections of accounts and the purchase of supplies and issuance of them, and to insure that all funds are collected and expedited to the best possible advantage. F. To submit at each regular meeting reports showing the Professional Services, the Financial Activities of EMS and to propose and submit such special reports as may be required by the Governing Board. G. To attend all meetings of the Governing Board. H. To perform any of the duties that may be necessary in the best interest of the hospital. I. To serve as the liaison officer and channel of communications between the Governing Board of the Hospital and the Governing Board of the EMS. Section 4 Duties of the EMS Director DUTIES OF THE EMS DIRECTOR The EMS Director or Administrator is the individual in charge and responsible for the overall operation of the EMS district, administration and clinical segments. Whether the Board operates the EMS district itself or makes contractual arrangements with a community, hospital or private provider, there should be an EMS director appointed who will be responsible to the Board and the electorate. The EMS director shall be responsible for the fiscal aspects of the system. He should pursue diligently the collection of fees for service and must be cognizant of all avenues of payment for services rendered, particularly those involving third party reimbursement. The EMS director should also consider an alternative of contracting with a billing service to pursue billing and collections. The EMS director should have a thorough knowledge of the EMS system and the components of which it is comprised. He should establish contact with the EMS Division of the Oklahoma State Department of Health and take full advantage of the technical assistance available. Medical direction by physicians is required by statute and rule. Additional assistance from nurses and allied health professionals within the district are valuable allies in building an EMS system. Their expertise and cooperation will be invaluable in acquiring necessary involvement from public officials, civic leaders and the district at large. The EMS director should establish a good rapport with the medical community to ascertain their needs and solicit their participation in the system. The EMS director, who is a licensed EMT, should be capable of responding to major incidents to serve as Medical Incident Commander. If not, a senior EMT should be appointed to this important function. Public education is a major component of any EMS system. The general public and industry will need instruction in basic first aid and cardiopulmonary resuscitation. Most will contact the EMS district to obtain this training. If this training is available from the EMS district under the auspices of the American Heart Association or the American Red Cross, the public relations benefits will be immeasurable. Education within the EMS system is another major task of the EMS director. He should be familiar with the educational resources available in or near the district. In some areas, it is desirable to appoint an In-house Instructor to provide continuing education to EMTs. It is important to seek guidance from the EMS Division in this process. In order for people to use the system, they must be informed of what it does and the reasons for its existence. This can be accomplished by stressing the EMS system’s goals and accomplishments through efficient media relations. The various media channels can be EMS’ greatest ally if properly utilized and nurtured. In some cases the EMS system will be operated directly by the Trustees rather than through a contractual arrangement for services. In this instance, the EMS director also should become the personnel director responsible for selecting and hiring personnel, scheduling shifts and personnel grievances. He should have authority from the Board to deal with day-to-day personnel matters. This should include hiring and dismissal of employees coupled with an appeal mechanism before the full Board available to employees who feel they have been unjustly treated. There are other duties and functions which will come within the purview of the EMS director, but those mentioned above are considered most important. The EMS director should be the coordinator of EMS resources, an innovator of workable solutions to problems, and a capable administrator or business manager. The utilization of a qualified EMS director will enhance the success of any EMS district, and lessen the burdens on the Trustees. DUTIES OF THE EMS SHIFT SUPERVISOR OR STATION SUPERVISOR The duties of the station or shift supervisor will vary according to the numbers of vehicles and stations, whether volunteer or paid. Nevertheless, the supervisor should be the person designated as responsible for both the station and personnel on a given shift. This person is directly responsible to the EMS director, and should have the following supervisory responsibilities: 1) Assure station routine is completed during the shift according to department policy, such as daily vehicle and equipment checks; vehicle, equipment and station cleaning, etc. 2) Schedule and present informal in-service training of EMTs assigned to shift. 3) Maintain supply and accountability of all necessary cleaning supplies, oxygen, medical supplies, etc., for the operation of the station and ambulances. 4) Be responsible for on-the-job orientation of new shift employees. 5) Assist the director in presenting public relations programs regarding the EMS system to civic groups and to other interested citizens. 6) Review ambulance run reports and other data reports for accuracy prior to submission to the director and medical director. 7) Attend EMS meetings as deemed necessary by the director. 8) Insure all policies and procedures of the director and the Board are followed during the shift. 9) Attend staff (supervisory) meetings as scheduled by the director. 10) The supervisor must not secure additional employment or pursue other activities which would preclude his ability to be available at all times without permission of the director and approval of the Board. These individuals should work in close contact with the director in the overall operation of the service. They may receive special assignments such as special research projects, revision of policies, meetings, committees and other such activities. Any problems regarding job duties should be brought to the director. RESPONSIBILITIES OF THE ADMINISTRATOR WHERE HE/SHE IS AN EMPLOYEE OF THE DISTRICT OR AUTHORITY I. Maintain such financial records as are necessary to substantiate actual costs of service. II. Prepare and submit invoices on monthly basis. III. Prepare and submit invoices for third party reimbursements. IV. Accomplish actions according to Board policy to assure maximum collection of accounts. V. Coordinate an effective public information program. VI. Maintain records on service utilization. VII.Maintain close working relationships with contractor to assure that the provisions of the contract and EMS laws and rules are met. RESPONSIBILITIES OF ADMINISTRATOR WHERE COUNTY OR AUTHORITY PROVIDES THE SERVICE I. To submit to the Board a plan of organization of personnel. II. To prepare an annual budget showing the expected receipts and expenditures. III. To oversee all physical properties and equipment, keeping in operating condition and good repair. IV. To supervise all business affairs such as records of financial transactions, collections, purchase and issue of supplies. V. To ensure that all funds are collected and expended as directed by the Board. VI. To submit, at each regular meeting, the financial records which must be approved by the Board. VII.To attend all meetings of the Board. VIII.To recommend to the Board personnel decisions. IX. To coordinate a public relations program. X. To perform other duties as may be necessary to maintain quality provision of EMS. XI. Ensure service is in compliance with EMS laws and rules. CHOCTAW COUNTY E.M.S. AUTHORITY POSITION DESCRIPTION – MANAGER In order to fulfill the duties and responsibilities of the Choctaw County E.M.S. Authority it is necessary that a full-time manager be employed. The person employed should be trained as an Emergency Medical Technician and have an office at the Choctaw County Courthouse with necessary clerical services provided by staff at the Courthouse. Ancillary expenses for postage, limited travel, and other necessary materials or activities would be paid for by funds accrued from the three-mill ad valorem tax assessment or invoices for services. Specifically, the responsibilities of the manager would be: 1. Maintain such financial records as are necessary to substantiate actual costs of service to Choctaw County. 2. Prepare and submit invoices to users of the ambulance service on a monthly basis. 3. Prepare and submit invoices for service to Medicare, Medicaid, and other third-party reimbursers where appropriate. 4. Accomplish actions necessary to assure maximum collection of invoices due for services including personal contact with debtors and where appropriate, file actions in small claims court to collect debts. 5. Assist in the transport of patients when necessary to compliment the availability of existing personnel. 6. Coordinate an effective public information and education program to both general and specific publics (i.e. medical and governmental) on the activities, goals and objectives of the Choctaw County E.M.S. System. 7. Maintain other such records on service utilization and effectiveness to provide necessary data for continuing evaluation of the service, thus assuring quality control. 8. Maintain close working relationships with the Fire Chief, Hugo Fire Department to assure that the provisions of the contract between the Choctaw County E.M.S. Authority and the Hugo Fire Department are met. 9. Coordinate with regional and State authorities for the provision of training for Emergency Medical Technicians, other ancillary medical personnel, physicians, and the general public from existing training resources at the regional and State levels. 10. Perform such other administrative duties as may be required by the Authority to assure the provision of quality emergency medical care and transportation services to the citizens of Choctaw County. DIRECTOR/MANAGER/ADMINISTRATOR DUTIES a. Carry out assigned duties in response to policy directions of the District Board. b. Prepare and submit to the Governing Board for approval a plan of organization of the personnel and others connected with the operation of the EMS. c. Prepare an annual budget showing the expected receipts and expenditures of the District. d. Select, employ, direct and discharge all employees authorized by the Governing Board. e. Appoint or designate such committees or subcommittees of the Board as the Board considers necessary. f. See that all physical properties and equipment are kept in a good state of repair and operating condition. g. Supervise business contracts and related matters, affairs, such as records of financial transactions and collection of accounts. Insure that all funds are collected and expended to the best possible advantage. h. Submit at each regular meeting reports showing the Professional Services, the Financial Activities of EMS and to prepare and submit such special reports as may be required by the Governing Board. i. Attend all meetings of the Governing Board. j. Serve as liaison officer and channel of communication between the Governing Board of the District and other medical and emergency service providers. k. Develop and coordinate a continuing public information program. l. Provide for and schedule training and continuing education for all emergency medical services personnel. m. Establish a system for the acquisition, control, issue, and accounting of supplies and equipment for use within the district. n. Perform such other duties and carry out other responsibilities as required to provide a quality level of service to all users. o. Develop Standard Operating Procedures guiding the day to day operations of the District. p. Develop and submit to the Governing Board for approval operating guidelines and criteria to be met in the functioning of the District. U. S. Department of Labor – Wage and Salary Division Application of Fair Labor Standards Act to Employees of State and Local Governments Title 29 §553 e-CFR Data is current as of December 14, 2009 Title 29: Labor PART 553—APPLICATION OF THE FAIR LABOR STANDARDS ACT TO EMPLOYEES OF STATE AND LOCAL GOVERNMENTS Subpart A—General Introduction § 553.1 Definitions. (a) Act or FLSA means the Fair Labor Standards Act of 1938, as amended (52 Stat. 1060, as amended; 29 U.S.C. 201–219). (b) 1985 Amendments means the Fair Labor Standards Amendments of 1985 (Pub. L. 99–150). (c) Public agency means a State, a political subdivision of a State or an interstate governmental agency. (d) State means a State of the United States, the District of Columbia, Puerto Rico, the Virgin Islands, or any other Territory or possession of the United States (29 U.S.C. 203(c) and 213(f)). § 553.2 Purpose and scope. (a) The 1985 Amendments to the Fair Labor Standards Act (FLSA) changed certain provisions of the Act as they apply to employees of State and local public agencies. The purpose of part 553 is to set forth the regulations to carry out the provisions of these Amendments, as well as other FLSA provisions previously in existence relating to such public agency employees. (b) The regulations in this part are divided into three subparts. Subpart A interprets and applies the special FLSA provisions that are generally applicable to all covered and nonexempt employees of State and local governments. Subpart A also contains provisions concerning certain individuals ( i.e., elected officials, their appointees, and legislative branch employees) who are excluded from the definition of “employee” and thus from FLSA coverage. This subpart also interprets and applies sections 7(o), and 7(p)(2), 7(p)(3), and 11(c) of the Act regarding compensatory time off, occasional or sporadic part-time employment, and the performance of substitute work by public agency employees, respectively. (c) Subpart B of this part deals with “volunteer” services performed by individuals for public agencies. Subpart C applies various FLSA provisions as they relate to fire protection and law enforcement employees of public agencies. § 553.3 Coverage—general. (a)(1) In 1966, Congress amended the FLSA to extend coverage to State and local government employees engaged in the operation of hospitals, nursing homes, schools, and mass transit systems. (2) In 1972, the Education Amendments further extended coverage to employees of public preschools. (3) In 1974, the FLSA Amendments extended coverage to virtually all of the remaining State and local government employees who were not covered as a result of the 1966 and 1972 legislation. (b) Certain definitions already in the Act were modified by the 1974 Amendments. The definition of the term “employer” was changed to include public agencies and that of “employee” was amended to include individuals employed by public agencies. The definition of “enterprise” contained in section 3(r) of the Act was modified to provide that activities of a public agency are performed for a “business purpose.” The term “enterprise engaged in commerce or in the production of goods for commerce” defined in section 3(s) of the Act was expanded to include public agencies. Section 3(e)(2)(C)—Exclusions § 553.10 General. Section 3(e)(2)(C) of the Act excludes from the definition of “employee”, and thus from coverage, certain individuals employed by public agencies. This exclusion applies to elected public officials, their immediate advisors, and certain individuals whom they appoint or select to serve in various capacities. In addition, the 1985 Amendments exclude employees of legislative branches of State and local governments. A condition for exclusion is that the employee must not be subject to the civil service laws of the employing State or local agency. § 553.11 Exclusion for elected officials and their appointees. (a) Section 3(e)(2)(C) provides an exclusion from the Act's coverage for officials elected by the voters of their jurisdictions. Also excluded under this provision are personal staff members and officials in policymaking positions who are selected or appointed by the elected public officials and certain advisers to such officials. (b) The statutory term “member of personal staff” generally includes only persons who are under the direct supervision of the selecting elected official and have regular contact with such official. The term typically does not include individuals who are directly supervised by someone other than the elected official even though they may have been selected by the official. For example, the term might include the elected official's personal secretary, but would not include the secretary to an assistant. (c) In order to qualify as personal staff members or officials in policymaking positions, the individuals in question must not be subject to the civil service laws of their employing agencies. The term “civil service laws” refers to a personnel system established by law which is designed to protect employees from arbitrary action, personal favoritism, and political coercion, and which uses a competitive or merit examination process for selection and placement. Continued tenure of employment of employees under civil service, except for cause, is provided. In addition, such personal staff members must be appointed by, and serve solely at the pleasure or discretion of, the elected official. (d) The exclusion for “immediate adviser” to elected officials is limited to staff who serve as advisers on constitutional or legal matters, and who are not subject to the civil service rules of their employing agency. § 553.12 Exclusion for employees of legislative branches. (a) Section 3(e)(2)(C) of the Act provides an exclusion from the definition of the term “employee” for individuals who are not subject to the civil service laws of their employing agencies and are employed by legislative branches or bodies of States, their political subdivisions or interstate governmental agencies. (b) Employees of State or local legislative libraries do not come within this statutory exclusion. Also, employees of school boards, other than elected officials and their appointees (as discussed in §553.11), do not come within this exclusion. Section 7(o)—Compensatory Time and Compensatory Time Off § 553.20 Introduction. Section 7 of the FLSA requires that covered, nonexempt employees receive not less than one and one-half times their regular rates of pay for hours worked in excess of the applicable maximum hours standards. However, section 7(o) of the Act provides an element of flexibility to State and local government employers and an element of choice to their employees or the representatives of their employees regarding compensation for statutory overtime hours. The exemption provided by this subsection authorizes a public agency which is a State, a political subdivision of a State, or an interstate governmental agency, to provide compensatory time off (with certain limitations, as provided in §553.21) in lieu of monetary overtime compensation that would otherwise be required under section 7. Compensatory time received by an employee in lieu of cash must be at the rate of not less than one and one-half hours of compensatory time for each hour of overtime work, just as the monetary rate for overtime is calculated at the rate of not less than one and one-half times the regular rate of pay. § 553.21 Statutory provisions. Section 7(o) provides as follows: (o)(1) Employees of a public agency which is a State, a political subdivision of a State, or an interstate governmental agency may receive, in accordance with this subsection and in lieu of overtime compensation, compensatory time off at a rate not less than one and one-half hours for each hour of employment for which overtime compensation is required by this section. (2) A public agency may provide compensatory time under paragraph (1) only— (A) Pursuant to— (i) Applicable provisions of a collective bargaining agreement, memorandum of understanding, or any other agreement between the public agency and representatives of such employees; or (ii) In the case of employees not covered by subclause (i), an agreement or understanding arrived at between the employer and employee before the performance of the work; and (B) If the employee has not accrued compensatory time in excess of the limit applicable to the employee prescribed by paragraph (3). In the case of employees described in clause (A)(ii) hired prior to April 15, 1986, the regular practice in effect on April 15, 1986, with respect to compensatory time off for such employees in lieu of the receipt of overtime compensation, shall constitute an agreement or understanding under such clause (A)(ii). Except as provided in the previous sentence, the provision of compensatory time off to such employees for hours worked after April 14, 1986, shall be in accordance with this subsection. (3)(A) If the work of an employee for which compensatory time may be provided included work in a public safety activity, an emergency response activity, or a seasonal activity, the employee engaged in such work may accrue not more than 480 hours of compensatory time for hours worked after April 15, 1986. If such work was any other work, the employee engaged in such work may accrue not more than 240 hours of compensatory time for hours worked after April 15, 1986. Any such employee who, after April 15, 1986, has accrued 480 or 240 hours, as the case may be, of compensatory time off shall, for additional overtime hours of work, be paid overtime compensation. (B) If compensation is paid to an employee for accrued compensatory time off, such compensation shall be paid at the regular rate earned by the employee at the time the employee receives such payment. (4) An employee who has accrued compensatory time off authorized to be provided under paragraph (1) shall, upon termination of employment, be paid for the unused compensatory time at a rate of compensation not less than— (A) The average regular rate received by such employee during the last 3 years of the employee's employment, or (B) The final regular rate received by such employee, whichever is higher. (5) An employee of a public agency which is a State, political subdivision of a State, or an interstate governmental agency— (A) Who has accrued compensatory time off authorized to be provided under paragraph (1), and (B) Who has requested the use of such compensatory time, shall be permitted by the employee's employer to use such time within a reasonable period after making the request if the use of the compensatory time does not unduly disrupt the operations of the public agency. (6) For purposes of this subsection— (A) The term overtime compensation means the compensation required by subsection (a), and (B) The terms compensatory time and compensatory time off means hours during which an employee is not working, which are not counted as hours worked during the applicable workweek or other work period for purposes of overtime compensation, and for which the employee is compensated at the employee's regular rate. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.22 FLSA compensatory time” and “FLSA compensatory time off”. (a) Compensatory time and compensatory time off are interchangeable terms under the FLSA. Compensatory time off is paid time off the job which is earned and accrued by an employee in lieu of immediate cash payment for employment in excess of the statutory hours for which overtime compensation is required by section 7 of the FLSA. (b) The Act requires that compensatory time under section 7(o) be earned at a rate not less than one and one-half hours for each hour of employment for which overtime compensation is required by section 7 of the FLSA. Thus, the 480-hour limit on accrued compensatory time represents not more than 320 hours of actual overtime worked, and the 240-hour limit represents not more than 160 hours of actual overtime worked. (c) The 480- and 240-hour limits on accrued compensatory time only apply to overtime hours worked after April 15, 1986. Compensatory time which an employee has accrued prior to April 15, 1986, is not subject to the overtime requirements of the FLSA and need not be aggregated with compensatory time accrued after that date. § 553.23 Agreement or understanding prior to performance of work. (a) General. (1) As a condition for use of compensatory time in lieu of overtime payment in cash, section 7(o)(2)(A) of the Act requires an agreement or understanding reached prior to the performance of work. This can be accomplished pursuant to a collective bargaining agreement, a memorandum of understanding or any other agreement between the public agency and representatives of the employees. If the employees do not have a representative, compensatory time may be used in lieu of cash overtime compensation only if such an agreement or understanding has been arrived at between the public agency and the individual employee before the performance of work. No agreement or understanding is required with respect to employees hired prior to April 15, 1986, who do not have a representative, if the employer had a regular practice in effect on April 15, 1986, of granting compensatory time off in lieu of overtime pay. (2) Agreements or understandings may provide that compensatory time off in lieu of overtime payment in cash may be restricted to certain hours of work only. In addition, agreements or understandings may provide for any combination of compensatory time off and overtime payment in cash (e.g., one hour compensatory time credit plus one-half the employee's regular hourly rate of pay in cash for each hour of overtime worked) so long as the premium pay principle of at least “time and one-half” is maintained. The agreement or understanding may include other provisions governing the preservation, use, or cashing out of compensatory time so long as these provisions are consistent with section 7(o) of the Act. To the extent that any provision of an agreement or understanding is in violation of section 7(o) of the Act, the provision is superseded by the requirements of section 7(o). (b) Agreement or understanding between the public agency and a representative of the employees. (1) Where employees have a representative, the agreement or understanding concerning the use of compensatory time must be between the representative and the public agency either through a collective bargaining agreement or through a memorandum of understanding or other type of oral or written agreement. In the absence of a collective bargaining agreement applicable to the employees, the representative need not be a formal or recognized bargaining agent as long as the representative is designated by the employees. Any agreement must be consistent with the provisions of section 7(o) of the Act. (2) Section 2(b) of the 1985 Amendments provides that a collective bargaining agreement in effect on April 15, 1986, which permits compensatory time off in lieu of overtime compensation, will remain in effect until the expiration date of the collective bargaining agreement unless otherwise modified. However, the terms and conditions of such agreement under which compensatory time off is provided after April 14, 1986, must not violate the requirements of section 7(o) of the Act and these regulations. (c) Agreement or understanding between the public agency and individual employees. (1) Where employees of a public agency do not have a recognized or otherwise designated representative, the agreement or understanding concerning compensatory time off must be between the public agency and the individual employee and must be reached prior to the performance of work. This agreement or understanding with individual employees need not be in writing, but a record of its existence must be kept. (See §553.50.) An employer need not adopt the same agreement or understanding with different employees and need not provide compensatory time to all employees. The agreement or understanding to provide compensatory time off in lieu of cash overtime compensation may take the form of an express condition of employment, provided (i) the employee knowingly and voluntarily agrees to it as a condition of employment and (ii) the employee is informed that the compensatory time received may be preserved, used or cashed out consistent with the provisions of section 7(o) of the Act. An agreement or understanding may be evidenced by a notice to the employee that compensatory time off will be given in lieu of overtime pay. In such a case, an agreement or understanding would be presumed to exist for purposes of section 7(o) with respect to any employee who fails to express to the employer an unwillingness to accept compensatory time off in lieu of overtime pay. However, the employee's decision to accept compensatory time off in lieu of cash overtime payments must be made freely and without coercion or pressure. (2) Section 2(a) of the 1985 Amendments provides that in the case of employees who have no representative and were employed prior to April 15, 1986, a public agency that has had a regular practice of awarding compensatory time off in lieu of overtime pay is deemed to have reached an agreement or understanding with these employees as of April 15, 1986. A public agency need not secure an agreement or understanding with each employee employed prior to that date. If, however, such a regular practice does not conform to the provisions of section 7(o) of the Act, it must be modified to do so with regard to practices after April 14, 1986. With respect to employees hired after April 14, 1986, the public employer who elects to use compensatory time must follow the guidelines on agreements discussed in paragraph (c)(1) of this section. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.24 Public safety”, “emergency response”, and “seasonal” activities. (a) Section 7(o)(3)(A) of the FLSA provides that an employee of a public agency which is a State, a political subdivision of a State, or an interstate governmental agency, may accumulate not more than 480 hours of compensatory time for FLSA overtime hours which are worked after April 15, 1986, if the employee is engaged in “public safety”, “emergency response”, or “seasonal” activity. Employees whose work includes “seasonal”, “emergency response”, or “public safety” activities, as well as other work, will not be subject to both limits of accrual for compensatory time. If the employee's work regularly involves the activities included in the 480-hour limit, the employee will be covered by that limit. A public agency cannot utilize the higher cap by simple classification or designation of an employee. The work performed is controlling. Assignment of occasional duties within the scope of the higher cap will not entitle the employer to use the higher cap. Employees whose work does not regularly involve “seasonal”, “emergency response”, or “public safety” activities are subject to a 240-hour compensatory time accrual limit for FLSA overtime hours which are worked after April 15, 1986. (b) Employees engaged in “public safety”, “emergency response”, or “seasonal” activities, who transfer to positions subject to the 240-hour limit, may carry over to the new position any accrued compensatory time. The employer will not be required to cash out the accrued compensatory time which is in excess of the lower limit. However, the employee must be compensated in cash wages for any subsequent overtime hours worked until the number of accrued hours of compensatory time falls below the 240-hour limit. (c) “Public safety activities”: The term “public safety activities” as used in section 7(o)(3)(A) of the Act includes law enforcement, fire fighting or related activities as described in §§553.210 (a) and (b) and 553.211 (a)–(c), and (f). An employee whose work regularly involves such activities will qualify for the 480-hour accrual limit. However, the 480- hour accrual limit will not apply to office personnel or other civilian employees who may perform public safety activities only in emergency situations, even if they spend substantially all of their time in a particular week in such activities. For example, a maintenance worker employed by a public agency who is called upon to perform fire fighting activities during an emergency would remain subject to the 240-hour limit, even if such employee spent an entire week or several weeks in a year performing public safety activities. Certain employees who work in “public safety” activities for purposes of section 7(o)(3)(A) may qualify for the partial overtime exemption in section 7(k) of the Act. (See §553.201) (d) “Emergency response activity”: The term “emergency response activity” as used in section 7(o)(3)(A) of the Act includes dispatching of emergency vehicles and personnel, rescue work and ambulance services. As is the case with “public safety” and “seasonal” activities, an employee must regularly engage in “emergency response” activities to be covered under the 480-hour limit. A city office worker who may be called upon to perform rescue work in the event of a flood or snowstorm would not be covered under the higher limit, since such emergency response activities are not a regular part of the employee's job. Certain employees who work in “emergency response” activities for purposes of section 7(o)(3)(A) may qualify for the partial overtime exemption in section 7(k) of the Act. (See §553.215.) (e)(1) “Seasonal activity”: The term “seasonal activity” includes work during periods of significantly increased demand, which are of a regular and recurring nature. In determining whether employees are considered engaged in a seasonal activity, the first consideration is whether the activity in which they are engaged is a regular and recurring aspect of the employee's work. The second consideration is whether the projected overtime hours during the period of significantly increased demand are likely to result in the accumulation during such period of more than 240 compensatory time hours (the number available under the lower cap). Such projections will normally be based on the employer's past experience with similar employment situations. (2) Seasonal activity is not limited strictly to those operations that are very susceptible to changes in the weather. As an example, employees processing tax returns over an extended period of significantly increased demand whose overtime hours could be expected to result in the accumulation during such period of more than 240 compensatory time hours will typically qualify as engaged in a seasonal activity. (3) While parks and recreation activity is primarily seasonal because peak demand is generally experienced in fair weather, mere periods of short but intense activity do not make an employee's job seasonal. For example, clerical employees working increased hours for several weeks on a special project or assigned to an afternoon of shoveling snow off the courthouse steps would not be considered engaged in seasonal activities, since the increased activity would not result in the accumulation during such period of more than 240 compensatory time hours. Further, persons employed in municipal auditoriums, theaters, and sports facilities that are open for specific, limited seasons would be considered engaged in seasonal activities, while those employed in facilities that operate year round generally would not. (4) Road crews, while not necessarily seasonal workers, may have significant periods of peak demand, for instance during the snow plowing season or road construction season. The snow plow operator/road crew employee may be able to accrue compensatory time to the higher cap, while other employees of the same department who do not have lengthy periods of peak seasonal demand would remain under the lower cap. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.25 Conditions for use of compensatory time (“reasonable period”, “unduly disrupt”). (a) Section 7(o)(5) of the FLSA provides that any employee of a public agency who has accrued compensatory time and requested use of this compensatory time, shall be permitted to use such time off within a “reasonable period” after making the request, if such use does not “unduly disrupt” the operations of the agency. This provision, however, does not apply to “other compensatory time” (as defined below in §553.28), including compensatory time accrued for overtime worked prior to April 15, 1986. (b) Compensatory time cannot be used as a means to avoid statutory overtime compensation. An employee has the right to use compensatory time earned and must not be coerced to accept more compensatory time than an employer can realistically and in good faith expect to be able to grant within a reasonable period of his or her making a request for use of such time. (c) Reasonable period. (1) Whether a request to use compensatory time has been granted within a “reasonable period” will be determined by considering the customary work practices within the agency based on the facts and circumstances in each case. Such practices include, but are not limited to (a) the normal schedule of work, (b) anticipated peak workloads based on past experience, (c) emergency requirements for staff and services, and (d) the availability of qualified substitute staff. (2) The use of compensatory time in lieu of cash payment for overtime must be pursuant to some form of agreement or understanding between the employer and the employee (or the representative of the employee) reached prior to the performance of the work. (See §553.23.) To the extent that the (conditions under which an employee can take compensatory time off are contained in an agreement or understanding as defined in §553.23, the terms of such agreement or understanding will govern the meaning of “reasonable period”. (d) Unduly disrupt. When an employer receives a request for compensatory time off, it shall be honored unless to do so would be “unduly disruptive” to the agency's operations. Mere inconvenience to the employer is an insufficient basis for denial of a request for compensatory time off. (See H. Rep. 99–331, p. 23.) For an agency to turn down a request from an employee for compensatory time off requires that it should reasonably and in good faith anticipate that it would impose an unreasonable burden on the agency's ability to provide services of acceptable quality and quantity for the public during the time requested without the use of the employee's services. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.26 Cash overtime payments. (a) Overtime compensation due under section 7 may be paid in cash at the employer's option, in lieu of providing compensatory time off under section 7(o) of the Act in any workweek or work period. The FLSA does not prohibit an employer from freely substituting cash, in whole or part, for compensatory time off; and overtime payment in cash would not affect subsequent granting of compensatory time off in future workweeks or work periods. (See §553.23(a)(2).) (b) The principles for computing cash overtime pay are contained in 29 CFR part 778. Cash overtime compensation must be paid at a rate not less than one and one-half times the regular rate at which the employee is actually paid. (See 29 CFR 778.107.) (c) In a workweek or work period during which an employee works hours which are overtime hours under FLSA and for which cash overtime payment will be made, and the employee also takes compensatory time off, the payment for such time off may be excluded from the regular rate of pay under section 7(e)(2) of the Act. Section 7(e)(2) provides that the regular rate shall not be deemed to include . . . payments made for occasional periods when no work is performed due to vacation, holiday, . . . or other similar cause. As explained in 29 CFR 778.218(d), the term “other similar cause” refers to payments made for periods of absence due to factors like holidays, vacations, illness, and so forth. Payments made to an employee for periods of absence due to the use of accrued compensatory time are considered to be the type of payments in this “other similar cause” category. § 553.27 Payments for unused compensatory time. (a) Payments for accrued compensatory time earned after April 14, 1986, may be made at any time and shall be paid at the regular rate earned by the employee at the time the employee receives such payment. (b) Upon termination of employment, an employee shall be paid for unused compensatory time earned after April 14, 1986, at a rate of compensation not less than— (1) The average regular rate received by such employee during the last 3 years of the employee's employment, or (2) The final regular rate received by such employee, whichever is higher. (c) The phrase last 3 years of employment means the 3-year period immediately prior to termination. Where an employee's last 3 years of employment are not continuous because of a break in service, the period of employment after the break in service will be treated as new employment. However, such a break in service must have been intended to be permanent and any accrued compensatory time earned after April 14, 1986, must have been cashed out at the time of initial separation. Where the final period of employment is less than 3 years, the average rate still must be calculated based on the rate(s) in effect during such period. (d) The term “regular rate” is defined in 29 CFR 778.108. As indicated in §778.109, the regular rate is an hourly rate, although the FLSA does not require employers to compensate employees on an hourly basis. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.28 Other compensatory time. (a) Compensatory time which is earned and accrued by an employee for employment in excess of a nonstatutory (that is, non-FLSA) requirement is considered “other” compensatory time. The term “other” compensatory time off means hours during which an employee is not working and which are not counted as hours worked during the period when used. For example, a collective bargaining agreement may provide that compensatory time be granted to employees for hours worked in excess of 8 in a day, or for working on a scheduled day off in a nonovertime workweek. The FLSA does not require compensatory time to be granted in such situations. (b) Compensatory time which is earned and accrued by an employee working hours which are “overtime” hours under State or local law, ordinance, or other provisions, but which are not overtime hours under section 7 of the FLSA is also considered “other” compensatory time. For example, a local law or ordinance may provide that compensatory time be granted to employees for hours worked in excess of 35 in a workweek. Under section 7(a) of the FLSA, only hours worked in excess of 40 in a workweek are overtime hours which must be compensated at one and one-half times the regular rate of pay. (c) Similarly, compensatory time earned or accrued by an employee for employment in excess of a standard established by the personnel policy or practice of an employer, or by custom, which does not result from the FLSA provision, is another example of “other” compensatory time. (d) The FLSA does not require that the rate at which “other” compensatory time is earned has to be at a rate of one and one-half hours for each hour of employment. The rate at which “other” compensatory time is earned may be some lesser or greater multiple of the rate or the straight-time rate itself. (e) The requirements of section 7(o) of the FLSA, including the limitations on accrued compensatory time, do not apply to “other” compensatory time as described above. Other Exemptions § 553.30 Occasional or sporadic employment-section 7(p)(2). (a) Section 7(p)(2) of the FLSA provides that where State or local government employees, solely at their option, work occasionally or sporadically on a part-time basis for the same public agency in a different capacity from their regular employment, the hours worked in the different jobs shall not be combined for the purpose of determining overtime liability under the Act. (b) Occasional or sporadic. (1) The term occasional or sporadic means infrequent, irregular, or occurring in scattered instances. There may be an occasional need for additional resources in the delivery of certain types of public services which is at times best met by the part-time employment of an individual who is already a public employee. Where employees freely and solely at their own option enter into such activity, the total hours worked will not be combined for purposes of determining any overtime compensation due on the regular, primary job. However, in order to prevent overtime abuse, such hours worked are to be excluded from computing overtime compensation due only where the occasional or sporadic assignments are not within the same general occupational category as the employee's regular work. (2) In order for an employee's occasional or sporadic work on a part-time basis to qualify for exemption under section 7(p)(2), the employee's decision to work in a different capacity must be made freely and without coercion, implicit or explicit, by the employer. An employer may suggest that an employee undertake another kind of work for the same unit of government when the need for assistance arises, but the employee must be free to refuse to perform such work without sanction and without being required to explain or justify the decision. (3) Typically, public recreation and park facilities, and stadiums or auditoriums utilize employees in occasional or sporadic work. Some of these employment activities are the taking of tickets, providing security for special events ( e.g., concerts, sports events, and lectures), officiating at youth or other recreation and sports events, or engaging in food or beverage sales at special events, such as a county fair. Employment in such activity may be considered occasional or sporadic for regular employees of State or local government agencies even where the need can be anticipated because it recurs seasonally ( e.g., a holiday concert at a city college, a program of scheduled sports events, or assistance by a city payroll clerk in processing returns at tax filing time). An activity does not fail to be occasional merely because it is recurring. In contrast, for example, if a parks department clerk, in addition to his or her regular job, also regularly works additional hours on a part-time basis ( e.g., every week or every other week) at a public park food and beverage sales center operated by that agency, the additional work does not constitute intermittent and irregular employment and, therefore, the hours worked would be combined in computing any overtime compensation due. (c) Different capacity. (1) In order for employment in these occasional or sporadic activities not to be considered subject to the overtime requirements of section 7 of the FLSA, the regular government employment of the individual performing them must also be in a different capacity, i.e., it must not fall within the same general occupational category. (2) In general, the Administrator will consider the duties and other factors contained in the definitions of the 3-digit categories of occupations in the Dictionary of Occupational Titles (except in the case of public safety employees as discussed below in section (3)), as well as all the facts and circumstances in a particular case, in determining whether employment in a second capacity is substantially different from the regular employment. (3) For example, if a public park employee primarily engaged in playground maintenance also from time to time cleans an evening recreation center operated by the same agency, the additional work would be considered hours worked for the same employer and subject to the Act's overtime requirements because it is not in a different capacity. This would be the case even though the work was occasional or sporadic, and, was not regularly scheduled. Public safety employees taking on any kind of security or safety function within the same local government are never considered to be employed in a different capacity . (4) However, if a bookkeeper for a municipal park agency or a city mail clerk occasionally referees for an adult evening basketball league sponsored by the city, the hours worked as a referee would be considered to be in a different general occupational category than the primary employment and would not be counted as hours worked for overtime purposes on the regular job. A person regularly employed as a bus driver may assist in crowd control, for example, at an event such as a winter festival, and in doing so, would be deemed to be serving in a different capacity. (5) In addition, any activity traditionally associated with teaching (e.g., coaching, career counseling, etc.) will not be considered as employment in a different capacity. However, where personnel other than teachers engage in such teaching-related activities, the work will be viewed as employment in a different capacity, provided that these activities are performed on an occasional or sporadic basis and all other requirements for this provision are met. For example, a school secretary could substitute as a coach for a basketball team or a maintenance engineer could provide instruction on auto repair on an occasional or sporadic basis. § 553.31 Substitution—section 7(p)(3). (a) Section 7(p)(3) of the FLSA provides that two individuals employed in any occupation by the same public agency may agree, solely at their option and with the approval of the public agency, to substitute for one another during scheduled work hours in performance of work in the same capacity. The hours worked shall be excluded by the employer in the calculation of the hours for which the substituting employee would otherwise be entitled to overtime compensation under the Act. Where one employee substitutes for another, each employee will be credited as if he or she had worked his or her normal work schedule for that shift. (b) The provisions of section 7(p)(3) apply only if employees' decisions to substitute for one another are made freely and without coercion, direct or implied. An employer may suggest that an employee substitute or “trade time” with another employee working in the same capacity during regularly scheduled hours, but each employee must be free to refuse to perform such work without sanction and without being required to explain or justify the decision. An employee's decision to substitute will be considered to have been made at his/her sole option when it has been made (i) without fear of reprisal or promise of reward by the employer, and (ii) exclusively for the employee's own convenience. (c) A public agency which employs individuals who substitute or “trade time” under this subsection is not required to keep a record of the hours of the substitute work. (d) In order to qualify under section 7(p)(3), an agreement between individuals employed by a public agency to substitute for one another at their own option must be approved by the agency. This requires that the agency be aware of the arrangement prior to the work being done, i.e., the employer must know what work is being done, by whom it is being done, and where and when it is being done. Approval is manifest when the employer is aware of the substitution and indicates approval in whatever manner is customary. § 553.32 Other FLSA exemptions. (a) There are other exemptions from the minimum wage and/or overtime requirements of the FLSA which may apply to certain employees of public agencies. The following sections provide a discussion of some of the major exemptions which may be applicable. This list is not comprehensive. (b) Section 7(k) of the Act provides a partial overtime pay exemption for public agency employees employed in fire protection or law enforcement activities (including security personnel in correctional institutions). In addition, section 13(b)(20) provides a complete overtime pay exemption for any employee of a public agency engaged in fire protection or law enforcement activities, if the public agency employs less than five employees in such activities. (See subpart C of this part.) (c) Section 13(a)(1) of the Act provides an exemption from both the minimum wage and overtime pay requirements for any employee employed in a bona fide executive, administrative, professional, or outside sales capacity, as these terms are defined and delimited in part 541 of this title. An
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Description
Title | EMS Board Handbook |
OkDocs Class# | H955.5 E55b 2010 |
Digital Format | PDF, Adobe Reader required |
ODL electronic copy | Downloaded from agency website: http://www.ok.gov/health/documents/EMS%20Board%20Handbook%20Jul%202010.pdf |
Rights and Permissions | This Oklahoma state government publication is provided for educational purposes under U.S. copyright law. Other usage requires permission of copyright holders. |
Language | English |
Full text | Oklahoma EMS Board Handbook July 2010 Oklahoma EMS Board Handbook Prepared as a joint project: Oklahoma State Department of Health Emergency Systems and Oklahoma Cooperative Extension Service Oklahoma State University For additional information, contact: Lee Martin Trauma and Systems Director Emergency Systems Oklahoma State Department of Health (405) 271-4027 or Dr. Gerald A. Doeksen Extension Economist & Regents Professor Oklahoma Cooperative Extension Service Oklahoma State University (405) 744-6083 July 2010 Oklahoma EMS Board Handbook Introduction One method of funding emergency medical services in Oklahoma is through Article X of the Oklahoma Constitution. This article allows Oklahoma residents to vote for a special taxation district to fund emergency medical services. Currently, the legislation allows up to three mills for operating expenses and up to three mills for capital equipment expenditures. Once a special taxation district is successfully voted in, the County Commissioners will appoint a Board of Directors to operate the District as a business. The appointed Board of Directors are volunteers. The Board of Directors of Emergency Medical Services (EMS) Districts are dedicated, hard-working, community leaders who are successful in their chosen occupations. However, the members of the Board of Directors often lack information and experience on directing an EMS system. The purpose of this Handbook is to provide the Board members with information to aid them in their decisions regarding the provision of Emergency Medical Services. Section 1 is an overview of EMS budget studies available through Oklahoma Cooperative Extension Service. The County Commissioners’ duties are illustrated in Section 2. The Board duties are covered in Section 3, with the duties of the EMS Director in Section 4. Examples of EMS Contracts are in Section 5. The EMS Rules and Regulations from the Oklahoma State Department of Health are included in Section 6, with EMS legislation in Section 7. Legal opinions regarding EMS are in Section 8. Section 9 contains information on Occupational Safety and Health. Section 10 includes EMS forms. Trauma legislation is included in Section 11 and EMS data in Section 12. Recently, HB 1888 was passed and is included under Section 7 EMS Legislation. County Commissioners will be receiving information on how to implement this new legislation in the near future. The Oklahoma State Department of Health and the Oklahoma Cooperative Extension Service, Oklahoma State University, have collaborated to provide the Oklahoma EMS Board Handbook for EMS Board members. Any suggestions or ideas on how to make this Handbook more useful to your Board are welcome. Contacts for both organizations are included. Good luck with your EMS District! Oklahoma EMS Board Handbook Table of Contents Introduction 1. Services Available 2. Commissioner’s Duties 3. EMS Board Duties 4. Duties of the EMS Director 5. EMS Contracts 6. Emergency Medical Service Regulations (Chapter 641) 7. EMS Legislation 8. Legal Opinions 9. Occupational Safety and Health 10. Forms 11. Trauma 12. EMS Data December 2009 Oklahoma Cooperative Extension Service Dr. Gerald A. Doeksen Extension Economist and Regents Professor Email: gad@okstate.edu Cheryl F. St. Clair Associate State Extension Specialist Email: cheryl@okstate.edu Oklahoma Cooperative Extension Service Oklahoma State University 513 Ag Hall Stillwater, OK 74078 Phone: 405-744-6083 Fax: 405-744-9835 Website: www.okruralhealthworks.org Stan Ralstin Area Extension Rural Development Specialist (Western half of Oklahoma) Email: stan.ralstin@okstate.edu Oklahoma Cooperative Extension Service Northwest District Office 316 E. Oxford Enid, OK 73701-1335 Phone: 580-237-7677 Fax: 580-242-1955 Jack Frye Area Extension Rural Development Specialist (Eastern half of Oklahoma) Email: jack.frye@okstate.edu Oklahoma Cooperative Extension Service Southeast District Office 1700 N. Broadway Ada, OK 74820-1406 Phone: 580-332-7011 Fax: 580-332-9234 December 2009 Oklahoma State Department of Health Lee Martin Trauma and Systems Director Email: LeeM@health.ok.gov Dale Adkerson Emergency Systems Administrator Email: DaleA@health.ok.gov Theresa Hope Emergency Systems Administrator Email: TheresaH@health.ok.gov Robert Irby Emergency Systems Administrator Email: RobertI@health.ok.gov Jackie Whitten Emergency Systems Administrator Email: JackieW@health.ok.gov Dr. Timothy Cathie Interim EMS Director Oklahoma State Department of Health Emergency Systems 1000 Northeast Tenth Street Oklahoma City, OK 73117-1299 Phone: 405-271-4027 Fax: 405-271-4240 Website: http://www.ok.gov/health/ July2010 522 EMS DISTRICTS COUNTY WIDE DISTRICTS AREA SERVICE & ADDRESS LEVY Alfalfa County Alfalfa County EMS 3 mills P O Box 36 Helena OK 73741 Phone: 580-852-3258 Atoka County Atoka County EMS 2 mills 700 W. Cedar Atoka OK 74525 Phone: 580-364-0777 Beaver County Beaver County EMS 1 mill P O Box 640 Beaver OK 73932 Phone: 580-625-4551 Bryan County Bryan County EMS 3 mills P O Box 1 Durant OK 74702 Phone: 580-924-4687 Choctaw County Choctaw County Ambulance Authority 3 mills P O Box 567 Hugo OK 74743 Phone: 580-326-2634 Cimarron County Cimarron County EMS 2.5 mills P O Box 367 Boise City OK 73933 Phone: 580-544-3021 Coal County Coalgate Fire Dept / EMS 3 mills P O Box 475 Coalgate OK 74538 Phone: 580-927-3913 Cotton County Walters Volunteer Ambulance 3 mills P.O. Box 394 Walters OK 73572 Phone: 580-875-2400 July2010 COUNTY WIDE DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Creek County Creek County Emergency Ambulance 3 mills (Excludes Mannford Service Dist School District) 123 E. Hobson Sapulpa OK 74066 Phone: 918-227-4111 Ellis County Ellis County EMS 3 mills P O Box 591 Shattuck OK 73858 Phone: 580-938-5267 Grady County Chickasha Fire Dept EMS 3 mills (Except Independent 1700 Harly Day Drive Districts 1, 2, and 29) Chickasha OK 73018 Phone: 405-222-6033 Harmon County Southwest Oklahoma Ambulance Authority 3 mills P.O. Box 88 Hollis OK 73550 Phone: 580-688-3363 Hughes County Hughes County EMS 3 mills P.O. Box 671 Holdenville OK 74848 Phone: 405-379-7046 Jackson County Jackson County EMS 3 mills 1309 N. Park Lane Altus OK 73521 Phone: 580-477-4112 Johnston County Johnston County EMS 3 mills 604 E. 24th Street Tishomingo OK 73460 Phone: 580-371-0569 LeFlore County EMS of LeFlore County 3 mills P O Box 1025 Poteau OK 74953 Phone: 918-647-9270 July2010 COUNTY WIDE DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Love County Love County EMS 3 mills Mercy Health – Love County 300 Wanda Street Marietta OK 73448 Phone: 580-276-3347 Major County Major County EMS 3 mills P O Box 511 Fairview OK 73737 Phone: 580-227-2322 Marshall County Marshall County EMS District 3 mills P O Box 707 Madill OK 73446 Phone: 580-795-7541 McCurtain County McCurtain County EMS 3 mills 827 Lincoln Road Idabel OK 74745 Phone: 580-286-7585 Murray County Murray County EMS 3 mills P O Box 545 Sulphur OK 73086 Phone: 580-622-6630 Muskogee County Muskogee County EMS 3 mills 200 Callahan Muskogee OK 74403 Phone: 918-683-0130 Pushmataha County City of Antlers EMS 3 mills 100 S.E. 2nd Antlers OK 74523 Phone: 580-298-0288 Roger Mills County Roger Mills County Ambulance Service 3 mills PO Box 219 Cheyenne OK 73628 Phone: 580-497-3336 July2010 COUNTY WIDE DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Tillman County Tillman County EMS District 2 mills P O Box 122 Frederick OK 73542 Phone: 580-335-5877 Woodward County Woodward County EMS 3 mills P O Box 771 Woodward OK 73802 Phone: 580-254-3341 July2010 522 EMS DISTRICTS SCHOOL DISTRICTS AREA SERVICE & ADDRESS LEVY Ardmore Southern Oklahoma Ambulance Service 3 mills Po Box 1387 Ardmore OK 73402 Phone: 580-223-1226 Buffalo Buffalo EMS District 3 mills P O Box 676 Buffalo OK 73834 Phone: 580-727-5421 Butler Butler EMS 3 mills HC 66 Box 94-2F Foss, OK 73647 Phone: 580-664-3915 Caddo Cashion Fire Department EMS 3 mills P.O. Box 27 Cashion OK 73016 Phone: 405-433-2243 Canton-Longdale Canton-Longdale EMS District 3 mills P.O. Box 39 Canton OK 73724 Phone: 580-886-2515 Cleora Cleora EMS District Trust 3 mills 32922 Pebble Creek Afton OK 74331 Phone: 918-782-9434 Crescent Crescent Ambulance District 3 mills P O Box 233 Crescent OK 73028 Phone: 405-969-2000 Geary Park View Ambulance -Geary 3 mills 2115 Parkview Drive El Reno OK 73036 Phone: 405-262-2640 July2010 SCHOOL DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Glenpool EMS Plus, LLC 3 mills 1408 W. Detroit Street Broken Arrow, OK 74012 Phone: 918-258-6671 Greer Greer County Special Ambulance 3 mills P.O. Box 308 Mangum OK 73554 Phone: 580-782-5314 Grove Grove EMS 3 mills 1310 S. Main Grove OK 74344 Phone: 918-787-3457 Guthrie Guthrie EMS 3 mills 209 E. Springer Guthrie OK 73044 Phone: 405-282-4433 Hinton Park View Ambulance - Hinton 3 mills 2115 Parkview Drive El Reno OK 73036 Phone:405-262-2640 Jefferson Waurika Ambulance 3 mills 122 N. Main Waurika OK 73573 Phone: 580-228-2713 Kingfisher Kingfisher Fire/EMS 3 mills 415 S Main Kingfisher OK 73750 Phone: 405-375-4070 Laverne Laverne EMS 3 mills P O Box 902 Laverne OK 73848 Phone: 580-921-3930 July2010 SCHOOL DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Leedey Leedey Emergency Ambulance 3 mills P.O. Box 232 Leedey OK 73654 Phone: 580-488-2101 McClain/Grady Counties McClain/Grady County EMS Dist #1 3 mills (Newcastle, Blanchard and P O Box 430 Dibble School Districts) Blanchard OK 73010 Phone: 405-485-2000 Miami Integris Baptist Regional EMS 3 mills 200 2nd SW Street Miami OK 74354 Phone: 918-542-5171 Mountain View/Gotebo Mountain View/Gotebo Ambulance Service 3 mills P O Box 294 Mountain View OK 73062 Phone: 580-347-2268 Okeene Okeene Ambulance 2 mills P.O. Box 508 Okeene OK 73763 Phone: 580-822-4031 Oologah – Talala Oologah – Talala EMS District 3 mills P.O. Box 165 Oologah OK 74053 Phone: 918-443-2350 Seiling Community Ambulance Service 3 mills P O Box 811 Seiling OK 73663 Phone: 580-922-4241 Vici – Camargo Vici – Camargo EMS 3 mills 619 Main Street Vici OK 73859 Phone: 580-995-3350 July2010 SCHOOL DISTRICTS (Continued) AREA SERVICE & ADDRESS LEVY Weleeka/Graham Weleeka-Graham EMS 3 mills P O Box 445 Weleeka OK 74880 Chair: John Anglin Meets: 1st Mon @ 7:00 PM July2010 522 EMS DISTRICTS CITY DISTRICTS AREA SERVICE & ADDRESS LEVY Noble Noble Fire Department EMS 3 mills P.O. Box 557 Noble OK 73068 Phone: 405-872-3030 Pauls Valley Pauls Valley Gen. Hospital EMS 3 mills P.O. Box 368 Pauls Valley OK 73075 Phone: 405-238-5501 Section 1 Financing Alternatives for EMS Systems Financing Alternatives for EMS Systems The Oklahoma Cooperative Extension Service, in cooperation with the Oklahoma State Department of Health Emergency Systems Division, is available to provide EMS call analysis and/or EMS budget and revenue alternatives. These are available on a “first-come, first-serve” basis and will be available as long as funding is available to support them. To begin a study, contact the Extension Service or your EMS Field Coordinator (details below). To do a call analysis, your reports will need to be up-to-date in the OSDH Emergency Systems Division. An analysis of a year’s call reports will provide data for your EMS service. The call data will assist the Oklahoma Cooperative Extension Service in providing a report on alternative financing for your EMS service. To develop EMS budget and revenue alternatives, the EMS service will need to provide the call data (above), as well as cost and revenue data. The study will include at least two alternatives. The total capital costs, annual capital costs, and annual operating costs (building expenses, vehicle expenses, labor expenses, etc.) will be itemized. The total annual capital and operating expenses will be summarized and include the average cost per call. The revenue tables will include different options, and may include fee per call, mileage fees, special taxation district millage levies, sales tax, and fees per utility bill (when appropriate). These studies do not recommend a particular action or option, rather they are intended to provide information to the local EMS service to utilize in their decision-making process. To request this service, contact: Cheryl F. St. Clair Oklahoma Cooperative Extension Service Oklahoma State University 513 Ag Hall Stillwater, OK 74078 Phone: 405-744-6083 or 9824 OR Oklahoma State Department of Health Emergency Systems 1000 NE 10th St. Oklahoma City, OK 73124 Phone: 405-271-4027 Section 2 Commissioner’s Duties COMMISSIONER’S DUTIES This section contains a brief list of the County Commissioner’s main responsibilities. Also included is a memorandum from the Oklahoma State Attorney General describing who may appoint, and who may be appointed to, the EMS Board of Directors. For more detail on County Commissioner’s duties and responsibilities, see the sections titled “EMS Laws” and “Attorney General.” RESPONSIBILITIES OF COUNTY COMMISSIONERS I. Call for election. II. Appoint the EMS Board Members. Those members should live within the District, and may not hold another office. III. Instruct the EMS Board to operate the District as a business. IV. After this, your only requirement is to appoint new Board members. The law states that County Commissioners shall not act as Board members, but allow the Board to make decisions. §51-6. Officers and deputies not to hold other offices - Exemptions. A. Except as may be otherwise provided, no person holding an office under the laws of the state and no deputy of any officer so holding any office shall, during the person's term of office, hold any other office or be the deputy of any officer holding any office, under the laws of the state. The provisions of this