Sumner County Emergency Medical Services

Standard Operations Policy/ Procedure Manual

, Issue Date: 2;14'2007

Welcome to the Employee Handbook

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Page Left B lank on Purpose

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Employee Acknowledgement Form

The employee handbook describes important infonnation about SeEMS and I understand that I should consult the Operations Manager regarding any questions not answered in the handbook.

I have entered into my employment relationship \vith SeEMS voluntarily and ackno\dedge that there is no specified length of employment. Accordingly, either SeEMS or I may terminate the employment relationship at will at any time, with or without cause, so long as there is no violation of applicable federal or state law.

Since the information, policies, and benefits desclibed in the handbook are subject to change as needed, I acknowledge that revisions to the handbook may occur, except to the employmenl-atwill policy of seEMS. All such changes will be communicated through official notices, and I understand that revised information may supersede, modify, or eliminate existing policies. I also understand that only the chief executive officers of seEMS have the ability to adopt revisions to the policies in this handbook.

Furthermore, I acknowledge that this handbook is neither a contract of employment nor a legal document. I have received the handbook, and I understand that it is my responsibility to read and comply with the policies contained in this handbook and any revisions made to it.

EMPLOYEE'S NAME (printed): ____________"_______

EMPLOYEE'S SIGNATURE: ____________________

DATE: ________________

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, Welcome to Sumner County Emergency Medical Services

On behalf of your colleagues, we welcome you and wish you e\'ery success here.

We believe that each employee contributes directly to our growth and success, and we hope you will take pride in being a member of our team.

This handbook outlines the policies, programs, and benefits available to eligible employees. It was also developed to describe some of the expectations we have of our employees. The employee handbook will answer many questions about employment with SCEyfS so I suggest that you familiarize yourself with the contents of the employee handbook as soon as possible

We hope that your experience here will be challenging, enjoyable, and re\varding. Again, welcome!

Sincerely,

Sumner County EMS Management

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, Preface Page The Policy and Procedure Manual has been written and distributed to each employee to enable our

Seryice to accomplish its strategic mission: high quality patient care to the residents and visitors of Sunmer County, Tennessee.

This handbook is designed to acquaint you with SCElI-IS and prodde you with infonnation about working conditions, employee benefits, and some of the policies affecting your employment. You should read, understand, and comply with all provisions of the handbook. The handbook describes many of your responsibilities as an employee and outlines the programs we have developed to benefit our employees. One of our objectives at SeEMS is to provide a work environment that is conducive to both personal and professional growth. This is a departmental policy and procedure manual. The County's policy and procedure manual will supersede any departmental policy if a contradiction should occur.

There are many standards and practices that must be carried out by our employees on a daily basis to ensure that the organization is successful. This document is an effort to conununicate to our employees the various policies and procedures, which will help ensure our success.

, By the very nature of our business, it is difficult to foresee all of the variable situations and

circumstances that may be encountered in our normal day to day operations. To develop a specific policies and procedures to address each situation that could be encountered would be difficult if not impossible. Therefore this manual will serve as a guideline for our employees; common sense should always be utilized in areas not specifically covered in this manual. Areas that are covered in this manual will be expected to be followed, and if deviated from without justifiable cause, can result in disciplinary action being taken against the transgressing party.

This manual cannot be construed as a17 emplovment contract. As an employee, you may terminate your employee-employer relationship at any time. Additionally, Sumner County E.M.S. may terminate its employer-employee relationship at any time.

There may be situations where the need arises for us to revise, add, or cancel policies. Therefore, SCEMS reserves the right to add new policies, and to change or cancel existing policies at any time. The only exception is that our employment-at-will policy will not be changed or cancelled. The employmentat-will policy permits you or SeEMS to end the employment relationship at any time for any reason. We \\'ill notify you of any changes to the handbook as they occur. The only recognized deviations from the policies in this handbook must be authorized and signed by the Director of SeEMS.

The enhanced conununication afforded by this documentation will increase the potential of maximizing our organization's potential in our industry, and in our providing the quality service that \\'e strive to deliver in each of our areas of operation. Therefore, each employee will be required to read, understand and comply with the policies and procedures contained within this manual.

Sumner County E.M.S. Administration

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Section #1

Hiring/Employment Related Issues

The fol1owing SOG applies to all personnel seeking employment at Sumner Count)' El\IS:

Contents: Section 1.0 Employment Applications Section 1.1 Pre-requisites Section 1.2 Employment Reference Checks Section 1.3 El\tlS Certification

Section 1.0 Procedure: Employment Applications 1) SeEMS relies on the accuracy of the information provided on the employment application, as well as

the accuracy of other data presented during the hiring process and employment. If there are any misrepresentations, falsifications, or material omissions in any of this infomlation, we may exclude that applicant from further consideration. If the person was already hired, it could result in termination of employment.

Section 1.1 Procedure: Pre-requisites: I) Be at least 18 years of age. 2) Be currently certified by the Tennessee Department of Health with at least one of the

following certifications: a) Emergency Medical Technician (EMT) b) Emergency Medical Technician IV (EMT- IV) c) Emergency Medical Tec1mician- Paramedic (EMT-P) d) Emergency Medical Dispatcher (EMD)

3) Have a current and valid Tennessee Class "D" Driver's License with "F" endorsement (or obtain within two (2) weeks after employment) or a state of residence equivalent.

4) Submit infonnation for a driving record check by Sumner County EMS. 5) A state EMS Licensure check will be perfonned 6) Must successful complete the following pre-emplo)1nent requirements:

a) Fonnal interview process b) Written Test c) Pass Assessment Evaluation d) Pass a background check e) Complete a new employee orientation program including FTO rides. f) Successfully complete a three month orientation period. This period may be extended an

additional 3 months if required. 7) Must successfully complete the following post-employment offer requirements.

a) Pass a drug test. b) Successfully complete a physical ability testing relevant to the job requirements.

8) Upon employment the new employee will review with management all responsibilities of the employee's position as per the Related Job Description.

9) All employees shall become familiar, through orientation. with the policies and procedures of

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, the County and the individual area of operation to which he,!she will be assigned. 10) \1eet all criteria of position contained in the job description. 11) Administrative Support personnel are excluded from the certification and drivers license "F"

endorsement requirements.

Section 1.2 Procedure: Employment Reference Checks 1) To help select the best person for the job, SCEMS checks the employment references of job

candidates. 2) SCEIvtS wil! respond in writing when \ve receive a written request for a reference check. We will

provide only factual infonnation that can be substantiated by our records. SCEMS 'will not release any employment data without an employee or fom1er employee's written authorization and signed release.

Section 1.3 Procedure: EMS Certification 1) All transport personnel who are assigned to ambulance must be currently certified as an EMT

(including all variants), or EMT-P by the Tennessee Department of Health. 2) All field personnel are required to maintain Tennessee Department of Health EMS Licensure. 3) Obtaining the appropriate CEU's to maintain certification/licensure is the responsibility of the

employee. 4) It is the responsibility of the employee to assure that the SCEMS Training Department has a copy of

the CEU's related to EMS Licensure as well as copies of all EMS training related cards, updated licensures and drivers license. ,

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, Section #3 General Employment IDaily Routine Related Issues

Policy: SCE:ltIS vailles its employees and strives to mailltaill all equitable Admillistration/Employee relatiollslrip. IV also recogni:e that tire necessity of mailllaillillg dai{1' rOlltines is self-evident ill tlrM these dai{r routines ensure ej]icielll operatioll ofS.C.E.J,I.S. while projectillg a professional image. To tlrat end we /tape provided the following guidelines:

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Contents: Procedures

Section 3.0 Employee Conduct and \Vork Rules

Section 3.1 Employee Relations

Section 3.2 Equal Employment Opportunity

Section 3.3 Business Ethics and Conduct

Section 3.4 Employee Medical Requirements

Section 3.5 Conflicts of Interest

Section 3.6 Outside Employment

Section 3.7 Light Duty

Section 3.8 Disability Accommodation

Section 3.9 Job Posting and Shift Bidding

Section 3.10 Access to Personnel Files

Section 3.11 Personnel Data Change Section 3.12 Orientation Period Section 3.13 Courtesy Section 3.14 Community relations Section 3.15 Health Care Facility Relations Section 3.16 News l\fedia Interaction Section 3.17 Governmental Relations Section 3.18 Law Enforcement Request for PHI Section 3.19 Smoking and Tobacco Usage Section 3.20 Personal Hygiene Section 3.22 Red Bag Usage Section 3.23 General Information Section 3.24 Sexual and Other Unlawful Harassment - No Harassment

Policy

Section 3.25 Attendance and Punctuality

, 3.0 Procedure: Employee Conduct and \Vork Rules I) To ensure orderly operations and proyide the best possible work em"ironment, we expect you to follow rules of conduct that will protect the interesls and safety of all employees and SeEMS. 9

, 2) Although it is not possible to list all the fomls of behavior that are considered unacceptable at work, the following are some examples of conduct that may result in disciplinary action, up to and including termination of employment: a) Violation of personnel policies b) Repeated absences or tardiness c) Damage or loss of company property due to carelessness, neglect or intentional acts d) Inappropriate language or conduct toward other personnel, patients, patients families, healthcare

facility staff, guests to SCEr-itS and toward other responding agency personnel e) Violation of the Sexual and other Harassment policy f) Department safety rules violations g) Participation in dangerous practical jokes or horseplay in general h) Violation of policies pertaining to patient privacy i) Unsatisfactory perfoml3nce or conduct j) Falsification of timekeeping records k) Possession, distribution, sale, transfer or use of alcohol or illegal drugs in the workplace, while on

duty, or while operating employer-owned vehicles or equipment I) Fighting or threatening violence in the workplace m) Stealing in general. Theft or inappropriate removal or possession of company property, property

belonging to patients or patients families or belonging to one or our associate facilities n) Deviation from Professional standards (agency expectations concerning such things as personal

behavior, code of conduct and ethics, quality of work) 0) Inefficiency (Wastefulness of time, energy, money, etc) p) Incompetence (being inadequate or unsuitable for a particular purpose) , q) Failure to maintain skills / Adequate perfoffilance levels r) Insubordinate I Disloyal to others s) Perfoffilance of a lawful action in an illegal or improper manner t) Intentional wrongdoing; deliberate violation of law or standards; mismanagement of

responsibilities u) Omission or failure to do what ought to be done v) Boisterous or disruptive activity in the workplace w) Smoking and or tobacco usage in prohibited areas x) Possession of dangerous or unauthorized materials such as explosives or fireaffils, 111 the

workplace y) Unauthorized absence from work station during the workday z) Unauthorized use of telephones, mail systems, or employer-owned equipment aa) Dishonesty bb) Failure to complete assigned tasks cc) (This list is not all inclusive)

3) As an employee, you may teffilinate your employee-employer relationship at any time. Additionally, Sumner County E.M.S, may tenninate its employer-employee relationship at any time, with or without cause, so long as there is no violation of applicable federal or state laws.

3.1 Procedure: Employee Relations 1) We believe that the work conditions, wages, and benefIts we offer to SCEMS employees are

competitive with those offered by other employers in this area and in this industry. If you have concerns about work conditions or compensation, you are strongly encouraged to voice these concerns openly and directly to your Captain.

2) Our experience has shown that when employees deal openly and directly with management, the work environnlent can be excellent, communications can be clear, and attitudes can be posith·e. We belie\'e that SeEMS amply demonstrates its commitment to employees by responding effectively to employee concerns.

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, 3.2 Procedure: Equal Employment Opportunity 1) In order to provide equal employment and advancement opportunities to all individuals, employment

decisions at SCEMS will be based on merit, qualitlcations, and abilities. SCE~IS does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex. national origin, age, disability, or any other characteristic protected by law.

2) We will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship. This policy co\"ers all aspects of empIO)lnent, including selection, job assignment, compensation, discipline, tennination, and access to benefits and training.

3) In addition to our commitment to provide equal emplO)111ent opportunities to all qualified individuals. \ve have established an affinnative action program to promote opportunities for individuals in certain protected classes throughout SCEi'vIS.

4) If you have a question or concem about any type of discrimination in the workplace, you are encouraged to bring the issue to the attention of your Captain or Operations Manager. At SCE\1S, be assured that you can raise concems and make reports without fear of reprisal. Further, anyone found to be engaging in any type of unlawful discrimination will be subject to disciplinary action, up to and including termination of employment.

3.3 Procedure: Business Ethics and Conduct I) The successful business operation and reputation of SCEMS is built upon the principles of fair

dealing and ethical conduct of our employees. Our reputation for integrity and excellence requires careful observance of the spirit and letter of all applicable laws and regulations, as well as a scrupulous regard for the highest standards of conduct and personal integrity.

2) Our continued success is dependent upon the public's trust and we are dedicated to preserving that trust. Employees owe a duty to SCEMS, our patients, affiliates, customers and the public to act in(; ways that will merit the continued trust and confidence.

3) As an organization, SCEMS will comply with all applicable laws and regulations and \ve expect our directors, officers, and employees to conduct business in accordance with the letter, spirit, and intent of all relevant laws and to refrain from any illegal, dishonest, or unethical conduct.

4) In general, you should find that using good judgment, based on high ethical principles, will guide you to act appropriately. If you are unsure about the proper course of action, you should discuss the matter openly with your Captain. If necessary, you may also contact the Operations Manager for advice and consultation.

5) It is the responsibility of every SCEMS employee to comply with our policy of business ethics and conduct. Disregarding or failing to comply \\'jth this standard of business ethics and conduct could lead to disciplinary action, up to and including possible temlination of employment.

3.4 Procedure: Employee Medical Req uirements I) We consider infom1ation about medical conditions or history to be highly confidential and keep it

separate from other personnel infonnation. Access to this infonnation is limited only to persons who have a legitimate need to know.

2) In addition, the State of Tennessee requires that all EMS professionals have, on file, a "Medical Statement" clearing you to perfonn your duties. This is the responsibility of the employee and must be submitted at the time of employment.

3.5 Procedure: Conflicts of Interest I) As an employee of SCEMS, you have the obligation to conduct business within guidelines that

prohibit actual or potential conflicts of interest. In this policy, SCEMS is establishing the framework within which we wish to operate. These guidelines are intended to provide a general direction so that

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you can get further clarification on areas that affect you. For more infonnation or questions on conflict of interest, contact the Director.

2) All transactions with finns outside SCH.IS muSI be conducted within the framework established and controlled by the executive level of SCE\;lS. Business dealings with outside finns should not result in unusual gains for those firn1s. "Unusual gains" refers to bribes, product bonuses, special fringe benefits, unusual price breaks, and other windfalls designed to ultimately benefit, either the employer. the employee, or both. Promotional plans that could be interpreted 10 involve unusual gain require specific executive-level approval.

3) An actual or potential conflict of interest occurs when an employee is in a position to influence a decision that may result in a personal gain for that employee or for a relati\'e as a result of business dealings with SCEMS. For the purposes of this policy. we define a relative as any person who is related by blood or marriage, or whose relationship with the employee is similar to that of persons who are related by blood or marriage.

4) There is no "presumption of guilt" created by the mere existence of a relationship with outside finns. However. if you have any influence on transactions involving purchases, contracts, or leases, it is imperative that you disclose this fact to an officer of SCEMS as soon as possible. By alelting us to the existence of any actual or even a potential conflict of interest, we can establish safeguards to protect all parties.

5) The potential for personal gain is not limited to situations where an employee or relative has a significant ownership in a firn1 with which SCEMS does business. Personal gains can also result from situations where an employee or relative receives a kickback, bribe, substantial gift, or special consideration as a result of a transaction or business dealings involving SCEMS.

3.6 Procedure: Outside Employment I} SeEMS employees may hold outside jobs as long as they can satisfactorily perforn1 their SCEMS job

and there is no interference with our scheduling demands. 2) All employees will be held to the same standards of perfonnance and scheduling expectations,

regardless of any outside job. If we detennine that outside work is impacting your perfonnance or the ability to meet our requirements, which may change over time, you \\'ill be asked to ternunate the outside job in order to stay employed at SCEMS.

3) [f your outside employment has an adverse impact on SCEMS, it will be considered a conflict of interest.

3.7 Procedure: Light Duty 3.7.1 Policy 1) Light duty shall be a means to have useful work for an employee to do when, because of injury or

illness, he/she is unable to do the regular work. 2) EMS employees who are either on injury or sick leave are expected to return to work as early as

medically feasible. 3} During incapacity from regular duty, when an employee is medically able to perfonn light work,

SCEMS will attempt to find work which the employee is able to perfom1, even if it is in a different department within EMS.

4} If the employee accepts light duty, he/she maintains eligibility for salary continuation. 5) For those employees (on on-duty injury leave) who refuse light duty, no injury leave or salary will be

paid. In addition, the employee loses eligibility for Workers' Compensation payments. 6) Light duty work is not guaranteed from day to day of from week to week. It is dependant on the

availability of light duty work, that the sick or injured employee is qualified and capable of doing, being available.

7) Light duty, when available, is an 8 hour a day, up to 40 hour a week position (tor those on on-duty injury leave off duty injury leave light duty is on an as available basis).

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3.7.2 Responsibility I) The department division that has the light duty will be responsible for supenision of the employee

assigned to do it. 2) The on duty Captain Supen'isor is responsible for contacting the SCE~IS Operations \lanager if the

member fails to report for work.

3.7.3 Definition 1) Light duty shall consist of any light work which does not conflict with restrictions set forth by a

physician.

3.7.4 Procedure I) Light duty assignments will be determined either by the EMS Director or the Operations Manager. In

most cases, individuals will be assigned duties in the Administration Office. Work hours will be 0800 - 1630, Monday through Friday unless otherwise indicated. While on Light duty schedule an automatic deduction for the lunch period (30 minutes) will be taken out of the work schedule.

2) Once an individual accepts a light duty assignment, he/she will be infonned as to the reporting date, time and place.

3) If the individual(s) fail to report for work, any disciplinary action will be taken by the regular Captain after consultation with the Operations Manager.

4) At the end of the light duty period, the on duty Captain will inform the Operations Manager as to the member's perforn1ance and date of return to regular duty.

5) Light duty for employees who were not injured in the line of duty will be offered to employees based on date of injury I illness notification. Not all employees who are on sick leave will be able to work light duty due to the limited amount of extra work and'or budgetary impact. (.,

3.8 Procedure: Disability Accommodation I) SCEMS is conunitted to complying fully \vith the Americans with Disabilities Act (ADA) and

ensuring equal opportunity in employment for qualified persons with disabilities. 2) All employment practices and activities are conducted on a non-discriminatory basis. Our hiring

procedures have been reviewed and provide persons with disabilities meaningful employment opportunities. When requested, we will make job applications available in alternative, accessible fonnats, as well as provide assistance in completing the application. Pre-employment inquiries are made only regarding an applicant's ability to perfonn the duties of the position.

3) We require post-offer medical examinations only for positions that have bona fide job-related physical requirements. An examination will be given any person who enters the position but only after being given a conditional job offer. Medical records are kept separate and confidential.

4) Reasonable accommodation is available to an employee with a disability if the disability affects the perfornlance ofjob functions. We make all employment decisions based on the merits of the situation in accordance \vith defined criteria, not the disability of the indi vidual.

5) Qualified individuals with disabilities are entitled to equal pay and other forms of compensation (or changes in compensation) as well as job assignments, classifications, organizational structures, position descriptions, lines of progression, and seniority lists. We make leaves of all types available to all employees on an equal basis.

6) SCEMS is also committed to not discriminating against any qualified employee or applicant because the person is related to or associated with a person with a disability. SCE[v1S will follow any state or local law that provides individuals with disabilities greater protection than the ADA.

7) This policy is neither exhausth'e nor exclusive. SCEMS is committed to taking all other actions necessary to ensure equal employment opportunity for persons with disabilities in accordance with

(., the ADA and all other applicable federaL state, and local laws.

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3.9 Procedure: Job Posting and Shift Bidding 1) Our job posting program provides you with the opportunity to indicate your interest in open positions

and advance within the organization according to your skills and experience. In general, we post all regular, full-time job openings, although SCEl\IS reserves its right to not post a particular opening.

2) Job openings will be posted on the SCevfS website and nonnally remain open for 5-7 days. Each job posting notice will include the dales of the posting period, job title, shift, location, and start date of the new assignment.

3) To be eligible to apply for a posted job, you must have perfon11ed competently for at least 15 calendar days in your current position. If you are on probation (due to a disciplinary action) or suspension, you are not eligible to apply for posted jobs. You may only apply for posted jobs for which you possess the required skills, competencies, and qualifications.

4) To apply for an open position, submit a request to the Systems Manager listing your intent. It is your responsibility to contact your Captain when awarded the bid. \\'hen a position is awarded you must work your current scheduled shift and change immediately after.

5) After you apply for a job, your Captain may be contacted to verify your perfon11ance, skills, and attendance. Any staffing limitations or other circumstances that might affect a prospective transfer may also be discussed.

6) The selection process for the posted position will take into consideration various factors including seniority, job perfonnance, any post application testing, history of complaints and the nature of the complaints, interview performance (if conducted), CQI scores, absence history, etc.

7) W'hen taking into consideration seniority points for during the year open positions, the seniority points that will be considered are the actual points of the employee and not any Team Bid points that may have been used in the yearly shift bid process.

3.9.1 Purpose 1) In order to keep seniority a vital part of station assignments it is necessary to have a system wide bid

annually. Bids will begin December 1 each year and take effect on the 15t full pay period of January the following year. Open positions during the year will be bid out individually as needed.

2) This policy will direct and outline how employees will "bid for positions".

3.9.2 General Guidelines for ALS Division shift bids: I) The bases for all shift bids will be seniority. However, employees (regardless of seniority) who have

greater than 3 documented policy violations within 6 months of the system bid may be assigned. The review and decision to keep an employee from bidding based on behavior may be done by either a conunittee of peers, administration, or both.

2) Employees with 15 years or greater of service will be recognized for this conmlitment by being allowed to choose any open station assignment. This employee will also be allowed to choose a pemlanent team partner as long as both employees agree. 'These employees will be exempt, if they so choose, from future system bids unless stafting requirements deem otherwise."

3) Employees with at least 1 0 years of service will be allowed to choose any open station assignment. These employees may also choose and protect a pennanent team partner, whose seniority is at least 1 year, as long as the combined years of service between the two employees equal 15 or greater. If this employee wishes to bid with someone \vhose combined seniority does not equal 15 years or more then an average will be taken and the lesser senior employee will be given those bid points for the open position.

4) Any two employees of 1 year or more of service who want to team bid may do so by averaging both people's points. All requests for team bids must be submitted prior to the opening of bidding. Team bids will be at your own risk. If this option is taken and there are no open positions when your tum c

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comes up, the senior pattner wilJ bid at that point and the lesser senior partner will resume bidding with their nomlal points.

5) Lieutenants will be assigned to a Medic Unit at station I but may choose a team partner. 6) A.ll other open positions will be a\rarded based on seniority. 7) Double medic teams will be allowed provided staffing levels pemlit. :'hailable double medic teams

will be distributed as equally as possible among the shifts. The number of available double medic teams will be announced prior to the opening of bidding.

8) If employees have the same hire date then we will use the seniority of your E~H license number to detemline the senior position.

9) Bid points are calculated by months of service. An employee will receive I point for each month of service he/she has will Sumner Co. PvIS. Crew members that have sen'ed in dispatch and are now in the ALS Division will have time sen'ed in dispatch counted toward their total bid points at 0.5 points per month

10) Team Bids/Pennanent Team Partners - Nothing

3.9.3 General Guidelines for BLS Division shift bids: 1) The BLS Division will do their annual bid process at the same time as the ALS Division. The same

process and guidelines used for the ALS Division above will be followed with a few exceptions. 2) The 24 hour BLS Division unit will be primarily for employees who are attending paramedic school.

Any full-time BLS Division employee who is accepted into paramedic school \vi1l be moved to a 24 hour BLS Division unit to accommodate their school schedule. The non-paramedic level employee who has the least seniority on a 24 BLS Division unit will be moved to allow the employee that is in paramedic school a position on the 24 hour BLS unit. , 3) Team bidding will be allowed in the BLS division. Any two full-time employees may team bid regardless of their months or years of service. The team bid points will be calculated in the same way the ALS Dh'ision team bid points are. See % below for the exception to this rule.

4) Sumner Co. Administration reserves the right to assign any employee a position regardless of seniority due staffing needs, disciplinary issues, or disagreements between employees.

5) Team Bid _. Nothing in this term will preclude the possibility that team members may be separated for a period of time as staffing needs may dictate.

6) Unit 15 will be the designated ALS unit for the BLS Division (taking effect during the 2011/2012 shift bid) and BLS Division paramedics must bid on this unit until the three open positions are filled or there are not enough available medics to cover the openings. Double medic bids will only be penllitted in the BLS Division in there are more than three BLS Division medics participating in the shift bid process. \\-'hen considering the approval of double medic shift bids, 1) all medic positions must be filled. 2) seniority will be the basis for approval on the part of the medic making the request for double medic team bid. If there are not enough medics to fill all three ALS positions on Unit 15, the positions will be open to EMT's.

3.9.4 Special Situations: I) From time to time special circumstances arise where there is an open position that cannot be filled by

the Job Posting process. \\;ben this happens SCEMS will need to assign appropriately qualified individuals to the open positions. The following are a list of potential solutions to handle this situation: a} Promoting a BLS Division employee to the open position. b) If the open position is a medic position and there are not qualified BLS Division employees to

move to this open position: i) Consider the double medic units on the shift that has the open position and move the lowest

seniority double medic personnel to the open position. (l) Replace this medic with a promotion of an EMT from the BLS Division

ii) If there are not double medic units on shift, consider double medic units on other shifts taking into account, seniority and the ability of the medic(s) to make the mo\'e across shifts. c

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(1) Replace this medic with a promotion of an EMT from the BLS Di\'ision. iii) If there are no double medic units a\'aUable consider hiring one of the part-time medics to full

time or hiring a paramedic for the open position.

3.10 Procedure: Access to Personnel Files I) At SCE~IS we maintain a personnel file on each employee that includes the job application and

related hiring documents, training records (kept by the training department). perf0n11anCe documentation, salary his10I)', and other employment records.

2) Personnel files are the property of SCEMS. Because this infom1ation is highly confidential and we respect your privacy, only persons with a legitimate business reason will be allowed access to personnel files. Keep in mind that the Tennessee Open Records act makes some of these files open to public review.

3) If you wish to see your personnel file, contact the Director. With reasonable advance notice, you may review your own personnel file in our offices and in the presence of a person authorized by SCEMS.

4) Personnel records that contain your medical infonnation will not be kept in your personnel fi Ie. These records are maintained by the Exposure Control Officer and access to these records is strictly limited. If you would like to review the records kept in your medical file send a written request to revie\v these files to the Exposure Control Officer.

3.11 Personnel Data Changes

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I) To help us keep records and benefit program infonnation accurate, please notify SCEMS of any changes to your personal infonnation. The infon11ation we need includes your mailing address, telephone numbers, your marital status, changes to your dependents' infonnation, who to contact in case of an emergency, educational accomplishments, and other possibly rele\'ant information. To make changes or if you have questions about what infonnation is required, contact your Captain.

3.12 Orientation Period I) At SCEMS we want you to be successful at your job. We have found that having an orientation

period can be very helpful to new employees. The orientation period provides you with the opportunity to demonstrate that you can perfonn your job at a satisfactory level of perfonnance and to determine if the new job meets your expectations. We use this period to evaluate your capabilities, work habits, and overall perfom1ance. Since employment at SCEMS is based on mutual consent, either you or SCEYlS may end the employment relationship at will at any time during or after the introductory period, with or without cause or advance notice.

2) The orientation period only applies to employees who are hired to full time status. PRN employees can be evaluated during their working period(s). If they proved to be unacceptable to SCEMS their use on a PRN bases will be discontinued.

3) The orientation period for all new and rehired employees is the first 6 months after the date of hire. If there is a significant period of absence during the orientation, the period will automatically be extended by the length of the absence. Either during the orientation or at the end, we may extend the period if we detennine there was not adequate time to evaluate perfon11ance or if the perfonnance of the employee warrants an extension of the orientation period.

4) After successful completion of the orientation period the employee will enter a "probationary full time" period that will extend to one (6) month probation from the start of the "probationary full time" period.

5) \\-'hen the probation period is satisfactorily completed, employees enter the "regular full time" employment classification.

6) Regularly scheduled part-time employees enter an orientation period of six (6) months. Upon successful completion of this orientation period the employee will continue as a regularly scheduled

("

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part-time employee. The six (6) month probationary full time period \\ ill be entered into if and when the regularly scheduled part time employee enters the full time ranks.

7) Employees that are hired from the PRN part time ranks into a regularly scheduled part time or into a full time position will enter as an "Orientation Status" employee. The orientation period could be 6 months, or longer, depending on the amount of time that was worked while in the PRNipart time rankd and the o\'erall reputation that this person has developed while working PRN .1 part time.

8) Employees that transition from the BLS Division to the ALS Division will enter into a probationary period of 90 calendar days.

9) At or near the end of an orientatiorL'probationary period a decision will be made as to the status of the employee. This may include: a) Release of the employee as unsatisfactory b) Continuation from Orientation into Probationary Full Time Status or from Probationary Full

Time to Regular Full Time Stalus c) Tn the event of a BLS to ALS move. continuation with the ALS Division for a successful

evaluation of demotion back to the BLS Division for an unsuccessful evaluation.

3.13 Procedure: Courtesy I) Every employee of the County shall project a positive and courteous image at all times, not only to

maintain and improve relations with the general public, but also in the best interest of patient care and working relations with law enforcement agencies, other pre-hospital care providers and agencies, and urgent/non-urgent health care facilities.

2) Each employee represents SCEMS to our customers, to the public and all of our affiliates. The way we conduct ourselves in the performance of our duties presents an image of our entire organization. These professionals and others judge their experiences by how they are treated each time they come in contact with us. Therefore, one of our top priorities is to be courteous, friendly, helpful, professional, and prompt in your dealings with all you encounter.

3) If any person wishes to make a specific comment or complaint, you should direct that person to the Operations Manager for appropriate action. Remember that your contacts with the public in person, over the telephone, and through all your cOlmnunications reflect not only on you but on SCEMS as a whole.

4) Employees shall refrain from "cursing" or the use of vulgar language when in unifonn both on and off duty or on County property.

5) Failure to interact courteously and tactfully with managers, co-workers, customers. patients, vendors or associates of any type to the point that productivity or morale suffers may be grounds for termination.

3.14 Procedure: Community Relations I) Participation by S.C.E.M.S. employees in cOlmTIunity activities is encouraged. 2) When appropriate, county equipment and employees may be conunitted to community functions and

e\·ents. Refer all such requests for S.C.E.I\1.S. involvement in such events to the S.C.E.I\I.S. Event Manager for acceptance consideration and, if accepted, subsequent equipment and manpower assignment.

3) All employees who are capable of speaking to a group about their profession and area of expertise are encouraged to participate. All such requests for speakers must be approved by the Event Manager.

3.15 Procedure: Health Care Facility Relations 1) Positive Health Care Facility relations are of paramount Concern to SCEMS.

2) SCEMS persolmel are to present themselves in a clean and neat manner at all times, in accordance

with Uniform standards. Further, SCEMS personnel are to present their equipment (including, but not limited to, the ambulance, stretcher, and other durable equipment) in a clean and serdceable c

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c

condition at all times, Should any equipment become soiled during patient transport. SCEMS personnel will inU11ediately clean the equipment and return it to serviceable condition as soon as possible, Any broken equipment will be reported to the Shift Captain as soon as possible.

3) When in any health care facility, SCEMS personnel are expected to conduct themselves as Medical Sen'ice Professionals and are to work cooperati\'ely with the personnel of that facility.

4) SCEMS personnel should avoid conflict with health care facility personnel at all times. Should a conflict arise in the facility setting, SCEMS personnel must remain courteous and professional to all others at all times. A report of the incident should be submitted. in writing, to the Shift Captain immediately.

5) Any discussions arising from such conflicts should be calTied out away from the patient, his family. or any bY-Slanders. SCEMS staff should refer all concerns to their Shift Captain.

6) Should the facility staff require help and ask personnel for assistance (i.e. CPR. lifting, special handling of a patient, etc.), the personnel will render whatever assistance is requested, unless System Status will not allow. Advice SCHIS Communications Center of the situ

, the public only to the extent that the law allows us. We \vill at all times treat members of the media in a professional manner when a request for information is made.

3.16.2 Scope 1) This policy applies to all Sunmer County E.~l.s. staff members who come in contact with or are

contacted by members of the various media. 3.16.3 Procedure I) Day to Day Operations:

a) SCEMS maintains the highest standards of patient confidentiality. It is impossible, however, to accomplish this standard without the compliance of our staff. During the day-to-day operations of Sunmer County EMS, the media may arrive at the scene of an emergency incident and request infonnation about the incident. When on-scene persolme\ are approached by the media or member of the public, tbey shall act professionally and \vith coul1esy, they shall direct all media inquiries to the PIO. If the PIO is not available then all inquiries shall be directed to the on duty Captain.

b) To ensure that there are no inappropriate disclosures or uses of a patient's PHI, only the follO\ving information may be disclosed by SeEMS Captains or the Public Information Officer to media representati \'es. i) Name of hospital. You may provide the name of the hospital to which patients have been

transported. (Acceptable Example: The media calls about "the accident at Third and Main earlier this afternoon." You may infonn the media "a patient \vas transported from the accident scene to ABC Hospital.").

ii) THE NA.1\IE OF THE PATIENT(s) SHOULD NOT BE RELEASED TO THE MEDIA. It is not appropriate for us to confirnl or deny the identity of a patient. Requests for patient identity should be directed to a law enforcement agency or to the hospital. Law enforcement agencies are not subj ect to the strict requirements of protecting patient information as we are under HlP AA.

iii) Number of patients. You may provide the total number of patients il1\,oh'ed in an accident or transported to a facility. You may not indicate specifics about the vehicle a patient was driving or which patient \vent to a particular facility. (Acceptable Example: You may infornl the media that "four patients were transported from the fire at the i\BC Chemical Factory. Two 'were taken to County General and two were taken to the Regional Medical Center.")

i\,) Age & Gender. You may provide the age of a patient and the gender of the patient, unless it could reasonably be used to identify the patient. (Acceptable Example: You may inform the media "a 39 ylo male was transported from the accident on the Interstate." You would not want to disclose to the media "a 39 ylo male was transported from 124 Main St.")

v) Designation of crew members. The designation of crew members as paramedics or EMTs is not protected health infon11ation. You may state, for example, that one paramedic and two EMTs were involved in caring for the patients invoh'ed in a motor vehicle accident. (Do not release he names of the EMTiParamedic that was inmlved in the care of the patient. If this is to be released to the media it should be done so at the discretion of the Public Infonnation Officer). You are not permitted to describe the speci fie type of care rendered to patients at the scene or on the way to the hospital. Nor may you speculate on what injuries a patient may or may not have sustained. (Acceptable Example: "SCEvlS personnel on the scene of the incident included two paramedics and a supervisor and advanced life support was administered. ")

, vi) Type of Transport. You may indicate that a particular call was an emergency and that

transportation was facilitated by ambulance or helicopter. Do not speculate on the patient's condition even if you are sure of that condition. For example, do not disclose to a member of the media that a patient was critical or stable unless you are comfortable in knowing this to be their general condition. (Acceptable Example: "Of the 3 patients on the scene of the incident.

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one was transported by helicopter to the ABC Trauma Center and two were transported as(., non-emergency patients to the local hospital emergency depaJ1ment:') vii) Non-PHI Information. Information that is not classified as PHI may be released to the

media consistent with SCEMS policy and state \;m. For instance, infonnation about a fire response or a standby that did not involve patient care may be released to the media, as may general infonnation about an event. (Acceptable Example: "We treated 45 patients during the two-day festival, and 6 were transported to local hospitals for various heat-related complaints").

viii) Disclosures Authorized by the Patient. In the event that the patient or the patient's legally responsible decision maker signs a HIPA.A. authorization form, disclosures of infomlation, including PHI, may be made so long as they are done in accordance with the express terms of the \vritten authorization. Authorization forms for this purpose must be HIPA.A.-compliant and must be approved by the Privacy Officer.

3.16.4 Large Scale Incidents: 1) The PIO, as a member of the command staff, is responsible for the fomllllation and release of

infomlation about the incident to the news media and other appropriate agencies. Crew Members, Officers and Support Personnel are responsible to refer any media inquiries to the Incident Commander; those inquiries in tum will be directed to the PIO.

3.16.5 Procedures:

I) Once on-scene, the PIO will report to the Incident Commander to receive briefing on the incident.

2) When necessary, a media center or area will be established for coordinated dissemination of

information and scene control. The PIO acts as the official spokesperson for the Fire District. 3) \\tl1en on-scene personnel are approached by the media or member of the public, they shall act

professionally and with courtesy, they shall direct all media inquiries to the Incident Commander. Personnel shall not give comments to the media regarding the incident unless the PIO or Incident Commander has given prior approval.

4) The PIO will release information verbally or in writing to the media. When appropriate, news releases will be posted in public areas for access.

5) The PIO will attend all briefing/command meetings, when possible, and update the media accordingly.

6) The PIO will coordinate with the Incident Commander in an effort to give the media access to areas within the incident perimeter as soon as possible, accounting for the safety of the media, the emergency personnel and the pUblic. When possible, 'media pools' will be utilized. If at any time you are unclear about whether information may be disclosed to the media, always err on the side of caution and do not disclose the questionable item of information. Again, all requests for patient infom1ation should be directed to the Public Information Officer.

3.16.6 Images and pictures: I) Due to the sensitive nature of the calls \\'e respond to any pictures, videos or images taken of any

scene or call is strictly prohibited unless done by an approved member of SeEMS and may only be taken by equipment owned by SCEMS.

2) Posting of these type pictures, videos or images on public or private media site, of any type, is strictly prohibited unless othenvise approved by the EMS Director.

3) Pictures, videos or images that contain PHI (ex: pictures with facial features or other identifying marks, license plates of \·ehicles) are protected by HIPA..A. and cannot be released or disclosed without proper authorization. a) Such an unauthorized disclosure is potentially punishable by monetary fines and imprisonment as

established by the Privacy Rule. b) Such an unauthorized disclosure can result in disciplinary." action being taken against the

offending employee, up to and including termination. (.,

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, 3.17 Procedure: Governmental Relations

1) Positive Governmental relations are of paramount impoltance to S.C .E.M.S.

2) When encountering or \vorking in conjunction with a gO\'ernmental official (elected or emergency

services personnel), personnel are expected to conduct themsehes as :Yledical Services Professionals and to work cooperath'e!y \vith the officials.

3) Personnel should avoid conflict with governmental officials at all times. Should a conflict arise, personnel must remain courteous and professional. A report of the incident should be submitted, in writing, to the Shift Captain inunediately.

4) Any discussions arising from any such conflict should be held away fonn the palient, his family. or any by-standers.

3.18 Procedure: Law Enforcement Request for PHI 1) Investigations are usually initiated by the law enforcement agencies following motor vehicle

accidents, acts of violence, unexplained deaths. etc. All inquiries for information should be directed to SCEMS Privacy Officer.

2) The Patient Care Report that is completed every time a patient is transported becomes a part of the patient's permanent file. It cannot be copied for or discussed with law enforcement without HIPAA. approved authorization(s). This is a legal document and may be subpoenaed by the court. If an appropriately issued subpoena or other HlPA ..A. authorized request is submitted by law enforcement, the PCR may be disclosed to law enforcement.

3) All disclosures of PCR(s) to law enforcement will be provided by the Privacy Officer as indicated by HIPAA.

4-) More information regarding the release of PHI to Law Enforcement can be found in Section 13.13 Release of Protected Health Information to Law Enforcement

, 3.19 Procedure: Smoking and Tobacco Usage 1) In keeping with SCEMS's intent to provide a safe and healthful work envirOlID1ent, smoking/tobacco

usage in the I,vorkplace is discouraged. Smoking/tobacco usage is prohibited in all Sumner County EMS buildings and offices and in any enclosed area that is assigned to house an ambulance. This restriction on tobacco usage in areas assigned to house an ambulance is being put into affect due to two state regulations. One of the regulations states that smoking or any other use of a tobacco product within ten (10) feet of an ambulance is prohibited. (Rule 1200-12-1-.11 (6» Another regulation, when mentioning exceptions states, any area enclosed by garage type doors on one (I) or more sides when all those doors are completely open (TCA 39-] 7-1804(4)(A)(ii) and smoke from those non-enclosed areas shall not infiltrate into areas 1!'here smoking is prohibited pursuant to this part. (TCA 39-17 -1804( 4 )(B» Since smoking is prohibited within I 0 feet of an ambulance by Rule 1200-12-1-.11 (6) and it is not possible, in most cases, to prevent the smoke in the bays from infiltrating into this 1 0 feet region, this restriction is being imposed.

2) This same restriction will apply to the use of smokeless tobacco products due to Rule 1200-12-1.11 (6) and the multiple complaints that we have received from employees regarding the spitting into the drain lines and containers used as spittoons being left laying around.

3) The Non Smoker Protection Act enacted does not regulate the distances that one needs to be from a main entrance while smoking. It does suggest that such smoking should nol allow smoke to infiltrate into a restricted area and a11o\\"s individual employers to set their own regulations. With this in mind. SCEMS has set this distance to be not less than 20 to 25 feet or even greater depending on if smoke is infiltrating into a restricted portion of the building. Please be respectful and do not smoke at the entrances of buildings since nonsmokers may ha\'e to tra\'el through these areas. Any conflict between smokers and nonsmokers will result in SCEMS siding with the nonsmoker.

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http:1200-12-1-.11http:1200-12-1-.11

(, 4) Tennessee state law prohibits smoking inside of an ambulance and requires that any smoking done around an ambulance has to be at least 10 feet from the ambulance. Violation of this state law could result in fines and termination.

5) SCEvIS also prohibits tobacco usage while in the presence of or while operating any of the computer or other sensitive computer, IT or radio equipment

6) This policy applies equally to all employees as well as to our customers and \'isitors. 7) Violation of this policy will result in disciplinary action up to and including temlination.

3.20 Procedure: Personal Hygiene I Personal Appearance 1) We want SCE:vIS employees to reflect an appropriate business image to customers and visitors. HO\v

you dress, your grooming and personal cleanliness standards all contribute to that image and also to the morale of your co-workers.

2) During business hours or whenever representing SCE\.IS, you are expected to present a clean, neat, and tasteful appearance. You should always dress and groom yourself according to the requirements of your position and accepted social standards. This is particularly tme if your job involves dealing in person with the public.

3) Your captain or department head is responsible for establishing a reasonable dress code appropriate to the job you perform. If your captain feels your personal appearance is inappropriate, you may be asked to leave work until you can return properly dressed or groomed. If this happens, you will not be paid for the time away from work. Be sure to consult your captain if you have questions as to \vhat constitutes appropriate appearance. We may, when necessary, make reasonable accommodation in the personal appearance policy for a person with a disability.

4) Because personal style can be important to people, \ve do not want to restrict individual tastes unnecessarily. However, to give additional guidance, we expect SeEMS employees to follow the personal appearance guidelines below: (, a) General Guidelines for all employees

i) Personal cleanliness is mandatory. Offensive body odor and poor personal hygiene is not professionally acceptable.

ii) Fingernails will be kept short, clean and well groomed. iii) Perfume, cologne, and aftershave lotion should be used moderately or avoided altogether, as

some individuals may be sensitive to strong fragrances. All perfumes, colognes and lotions, if worn, should be undetectable to the public.

iv) One set of studded, non-dangling matching earrings will be pennitted. If earrings are worn1 they must be worn as a set. No dangling necklaces or bracelets shall be worn in a maIU1er as to be visible from outside the unifonn. Jewelry should not be functionally restrictive, dangerous to job performance, or excessive. Facial jewelry, such as eyebrow rings, nose rings, lip rings, and tongue studs, is not professionally appropriate and must not be worn during business hours.

v) Torso body piercings with visible jewelry or jewelry that can be seen through or under clothing must not be worn during business hours.

vi) Hairstyles are expected to be in good taste. vii) UIU1aturally colored huir and extreme hairstyles, such as spiked hair and partially shaved

heads, do not present an appropriate professional appearance . ....1l1) Employees must make a reasonable attempt to co\'er visible excessive tattoos and similar

body art while on duty. ix) Unifonlls are expected to be cared for according to the care labels to pre\ent excess fading. x) Uniforms should be wrinkle free, shirts tucked in, free of stains and tears. xi) Unifom1s items must conform to the accepted items as indicated in the Unifonn Policy

(Section 11.2)(, b) Personal Hygiene- Female Personnel

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i) Fingernails: l\ails should be clean, shOtt, \Ii'ith clear or conservative pale colored nail polish if(" used ii) Excessive makeup is not permitted. Use of make-up should be cOl1seryative, not distracting

or offensive to the public. iii) Hair should be neat, styled, clean, and worn in such a manner as to be no lower than the

shoulder. Females with long hair longer than the shoulder must pull hair back so as not to interfere with patient care or become a safety or health hazard.

iv) Long hairstyles should be worn \vith hair pulled back off the face and neck to avoid interfering with job perfonnance.

c) Personal Hygiene- Male Personnel i) Mustaches and goatees must be clean, well trimmed, and neat so as not to interfere with the

Niosh 95 Respirator sealing surfaces .. Full beards are not allowed under OSI-LA. standards therefore full beards or goatees \vill not be pennitted. Facial hair that comes between the sealing surface of the face-piece of the Niosh 95 respirator and the face or that interferes with the vahe function will not be permitted.

ii) Hair will be neatly cut, styled, and clean at all times. Length will be no longer than the bottom of the shirt collar. Ponytails are not allowed.

3.21 Procedure: Red Bag Usage 1) Procedure for red bagging items:

a) Any time a red bag is used, either for disposable items or for durable goods being sent for cleaning, each bag must be tagged as follows: i) Using a wide piece of tape, ID the bag with the following infon11ation:

(I) Run number, if known (2) Date bagged

(" (3) Station and unit red bag came from (4) Crew doing the bagging of the material

2) When red bagging durable items for cleaning, no other trash or items not intended for cleaning/reuse is to be placed into the bag

3) In red bags used for contaminated items, only those that are grossly contaminated should be placed into this bag. For further information as to what is considered to be grossly contaminated, contact your Exposure Control Officer.

4) The above information \\fill be used to track red bags that are found to have inappropriate trash or other necessary items in them. The supply/rounds personnel wiII not pick up a red bag item forn1 your station that is not properly labeled.

5) Disciplinary action can and will be taken as required by supervisory persolmel.

3.22 Procedure: General Information 1) Conduct Sunmer County EMS is staffed \vith professionals in the area of pre-hospital care. The

public's perception of EMS depends upon the conduct, appearance and professionalism of each employee. All employees shall conduct themselves in a professional manner at all times. Respect will be shown to co-workers, emergency service personnel and to the public.

2) Chain of Command All personnel must remain \vithin the chain of command. Problem resolution shall begin at the shift supervisor and progress until the problem is solved. The Director's office is always available to discuss problems provided the chain of command has been followed. Personnel shall refrain from making operational decisions without first discussing the issue with the shift supervisor. Going outside the chain of command will result in disciplinary action. (All employees are encouraged to voice 'document their concerns).

3) Dress and Grooming All employees are expected to be groomed, at all times. Beards are not acceptable (see procedure 3.19). Uniforn1s shall be clean and neat at all times. All uniforms must be in accordance with the uniform policy provided in this manual. Hats must be the ofticially issued

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, SCEMS hats or toboggans.

4) Controlled Substance ese - The use of controlled substances or prescription medications that may

impair your ability to perfonn your dUlies is prohibited. Violation of this policy may result in immediate tennination of employment.

5) Weapons Possession of a weapon while on duty at any location is prohibited. SCE~IS has a zero tolerance policy regarding weapons at work. Please see procedure 5.1 for further infonnation on this policy

6) Outside Activities Outside activities while on duty is prohibited. Personal errands should be limited (Le. going to the bank, etc.).

7) Visitors Visitors are always welcome. However, visits should be limited in length and number. Respect should be shown to other crewmembers so as not to be inconvenienced by a \·isitor. All visitors and non-duty employees shall be out of the EMS stations by 2200 hours. For more infonnation regarding Visitation see 6.9 and 11.5.

8) Crewmembers at the Hendersonville stations will be accountable to the Station CaptainiOfficer concerning Hall duties.

9) Crewmembers are expected to be at work on time for their assigned shift. In the case of a shift s\vap that will cause you to be late, prior arrangements must be made by the crevvmember to have the time covered. Otherwise, the crewmember will be considered late. Travel time is not paid to a crew member that is traveling from a shift swap station to their norn1ally assigned station and vise versa

10) Crewmembers are expected to be in unifonn and prepared for work at shift change time. If reporting from another job, employees must be in Sunmer County E.M.S. approved unifonn at shift change.

, 11) Crewmembers are expected to perfonn their regular share of the assigned hall duties (sv"eeping and

mopping floors, vacuuming, cleaning bathrooms, taking out trash, washing dishes, etc.) at the station that they are assigned to.

12) Riders - See procedure 10.24 & 10.26 for more inforn1ation on Riders on SCEMS Units. 13) Violent Situations - E.M.S. personnel should never enter an unsafe scene. Crewmembers should

verify scene safety before entering the scene. If you are advised that the scene is not safe you should stage an adequate distance from the scene so as not to become involved in the situation inadvertently. Remember, just because law enforcement has past you going to the scene, it does not mean that the scene is secure. Do not proceed in to a potentially violent scene till advised by dispatch that the scene is secure.

14) Continuing Education It is the responsibility of the employee to acquire the proper CEU's in order to maintain his/her level of licensure. All employees shall maintain adequate CEU's as required for licensure. In-service classes will be sponsored by SCEMS to assist employees in maintaining his/her license. Outside class room training for CEU's must be registered with the SCEMS Training Department for tracking purposes. It is the responsibility of the SCEMS employee to assure that the SCEMS Training Department has the necessary proof of certification for all EMS related training taken by the employee.

15) Quality Improvement Quality improvement is an integral part of SCEMS operations and patient care. It is to be used as a tool for identifying problem areas indicating a need for additional training, assurance of protocol procedures and changes in patient care techniques.

3.23 Procedure: Sexual and Other Unlawful Harassment - l"o Harassment Policy

, I) SCEMS is committed to providing a work environment that is free from all fonns of discrimination

and conduct that can be considered harassing, coercive, or disruptive, including sexual harassment. Actions, words, jokes. or comments based on an individual's sex, race, color, national origin, age, religion, disability, sexual orientation, or any other legally protected characteristic will not be tolerated. We provide ongoing sexual harassment training to ensure you the opportunity to work in an environment free of sexual and other unlawful harassment.

2) Sexual harassment is defined as unwanted sexual advances, or visuaL verbal, or physical conduct of a sexual nature. This definition includes many forn1s of offensive behavior and includes gender-based

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harassment of a person of the same sex as the barasser. The following is a partial list of sexual

harassment examples:

a) Unwanted sexual advances.

b) Offering employment benefits in exchange for sexual favors.

c) l\Iaking or threatening reprisals after a negative response to sexual advances.

d) Visual conduct that includes leering, making sexual gestures, or displaying of sexually suggestive

obj ects or pictures, cartoons or posters. e) Verbal conduct that includes making or using derogatory comments, epithets, slurs, or jokes. f) Verbal sexual advances or propositions. g) Verbal abuse of a sexual nature, graphic verbal commentaries about an individual's body,

sexually degrading words used to describe an individual, or suggestive or obscene letters, notes, or invitations.

h) Physical conduct that includes touching, assaulting, or impeding or blocking movements. 3) Unwelcome sexual advances (either verbal or physical), requests for sexual favors, and other verbal

or physical conduct of a sexual nature constitute sexual harassment when: a) submission to such conduct is made either explicitly or implicitly a ternl or condition of

employment; b) submission or rejection of the conduct is used as a basis for making employment decisions; or, c) the conduct has the purpose or effect of interfering with \vork perforn1ance or creating an

intimidating, hostile, or offensive work environment.

, 4) If you experience or witness sexual or other unlawful harassment in the workplace, report it

immediately to your captain. If the captain is unavailable or you believe it would be inappropriate to contact that person, you should immediately contact the Operations Manager or any other member of management. You can raise concerns and make reports without fear of reprisal or retaliation.

5) All allegations of sexual harassment will be quickly and discreetly investigated. To the extent possible, your confidentiality and that of any witnesses and the alleged harasser \\'ill be protected against unnecessary disclosure. Wl1en the investigation is completed, you will be infonned of the outcome of the investigation.

6) Any captain or manager who becomes aware of possible sexual or other unlawful harassment must immediately advise the Operations Manager or any member of management so it can be investigated in a timely and confidential manner. Any employee engaging in sexual or other unlawful harassment will be subject to disciplinary action, up to and including ternunation of employment.

The Sumner County Personnel Policies Manual contains the following policy: Sumner County's Position on Harassment 1) Sumner County is committed to maintaining a work environment that is free from discrinunation

where employees at all levels of Sumner County are able to devote their full attention and best efforts to the job. Harassment, either intentional or unintentional, has no place in the work environn1ent. Accordingly, Sumner County does not authorize and will not tolerate any fonn of harassment of or by any employee (i.e., supervisory or non-supervisory) based on: a) race, b) sex, c) religion, d) color, e) national origin, f) age, g) disability, h) or any other factor protected by law.

2) The tenn "harassment" for all purposes includes, but is not linuted to, offensi\'e language, jokes, or other verbal, graphic or physical conduct relating to any employee's race, sex religion, color. national

25

, ongm, age, disability, or other faclor protected by law, which would make the reasonabk person experiencing such harassment uncomfortable in the work envirolUnent or which could interfere with the person's job perfonnance.

Sexual Harassment Sexual harassment includes:

(a) physical assaults of physical conduct that is sexual in nature: (b) unwelcome sexual advances or comments or requests for sex or sexual activities linked to ones' employment or advancement, regardless of whether they are based on promises or threats; (c) sexual displays or publications such as calendars, cartoons, or graffiti; (d) other verbal, electronic or physical conduct of a sexual nature that has the purpose or effect of interfering with an individual's work perfonnance or creating an intimidating, hostile, or offensive work environment; or (e) retaliation for complaints of harassment.

3) Sumner County regards all such pervasive conduct as creating a hostile and offensive work environment in violation of this policy, regardless of whether submission to such conduct is made either explicitly or implicitly a tenn or condition of employment.

,

4) Examples of sex harassment include:

a) sexual propositions,

b) sexual innuendo,

c) sexually suggestive comments,

d) sexually-oriented "kidding", "teasing", or "practical jokes,"

e) jokes about gender specific traits,

f) foul or obscene language or gestures,

g) displays of foul or obscene printed or visual material,

h) electronic conununications

i) physical contact, such as patting, pinching or brushing against another person's body; j) reading or otherwise publicizing in the work environment materials that are sexually suggestive

or revealing. Other Forms of Harassment 5) Harassment based on an individual's race, religion, age, national origin, disability, or other protected

status is also expressly prohibited. This includes any verbal, written, or physical act in which race, religion, age, national origin, or disability is used or implied in a manner that would make a reasonable employee uncomfortable in the work environment or that would interfere with the employee's ability to perfonn the job. Examples of harassment based upon race, religion, age, national origin, and disability include the display or use of objects, pictures, or language that adversely reflect on or are offensive due to a person' race, religion, age, national origin, or disability.

How to Report Instances of Harassment 6) Sumner County cannot resol ve matters that are not brought to its attention. .£\ny employee, regardless

of position, who has a complaint of or who \vitnesses harassment at work by anyone, including supervisors, managers, employees or even non-employees, is responsible for inli11ediately bringing that matter to SUHmer County's attention. The complaint should be brought to the attention of the County Executive or appropriate elected official.

How Sunmer County will Investiuate Complaints

, 7) Sumner County will thoroughly and promptly investigate all claims of harassment. Sumner County

will meet with the complaining employee to obtain a written account of the harassment, to discuss the results of the investigation, and where appropriate, review the proposed resolution of the matter. If an investigation confinns that harassment has occurred, Sumner County will take corrective action. including such discipline up to and including immediate termination of an employee. as is appropriate. Claims of assault or the threat of assault will result in dismissal.

Our Commitment to an Effective No Harassment Policv

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, 8) Finally, if you feel that Sumner County has not met its obligations under the policy. you should contact the La\\- Director at 451-6060. An effective ~o Harassment Policy depends on all of us. working together. to address this very important subj eCL

3.24 Procedure: Attendance and Punctualit)· I) As an employee of SCE:vlS, we expect you to be reliable and punctual by reporting for work on time

and as scheduled. When you are absent or late, it places a burden on other employees and can impact productivity and service. fn the rare instances when you cannot avoid being late or are unable to work as scheduled, be sure to notify your captain as soon as possible so that appropriate arrangements can be made.

2) An employee is responsible for notifying his Captain of his absence each day of the absence and advising when he will report back to work. (This does not apply to absences due to scheduled vacation or camp time usage). Unexcused absences and excessive excused absences are cause for progressive disciplinary action and may result in tennination. SCEMS also resef\'es the right to ternunate any employee who is absent without notification. Below are guidelines regarding employee absence: a) An employee is considered absent if he or she is not present for work as scheduled, regardless of

cause.

, b) Employees will not be allowed to apply paid absence benefits to unexcused absences. - For

absences that result from a sickness but there is no sick time available to cover the absence the Sumner County policy states: Employees who have used all of their accumulated sick leave will not receive financial compensation for additional days needed due to illness or injury. For any additional time needed, the employee will be considered as on a leave-without-pay-status unless the employee has any accumulated vacation time or compensatory time remaining. The employee may request that additional sick leave be credited against the remaining vacation or compensatory time."

c) Absences resulting from jury duty, appro\'ed participation in professional affairs and nlilitary leave are exceptions to this policy.

d) Supef\'isors are to give special attention to absence patterns such as: i) Absences on scheduled weekends, Saturday, Sunday, or both; ii) Absence the day before and/or the day after a scheduled holiday or day off. iii) Absence the day after payday; iv) Calling in sick as rapidly as sick time is accrued, especially if used one day at a time; v) Coincidence of absence with desirable days off.

3) Because unplanned absences can be disruptive to work, a poor attendance record or excessive lateness may lead to disciplinary action, up to and including tennination of employment.

3.25 Procedure Absenteeism/Tardiness

Purpose

1) One of the most disruptive acts on the part of any employee is that of absenteeism or tardiness. As

such, absenteeism and tardiness must be subject to appropriate, progressive discipline, applied in a consistent marmer.

Records Revie'w 1) Records on employee absenteeism and tardiness must be maintained each pay period by the captain

for each assigned employee. Captains should review at least weekly the records of all assigned employees for any incidents of unacceptable absenteeism or tardiness for action as mentioned in the procedure below. The key factor is that supef\'isors must regularly review all records, not only those of employees with preyiously unsatisfactory records.

Procedures: Absences I) All regular full time employees are provided vacation time. The amount that is awarded is

dependent on the length of time worked.

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a) 40 hours for the firs! year

b) 80 hours for years 2,3 and 4

c) 120 hours for years 5 and above

2) Requests for Vacation Time Requests for vacation lime shall be requested via SeEMS Web site vacation request form and be submitted a minimum of seven (7) calendar days prior to the requested day(s). Requests will be filled on a first-come first-serve basis. Requests less than the seven (7) calendar day limit shall be subject to the approval of the Captain/Supervisor.

3) NOTE: Submitting a vacation request does not automatically mean that the request has been approved. Check with the SCEMS Web page Scheduling calendar to see if your time has been filled. If you have any further questions about your request being approved, contact your Captain/Supervisor.

4) For more information regarding absences, please review Section #4 Timekeeping and Time Off Related Issues

Procedure: Tardiness I) "Tardiness" is defined as reporting to work after the nomlal stal1ing time or lea\'ing prior to the

regularly scheduled time to get off 2) All regular, full time employees may be excused for good cause by their Captain/Supervisor up to a

maximum of five (5) latenesses per calendar year 3) This procedure is in no way intended to condone tardiness. The maximum number of latenesses

allowed under this procedure should more that cover the number of emergency situations that would cause the average conscientious employee to be late for work. Captains/Supervisors, however, are not obligated to excuse any lateness if, in their opinion, the reason for the lateness is not acceptable.

, 4) Each incident of tardiness should be addressed by the Captain/Supervisor and may result in a reprimand. The reprimand procedure will follow the Progressive Discipline policy guidelines. 5) Employees who, because of personal business, must be absent from work for any period of time should arrange with their Captain or Supervisor to be excused. The request should be placed well in advance of the anticipated time for the absence. Such an absence will require that the employee has the personal time, comp, sick, etc, as applies to cover the absence.

6) Requests for absence may be denied based on the ability of the Captain/Supervisor to cover the requested time off

3.26 Procedure: Cellular Phone and Camera Use Policy Purpose: To prevent distractions in the workplace and help ensure the safety and privacy of all

personnel and the patients we serve.

Policy: Cellular phone use and use of personal digital assistants (PDAs) while on duty shall be limited to necessary \vork-related calls made on work-issued phones. Personal use of cell phones whether personal or company-issued is only permitted during limited times when work responsibilities are not being perfonned. Use of personal cameras - whether cell phone cameras, stand-alone cameras, or cameras contained on any other such personal devices whether digital or conventional film cameras while on duty or when perfol1ning any patient care functions for or on behalf of SCEMS - is strictly prohibited.

Procedure:

A - Cellular Telephone Use.

, I) Personal cellular telephones are pennitted to be carried while on duty, but must be placed on silent

mode, and allow voice mail to answer the call. Messages may be checked on "down time" when not actively involved in a call or about to perfonn or in the process of perfonning work duties. All personal cell phones must be "intrinsically safe" consistent with the national standards for portable electronic equipment (such as portable radios) carried by emergency service personnel into hazardous environnlents, and be carried in a safe and concealed area on the person that does not

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, interfere with the physical requirements of the job. \vill not fall off, or cause others to be distracted by the presence or appearance of the dnice.

2) Personal cell phone use must never be cause for delay in responding to a patient or beginning an assignment, and should never be used while completing an assignment.

3) While attending to a patient or while operating a Company vehicle, personnel shall not, under any circumstances, respond to (or make) a personal cellular telephone call, send text messages, or check electronic mail on PDAs or other such devices. The use of these devices is also at all times prohibited while walking near the aircraft in the care of a patient.

4) Personnel are prohibited from using personal cellular telephones or PDAs between the dispatch of a call and the time that the call is cleared. This is to prevent any distractions while engaged in patient care, and to avoid any possible interference with equipment that may occur based upon the cellular activity. Example: Use of a personal cell phone is prohibited while at the hospital and while getting the unit ready to respond or while completing necessary paperwork. But once all post-run activities at the hospital are completed and the unit is back in service, the personal cell phone may be used if necessary in an appropriate location as long as the use does not delay movement of the vehicle back to the station or to the next assignment.

B - Camera Use. I) Under no circumstances shall any personnel be pennitted to use the camera function of a personal

cellular telephone while on duty in the process of responding to, working on the scene, transporting to the hospital or dropping off the patient at a medical facility.

, 2) Personnel are only permitted to use cameras or other picture taking or image generating devices

authorized and issued by SCEMS while on duty. The company issued devices are intended to be used by the captain or supen'isory crew in activities related to the needs of SCEMS. No other picture taking devices including personal electronic devices, PDA's, cameras, or other personal computers (not issued or authorized by SCEMS for patient care purposes) shall be used by personnel while on duty.

3) All on-scene photography shall be for clinical and/or documentation purposes only and conducted only at the direction of SCEMS supervisory personnel in charge at the scene or by medical command.

4) l\ny photographs containing individually identifiable infon11ation are covered by the HIP AA Privacy Rule and must be protected in the same manner as patient care reports and other such documentation.

5) Anyon-scene images and any other images taken by an employee in the course and scope of their employment are solely the property of SCEMS and not the property of the indi vidual stafT member. This includes any image inadvertently taken with a staff member's personally o\voed cell phone camera or other digital imaging device.

6) No images taken by an employee in the course and scope of their employment may be used, printed, copied, scanned, e-mailed. posted, shared or distributed in any manner without the express, written approval of SCEMS's Privacy Officer. Example: This prohibition includes posting photos on personal web sites, such as FaceBook or MySpace, or on other public safety agency web sites, or emailing images to friends, colleagues or others in the EMS industry.

7) Failure to comply with this policy on cell phone and cameras usage can result in disciplinary action up to and including termination.

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, Section #4 Timekeeping and Time Off Related Issues

Policy: SCEJIS vailles its employees reali:es that each employee willueed time offfrolll duty from tillle to time for various reasolls. The fol/mvillg sectioll will address this ami tillle off benefits extellded to the employee:

Contents: Procedures Section 4.0 Time Off - General Section 4.1 Sick Leave Benefits Section 4.2 Time Off to Vote Section 4.3 Bereavement Leave Section 4.4 Family l\·ledical Leave/l\

4.1 Procedure: Sick Leave Benefits 1) SCEMS provides paid sick lea\'e benefits to eligible employees for periods of temporary absence due

to illnesses or injuries. Employees in the following employment classifications are eligible for sick leave: a) Regular full-time employees b) Orientation employees

2) Earning and Accumulating Sick Davs. Sick lea\'e shall be considered a benefit and privilege and not a right. Full-time employees will receive full pay during incapacity caused by illness if sick leave is taken. Sick leave is earned at the rate of one day (8 hours) per month (12 days per year). There is no maximum accumulation of sick leave credits. Sick leave has no cash value. In the event of retirement, all unused sick leave will be credited toward time of service and used to calculate retirement benefits.

3) If an employee is in a paid status for one-half of the month or more, he. she will be credited with one day of sick leave for the month. Otherwise, he.'she will not accrue any time for the month.

4) Use of Sick Leave An employee may utilize sick leave allO\vance for absence due to his her own illness or injury. Sick leave may be used during an illness related to mother, father, wife, husband, or children. Sick leave may also be used for appointments with a licensed doctor, dentist, or recognized practitioners. Wilen appropriate, a partial sick day maybe used rather than a full day. Employees who become ill during the period of their vacation may request that their vacation be temporarily temlinated and the time changed to sick leave. However, such request must be justified by means of a doctor's statement upon return to work. No employee may give or loan sick leave to another employee.

5) Unless a partial sick day is granted by your Captain, all requests for sick time are 24 hours. 6) Documentation of Sick Leave. Employees are required to notify their Captain as early as possible on

the first day of their sick leave absence. If you are unable to report to work due to illness or injury, you should notify your Captain at least 1 hour before the scheduled start of your workday. In this way the Captain will be able to make arrangements for your replacement without taxing the system too much. Your captain must also be contacted on each additional shift of absence. Notice of these subsequent days of absence should be made to your Captain as early in advance as is possible. Employees must physically talk to a Captain when calling out of work.

7) If you are absent for more than 24 consecutive hours due to illness or injury, a physician's certification must be obtained. The certi