For example, you might be told that you are not ""working" you are "volunteering for charity". OK, provided you don't show up in the company uniform or in one of their vehicles, and no one from "the charity" announces that XYZ EMS has generously "donated" stand by coverage for the event, I might buy that (if you are the one who is giving your time, why should your employer get any credit). As for work comp (if you are injured including exposure to HIV, Hep C, TB, etc) and malpractice protection in the event of a claim of negligence, ask "the charity" to show you their policy and limits of liability. Oh, did I mention that since the charity is not a licensed EMS agency, you cannot perform any act that, under your normal scope of practice as defined by state regulation, requires the prior authority of an operational medical director- "charities" don't have operational medical directors, just some local doc "on scene" who says something catchy like "whatever you do is OK by me". If, after you have raised these issues, you employer smiles and says "don't worry, we will make sure your covered" (wink wink), he (or she or whatever) is violating the FLSA regulations, knows it, and wants you to agree to be a party to the deed for the "good of the company". Ms. Fishbine, take a memo: 

TO: All EMS Employees- If you get sucked into this, then you deserve what you get. An agency lame enough to try to nickel and dime you out of $40 or $50 just to look good is not interested in your welfare. As for supporting charity and humanitarian causes, I wish everyone could, or would, do more to help others. But I will bet you that if you asked the head fund-raiser what federal regulations he/she is violating for the "good of the community", the answer will be "Do What?" 

TO: All EMS Management- Isn't it about time management in this industry stopped playing silly games with other people's money, just so you can pump a little sunshine up your own skirt or get another plaque from the local Chamber of
Commerce? If you want your employees to respect you and your agency, and really make you look good, start playing by the rules. Otherwise, someone is just going to drag you into court and pummel you- how do you think that will look on your resume?

Workers of the world unite. Karl Marx. 

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  6- OSHA and Empowered Employees 

Q: 
I have questions about a service that I used to work for. For months, the Director and Assistant Director forced us to reuse disposable equipment, such as BVM's and C-Collars. They also had EOA's on
the truck that looked like they had been through the first world war, with one EOA that even had tape around the bulb part. We had no actual cleaning facilities other than a small closet located at the hospital where we parked the ambulances. This closet had a shower type sink in it that we put backboards, KED's, and such to wash them. We had absolutely NO PLACE to clean laryngascope blades, and the small stuff, before reusing them. The answer to cleaning the small stuff was peroxide to loosen the crud, and alcohol to "sterilize" it, according to the Director!
When we washed patient linen off the trucks, we were forced to use 1/2 to 1 cup detergent and 1/4 cup bleach. I argued that this did not kill germs, but the Director said that if we used any more bleach, it would destroy the linens. (By the way, this was on FULL LOADS of whites) After a long hard battle of me trying to tell the Directors that this was not proper and that we were not cleaning equipment properly and that we needed to throw disposables away after use, with no action, I gave up. 
I called OSHA and EMS Division from the state, and they came in and did inspections. OSHA found 8 violations. When the state EMS came in, they began throwing stuff off the trucks. They also made a big
deal over us carrying contaminated laundry and sharps containers through the office, through our kitchen area, to the laundry room. They also busted the service for keeping clean laundry in the contaminated laundry room.
Needless to say, this ambulance service has been in business since the 1970's. All of these incidents were swept under the rug, and that is where it has stayed. The Director went to work trying to fix the problems,
but I wasn't around to see it happen. I got fired for the mess. I can say that they still store their IC gear in the office, though.
By the way, I am not a disgruntled employee. I now have a job with the US Govt. making quite a bit more than I did with this service.
Here is a few news stories about this agency. Please remember that the Director and the Employee accused in the first two stories, who is also the Assistant Director, are still employed in those positions.
The lawsuit is still pending, also!
story 1
story 2
story 3

What do you think of this EMS service? 

A:

