The purpose of the Lanesboro Ambulance Department is to provide basic life support (BLS) ground ambulance emergency medical service for the City of Lanesboro and throughout the rural service area as assigned to the Department. The Lanesboro Ambulance Department is composed of a group of volunteers employed by the City of Lanesboro who meet or exceed the State of Minnesota’s qualifications for EMT-B certification

General Policies

1. Membership Requirements

The number of members allowed shall be determined by the City of Lanesboro and will depend on the service load and local demographics. The City of Lanesboro will try to maintain a minimum staffing level of twenty members.

To be eligible, persons must apply for employment to the City of Lanesboro. The Lanesboro City Administrator, City Council, and Ambulance Director will review the application and make the final recommendation to accept or decline all applicants. In general, all applicants should be 18 years of age, possess a high school diploma or equivalent, be of good moral character (no felony record), be in good physical condition, and hold a valid Minnesota Class D drivers license. The City of Lanesboro reserves the right to request additional information from all applicants, including but not limited to a physical examination.

Upon acceptance for membership all persons will be given a reasonable time period to successfully complete the necessary requirements to obtain EMT-B certification through the State of Minnesota. This will include but is not limited to the completion of the required emergency vehicle operator’s safety course as directed by the City. The City of Lanesboro will pay appropriate expenses incurred for all required certifications. All new members will complete a one year probationary period beginning from the time of successful certification. After satisfactorily completing the probationary period, members are eligible to receive state reimbursement funds paid to the City. Members not successfully completing the one-year probationary period will be responsible for reimbursing the City of Lanesboro for all expenses incurred during that time period. The City also retains the right to withhold any payments due to the unsuccessful applicant for services rendered during the probationary period. The reimbursement requirement may be waived by the City Council upon a finding that the failure to complete the probationary period is due to circumstances beyond the volunteer’s control or other extenuating circumstances.

To remain a member of the Lanesboro Ambulance Department all volunteers will be expected to maintain necessary certifications as established by the State, City of Lanesboro, and the current Medical Director of the Ambulance Department. The City of Lanesboro retains the right to release any member of the Ambulance Department if inappropriate behavior or negligence by the member is found through investigation of any received complaints. All members are responsible for their own behaviors and actions.

2. Ambulance Director

The City Council and City Administrator will appoint an Ambulance Director annually with recommendations from the Ambulance Department members. The Ambulance director in cooperation with the Lanesboro City Administrator is responsible for administering all aspects of the Ambulance service. The Ambulance Director shall be a member of the Lanesboro Ambulance Department.

3. Ambulance Squads

The Ambulance Director shall establish and maintain a minimum of three ambulance squads. Ambulance squads are responsible for maintenance of the ambulance and all ambulance equipment and supplies and for ongoing training with onboard equipment. All members of the Ambulance Department will be assigned to a squad and the Ambulance Director will appoint a squad leader for each squad. Squad leaders are responsible for the oversight and record keeping for their squads. The squad leaders and Ambulance Director will assure necessary drills and maintenance objectives are being completed as scheduled. The position of “squad leader” should be reserved for members with experience and who are interested in becoming ambulance director at a future time. Squad leaders will direct operation of the ambulance department in absence of the appointed ambulance director. The ambulance squads will be assigned a time frame for each month, generally a 10-11 day period where each squad will meet at least one time and during which the squad is responsible for ambulance operation. Members are expected to attend the scheduled ambulance drill for each month. Ambulance members are responsible for contacting their squad leader if drills or other scheduled meetings cannot be attended and all missed meetings shall be made up during the scheduled month or the following month.

4. Ambulance Department Meetings and Training

Meetings will be held at least bimonthly in accordance to Ambulance Consortium training schedules. Meetings will be held at a previously agreed upon location and generally occur the night of the last fourth Monday of the month according to the schedule established by the Southeastern Minnesota Emergency Medical Services consortium. All meetings are mandatory and any member missing a meeting will be responsible for making up missed meetings and associated consortium training at their expense. Unexcused absences may result in disciplinary action.

5. Annual Reimbursements

Ambulance members shall receive reimbursement for training, time at meetings, and for each emergency call they provide services (in accordance to all policies). For the purpose of payment of reimbursements the annual year runs from December 1 to November 31. The rate of reimbursement for each run completed and meeting or drill attended shall be determined by the City of Lanesboro. The rate at the time of Department Policy adoption is $30.00/call and $7.00/meeting. The Ambulance Director shall receive an annual allowance the amount of which shall be determined by the City of Lanesboro. Annual reimbursements are provided in December.

Procedures

1. Personal Appearance and Protection

Lanesboro Ambulance Department members are expected to maintain personal grooming habits consistent with the purpose of the department including Standing Orders or Protocols and as described in all pertinent policy or law for personal protection of patients and EMTs

2. Uniforms

At this time uniforms are not provided. All members responding to an emergency medical call are expected to dress consistent with the purpose of the department including Standing Orders or Protocol and as described in all pertinent policy or law for personal protection of patients and EMTs.

