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Policy Manual

Effective July 1, 2014 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 2 ======TABLE OF CONTENTS

100 Introduction 4 101 Mission Statement 4 102 Equal Opportunity Statement 5 103 Sexual and Other Unlawful Harassment 5 104 Pre-Employment Policies 6 105 Conditions of Employment 6 106 Introductory Period 6 107 Job Performance Expectations 7 108 Work Schedules 7 109 Time Documentation Parameters 8 110 Payroll/Pay Periods 8 111 Method of Paycheck Distribution 8 112 Leaves of Absence 8 113 Personal Illness/Injury Policy 10 114 Absentee Policy 11 115 PTO/Vacation Policy 11 116 Incentive Plans 12 117 Employee Performance Evaluation Review 12 118 Transfers 12 119 Termination Policy 12 120 Compliance with Orders 13 121 Meal/Break Periods 13 122 Work Rules 13 123 Required Identification 14 124 Drug/Alcohol Testing Policy 14 125 Ethical Behavior 15 126 Bulletins/Memorandums 15 127 Solicitation 16 128 Tobacco Use 16 129 Disciplinary Procedures 16 130 Conflict of Interest 16 131 Company Internet Policy 17 132 Personal Telephone Calls 18 133 Personal Business 18 134 Moonlighting 18 135 Employment with Competing Firms 18 136 Theft and Pilferage 19 137 Rehiring 19 138 Customer Relations 19 139 Damaged Equipment 19 140 Safety 20 141 Insurability 20

2 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 3 ======142 Rider Authorization 22 143 Vehicle Maintenance 22 144 Medical Protocol 22 145 Records and Reports 22 146 Radio/Telephone Communications 23 147 Equipment 23 148 Station Guidlelines 23 149 Employee Appearance 24 150 Jewelry/Tattoos 24 151 Hair 25 152 Uniforms 25 153 Business Office Dress Code 26 154 Disciplinary Action 26 155 Employee Safety & Health Protection 27 156 Exposure to Control Plan 27 157 On the Job Injury or Illness 28 158 Driving Policy 32 159 Emergency Driving 33 160 Speed Limits 33 161 Backing and Parking 34 162 Parking of Company Vehicles 34 163 Vehicle/Property Damage 35 Glossary 36

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100 Introduction

The following employee policies and procedures have been prepared in order to provide the employees of, or contracted to, Heartland Ambulance Service, LLC hereinafter sometimes referred to as the (“Company”) with a description of the Company’s policies and procedures. This Policies and Procedures Manual is intended to answer questions, clarify answers and give definition to specific areas regarding the day-to-day operations of the Company. It is designed to be a positive tool and aid in your job with the Company.

The policies and procedures presented in this manual shall be in effect until changed by the Chief Executive Officer or Director of Operations. Since our business is constantly changing, we expressly reserve the right to change any of our policies, including those set forth below, at any time. Employees will be notified, in writing, of those changes and their effective date. Changes will be effective on dates determined by the Company, and you may not rely on policies that have been superseded. Only the Chief Executive Officer of the Company or Director of Operations has any authority to alter the foregoing.

Unless otherwise indicated in a separate written employment contract, the employment of all employees of the Company continues to be on an at-will basis. The employment of all employees is entered into voluntarily, and all employees are free to resign at any time, for any reason. Similarly, the Company is free to conclude the employment relationship of any employee at any time, for any reason not prohibited by law, with or without notice.

Nothing herein shall be construed as an expressed or implied promise of continued employment if you adhere to the policies stated herein.

101 Mission Statement

Our mission is to become a fully integrated mobile healthcare provider delivering high quality healthcare to anyone who needs it. We are dedicated to being a responsible company, to our employees, our customers, and our community. Our philosophy is focused on creating a system, which increases both employee and customer satisfaction by meeting and exceeding our internal and external customer needs.

Our values reflect our commitment to exemplify the “service before self-interest philosophy” at every level of our organization, to treat everyone we meet – including each other- with compassion, dignity and respect, to deal fairly and honestly and to honor all our commitments.

The focus of all we do should be on serving our patients and those who care for them. Our existence depends on them. We should always be mindful that our patients are “people” too. They call us when there is a crisis in their life, and depend on us to help them. Our treatment should be of the whole person not just their illness or injury. Reassurance and empathy are as much of our job as diagnosis and treatment. Total professionalism is our duty and our mission.

4 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 5 ======102 Equal Opportunity Statement

Applicants will be hired on the basis of experience, training, personal background, and the potential for growth to accomplish the best possible for the continued success of the Company. There shall be no discrimination based on religion, age, sex, race or national origin. It is the intent of the management that equal opportunity will be provided in all promotions, wages, benefits, and other privileges, terms, and conditions of employment.

103 Sexual and Other Unlawful Harassment

The Company will not condone, permit or tolerate any form of discrimination and/or harassment by or against any employee, customer, vendor, independent contractor or other individual with whom our employees come into contact in connection with their employment with this Company based upon age, race, color, creed, religion, sex, sexual orientation, national origin, disability or other protected class or characteristic established under applicable federal, state or local statue or ordinance.

Sexual harassment is a form of illegal sex discrimination. Sexual harassment refers to behavior that is unwelcome, personally offensive, and which interferes with our work effectiveness. Federal law defines unlawful sexual harassment as unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature, whether by male or female, when (1) submission to such conduct is made either explicitly or implicitly a term or condition of an individual's employment, (2) submission to or rejection of such conduct by an individual is used as a basis for employment decisions affecting such individual, or (3) such conduct has the purpose or effect of unreasonably interfering with an individual's work performance or creating an intimidating, hostile or offensive work environment.

Individuals who believe they have been subjected to discrimination or harassment as described or have questions about whether certain conduct is unlawful should immediately speak to their supervisor or Director of Operations. This is particularly important in cases involving sexual harassment where there can be uncertainty about what is unlawful conduct.

Supervisors who receive complaints of discrimination or harassment or who are made aware of conduct that may constitute discrimination or harassment must immediately notify Kenneth W. Jackson II or, if appropriate Eric Hiatt, Director of Operations, in place of Kenneth W. Jackson II

All complaints will be investigated promptly and the existence of a complaint will be disclosed only to the extent necessary to make a prompt and thorough investigation or to take appropriate corrective measures. In all cases, the person who initiated the complaint will be informed of the findings and disposition of the matter at the conclusion of the investigation. Management will ensure that there is no coercion, retaliation, intimidation, discrimination or harassment directed against any individual who registers a complaint or serves as a witness on behalf of another individual.

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PERSONS WHO ENGAGE IN PROHIBITED DISCRIMINATION OR HARASSMENT WILL BE SUBJECT TO APPROPRIATE DISCIPLINE UP TO AND INCLUDING TERMINATION OF EMPLOYMENT.

104 Pre-Employment Policies

All persons seeking employment must first fill out an application. This will be reviewed with previous references and employment dates checked along with a Motor Vehicle Report to review driving record and criminal background check. The Company reserves the right to test new prospective employees to verify statements concerning proficiency in a stated area or to test for basic skills that are critical for the successful performance of their job. The Company also has the right to test employees for substance abuse and physical agility.

105 Conditions of Employment

The Company will maintain definitions of employment consistent with the State Department of Labor, and will classify employees according to the following definitions:

a. The term “employee” shall mean an individual employed by the Company.

b. All employees are first hired into a 90-day introductory period. During this time they will be considered probationary employees. Please see the full details in section 106 below. To become a non-probationary employee, a review of the employee’s job performance shall occur between the Supervisor(s) and the Director of Operations after approximately 60 – 90 days of service and if the employee receives a favorable review at that time, he or she will be awarded non-probationary status.

c. The term “full-time employee” shall mean an employee who regularly works in excess of Thirty-two (32) hours per workweek. When an employee is granted regular full-time status, all company benefits become available at that time (subject to standard entry periods for each benefit). Accruals shall begin after the 90-day introductory period. After Full Time status has been granted and Human Resources have received completed appropriate paper work.

d. The term “part-time employee” shall mean an employee who regularly works less than thirty-two (32) hours per workweek. Part time employees must maintain a minimum of 24 hours per month.

106 Introductory Period

All Individuals are hired on an introductory basis. During this time, the Company decides whether or not an employment relationship should be established with the new employee. In addition:

a. The new hire decides whether he or she is ready and able to make the necessary commitment to our organization.

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b. The supervisor decides whether the employee's skills, productivity, quality of work, attendance, and personal conduct meet the requirements of the Company.

c. Employee has completed the Probationary Packet in its entirety.

d. The initial introductory period shall last ninety-days (90) from the starting date of employment.

e. If there have been some problems during the introductory period, the employee may be placed on probation for an additional period of up to 90 days, or released from employment.

f. At the end of the probationary period, an evaluation of performance will occur ending probationary status.

107 Job Performance Expectations

Regarding your relationship with coworkers and customers, the Company operates on the basis that every individual deserves to be treated with respect, courtesy, tact and consideration. Therefore, we expect you to treat patients, customers and fellow employees accordingly. The employee will, at all times, portray the highest ethical standards. This will include complete control of his/her emotions, tone of voice (including tone of voice on radio communications), facial expressions and verbal and/or body language. The employee will be courteous and will endeavor to conduct himself/herself in a highly professional manner at all times. Personnel are strictly forbidden to use profane or off-color language in public. You should be aware of and sensitive to any behavior that is offensive to others. If you observe or are the object of such conduct, you are responsible to report it to your supervisor.

108 Work Schedules

Work schedules for all personnel will be established by Director of Operations in consultation with Station Managers. Placement and utilization of scheduled units will be determined by the Director. Change in system demand may cause the need for other modifications in number and placement of staffed units and can occur anytime the Director deems necessary. Dispatch will make all daily call assignments based on their current direction from the Director.

Work schedules are established in order to ensure that the Company will have the proper number of employees in each necessary job classification to handle the anticipated workload at any given time. Schedules are carefully worked out by Management and must be adhered to by all employees. Tardiness causes serious problems in maintaining schedules. Frequent tardiness is grounds for corrective action and possible dismissal.

In order that the Company may call your home in the event of work schedule changes, personal illness, accident, or for mailing purposes, it is extremely important that your

7 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 8 ======current telephone number and address be on record. You must inform your supervisor at once of any change of your telephone number or address. In case of emergency, the company should also have the name of a person to notify on your behalf. Be assured that this information will be kept entirely confidential and be released only with your permission.

109 Time Documentation Parameters

Employees should not “punch in” more than 5 minutes prior to the scheduled start of the shift as posted on the schedule, and may not “punch out” more than 5 minutes after the end of the shift unless supervisor is notified of reason ie late call, etc. End of shift is defined as the time Dispatch cuts your unit for the day, not what schedule says, plus 30 minutes for clean-up. Failure to notify the supervisor of a clock variance in writing or by email is grounds for termination.

Employee will be considered late if not clocked in and ready for work at the start of the assigned shift as posted on the schedule.

110 Payroll / Pay Periods

The pay period starts on a Sunday at 00:00 a.m. and ends 14 days later on Saturday at 11:59 p.m. Employees will be paid bi-weekly on Fridays following the end of the pay period.

111 Method of Paycheck Distribution

Paychecks can be picked up on payday Friday after 3:00pm at designated locations. Check with your Supervisor for your precise pick-up location. Checks may be distributed at other offices as deemed justified by management. For any special arrangements regarding paycheck distribution contact the Director of Operations.

112 Leaves of Absence

In emergencies, and under certain other conditions, provisions are made to protect the continuous service rights of eligible employees who have successfully completed their orientation period who must, for some period of time, stop working. Medical and Maternity Leaves may not be taken prior to completion of the orientation period. Should the employee find himself or herself in a position requiring prolonged absence from work, it is necessary for the employee to submit a written request for a leave of absence to their Station Manager or Operations Director. Prolonged absence from work is defined as more than three shifts or 7 days. Except for paid time off-hours, which may be paid per policy, leave is granted without pay.

Please Understand, all employees will be required to pay their part of any deductions for company benefits and any other money owed to the company while on leave. If an employee terminates employment during a leave of absence, the employee will pay any money owed the company.

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The employee, for review by their immediate Supervisor or Manager, must submit a written request. If the Supervisor or Manager recommends approval, they will forward the request to the Human Resources Department, who in conjunction with the Director of Operations will determine if the leave is approved. The written request must include the specific reason for requesting a personal leave and the exact duration of the leave requested. The Company will decide if the leave can be granted based on the following criteria:

a. Reason for the leave. A leave of absence will not be granted for employees to conduct a search for alternative employment or engage in other gainful employment.

b. Workload demand for the time covered by the leave being requested.

c. Frequency of requests by the employee and length of their service.

d. Number of other leaves already approved for any part of the time covered by the requested leave.

e. Necessity of providing a temporary or permanent replacement.

An employee who fails to return to work on the next scheduled workday after expiration of a leave of absence, or fails to contact their supervisor, or falsifies the reason for a leave of absence, will be deemed to have voluntarily terminated their employment. After you return from an extended leave of absence your insurance and PTO will resume after 90 days.

If the Family Medical and Leave Act of 1993 provides greater benefits to the employee than those benefits provided in this paragraph and the following paragraphs, such Act shall apply if the company falls within the guidelines of the Act at the time of the leave. Any leave granted hereunder shall be credited as leave granted under the Act and not in addition to the leave provided under Family Medical and Leave Act of 1993.

 Bereavement Regular full time employees who have completed ninety (90) days of service will be allowed up to three (3) working days off each year, with pay, to attend the funeral of any member of their immediate family. Immediate family includes your spouse, mother; father, brother, sister, and children.

 Military Service If you are called for active military service or military reserve training, the Company will grant you a military leave and will otherwise comply with the universal Military Training and Reemployment Act. You may choose but are not required to consider your Military duty as vacation and receive your vacation pay. PTO time may also be used during any military service and training.

Disability See posted workman’s comp information in the employee information center.

9 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 10 ======Parental The Company shall grant Parental LOA to employees (male or female) for the birth of an employee's child. (This applies when there are no medical complications due to pregnancy or childbirth; if there are medical complications due to pregnancy childbirth, a Medical LOA will apply.) A parental leave of absence may also be granted for placement of a child in the employee's care for adoption or foster care. Upon making a request for a LOA, the employee may be required to provide documentation to support the birth or legal placement of a child.

o The "parental leave" is also designed to give benefits in accordance with the FMLA. If you have questions concerning your eligibility, please contact the Human Resources department. Eligibility: Employees who have at least 12 months of service and have worked at least 1,250 hours in the last consecutive 12 months.

o As with other types of leave of absence, any company benefits that are charged to the employee are still the responsibility of the employee to pay while on leave.

113 Personal Illness/Injury Policy

Due to the nature of the EMS business it is imperative to maintain staffing levels that will meet the projected call volume. When unexpected absence is unavoidable, it is important that you advise your Manager, a minimum of twelve (12) hours prior to starting time so that arrangements can be made to cover your absence.

a. Illness/Injury (off-Duty) If the employee misses any shifts due to illness, from 1 to 3 days, the employee may be required to produce a physician’s release to work. Any absences greater than 3 shifts the employee will be required to provide a physician’s release to work. In the event the employee has been injured off duty, the employee will be required to produce a physician’s release prior to their return to duty. In the event abuse of sick leave/time off is suspected; the supervisor may require a doctor’s release at anytime.

b. Illness (On-Duty) If an employee becomes ill while on-duty, the employee will contact their supervisor immediately. The Supervisor will then make the decision weather to send the employee home or not. The absence will be excused if the Supervisor deemed it necessary for the employee to leave work.

If the supervisor deems it unnecessary to leave work, and the employee disagrees, the employee can leave work with the understanding that a physician’s release will be required prior to returning to work.

c. Injury (On Duty) An employee injured while on duty shall: 1. Receive immediate medical attention if necessary

10 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 11 ======2. Contact their Supervisor 3. The Supervisor shall complete an injured employee report, which the injured employee shall sign. 4. Contact Risk and Safety Manager within 12 hours of injury.

114 Absentee Policy

All absences will be considered unexcused unless a physician’s release to work has been presented to the Supervisor. Any exceptions to this will be at the Director of Operations discretion.

The number of incidents before disciplinary action is initiated will be two (2) occurrences within a 180-day period. This includes late arrivals, early quits, and unexcused absences. However, the Company reserves the right to take any disciplinary action up to and including termination. The following actions will be cumulative and may extend past the 180 day period of the original infraction.

2 unexcused absences, late arrivals, early quits Written Warning 3 unexcused absences, late arrivals, early quits Suspension – 1 shift 4 unexcused absences, late arrivals, early quits Suspension - 2 shifts 5 unexcused absences, late arrivals, early quits Termination

Any employee that accumulates excessive excused absences that puts an undue burden on other employees covering the open spot or causes increased payroll expenses for the company covering open shifts with extraordinary over time is subject to termination from employment.

An employee that has been suspended due to disciplinary action will not be eligible to pick up a vacated shift during the same pay period.

115 PTO/Vacation Policy

Full time hourly employees will accrue 4.6 hours of personal time off (PTO) per pay period that the employee works 64 hours in the pay period. Employees will be allowed to accrue a maximum of 240 hours in their PTO account.

Hourly employees will not be able to use PTO during a week that they accrue 48 hours (40 hours regular and 8 hours overtime) of actual time worked. Employee may not take more than enough PTO to complete their work week with a total of 48 hours combined PTO and hours worked.

Employees wishing to use PTO time for unexpected excused absences shall submit a PTO/Vacation Request to your station manager prior to the end of the current pay period.

Hourly employees requests for PTO/Vacation time off shall be submitted to your station manager, salaried employees requests shall be submitted to the Operations Director, a minimum of 30 days in advance. Don’t assume that because a request is submitted that it has been approved. Always check with the station manager for confirmation.

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PTO/Vacation may not be requested on the following days:

New Year’s Day Memorial Day Independence Day Labor Day Thanksgiving Day Christmas Eve Day Christmas Day New Year’s Eve

All illnesses on these dates shall require a physician’s release.

Employees that are promoted to a salaried position shall receive payment of accrued PTO at a rate of $.50 on the dollar times accrued PTO, less 40 hours. The rate shall be at the hourly pay scale prior to promotion to a salaried position. Salaried employees shall receive two (2) weeks of vacation and one (1) week of sick leave on an annual basis. Unused vacation and sick leave shall not exceed 4 weeks of vacation and 1 week of sick leave. Salaried employees may not cash in unused vacation upon termination of employment.

An employee that moves from a salaried position to an hourly position shall receive 40 hours in their PTO account for illness.

Employees will receive compensation for their PTO account upon termination of employment if two (2) weeks notice is given. Payment shall be at a rate of $.50 on the dollar.

116 Incentive Plans

The Incentive Plans will be available to employees and explained in greater detail under separate cover. Incentives and bonuses are not perpetual. The Management reserves the right to terminate any incentive or bonus with or without notice.

117 Employee Performance Evaluation Review

The management may choose to conduct an evaluation review of its employees. The supervisor will discuss the evaluation with the employee, one-on-one and give him or her a copy of the completed evaluation.

118 Transfers

A transfer within the company may provide you with an opportunity for personal growth and job enrichment. If you think that you and the Company would benefit from such a transfer, contact your Supervisor.

119 Termination Policy

For a voluntary termination, upon giving two (2) weeks notice, the resignation will be accepted at management’s discretion after turning in all Company equipment and uniforms and paying off any items of debt owed the company. If notice is given,

12 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 13 ======Personal Time Off will be paid (at $.50 on the dollar), if less than a full two (2) weeks notice is given, there will be no Personal Time Off paid. PTO will NOT be paid due to an Involuntary Termination.

120 Compliance with Orders

Refusal or failure to follow an order from Management (written or oral) is considered insubordination. Due to the very serious nature of the job, this infraction is considered to be a major offense. Any violation of this rule will result in disciplinary action. If an order is disagreed with, the employee is hereby directed to follow the order and to make an official complaint as soon as possible thereafter. The only exception that such an order should not be followed is if it were illegal or to cause injury to oneself or to a patient.

Refusing a call or posting assignment from dispatch will be considered an act of insubordination. If you feel you have a reason to question a call, make the call and contact a supervisor after you have made the call. If you feel a posting assignment is incorrect contact the Station Manager or the Director of Operations. Otherwise disciplinary action will be taken, up to and including termination.

Employees are required to be honest with supervisors and co-workers at all times. Purposely lying or misrepresenting facts to a member of supervision or administration is grounds for immediate termination.

121 Meal / Break Periods

Dispatch: Meals/Breaks will be taken as the dispatcher finds time throughout the shift due to the nature of the EMS System; we can not specify specific break times or dedicated relief. Dispatchers are not to sleep during their dispatch shift unless they are working an unplanned extended coverage shift with permission from the Director.

Medics: It is the responsibility of EMS personnel to obtain meals when time allows, bearing in mind that meals may be interrupted for calls. Dispatch will try its best to accommodate meal periods but calls come first.

122 Work Rules

It is essential for orderly, safe, and efficient operations that certain rules and regulations be established for the guidance of all. The Company will take appropriate action with employees who violate any of the following rules while on company time and/or company property, which may include immediate dismissal. This list is not intended to be all-inclusive. a. Immoral or indecent conduct. b. Theft of monies or company property or the monies or properties of another person or company.

13 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 14 ======c. Intoxication, or the use, possession or sale of any intoxicants, drugs, or narcotics, including marijuana. d. Possessing firearms or other dangerous weapons on company property or while on company time. e. Excessive or unexcused absences or tardiness. f. Leaving your job without permission. g. Failure to abide by the Company’s Drug Screening policy. h. Falsification of Company records, skills certificates, having multiple driver’s licenses, etc. i. Violating a safety rule or doing anything that creates a safety hazard on Company property or while driving a Company vehicle. j. Unauthorized dissemination of confidential information as defined by HIPPA k. Overstaying your lunch period. l. Intentional failure to time in or out, timing in or out for another employee or permitting another employee to time you in or out. m. Using abusive or threatening language to any employee. n. Fighting or attempting to inflict bodily injury on another. o. Willfully destroying or defacing Company property or recklessly operating Company vehicles or equipment. p. Insubordination; the refusal to follow direct verbal or written directives from management, or the undermining of company policies, procedures, management, fellow employees, customers or patients. q. Using Company property for personal use without prior authorization from management. r. Horseplay or disorderly conduct that jeopardizes the Company image, property, employees, patients or customers or their general safety. s. Refusing to cooperate in the investigation of any accident, felony or theft on Company property or Company time. t. Accepting of tips, gratuities, is not allowed. Management must approve accepting gifts, merchandise, or prizes from patients, contractors, etc, in advance. u. Other employments while on sick leave, worker’s compensation, or on an approved leave of absence are prohibited. Other employment, which adversely affects employee efficiency or working for competition, without management approval is also prohibited. v. Any act that seriously injures or tends to injure the best interest of the company.

123 Required Identification

All Employees of the Company are required to have on their person the documents that are listed below. These documents must be presented anytime it is requested of the employee. These documents include:

a. Current State Drivers License/ID Card b. Heartland Ambulance Service Identification/Name Badge c. Indiana State EMS certification d. Any other Company requirements.

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124 Drug / Alcohol Testing Policy

It is the policy of the Company that its employees should be free of substance abuse. The use, possession or being under the influence of alcohol or a prohibited drug on Company property or while on Company business is strictly prohibited. Misuse or abuse of prescription drugs is also prohibited by this policy. Prescription drugs should be kept in their original containers and any side effects that could adversely affect work performance should be reported to your supervisor prior to starting work. Unlawful use, possession, sale or transfer of illegal drugs on or off the Company property is strictly prohibited. The use of alcohol, prescription drugs or any illegal drug off Company property is strictly prohibited if it affects the employee’s performance or other persons’ safety or the employer’s position in the community. The Company reserves the right to conduct reasonable searches of any employee, the work area or any vehicle on Company property to monitor compliance with this drug policy. The Company reserves the right to conduct medical tests of the employee’s hair, blood or urine to confirm compliance with the policy. Any employee that refuses to be tested under this policy will be terminated. An infraction of this rule will result in strict disciplinary action. We have four (4) types of drug testing as follows:

1. Pre-employment - any person employed by the Company may be tested for drugs and shall have a negative test result before that employee shall be hired. 2. Reasonable Cause - you will be tested for drugs if your conduct gives the Company reasonable cause to believe you are under the influence of drugs.

3. Post-accident Testing - you may have to submit to a drug test in the event of a reportable accident.

4. The Company reserves the right to conduct random drug tests to ensure compliance with this drug policy.

125 Ethical Behavior

All employees are expected to maintain a high standard of ethics relating to medical problems and incidents in our service. Gossiping, rumor-spreading, and open criticisms of fellow employees and customers does not meet this high standard of behavior and will not be tolerated.

126 Bulletins/Memorandums

Employees are required to read all memorandums regarding their areas of responsibilities and about the company. Employees must check their company provided email every shift (if provided) and read any notifications sent. Changes, additions, and informational memorandums will be issued and distributed to employees as needed in print or email.

15 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 16 ======ALL BULLETINS MUST BE APPROVED AND SIGNED BY STATION MANAGERS OR OPERATIONS DIRECTOR PRIOR TO BEING POSTED OR DISTRIBUTED.

127 Solicitation

Solicitation and distributions of literature of any type by employees during work hours is prohibited unless approved by the Director.

128 Tobacco Use

There will be no use of tobacco (smoking, e-cigarettes, dipping, or chewing) in the office, stations, on a call (dispatched until destination) or in any Company vehicle. Tobacco use will be permitted in restricted areas only. Tobacco use will not be allowed outside of Emergency Room doors under any circumstances.

129 Disciplinary Procedures

The following approach will be taken in those instances where corrective action is deemed necessary:

Verbal Counseling or memo of discussion Written Warning Suspension or Demotion Termination

If suspended: You will not be allowed to work overtime or make up hours of suspension by picking up additional shifts.

Two (2) suspensions in twelve (12) months may result in termination.

Disciplinary Probation periods will be for up to 90 days. (Extensions shall not exceed 90 days)

Suspension periods will be for 1-5 shifts.

The Company retains the right to bypass progressive discipline when it deems necessary, and the company retains its right to employment at will.

130 Conflict of Interest

As a full time employee of Heartland Ambulance Service, your primary responsibility is to this Company. Since we deal with many organizations, it is essential that employees treat information about clients, customers, suppliers, or internal operations, and internal records, with absolute confidentiality. Additionally, employee's personal relationships

16 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 17 ======should in no way compete with, or compromise, the Company's interests. The following guidelines, when strictly adhered to, will help you avoid situations where a conflict of interest could occur:

a. Do not accept gifts or other favors of value, which are offered as a result of carrying out your duties for the Company.

b. Do not divulge internal information, statistics, records, pay rates, or operating methods to anyone outside of your supervisor.

c. Cooperate with management in resolving any possible conflict situation involving yourself or your family.

By observing these guidelines, you will protect yourself and the Company from difficulties and / or legal repercussions, which naturally result from a conflict of interest.

131 Company Internet Policy

The Company provides Internet access (including e-mail) to its employees to assist and facilitate business communications and work-related research. These services are for legitimate business use only in the course of employee’s assigned duties. All materials, information and software created, transmitted, downloaded or stored on the company’s computer system are the property of the Company and may be accessed only by authorized personnel.

 Prohibited Uses Inappropriate Internet use includes: transmitting obscene, harassing, offensive or unprofessional messages; accessing any site that is sexually or racially offensive or discriminatory; displaying, downloading or distributing any sexually explicit material; transmitting any of the Company’s confidential or proprietary information, including customer data, trade secrets or other materials covered by the company’s confidentiality policy.

 Monitoring The Company reserves the right to monitor employee use of the e-mail system or the Internet at any time. Employees should not consider their Internet usage or e-mail communications to be private. Personal passwords are not an assurance of confidentiality, and the Internet itself is not secure.

 Copyright restrictions, permission required Any software or other material downloaded into a company computer may be used only in ways consistent with the licenses and copyrights of the vendors, authors, or owners of the material. Prior written authorization from the Company is required before introducing any software into the company computer system. Employees may not download entertainment software, games or any other software unrelated to their work.

 No company representation

17 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 18 ======Only authorized employees may communicate on the Internet on behalf of the Company. Employees may not express opinions or personal views that could be misconstrued as being those of the company. Employees may not state their company affiliation on the Internet unless required as part of their assigned duties.

 Violations of this policy Any violation of this policy may result in loss of computer access and disciplinary action, including immediate termination.

132 Personal Telephone Calls

Company phones are for business use only. No long distance calls are permitted from company telephones, land or cell. .If absolutely necessary, incoming personal calls shall be kept to a minimum as to not interfere with business calls. Office and dispatch personnel may use your personal cell phones for personal calls on breaks only. When a conflict exists with personal calls and business calls, business always comes first!

Medics may make personal telephone calls on their personal cell phones when it does not interfere with their duties. Absolutely no cell phones are to be used while driving company vehicles.

133 Personal Business

Personal business should not be conducted on Company time. If, due to unusual circumstances, personal business must be conducted during your regular hours, you may request time off, without pay, from your supervisor or use a portion of your vacation days. Normally (7) day’s notice is required for such items as doctor’s appointments, dentist appointments, or any other similar absences that requires an appointment. Where we have conflicting appointments (2 or more people that need to be off at the same time), someone will have to reschedule their appointment to ensure that we have adequate coverage.

134 Moonlighting

While the Company does not encourage members of the staff to have more than one job, the Company recognizes that certain circumstances may make it necessary for an employee to consider outside employment. However, the employee's right to do as he / she pleases during off-hours must be balanced against the needs of the Company for employee productivity and alertness at all times. Employees are responsible for covering his or her own shift if they are going to be late or must leave early.

135 Employment with Competing Firms

Outside employment with any competing firm such as another emergency or non- emergency ambulance service provider, without the prior written permission of the

18 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 19 ======Director of Operations, is strictly prohibited. In addition, no employee will accept employment with any business, which is likely to be harmful to the Company's image.

Outside employment will not be considered an excuse for poor job performance, tardiness or absenteeism.

In no event will an employee serve as an employee, owner, officer, director, shareholder, partner, consultant or agent for any business enterprise that:

Requires personal attention or work during the employees scheduled work hours at Heartland Ambulance Service; involves a business venture that would be in direct competition with Heartland Ambulance Service. (Competition is defined as an entity that competes for any aspect of the Company’s business or resources.)

Involves the use of information from the Company’s records or concerning its clients, patients or employees.

Involves the use of the Company’s equipment, supplies or facilities.

Could place the employee or the Company in an embarrassing / unethical position or otherwise have an adverse effect on Heartland Ambulance Service

Could be harmful to the Company’s professional image with the public, contractors or other customers.

136 Theft and Pilferage

Any theft or pilferage of Company property is grounds for immediate termination.

137 Rehiring

All rehiring decisions will be made by the Director of Operations, or his designee, in consultation with Station Manager and will be reviewed on a case-by-case basis.

138 Customer Relations

Maintain a courteous and respectful attitude toward patients, customers and the general public. If you have trouble with a customer for any reason, call your supervisor immediately.

139 Damaged/Lost Equipment

Inspect all equipment prior to starting the day. If damage is found, note it on the mechanical or medical checklist and notify your supervisor. If you damage or lose any equipment, you are to notify your supervisor. In the event of damages to company property the employee could be held financially responsible at managements discretion.

19 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 20 ======

140 Safety

Employees' safety on and off the job is vitally important to your family and your Company. The following rules are written and enforced to help protect everyone in or on Company property. They may not cover every situation, but outline most of the precautions you should follow:

a. Practical jokes, horseplay, running and fighting are forbidden.

b. All personnel shall wear protective equipment when required to work in designated areas that require such equipment.

c. Report to your supervisor any known dangerous practice, faulty equipment, machines, etc.

d. Observe speed and traffic regulations on and off Company property. This pertains to ALL employees.

e. Never distract, interrupt or annoy another worker unnecessarily as it may cause an accident.

f. All drivers and maintenance personnel shall exercise caution while working around any moving or operating vehicle.

g. Only authorized personnel shall operate mobile equipment.

h. No one shall operate any equipment unless thoroughly familiar with it.

i. Personnel handling hazardous materials shall wear proper protective equipment.

j. All inventory shall be handled and stacked safely using proper procedures and never to exceed a safe height.

Safety Considerations When Staging Units:

All units must stage as a guideline at least two (2) blocks away from incidents such as riots, mass casualty incidents, or unsecured scenes unless specifically authorized to do otherwise by your assigned supervisor.

141 Insurability

20 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 21 ======The continued employment of any employee whose duties include driving while in the course and scope of employment depends on such employee’s insurability. Any employee whose job entails driving for the Company is subject to immediate termination if he/she becomes uninsurable due to traffic violations, irrespective of fault, during the term of employment, regardless of whether such traffic violations took place on or off the job. Yearly MVR reports will be made on all employees whose duties include driving while in the course and scope of employment.

The Company reserves the right to request a copy of the employee’s Motor Vehicle Report to review the employee’s driving record at any time. Excessive violations and/or any violations, which lead the Company to believe that the employee is an unsafe driver and/or an unreasonable risk to himself/herself, other employees, clients or the public at large, shall result in immediate termination of the employee.

Minimum Standards for Drivers of Company Vehicles

Violations: <= 2 moving violations in the past 3 years <= 1 moving violation in the past 12 months

(This does not include violations involving drugs or alcohol, reckless driving, license suspension, negligent driving, etc. Violations of this type will normally make the driver unacceptable)

Accidents: <= 1 accident in past 3 years

(A preventable accident is any traffic accident which results in property damage and/or personal injury, regardless of who was injured, what property was damaged, to what extent, or to where it occurred, in which the driver in question failed to exercise every reasonable precaution or action to avoid the accident. Driving to avoid preventable accidents is defensive driving. The fact that the driver was not charged with a traffic violation is not a part of our definition.)

Combination of Tickets / Accidents: <= 1 moving violation in last 3 years <= 1 accident in last 3 years

Age Profile: All drivers younger than 21, and older than 65, must be submitted for individual consideration. Drivers under the age of 25 will be limited to no more than 40% of the total number of drivers.

Ineligible Drivers: Any driver without a valid driver’s license

Any driver with the following violations regardless of the time period: Homicide involving a vehicle

21 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 22 ======Using a vehicle to elude a peace officer Hit and Run Manslaughter with a vehicle Felony with vehicle False report to police department Permitting an unlicensed driver to drive

Any driver convicted of any of the following within the last 3 years: Driving while under the influence of drugs or alcohol Refusal to submit to an alcohol or drug test Reckless Driving Negligent Driving Exceeding the speed limit over 25 MPH License suspension

142 Rider Authorization

It is the policy of the Company to not allow a ride along in the ambulance other than those directly involved in patient care. However, the Company recognizes that in certain cases, an unavoidable need to provide transportation to another party related to, but not involved in immediate patient care may arise. These exceptions would be family members riding to the hospital with the patient, limit one (1) family member. Family members are to ride in the front seat with their seat belts on. Other authorized to riders include; hospital personnel riding with the patient, law enforcement officers riding with the patient, emergency service personnel who are assisting with the patient, or off duty employees. Students doing ride along time must be scheduled and approved through the education director or Director of Operations. Students doing ride along time must sign a release and will not be allowed to ride after 10:00 pm.

143 Vehicle Maintenance

Vehicle maintenance is performed by certified personnel only. Employees discovering mechanical problems should report them to the Station Manager and mark them on the appropriate check off sheet. If vehicle breaks down, notify dispatch and supervisor immediately.

144 Medical Protocols

Medical personnel (basic, advanced, and paramedic) will follow guidelines and standards set down by the medical director through written protocols, which will be on each and every ambulance. Failure to follow protocol guidelines may result in disciplinary action up to and including termination.

145 Records and Reports

All patient care reports are to be carefully, accurately and completely filled out at the time of the call or as soon as practical. This is to include;

22 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 23 ======

PCS: Demographics completed Sections A, B or C checked appropriately Signature with credentials and date Face Sheet Signatures: Patients or responsible party Receiving nurse Yours, with credentials

All patient care reports, including those sent back in mobile shall be completed prior to going off duty, and sent to for supervisor review. Patient care reports not being completed prior to leaving shift will result in disciplinary action.

836 IAC 1-1-5 Reports and records Authority: IC 16-31-2-7; IC 16-31-3 Affected: IC 4-21.5; IC 16-31-3

(3) A copy of the completed run report form shall be provided to the receiving facility when the patient is delivered unless it is not feasible; however, the form shall be provided to the receiving facility not later than twenty-four (24) hours after the patient is delivered.

Supervisors should be notified of any incomplete patient care reports before going off duty. Patient care reports are not to be taken home for completion. Copies of all run sheets must be provided to receiving facility for any patient transported to a hospital. It is the medic that completes the reports responsibility to send the report to that facility by print or fax.

146 Radio and Telephone Communications

One should strive for professionalism in all radio communications. Communications are to be clear and concise, both in content and verbiage. A portable radio or company cell phone shall be worn at all times by one of the crew members when away from your assigned stations or ambulance.

147 Equipment

On occasions, the need to leave equipment at hospitals may arise (i.e. backboards, splints, ect.). When this occurs you should document where and when equipment was left on your daily check sheets. If possible you should retrieve equipment before you leave your shift.

148 Station Guidelines

Visitors – Visitors to the station are to limit their visits to thirty (30) minutes. There are to be no visitors past 10 PM.

23 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 24 ======Linens – It is the responsibility of each crew to keep their dirty linen retrieved on each transport. Crews are to bring their own linens and towels for personal care.

Enroute times – Response times are critical. Crews are to be enroute within 2 minutes during the daytime, 5 minutes during the night after receiving a call from dispatch.

Food and Personal Property – When bringing food or personal items to the station be sure they are clearly marked and removed by the end of your shift. Please respect each other’s property.

149 Employee Appearance

It is expected that all employees will maintain the highest standards of personal cleanliness and grooming. Employees must present a neat, businesslike and professional appearance at all times during working hours. Every employee has some contact with the public, and therefore, represents the Company in their appearance and actions. The properly attired employee helps to create a favorable image for the Company as well as reflecting on their personal professionalism.

This policy is to provide a standard for employees in regard to personal safety and grooming. Personal hygiene and good personal health habits are essential elements of an effective infection control program.

150 Jewelry/Tattoos

Females may wear earrings only if the following guidelines are followed:

Must be worn bilaterally on the ear lobe only. Must be matching with a single earring on each ear lobe. Must be "stud" type or "non-dangle" earrings only, no loops.

Males are not permitted to wear earrings.

No visible body piercing is allowed.

No visible tattoos will be allowed. If tattoos are present they will need to be covered with appropriate clothing.

Extremes of fingernail length, color, or design are not permissible. The length of any fingernail (s) will not extend greater than one-quarter (¼) inch from the tip of the finger.

Other jewelry must be worn conservatively. Bracelets are not allowed, except medical alert bracelets. Necklaces must be worn inside the shirt. It is recommended that field employees not wear rings while on duty. Employees choosing to wear rings do so at their own risk and employees are limited to one ring per hand. A wedding set will be considered as one ring. The Company is not responsible for damage to rings or any other jewelry as a result of working conditions.

24 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 25 ======Employees choosing to wear rings must use extra caution while caring for patients, to assure the ring does not tear required gloves during patient care. This could become a source of possible infection.

Perfume or cologne must be used conservatively.

151 Hair

Hair will be clean, combed and neatly trimmed or arranged. Dirty, unkempt, or hair not of a naturally occurring human color is not permissible, regardless of length and style. Extremes of any hairstyle are not permissible.

For personnel involved in direct patient care, hair will be neatly secured away from the face and off the collar for males. Female Field Employees with shoulder length or longer hair must tie the hair back while on duty. Hair is not to come in contact with the patient, wounds, blood, other body fluids or sterile fields.

Wearing of wigs, or hairpieces will be prohibited, unless they conform to all conditions of this policy.

Plain pins and clips are acceptable to keep hair up. This policy will be enforced from the time the employee clocks in until the time the employee clocks out.

Facial hair must be kept clean and trimmed at all times. Sideburns will not extend below the lowest part of the ear lobe and will end in a clean-shaven, horizontal line. Mutton chop sideburns are not permissible. Mustaches are not allowed to extend more than three-quarters (¾) of an inch beyond the edge of the mouth or not more than three- quarters (¾) of an inch below the mouth. Go tees must be kept clean, and trimmed close to the face. The initial period of growing facial hair must occur when the employee is not on duty. Facial hair must be no less than one-quarter (¼) inch in length when reporting for work. