POLICIES & PROCEDURES INDEX COMMACK VOLUNTEER · PDF filePOLICIES & PROCEDURES INDEX COMMACK VOLUNTEER AMBULANCE. GENERAL POLICY . 0001 Member personal injury policy

POLICIES & PROCEDURES INDEX COMMACK VOLUNTEER AMBULANCE

GENERAL POLICY 0001 Member personal injury policy

0002 In-house availability policy

0003 Animal / Pet Policy

0004 9/16 Violence Progress call

0005 Chain of Command

0006 Sexual Harassment Policy

0007 Response Policy

0008 Stand-by Policy (in-house)

0009 Privacy Policy

0010 Incident Management System

0013 Overnight Hour Restriction

0015 Physical exams

0016 Computer Etiquette

0017 Length of Service Award System

0018 Educational Sponsorship

0019 Minimum passing grade

0020 Firefighter Driver

0021 Social Suspension

0022 Good Standing

0023 Honor Guard

0024 Electronic Information

0025 Borrowing

0026 Good & Welfare

RADIO POLICY

0001 CVAC IDENTIFIER

0002 Portable radio usage policy

0003 Auxiliary phone panel

MEDICAL COMMITTEE POLICY

0001 Ambulance clean-up / Decon

0002 Ambulance Checks

0005 Conference selection criteria

MUTUAL AID POLICY

0001 CVAC Mutual aid policy

0004 East Brentwood / LIE M/A policy

UNIFORM POLICY

0001 Citation Bars / Collar Brass

0002 Uniform distribution policy

RESPONDER CAR POLICY

0001 Responder

0002 Chiefs Vehicles

MOTOR VEHICLE POLICY

0001 Ambulance Checks

0002 Driver Training Qualifications

DISPATCHER POLICY 0001 FRES phone numbers

0002 Subpoenas

0003 Maximum occupancy

0004 Direct calls for assistance

0005 Alphamate policy

0006 Servicemen and deliveries

0007 Suspected false alarms

0008 Dispatch Office Coverage Policy

0010 Beginning of tour

0011 End of tour

0012 Power failure

0013 Paging procedure

0015 Paging with brevity

OPERATNG POLICY

0001 Pt. In Policy Custody

0002 Unable to access/locate pt.

0003 Unattended Death

0004 Sexual Assault

0005 Crime Scene

0006 Child Abuse reporting

0007 DOH Reporting

0008 Refusal of Medical Aid

0009 Designated Receiving Hospitals

0010 Gurwin Center

0011 Cellular phone / pager use on call

0013 Crew Configuration

0014 Diversion Enroute

0015 EMT

0016 Crew Chief Training

0017 High Visibility Vests

0018 Probie Response Guidelines

0019 Incident Action Plan

0020 Senior Corps / YS Interaction

0021 Probationary Member

0023 Bike Team

BUILDING POLICY

0001 Parking

0002 Work on the Building

CREW ASSIGNMENT POLICY

0001 Assignment Policy

YOUTH SQUAD POLICY

0001 Participation

MEMBERSHIP COMMITTEE

0001 Date of Membership

MCI

0001 MCI Trailer

MEMBER PERSONAL INJURY COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 08/26/01 General 0001

Updated 06/11/12

This policy was created to guide the members in the appropriate actions to take in treating and reporting any accident or injury to a Corps Member while on duty and/or acting as a member of the CVAC. MEMBER SHOULD: Immediately report injury / accident to the Chief, Crew Chief, or EMT in charge Report the incident to dispatch Seek appropriate emergency medical treatment (ie: ambulance transport or ER visit, Drs Office) The Corps address (PO Box 819) is to be used when registering for treatment. This prevents billing to the member’s home. ALL incidents are to be reported as a Worker’s Compensation case. Complete CVAC WORKERS COMPENSATION PACKET upon return to the building (or as soon as possible thereafter). Packets are available in the ambulance and the Atrium forms rack. Forms are completed even if emergency medical attention is not immediately sought.

DISPATCHER SHALL:

Log the Incident in the Daily Log AND ambulance log only if treated/transported Alphamate Officers and advise of the particulars. Who was injured – how, when, actions taken.

OFFICERS WILL:

The Chief and the Board of Director Representative will review the incident and make appropriate recommendations to the Board and the Officers. PCR:

ALL treated injuries to a member require a PCR. If transport is not required or desired, follow normal protocol for RMA.

IN-HOUSE AVAILABILITY COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 08/26/01 General 0002 Updated 10/16/01

This policy was created to guide the Dispatcher and Members in appropriate conduct for when a call is received. It includes expected behavior should a member become unavailable to participate as an Operational/Dispatching Member while in the building. For the purposes of this policy ‘in the building’ Shall be considered to include: physically in the building, on Corps property, and /or participating in a Corps event. DISPATCHER

Often members come in and out of the building without checking in with dispatch. The dispatcher should consider persons that may be out back washing vehicles, in the garages, or in the basement. When a call is received an overhead page should be done requesting available personnel to contact dispatch. “Anyone available for a signal 16 intercom dispatch” MEMBERS are:

Expected to be free of disability and ready for service when in the building Expected to be alcohol/drug free for at least six (6) hours Expected to have appropriate clothing and footwear to prevent injury on call Expected to report their availability to dispatch upon receipt of an alarm RESPONDING FROM THE BUILDING.

Personnel utilizing a responder vehicle from the building , in response to an alarm, must first ensure the adequate staffing of the ambulance.. UNAVAILABILITY

Should a member in the building be unavailable he/she is to leave the building immediately upon receipt of the ambulance call and MAY NOT RETURN until the end of the duty shift, or until such time as they become available. Unavailability of a member includes deferring/refusing to go on a call pending the response of another member. (ie: I have work to do…but if you can’t get anyone else) Members are encouraged to do work, study, relax, and utilize the corps facilities for personal use. However, it is to be understood that the primary responsibility of handling ambulance calls supercedes these activities and does not constitute a valid reason to refuse active ambulance service.

ANIMAL / PET POLICY COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Updated; 01/01/2009

This policy is designed to guide members in the expected behavior for themselves and their pet guests while in the building. It is a compromise that will allow members to share equally and equitably our facility. AMBULANCES

Under no circumstance shall any pet be allowed in any part of the ambulance(s) and or responder vehicle(s), this includes both the patient and driver compartments where applicable. BUILDING

Pets are not permitted in the lounge or bunk rooms at anytime. Please remember that some of our members have severe allergies to animal dander and will have a reaction even after you leave. Pets are permitted in the meeting room, provided that they are attended and controlled. A member retains full responsibility for the actions of their pet guest at all times. A suitable cage or leash must be on hand to secure the pet. GROUNDS

Members may bring their pets onto Corps ground provided that they have a method for securing the pet ie: leash or cage. They are responsible for the conduct of the pet and for appropriate cleaning up of animal waste. SERVICE ANIMALS

The American’s with Disability Act and NYS DOH Policy Statement 07-01 Service Animals allows Service animals to accompany their masters anywhere, including hospitals and ambulances. This is an exception to our pet policy. These animals will be given appropriate access to CVAC facilities and transported with the patient. Service animal: Any dog that has been trained to do work or perform tasks for the benefit of a person with disability provided that the dog is owned by such person or that person’s guardian.

9/16 VIOLENCE IN PROGRESS COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


This policy is designed to guide members in the appropriate safe handling of (VIP) violence in progress calls. All are reminded that common sense and protection of CVAC personnel and equipment are the paramount concern here and not adherence to a policy. INITIAL NOTIFICATION

The dispatcher and only the dispatcher shall contact MEDCOM and request the specifics for a 9/16 violence call when activated. An EMD priority code is available for these calls and should be obtained. DISPATCHER

1) Notify in-house crew of alarm particulars 2) Page for crew members as needed (no specifics over the radio). All crew to HQ. 3) Alphamate officers with particulars – make sure VIP or 9/16 status is noted clearly 4) Maintain crew on stand-by in-house until requested or cancelled

MEDCOM FOLLOW UP REQUESTS / INFORMATION

If no request or cancellation is received within the first ten (10) minutes the MEDCOM operator will follow up with the PD dispatcher. They will recheck every ten (10) minutes thereafter until there is a resolution.

CHAIN OF COMMAND COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Updated 06/11/12

OPERATIONAL OFFICERS

The Operational Officers, Chief Officers, are elected and authorized by the By-Laws to govern the organization on a day-to-day basis including the establishment of operating procedures such as this. The ultimate authority for governing the day-to-day operation as well as on scene command when present rests with these officers. CREW CHIEF

Duly appointed and authorized by the Officers of the Corps to act on their behalf at all times. The Crew Chiefs duties and responsibilities extend through the operational and administrative branches of the Corps EMT-CREW CHIEF

Article 9 of the Rules and Regulations provides for the operational authority of a non-crew Chief EMT when one is not available or required. Particulars on the definition of such personnel can be found in that article. HEIRARCHY

It is expected that all members of the ambulance crew shall work together as a team to provide the best in patient care/transport to the hospital. It is expected that the operational control at an incident shall be as follows: ON SCENE PATIENT CARE Chief Highest Level of Care Crew Chief Senior EMT COMMAND

For the continuity of care and operation on scene it is necessary for the ambulance crew to determine someone in charge. Lack of an Incident Commander on any alarm will quickly lead to lack of coordination on the simplest of alarms…and anarchy on the larger incidents.

SEXUAL HARASSMENT POLICY COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Updated 06/11/12

It is the policy of Commack Volunteer Ambulance Corps to prohibit harassment of its members and employees in the workplace. Harassment on the basis of sex is a violation of Sec. 703 of Title VII of the Equal Employment Opportunity Commission Regulations. Unwelcome sexual advances, request for sexual favors, and other verbal or physical conduct of a sexual nature constitute sexual harassment when; (1) submission to such conduct is made either explicitly or implicitly a term or condition of an individual’s membership or employment; (2) submission to or rejection of such conduct by an individual is used as the basis for membership or employment decisions affecting such individual; or (3) such condition has the purpose or effect of unreasonably interfering with an individual’s work performance or creating an intimidating, hostile, or offensive working environment. CVAC will not condone any sexual harassment of its members or employees. All Officers, Members, and employees, will be subject to severe discipline, including termination, for engaging in behavior determined to constitute sexual harassment. A member or employee, who feels victimized by sexual harassment should report the alleged harassment to the President or Vice President (Chief/Assistant Chief) immediately. No member or employee will be subject to any form of retaliation or discipline for pursuing a sexual harassment complaint. POLICY: 1. Purpose: To provide CVAC members and employees with a work environment free of

harassment, thus encouraging efficient, productive and creative work. 2. Scope: All members and employees. Probationary members, Support Personnel, and members of

any other ancillary organization including seasonal and intern members are also covered by this policy.

3. Policy Definitions:

A. Member/employee conduct: CVAC will not tolerate verbal or physical conduct by any member or employee which harasses, disrupts, or interferes with another member’s or employee’s work performance or which creates an intimidating , offensive, or hostile environment.

B. Basis of harassment: While all forms of harassment are prohibited, it is CVAC’s policy

to emphasize that harassment on the basis of sex, race, religion, age, national origin, or other illegal or immoral basis is specifically prohibited. Each Officer or crew chief has the responsibility to maintain a workplace free of any form of harassment. No officer or crew chief shall threaten or imply, either explicitly or implicitely , that a member or employee’s refusal to submit to such harassment will impact assigned duties, shifts, or other conditions of membership or employment.

C. Other types of harassment: Other harassing conduct in the workplace, whether committed

by officers, crew chiefs, other members or employee’s is prohibited. D. Such conduct includes: 1) Sexual innuendo, jokes, touching, advances, or propositions 2) Racial or religious slurs 3) Ethnic or age jokes

4) Excessive use of profanity and/or use of profanity within the hearing of minors or visitors

4. PROCEDURE A. Reporting of Harassment

1) Any member or employee who believes that the actions or words of an Officer, Board Member, Crew Chief, or fellow member/employee constitutes harassment, has a responsibility to report or complain as soon as possible to the President or Vice President.

2) Once an Officer, Board Member, or Crew Chief is aware of any harassing

behavior, CVAC can be held liable if management is aware of such harassment and no action is taken. EEOC guidelines hold a company responsible for the acts of its agents and supervisory personnel with respect to harassment. The Officer, Crew Chief, or Board member can be held personally liable for any proven charge of harassment.

B. Investigation of harassment charges

All complaints of harassment must be investigated within ten (10) days in a confidential manner by the President and/or Vice President. The President or Vice President must provide a written report of findings to the Officers of the Board of Directors. If any member or employee is not satisfied with the handling of a complaint or the action taken by the President or Vice President, then he/she should bring the complaint to the attention of the Officers of the Board of Directors. In all cases, the member or employee is to be advised of the findings of the President, Vice President, or Board of Directors. C. Disciplinary Action Any member or employee, Officer, Crew Chief, or Board of Director who is found after appropriate investigation to have engaged in harassment of another member or employee will be subject to appropriate disciplinary action, depending upon the circumstance, up to and including termination. No member or employee will be subject to any form of retaliation or discipline for pursuing any harassment complaint.

RESPONSE POLICY COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 01/01/01 General 0007 Updated 06/11/12 The following shall define CVAC’s response policies and supercedes any previous document contrary to the information provided herein. Any changes to the current procedures become effective immediately. AMBULANCE RESPONSE

The ambulance shall respond COLD to the scene of all calls received and determined to be ALPHA responses in accordance with the correct use of the MPDS dispatch protocol system version currently in use. The ambulance shall respond HOT to all other alarms (BRAVO, CHARLIE, DELTA, ECHO, and UNDETERMINED). If a second ambulance responds, it shall respond cold unless the call is an Echo, the initial responder requests an upgrade or there are multiple patients reported or likely.

ALS RESPONSE

Advanced life support personnel should be requested to respond to all CHARLIE, DELTA, AND ECHO level calls. An ALS provider in the responder can satisfy this requirement if necessary although the intention is to keep the responder available whenever possible. PERSONAL VEHICLES

Unless very close to the scene (this requires personal judgment) or responding to an Echo Alarm, operating members should await a Signal 3 or request permission from the Dispatcher before responding to the scene. In all cases, they should radio or call into dispatch for effective coordination of responding resources. When calling in, please provide your operating capacity (e.g., EMT/Driver, ALS/Driver, etc.) These members may utilize a green light for the purposes of responding to the scene and/or headquarters for alarms with EMD determinants Bravo or highter. The utilization of such a device does not allow the operator of the vehicle to disregard normal traffic laws. It is a courtesy light requesting other vehicle operators to yield the right of way. Members in personal vehicles should not respond to MVAs on the LIE, NSP ,SMP or their service roads unless a Signal 3 with member needed to the scene, is given and you are either cleared to respond by the Dispatcher or directed by CVAC Command. You may in all cases respond immediately to the building in case an additional crew is needed.

STAND-BY POLICY (IN-HOUSE) COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 01/01/01 General 0008 Updated 06/11/12 POLICY:

CVAC Officers shall have the power to place CVAC Headquarters and grounds off limits during an in-house stand-by. (ie: Installation Dinner, picnic). The neighboring department should be made to feel as at home as possible. This includes free and unrestricted access to the lounge…. Etc… without CVAC members wandering through the building. Stand-by Crew members are to handle all alarms. CVAC personnel are not to respond on alarms without the expressed verbal consent of the officer in charge at that time. (ie: jumping in an ambulance and beating the stand-by crew out the door). OFFICERS:

The CAO shall make arrangements for the stand-by crew and he or his designee shall be present to great the crew when they arrive. The MVO shall insure the presence of a working vehicle and he or his designee shall be on hand to familiarize the stand-by crew. The MVO shall ensure the provided ambulance is stocked and he or his designee shall be on hand to familiarize the stand-by crew. The SAA shall provide adequate signal 8, or arrangements thereof. With the appropriate sanctions one member may handle greeting and familiarizing the stand by crew.

PRIVACY POLICY COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


CORPS MEMBERS

CVAC maintains a policy of complete privacy for all information regarding the active membership and

It’s support organizations.

Information on Corps Members is available only to other Corps Members. All care should be given to protect the integrity of CVAC membership information, lists, etc… Only other Corps Members are entitled to information on Corps Members. As a rule of thumb the dispatcher should only give out such information if they can find the calling party on the active CVAC Roster (roll-a-dex). The dispatcher should consult an Officer, the Duty Crew Chief, or the EMT in Charge if a question exists. Dispatchers are instructed to err on the side of caution at all times. CVAC shall not make public its membership list except where required by law.

PATIENT CARE DOCUMENTS (PCRS) - CALL INFORMATION

Patient care documents are protected by patient confidentiality laws. No information on patients, their medical condition, or treatment is to be given out by any member of the organization. All requests for such information should be forwarded to either the Chief of Department or the Record Keeper of record for the department. Documents are released by notarized letter to 1st party requestors and by subpoenas only to all other interested parties. This includes law enforcement officers. It is acceptable to provide generalized information, where appropriate, to assist patient family in finding their loved ones etc…. confirming an alarm or the hospital of transport. Great care must be given not to break confidentiality laws by providing patient information. (A) EMT STUDENTS

No member of the CVAC is authorized to make a copy of a patient care document for ANY reason. Those requiring copies of PCRs for Suffolk County (A) EMT training shall submit a request for copies of such records to the CVAC Record Keeper. The form for this purpose shall be found on the CVAC Website. Only the Record Keeper shall be authorized to copy such documents.

INCIDENT MANAGEMENT (IMS) COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Updated 06/11/12

INCIDENT MANAGEMENT (IMS) is a modular system of coordination nationally recognized as the standard for emergency operations. It has been adopted, almost universally, by fire, police, and ems agencies around the world. CVAC has adopted the IMS system, in it’s most current version, for use at all incidents. INFORMAL COMMAND is acceptable for operating at one ambulance / one patient incidents involving only CVAC. It requires only the designation of an Incident Commander who operates as the defacto commander for all operations. FORMAL COMMAND must be utilized at all multi-patient, multi-ambulance, and/or multi-jurisdictional incidents. (multi patient is 3 or more ambulances or mutual aids).

A. COMMAND

The chief, crew chief, or senior EMT shall assume command, designate a command post, and give an initial situation report to base.

1. Situation report: a. Individual assuming command b. Scene size up c. Initial request for apparatus and personnel d. Location of command post and staging area B. STAGING The Driver of the first ambulance shall assume the role of staging / transport officer And shall determine the proper positioning for arriving vehicles, staging area etc… 1. In-formal staging. Smaller incidents where ambulances are positioned at on-set for the duration of their presence. 2-3 ambulances only. 2. Formal staging. Establishment of actual staging area, listing of equipment and personnel on site, tracking of vehicular transports. 4 + ambulances. C. TRIAGE / TREATMENT Highest ranking member of the crew remaining or next qualified responder shall assume

the role of Triage Officer and/or Treatment area officer. Incident size will determine if this is one or two separate sectors.

D. OTHER SECTORS

Determined by the size and scope of the incident. Appointed by the Incident Commander and serving until terminated. Sectors may include: logistics, safety, public information, supply, planning, and administration.

E. OPERATIONAL OFFICERS

Shall assist Incident Commander as Support Personnel. Large scale incidents may

necessitate Operational Officers replacing lesser trained personnel as Sector commanders where appropriate.

F. PRACTICE

In order to remain proficient all members are expected to utilize the IMS System as

outlined above. Practice makes perfect. A complete explanation and delineation of the CVAC plan can be found in the latest

revision of the CVAC Mass Casualty Incident Plan.

OVERNITE HOURS RESTRICTION COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


POLICY: Persons not assigned to the overnight shift shall not enter the CVAC Headquarters building between the hours of 01:00 and 05:00 without prior permission of the Crew Chief or in his absence, the senior EMT. 0000 – 0600 are quite hours; loud games, conversations, etc. should be avoided. Officers and persons responding to or from an alarm are exempt from this restriction.

PHYSICAL EXAMS COMMACK VOLUNTEER AMBULANCE IMMUNIZATION RECORDS OPERATING PROCEDURE


Updated: 06/11/12 SCHEDULE OF PHYSICALS

ALL NEW MEMBERS PRIOR TO INITIAL DUTY

MEMBERS EVERY TWO YEARS

LAST NAME STARTS WITH A-M EVEN YEARS LAST NAME STARTS WITH N-Z ODD IMMUNIZATION RECORDS

The member shall provide immunization records. In the absence of such records the CVAC medical authority conducting the physical exam shall require titers to insure immunization and administer boosters as needed. Immunization records must include, but are not limited to: diphtheria, tetanus, polio, measles, mumps, rubella, hepatitis b, and chicken pox. HEPATITIS ‘B’ VACCINATION

Shall be provided to all members at their initial physical examination/clearance. Those refusing administration of the vaccine shall be required to sign a waiver to that effect.

DRUG TESTING

Shall be part of the new member physical for all categories of adult membership. Youth Squad members shall not be subject to drug testing. YOUTH SQUAD MEMBERS

A parent is responsible to accompany their minor child for their physical examination. PPD TESTING

Shall be conducted at least annually and in accordance with DOH procedures. RESPONSIBILITY

The CVAC bookkeeper is charged with maintaining records of those individuals who are due for physicals and are compliant. The 1st Assistant Chief / Vice President shall be the authority to ensure compliance of all members with the physical exam policies. MEDICAL PROVIDER

CVAC shall maintain only pass/fail and compliance notifications of member physicals. All documentation shall remain with the contracted provider. Records shall be maintained off-site by that providing agency. NOTE: The current provider is Sound Medical Systems of Islandia NY

PERSONAL USE OF COMPUTER COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Updated 06/11/12

Purpose: To provide a comprehensive policy to govern a member’s use of CVAC computers, peripherals, and network.

General

CVAC provides computer and internet access for the use of its membership to conduct corps and personal business. Members are at all times responsible for the appropriateness of their computer use.

All software on the CVAC Network shall be approved by the Officers and installed by the Technical Committee or their designee. No member shall be authorized to download software of any kind.

Inappropriate subject matter

As a family and quasi-public organization we expect all members to be free from exposure to potentially offensive information and/or pictures. Sexually explicit materials can be construed as harassing in nature and inappropriate for a business environment.

Security

The CVAC Network contains information protected by law and proprietary in nature. All efforts to protect the integrity of this data should be taken and are the responsibility of every member.

Members are responsible for maintaining the integrity of the CVAC Computer System through their actions. Websites of a questionable nature should be avoided. Members are responsible to maintain the secrecy of their password and responsible for the materials / actions produced by their account. Each member should be issued his or her own access, there is no reason to allow another access to your account.

Violations

Any member found in violation of this policy shall be subject to disciplinary action and reported for any violation of state or local law.

Length of Service Award Plan

COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE Volunteer Ambulance Worker’s Benefit Law

Effective 2002 General 0017-add

GUIDELINES

Tour of Duty hours: Credit is based upon the successful completion of 216 or 288 hours for the

year (based on your membership requirement) to earn the 20 points for this category. There is no partial credit and no provision for leaves of absence. (All or nothing).

Alternative Participation: Fraction of a point per call for every call you dispatch or respond on.

Dispatcher must enter you on dispatch worksheet, or listed on PCR for credit. Must be entered into Redalert by dispatch when activated.

Meetings: Credit earned for attendance at scheduled meetings of your committees

and General Meetings of the Department. Also credit for representatives to county and state councils. Officers, Board Members, Coordinators, Committee members are all entitled to points for their meetings.

Elected / Appointed: Officers, Board Members, Coordinators, Advisors receive full year, all or

nothing credit, for their responsibilities as listed above. Training Sessions: Credit, 5-10-15 points, based upon length of course. Credit awarded in the

year in which course is completed. Certification is a requirement for points. Points in this category are for classes in which you are registered for the entire class ie: CFR, EMT, EMT-CC, probies in probie class.

Drills/Seminars: CVAC offered or approved practical or lecture sessions (in-house or out

of house). 1 point per session (minimum of two hours). Drill night, Stonybrook lecture series, a member attending an evening of probie or dispatch class for credit as instructor or student (not enrolled).

Example 1:

Members should carefully consider the type of credit for which they are applying based upon past points earned and intentions for future attendance at events. As an example is a member of the training committee using a probie class as a meeting point, or are they already maxed out in meetings for the year and can use drill points. They could not use Training session points as they are not enrolled in the course. Example 2:

A Board of Director receives 12 points for their service and responsibilities as a Board Member. They are also eligible to receive up to 12 points a year if they make all Board Meetings. Example 3:

A member who is a board member and holds two coordinator positions can only earn 24 points in this Category as that is the max, despite the fact that his/her points total 36.

Length of Service Award Plan

COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE Volunteer Ambulance Worker’s Benefit Law

Effective 2002 General 0017

This Length of Service Award Program (LOSAP) is written in accordance with the New York State Law governing pension plan systems in voluntary EMS agencies. It has been adopted through resolution and referendum by the residents of Smithtown and Huntington. It is not subject to arbitrary change.

A. REQUIREMENTS

1. A Member must make fifty (50) points during the calendar year (January through December). To meet the requirements of the point system and earn one (1) year of service award credit.

2. Participation in LOSAP is voluntary. 3. You must be 18 years old to participate in LOSAP.

B. CATEGORIZATION / MAXIMUM POINTS

1. Tour of Duty/Duty Hours Maximum of 20 Points 2. Back-up responses/Alternate participation “ 25 Points 3. Elected or appointed positions “ 24 Points 4. Training sessions “ 20 points 5. Drills/Seminars “ 10 points 6. Miscellaneous activities “ 15 points 7. Meetings “ 20 points

C. TOUR OF DUTY / DUTY HOURS (Max 20 points)

1. “Tour of Duty Hours” shall be consistent with CVAC Duty Hours. Members shall earn 1/11 of a

point for every hour of riding time to a maximum of 20 points / 216 hours per year.

2. Members must sign in the sign-in log indicating T/D for all hours for which they claim credit.

3. All log entries are subject to verification of documentation.

D. ALTERNATIVE PARTICPATION / BACK-UP RESPONSES (Max 25 points)

1. Members may earn 1/8 point for every alarm responded to while on tour of duty. (in house)

2. Members may earn 1/15 point for every back-up alarm responded to /on. (responding to a page

from out of the building.

3. All log entries are subject to verification of documentation.

E. ELECTED OR APPOINTED POSITIONS

1. Points are earned for the completion of a one-year term (January – December)

a. Chief Officers 24 Points b. Administrative Officers 18 Points c. Board Member 12 Points d. Coordinator / Advisor 12 Points

2. A Member who is elected to serve as a delegate to an ambulance worker’s convention shall also

be eligible to receive one point per meeting.

3. A Member who is appointed to serve on a NYS Emergency Medical Services Council, The State Emergency Medical Advisory Committee, a regional EMS council, or a regional MAC, established pursuant to Article 30 of the Public Health Law shall also be eligible to receive one point per meeting.

F. TRAINING SESSIONS (max 20 points)

1. A maximum of twenty points can be earned in this category per year.

2. Training courses must be approved by the CVAC and shall consist of courses that further the

objectives pf the department. Ie: AEMT, EMT, CFR.

3. The member must successfully complete the course, and provide such documentation for credit.

4. Points will be awarded in the calendar year in which the course is completed.

5. Points are awarded as follows:

i. Less than 20 hours in duration – 1 point per hour , max 5 per course ii. 20-45 hours in duration – 5 points +1 point per hour over first 20 – max 10

iii. Greater than 45 in duration – 1 pt per hour over first 45 – max 15.

6. A list of acceptable training classes shall be approved by the officers and posted regularly

G. DRILLS / SEMINARS

1. A maximum of ten (10) points shall be awarded in this category per year.

2. One (1) point will be awarded per drill or seminar (minimum of two hours)

3. Drills indicate skills practice while seminars indicate lectures

4. CVAC sponsored sessions shall be approved by the Officers

5. All outside attendance shall be approved by the Officers

6. A list of acceptable drills/Seminars shall be posted regularly

H. MISCELLANEOUS ACTIVITIES

1. A maximum of fifteen points (15) can be earned in this category.

2. Participation in other activities covered by the volunteer worker’s benefit law and not otherwise listed are worth one (1) point.

3. A member shall earn one (1) point for attendance at officially recognized emergency services

meetings for which they are instructed to attended (authority of Chiefs/Officers)

4. The list shall be approved by the officers and shall included but not be limited to:

i. Parades ii. Funeral details

iii. Work details iv. Demonstrations/classes v. Ad hoc meetings/non-standing committee meetings

vi. Community service activity

EDUCATIONAL SPONSORSHIP COMMACK VOLUNTEER AMBULANCE

OPERATING PROCEDURE


Reimbursement of personal expense – Suffolk County EMT sponsored course

Members registering in Suffolk County EMS sponsored classes must submit a check for the required enrollment fee made out to “Suffolk County EMS”. Upon proof of successful completion the member should submit a signed purchase order, AND a LOSAP form, with a copy of certification attached.

Reimbursement is only available for those who meet the following requirements:

A member approved by the medical committee and in good standing when registering, throughout course, and upon course completion

Probationary members and Youth Squaders will not be reimbursed until such time as they are sworn in

Registered through CVAC

Those who receive their certification through employment, without personal expense, or enrolled through another agency are not eligible for reimbursement.

Sponsorship through an educational institution - SCCC, Suny Stonybrook etc..

Members who avail themselves of the opportunity to earn college credit for their EMT/CC certification *MUST* follow the following procedure to receive reimbursement through NYS.

The individual must be a member in good standing (any appropriate category: (OPR, YS etc..) of CVAC when registering, throughout course, and upon course completion. Probationary members and Youth Squaders will not be reimbursed until such time as they are sworn into the department.

The member shall pay CVAC the amount currently eligible for reimbursement from NYS DOH and CVAC will in turn write a check to the institution. NYS will not longer reimburse students directly; the enrolling organization must receive the money.

Upon successful completion of the course, and immediately upon receipt of card, the member *must* submit for reimbursement. NYS requires this to be processed within two weeks of receipt of the card.

Upon receipt of tuition reimbursement from the State, CVAC will issue a check back to the member in the amount of funds returned.

Sponsorship for a Paramedic Program Members who are interested in reimbursement for a paramedic program will submit a letter of intent to the officers for their review at the next scheduled officers meeting.

If approved by he Officers;

- The member will be responsible for the entire cost of the class upfront. - After successful completion of the class, CVAC will reimburse the member a total amount of $6500.00

or the price of the class (whatever is less), quarterly over a period of three years. - At the end of each CVAC quarter, if the member is in good standing, they will receive a check for the

set amount. This will continue over the three-year period. - If a member is not in good standing for the quarter, they will NOT receive reimbursement for that

quarter. A contract will be signed between the members and the board of directors.

MINIMUM PASSING GRADE COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


This statement reaffirms CVAC’s long standing position on a minimum passing grade. The minimum passing grade on any CVAC examination is 80 %

FIREFIGHTER DRIVER COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 2002 General 0020 Updated 06/11/12 Pre Requisites:

Be twenty (20) years of age or older Be a qualified driver on a truck or an engine (vans/cars/SUV’s do not qualify)

CVAC Training Requirements:

Must have CEVO Valid CPR / First Aid Card Rig / Oxygen Orientation Class Take and pass CVAC drivers training program

Requirements to maintain FFD status:

Keep a valid CPR / First Aid Card Make mandatory drills Must hold a scheduled shift, or a rotating shift at the discretion of the Crew Assignment Officer Must participate in any driving related drills and/or training as established for EVO’s by the MVO

SOCIAL SUSPENSION COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 06/15/2008 General 0021 Purpose:

To provide a uniform understanding of what a social suspension is and its ramifications to the member.. General:

Members under social suspension shall: continue to enjoy voting rights and a voice at meetings be required to make their duty hours requirements Appear weekly for their scheduled shifts (not be unassigned) Make their drill requirements

Members under a social suspension MAY:

Be in the building for their scheduled shifts May attend meeting and drills, departing immediately after the function ends May respond on back-up calls, departing immediately after the call ends

Members under social suspension MAY NOT:

Be in the building for any reason other than what is listed above Attend any CVAC social functions (on or off site) Avail themselves of any privileges connected with membership (movie passes, gym use, etc…)

GOOD STANDING COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 04/07/10 General 0022 Updated General:

A Member in good standing shall be: In compliance with the mandatory drill requirements of the department Be current in all drill requirements Not in receipt of a letter from the membership committee for hours requirement shortage Not be receipt of a letter from the membership committee for a period of unassignment Not under any suspension as defined by the rules and regulations of the department

HONOR GUARD

COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


PURPOSE: TO HAVE AN HONOR GUARD TO REPRESENT CVAC AT FUNERALS, WEDDINGS, PARADES, OR ANY OTHER FUNCTION DEEMED NECESSARY BY THE CHIEF OF DEPARTMENT. REQUIREMENTS: THE HONOR GUARD WILL CONSIST OF MINIMUM OF CHIEFS, AND 15 SENIOR CORPS MEMBERS. THE HONOR GUARD WILL HAVE QUARTERLY MEETINGS / UNIFORM INSPECTIONS. THEY WILL KEEP THEIR UNIFORMS SERVICEABLE AND READY TO GO AT ALL TIMES. UNIFORM: UNIFORM WILL CONSIST OF THE CVAC CLASS A (AS PRESCRIBED IN THE DEPARTMENT BY-LAWS AND RULES AND REGULATIONS) WITH COVER, WHITE GLOVES, AND BLACK PATTEN LEATHER SHOES. MOURNING BAND WILL BE WORN WHEN APPROPRIATE. ROLES:

HONOR GUARD COORDINATOR: ACT AS LIASON BETWEEN THE HONOR GUARD AND THE CHIEFS OFFICE. RUN ALL MEETINGS AND ENSURE THE HONOR GUARD IS READY TO GO AT ALL TIMES. HE SHALL APPOINT SOMEONE AS ACTING COORDINATOR IN HIS ABSENCE. FUNERALS: THERE WILL BE TWO MEMBERS POSTED AT ALL ENTRANCES TO THE FUNERAL HOME DURING THE HOURS OF THE WAKE AND FUNERAL. THESE MEMBERS WILL OPEN THE DOOR AND ASSIST ANYONE COMING TO PAY THERE RESPECTS TO THE FAMILY. ONE MEMBER WILL STAY INSIDE TO ASSIST THE FAMILY. THE HONOR GUARD WILL LINE UP IN TWO ROWS FROM THE DOOR TO THE HEARSE. THEY WILL RENDER A PROPER HAND SALUTE WHILE THE DECEASED IS BEING MOVED TO AND FROM THE HEARSE. AT THE FAMILY’S REQUEST THE HONOR GUARD CAN BE USED AS PALL BEARERS. WEDDINGS: HONOR GUARD SHALL BE USED AS REQUESTED BY THE MEMBER WITH APPROVAL OF THE CHIEF OF DEPARTMENT. PARADES: THE PARADE DETAIL WILL CONSIST OF FOUR MEMBERS. ONE WILL CARRY THE AMERICAN FLAG, ONE WILL CARRY THE DEPARTMENT FLAG, AND TWO WILL BE USED TO MARCH ALONG SIDE OF THE COLORS. HONOR GUARD WILL MARCH 5 PACES IN FRONT OF THE REST OF THE FORMATION OTHER FUNTIONS: HONOR GUARD WILL BE PUT TOGETHER AS NEEDED AT THE RQUEST OF THE CHIEF OF DEPARTMENT.

ELECTRONIC INFORMATION COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 2010 General 0024

1. Purpose:

To manage the authorized release of electronic information including photographic film used to create

digital images, digital images and all forms of electronic voice recordings taken by CVAC personnel and

CVAC members during official duties.

2. Procedure:

Authorized Release

a) Authorized Release of electronic information including photographic film used to create digital images, digital images and all forms of electronic voice recordings are limited to the performance of official duties of CVAC, Fire Chiefs, CVAC Photographer or Public Information Officers, and shall be for clinical presentations, CVAC / District Training, or public relation or at the discretion of the Chief.

b) All On Scene photography, images and information must be approved by the Chiefs office or Public Information Officer prior to releasing.

c) All photographs containing individually identifiable patient information are covered by HIPAA privacy laws and must be protected in the same manner as patient care reports and documentation.

Unauthorized Release

a) Unauthorized release of electronic information includes but is not limited to: photographic film used to create digital voice and images taken by an officer, employee or member of CVAC using personal voice and imaging technology of any kind in any format without prior approval. The use of current and future voice and photographic technologies, representing or portraying as official information or logos is strictly prohibited

b) Unauthorized release includes but is not limited to: printing, copying, scanning, transmission via electronic mail (e-mail), shared social networking or with any public safety agency or website for a fee, for free or as form of political comment.

c) CVAC has a zero tolerance policy for electronic information used to harass or intimidate an officer or employee of CVAC, officer or member of CVAC. Personnel will be subject to discipline and/or dismissal.

Requests for Authorized Release

a) Employees or members wanting to record and use electronic imaging and voice information devices in advance of a specific event other than a sanctioned CVAC or CVAC social event, must submit a written request to Chief.

b) Violation of this policy, or failure to permit inspection of any device covered in this policy may result in disciplinary action.

Social Networking Sites/Blogs such as but not limited to Facebook, Twitter and the Schwartz Report, should not be considered Private, regardless of your security settings. Most if not all members utilizing such sites provide access to other members and/or members of other VACs or FDs. Posting information on any these sites that is contrary to the promotion of a positive image of the Commack Volunteer Ambulance Corps, its members or its officers could result in a grievance against the posting member for Conduct Unbecoming. There is an appropriate chain of command within CVAC that permits any member with a complaint to seek appropriate redress within the organization. **Nothing within this SOP, the Rules and Regulations or the Policies of the Commack Volunteer Ambulance Corps is intended to limit a member’s rights under prevailing NY State or federal Whistleblower Laws.

COMMACK VOLUNTEER AMBULANCE BORROWING OF EQUIPMENT OPERATING PROCEDURE


1) Equipment:

a) To properly track and log equipment or resources borrowed by members.

i) Members will contact the Sgt. @ Arms and request to borrow CVAC equipment. - Member will complete a “Request for use of CVAC Equipment” form - Once approved, the member will need to provide a deposit of $100. - The item will be logged in the Daily Log when removed from and returned to the building.

ii) After inspection of the items, if no damage and all items are returned, your deposit will be returned to you.

Building Use

a. A $100.00 deposit shall be placed. This deposit shall be returned after the function at the discretion of the President if the facility is returned in acceptable condition with no damage. The president may waive the deposit at his discretion.

b. The member must remain in the building at all times during the function. If the member leaves the building or CVAC property, the function shall be terminated immediately and the President notified. The deposit shall be forfeited.

c. All functions shall be scheduled between the hours of 0900-2100 only, and all clean¬up shall be completed by 2200.

d. The member shall provide all necessary items for the function, but may use CVAC tables and chair if available.

e. Only tape may be used to hang decorations. No nails or tacks may be used. All decorations must be completely removed at the end of the function.

f. CVAC tables and chairs may not be removed from CVAC property.

g. Alcoholic beverages may not be served to nor consumed by anyone under age twenty-one (21), nor to anyone who appears to be intoxicated. The member shall be responsible for ensuring such controls are in place and are being enforced.

h. Guests are to remain in the designated area and are prohibited from the lounge, offices, Dispatchers Office, garages, ambulances, and bunk rooms.

Music by stereo or tape may be used, but no D.J.'s or bands may play at any function. Any music must be played at low levels so as not to disturb the Duty Crews or neighbors.

COMMACK VOLUNTEER AMBULANCE GOOD AND WELFARE OPERATING PROCEDURE


Updated 06/11/12 This policy will delineate the actions to be undertaken by the Good and Welfare Officer and the Chiefs, Officers and members of The Commack Volunteer Ambulance Corps following a Good and Welfare notification, except where otherwise noted in this policy. A notification is defined only as a submission of information through the Good and Welfare section of the website. For the purpose of this policy, an Active Member is defined as a current Operating, Dispatching or Probationary member, any non-operational member of the Board of Directors and all members of the CVAC Youth Squad and Auxiliary.

Hospitalization: Defined as being admitted to a hospital, including one or more overnight stay. If this requirement is not met, the G&W Officer will send a “Get Well Soon” card from the department.

Active Member: The G&W Officer will send a gift basket, cost not to exceed $75, the contents of which are at his discretion. The G&W Officer will contact the member to ascertain the member’s wishes regarding notification to the corps. All Officers will be notified of the findings. If the member wishes the corps to be notified, the G&W Officer will direct notification through the email notification account and the bulletin board. Included in the notification will be the members wishes regarding the acceptance of phone calls and visitors.

Immediate Family: The G&W Officer will send a gift basket, cost not to exceed $75 to only the spouse or children of an active member who is hospitalized. No notification will be made to the membership.

Retired Member (5 years or less): The G&W Officer will send a $50 gift basket to a retired member who is hospitalized. No notification will be made to the membership.

All other notifications: The G&W Officer will send a get-well card to the hospitalized person.

Engagement: The G&W Officer will send a card only to an active member upon receiving notification of their engagement. If requested, a note of congratulations will be posted on the bulletin board and/or atrium plasma screen.

Birth of Child: The G&W Officer will send a card along with a $50 gift card only to an active member upon receiving notification of a birth of a child. If requested, a note of congratulations will be posted on the bulletin board and/or atrium plasma screen. All other notifications receive a card only.

Wedding: The G&W Officer will send a card along with a $100 gift card to only an active member upon receiving notification of their wedding. If requested, a note of congratulations will be posted on the bulletin board and/or atrium plasma screen. All other notifications receive a card only. In the event both bride and groom are members, only one gift card will be sent.

Birthday: The G&W Officer will send out a card, containing one (1) $2 lottery ticket to all active members on their birthday month. No notification is required for Birthdays.

Holiday Card: The G&W Officer will send a card to all active members during the winter holiday season. No notification is required for a holiday card.

Funerals: The G&W Officer will serve as the officer-in-charge of all funeral proceedings. The Chief of Department has sole discretion to replace the G&W Officer with another individual to serve in this capacity on a case by case basis. Line of Duty Death (LODD) procedures are covered under the LODD policy. The following are procedures for notification of a non-LODD death.

Chief / Crew chief / Administrative Officer: The G&W Officer will send an appropriate flower/food arrangement. The Department with Honor Guard will attend both the wake and funeral services. Black bunting will be displayed above the bay doors for a period of thirty days. The Chief of Department will direct the flag to be flown at half mast until burial.*

Active Member: The G&W Officer will send an appropriate flower/food arrangement. The Department will attend both the wake and funeral service. Honor Guard will be provided if the member is buried in uniform or upon request of the family. Black bunting will be displayed above the bay doors for a period of thirty days. The Chief of Department will direct the flag to be flown at half-staff until burial. *

Spouse, Children or Parents of Active Members: The G&W Officer will send an appropriate flower arrangement. The Department will attend wake services.*

Retired Member: The G&W Officer will send an appropriate flower arrangement. Members will be notified of service arrangements and those wishing to attend will do so in civilian attire.

Spouse of Retired Member: The G&W Officer will send an appropriate flower arrangement.

Honorary Member: The G&W Officer will send an appropriate flower arrangement.

Corps Employee: The G&W Officer will send an appropriate flower arrangement. Chiefs, Crew chiefs and Administrative Officers will attend wake services.*

Spouse of Corps Employee: The G&W Officer will send an appropriate flower arrangement. *In cases where religious practices differ, the chief’s office will provide guidance to the membership.