section shall not apply to: 1. Notaries public; 2. Members of the State Textbook Committee; 3. County free fair board members; 4. Municipal and county law enforcement officers serving in positions as law enforcement officers of both such governmental entities upon such terms and conditions as are mutually approved by resolutions adopted by the board of county commissioners and governing body of the municipality employing such officers; 5. Any person holding a county or municipal office or position, or membership on any public trust authority, who is a member of a board or commission that relates to federal, state, county or municipal government and is created by the United States Government, the State of Oklahoma or a political subdivision of the state, except where the duties of the offices or positions conflict; 6. Any elected municipal officers and school board members who are appointed to a state board, commission, or similar entity if there is no compensation for such services other than reimbursement for necessary travel expenses pursuant to the provisions of the State Travel Reimbursement Act, Section 500.1 et seq. of Title 74 of the Oklahoma Statutes; 7. Any trustee of a public trust, who is appointed as a trustee of a different public trust or any trustee of the Tulsa County Public Facilities Authority who may also be employed by the Department of Transportation; 8. Law enforcement officers employed by municipal or county law enforcement departments or agencies, other than those law enforcement officers elected or appointed as sheriff, chief of police or some similar position in which they are the head of a county or municipal law enforcement agency, who are elected to local boards of education; provided, the provisions of this paragraph shall not prohibit any law enforcement officer employed by a municipality having a population of ten thousand (10,000) or fewer people from serving as a member of a local board of education; 9. Any member of the Oklahoma Highway Patrol Division of the Department of Public Safety who is elected to a local board of education; 10. Any District Supervisor, Assistant District Supervisor, Team Supervisor, Parole Officer 1 or Parole Officer 2 of the Department of Corrections who is elected or appointed to a city council; 11. Any trustee or director of a rural electric cooperative, or port authority who is appointed or elected to a state, county or municipal board, commission or similar entity; 12. County employees who are elected as members of town or city councils; 13. Municipal, county, state or tribal law enforcement or peace officers operating under cross-deputization agreements with an Indian tribe or branch of the federal government; 14. Municipal or county law enforcement or peace officers serving in positions as campus police officers or campus public safety officers pursuant to the provisions of the Oklahoma Campus Security Act, upon such terms and conditions as are mutually approved by resolution adopted by the governing body of the municipality or county and the governing board of the institution of higher education; 15. State law enforcement or peace officers serving in positions as campus police officers or campus public safety officers pursuant to the provisions of the Oklahoma Campus Security Act, upon such terms and conditions as are mutually approved by written agreement between the Commissioner of Public Safety and the governing board of the institution of higher education; 16. Municipal and county law enforcement officers serving in positions as part-time rangers under the Oklahoma Tourism and Recreation Department; 17. The Administrator of a Scenic Rivers Commission serving in the position of a park ranger under the Oklahoma Tourism and Recreation Department; 18. Members of the University Hospitals Authority; 19. Any person holding a state office or position who is a reserve force deputy sheriff or a reserve municipal police officer; 20. Any person holding a state office or position who serves as a special assistant district attorney without compensation; 21. Any elected or appointed member of a local school board who is a member of a municipal planning commission; 22. Any elected or appointed member of a local school board who is a member or an officer of a volunteer fire department; 23. Directors or officers of a rural water district and chiefs of municipal fire departments or rural fire districts who are appointed or elected to an unsalaried office in a state, county, municipal, school, or technology center school board, commission, or similar entity, except where the duties of the office would create a conflict of interest; 24. Any person who is a dispatcher or confinement officer at a municipal jail who is a noncompensated reserve municipal police officer; and 25. Any person who is an assistant district attorney serving as a municipal judge or prosecutor. The provisions of this section shall not prohibit any person holding an office under the laws of the state or any deputy of any officer so holding any office from serving upon the board of Oklahoma Futures or upon the board of directors of the Oklahoma Center for the Advancement of Science and Technology. The provisions of this section shall not prohibit a member of the board of directors of the Oklahoma Center for the Advancement of Science and Technology from serving upon the board of Oklahoma Futures. B. Any salaries, emoluments or benefits that would otherwise be paid by the agency or political subdivision to a loaned employee or officer shall instead be paid to the regular employer of such employee. The loaned employee shall in turn be paid regular salary and benefits the same as if continuing regular employment with the permanent employer. R.L.1910, § 4274. Amended by Laws 1929, c. 255, p. 363, § 1; Laws 1939, p. 22, § 1, emerg. eff. April 27, 1939; Laws 1981, c. 47, § 1, emerg. eff. April 13, 1981; Laws 1986, c. 207, § 54, operative July 1, 1986; Laws 1987, c. 222, § 116, operative July 1, 1987; Laws 1987, c. 236, § 128, emerg. eff. July 20, 1987; Laws 1989, c. 357, § 1, emerg. eff. June 3, 1989; Laws 1990, c. 230, § 1, eff. Sept. 1, 1990; Laws 1991, c. 202, § 1, emerg. eff. May 17, 1991; Laws 1991, c. 298, § 9, operative July 1, 1991; Laws 1992, c. 43, § 1, eff. Sept. 1, 1992; Laws 1992, c. 373, § 11, eff. July 1, 1992; Laws 1993, c. 331, § 3, eff. July 1, 1993; Laws 1994, c. 2, § 18, emerg. eff. March 2, 1994; Laws 1995, c. 127, § 1, emerg. eff. April 27, 1995; Laws 1996, c. 24, § 5, emerg. eff. April 3, 1996; Laws 1997, c. 317, § 1, emerg. eff. May 29, 1997; Laws 1998, c. 184, § 1, eff. July 1, 1998; Laws 2000, c. 162, § 1, eff. Nov. 1, 2000; Laws 2001, c. 33, § 39, eff. July 1, 2001; Laws 2001, c. 414, § 6, eff. Nov. 1, 2001; Laws 2002, c. 389, § 2, emerg. eff. June 4, 2002. NOTE: Laws 1992, c. 2, § 2 repealed by Laws 1992, c. 373, § 22, eff. July 1, 1992. Laws 1993, c. 330, § 22 repealed by Laws 1994, c. 2, § 34, emerg. eff. March 2, 1994. Laws 2001, c. 19, § 1 repealed by Laws 2001, c. 414, § 16, eff. Nov. 1, 2001. Section 3 EMS Board Duties EMS BOARD DUTIES This section has five parts. The first section is a brief description of the duties and responsibilities of the Board. Examples of the EMS District by-laws are provided. The second section contains an outline of Board responsibilities after they have selected one of the three alternative methods of providing EMS to their constituents. The first alternative is for the Board to oversee the day-to-day operation of the EMS with the aid of a paid EMS administrator. Secondly, the Board may contract with a hospital, city, county, fire department, an individual, or some other entity to provide EMS, but hire an EMS administrator to report to the Board. The third alternative is for the Board to contract with one of the above entities to provide all EMS functions, including that of the administrator, with the main duty of the Board to oversee the contractual agreement. The third part of this section is a set of common questions about EMS Districts and how they operate. It will help answer some of the questions about your duties, responsibilities, opportunities, and limitations. Next, we have included a synopsis of the EMS Agenda for the Future to help you understand how the functions of your district are important to the overall mission of delivering emergency medical service to the entire State of Oklahoma, and to the nation. Finally, we have included a publication of the Small Business Administration on how to prepare a business plan. For more information on EMS Board duties and responsibilities, Board members should familiarize themselves with the entire Handbook. DUTIES OF THE BOARD OF TRUSTEES The operation of an EMS District is constantly under the authority and diligent surveillance of the appointed Board of Trustees. The Board shall enact and maintain an approved set of By- Laws, which shall define the parameters of operations and oversight of the 522 EMS District in accordance with Article X of the Oklahoma Constitution. The Board becomes more than merely a “pass through” agency for funding. It is, in essence, the responsible body for operational functions and business administration of the EMS District. The Board has the duty and the power to make rules applying to such details as vehicle specifications, patient care equipment, level of care to be delivered to the constituents of the District, stations locations, and other functions necessary to the operation of a high-quality EMS District. They are also responsible to ensure that necessary patient care equipment which is lacking or needing replacement is purchased when funds become available. The purchases should be made with advice from the service providers, EMTs, and the medical control physician. The board may also establish procedures for the operation of the District, typically referred to as Standard Operating Procedures (SOP). It is recommended they hire an EMS administrator, who will be responsible for day-to-day operations, quality assurance, collection of accounts, and future planning. It is recognized that EMS Board Members have their own affairs to conduct, and may not be fully knowledgeable of the technical aspects of EMS operations and management. The Board may contract with service providers necessary for the operation of the District. The Board of Trustees may issue bonds, if approved by a majority vote at a special election called for such purpose. The bonds may be issued for purchase of vehicles and stations. A special ad valorem tax will be levied not to exceed three mills per dollar annually for the payment of principal and interest until the outstanding bonds have been paid. Detailed information on the issuance of bonds and manner of payment is contained in Sections 9C(b) through (n) of Article X of the Oklahoma Constitution. The District, under the jurisdiction of the Board of Trustees, is empowered to charge fees for service and accept gifts, funds or grants from sources other than the mill levy to be used for the provision of emergency medical services. RESPONSIBILITIES OF THE BOARD OR AUTHORITY WHERE THEY PROVIDE SERVICE I. Be knowledgeable and responsible for compliance of State EMS statutes, rules and regulations. II. Hire a good administrator A. Administrator should be, at least, EMT-Basic, but role should primarily be administrative. B. Salary and benefits package should be sufficient to attract and retain qualified professionals. III. Responsible for operating a business. Some responsibilities include: A. Review annual budget prepared by administrator; B. Adopt an annual budget; C. Approve monthly dispensation of tax funds; D. Approve salaries and benefits of personnel; E. Approve capital expenditures; and F. Insure system stays economically solvent. IV. Responsible for policy decisions. Some examples include: A. Setting ambulance service fees (inside and outside district); B. Deciding on station location(s); C. Deciding on number and types of crews (paid versus volunteer); and D. Deciding on level of care (basic versus paramedic). V. Responsible for public relations A. Assist in promotion of district through the media; and B. Assist in resolving complaints. RESPONSIBILITIES OF BOARD OR AUTHORITY WHERE THEY HIRE ADMINISTRATOR AND CONTRACT FOR SERVICE I. Be knowledgeable of State EMS statutes, rules and regulations. II. Hire a good administrator. III. Assure adequate and accurate record keeping. IV. Approve monthly expenditures and annual budget. V. Approve and adopt Standard Operating Procedures. VI. Maintain compliance with State EMS statutes, rules and regulations. RESPONSIBILITIES OF BOARD OR AUTHORITY WHERE THEY CONTRACT FOR SERVICE I. Be knowledgeable of State EMS statutes, rules and regulations. II. Develop contract specifications.1 A. Specify who owns vehicles. B. Specify desired level of service. III. Review the bids (specify such things as insurance, personnel, level of service, response times, quality assurance, etc.) IV. Write contract.2 V. Monitor performance of contract. VI. Keep records according to established accounting principles. 1 An example bidding specification document is presented in Appendix A. 2 An example contract is presented in Appendix B. It is only an example and your contract needs to be reviewed by your attorney before you sign the document. FREQUENTLY ASKED QUESTIONS 1. Question: What is a “522” EMS District? Answer: “522” refers to State Question 522 which was a constitutional amendment which allows a district to be formed following the boundaries of a county, school district or an incorporated city or town and to establish an annual recurring ad valorem tax levy of not more than three (3) mills per dollar of assessed valuation of all taxable property in the district. 2. Question: How is the election called? Answer: By the board of county commissioners or by petition of 10% of registered voters in the region affected. 3. Question: What is the time frame involved in calling the election? Answer: Elections shall be conducted by the county election board or boards upon receipt of an election proclamation issued by a majority of the board or boards of county commissioners of the proposed district. The proclamation setting forth the purpose and date of the election shall be published in one issue of a newspaper of general circulation in each county involved at least ten (10) days prior to the election. 4. Question: When can the district be organized following the election? Answer: The board can be appointed immediately. Funds will not be available until the following collection period. The board may borrow from anticipated tax funds for operating expense if service is begun before funds are actually available. 5. Question: Who serves as administrators of the district? Answer: A board of trustees of not less than five (5) members shall be chosen jointly by the board or boards of county commissioners following the election establishing the district. One individual from each county or part thereof must be appointed to the board. 6. Question: Does the board operate the emergency medical service? Answer: The board may hire a manager, contract, organize, maintain and otherwise operate the district. 7. Question: What is the term of office for board members? Answer: The first board draws lots for length of office ranging from one to five years, after which the appointment is for five years. 8. Question: What duties do board members have? Answer: The have the power and duty to promulgate and adopt rules, procedures and contract provisions necessary to carry out purposes and objectives of the legislation and such additional powers as authorized by the legislature. 9. Question: Must board members be bonded? Answer: Yes. All board members must be able to be bonded. The minimum is $10,000. 10. Question: May the board members serve on another public board or hold public office? Answer: No. 11. Question: Is the board required to follow the procedures of the open meeting law? Answer: Yes. It is a public body administering public funds. 12. Question: May additional tax revenues be raised through “522”? Answer: Yes. The trustees may issue bonds if approved by a majority vote in a special election to acquire emergency vehicles, other equipment and maintain the same. 13. Question: Can the three mills for the operation of the service and the bond issue be voted on at the same time? Answer: Yes. The bond issue can be contingent to the passing of the question establishing an EMS district. 14. Question: How are the bonds repaid? Answer: By an additional annual three mill ad valorem levy until the bonds are repaid. 15. Question: Who conducts audits for the district? Answer: The State Examiner and Inspector shall conduct an annual audit of the operations of such districts. 16. Question: Are there other sources of revenue for the district? Answer: Yes. The board of trustees are empowered to charge fees for service, accept gifts and funds or grants from other sources. 17. Question: What agency of government is pecuniarily liable? Answer: The board of trustees of the district has jurisdiction over funds received and disbursed. The board of trustees have the capacity to sue and be sued. They have the same immunity from civil suits for actions arising from the operation of the district as municipalities and counties. 18. Question: What happens to the existing service and equipment when an EMS District is established? Answer: The existing service, if one exists, can be donated to the district, purchased, leased, or contracted to provide services for the district. 19. Question: May the district be expanded? Answer: Yes, by a majority vote of both the existing district and the area of expansion. 20. Question: May the district be dissolved? Answer: Yes, by a majority vote at an election called for that purpose. The election may be called by three-fifths of the EMS District trustees or upon petition of not less than 20% of all registered voters in the district. 21. Question: Are these districts a part of county government? Answer: No. They are special government entities which may constitute a part of a county or part of more than one county, a county or more than one county. 22. Question: Will the district provide free ambulance service? Answer: Probably not, though this is entirely up to the board. The tax revenue is designed to help with the cost of financing the availability of an emergency medical service. However, some districts have been able to provide service with funds from tax revenues and reimbursements through Medicare, Medicaid and private insurance policies. 23. Question: What are advantages of EMS Districts? Answer: 1. Some funding is available on recurring basis. 2. Quality of service is overseen by a board representing the interests of the constituents of the region. 3. Cost to consumer can be lower than it would be otherwise. 4. Funds can be generated for capital investment. 5. Wide variety of options available for operation of EMS. 6. Work toward development of EMS system for pre-hospital care. 24. Question: What will three mill ad valorem levy cost average homeowner? Answer: 1. $ 40,000 x .09 x .003 = $10.80 per year 2. $ 60,000 x .09 x .003 = $16.20 per year 3. $ 80,000 x .09 x .003 = $21.60 per year 4. $120,000 x .09 x .003 = $32.40 per year 5. $200,000 x .09 x .003 = $54.00 per year §51-6. Officers and deputies not to hold other offices - Exemptions. A. Except as may be otherwise provided, no person holding an office under the laws of the state and no deputy of any officer so holding any office shall, during the person's term of office, hold any other office or be the deputy of any officer holding any office, under the laws of the state. The provisions of this section shall not apply to: 1. Notaries public; 2. Members of the State Textbook Committee; 3. County free fair board members; 4. Municipal and county law enforcement officers serving in positions as law enforcement officers of both such governmental entities upon such terms and conditions as are mutually approved by resolutions adopted by the board of county commissioners and governing body of the municipality employing such officers; 5. Any person holding a county or municipal office or position, or membership on any public trust authority, who is a member of a board or commission that relates to federal, state, county or municipal government and is created by the United States Government, the State of Oklahoma or a political subdivision of the state, except where the duties of the offices or positions conflict; 6. Any elected municipal officers and school board members who are appointed to a state board, commission, or similar entity if there is no compensation for such services other than reimbursement for necessary travel expenses pursuant to the provisions of the State Travel Reimbursement Act, Section 500.1 et seq. of Title 74 of the Oklahoma Statutes; 7. Any trustee of a public trust, who is appointed as a trustee of a different public trust or any trustee of the Tulsa County Public Facilities Authority who may also be employed by the Department of Transportation; 8. Law enforcement officers employed by municipal or county law enforcement departments or agencies, other than those law enforcement officers elected or appointed as sheriff, chief of police or some similar position in which they are the head of a county or municipal law enforcement agency, who are elected to local boards of education; provided, the provisions of this paragraph shall not prohibit any law enforcement officer employed by a municipality having a population of ten thousand (10,000) or fewer people from serving as a member of a local board of education; 9. Any member of the Oklahoma Highway Patrol Division of the Department of Public Safety who is elected to a local board of education; 10. Any District Supervisor, Assistant District Supervisor, Team Supervisor, Parole Officer 1 or Parole Officer 2 of the Department of Corrections who is elected or appointed to a city council; 11. Any trustee or director of a rural electric cooperative, or port authority who is appointed or elected to a state, county or municipal board, commission or similar entity; 12. County employees who are elected as members of town or city councils; 13. Municipal, county, state or tribal law enforcement or peace officers operating under cross-deputization agreements with an Indian tribe or branch of the federal government; 14. Municipal or county law enforcement or peace officers serving in positions as campus police officers or campus public safety officers pursuant to the provisions of the Oklahoma Campus Security Act, upon such terms and conditions as are mutually approved by resolution adopted by the governing body of the municipality or county and the governing board of the institution of higher education; 15. State law enforcement or peace officers serving in positions as campus police officers or campus public safety officers pursuant to the provisions of the Oklahoma Campus Security Act, upon such terms and conditions as are mutually approved by written agreement between the Commissioner of Public Safety and the governing board of the institution of higher education; 16. Municipal and county law enforcement officers serving in positions as part-time rangers under the Oklahoma Tourism and Recreation Department; 17. The Administrator of a Scenic Rivers Commission serving in the position of a park ranger under the Oklahoma Tourism and Recreation Department; 18. Members of the University Hospitals Authority; 19. Any person holding a state office or position who is a reserve force deputy sheriff or a reserve municipal police officer; 20. Any person holding a state office or position who serves as a special assistant district attorney without compensation; 21. Any elected or appointed member of a local school board who is a member of a municipal planning commission; 22. Any elected or appointed member of a local school board who is a member or an officer of a volunteer fire department; 23. Directors or officers of a rural water district and chiefs of municipal fire departments or rural fire districts who are appointed or elected to an unsalaried office in a state, county, municipal, school, or technology center school board, commission, or similar entity, except where the duties of the office would create a conflict of interest; 24. Any person who is a dispatcher or confinement officer at a municipal jail who is a noncompensated reserve municipal police officer; and 25. Any person who is an assistant district attorney serving as a municipal judge or prosecutor. The provisions of this section shall not prohibit any person holding an office under the laws of the state or any deputy of any officer so holding any office from serving upon the board of Oklahoma Futures or upon the board of directors of the Oklahoma Center for the Advancement of Science and Technology. The provisions of this section shall not prohibit a member of the board of directors of the Oklahoma Center for the Advancement of Science and Technology from serving upon the board of Oklahoma Futures. B. Any salaries, emoluments or benefits that would otherwise be paid by the agency or political subdivision to a loaned employee or officer shall instead be paid to the regular employer of such employee. The loaned employee shall in turn be paid regular salary and benefits the same as if continuing regular employment with the permanent employer. R.L.1910, § 4274. Amended by Laws 1929, c. 255, p. 363, § 1; Laws 1939, p. 22, § 1, emerg. eff. April 27, 1939; Laws 1981, c. 47, § 1, emerg. eff. April 13, 1981; Laws 1986, c. 207, § 54, operative July 1, 1986; Laws 1987, c. 222, § 116, operative July 1, 1987; Laws 1987, c. 236, § 128, emerg. eff. July 20, 1987; Laws 1989, c. 357, § 1, emerg. eff. June 3, 1989; Laws 1990, c. 230, § 1, eff. Sept. 1, 1990; Laws 1991, c. 202, § 1, emerg. eff. May 17, 1991; Laws 1991, c. 298, § 9, operative July 1, 1991; Laws 1992, c. 43, § 1, eff. Sept. 1, 1992; Laws 1992, c. 373, § 11, eff. July 1, 1992; Laws 1993, c. 331, § 3, eff. July 1, 1993; Laws 1994, c. 2, § 18, emerg. eff. March 2, 1994; Laws 1995, c. 127, § 1, emerg. eff. April 27, 1995; Laws 1996, c. 24, § 5, emerg. eff. April 3, 1996; Laws 1997, c. 317, § 1, emerg. eff. May 29, 1997; Laws 1998, c. 184, § 1, eff. July 1, 1998; Laws 2000, c. 162, § 1, eff. Nov. 1, 2000; Laws 2001, c. 33, § 39, eff. July 1, 2001; Laws 2001, c. 414, § 6, eff. Nov. 1, 2001; Laws 2002, c. 389, § 2, emerg. eff. June 4, 2002. NOTE: Laws 1992, c. 2, § 2 repealed by Laws 1992, c. 373, § 22, eff. July 1, 1992. Laws 1993, c. 330, § 22 repealed by Laws 1994, c. 2, § 34, emerg. eff. March 2, 1994. Laws 2001, c. 19, § 1 repealed by Laws 2001, c. 414, § 16, eff. Nov. 1, 2001. 15 COMPONENTS OF AN EMS SYSTEM 1. MANPOWER 2. TRAINING 3. COMMUNICATIONS 4. TRANSPORTATION 5. FACILITIES 6. ACCESS TO CRITICAL CARE UNITS 7. UTILIZATION OF PUBLIC SAFETY AGENCIES 8. CONSUMER PARTICIPATION 9. ACCESSIBILITY TO CARE 10. TRANSFER OF PATIENTS 11. STANDARD MEDICAL RECORD-KEEPING 12. MEDICAL DIRECTION A. QUALITY ASSURANCE B. MEDICAL PROTOCOLS 13. CONSUMER INFORMATION - PUBLIC EDUCATION 14. REVIEW AND EVALUATION 15. MUTUAL AID AGREEMENTS 16. TRIAGE TRANSPORT TRANSFER 17. PATIENT CARE EMS Agenda for the Future During the past 30 years, emergency medical services (EMS) in the Untied States have experienced explosive development and growth. Yet initiatives to create a system to provide emergency medical care for the nation’s population began with limited knowledge about what constituted the most efficient processes for delivering ideal resources to the spectrum of situations encountered by contemporary EMS. The “15 Components of an EMS System” on the previous page were a part of the genesis of the EMS we know today. In 1996, a multi-disciplinary group, under the leadership of the National Highway Traffic Safety Administration, developed the EMS Agenda for the Future. The Vision Emergency medical services (EMS) of the future will be community-based health management that is fully integrated with the overall health care system. It will have the ability to identify and modify illness and injury risks, provide acute illness and injury care and follow-up, and contribute to treatment of chronic conditions and community health monitoring. This new entity will be developed from redistribution of existing health care resources and will be integrated with other health care providers and public health and public safety agencies. It will improve community health and result in more appropriate use of acute health care resources. EMS will remain the public’s emergency medical safety net. To realize this vision, the EMS Agenda for the Future proposes continued development of 14 EMS attributes. You will note that this list is similar to the 15 Components of an EMS system listed previously. These attributes are a modernized expansion. They are: ◊ Integration of Health Services ◊ EMS Research ◊ Legislation and Regulation ◊ System Finance ◊ Human Resources ◊ Medical Direction ◊ Education Systems ◊ Public Education ◊ Prevention ◊ Public Access ◊ Communication Systems ◊ Clinical Care ◊ Information Systems ◊ Evaluation The EMS Agenda for the Future provides a vision for pre-hospital EMS. Achieving such a vision will require deliberate action and application of the knowledge gained during the past 30 year EMS experience. You will see that the EMS of the future will be more than merely an emergency transportation service. The EMS Division of the State Department of Health and the local EMS Districts are the workhorses of the national agenda. An understanding of the Agenda will help the local EMS Board of Trustees understand the reasoning behind some of the EMS legislation and regulation. If pursued conscientiously, the Agenda will be an achievement with great benefits for all of society. The goals associated with these 14 attributes follow. Integration of Health Services ◊ Expand the role of EMS in public health ◊ Involve EMS in community health monitoring ◊ Integrate EMS with other health care providers and provider networks ◊ Incorporate EMS within health care networks’ structure to deliver quality care ◊ Be cognizant of the special needs of the entire population ◊ Incorporate health systems within EMS that address the special needs of all segments of the population EMS Research ◊ Allocate federal and state funds for major EMS systems research ◊ Develop information systems that provide linkage between various public safety services and other health care providers ◊ Develop academic institutional commitments to EMS-related research ◊ Interpret informed consent rules to allow for clinical and environmental circumstances inherent in conducting credible EMS research ◊ Develop involvement and/or support of EMS research by all those responsible for EMS structure, processes, and/or outcomes ◊ Designate EMS as a physician subspecialty, and a subspecialty for other health professions ◊ Include research related objectives in the education processes of EMS providers and managers ◊ Enhance the quality of published EMS research ◊ Develop collaborative relationships between EMS systems, medical schools, other academic institutions, and private foundations Legislation and Regulation ◊ Authorize and sufficiently fund a lead federal EMS agency ◊ Pass and periodically review EMS enabling legislation in all states that supports innovation and integration, and establishes and sufficiently funds an EMS lead agency ◊ Enhance the abilities of state EMS lead agencies to provide technical assistance ◊ Establish and fund the position of State EMS Medical Director in each state ◊ Authorize state and local EMS lead agencies to act on the public’s behalf in cases of threats to the availability of quality EMS to the entire population ◊ Implement laws that provide protection from liability for EMS field and medical direction personnel when dealing with unusual situations System Finance ◊ Collaborate with other health care providers and insurers to enhance patient care efficiency ◊ Develop proactive financial relationships between EMS, other health care providers, and health care insurers / provider organizations ◊ Compensate EMS on the basis of a preparedness-based model, reducing volume-related incentives and realizing the cost of an emergency safety net ◊ Provide immediate access to EMS for emergency medical conditions ◊ Address EMS relevant issues within governmental health care finance policy ◊ Commit local, state, and federal attention and funds to continued EMS infrastructure Human Resources ◊ Ensure that alterations in expectations of EMS personnel to provide health care services are preceded by adequate preparation ◊ Adopt the principles of the National EMS Education and Practice Blueprint ◊ Develop a system for reciprocity of EMS provider credentials ◊ Develop collaborative relationships between EMS systems and academic institutions ◊ Conduct EMS occupational health research ◊ Provide a system for critical incident stress management Medical Direction ◊ Formalize relationships between all EMS systems and medical directors ◊ Appropriate sufficient resources for EMS medical direction ◊ Require appropriate credentials for all those who provide on-line medical direction ◊ Develop collaborative relationships between EMS systems and academic institutions ◊ Develop EMS as a physician and nurse subspecialty certification ◊ Appoint state EMS medical directors Education Systems ◊ Ensure adequacy of EMS education programs ◊ Update education core content objectives frequently enough so that they reflect EMS patient health care needs ◊ Incorporate research, quality improvement, and management learning objectives in higher level EMS education ◊ Commission the development of national core contents to replace EMS program curricula ◊ Conduct EMS education with medical direction ◊ Seek accreditation for EMS education programs ◊ Establish innovative and collaborative relationships between EMS education programs and academic institutions ◊ Recognize EMS education as an academic achievement ◊ Develop bridging and transition programs ◊ Include EMS-related objectives in all health professions’ education Public Education ◊ Acknowledge public education as a critical activity for EMS ◊ Collaborate with other community resources and agencies to determine public education needs ◊ Engage in continuous public education programs ◊ Educate the public as consumers ◊ Explore new techniques and technologies for implementing public education ◊ Evaluate public education incentives Public Access ◊ Implement 9-1-1 nationwide ◊ Provide emergency telephone service for those who cannot otherwise afford routine telephone services ◊ Ensure that all calls to a Public Safety Answering Point (PSAP), regardless of their origins, are automatically accompanied by unique location-identifying information ◊ Develop uniform cellular 9-1-1 service that reliably routes calls to the appropriate PSAP ◊ Evaluate and employ technologies that attenuate potential barriers to EMS access ◊ Enhance the ability of EMS systems to triage calls, and provide resource allocation that is tailored to patient���s needs Communications Systems ◊ Assess the effectiveness of various personnel and resource attributes for EMS dispatching ◊ Receive all calls for EMS using personnel with the requisite combination of education, experience, and resources to optimally query the caller, make determination of the most appropriate resources to be mobilized, and implement an effective course of action ◊ Promulgate and update standards for EMS dispatching ◊ Develop cooperative ventures between communications centers and health providers to integrate communications processes and enable rapid patient-related information exchange ◊ Determine the benefits of real-time patient data transfer ◊ Appropriate federal, state, and regional funds to further develop and update geographically integrated and functionally-based EMS communications networks ◊ Facilitate exploration of potential uses of advancing communications technology by EMS ◊ Collaboration with private interests to effect shared purchasing of communication technology Prevention ◊ Collaborate with community agencies and health care providers with expertise and interest in illness and injury prevention ◊ Support the Safe Communities concept ◊ Advocate for legislation that potentially results in injury and illness prevention ◊ Develop and maintain a prevention-oriented atmosphere within EMS systems ◊ Include the principles of prevention and its role in improving community health as part of EMS education core contents ◊ Improve the ability of EMS to document injury and illness circumstances Clinical Care ◊ Commit to a common definition of what constitutes baseline community EMS care ◊ Subject EMS clinical care to ongoing evaluation to determine its impact on patient outcomes ◊ Employ new care techniques and technology only after shown to be effective ◊ Conduct task analyses to determine appropriate staff configurations during secondary patient transfers ◊ Eliminate patient transports as a criterion for compensating EMS systems ◊ Establish proactive relationships between EMS and other health care providers Information Systems ◊ Adopt uniform data elements and definitions and incorporate them into information systems ◊ Develop mechanisms to generate and transmit data that are valid, reliable, and accurate ◊ Develop information systems that are able to describe an entire EMS event ◊ Develop integrated information systems with other health care providers, public safety agencies, and community resources ◊ Provide feedback to those who generate data Evaluation ◊ Develop valid models for EMS evaluations ◊ Evaluate EMS effects for multiple outcome categories ◊ Determine EMS cost-effectiveness ◊ Incorporate consumer input in evaluation processes Write a Business Plan Essential Elements of a Good Business Plan for Growing Companies A business plan should be a work-in-progress. Even successful, growing businesses should maintain a current business plan. As any good salesperson knows, you have to know everything you can about your products or services in order to persuade someone to buy them. In this discussion, you are the salesperson and your products represent your business. Your customers are potential investors and employees. Since you want your customers to believe in you, you must be able to convince them that you know what you are talking about when it comes to your business. To become an expert (or to fine-tune your knowledge if you already believe you are one), you must be willing to roll up your sleeves and begin digging through information. Since not all information that you gather will be relevant to the development of your business plan, it will help you to know what you are looking for before you get started. In order to help you with this process, we have developed an outline of the essential elements a good business plan. Every successful business plan should include something about each of the following areas, since these are what make up the essentials of a good business plan: • Executive Summary • Market Analysis • Company Description • Organization & Management • Marketing & Sales Management • Service or Product Line • Funding Request • Financials • Appendix Writing The Plan What goes in a business plan? The body can be divided into four distinct sections: 1) Description of the business 2) Marketing 3) Finances 4) Management Agenda should include an executive summary, supporting documents, and financial projections. Although there is no single formula for developing a business plan, some elements are common to all business plans. They are summarized in the following outline: Elements of a Business Plan 1. Cover sheet 2. Statement of purpose 3. Table of contents I. The Business A. Description of business B. Marketing C. Competition D. Operating procedures E. Personnel F. Business insurance II. Financial Data A. Loan applications B. Capital equipment and supply list C. Balance sheet D. Breakeven analysis E. Pro-forma income projections (profit & loss statements) F. Three-year summary G. Detail by month, first year H. Detail by quarters, second and third years I. Assumptions upon which projections were based J. Pro-forma cash flow III. Supporting Documents A. Tax returns of principals for last three years Personal financial statement (all banks have these forms) B. For franchised businesses, a copy of franchise contract and all supporting documents provided by the franchisor C. Copy of proposed lease or purchase agreement for building space D. Copy of licenses and other legal documents E. Copy of resumes of all principals F. Copies of letters of intent from suppliers, etc. Sample Plans One of the best ways to learn about writing a business plan is to study the plans of established businesses in your industry. Check out available Business Plan Workshops and review examples of real business plans on the U. S. Small Business Administration’s website at: http://www.sba.gov/smallbusinessplanner/plan/writeabusinessplan/SERV_WRRITINGBUSPLA N.html Detailed information on Writing a Business Plan is available through the U. S. Small Business Administration at http://www.sba.gov/smallbusinessplanner/plan/ 1 | P a g e BY-LAWS OF EMERGENCY MEDICAL SERVICES OF _________ COUNTY 1. THE BOARD OF COUNTY COMMISSIONERS OF ____________ COUNTY, COMPLYING TO STATE LAWS OF CONSTITUTION OF STATE OF OKLAHOMA (ARTICLE 10-SECTION 9 B), PLACED THE QUESTION BEFORE THE PEOPLE ON SAID DAY OF _____________ _____. _____, WHEREUPON THE COUNTY OF ____________ APPROVED THE FORMATION OF AN AMBULANCE DISTRICT UNDER THE EMERGENCY MEDICAL SERVICES DISTRICT ACT OF AUGUST, 1976, TO FORM ____________ COUNTY EMERGENCY MEDICAL SERVICES. TO COMPLY WITH SAID ELECTION, THE BOARD OF COUNTY COMMISSIONERS HAVE APPOINTED SAID MEMBERS TO THE BOARD OF TRUSTEES OF ____________ COUNTY EMERGENCY MEDICAL SERVICES: 1. __________________________ 2. __________________________ 3. __________________________ 4. __________________________ 5. __________________________ 6. __________________________ 7. __________________________ 8. __________________________ 9. __________________________ 2. APPOINTMENT OF BOARD MEMBERS THE ORIGINAL BOARD OF TRUSTEES FOR THE ____________ COUNTY EMS SHALL BE COMPOSED OF NINE (9) MEMBERS, THREE (3) FROM EACH COUNTY COMMISSION DISTRICT. THE MEMBERS OF SAID BOARD SHALL ELECT BY ORAL VOTE THE FOLLOWING OFFICES: ONE (1) CHAIRPERSON, ONE (1) VICE-CHAIRPERSON, ONE (1) SECRETARY. SUCH BOARD OF TRUSTEES SHALL HAVE THE POWER AND DUTY TO PROMULGATE AND ADOPT SUCH RULES, PROCEDURES, AND CONTRACT PROVISIONS TO CARRY OUT THE PURPOSE AND OBJECTIVES OF THESE PROVISIONS AND SHALL POST SUCH BOND AS REQUIRED BY THE COUNTY COMMISSIONERS. 3. TERM OF OFFICE THE ORIGINAL MEMBERS OF THE BOARD OF TRUSTEES SHALL HOLD OFFICE AS FOLLOWS: 2 | P a g e AT FIRST MEETING OF SAID BOARD, BOARD MEMBERS SHALL DRAW LOTS TO DETERMINE EACH TRUSTEE’S ORIGINAL LENGTH OF TERM OF OFFICE. THE NUMBER OF LOTS TO BE PROVIDED SHALL BE EQUAL TO THE NUMBER OF ORIGINAL MEMBERS OF THE BOARD. LOTS SHALL BE NUMBERED SEQUENTIALLY FROM ONE (1) THROUGH FIVE (5), WITH LOTS IN EXCESS OF THE FIFTH LOT BEING ALSO NUMBERED SEQUENTIALLY FROM ONE THROUGH FIVE (5) UNTIL ALL LOTS ARE NUMBERED. EACH ORIGINAL MEMBER OR MEMBERS ADDED BY AN EXPANSION AREA OF THE BOARD SHALL HOLD OFFICE FOR THE NUMBER OF YEARS INDICATED ON SAID PARTY’S LOT. EACH YEAR AS NECESSARY THE BOARD OF BOARDS OF COUNTY COMMISSIONERS SHALL APPOINT SUCCESSORS TO SUCH MEMBERS OF THE BOARD OF TRUSTEES WHOSE TERM HAS EXPIRED, AND SUCH APPOINTMENTS SHALL BE FOR TERMS OF FIVE (5) YEARS. THE ORIGINAL MEMBERS OF THE BOARD OF TRUSTEES OF ____________ COUNTY EMS WILL SERVE A TERM OF OFFICE AS TO THE FOLLOWING TERMS: FROM TIME OF APPOINTMENT IN CALENDAR YEAR _____, TO THE END OF FISCAL YEAR ____. IN THE CALENDAR YEAR ____, MONTH OF ______, THE BOARD OF COUNTY COMMISSIONERS WILL APPOINT SUCCESSORS TO SUCH MEMBERS WHOSE TERMS HAVE EXPIRED, AND SUCH SUBSEQUENT APPOINTMENTS SHALL BE FORE TERMS OF FIVE (5) YEARS. EACH YEAR THEREAFTER, IN THE MONTH OF ____, THE BOARD OF BOARDS OF COUNTY COMMISSIONERS SHALL APPOINT SUCCESSORS TO SUCH MEMBERS WHOSE TERMS HAVE EXPIRED, AND SUCH SUBSEQUENT APPOINTMENTS SHALL BE FOR FIVE (5) YEARS. FOLLOWING HIS APPOINTMENT EACH NEW MEMBER WILL BE SWORN IN AT THE NEXT REGULAR MEETING IN THE MONTH OF _______, AND WILL ASSUME THE DUTIES OF A MEMBER OF THE ____________ COUNTY EMS BOARD OF TRUSTEES. THE MEMBERS OF THE BOARD OF TRUSTEES SHALL, ANNUALLY IN THE MONTH OF _______, ELECT BY ORAL VOTE THE FOLLOWING OFFICES: ONE (1) CHAIRPERSON, ONE (1) VICE-CHAIRPERSON, ONE (1) SECRETARY. AT ANY TIME A MEMBER OF THE ____________ COUNTY EMS BOARD OF TRUSTEES SHOULD SUBMIT A LETTER OF RESIGNATION TO THE BOARD OF TRUSTEES, SAID LETTER OF RESIGNATION SHALL BE REVIEWED AND VOTED ON AT THE NEXT REGULAR MEETING OF THE BOARD OF TRUSTEES, WITH A MAJORITY OF THE REMAINING BOARD MEMBERS OF THE ____________ COUNTY EMS TRUSTEES IN AGREEMENT. THE BOARD OF COUNTY COMMISSIONERS SHALL THEN APPOINT A MEMBER TO REPLACE THE ABSENT MEMBER, WHO SHALL THEN SERVE THE REMAINING TERM OF SAID DISCHARGED MEMBER. 3 | P a g e 4. DUTIES OF THE BOARD THE BOARD OF TRUSTEES SHALL HAVE THE ADDITIONAL POWERS TO HIRE OR DISMISS AN ADMINISTRATOR AND TO CONTRACT, ORGANIZE, MONITOR, OR OTHERWISE OPERATE THE EMERGENCY MEDICAL SERVICE IN SAID DISTRICT, AND SUCH ADDITIONAL POWERS AS MAY BE AUTHORIZED, INCLUDING THE REVIEW OF SUCH PERSONNEL THE ADMINISTRATOR MAY UTILIZE IN THE PROVISION OF SERVICES. THE BOARD OF TRUSTEES OF THE ____________ COUNTY EMERGENCY MEDICAL SERVICES WILL APPROVE PAYMENT OF ALL BILLS AND LIABILITIES MADE BY SAID AMBULANCE SERVICE OR ITS REPRESENTATIVES. THE BOARD OF TRUSTEES OF THE ____________ COUNTY EMS WILL NOT BE SALARIED OR PAID FOR SERVICES RENDERED FOR THEIR DUTIES AS MEMBERS OF SAID BOARD UNTIL AT SUCH TIME A RESOLUTION IS MADE BY SAID BOARD, AND LEGALLY VOTED ON, AND PASSED BY A MAJORITY OF THE SAID BOARD MEMBERS. THE ____________ COUNTY EMS BOARD WILL CONDUCT A MONTHLY MEETING THE ________ _________ EACH CALENDAR MONTH, UNLESS OTHERWISE ANNOUNCED AT THE PRECEDING MONTH MEETING, AT WHICH TIME THE CHAIRPERSON, OR PERSONS IN CHARGE SHALL MAKE SUCH ANNOUNCEMENT. TIME AND PLACE OF SAID MEETINGS SHALL BE AT _________. IN THE ____________ COUNTY COURT HOUSE UNLESS A CHANGE OF DATE, TIME, AND/OR PLACE IS DULY AGREED UPON AND ANNOUNCED TO THE PUBLIC AT LEAST FORTY-EIGHT (48) HOURS PRIOR TO THE MEETING. TIME, DATE, AND PLACE OF EACH REGULAR MEETING SHALL BE FILED WITH THE COUNTY CLERK FOR THE ENTIRE CALENDAR YEAR BY _____________ ANNUALLY. NO MEMBER OF THE BOARD OR PERSON HOLDING A HIRED OR OTHER APPOINTED POSITION SHALL HAVE PECUNIARY INTEREST EITHER DIRECTLY OR INDIRECTLY FOR PURCHASE FOR SAID EMS UNLESS THE SAME ARE PURCHASED ON COMPETITIVE BIDS. THE BOARD SHALL HAVE THE EXCLUSIVE CONTROL OF THE EXPENDITURES OF ALL MONIES COLLECTED OR DEPOSITED TO THE CREDIT OF THE EMS FUND, THE AMBULANCES, AND ALL OTHER EQUIPMENT LEASED, PURCHASED, OR SET APART FOR THE PURPOSE. ALL MONEY DRAWN FROM THE COUNTY TREASURY MEMBERS ON A REGULAR OR MONTHLY BASIS MUST HAVE BEEN AUTHORIZED BY THE CHAIRPERSON AND MEMBERS OF THE GOVERNING BOARD. NO PERSON SHALL BE ALLOWED TO SPEND OVER ________ WITHOUT FIRST BRINGING THE MATTER BEFORE A MEETING OF THE BOARD AND RECEIVING ITS APPROVAL. ALL PURCHASES OR CONTRACTS IN EXCESS OF ________ WILL BE SUBMITTED FOR COMPETITIVE BIDDING, WITH THE BOARD OF TRUSTEES RESERVING THE 4 | P a g e RIGHT TO REJECT ANY OR ALL BIDS. BIDDING PROCEDURES WILL COMPLY WITH THE STANDARDS SET FORTH BY THE BOARD OF COUNTY COMMISSIONERS. ALL PAYMENT VOUCHERS OR CHECKS WILL BE ENDORSED BY CHAIRMAN OF BOARD OF COUNTY COMMISSIONERS AND COUNTY CLERK. THIS MEMBER SHALL BE DESIGNATED THE REQUISITIONING OFFICIAL, AND SHALL HAVE THE AUTHORITY TO MAKE PURCHASES, NOT EXCEEDING THE AMOUNT OF ________, SUCH PURCHASES TO BE USED ON AN EMERGENCY BASIS ONLY. IN THE ABSENCE OF THE REQUISITIONING OFFICIAL, THE REQUISITION PURCHASE ORDERS SHALL BE SIGNED BY THE CHAIRPERSON. 5. QUORUM EXCEPT AS HEREIN OTHERWISE, SPECIFICALLY PROVIDED A MAJORITY OF FIVE OF THE AUTHORIZED NUMBER OF TRUSTEES SHALL CONSTITUTE A QUORUM OF THE BOARD, FOR TRANSACTION OF BUSINESS. EVERY ACT OR DECISION DONE OR MADE BY A MAJORITY OF THE TRUSTEES PRESENT AT A MEETING DULY HELD, AT WHICH A QUORUM IS PRESENT, SHALL BE THE ACT OF THE BOARD OF TRUSTEES. PROVIDED, HOWEVER, THAT A MINORITY OF THE BOARD OF TRUSTEES, FROM DAY TO DAY, BUT MAY NOT TRANSACT ANY BUSINESS. SHOULD A PERIOD OF THREE MONTHS PASS DURING WHICH NO BUSINESS MAY BE CONDUCTED FOR LACK OF A QUORUM, THE MATTER SHALL BE REMANDED TO THE COUNTY COMMISSIONERS AT THEIR NEXT STATED MEETING AND THEY MAY TAKE SUCH ACTION AS MAY BE NECESSARY TO CORRECT THE MATTER. ANY MEMBER OF THE ____________ COUNTY EMS BOARD WHO IS ABSENT FROM THREE (3) CONSECUTIVE REGULAR MEETINGS SHALL BE HELD IN VIOLATION AND SHALL BE DISMISSED AUTOMATICALLY FROM HIS POSITION ON THE BOARD. THE VIOLATOR SHALL BE NOTIFIED OF SAID DISMISSAL BY REGISTERED LETTER, A COPY OF WHICH SHALL BE SENT TO THE COUNTY COMMISSIONER. THE COUNTY COMMISSIONER SHALL THEN APPOINT A NEW MEMBER WHO SHALL SERVE THE REMAINDER OF THAT TERM OF OFFICE. 6. SPECIAL MEETINGS SPECIAL MEETINGS OF THE BOARD OF TRUSTEES MAY BE CALLED AT ANY TIME, BY ORDER OF THE CHAIRPERSON, OR FIVE (5) OR MORE OF THE BOARD OF TRUSTEES. NOTICE OF THE TIME AND PLACE OF ALL SPECIAL MEETINGS OF THE BOARD OF TRUSTEES SHALL BE GIVEN TO EACH TRUSTEE BY THE DELIVERY PERSONALLY, OR BY MAIL, OR BY TELEPHONE CONTACT, AT LEAST TWENTY-FOUR (24) HOURS BEFORE THE TIME FIXED FOR HOLDING SAID MEETING. EACH TRUSTEE SHALL REGISTER HIS OR HER ADDRESS WITH THE SECRETARY OF THE BOARD OF TRUSTEES. THE NOTICE OF MEETING SENT OR GIVEN BY MAIL, OR TELEPHONE TO SUCH ADDRESS, AS HEREIN ABOVE PROVIDED, AND SUCH ADDRESS SHALL BE VALID NOTICE OF SUCH MEETING. 5 | P a g e 7. SPECIAL APPOINTMENTS NON-VOTING A PHYSICIAN (MD) MAY BE APPOINTED AS MEDIAL DIRECTOR TO THE ____________ COUNTY EMS DISTRICT TO SERVE AS ADVISORY PERSONNEL IN THE DIRECT PROVISION OF EMERGENCY CARE IN THE FIELD AND TO ESTABLISH AND MAINTAIN CURRENT PATIENT CARE PROTOCOLS IN ACCORDANCE WITH THE GUIDELINES ESTABLISHED BY THE TECHNICAL MEDICAL DIRECTIONS COMMITTEE OF THE STATE OF OKLAHOMA. THE MEDICAL DIRECTOR MAY AND SHOULD ACT IN CONJUNCTION WITH THE ADMINISTRATOR AS LIAISON TO THE RECEIVING HOSPITALS. OTHER PERSONS MAY BE APPOINTED FOR SPECIFIC SERVICES AND FOR SPECIFIC TERMS OF TENURE AS REQUIRED TO ASSIST THE BOARD IN THE TRANSACTION OF ITS BUSINESS AND THE DISCHARGE OF ITS DUTIES. SUCH APPOINTEES WILL NOT BE SALARIED OR PAID FOR SERVICES RENDERED FOR THEIR DUTIES AS APPOINTEES UNTIL AT SUCH TIME A RESOLUTION IS MADE BY SAID BOARD, AND LEGALLY VOTED ON, AND PASSED BY A MAJORITY OF THE BOARD MEMBERS ON EACH SPECIFIC INSTANCE. 8. DUTIES OF THE ADMINISTRATOR ADMINISTRATION OF THE ____________ COUNTY EMERGENCY MEDICAL SERVICE SHALL BE HELD BY A PERSON WHO IS AN EMERGENCY MEDICAL TECHNICIAN (EMT) OR BECOMES AN EMT WITHIN ONE YEAR OF ASSUMING THE OFFICE OF ADMINISTRATOR TO THE SERVICE. THIS ADMINISTRATOR SHALL BE GIVEN THE NECESSARY AUTHORITY TO HOLD RESPONSIBLE FOR THE ADMINISTRATION OF THE EMS IN ALL ITS ACTIVITIES. THIS PERSON SHALL ACT AS THE DULY AUTHORIZED REPRESENTATIVE OF THE BOARD OF TRUSTEES IN ALL MATTERS. THE AUTHORITY AND DUTIES OF THE ADMINISTRATOR SHALL BE: A. To perfect and submit to the Board of Trustees for approval a plan of organization of the personnel and others connected with the operation of the EMS, and to maintain other such records on service utilization and effectiveness to provide necessary data for continuing evaluation of the service. B. To prepare an annual budget showing the expected receipts and expenditures. C. To select, employ, control and discharge all employees authorized by the Board of Trustees. D. To see that all physical properties and equipment are kept in a good state of repair and operating condition. E. To supervise all business affairs, such as records of financial transactions, collections of accounts, and the purchase of supplies in issuance of them, and to insure that all funds are collected and expended to the best possible advantage. F. To submit at each regular meeting reports showing the Professional Services, the Financial Activities of EMT and to propose and submit such special reports as may be required by the Board of Trustees. G. To attend all meetings of the Board of Trustees. 6 | P a g e H. To perform any of the duties that may be necessary to maintain constant provision of services. I. TO serve as the Liaison Officer in conjunction with the Medical Director for the provision of communications between the Board of Trustees and the Governing Boards of the receiving hospitals. J. Co-ordinate a continuing public information program. K. Provide for the training and continuing education of all ambulance personnel including the administrator. L. Disburse such equipment and supplies as may be purchased to the appropriate ambulance and/or personnel. 9. Service Area SPECIFICALLY THE GEOGRAPHIC AREA LYING WITHIN THE CONFINES OF THE LINES OF BOUNDARY DEFINED AND DESIGNATED BY THE STATE OF OKLAHOMA AS ____________ COUNTY. THIS AREA SHALL, UNLESS SUBSEQUENTLY REDEFINED BY THE BOARD, CONSIST OF ONE DISTRICT KNOWN AS ____________ COUNTY EMERGENCY MEDICAL SERVICES. THE UNIT, HEREINAFTER REFERRED TO AS COUNTY UNIT EIGHTEEN (18) SHALL BE HEADQUARTERED AT ________, OKLAHOMA. THE UNIT HEREINAFTER REFERRED TO AS COUNTY UNIT NINETEEN (19) SHALL BE HEADQUARTERED EITHER AT ___________, ___________, _______________, OKLAHOMA AS SPECIFIED BY THE GUIDELINES. THE UNIT HEREINAFTER REFERRED TO AS COUNTY UNIT SEVENTEEN (17) MAY BE HELD IN THE RESERVE FOR BACK-UP DUTY OR FOR USE IN SUCH CAPACITY AS IS REQUIRED BY THE SERVICE. IT OR ITS FUNCTION MAY BE RETIRED FROM SERVICE WHEN AND IF THE BOARD OF TRUSTEES MAKES SUCH AN AGREEMENT. THE UNITS SHALL SERVE IN CONJUNCTION WITH EACH OTHER AND MAY AND SHALL PROVIDE ASSISTANCE TO EACH OTHER AND TO REGIONAL JURISDICTIONS OUTSIDE THE BOUNDARIES OF THE DISTRICT AS DELINEATED IN WRITTEN AND VERBAL MUTUAL AID AGREEMENTS WITH OTHER EMERGENCY MEDICAL SERVICES AND/OR RECEIVING FACILITIES. ALL UNITS SHALL, UNLESS OTHER WRITTEN ARRANGEMENTS ARE MADE WITH A PROVIDER AND AGREED TO BY THE BOARD OF TRUSTEES, BE QUARTERED IN COUNTY BUILDINGS AT COUNTY EXPENSE. ALL UNITS ARE DEEMED THE PROPERTY OF THE COUNTY AND MAY BE BARTERED, TRADED, OR SOLD BY THE BOARD OF TRUSTEES UNLESS OWNERSHIP BY ANOTHER ENTITY CAN BE PROVEN. 1 CONSTITUTION AND BY-LAWS OF THE GOVERNING BOARD, LATIMER COUNTY EMERGENCY MEDICAL SERVICES ARTICLE I. OFFICERS. Section 1. The membership of the Governing Board shall consist of five (5) qualified members appointed by the Board of County Commissioners, and the Officers of the Governing Board shall be a chairman, a Vice-Chairman, a Secretary and a Treasurer, and such other officers as the Board of Control may authorize. All of them shall be elected or appointed by the board from among its own membership at the first regular meeting after it has been appointed, and shall hold office for a period of one (1) year or until their successors shall have been selected and duly qualified. Members of the Governing Board shall draw lots to determine each members original length of term in office. The number of lots to be provided shall be equal to the number of original members of the board, and lots shall be numbered sequentially from one through five. Each year as necessary, the board or boards of county commissioners shall appoint successors to such members whose terms have expired, and such subsequent appointments shall be for terms of five (5) years. Members of the Board as such, shall receive no salary or compensation for their services. Section 2. The chairman shall call and preside at all meetings. The Vice-Chairman shall act as chairman in the absence of the chairman, and when acting, shall have all power and authority of the chairman. The Secretary shall be responsible for taking of the minutes of all meetings of the Governing Board. ARTICLE II. REGULAR AND SPECIAL MEETINGS. A. The annual meeting of the Governing Board shall be the first meeting after the close of the Fiscal year (month of July). B. Regular meetings will be held every three (3) months. C. Special meetings can be called by the chairman of the Board or executive director of EMS. D. The time, date, and place of each meeting will be filed with the County Clerk at the court house for the whole calendar year by December 15 of each year. It will also be published in the local paper. ARTICLE III. COMMITTEES. A. Finance Committee. The finance committee shall be the responsibility of the Governing Board as a whole. This committee is responsible for Policy, Review of Budget, Financial Statements and related problems. Section 1. Building, Grounds, and Maintenance Committee. This committee shall be the responsibility of the Governing Board as a whole. This committee will inspect the premises every three months, and report on the up-keep of the grounds, building, ambulance, and all other items which are essential to the operation of the EMS. 2 ARTICLE IV. No member of the Board shall have pecuniary interest either directly or indirectly for purchase for said EMS unless the same are purchased on competitive bids. The Governing Board shall have the exclusive control of the expenditures of all monies collected or deposited to the credit of the EMS Fund, the ambulance, building, and all other equipment leased or set apart for the purpose. All money drawn from the County Treasurers must have been authorized by the Chairman and Secretary of the Governing Board. No person shall be allowed to spend over ______ without first bringing the matter before the Governing Board. ARTICLE V. ADMINISTRATION. Section 1. Administrator of __________________________________ shall be the Administrator of EMS. This administrator shall be given the necessary authority and held responsible for the administration of the EMS in all its activities. He shall act as the duly authorized representative of the Governing Board in all matters. Section 2. The authority and duties of the Administrator shall be: A. To perfect and submit to the Governing Board for approval a plan of organization of the personnel and others connected with the operation of the EMS. B. To prepare an annual budget showing the expected receipts and expenditures by the Governing Board. C. To select, employ, control, and discharge all employees authorized by the Governing Board. D. To see that all physical properties and equipment are kept in a good state of repair and operating condition. E. To supervise all business affairs, such as records of financial transaction, collections of accounts and the purchase of supplies and issuance of them, and to insure that all funds are collected and expedited to the best possible advantage. F. To submit at each regular meeting reports showing the Professional Services, the Financial Activities of EMS and to propose and submit such special reports as may be required by the Governing Board. G. To attend all meetings of the Governing Board. H. To perform any of the duties that may be necessary in the best interest of the hospital. I. To serve as the liaison officer and channel of communications between the Governing Board of the Hospital and the Governing Board of the EMS. Section 4 Duties of the EMS Director DUTIES OF THE EMS DIRECTOR The EMS Director or Administrator is the individual in charge and responsible for the overall operation of the EMS district, administration and clinical segments. Whether the Board operates the EMS district itself or makes contractual arrangements with a community, hospital or private provider, there should be an EMS director appointed who will be responsible to the Board and the electorate. The EMS director shall be responsible for the fiscal aspects of the system. He should pursue diligently the collection of fees for service and must be cognizant of all avenues of payment for services rendered, particularly those involving third party reimbursement. The EMS director should also consider an alternative of contracting with a billing service to pursue billing and collections. The EMS director should have a thorough knowledge of the EMS system and the components of which it is comprised. He should establish contact with the EMS Division of the Oklahoma State Department of Health and take full advantage of the technical assistance available. Medical direction by physicians is required by statute and rule. Additional assistance from nurses and allied health professionals within the district are valuable allies in building an EMS system. Their expertise and cooperation will be invaluable in acquiring necessary involvement from public officials, civic leaders and the district at large. The EMS director should establish a good rapport with the medical community to ascertain their needs and solicit their participation in the system. The EMS director, who is a licensed EMT, should be capable of responding to major incidents to serve as Medical Incident Commander. If not, a senior EMT should be appointed to this important function. Public education is a major component of any EMS system. The general public and industry will need instruction in basic first aid and cardiopulmonary resuscitation. Most will contact the EMS district to obtain this training. If this training is available from the EMS district under the auspices of the American Heart Association or the American Red Cross, the public relations benefits will be immeasurable. Education within the EMS system is another major task of the EMS director. He should be familiar with the educational resources available in or near the district. In some areas, it is desirable to appoint an In-house Instructor to provide continuing education to EMTs. It is important to seek guidance from the EMS Division in this process. In order for people to use the system, they must be informed of what it does and the reasons for its existence. This can be accomplished by stressing the EMS system’s goals and accomplishments through efficient media relations. The various media channels can be EMS’ greatest ally if properly utilized and nurtured. In some cases the EMS system will be operated directly by the Trustees rather than through a contractual arrangement for services. In this instance, the EMS director also should become the personnel director responsible for selecting and hiring personnel, scheduling shifts and personnel grievances. He should have authority from the Board to deal with day-to-day personnel matters. This should include hiring and dismissal of employees coupled with an appeal mechanism before the full Board available to employees who feel they have been unjustly treated. There are other duties and functions which will come within the purview of the EMS director, but those mentioned above are considered most important. The EMS director should be the coordinator of EMS resources, an innovator of workable solutions to problems, and a capable administrator or business manager. The utilization of a qualified EMS director will enhance the success of any EMS district, and lessen the burdens on the Trustees. DUTIES OF THE EMS SHIFT SUPERVISOR OR STATION SUPERVISOR The duties of the station or shift supervisor will vary according to the numbers of vehicles and stations, whether volunteer or paid. Nevertheless, the supervisor should be the person designated as responsible for both the station and personnel on a given shift. This person is directly responsible to the EMS director, and should have the following supervisory responsibilities: 1) Assure station routine is completed during the shift according to department policy, such as daily vehicle and equipment checks; vehicle, equipment and station cleaning, etc. 2) Schedule and present informal in-service training of EMTs assigned to shift. 3) Maintain supply and accountability of all necessary cleaning supplies, oxygen, medical supplies, etc., for the operation of the station and ambulances. 4) Be responsible for on-the-job orientation of new shift employees. 5) Assist the director in presenting public relations programs regarding the EMS system to civic groups and to other interested citizens. 6) Review ambulance run reports and other data reports for accuracy prior to submission to the director and medical director. 7) Attend EMS meetings as deemed necessary by the director. 8) Insure all policies and procedures of the director and the Board are followed during the shift. 9) Attend staff (supervisory) meetings as scheduled by the director. 10) The supervisor must not secure additional employment or pursue other activities which would preclude his ability to be available at all times without permission of the director and approval of the Board. These individuals should work in close contact with the director in the overall operation of the service. They may receive special assignments such as special research projects, revision of policies, meetings, committees and other such activities. Any problems regarding job duties should be brought to the director. RESPONSIBILITIES OF THE ADMINISTRATOR WHERE HE/SHE IS AN EMPLOYEE OF THE DISTRICT OR AUTHORITY I. Maintain such financial records as are necessary to substantiate actual costs of service. II. Prepare and submit invoices on monthly basis. III. Prepare and submit invoices for third party reimbursements. IV. Accomplish actions according to Board policy to assure maximum collection of accounts. V. Coordinate an effective public information program. VI. Maintain records on service utilization. VII.Maintain close working relationships with contractor to assure that the provisions of the contract and EMS laws and rules are met. RESPONSIBILITIES OF ADMINISTRATOR WHERE COUNTY OR AUTHORITY PROVIDES THE SERVICE I. To submit to the Board a plan of organization of personnel. II. To prepare an annual budget showing the expected receipts and expenditures. III. To oversee all physical properties and equipment, keeping in operating condition and good repair. IV. To supervise all business affairs such as records of financial transactions, collections, purchase and issue of supplies. V. To ensure that all funds are collected and expended as directed by the Board. VI. To submit, at each regular meeting, the financial records which must be approved by the Board. VII.To attend all meetings of the Board. VIII.To recommend to the Board personnel decisions. IX. To coordinate a public relations program. X. To perform other duties as may be necessary to maintain quality provision of EMS. XI. Ensure service is in compliance with EMS laws and rules. CHOCTAW COUNTY E.M.S. AUTHORITY POSITION DESCRIPTION – MANAGER In order to fulfill the duties and responsibilities of the Choctaw County E.M.S. Authority it is necessary that a full-time manager be employed. The person employed should be trained as an Emergency Medical Technician and have an office at the Choctaw County Courthouse with necessary clerical services provided by staff at the Courthouse. Ancillary expenses for postage, limited travel, and other necessary materials or activities would be paid for by funds accrued from the three-mill ad valorem tax assessment or invoices for services. Specifically, the responsibilities of the manager would be: 1. Maintain such financial records as are necessary to substantiate actual costs of service to Choctaw County. 2. Prepare and submit invoices to users of the ambulance service on a monthly basis. 3. Prepare and submit invoices for service to Medicare, Medicaid, and other third-party reimbursers where appropriate. 4. Accomplish actions necessary to assure maximum collection of invoices due for services including personal contact with debtors and where appropriate, file actions in small claims court to collect debts. 5. Assist in the transport of patients when necessary to compliment the availability of existing personnel. 6. Coordinate an effective public information and education program to both general and specific publics (i.e. medical and governmental) on the activities, goals and objectives of the Choctaw County E.M.S. System. 7. Maintain other such records on service utilization and effectiveness to provide necessary data for continuing evaluation of the service, thus assuring quality control. 8. Maintain close working relationships with the Fire Chief, Hugo Fire Department to assure that the provisions of the contract between the Choctaw County E.M.S. Authority and the Hugo Fire Department are met. 9. Coordinate with regional and State authorities for the provision of training for Emergency Medical Technicians, other ancillary medical personnel, physicians, and the general public from existing training resources at the regional and State levels. 10. Perform such other administrative duties as may be required by the Authority to assure the provision of quality emergency medical care and transportation services to the citizens of Choctaw County. DIRECTOR/MANAGER/ADMINISTRATOR DUTIES a. Carry out assigned duties in response to policy directions of the District Board. b. Prepare and submit to the Governing Board for approval a plan of organization of the personnel and others connected with the operation of the EMS. c. Prepare an annual budget showing the expected receipts and expenditures of the District. d. Select, employ, direct and discharge all employees authorized by the Governing Board. e. Appoint or designate such committees or subcommittees of the Board as the Board considers necessary. f. See that all physical properties and equipment are kept in a good state of repair and operating condition. g. Supervise business contracts and related matters, affairs, such as records of financial transactions and collection of accounts. Insure that all funds are collected and expended to the best possible advantage. h. Submit at each regular meeting reports showing the Professional Services, the Financial Activities of EMS and to prepare and submit such special reports as may be required by the Governing Board. i. Attend all meetings of the Governing Board. j. Serve as liaison officer and channel of communication between the Governing Board of the District and other medical and emergency service providers. k. Develop and coordinate a continuing public information program. l. Provide for and schedule training and continuing education for all emergency medical services personnel. m. Establish a system for the acquisition, control, issue, and accounting of supplies and equipment for use within the district. n. Perform such other duties and carry out other responsibilities as required to provide a quality level of service to all users. o. Develop Standard Operating Procedures guiding the day to day operations of the District. p. Develop and submit to the Governing Board for approval operating guidelines and criteria to be met in the functioning of the District. U. S. Department of Labor – Wage and Salary Division Application of Fair Labor Standards Act to Employees of State and Local Governments Title 29 §553 e-CFR Data is current as of December 14, 2009 Title 29: Labor PART 553—APPLICATION OF THE FAIR LABOR STANDARDS ACT TO EMPLOYEES OF STATE AND LOCAL GOVERNMENTS Subpart A—General Introduction § 553.1 Definitions. (a) Act or FLSA means the Fair Labor Standards Act of 1938, as amended (52 Stat. 1060, as amended; 29 U.S.C. 201–219). (b) 1985 Amendments means the Fair Labor Standards Amendments of 1985 (Pub. L. 99–150). (c) Public agency means a State, a political subdivision of a State or an interstate governmental agency. (d) State means a State of the United States, the District of Columbia, Puerto Rico, the Virgin Islands, or any other Territory or possession of the United States (29 U.S.C. 203(c) and 213(f)). § 553.2 Purpose and scope. (a) The 1985 Amendments to the Fair Labor Standards Act (FLSA) changed certain provisions of the Act as they apply to employees of State and local public agencies. The purpose of part 553 is to set forth the regulations to carry out the provisions of these Amendments, as well as other FLSA provisions previously in existence relating to such public agency employees. (b) The regulations in this part are divided into three subparts. Subpart A interprets and applies the special FLSA provisions that are generally applicable to all covered and nonexempt employees of State and local governments. Subpart A also contains provisions concerning certain individuals ( i.e., elected officials, their appointees, and legislative branch employees) who are excluded from the definition of “employee” and thus from FLSA coverage. This subpart also interprets and applies sections 7(o), and 7(p)(2), 7(p)(3), and 11(c) of the Act regarding compensatory time off, occasional or sporadic part-time employment, and the performance of substitute work by public agency employees, respectively. (c) Subpart B of this part deals with “volunteer” services performed by individuals for public agencies. Subpart C applies various FLSA provisions as they relate to fire protection and law enforcement employees of public agencies. § 553.3 Coverage—general. (a)(1) In 1966, Congress amended the FLSA to extend coverage to State and local government employees engaged in the operation of hospitals, nursing homes, schools, and mass transit systems. (2) In 1972, the Education Amendments further extended coverage to employees of public preschools. (3) In 1974, the FLSA Amendments extended coverage to virtually all of the remaining State and local government employees who were not covered as a result of the 1966 and 1972 legislation. (b) Certain definitions already in the Act were modified by the 1974 Amendments. The definition of the term “employer” was changed to include public agencies and that of “employee” was amended to include individuals employed by public agencies. The definition of “enterprise” contained in section 3(r) of the Act was modified to provide that activities of a public agency are performed for a “business purpose.” The term “enterprise engaged in commerce or in the production of goods for commerce” defined in section 3(s) of the Act was expanded to include public agencies. Section 3(e)(2)(C)—Exclusions § 553.10 General. Section 3(e)(2)(C) of the Act excludes from the definition of “employee”, and thus from coverage, certain individuals employed by public agencies. This exclusion applies to elected public officials, their immediate advisors, and certain individuals whom they appoint or select to serve in various capacities. In addition, the 1985 Amendments exclude employees of legislative branches of State and local governments. A condition for exclusion is that the employee must not be subject to the civil service laws of the employing State or local agency. § 553.11 Exclusion for elected officials and their appointees. (a) Section 3(e)(2)(C) provides an exclusion from the Act's coverage for officials elected by the voters of their jurisdictions. Also excluded under this provision are personal staff members and officials in policymaking positions who are selected or appointed by the elected public officials and certain advisers to such officials. (b) The statutory term “member of personal staff” generally includes only persons who are under the direct supervision of the selecting elected official and have regular contact with such official. The term typically does not include individuals who are directly supervised by someone other than the elected official even though they may have been selected by the official. For example, the term might include the elected official's personal secretary, but would not include the secretary to an assistant. (c) In order to qualify as personal staff members or officials in policymaking positions, the individuals in question must not be subject to the civil service laws of their employing agencies. The term “civil service laws” refers to a personnel system established by law which is designed to protect employees from arbitrary action, personal favoritism, and political coercion, and which uses a competitive or merit examination process for selection and placement. Continued tenure of employment of employees under civil service, except for cause, is provided. In addition, such personal staff members must be appointed by, and serve solely at the pleasure or discretion of, the elected official. (d) The exclusion for “immediate adviser” to elected officials is limited to staff who serve as advisers on constitutional or legal matters, and who are not subject to the civil service rules of their employing agency. § 553.12 Exclusion for employees of legislative branches. (a) Section 3(e)(2)(C) of the Act provides an exclusion from the definition of the term “employee” for individuals who are not subject to the civil service laws of their employing agencies and are employed by legislative branches or bodies of States, their political subdivisions or interstate governmental agencies. (b) Employees of State or local legislative libraries do not come within this statutory exclusion. Also, employees of school boards, other than elected officials and their appointees (as discussed in §553.11), do not come within this exclusion. Section 7(o)—Compensatory Time and Compensatory Time Off § 553.20 Introduction. Section 7 of the FLSA requires that covered, nonexempt employees receive not less than one and one-half times their regular rates of pay for hours worked in excess of the applicable maximum hours standards. However, section 7(o) of the Act provides an element of flexibility to State and local government employers and an element of choice to their employees or the representatives of their employees regarding compensation for statutory overtime hours. The exemption provided by this subsection authorizes a public agency which is a State, a political subdivision of a State, or an interstate governmental agency, to provide compensatory time off (with certain limitations, as provided in §553.21) in lieu of monetary overtime compensation that would otherwise be required under section 7. Compensatory time received by an employee in lieu of cash must be at the rate of not less than one and one-half hours of compensatory time for each hour of overtime work, just as the monetary rate for overtime is calculated at the rate of not less than one and one-half times the regular rate of pay. § 553.21 Statutory provisions. Section 7(o) provides as follows: (o)(1) Employees of a public agency which is a State, a political subdivision of a State, or an interstate governmental agency may receive, in accordance with this subsection and in lieu of overtime compensation, compensatory time off at a rate not less than one and one-half hours for each hour of employment for which overtime compensation is required by this section. (2) A public agency may provide compensatory time under paragraph (1) only— (A) Pursuant to— (i) Applicable provisions of a collective bargaining agreement, memorandum of understanding, or any other agreement between the public agency and representatives of such employees; or (ii) In the case of employees not covered by subclause (i), an agreement or understanding arrived at between the employer and employee before the performance of the work; and (B) If the employee has not accrued compensatory time in excess of the limit applicable to the employee prescribed by paragraph (3). In the case of employees described in clause (A)(ii) hired prior to April 15, 1986, the regular practice in effect on April 15, 1986, with respect to compensatory time off for such employees in lieu of the receipt of overtime compensation, shall constitute an agreement or understanding under such clause (A)(ii). Except as provided in the previous sentence, the provision of compensatory time off to such employees for hours worked after April 14, 1986, shall be in accordance with this subsection. (3)(A) If the work of an employee for which compensatory time may be provided included work in a public safety activity, an emergency response activity, or a seasonal activity, the employee engaged in such work may accrue not more than 480 hours of compensatory time for hours worked after April 15, 1986. If such work was any other work, the employee engaged in such work may accrue not more than 240 hours of compensatory time for hours worked after April 15, 1986. Any such employee who, after April 15, 1986, has accrued 480 or 240 hours, as the case may be, of compensatory time off shall, for additional overtime hours of work, be paid overtime compensation. (B) If compensation is paid to an employee for accrued compensatory time off, such compensation shall be paid at the regular rate earned by the employee at the time the employee receives such payment. (4) An employee who has accrued compensatory time off authorized to be provided under paragraph (1) shall, upon termination of employment, be paid for the unused compensatory time at a rate of compensation not less than— (A) The average regular rate received by such employee during the last 3 years of the employee's employment, or (B) The final regular rate received by such employee, whichever is higher. (5) An employee of a public agency which is a State, political subdivision of a State, or an interstate governmental agency— (A) Who has accrued compensatory time off authorized to be provided under paragraph (1), and (B) Who has requested the use of such compensatory time, shall be permitted by the employee's employer to use such time within a reasonable period after making the request if the use of the compensatory time does not unduly disrupt the operations of the public agency. (6) For purposes of this subsection— (A) The term overtime compensation means the compensation required by subsection (a), and (B) The terms compensatory time and compensatory time off means hours during which an employee is not working, which are not counted as hours worked during the applicable workweek or other work period for purposes of overtime compensation, and for which the employee is compensated at the employee's regular rate. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.22 FLSA compensatory time” and “FLSA compensatory time off”. (a) Compensatory time and compensatory time off are interchangeable terms under the FLSA. Compensatory time off is paid time off the job which is earned and accrued by an employee in lieu of immediate cash payment for employment in excess of the statutory hours for which overtime compensation is required by section 7 of the FLSA. (b) The Act requires that compensatory time under section 7(o) be earned at a rate not less than one and one-half hours for each hour of employment for which overtime compensation is required by section 7 of the FLSA. Thus, the 480-hour limit on accrued compensatory time represents not more than 320 hours of actual overtime worked, and the 240-hour limit represents not more than 160 hours of actual overtime worked. (c) The 480- and 240-hour limits on accrued compensatory time only apply to overtime hours worked after April 15, 1986. Compensatory time which an employee has accrued prior to April 15, 1986, is not subject to the overtime requirements of the FLSA and need not be aggregated with compensatory time accrued after that date. § 553.23 Agreement or understanding prior to performance of work. (a) General. (1) As a condition for use of compensatory time in lieu of overtime payment in cash, section 7(o)(2)(A) of the Act requires an agreement or understanding reached prior to the performance of work. This can be accomplished pursuant to a collective bargaining agreement, a memorandum of understanding or any other agreement between the public agency and representatives of the employees. If the employees do not have a representative, compensatory time may be used in lieu of cash overtime compensation only if such an agreement or understanding has been arrived at between the public agency and the individual employee before the performance of work. No agreement or understanding is required with respect to employees hired prior to April 15, 1986, who do not have a representative, if the employer had a regular practice in effect on April 15, 1986, of granting compensatory time off in lieu of overtime pay. (2) Agreements or understandings may provide that compensatory time off in lieu of overtime payment in cash may be restricted to certain hours of work only. In addition, agreements or understandings may provide for any combination of compensatory time off and overtime payment in cash (e.g., one hour compensatory time credit plus one-half the employee's regular hourly rate of pay in cash for each hour of overtime worked) so long as the premium pay principle of at least “time and one-half” is maintained. The agreement or understanding may include other provisions governing the preservation, use, or cashing out of compensatory time so long as these provisions are consistent with section 7(o) of the Act. To the extent that any provision of an agreement or understanding is in violation of section 7(o) of the Act, the provision is superseded by the requirements of section 7(o). (b) Agreement or understanding between the public agency and a representative of the employees. (1) Where employees have a representative, the agreement or understanding concerning the use of compensatory time must be between the representative and the public agency either through a collective bargaining agreement or through a memorandum of understanding or other type of oral or written agreement. In the absence of a collective bargaining agreement applicable to the employees, the representative need not be a formal or recognized bargaining agent as long as the representative is designated by the employees. Any agreement must be consistent with the provisions of section 7(o) of the Act. (2) Section 2(b) of the 1985 Amendments provides that a collective bargaining agreement in effect on April 15, 1986, which permits compensatory time off in lieu of overtime compensation, will remain in effect until the expiration date of the collective bargaining agreement unless otherwise modified. However, the terms and conditions of such agreement under which compensatory time off is provided after April 14, 1986, must not violate the requirements of section 7(o) of the Act and these regulations. (c) Agreement or understanding between the public agency and individual employees. (1) Where employees of a public agency do not have a recognized or otherwise designated representative, the agreement or understanding concerning compensatory time off must be between the public agency and the individual employee and must be reached prior to the performance of work. This agreement or understanding with individual employees need not be in writing, but a record of its existence must be kept. (See §553.50.) An employer need not adopt the same agreement or understanding with different employees and need not provide compensatory time to all employees. The agreement or understanding to provide compensatory time off in lieu of cash overtime compensation may take the form of an express condition of employment, provided (i) the employee knowingly and voluntarily agrees to it as a condition of employment and (ii) the employee is informed that the compensatory time received may be preserved, used or cashed out consistent with the provisions of section 7(o) of the Act. An agreement or understanding may be evidenced by a notice to the employee that compensatory time off will be given in lieu of overtime pay. In such a case, an agreement or understanding would be presumed to exist for purposes of section 7(o) with respect to any employee who fails to express to the employer an unwillingness to accept compensatory time off in lieu of overtime pay. However, the employee's decision to accept compensatory time off in lieu of cash overtime payments must be made freely and without coercion or pressure. (2) Section 2(a) of the 1985 Amendments provides that in the case of employees who have no representative and were employed prior to April 15, 1986, a public agency that has had a regular practice of awarding compensatory time off in lieu of overtime pay is deemed to have reached an agreement or understanding with these employees as of April 15, 1986. A public agency need not secure an agreement or understanding with each employee employed prior to that date. If, however, such a regular practice does not conform to the provisions of section 7(o) of the Act, it must be modified to do so with regard to practices after April 14, 1986. With respect to employees hired after April 14, 1986, the public employer who elects to use compensatory time must follow the guidelines on agreements discussed in paragraph (c)(1) of this section. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.24 Public safety”, “emergency response”, and “seasonal” activities. (a) Section 7(o)(3)(A) of the FLSA provides that an employee of a public agency which is a State, a political subdivision of a State, or an interstate governmental agency, may accumulate not more than 480 hours of compensatory time for FLSA overtime hours which are worked after April 15, 1986, if the employee is engaged in “public safety”, “emergency response”, or “seasonal” activity. Employees whose work includes “seasonal”, “emergency response”, or “public safety” activities, as well as other work, will not be subject to both limits of accrual for compensatory time. If the employee's work regularly involves the activities included in the 480-hour limit, the employee will be covered by that limit. A public agency cannot utilize the higher cap by simple classification or designation of an employee. The work performed is controlling. Assignment of occasional duties within the scope of the higher cap will not entitle the employer to use the higher cap. Employees whose work does not regularly involve “seasonal”, “emergency response”, or “public safety” activities are subject to a 240-hour compensatory time accrual limit for FLSA overtime hours which are worked after April 15, 1986. (b) Employees engaged in “public safety”, “emergency response”, or “seasonal” activities, who transfer to positions subject to the 240-hour limit, may carry over to the new position any accrued compensatory time. The employer will not be required to cash out the accrued compensatory time which is in excess of the lower limit. However, the employee must be compensated in cash wages for any subsequent overtime hours worked until the number of accrued hours of compensatory time falls below the 240-hour limit. (c) “Public safety activities”: The term “public safety activities” as used in section 7(o)(3)(A) of the Act includes law enforcement, fire fighting or related activities as described in §§553.210 (a) and (b) and 553.211 (a)–(c), and (f). An employee whose work regularly involves such activities will qualify for the 480-hour accrual limit. However, the 480- hour accrual limit will not apply to office personnel or other civilian employees who may perform public safety activities only in emergency situations, even if they spend substantially all of their time in a particular week in such activities. For example, a maintenance worker employed by a public agency who is called upon to perform fire fighting activities during an emergency would remain subject to the 240-hour limit, even if such employee spent an entire week or several weeks in a year performing public safety activities. Certain employees who work in “public safety” activities for purposes of section 7(o)(3)(A) may qualify for the partial overtime exemption in section 7(k) of the Act. (See §553.201) (d) “Emergency response activity”: The term “emergency response activity” as used in section 7(o)(3)(A) of the Act includes dispatching of emergency vehicles and personnel, rescue work and ambulance services. As is the case with “public safety” and “seasonal” activities, an employee must regularly engage in “emergency response” activities to be covered under the 480-hour limit. A city office worker who may be called upon to perform rescue work in the event of a flood or snowstorm would not be covered under the higher limit, since such emergency response activities are not a regular part of the employee's job. Certain employees who work in “emergency response” activities for purposes of section 7(o)(3)(A) may qualify for the partial overtime exemption in section 7(k) of the Act. (See §553.215.) (e)(1) “Seasonal activity”: The term “seasonal activity” includes work during periods of significantly increased demand, which are of a regular and recurring nature. In determining whether employees are considered engaged in a seasonal activity, the first consideration is whether the activity in which they are engaged is a regular and recurring aspect of the employee's work. The second consideration is whether the projected overtime hours during the period of significantly increased demand are likely to result in the accumulation during such period of more than 240 compensatory time hours (the number available under the lower cap). Such projections will normally be based on the employer's past experience with similar employment situations. (2) Seasonal activity is not limited strictly to those operations that are very susceptible to changes in the weather. As an example, employees processing tax returns over an extended period of significantly increased demand whose overtime hours could be expected to result in the accumulation during such period of more than 240 compensatory time hours will typically qualify as engaged in a seasonal activity. (3) While parks and recreation activity is primarily seasonal because peak demand is generally experienced in fair weather, mere periods of short but intense activity do not make an employee's job seasonal. For example, clerical employees working increased hours for several weeks on a special project or assigned to an afternoon of shoveling snow off the courthouse steps would not be considered engaged in seasonal activities, since the increased activity would not result in the accumulation during such period of more than 240 compensatory time hours. Further, persons employed in municipal auditoriums, theaters, and sports facilities that are open for specific, limited seasons would be considered engaged in seasonal activities, while those employed in facilities that operate year round generally would not. (4) Road crews, while not necessarily seasonal workers, may have significant periods of peak demand, for instance during the snow plowing season or road construction season. The snow plow operator/road crew employee may be able to accrue compensatory time to the higher cap, while other employees of the same department who do not have lengthy periods of peak seasonal demand would remain under the lower cap. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.25 Conditions for use of compensatory time (“reasonable period”, “unduly disrupt”). (a) Section 7(o)(5) of the FLSA provides that any employee of a public agency who has accrued compensatory time and requested use of this compensatory time, shall be permitted to use such time off within a “reasonable period” after making the request, if such use does not “unduly disrupt” the operations of the agency. This provision, however, does not apply to “other compensatory time” (as defined below in §553.28), including compensatory time accrued for overtime worked prior to April 15, 1986. (b) Compensatory time cannot be used as a means to avoid statutory overtime compensation. An employee has the right to use compensatory time earned and must not be coerced to accept more compensatory time than an employer can realistically and in good faith expect to be able to grant within a reasonable period of his or her making a request for use of such time. (c) Reasonable period. (1) Whether a request to use compensatory time has been granted within a “reasonable period” will be determined by considering the customary work practices within the agency based on the facts and circumstances in each case. Such practices include, but are not limited to (a) the normal schedule of work, (b) anticipated peak workloads based on past experience, (c) emergency requirements for staff and services, and (d) the availability of qualified substitute staff. (2) The use of compensatory time in lieu of cash payment for overtime must be pursuant to some form of agreement or understanding between the employer and the employee (or the representative of the employee) reached prior to the performance of the work. (See §553.23.) To the extent that the (conditions under which an employee can take compensatory time off are contained in an agreement or understanding as defined in §553.23, the terms of such agreement or understanding will govern the meaning of “reasonable period”. (d) Unduly disrupt. When an employer receives a request for compensatory time off, it shall be honored unless to do so would be “unduly disruptive” to the agency's operations. Mere inconvenience to the employer is an insufficient basis for denial of a request for compensatory time off. (See H. Rep. 99–331, p. 23.) For an agency to turn down a request from an employee for compensatory time off requires that it should reasonably and in good faith anticipate that it would impose an unreasonable burden on the agency's ability to provide services of acceptable quality and quantity for the public during the time requested without the use of the employee's services. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.26 Cash overtime payments. (a) Overtime compensation due under section 7 may be paid in cash at the employer's option, in lieu of providing compensatory time off under section 7(o) of the Act in any workweek or work period. The FLSA does not prohibit an employer from freely substituting cash, in whole or part, for compensatory time off; and overtime payment in cash would not affect subsequent granting of compensatory time off in future workweeks or work periods. (See §553.23(a)(2).) (b) The principles for computing cash overtime pay are contained in 29 CFR part 778. Cash overtime compensation must be paid at a rate not less than one and one-half times the regular rate at which the employee is actually paid. (See 29 CFR 778.107.) (c) In a workweek or work period during which an employee works hours which are overtime hours under FLSA and for which cash overtime payment will be made, and the employee also takes compensatory time off, the payment for such time off may be excluded from the regular rate of pay under section 7(e)(2) of the Act. Section 7(e)(2) provides that the regular rate shall not be deemed to include . . . payments made for occasional periods when no work is performed due to vacation, holiday, . . . or other similar cause. As explained in 29 CFR 778.218(d), the term “other similar cause” refers to payments made for periods of absence due to factors like holidays, vacations, illness, and so forth. Payments made to an employee for periods of absence due to the use of accrued compensatory time are considered to be the type of payments in this “other similar cause” category. § 553.27 Payments for unused compensatory time. (a) Payments for accrued compensatory time earned after April 14, 1986, may be made at any time and shall be paid at the regular rate earned by the employee at the time the employee receives such payment. (b) Upon termination of employment, an employee shall be paid for unused compensatory time earned after April 14, 1986, at a rate of compensation not less than— (1) The average regular rate received by such employee during the last 3 years of the employee's employment, or (2) The final regular rate received by such employee, whichever is higher. (c) The phrase last 3 years of employment means the 3-year period immediately prior to termination. Where an employee's last 3 years of employment are not continuous because of a break in service, the period of employment after the break in service will be treated as new employment. However, such a break in service must have been intended to be permanent and any accrued compensatory time earned after April 14, 1986, must have been cashed out at the time of initial separation. Where the final period of employment is less than 3 years, the average rate still must be calculated based on the rate(s) in effect during such period. (d) The term “regular rate” is defined in 29 CFR 778.108. As indicated in §778.109, the regular rate is an hourly rate, although the FLSA does not require employers to compensate employees on an hourly basis. [52 FR 2032, Jan. 16, 1987; 52 FR 2648, Jan. 23, 1987] § 553.28 Other compensatory time. (a) Compensatory time which is earned and accrued by an employee for employment in excess of a nonstatutory (that is, non-FLSA) requirement is considered “other” compensatory time. The term “other” compensatory time off means hours during which an employee is not working and which are not counted as hours worked during the period when used. For example, a collective bargaining agreement may provide that compensatory time be granted to employees for hours worked in excess of 8 in a day, or for working on a scheduled day off in a nonovertime workweek. The FLSA does not require compensatory time to be granted in such situations. (b) Compensatory time which is earned and accrued by an employee working hours which are “overtime” hours under State or local law, ordinance, or other provisions, but which are not overtime hours under section 7 of the FLSA is also considered “other” compensatory time. For example, a local law or ordinance may provide that compensatory time be granted to employees for hours worked in excess of 35 in a workweek. Under section 7(a) of the FLSA, only hours worked in excess of 40 in a workweek are overtime hours which must be compensated at one and one-half times the regular rate of pay. (c) Similarly, compensatory time earned or accrued by an employee for employment in excess of a standard established by the personnel policy or practice of an employer, or by custom, which does not result from the FLSA provision, is another example of “other” compensatory time. (d) The FLSA does not require that the rate at which “other” compensatory time is earned has to be at a rate of one and one-half hours for each hour of employment. The rate at which “other” compensatory time is earned may be some lesser or greater multiple of the rate or the straight-time rate itself. (e) The requirements of section 7(o) of the FLSA, including the limitations on accrued compensatory time, do not apply to “other” compensatory time as described above. Other Exemptions § 553.30 Occasional or sporadic employment-section 7(p)(2). (a) Section 7(p)(2) of the FLSA provides that where State or local government employees, solely at their option, work occasionally or sporadically on a part-time basis for the same public agency in a different capacity from their regular employment, the hours worked in the different jobs shall not be combined for the purpose of determining overtime liability under the Act. (b) Occasional or sporadic. (1) The term occasional or sporadic means infrequent, irregular, or occurring in scattered instances. There may be an occasional need for additional resources in the delivery of certain types of public services which is at times best met by the part-time employment of an individual who is already a public employee. Where employees freely and solely at their own option enter into such activity, the total hours worked will not be combined for purposes of determining any overtime compensation due on the regular, primary job. However, in order to prevent overtime abuse, such hours worked are to be excluded from computing overtime compensation due only where the occasional or sporadic assignments are not within the same general occupational category as the employee's regular work. (2) In order for an employee's occasional or sporadic work on a part-time basis to qualify for exemption under section 7(p)(2), the employee's decision to work in a different capacity must be made freely and without coercion, implicit or explicit, by the employer. An employer may suggest that an employee undertake another kind of work for the same unit of government when the need for assistance arises, but the employee must be free to refuse to perform such work without sanction and without being required to explain or justify the decision. (3) Typically, public recreation and park facilities, and stadiums or auditoriums utilize employees in occasional or sporadic work. Some of these employment activities are the taking of tickets, providing security for special events ( e.g., concerts, sports events, and lectures), officiating at youth or other recreation and sports events, or engaging in food or beverage sales at special events, such as a county fair. Employment in such activity may be considered occasional or sporadic for regular employees of State or local government agencies even where the need can be anticipated because it recurs seasonally ( e.g., a holiday concert at a city college, a program of scheduled sports events, or assistance by a city payroll clerk in processing returns at tax filing time). An activity does not fail to be occasional merely because it is recurring. In contrast, for example, if a parks department clerk, in addition to his or her regular job, also regularly works additional hours on a part-time basis ( e.g., every week or every other week) at a public park food and beverage sales center operated by that agency, the additional work does not constitute intermittent and irregular employment and, therefore, the hours worked would be combined in computing any overtime compensation due. (c) Different capacity. (1) In order for employment in these occasional or sporadic activities not to be considered subject to the overtime requirements of section 7 of the FLSA, the regular government employment of the individual performing them must also be in a different capacity, i.e., it must not fall within the same general occupational category. (2) In general, the Administrator will consider the duties and other factors contained in the definitions of the 3-digit categories of occupations in the Dictionary of Occupational Titles (except in the case of public safety employees as discussed below in section (3)), as well as all the facts and circumstances in a particular case, in determining whether employment in a second capacity is substantially different from the regular employment. (3) For example, if a public park employee primarily engaged in playground maintenance also from time to time cleans an evening recreation center operated by the same agency, the additional work would be considered hours worked for the same employer and subject to the Act's overtime requirements because it is not in a different capacity. This would be the case even though the work was occasional or sporadic, and, was not regularly scheduled. Public safety employees taking on any kind of security or safety function within the same local government are never considered to be employed in a different capacity . (4) However, if a bookkeeper for a municipal park agency or a city mail clerk occasionally referees for an adult evening basketball league sponsored by the city, the hours worked as a referee would be considered to be in a different general occupational category than the primary employment and would not be counted as hours worked for overtime purposes on the regular job. A person regularly employed as a bus driver may assist in crowd control, for example, at an event such as a winter festival, and in doing so, would be deemed to be serving in a different capacity. (5) In addition, any activity traditionally associated with teaching (e.g., coaching, career counseling, etc.) will not be considered as employment in a different capacity. However, where personnel other than teachers engage in such teaching-related activities, the work will be viewed as employment in a different capacity, provided that these activities are performed on an occasional or sporadic basis and all other requirements for this provision are met. For example, a school secretary could substitute as a coach for a basketball team or a maintenance engineer could provide instruction on auto repair on an occasional or sporadic basis. § 553.31 Substitution—section 7(p)(3). (a) Section 7(p)(3) of the FLSA provides that two individuals employed in any occupation by the same public agency may agree, solely at their option and with the approval of the public agency, to substitute for one another during scheduled work hours in performance of work in the same capacity. The hours worked shall be excluded by the employer in the calculation of the hours for which the substituting employee would otherwise be entitled to overtime compensation under the Act. Where one employee substitutes for another, each employee will be credited as if he or she had worked his or her normal work schedule for that shift. (b) The provisions of section 7(p)(3) apply only if employees' decisions to substitute for one another are made freely and without coercion, direct or implied. An employer may suggest that an employee substitute or “trade time” with another employee working in the same capacity during regularly scheduled hours, but each employee must be free to refuse to perform such work without sanction and without being required to explain or justify the decision. An employee's decision to substitute will be considered to have been made at his/her sole option when it has been made (i) without fear of reprisal or promise of reward by the employer, and (ii) exclusively for the employee's own convenience. (c) A public agency which employs individuals who substitute or “trade time” under this subsection is not required to keep a record of the hours of the substitute work. (d) In order to qualify under section 7(p)(3), an agreement between individuals employed by a public agency to substitute for one another at their own option must be approved by the agency. This requires that the agency be aware of the arrangement prior to the work being done, i.e., the employer must know what work is being done, by whom it is being done, and where and when it is being done. Approval is manifest when the employer is aware of the substitution and indicates approval in whatever manner is customary. § 553.32 Other FLSA exemptions. (a) There are other exemptions from the minimum wage and/or overtime requirements of the FLSA which may apply to certain employees of public agencies. The following sections provide a discussion of some of the major exemptions which may be applicable. This list is not comprehensive. (b) Section 7(k) of the Act provides a partial overtime pay exemption for public agency employees employed in fire protection or law enforcement activities (including security personnel in correctional institutions). In addition, section 13(b)(20) provides a complete overtime pay exemption for any employee of a public agency engaged in fire protection or law enforcement activities, if the public agency employs less than five employees in such activities. (See subpart C of this part.) (c) Section 13(a)(1) of the Act provides an exemption from both the minimum wage and overtime pay requirements for any employee employed in a bona fide executive, administrative, professional, or outside sales capacity, as these terms are defined and delimited in part 541 of this title. An |
Date created | 2011-12-13 |
Date modified | 2011-12-13 |