I did find one question in your submission. What do I think of this EMS agency? Since my only visit to Oklahoma was to Enid and Stillwater, I am
unable to establish anything more than the fact they are in Oklahoma. I'm crazy but I'm not stupid, and I have no desire to return to Oklahoma for a libel suit. 
A hospital with no utility room, no sink, and no materials for cleaning small items? That would be an unusual finding based on my 30 years experience with hospital policies on "crud" management. Sounds like OSHA may want to go see them, accompanied by the State Health Department. 
How does management "force" an employee to use a contaminated supply? Even in Oklahoma there must be some law about use of a firearm to enforce EMS supply
policy. On linen, I'm not sure how much bleach it takes to kill germs in textiles, be it in full load or not. I do have some fairly up to date data on sterilization in beer brewing - a useful subject but I will admit it is hardly interchangeable. 
Stories that imply there may not be a plan to protect employees from the risk of infectious and/or communicable disease, or any other recognizable hazard for that matter, always bother me. I have never been able to come up with a good justification, professional or personal, for putting other people, and subsequently the agency, at risk.
Mind you, this problem has been around for years- "industry leaders", in both EMS and health care, largely just ignored it until someone recited the now famous words "AIDS KILLS" (not to be confused with just turning orange from hepatitis and living the rest of your life with a bum liver).
Then OSHA shoved it down everyone's throat, everyone got paranoid about getting sued, and today you would think that work force protection has
always been at the top of the industry's management agenda since Johnny and Roy were an itch in their Daddy's pants. But that having been said, old
habits die hard. For some managers it's about "we don't need no nanny government telling us what to do", for others its some misguided or misinformed "cost"
nonsense as if paying out judgments and work comp claims for the rest of your life was just the cost of doing business. And then there is the old standby- "yea, but if we give in on this what are they going to want next, turn out gear?" But another thing that bothers me is when my brave brethren who preach management theory go on about how the new millennium employee is a "knowledge employee" who should be "empowered" toward a never-ending search for "quality", and when this doesn't happen everyone just trashes management. 
If a knowledge employee knows what they are doing is
wrong, they don't do it. Throw the stuff away, ask for another one and if you don't get it, park the truck, clock out, and if what is being done violates state and federal regulations, and as a knowledge employee your first
priority is "customer service", then empower yourself right on over to OSHA or EMS or the local newspaper or all three, present your side of the story and let the chips fall where they may. In short, a "knowledge employee" is prepared to "pursue quality" right up the point where his/her job, and the interests of the "customers", is right up there where his/her righteous
indignation is. That's part of what being a professional is all about. 
By the way, congratulations on your new job. And as for your not being "a disgruntled employee", I'd hate to think what you say about employers you don't like.

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7- Drug Testing/Physical Ability for Volunteers

Q:
Can volunteer fire/EMS responders (including those in the grey area of "volunteer, paid for run time") be required to submit to UA's for drug
testing? What about physical fitness tests? What are the legal
implications for a small volunteer service if a volunteer causes
harm and is under the influence of drugs including alcohol, or causes harm due to not being able to perform the physical aspects of the work, such as chest compressions or carrying the patient?

A:
These are both complex issues, not so much in terms of whether you can do something but how you would do them. I will try to provide some practical
advise, with a touch of legalese. 
Can you require drug testing?
My reaction is that if you can show that your goal is to protect the public interest, and arguably the interest of the agency, you can require drug and urine testing- at the least pre-employment, for cause and in the event of an accident or similar event. Most material you will read relates to "employees". How does this effect "volunteers"? I think the same argument can, or should, apply. Does it make any sense to say we don't protect the public because the person involved doesn't get a paycheck? No. How hard would a system be to implement? It can be a nightmare, and you really would need to jump through a number of hoops to achieve an effective system that protects everyone, including the staff. To get a good feel for this activity I recommend a web site for a company called Alaska Scientific. Though it deals with Alaska State law, is straightforward, and provides a good look at virtually every segment of the issue. For another look at how
this turns into policy, I recommend www.iaff.org site on DOT Alcohol and Drug Rules. Their guidelines seem very sensible. On the subject of physical fitness testing, this is a little easier to justify.
First it addresses the issue of any agency being able to insure it can perform its mission effectively. Second, it can be argued that this testing is used to
protect the employee or member and at the same time to protect the agency from the risk of an injury claim that could be avoided. Here is the catch-
do you have a job description for the employee (or member), and can you show that the physical skill you are testing reflects the ability to perform that job. It doesn't make much sense to ask your EMT to carry Rescue Ron down a ladder if they don't ever climb down ladders. But it makes sense to see if they can lift 75 or 80 pounds into an ambulance to carry a patient with another person down a flight of stairs. Anyway, these will be the issues if your policy is ever challenged, and there is a decent chance it will be when the day comes that you tell your 350 lb EMT who everyone thinks makes a
marvelous Santa at the Kiddies Christmas party that morbid obesity is a reasonable basis to terminate their provider status. I will do some searching for a few of these and post them, so look back here in the near
future. Two final points for those in management. There is nothing gray about someone who gets paid for run time. They are not a volunteer in the legal sense of the word. A volunteer is an individual who provides a service or some other form of activity with no expectation of compensation, other than possibly incidental costs. These people, based on everything I
have read in FLSA, would be classified as part time, or possibly per diem, employees, in an on call in the status referred to as of waiting to be engaged (therefore the do not have to be paid while they are on call).
Second, the size or status of your agency and its providers makes no difference if you have some slug out there who is too drunk or too stoned to be fit to provide care to a piece of drift wood. You are toast and well you should be.

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