3. Pagers and Communications Equipment

Ambulance Department members will be provided with communication pagers. Communication pagers are property of the City of Lanesboro Ambulance Department. Emergency services requests are generally provided through a Fillmore County 911 program. County dispatchers are responsible to page out the appropriate service based on predetermined service areas. Personal pagers must be carried, maintained, and operable at all times. Communication pagers are operated in accordance to procedures, policies, and as allowed by law. Communication equipment training will be provided. Weekly pager tests are conducted by Fillmore County the first Monday of every month @ 1800 hours.

4. Call Response

Lanesboro Ambulance Department procedure allows for the first three ambulance department members who respond to an emergency dispatch to attend to the call. Members attending to an emergency call can request additional help depending on the nature of the illness or the mechanism of injury and the number of patients found at the scene of the emergency. In addition to three EMTs on each call, members currently participating in an accredited EMT certification program can “ride along” as a training experience. One “ride along” can be allowed at the discretion of the most senior ambulance member in attendance. The most senior ambulance member in attendance on any call should be the point contact person at any emergency and shall be considered the attending squad leader in the absence of any Ambulance Squad leaders appointed by the Director or the Ambulance Director. At no time will members respond to a call while under the influence of drugs or alcohol.

The Ambulance Director may set up an “on call” schedule to aid in the coordination of emergency services during time periods of special events such as Buffalo Bill Days.

5. Protocol- Patient Assessment/Treatment

In Minnesota all licensed ambulance services operate under a Medical Director, a licensed physician, who is ultimately responsible for all care provided by the ambulance service.
The Medical Director for Lanesboro Ambulance Department provides written medical direction for all medications administered and for emergency care scenarios. The written medical direction is in the form of standing orders or “protocol”. In EMS, protocols are considered
“Off –line” medical direction. Protocol also describes patient assessment/treatment procedures which require the EMTs to consult “on-line” medical direction which requires calling the emergency facility that will be the transport destination for an emergency service call.

All members of Lanesboro Ambulance Department must be familiar with the department’s protocols and shall follow protocol when treating all patients and with all aspects of an emergency call. A copy of the current protocols shall be present in the ambulance for reference. The City will provide copies as requested to all members. All required continuing education training is according to protocol for the Lanesboro Ambulance Department or refers EMTs to follow local protocol.

6. Patient Confidentiality

Under the Minnesota Government Data Practices Act a patient’s right to privacy is protected. More recently, the Health Insurance Portability and Accountability Act of 1996, (HIPPA), is Federal legislation that deals with the uses of patient information and privacy rights and must be addressed by all pre-hospital health care services. HIPPA requires that all patients be notified of their rights to privacy and how information gathered during pre-hospital care will be used. All information relating to a patient must be kept confidential by Ambulance members. All inquiries for patient information must be directed through the Ambulance Director.

7. Documentation

Ambulance members are responsible for the completion of run reports for all calls. Complete and accurate run reports are important for patient care, liability issues, insurance and billing. Run reports need to be signed off by receiving facility staff and a copy is transferred with the patient. Patients refusing treatment and transport must sign off on the run report thereby acknowledging that they are refusing further care and that they understand potential risks and assume responsibility in doing so. If it’s not on the run report, it didn’t happen. Run reports are to be deposited in the report box where the ambulance is stored. The Ambulance Director is responsible for entering all run reports into the statewide system and delivering the reports to the City office for billing.

8. Vaccinations

The City of Lanesboro must make Hepatitis B vaccinations available to all ambulance Department members. If members decline the vaccination they must sign a declination form that should be kept with the members employee file. The City retains the right to require other vaccinations if deemed necessary for EMT and patient safety.

9. Exposure Control Plan

The Occupational Safety and Health Administration, (OSHA), requires a plan be established by the City of Lanesboro that addresses issues regarding exposures to blood borne pathogens. All employees will be aware of the plan, the risks of exposure to bloodborne pathogens, understand the uses of personal protective equipment, and the steps to take if an accidental exposure occurs.

10. Complaint Procedure

All complaints regarding any issues of the Ambulance Department should be brought to the attention of the Ambulance Director. All formal complaints must be in writing, reported to the City Administrator within 5 days of receipt of the written complaint, and the complaint shall be kept on file at the City Office.

Any complaint on a Department Member regarding patient care with the general public shall be the responsibility of the Ambulance Director. If any Department member is advised of a problem, that Member should contact the Ambulance Director immediately and provide the name of the complainant so that the Ambulance Director may contact the individual.

Department Members having complaints or disagreements may seek to have their complaints reviewed, these complaints shall be brought forth to the Ambulance Director, if the complaint involves the Ambulance Director, the complaint shall then be brought forth to the City Administrator.

Any complaints or issues that cannot be resolved by the Ambulance Director shall be brought to the attention of the City Administrator. The Medical Director shall be informed of all patient care issues. The Ambulance Director shall also notify the Minnesota Department of Health EMS Consultant on issues that directly involve patient care. All resolutions to complaints shall be in writing from the Ambulance Director.

(A copy of the adopted version of this document should be given to all members of the Ambulance Service and all potential new applicants should be provided a copy of this document at the time of application for review and acceptance.)