CVAC STANDARDIZED IDS COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 11/12/93 Radio 0001

Updated 06/11/12

The following shall be considered authorized radio identifiers for use by CVAC personnel: EMERGENCY VEHICLES: 2-16-17 Ambulance 2-16-18 Ambulance 2-16-19 Ambulance 2-16-20 Ambulance 2-16-80 Responder vehicle 2-16-82 Responder vehicle 2-16-83 Responder vehicle 2-16-84 Responder vehicle 2-16-85 Responder vehicle 2-16-86 Responder vehicle NON-EMERGENCY VEHICLES

2-16-16 Cadillac ambulance 2-16-21 Transport vehicle / van BASE STATION OPERATIONS

2-16-0 CVAC BASE 2-11-0 CVAC BACK-UP BASE BOARD OF DIRECTORS*

2-16-90 Chairman of the board 2-16-91 Vice Chairman 2-16-92 Secretary of the Board 2-16-96 Head houseman

* - Radio ID is for identification purposes only. Non-Operational.

CHIEFS:

2-16-30 Chief 2-16-31 Assistant Chief 2-16-32 2nd Assistant Chief 2-16-33 3rd Assistant Chief 2-16-34 4th Assistant Chief OFFICERS:*

2-16-71 Treasurer 2-16-72 Sgt. @ Arms 2-16-73 Secretary PAID EMPLOYEES:

2-16-89 District Medic INDIVIDUAL MEMBERS

Individual members, with authorization from the chief may utilize privately owned portable radio devices. They shall identify themselves by operator# “2-16-0, this is operator #71”

PORTABLE RADIO USAGE COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 01/01/95 Radio 0002

Updated 06/11/12

MEMBER OWNED PORTABLES

Members with personally owned portable radios may request permission from the Chief of the Department to utilize such radios on CVAC licensed frequencies for emergency / alarm purposes. Portables will only be authorized to transmit on CVAC frequencies, and must have the ability to transmit a MDC ID. As per Part 90 of the FCC rules and regulations such an authorization should be in writing and available for inspection by an authorized agent of the FCC. The Officers reserve the right to limit/refuse/revoke use of such portables. Members are to limit radio traffic whenever possible and follow the appropriate chain of command at all trimes.

AUXILIARY PHONE PORTS/

Power Failure phone system COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 08/30/02 RADIO 0003 Updated 06/11/12

In the case of a complete power failure or telephone system failure Headquarters is equipped with POTS (plain old telephone sets) that can be accessed from two locations. In the event of a power or system failure the POTS phones are routed automatically. Location #1 Communications Center

Emergency lines are provided for the following lines. They are permanently affixed to the wall in The communications center. The dispatcher must remember to turn the ringers up on the side of each. All the phones ring the same, the easiest way to see which is ringing is to place your hand on it. 499-9342 MAIN BUSINESS LINE 499-0884 DISPATCHER’S LINE ----------- INTERAGENCY LINE ----------- MEDCOM LINE

Location #2 Meeting Room

Emergency ports are provided on the South wall of the General Meeting Room. The emergency telephone sets are kept locked in the Radio Room for safe keeping. In the event they are required the dispatcher will have an Officer or Radio Committee Member access and install. 6 additional POTS lines are accessible in the meeting room. #1 499-9827 #2 499-9828 #3 499-7390 #4 499-8318 #5 493-1414 #6 462-2822 System phone jacks

Two system phone jacks are available for use in the meeting room attached to the main telephone access panel on the South wall. Any standard 12 button set (atrium, lounge, downstairs offices) can be plugged into these ports. DO NOT ATTEMPT TO USE BUNK ROOM OR DISPATCH OFFICE PHONES. They will not work. MEETING ROOM PANEL

AUX 1 AUX 4 SYSTEM 1 X 22 AUX 2 AUX 5 SYSTEM 2 X28 AUX 3 AUX 6

PROCEDURE FOR COMMACK VOLUNTEER AMBULANCE DECONTAMINATION AND CLEAN-UP OPERATING PROCEDURE OF AMBULANCES

Effective 04/17/02 Medical 0001 Updated: 01/01/09

POLICY: All members shall be responsible for assuring that an ambulance is properly cleaned/disinfected at the completion of an ambulance call. SUPPLIES: Gloves

Cleaning agent Disinfectant solution (household bleach diluted with water 1:100, ¼ cup bleach per gallon of water, or equivalent commercial agent) Should be prepared at the time of use. Disposable toweling Plastic bags (red biohazard bags, household garbage bags)

CLEAN-UP PROCEDURE FOR AFTER EVERY CALL:

1. Prepare ambulance for cleaning/decontamination. a) Always wear gloves throughout clean-up procedures. b) Remove used or soiled linen and place in designated receptacle at hospital or in Bay 1 at CVAC. Soiled linen shall be cleaned using warm water, detergent and bleach as necessary. c) Discard any soiled dressings, bloody materials, and other contaminated non-sharps waste in a red biohazard bag and leave at hospital or in designated receptacle in Bay 1 at CVAC. d) Clean reusable equipment in designated area at hospital or place reusable equipment in a plastic bag (other than a biohazard bag) for transport back to CVAC for cleaning. e) Check the vehicle for needles or other sharps that may have been left and carefully dispose of them in a sharps container.

2. Check for areas soiled with blood or other body substances and clean. a) Clean moist blood and other body substances with disposable toweling and discard in red bag. b) Spray cleaning agent on affected area and remove any remaining blood or body substance.

Dispose of toweling in red bag. c) Spray disinfectant solution on affected area. Wipe over area and allow to air dry. Dispose of toweling in red bag.

3. Spray cleaning agent on remaining surfaces that the patient came in contact with, as well as

surfaces used in providing patient care. Wipe the surfaces with toweling and allow to air dry. Dispose of toweling in normal garbage.

PERIODIC CLEANING OF AMBULANCES:

CVAC shall maintain a contract with a professional cleaning service that shall clean and sanitize all ambulances at CVAC Headquarters on a quarterly basis, or more frequently, if deemed necessary. This service shall clean the floors, walls, interior and exterior of cabinets, benches and other surfaces.

CVAC shall maintain a contract with a sharps removal service that shall replace sharps containers on

CVAC ambulances on a quarterly basis, or more frequently, if deemed necessary.

POLICY FOR AMBULANCE COMMACK VOLUNTEER AMBULANCE & RESPONDER VEHICLE OPERATING PROCEDURE CHECKOUTS

Effective 04/17/02 Medical 0002 Updated 06/11/12

The crew shall be responsible for assuring that the duty and back-up ambulances are in compliance with Article 30, Part 800 requirements at the beginning of each duty shift. The crew shall use a “CVAC Ambulance Checkout Form” to complete the ambulance checkouts. Any missing equipment or supplies shall be replaced from the lockers located in Bay 1. Any discrepancies that can not be corrected must be reported to the Medical Officer immediately. Additionally, the crew, shall be responsible for assuring that used equipment and supplies are replaced at the completion of each ambulance call.

The Medical Committee shall be responsible for assuring that all four ambulances and the responders are in compliance with Article 30, Part 800 requirements. A “CVAC Ambulance Checkout Form” or “CVAC Responder Checkout Form” shall be used to complete the checkouts. Any missing equipment or supplies shall be replaced from the lockers located in Bay 1. Any discrepancies that can not be corrected must be reported to the Medical Officer immediately.

SELECTION CRITERIA / MEMBERSHIP COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 01/01/90 Medical 0005 1. Member in Good standing 2. No disciplinary actions/suspensions past 12 months 3. Assigned 4. Highest point accumulation on matrix 1PT 2PT 3PT 4PT 5PT LONGEVITY: >1 yr 1-5 6-10 11-15 15+ HOURS: short making exceed exceed + outstanding ATTITUDE poor better good great exceptional COMMITTEES: none some multiple chairman x – chairman

CVAC MUTUAL AID POLICY COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 01/01/01 Mutual 0001 Updated 5/21/04

This policy is designed to guide the dispatcher in properly handling alarms and their mutual aid when necessary. MINIMUM TIME

There is no minimum time that an ambulance call should be held for. If a ‘no available ambulance’ condition exists OR if the dispatcher is reasonably certain based upon available personnel that no adequate crew will become available within the allotted time frame the call should be mutual aided immediately. The dispatcher must however continue to page for a crew as prescribed below. MAXIMUM TIME

The dispatcher must confirm a minimum responding crew compliment, based upon the response level of the alarm, within the time frame indicated Response Determinant Maximum Time to confirm Minimum Crew Compliment

Alpha & Bravo Alarms 4 minutes Driver & EMT Charlie, Delta, & Echo Alarms 2 minutes Driver & ALS provider In the event that only a BLS crew is available for an ALS level call (C,D,E) the dispatcher will immediately send the BLS crew and request a mutual aid for ALS to the scene. The dispatcher will continue to page every two minutes, to a maximum of ten (10) minutes for all calls on which a mutual aid response is required. If at any time CVAC’s crew status changes during that ten minutes the dispatcher shall immediately send the ambulance and must ascertain from MedCom if another ambulance is on scene (21). DETERMINATION OF MUTUAL AID AGENCY

It is the policy of Commack Volunteer Ambulance Corps to mutual aid (24) all calls that CVAC cannot handle to the Department of Fire, Rescue, and Emergency Services Dispatch Center (MEDCOM). They will be instructed to mutual aid the call to the closest appropriate district for handling.

SIMULTANEOUS ACTIVATION / LIE COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Auto 24 policy for LIE with East Brentwood Fire Department Effective 01/01/01 Mutual Aid 0004 Effective 1/1/2001 MEDCOM will simultaneously activate East Brentwood Fire Department for (1) ambulance to respond to all calls received on the Long Island Expressway Local and Express lanes, service roads, and on/off ramps within the CVAC District. CVAC has limited access and extended response times to much of these areas. East Brentwood has immediate and swift access to all LIE areas in question. DISPATCHER

1) Monitor Fire Radio (46.46) and insure EBFD activation 2) Apprise CVAC units of EB response and updates, if any 3) Log call has usual. Note EBFD response. 20:00 Auto/24 East Brentwood 1 ambulance MVA W/B Long Island Expressway at Exit 53 (3-3 unit) disposition - our alarm number

EMT IN CHARGE

The first arriving unit on scene, whether CVAC or EBFD will notify county control of the condition upon arrival (situation report) and indicate whether the other department is needed to continue responding. CVAC and/or EBFD units will take their direction from whatever officer / crew chief is on scene first.

FIRE DEPARTMENT RESPONSE

Commack Fire Department retains exclusive rights to all fire / rescue related incidents in this area and will be activated as appropriate. Should extrication or fuel spill request be necessary by CVAC personnel the request should be made through our dispatcher for CFD to respond.

CITATION BARS / COLLAR BRASS COMMACK VOLUNTEER AMBULANCE UNIFORM OPERATING PROCEDURE

Effective 01/01/01 Uniform 0001 Updated 06/11/12 BADGES

Corps provided badge in either Gold or Silver is to be worn with the class A uniform at all times. The General Membership shall be issued Silver badges and Chiefs/Ex Chiefs (30s) and Officers shall be issued Gold badges. CITATION BARS

A maximum of five (5) commendation bars may be worn on a black badge attachment (optional): American flag bar - May be worn by any member. If worn it must be the top bar. Solid Gold bar - Reserved for Jack Cotter Service Award Winners, if worn can only be topped by the an American flag. 9/11 bar - Reserved for MOS who participated in 9/11/2001 WTC service Stork bar - may be worn, in appropriate colors, (maximum of one) pink, blue or pink & blue as

appropriate for members who have delivered/assisted delivery of a baby(s) Bars allow for the placement of a number indicating multiple births, this may be worn as

appropriate. Level of training - member may wear (1) bar to designate level of EMS or EMD training Gold/Red/Gold - reserved for members who are recipients of dispatcher of the year Gold/Blue/Gold - reserved for members who are recipients of EMT/Rescuer of the year Gold/Gray/Gold - reserved for members who are recipients of Probie of the year COLLAR BRASS (worn as a pair) Shirt collar

5 horns gold - reserved for active chief of the department 4 horns gold - reserved for active assistant chief of the department 3 horns gold - reserved for active 2nd assistant chief of the department 2 horns gold - reserved for active 3rd assistant chief of the department 2 horns gold - reserved for active 4th assistant chief of the department 2 horns silver - reserved for administrative officers // parallel horns 5 horns gold –ex - reserved for past Chief of the Department Cpts Bars Silver - reserved for active Crew Chiefs

UNIFORM DISTRIBUTION COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 05/01/05 Uniform 0002 Updated 06/11/12

Request for new/replacement uniforms will be completed monthly after the General membership meeting. In the case of an emergency (blood soaked, ripped, etc), the Sgt@Arms, may issue uniforms at other times. In Uniform

1. Members on duty, or those responding directly from CVAC, shall only respond in department issued uniform as proscribed in the Rules and Regulations

2. Members responding to Signal 3 a. Where possible, member should dress as indicated above b. If necessary due to weather, road conditions or other extenuating circumstances,

members may respond wearing i. Blue Golf Shirt/Blue Work Shirt, or ii. Blue or ANSI jacket (vest is not sufficient)

c. Closed toed shoes, boots, or sneakers are required d. ANSI vest required on roads or active parking lots

i. ANSI Jacket eliminates need for vest e. Must be in long pants

COMMACK VOLUNTEER AMBULANCE RESPONDER CAR USE OPERATING PROCEDURE

Effective 07/01/98 Responder 0001 Updated 06/11/12

A. GENERAL 1)

a) The CVAC 1st responder vehicle shall be radio & county identified. b) The vehicle shall a t all times be equipped and stocked to New York State minimum standards as outlined in

Article 30, Part 800 of the Public Health L aw, and CVAC policy and practice. c) Only Corps certified drivers, cleared on it’s operation, may drive the responder vehicle. d) Corps certified Operating Members (EMT or Higher) are eligible to sign out the responder on a per shift basis. e) The responder may be signed out by any qualified member; not assigned to the duty crew, for the purposes of

first responding

2) A spot will be provided on the schedule for advanced sign up. An individual signed up for a particular time slot shall have precedent over other members for use of the vehicle. a) The responder will be signed out in the ambulance log book; with dispatcher approval. The operator of the

vehicle will give a signal 28 with their operator number to the dispatcher via radio upon signing out the vehicle and a Signal 6 when returning the vehicle.

b) A member signing out the responder vehicle does so with the understanding that they must be within three driving miles of the district border, and available to respond at all times when directed by the on-duty dispatcher. Any request for exception will be approved on a per case basis by the Chief of Department.

c) The responder is to be returned to headquarters at the end of the shift or immediately upon the direction of the on-duty dispatcher and restocked as necessary. This includes leaving the vehicle with at least ¾ tank of fuel

d) Only Corps Members are allowed to ride in the responder vehicle. Family members, friends, etc… are prohibited from traveling in the vehicle.

e) Personnel making up an ambulance crew may not take the responder. They should be available in the ambulance as a crew for alarms.

B. OPERATIONS

1. Upon activation by the dispatcher shall respond directly to an alarm for the purposes of stabilization, providing advanced life support care or administration.

2. Use of the MDT is mandatory. If MDT is non -operational, inform the dispatcher and

advise them to track your times manually.

2. When necessitated by the patient’s condition or when requested by the operator will accompany the ambulance to the hospital. Bearing in mind that the objective of the 1 st

responder is to keep such individuals available whenever possible.

3. If required to roll the ambulance, the dispatcher may direct, divert, or instruct the 1 st responder to respond to the building.

4. ALS personnel may relinquish care to BLS providers when deemed the patient’s presenting

problem and present condition warrant a BLS transfer. Any question on the patient’s status shall require the ALS provider to accompany the ambulance to the hospital.

5. The responder vehicle responds only on the expressed verbal consent of the on -duty dispatcher

6. Anytime the vehicle is left unattended it shall be parked in a safe location and secured. It shall

be picked up and returned to service at the earliest possible moment. C. MUTUAL AID APPLICATIONS

1. The responder shall respond to requests for mutual aid from neighboring departments for ALS .

The primary purpose of the responder is to provide 1st responder service to the CVAC community. The CVAC district must have a full crew in house in order for the responder to leave the district.

2. In the event of a mutual aid to CVAC by another district the responder car may respond to

the scene and stabilize the patient while he/she awaits transport from a neighboring department.

D. COMMAND APPLICATIONS

1. The responder may be utilized as the Command Post at large scale incidents. It shall

eliminate the necessity of placing the 1 st due ambulance out of service for command post operations.

2. The Crew Chief may relinquish his seat on the duty ambulance to respond in the responder,

if there is a crew for the ambulance.

E. 2-16-89

1. Will be reserved for the district at all times.

2. Will only respond on mutual aids with the permission of a Chief.

F. TRACKING The responder car operators are required to transmit a Signal 28 when leaving the building with the vehicle and a ‘6’ when returning to quarters.

Dispatchers are required to log the responder vehicle in and out of the ambulance log book.

The log book should contain one (1) entry, logged in a fashion similar to that used for the tracking of other Corps vehicles. (example below).

21:00 2-16-80 signal 28 W/ (member name); returned at 23:00

COMMACK VOLUNTEER AMBULANCE CHIEFS VEHICLES OPERATING PROCEDURE

Effective 2010 Responder 0002

Updated 06/11/12

PURPOSE:

To provide authorized Chief’s with a vehicle that allows for rapid response to alarms.

The vehicle must meet the requirements of a First Responder (EASV) as defined under Article 30, Part 800 of the

Public Health Law.

GENERAL:

The Chief of Department is responsible for allocation of the Chief’s vehicles.

The Chief of Department will allocate vehicles to Asst. Chief’s based on FULL TIME usage.

When a vehicle is available, the Chief of Department will allocate vehicles to Asst. Chief’s, Captains or Members as

TEMPORARY usage.

The Chief of Department will not allow a vehicle to leave the Island without informing the MVO and obtaining the

approval of the Chairman of BOD.

Only Corps certified drivers, cleared on its operation, may drive a Chief’s vehicle.

The MVO is responsible for the awareness of the Chief’s vehicle.

The user of the vehicle is responsible for reporting vehicle problems/maintenance requirements to the MVO in a

timely manner.

The Chief of Department is responsible for monitoring and ensuring effective usage of the vehicle. At any time, the

Chief of Department may remove the “FULL TIME” status of a vehicle from an Asst. Chief for lack of use.

The Chief of Department will provide the BOD with a monthly “First Responder Usage Report”.

FULL TIME

A FULL TIME user must live within 3 driving miles of the district.

Each January, the Chief of Department will submit the names of the Chief’s for FULL TIME usage to the BOD. In the

course of the year, the Chief of Department will notify the BOD of changes to FULL TIME usage.

TEMPORARY

The Chief of the Department will inform the MVO.

A TEMPORARY user must live within 3 driving miles of the district.

ACCIDENTS

Any accident involving a Chief with a Chief’s vehicle needs to be reported immediately to the 3rd

Asst. Chief / MVO

or in his absence, the highest ranking Chief available. An immediate determination will be made as whether the

vehicle may be driven to another location or needs to be towed or driven by another member. At the scene of the

accident, the Chief is responsible for obtaining all necessary information from the other driver (if one is involved)

before leaving the scene. Any accident requires a police report.

The MVO, Chief of Department, Chairman of the Board, Vice Chairman of the Board, and Motor Vehicle Board

Representative will form a review committee and make a determination regarding the driving status of the Chief

involved. In the event that either the Chief of Department or 3rd

Asst. Chief / MVO was the driver, the highest ranking

Chief available shall substitute. Any decision by this committee may be appealed to the full Board of Directors.

Nothing in this policy prevents the 3rd

Asst. Chief / MVO (or the Chief of Department if the 3rd

Asst. Chief / MVO

was the driver) from immediately suspending any or all driving privileges pending further investigation and a meeting

of the review committee.

All accident reports and insurance forms must be completed and submitted to the bookkeeper within 24 hours.

AMBULANCE CHECKS / MVO


Effective 04/20/02 MVO 0001

The Motor Vehicle Officer shall be responsible for contracting with and maintaining a relationship with a vehicle service provider who can insure compliance with Section 800.21 (p)(8) regarding the preventive maintenance of all vehicles. It shall include: 2,500 mile check 1. Change oil and filter 2. Lubricate all chassis fittings, king pins, and inspect front inspection 3. Lubricate all universal joints 4. Check level of steering fluid, transmission, and differential 5. Check the battery (gravity per cell) and clean terminals 6. Inspect emission control system canister (for damage) 7. Check return lines from carburetor to canister and fuel tank 8. Check pump and belt drive 9. Check the fuel filter cap (must be original equipment) 10. Inspect fuel lines for leak 11. Turn on air conditioning system on for 10 minutes and prevent freeze-up 12. Check coolant system and hoses 13. Inspect back-up alarm system 14. Check operation of wipers and blades 15. Inspect all lights on the vehicle, horn, sirens 16. Inspect radio, antenna 17. Road test by Motor Vehicle Officer 18. Set wheel nuts to proper torque 5,000 mile check 1. Inspect, clean, and lubricate face cam of fuel injector pump 2. Check engine idle speed, throttle operations and return spring 3. Inspect and lubricate body mechanisms 4. Drain water hose from fuel filter bowl (diesel vehicles) 10,000 mile check 1. Change the air filter, fuel filter, and PCV filter 2. Change the automatic transmission fluid and filter 3. Check the battery switch and isolator system 4. Replace the spark plugs 5. Check the distributor cap, rotor and spark plug wiring 6. Check the operating temperatures both front and rear for the air and heater 7. Check the condition of the coolant fluid, freon, and all parts of the air conditioner system. 8. Adjust all doors

9. Inspect and lubricate the weather stripping, latches, door positioners, hood latch, and spare tire

door 10. Inspect all cabinets , tighten and adjust screws 11. Inspect and repair all upholstery 12. Polish all paint and chrome 13. Inspect disc brake system and lubricate caliper slide rails 14. Inspect parking brake system for damage and operation 15. Inspect drum brake linings, and hoses 20,000 mile check 1. Replace battery cables 2. Test battery and starter voltage draw 3. Check radiator thermostat 4. Check radiator cap, inspect radiator for leaks, and replace hoses as needed 5. Steam clean the engine compartments (not diesel engines) 6. Check brake master cylinder fluid level

SERVICE PROVIDER

The contracted CVAC service provider is responsible to maintain all records and insure compliance with State DOH standards.

DRIVER TRAINER QUALIFICATIONS


Effective 08/30/02 MVO 0002

ALL DRIVER TRAINERS MUST HAVE A CURRENT C.E.V.O. II CERTIFICATE* ALL DRIVER TRAINEES MUST HAVE THEIR DRIVING TRAINING SHEET WITH THEM.

CATEGORY I – SIGNAL 8/5s Must be a CVAC Driver for a minimum of one year. NOTE: In order to drive back from Good Sam Hospital or drive on the highway the trainee must have highway driving signed off. CATEGORY II – LIGHTS/SIREN RUNS Must be a CVAC Driver for a minimum of two years. CATEGORY III-DRIVER TRAINER Must be a CVAC Driver for a minimum of three years. CATEGORY IV- DRIVER TESTERS Must be a CVAC Driver for a minimum of four years. All of the above categories must have the approval of the Third Assistant Chief / MVO All of the above must also attend a class given by the Third Assistant Chief to ensure all categories are taught the same way. A completed EVOC course may be used in place of CEVO II at the discretion of the MVO

F.R.E.S. (MEDCOM) PHONE NUMBERS COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 8/26/01 Dispatcher 0001 FRES (MEDCOM) phone numbers have been programmed into the speed dial. Two different numbers are provided. Specifics on when to use each of the two numbers are detailed below. Use of the wrong number slows down the process.

MED DSP This speed dial button should be used to contact the MEDCOM DISPATCHER Directly and is reserved for calls pertaining to specific alarm information or radio Issues. 1) To confirm information on a call 2) To get times for an alarm 3) To request a signal 19 MED PH This speed dial button should be used to contact the MEDCOM PHONE OPERATORS Directly and is for all issues not covered directly with the medcom dispatcher. 1) To mutual aid an alarm 2) To request mutual aid from a department 3) Other MEDCOM business

SUBPEONAS COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 01/01/90 Dispatch 0002

Updated 06/11/12

Often process servers will deliver subpoenas (requests for appearance of personnel or records at a deposition or court hearing) to CVAC. The Dispatcher is authorized to accept a subpoenas addressed to COMMACK VOLUNTEER AMBULANCE CORPS or any variation there of including listing the President/Chief/Board Chairman etc…and the agency title. A process server must personally hand over a subpoenas to an individual, if so named, on the paperwork and cannot and should not leave such papers with the duty dispatcher. No information such as personal phone numbers, names, or addresses are given out to these individuals. In the event an appropriately addressed subpoenas is received the dispatcher shall: 1) Immediately place the unopened subpoenas in the Chief’s Box 2) Log receipt of the document in the Misc Log book 3) Insure that the Chief is notified. This should include alphamate, voice mail, phoning. Subpoenas are often timely documents and dispatchers are encouraged to make every reasonable effort to insure that the Chief acknowledges notification of it’s receipt.

DISPATCHER’S OFFICE COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Updated 06/11/12 POLICY:

1. The communications center shall be limited to a maximum of three (3) members.

2. Only Members of CVAC should be in the communications center 3. The Communications Center must be manned at all times when an ambulance is on the road 4. No persons shall be permitted to sit on the counters at any time 5. No food or drinks shall be permitted in the office REASON: The communications center and the dispatcher play an invaluable role in the operations of CVAC. It is Imperative that the dispatcher and the communications center be positioned to handle the events as they Occur. The above policy has been created to assist the dispatcher in maintaining control of the center and assures swift response to radio and telephone communications.

DIRECT CALLS FOR ASSISTANCE COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 11/20/01 Dispatch 0004 Updated 06/11/12 This policy is intended to guide the dispatch in the proper handling of calls for assistance that are received direct at CVAC. PD RESPONSE

9-1-1 should be called and notified of all requests for assistance received direct to CVAC. The dispatcher should have the following information available: 1) Callers phone # 2) Location of alarm and cross street 3) Nature of alarm 4) Dispatch operator # (member #)

** The 9-1-1 dispatcher’s primary means of accessing records is by telephone # ** EMD DETERMINENT

All dispatchers, regardless of training are encouraged to ask the appropriate questions on the current version of the MPDS priority dispatch cards and develop an appropriate response determinant. All calls that are undetermined are BRAVO responses (third party calls) and treated as such for consideration of all CVAC policies and procedures. INTER-AGENCY ALARMS

The dispatcher should question the other agency dispatcher for any information that may be available, such as EMD code, call back number, etc. LIFT ASSIST

A call for a lift assist is treated like an other alarm. The crew is to respond accordingly, assess the situation, and determine if there is a patient or not.

TEXT PAGING COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 02/01/97 Dispatch 0005 Updated 06/11/12

POLICY: The text paging software will be used for official CVAC business only.

ALARM NOTIFICATIONS (made using the dispatch / call screen)

- Immediately upon receipt of the alarm in Red Alert, you will click the button that corresponds to the crew configuration that is needed. - The alarm page will only be sent out ONCE, regardless of crew status. The CVAC paging policy will continue to be followed in attempt to find crew members.

* Victim of Violence calls will NOT be paged out until we have been cleared to respond *

OTHER NOTIFICATIONS (made using the paging screen) It shall be the responsibility of the on-duty dispatcher to page the appropriate group of individuals as outlined below. ALARM ALL CVAC alarm updates, and mutual aid notifications CREW ASSIGNMENT Notification to the CAO and the CAO committee MEDIC Notification to the Lead Medic and Chief of Department RED ALERT Notification to Red Alert Coordinator and Chief of the Department. Used for any

issues with Red Alert TECHNOLOGY Notification to the tech committee. Notification of immediate tech problems BUILDING Notification to the Sgt @ Arms and building committee OFFICERS Messages specifically for viewing by CVAC Chiefs & Officers only MOTOR VEHICLE Notifications of vehicles in/out of service, accident, or breakdowns RADIOS Notifications of immediate radio/communications problems YS ADVISORS Notifications to the Youth Squad Advisors SIGNAL 19 Notifications to all holders. This is NOT to be used for alarm notification.

ALARM UPDATES – “ALARM” GROUP

- Will be made using this group

- Should include information of relevance to the alarm: Call 24’d no crew, 2nd ambulance needed, etc.

OFFICER NOTIFICATIONS – “OFFICERS” GROUP

Any Injury / Death to a Corps Member or Family Member reported Any activation of the Inclement Weather Policy (G0013) Any system effecting power failure or equipment failure All hospital diversionary notifications All major incidents occurring in surrounding agencies that may require immediate or short notice mutual aid from our agency. (ie: plane crash, bus accident, major incident, bio incident) Any other unusual occurrence deemed of importance by the dispatcher

SIGNAL 19 NOTIFICATIONS – “SIGNAL 19” GROUP

General Notifications will be made at 1200hrs and 2000hrs daily Notifications will be in addition to the current paging policy Notifications will include openings in the schedule Any Signal 19 Notification other than the “General Notification: must be approved by the Chief of Department.

*The paging software retains a history of all messages sent and by whom. Any inappropriate use of the

paging system will result in disciplinary action.

SERVICE MEN / DELIVERIES



Updated: 06/11/12

It shall be the responsibility of the dispatcher to keep accurate records, and make appropriate notifications on the arrival and departure of service providers as well as deliveries and pick ups that occur at Headquarters. As the 24/7 entity the dispatcher is relied upon heavily to act as the eyes and ears of the organization. SERVICEMEN

Servicemen will be scheduled by the houseman, appropriate officer, or coordinator to perform needed service at CVAC. Notification of the impending arrival of a serviceman should be made to the dispatcher (leave a note so we know he’s coming). The individual officer, coordinator, or houseman is responsible for insuring that required access, materials, and arrangements are made so that the scheduled work can be performed. The dispatcher shall: 1) Note the arrival and departure time of the company and their purpose in the Daily Log 2) Make notification to the appropriate officer, coordinator, or houseman 3) Ensure that someone escorts the serviceman to the appropriate area 4) The dispatcher may sign off on work performed and shall place the work order in the appropriate

officer/coordinator box DELIVERIES

Deliveries will arrive throughout the day and through a variety of carriers. When a delivery is received

the dispatcher shall: 1) Notify the Houseman, if on duty 2) Take due caution to ensure delivery is for CVAC 3) Sign for the items, checking to make sure appropriate number of items is received 4) Log the delivery in the Daily Log noting what, who, when, where 5) Notify the appropriate officer, coordinator, or member that the delivery has occurred

SUSPECTED FALSE ALARM COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


POLICY:

In the event the Dispatcher receives an alarm that he/she suspects is false the following shall occur: 1. The ambulance will be dispatched immediately 2. The crew shall be notified of the dispatcher’s suspicions 3. The Dispatcher shall notify Signal 10 (direct calls only) 4. Attempt to recontact on the call back number provided (direct calls only) 5. Verify call back number and address through the reverse directory (Coles) NOTE:

The Dispatcher may believe an alarm request is false, however it is impossible to be absolutely certain.

The ambulance must respond in normal fashion. The dispatcher should make every attempt to verify the alarm and the information provided.

DISPATCHING OFFICE COVERAGE COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 04/15/02 Dispatch 0008 Updated 06/11/12

Reiteration of CVAC policy for dispatching office coverage when there is no assigned dispatcher

The Dispatcher’s Office is to be covered at all times. The Crew Chief is responsible to make sure that the crew is properly trained for the task to which he has assigned them. He shall report members deficient in such tasks to the medical/training committee for remediation/review.

The Dispatcher / Member assigned to dispatch is expected to cover the office – and be in the office at all times. The portable telephone and radio are available for the dispatcher to take short respites such as eating with the crew, bathroom, etc…

The houseman on duty is allowed to cover the office for an ambulance call when necessary. At all other times the crew is expected to monitor the office and radio. The dispatcher’s office is to be manned at all times when ambulance is on the road.

COMING ON DUTY COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Dispatching tours of duty:

CVAC dispatching shifts are defined as 0000 -0700, 0700-1000, 1000-1300, 1300-1600, 1600-1900, and 1900-2400 hours daily.

“First seven (7) things you do when coming on duty”

When taking over the dispatcher’s office the dispatcher shall:

1) Sign in the duty log indicating name/operator number and start time (in military time) 2) Check the status of the duty crew and personnel available for duty in house 3) Check the status of all CVAC vehicles including the responder car 4) Check the status of assigned back-up personnel 5) Confirm replacement dispatcher for end of tour 6) Check white board, console, and under glass for new information/postings

Communications Center Checklist shall consist of:

1) Dispatcher’s worksheets & continuation forms 2) Fax machine ready in-service 3) Console review for function 4) Generator function / service indicators 5) Fire Alarm function / service indicators 6) Weather eagle turned on 7) Portable radio inventory / log

END OF TOUR COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Dispatching tours of duty:

CVAC dispatching shifts are defined as 0000-0700, 0700-1000, 1000-1300, 1300-1600, 1600-1900, and 1900-2400 hours daily. Four responsibilities at the end of shift:

1) Sign out of the log book 2) Confirm replacement dispatcher is available and briefed 3) Confirm and/or page out for crew members for following shift 4) Clean up after yourself Leave the office in the condition you would like to find it

POWER FAILURE PROCEDURE COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Updated 06/11/12

CVAC Headquarters has redundant protection from a power failure adversely affecting the operation of the Communication’s Center. A natural gas powered generator and battery back-up provide dual protection. These systems switch automatically in the event of power failure. The degree of involvement necessary by the dispatcher is directly related to the severity of the power failure and the circumstances under which it occurs. As an example: if neighborhood power failure fails during a lightning storm, the entire block loses power, and the generator provides power without a glitch – no action other than proper documentation is required. Conversely a power failure that causes the use of the limited battery power and affects only CVAC Headquarters is a serious emergency that requires swift and effectual action on the part of the dispatcher. POWER FAILURE – GENERATOR FUNCTIONS

The Generator switches automatically in the event of power failure and will return to street power when its internal sensors register ‘clean power’ coming from the street service. It can operate indefinitely. The dispatcher should pay particular attention to any change in the ‘status’ lights on communications position #1 and report them to the Officer in Charge. The dispatcher should report the power failure to LIPA at 755-7600 and request emergency service based on the nature of our operations. Note all communications with LIPA including names/operator numbers, times, and conversations. POWER FAILURE – NO GENERATOR – BATTERY POWER ONLY

True emergency. The batteries provide limited power, for a limited time, to only the essential systems in the communications center. The dispatcher should make immediate notification to both LIPA and the Generator Company requesting emergency service based on the nature of our organization. Notification must be made, by whatever means necessary to the operational officers, the sergeant @ Arms, and the Board Building Representative immediately. The dispatcher should pay particular attention to any change in the ‘status’ lights on the communications center console position #1 and report them to the officer in charge. Garage bays will need to be opened manually to facilitate rig deployment and response.

POWER FAILURE – COMPLETE FAILURE – NO POWER

True Emergency. A complete systems failure severely hinders the operations of the CVAC.

The following steps are mandated:

1) Turn ringers on for power failure phones in dispatch (colored phones on wall) 2) Turn on portable radio to CVAC RPTR 3) Call MEDCOM and advise to send all alarms by telephone 4) CALL Commack Fire Department and advise that they will need to monitor the repeater channel

and possibly page out if necessary for an alarm 5) Have crew / available personnel manually open garage bays 6) Notify LIPA of failure and request emergency service 7) Notify Generator company and request emergency service 8) Notify, through whatever means possible, the operational officers, Sgt @ Arms, and the Board

Building Representative 9) Canvas available membership by phone to get in-house crews for duration of the emergency 10) Instruct CFD dispatcher to page for all available personnel to respond to HQ on General Tones

CONSIDERATIONS:

- Each vehicle at CVAC is equipped with radios and cellular phone equipment - Console batteries will last no more than two (2) hours - Power failure phones are not electricity dependent

OFF SITE BACK-UP / COMMACK FIRE DEPARTMENT

CVAC maintains an off-site back-up system at CFD for use in emergency situations only. These situations shall be considered to be: system failures, unrecoverable power failures, and forced evacuation of Headquarters. It is not maintained to allow vacancy of the building for personnel issues at any time. Any member attempting to utilize the fire department in such fashion will face disciplinary action. This service is a ‘good neighbor agreement’ and is dependent upon the appropriate use and good neighbor policy that exists between the organizations. Return to CVAC Dispatch should be made as soon as reasonably possible. DOCUMENTATION / NOTIFICATION

Documentation in the Daily Log of all power failures is required along with actions taken by the dispatcher. Notification should be made, by whatever means necessary (alpha mate, corps page, telephone) to the operational officers and building representative of the Board of Directors of all power failure issues.

PAGING PROCEDURES


Effective 04/01/03 Dispatching 0013

Updated 01/01/09

PROCEDURE:

1) Receive call for assistance. (reset plectron if applicable) 2) Immediately page out as required below. 3) Alpha-mate alarm

REMINDER: Dispatchers should know what personnel are scheduled and/or available before an alarm is received. This should NOT be done when a call come in, this should be done when coming on shift. Dispatchers will be guided by the following: GENERAL TONES: Any time personnel are needed for alarms: Crew Chief, Driver, EMT ALS TONES: ALS personnel needed, regardless of paid medic status STILL TONES: When a full crew compliment is staffing the ambulance * REMINDER: Dispatchers are not to voice any incident type or location information when voicing a violence in progress alarm. All personnel must 34 for the information.

PAGING OUT FOR

AN ALARM

GENERAL ALARM

ALL PERSONNEL

ALS ALARM

ALS PERSONNEL

ONLY

STILL ALARM

MEDIC/OFFICER

S ONLY

ANY COMBINATION OF PERSONNEL

IS NEEDED: DRIVER, EMT,

ALS, ATTEDNANT

USED ONLY IF THE ONLY

PERSONNEL REQUIRED ARE ALS PROVIDERS

USED ONLY WHEN A FULL

CREW IS RESPONDING.

PAGING WITH BREVITY



Updated 06/11/12 Policy: Effective immediately dispatchers shall only announce the relevant information for the alarm

once on each page or when signing on. Dispatchers should be concise and speak at a conversation rate to minimize air time. (No more repeats)

Example: “2-16-0 on the air with a signal 3 on a 16 Crew Chief needed for MVA Larkfield Road &

Jericho Tpke available personnel 34 the base”

NO MORE REPEATING INFORMATION

WHEN PAGING

PATIENT IN POLICE CUSTODY COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 04/20/02 Operating 0001

In the cases where an individual has been placed under arrest (custodial cases), regardless of the injury potential or mechanism of injury, the police become the legal surrogate decision makers for that individual. If an individual in police custody has injuries that require transport by ambulance, the police should accompany the patient in the ambulance. The individual will either be restrained, or remain unrestrained depending on medical necessity, threat potential, crew safety, etc. If, in the opinion of the arresting office, the individual requires hospital evaluation, but does not require transport by ambulance, the police will transport the individual to the hospital. 1. Assess the patient to determine if a Prehospital medical intervention is needed. If not, follow

Refusal of Medical Assistance (RMA) procedures. Every effort to use the Police Officer as a witness should be made.

2. Carefully and accurately document all events leading to the patient contact or the refusal of

access to the patient by Police on the PCR. 3. Contact medical control for consultation where appropriate. 4. Avoid public confrontation with Police Officers, patients, and by-standers when attempting to

resolve the situation. 5. Fully document on a CVAC Incident report any untoward problems encountered on the call.

INABILITY TO ACCESS PATIENT COMMACK VOLUNTEER AMBULANCE UNABLE TO LOCATE PATIENT OPERATING PROCEDURE


If you arrive at the reported scene of a medical emergency and are unable to locate or gain access to the patient, take the following actions: 1. Confirm, through the dispatcher, that you have the correct address 2. Confirm, through the dispatcher, that a telephone call back was made to verify the alarm loc. 3. Sound the siren/horn for fifteen (15) second intervals for no less than one (1) minute 4. Confirm, or if necessary, request Police Department response to the scene 5. You must confirm that the patient is in a secured building/area or in a locked or inaccessible private residence before forcible entry is attempted. 6. If you are unable to confirm that the patient is present in a secured, locked, or inaccessible

location, the Police Department is to assume responsibility for the forcible entry decision. 7. If a call is determined to be unfounded, a PCR must be completed with all actions taken at the scene documented and all times noted. Note #1 In the event of a fire or suspected fire at the location in question the fire dept shall assume responsibility for the forcible entry decsion Note #2 The EMS agency and/or police department may request the fire department assistance in forcible entry if those agencies are not equipped to provide it. Note #3 CFD and HFD operate Technical Rescue Teams that can assist in reaching patients that

are otherwise inaccessible. This includes patients that are in confined spaces (eg. tunnels, drain pipes), high locations (eg. Roof tops, ledges, cranes), deep holes, building collapse, etc. Assistance should be requested in all such incidences.

UNATTENDED DEATH COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


1. Any location at which an unattended death victim is found, and where there are no family members or witnesses present, it is to be considered a crime scene until otherwise designated by proper authority.

2. If the Police Department is not present at the scene of the unattended death upon arrival of the

first EMS unit, a sector car response is to be requested before the EMS unit transports the patient or leave the scene following the determination that pre-hospital care and transport are not required. Do not delay transport if the police department is not on scene.

3. In unattended death situations certified EMS providers are obligated to perform CPR or other

prescribed resuscitative measures , unless a valid New York State “Do not Resuscitate” DNR form is presented, or there are signs of obvious death present.

4. In instances where bystander CPR is initiated prior to the arrival of the EMS unit and it is

determined by the arriving EMS personnel that there are signs of obvious death present, the EMS personnel may elect to refrain from continuing resuscitative measures.

5. Potential Crime scene considerations should be followed as per CVAC operating procedure #2

SEXUAL ASSAULT PATIENT COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 04/20/02 Operating 0004 Updated 06/11/12 CREW:

1. Avoid unnecessary disturbance of the patient or physical evidence. Limit physical patient contact to the treatment of injuries only. Do not cleans or cover wounds unless absolutely

necessary. Discourage the patient from rinsing, showering, combing hair, changing clothes, or brushing teeth.

2. Limit your patient interview to pre-hospital medical care questioning pertinent to visible injuries

or those claimed by the patient. Reenactment of the assault/incident may not be conducive to a good patient care outcome.

3. If the patient must be transported prior to arrival of the Police Department, advise the patient not

to wash or discard clothing worn during the incident. If possible and where appropriate, transport the patient with a female technician in attendance.

4. The patient is not only a victim of physical trauma, but also a victim of emotional/psychological trauma. Treat the patient accordingly.

5. All ambulance shall transport the patient to the hospital designated by the Suffolk County transport protocol. If a request is made to deviate from protocol ie: to a SANE Center, contact Medical Control at 689-1430. Where possible, try to honor the patient’s request concerning the destination hospital.

6. Prepare a PCR. Keep accurate records of the times, your findings and observations and

treatments rendered. 7. Avoid discussing the patient or the incident within hearing range of the patient or patient’s

family

DISPATCHER:

1. All consideration is to be given to having a female member of the department available for transport with the patient to the hospital. Pages should be done as necessary.

CRIME SCENE COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


CRIME SCENE: Any location at which evidence of a crime or suspected crime is found including, but not limited to homicide, suicide, sexual assault, vehicle pedestrian accidents, or other MVAs involving serious injury or death. Any location at which a deceased is found is to be considered a crime scene until otherwise designated by the proper authority. EMS PROVIDER RESPONSIBILITY: The primary responsibility of EMS personnel operating at the crime scene or suspected crime scene is rendering proper emergency care to those persons in need of such care. Patient care shall not be compromised in order to protect the crime scene or evidence. However, every attempt should be made not to disturb any physical evidence at the scene if possible. EMS providers should be aware of the responsibilities of other agencies operating at crimes scenes. The actions and observations of EMS providers at crime scenes are frequently an important part of court testimony, requiring accurate documentation at the time of the incident. After evaluating the scene for potential hazards, the following steps should be taken: 1. Consider the entire location as being involved in the crime scene. 2. Upon entering or leaving the scene, use a single path of travel if possible and have all personnel entering or leaving the scene use the same path 3. Limit the number of EMS providers entering the scene to only those necessary to evaluate, treat,

and/or remove patients. All non-essential EMS providers are to remain outside the crime scene. 4. If a presumptive diagnosis of obvious death is made, refrain from otherwise moving or

disturbing the victim’s remains. 5. Refrain from using sinks, toilets, or telephones within the immediate area of the crime scene. 6. Remove clothing from the crime scene and restrict the handling of any objects found on the

scene. 7. Offer information on observations pertinent to the incident to the proper authority. Do not offer

information or observations to those who do not have a legal need for such information or observations.

8. Restrict comments and opinions to known facts when speaking to other authorities.

Interdepartmental communications regarding the incident shall be directed to the proper authority at the scene. Do not offer any information to unauthorized parties such as the media, civilians, or other agencies as this may impede the investigation.

9. Complete all PCR and related documents pertaining to the incident accurately, using specific

language to indicate the position in which the patient was found, the presence of visible wounds and other pertinent data including the clinical information that led to your decision to withhold resuscitative measures. PCRs area legal documents subject to subpoena and must be complete, legible, and accurate.

POLICY FOR REPORTING COMMACK VOLUNTEER AMBULANCE SUSPECTED CHILD ABUSE OPERATING PROCEDURE OR MALTREATMENT

Effective 04/30/02 Operating 0006 POLICY:

All CVAC EMTs are required to report suspected cases of child abuse or maltreatment to the New York State Central Child Abuse and Maltreatment Registry in accordance with NYS DOH Policy Statement No. 02-01.

RESPONSIBILITY: If there are multiple CVAC EMTs responding to a call, it is only necessary for the EMT in charge of patient care to submit the required form. If there are EMTs from multiple agencies responding on a call to treat the same patient, the EMT in charge of patient care from each agency must file a separate report, regardless of which agency transports the patient.

REPORTING PROCEDURES:

1) An oral report must be made immediately to the NYS Child Abuse and Maltreatment Registry by calling 1-800-635-1522.

2) The oral report must be followed by a written report, using Form DSS-2221-A, within 48 hours.

This report must be mailed to the local child protective services for where the child resides. (There is no provision for faxing the report.) In Suffolk County, the address would be:

C.P.S. REGISTER/INTAKE UNIT Suffolk County Dept. of Social Services P.O. Box 18100 Hauppauge, NY 11788-8900 If the child does not reside in Suffolk County, submit the form to the Suffolk County C.P.S.

office because that is where the incident occurred. If the child resides in a Residential Institution, the report shall be mailed within 48 hours to: STATE CENTRAL REGISTER 40 N. Pearl Street Albany, NY 12243 3) It is understood that EMTs will need to complete the DSS-2221-A form after an emergency

situation. EMTs are not expected to have the form filled out in its entirety. EMTs should fill out as much information as possible, and submit the form to the Child Protective Service, who will obtain the rest of the information on the form.

4) A copy of the completed and submitted DSS-2221-A form shall be attached to the CVAC copy

of the Prehospital Care Report. The report shall be kept for a period of three (3) years past the child’s eighteenth birthday, as per NYS-DOH Policy Statement No. 96-01.

NYS DOH REPORTING CRITERIA

COMMACK VOLUNTEER AMBULANCE INJURY / DEATH OPERATING PROCEDURE EQUIPMENT FAILURE REPORTING

Effective 01/01/90 Operating 0007 1) Patient death, injury or other harm due to actions of commission or omission by a member of The CVAC 2) An EMS response vehicle (ambulance, responder, and van) is involved in a motor vehicle accident in which a patient, crew member, or other person is injured or killed to the extent requiring hospitalization or care by a physician 3) Any member of CVAC is killed or injured to the extent requiring hospitalization or care by a Physician while on duty 4) Patient care equipment fails while in use, causing patient harm; 5) It is alleged that any member of the ambulance service has responded to an incident or treated a patient while under the influence of alcohol or drugs; MEMBER:

1) Immediate notification to the Officer of CVAC 2) Immediate completion of CVAC Incident report (and where necessary Workers Comp. Packet) in compliance with member injury/accident reporting OFFICERS:

1) Immediate notification to the Chairman of the Board of Directors 2) Phone call to the NYS DOH no later than the next business day 3) Written follow up within five (5) days of the incident to NYS DOH EQUIPMENT FAILURE REPORTING

1) Immediate notification to the Officers of the Corps 2) Immediate completion of CVAC Incident Report (Atrium forms Rack) 3) Officers will maintain a record of all unexpected authorized EMS response vehicles and patient care equipment failures that could have resulted in harm to a patient and

the corrective action taken. A copy of this record shall be submitted to the Department with the EMS service’s biennial recertification application.

REFUSAL OF MEDICAL AID (RMA)



NO PATIENT

In the event that an ambulance service responds to a reported medical emergency where both the individuals at the scene and the EMS personnel believe that no injuries or illness exist and that there are no individuals requiring EMS assistance a PCR shall be prepared using the following disposition code: 008 GONE ON ARRIVAL or 009 UNFOUNDED / NO PATIENT FOUND. A physical assessment may be necessary to make the determination that there are no patients at the scene. Consider the high-risk criteria identified below before determining that there are no patients at the scene. The names of the individuals at the scene may be noted on the PCR. An RMA signature is not required, but may be obtained for the purposes of documentation. PATIENT EXISTS

If in the judgment of EMS personnel there is a patient at the scene who requires treatment and/or ambulance transport, but who refuses such services, Medical Control must be contacted in an attempt to convince the patient to consent to appropriate care. This includes children under 18 even when a parent is present and is declining service. The Medical Control Physician will assess the patient’s capability to refuse treatment, encourage the patient to allow appropriate care as indicated, and offer advice and guidance to EMS personnel. If the Medical Control Physician determines that the patient warrants treatment and/or transport, every effort should be made, using all available resources at the scene, to encourage the patient to consent to treatment and/or transport to the hospital. If all efforts are unsuccessful the refusal should be thoroughly documented on the PCR, signed by the patient, and witnessed, preferably by the police officer. In the event that a patient receives treatment but refuses transportation by ambulance, and the EMS provider agrees that ambulance transportation is not warranted, Medical Control need not be contacted. This decision, and any recommended follow-up by the patient, should not be contracted. This decision, and any recommended follow=up by the patient, refused transportation. If an EMS provider believes that ambulance transport is indicated, Medical Control must be contacted. In all cases where there is no transport to a hospital, the yellow copy of the PCR must be sent to Medical Control by the ambulance service. RMA HIGH RISK CRITERIA: An RMA should NOT be considered without contacting Medical Control if any of the following high-risk criteria are present. A physical assessment may be necessary to rule out these criteria. - The patient has an altered mental status or suspected head injury - The patient is less than 18 or older than 70 years of age - The patient has neurological, cardiac, or respiratory symptoms - The patient’s Glasgow Coma Scale is less than 15 - The patient’s vital signs are outside of normal limits - There is alcohol or drug use involved - There is Carbon Monoxide exposure

DESIGNATED RECEVING HOSPITALS

COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE TRANSPORT TO OTHER FACILITIES


CVAC by-laws allow for ambulances to transport to any of the five (5) hospitals listed below at any time. The decision as to which hospital the patient is transported is entirely up to the EMT running the call. The decision will be made based upon the patient’s condition at the time, and NYS and County protocols. Where possible and when allowed patient’s request should be considered. - St. Catherine’s of Sienna Medical Center Smithtown NY - Northport Veteran’s Administration* Northport NY - Huntington Hospital Huntington NY - Southside Hospital Bayshore, NY - Good Samaritan Hospital West Islip NY - University Hospital @ Stony Brook Stony Brook, NY

*The VA should not be used in cases of true emergencies; it is available for routine care only. DIVERSION

Section 405.19 (e) (4) of the NYS Hospital Code authorizes hospitals to request diversion of ambulances to other facilities when the acceptance of another critical patient might endanger the life of that patient or another. A request for diversion does not require that the ambulance divert from that facility. EMS Personnel are not obligated to honor such a request if they believe that a critically ill or inured patient’s condition warrants doing so. However, if it is determined that the patient is stable, the diversion request may be honored. Medical control may be contacted to assist in transport decisions. Personnel should document fully the reason(s) for their decision on the PCR.

THE GURWIN CENTER COMMACK VOLUNTEER AMBULANCE Gurwin Nursing Home OPERATING PROCEDURE Gurwin Assisted Living Facility

Effective 01/01/90 Operating 0010 Updated 06/11/12

CVAC provides primary 9-1-1 coverage for the Gurwin Campus of Commack including : The Gurwin Nursing Center and Weinberg Pavilion @ 68 Hauppauge Road, and, The Jay Linder Assisted Living Facility @ 50 Hauppauge Road All calls for assistance at the Gurwin Campus should come through the County 9-1-1 system and be properly dispatched as per the current version of the Medical Priority Dispatch System. Dispatcher’s should refer to Direct Call Policy General 0001 for the proper handling of all calls received directly at CVAC. TREATMENT POLICY

All members of the CVAC are expected to conduct themselves in the utmost polite manner when dealing with Gurwin Staff and Patients. Each and every patient is entitled to the most professional and expedient service CVAC has to offer. All patients are to be treated with the same respect one would afford their own relative. TRANSPORT POLICY

CVAC provides emergency care and transportation of emergency patients to St. Catherine’s Hospital in Smithtown except where transport to a specific alternative facility is required by protocol (ie: burn patient, or multi-trauma patient). For non-residents such as employees and visitors, the regular transport protocol applies. The EMT in charge does not have the authority to select an alternate facility except as noted above. It is expected that the facility will triage those patients who are requesting transport to another facility for stability and utilize proprietary transport services as warranted.

ACCESSING THE PATIENT

(NURSING HOME)

Agreed procedure requires CVAC to enter through the main (awning) entrance to the nursing home for all patients in the main facility. Security will direct the crew to the appropriate wing/room.

(WEINBERG PAVILION)

While not particularly effective, the agreed upon procedure for accessing all patients in the Weinberg Pavilion requires entry / exit through the main (awning) entrance of the main nursing home. CVAC has expressed concern over the extended patient contact time that occurs through this procedure and it is under review. The policy will be adjusted as warranted by future agreement. (LINDNER ASSISTED LIVING FACILITY)

The most appropriate entrance and exit to facilitate patient care shall be used at this facility. This may require compliance or defiance of the security guard request at the facility. Crews are expected to conduct themselves politely and professionally at all times. Assistance of the responding Police Officer should be used where necessary to facilitate treatment/transport.

REVIEW PROCEDURE

All calls will be reviewed by The Corps Medical Director, and presented at the quarterly QA/QI meeting conducted internally. The Corps physician shall, where appropriate, dialog with the facility and the County Medical Director regarding patient care issues.

CELLULAR PHONE USE ON CALL



Updated 06/11/12

The use of cellular phones, two-way phone devices, and audible pagers for personal use while on call is prohibited. Cell-phones and pagers that must be worn on call should be placed in the silent or vibrate position. It is inappropriate for members of the crew to take or receive calls during the patient oriented portions of an ambulance call (on scene/enroute to the hospital).

Crew Configuration



This policy is designed to maximize existing crew resources. The crew configuration should be determined prior to an alarm. This eliminates the confusion and delay in response upon the time of activation. Utilize your crew to their maximum potential, and think about the next alarm. Split your crews and use a second ambulance or responder if needed.

DIVERSION ENROUTE COMMACK VOLUNTEER AMBULANCE

OPERATING PROCEDURE Effective 6/17/04 Operating 0014 Updated 06/11/12

Effective immediately and until further notice the ambulance crew will be considered committed to their patient upon taking a signal 2. The responder can divert provided that there is a confirmed crew with the appropriate level of service provider responding on the initial alarm. Exception: If more than one crew is available the dispatcher should still send the closest appropriate unit to the alarm.

EMT COMMACK VOLUNTEER AMBULANCE

OPERATING PROCEDURE Effective 7/20/06 Operating 0015

Updated 06/11/12

Members: (sworn in dispatcher and riding)

The medical committee will set individual guidelines for being cleared as a provider. Once cleared by

the medical officer, the member may roll the ambulance immediately and act as the sole provider.

Crew Chief Training COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


ARTICLE 1. OBJECTIVES A. To ensure smooth daily operations within the building. B. To be an extension of the chiefs, in their absence. ARTICLE 2. REQUIREMENTS A. PREREQUISITES 1. Must be an operating member, in good standing 2. Two years as an operating member 3. Two years as an EMT or higher 4. Must be up to date with all CVAC drill requirements (OSHA, START triage, MARK I kits, CPC training, MCI, etc.) 5. Must get 70% or higher on pre-test. 6. Must respond to 1 or more Signal 3 calls per month B. CREW CHIEF CLASS 1. Dispatching – must show knowledge of dispatch procedures and equipment operations 2. Back to basics, surrounding departments, number of rigs, ALS/BLS, borders, etc. 3. CVAC policy and procedures 4. Operating with other departments (ems/fire/police) 5. Radio procedure and operations 6. Scenarios C. EXAM 1. After completion of the Crew Chief training classes, a written exam will be administered. As with all CVAC exams, a level of 80% must be achieved to meet this requirement. The exam will focus on the following areas. a. Operations b. CVAC policy and procedures c. Dispatching d. MCI D. MAINTAINING STATUS 1. Must be in good standing at all times 2. Must maintain EMT certification. 3. Regular submission of probationary training reports and rig checks. 4. Maintain drill quota, attend all mandatory drills. 5. Must meet hours requirements 6. Test yearly 7. Appointment is annual and expires each December 31 unless reappointed

ARTICLE 3. ROLES/RESPONSIBILITIES A. BUILDING 1. Shall report, to the appropriate chief/officer, any issues with the building (Anything broken, flooding, etc.) B. CONDUCT 1. Shall enforce good conduct within the building. (Anything that may cause harm to a member or the building.) 2. Shall act themselves in a manner appropriate for this level. C. ISSUES 1. Within their authority, handle any issue that may arise. 2. Be an extension of the chiefs, in their absence. If outside the scope of authority, contact a chief immediately. D. ON A CALL 1. In the absence of a Chief Officer the Crew Chief may take or take over command; command shall be transferred to a Chief upon arrival unless declined. ARTICLE 4. POWERS A. Shall have the power to enforce smooth daily operations in the building and on an alarm. 1. Authority to remove someone from the building who is acting in a manner that is disruptive. 2. Authority to remove someone from a scene operating in an unsafe manner. 3. Authority to enforce all bylaws, rules, and SOPs. 4. Authority to place a vehicle out of service due to equipment problems. ARTICLE 5. DISCIPLINE A. Failure to meet the above requirements will result in automatic removal of the Crew Chief. B. Crew Chief Remediation forms will be filled out for each incident involving a Crew Chief. 1. 1st offense – written warning 2. 2nd offense – review by chiefs C. Any suspension from a committee will result in removal of crew chief status. The committee chairman shall notify the Chief. D. A 2/3 vote of the chiefs is required to remove a Crew Chief’s status except as noted above. E. Once removed, the member must wait twelve months before reapplying for Crew Chief status again. ARTICLE 6. CHANGES A. The chiefs reserve the right to modify the above requirements to allow for updates in training and certification as deemed necessary by CVAC, New York State, and the federal government.

ANSI COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 3/31/2009 Operating 0017 Members operating on a roadway, shoulder, right-of-way to a roadway, parking lot, or adjacent roadway surfaces (shoulders etc..) are required to wear the ANSI approved reflective vest or jacket supplied by the department. Each operating member has been supplied with their own vest. A small number of vests, for probationary members, youth squaders, and other providers on scene are available on each ambulance. This policy applies to all operations on or near a roadway as defined above NOT only motor vehicle accidents. 23 CFR 634 // November 24, 2008

PROBATIONARY MEMBER COMMACK VOLUNTEER AMBULANCE RESPONSE GUIDELINES OPERATING PROCEDURE

Effective 04/07/10 Operating 0018 Updated 06/11/12 General:

- If you respond on an alarm, you MUST be available to transport to the hospital with the crew. - Make sure your jumpsuit is always in your car and ready to go. You are required to be in uniform on all calls. Responding:

- You may, and are encouraged to respond whenever the dispatcher pages for attendants. - You are to call the dispatcher and advise them of the following; YOUR NAME, you’re a PROBIE, and you are responding to the BUILDING. **You may only respond to the scene under the direction of the dispatcher. For your safety, if you are the first on scene, wait in your vehicle until the first unit arrives (medic, chief, ambulance, etc.)** Green Light:

- The department will issue a green light to you. - May only be used when responding to an alarm that has an EMD determinant of Bravo or higher. - Is a courteously light only. You MUST obey all traffic laws at all times. Pager:

- Will activate for Medcom Tones as well at all pages from the CVAC dispatcher. - You may only call in for a call when the CVAC dispatcher pages for attendants. - The rubber button on the side of the pager is the squelch and will reset the pager after an alarm. - The button on top of the A,B,C,D switch will replay the stored messages. - Button Layout: A: Medcom and CVAC (tones) B: Medcom and CVAC (vibrate) – must push the squelch to hear the alarm C: CVAC Only (vibrate) – must push the squelch to hear the alarm D: CVAC Only (tones) I, ___________________________, understand that being able to respond to alarms as a probationary member is a privilege, and may be revoked at any time. The equipment issued is the property of the Commack Volunteer Ambulance Corps and must be returned upon request. Signature:_____________________________

INCIDENT ACTION PLANNING (IAP) COMMACK VOLUNTEER AMBULANCE

OPERATING PROCEDURE

Effective 6/5/2010 Operating 0019 POLICY STATEMENT

Effective immediately, an Incident Action Plan (IAP) is required for ALL CVAC events. This includes, but is not limited to: Standbys, social events, parades, and fund raising events. The purpose of this plan shall be two fold. First, to help members maintain familiarity with the IAP process and its use. Second, to formalize CVAC events, eliminating confusion and providing written documentation that can be utilized to plan future such events. INCIDENT ACTION PLANS

An Incident Action Plan formally documents incident (event) goals (objectives). It will contain general tactics for achieving these goals while providing important information on the event and its parameters. Equally important the IAP facilitates dissemination of important information about the event to all concerned parties. The intricacy of the plan, the number of operational periods, and the required documentation will be sufficient as to properly reflect the event. The IAP shall include, but not be limited to:

Goals (what is the ultimate mission) Operational period objectives (for multiple period incidents Strategies for the incident Tactics for the incident Organizational list with ICS chart showing primary roles and relationships Assignment list with specific tasks Critical need/situation assessments Health and Safety plan for responders* Mandatory section Communications plan (functional exchange of information) Logistics plan (supporting the operation, supplies, equipment) Incident map

SENIOR CORPS / YOUTH SQUAD COMMACK VOLUNTEER AMBULANCE INTERACTION OPERATING PROCEDURE

Effective 04/07/10 Operating 0020 Updated 06/11/12 POLICY STATEMENT

The Commack Volunteer Ambulance Corps (CVAC) Youth Squad is a critical resource for CVAC. In addition to allowing parents who may be adult members of the Corps to share an activity and be close to their children, the youth squad serves as a feeder and training ground for the development of new members. The Youth Squad is a vital part of CVAC’s success. It is the responsibility of every member to protect the health, safety and welfare of members of the youth squad. Senior Corps members of CVAC, even those who may be only a little older than some members of the youth squad must keep in mind that members of the youth squad look up to them and respond to their mentoring and guidance. It is, therefore, essential to assure the comfort of the members of the youth squad and to avoid even the appearance of a member of CVAC taking advantage of a member of the Youth Squad. This policy is issued as guidance for senior members of CVAC with respect to how to behave toward Youth Squad members and to avoid the appearance of any impropriety. The objective is to avoid circumstances that are potentially coercive or subject to misinterpretation. Generally speaking there is safety in numbers and the greatest danger both of actual abuse or simple misinterpretation is when senior members are alone with junior members. This is to be avoided.

COMMACK VOLUNTEER AMBULANCE PROBATIONARY MEMBERS OPERATING PROCEDURE

o MANDATORY GENERAL MTGS

o COMMITTEE WORK Effective 3/15/11 Operating 0021

Updated 06/11/12

Purpose: Define minimum participation requirements, beyond hours and training, for probationary members.

Meetings: While on probation, the monthly general membership meetings are mandatory. Probationary

members unable to make a meeting for any reason; you must submit a request for excusal letter to the Asst. Chief prior to the night of the meeting.

Committee: Once a probationary member has completed their dispatching and/or riding training; they will be assigned to a committee by the Chief of the Department for the duration of the year.

Work Detail: While on probation, work details are mandatory. Probationary members unable to make a work detail for any reason; you must submit a request for excusal letter to the Asst. Chief prior to the work detail.

Bicycle Team COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE


Purpose When requested, to provide rapid first aid response, in district and out of district, for large-scale

events. Requirements As follows:

Must be an operating member in good standing as deemed by the Rules and Regulations. Current health physical on file with CVAC physician. Completed Bike Safety Course as required by Bike Team Coordinator. Minimum NYS EMT-Basic certification.

Deployment The CVAC Bike Team must be requested through the Bike Team Coordinator and the Crew

Assignment Officer for all in district and out of district standbys. Each team will consist of two (2) members deemed eligible by the Bike Team Coordinator. The team will act to provide quick- access care to aided persons while ambulance treatment and transportation is delayed by a difficult-to-access location.

Equipment Each team of bicycles will be issued all the equipment and supplies required by the Commack

Volunteer Ambulance Corps Bicycle Checkout Form. No bicycle will be permitted to leave CVAC Headquarters without the required supplies, verified by completed checkout form; including its complementary team member and bicycle. Each bicycle will be equipped with forward and rear lights, and a siren.

Uniform Members operating on the CVAC bicycle team will wear only the approved and issued uniform

of a neon yellow and black reflective shirt, black shorts or tech pants. Members will be required to supply their own closed toe sneaker or slip-resistant work shoe for use while riding. Members must is always wear a helmet while operating any CVAC bicycle.

Identification The bicycles will be hailed as “Bike One, Bike Two, etc.” while operating within the Commack

Volunteer Ambulance Corps District. They will be assigned an identifier by the event coordinator while operating out of district.

PARKING COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 01/01/90 Building 0001

AMBULANCE BAYS

No vehicles shall be parked in such a manner as to block access to any ambulance bay either front

or rear entrance. Free and unrestricted access to the ambulances and emergency ambulance

response vehicles is of primary importance.

PARKING SPACES

Parking spaces are provided on a first come first serve basis for the membership. It is expected that all members shall park in designated parking spots. Select spots, available on a first come first serve basis, are available towards the building as a courtesy to on-duty crew members. Members are expected to act courteously in the use of these spaces.

NO-PARKING AREAS

In addition to the areas mentioned above members are prohibited from parking their vehicles in any fashion that would block access to the adjoining property or directly to the rear of the atrium. This space is reserved wholly for the Emergency Ambulance Service Vehicles of the Corps and the Chief Officers. (responder vehicles).

ADDITIONAL PARKING

Additional parking spaces are available on the adjoining school property. CVAC maintains a standing mutual aid agreement with the maintenance department to share parking facilities while maintaining the integrity of access to all facilities.

FRONT APRON / CURB

No vehicle shall be left or allowed to park or stand on the front apron as this is contrary to the quick response of the duty ambulance. The front curb spaces are reserved, as a courtesy, for members responding on back-up.

WORK ON THE BUILDING COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 07/11/12 Building 0002

No work is to be done to the building or any piece of Corps property without prior permission from the

Chief of the Department. In his absence, the highest ranking Chief may approve any work.

Chiefs, Officers, and Committee Chairs may perform work that is within their job description and scope

or practice.

CREW ASSIGNMENT POLICY


Effective 07/1/03 CAO 0001 Updated 01/01/09

The Constitution and By-Laws, Rules and Regulations, and Officer’s Policy of the CVAC in various articles clearly give the Crew Assignment Officer the power to enforce a schedule on all Operating and Dispatching Personnel. In an effort to improve the efficacy of service provided to our community, the following is put into effect:

1) All Members, not on an authorized leave of absence, will immediately become assigned. 2) All Members are expected to remain assigned weekly; it is the responsibility of the member to notify

the CAO or his designee of any necessary changes to the schedule. 3) Any member who fails to appear for duty will be charged with an unexcused absence. 4) Any member who calls in for his shift with less than 48 hours notice, without due cause and/or

without finding his own coverage will be charged with an unexcused absence.

5) The member is responsible to submit any additions, scheduled absences, and changes on the prescribed form, via the current scheduling software, to the Crew Assignment Officer

6) Any member who accumulates more than (1) one unexcused absence in a month, or more than three

(3) unexcused absences in a quarter shall receive a suspension of social privileges.

7) Members who continue to be unexcused for their absences will receive a Corps Suspension after the 4th unexcused absence. Continued infractions will result in referral to the Membership Committee for further action.

CHANGES TO THE SCHEDULE MORE THAN 48 HOURS IN ADVANCE

1) Must be submitted through the current scheduling software

CHANGES TO THE SCHEDULE LESS THAN 48 HOURS IN ADVANCE

1) Must be submitted on the prescribed form, via email, to the CAO 2) Must be phoned into the dispatcher, the dispatcher will log in the daily log 3) The Dispatcher must immediately page the CAO .

YOUTH SQUAD PARTICIPATION

COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE Delineates Youth Squad Members responsibilities For active ambulance service/dispatching Effective 6/1/03 Youth 0001 Effective immediately Youth Squad members riding/dispatching at Commack Volunteer Ambulance Corps will be subject to the following policy. This policy is in addition to any rule, regulation, or procedure extent in the CVAC by-laws governing such participation. YOUTH SQUAD DISPATCHERS

1) Must be regularly assigned to a dispatching shift as prescribed by the CAO. 2) Are required to make twenty-seven (27) hours per CVAC quarter. 3) YS Dispatchers must comply with continuing dispatch education as prescribed by Medical Officer

YOUTH SQUAD RIDERS

1) Must be certified CVAC Dispatchers 2) Must maintain their active dispatcher status (assignment/hours) 3) Must complete a probationary riding class prior to assignment 4) Must be permanently assigned to a riding shift by the CAO 5) Youth Squad Riders are expected to have continuing riding education.

Riding for a Youth Squad Member is a privilege of membership extended by the Senior Corps in exchange for the invaluable service provided as dispatcher. This procedure will also allow Youth Squad Members to avoid probation time upon their eighteenth birthday, they will be eligible for membership having completed all training requirements.

Date of Membership


Effective 01/01/94 Membership 0001 Updated 06/11/12

To eliminate the confusion and subjectivity surrounding the official date of Membership the following shall apply. Senior Corps Accrued time in service begins with the date that a probationary member is sworn in as a full member. A former Youth Squad Members official date of membership shall be the date they were sworn in to the Youth Squad.

MCI TRAILER COMMACK VOLUNTEER AMBULANCE OPERATING PROCEDURE

Effective 04/07/10 MCI 0001 Purpose: This policy is to outline the operations of the MCI Trailer hereafter referred to as MCI-1. It will

include the training, equipment, operations, and response guide. General:

The Disaster Preparedness Committee will maintain the trailer, and its contents.

The trailer is to remain locked at all times when not in use. The key hanging in the dispatch office or any CVAC “master” key can open the locks.

The trailer may be pulled by any of the responder vehicles or the van. Under no

circumstances is an ambulance to pull the trailer.

Identifier: 2-16-MCI1 Requests:

In District: 2-16-MCI1 will respond as per the Special Operations Manual or at the request of the Incident Commander.

Mutual Aid: The trailer will respond if requested for mutual aid.

Training: The MVO will be responsible for training those members interested in becoming a driver for the trailer. ONLY those member qualified by the MVO will be able to tow the trailer.* Cleared drivers will be noted on the pager list under the glass in the dispatch office with a (T) next to their qualifications.

Response: The vehicle pulling the trailer will respond Code2 (no lights/sirens) to an incident. A 2-person

crew is ideal and the maximum number of people to be dedicated to the trailer. The member(s) responsible for the trailer are to remain with the trailer at all times. They are responsible for tracking all equipment removed and returned to the trailer.

Note: * These incidents are over a long period of time. You cannot respond with the trailer and expect relief in a short amount of time. You must be available to say with the trailer as the number and probability of getting another trailer driver to relief you is very low.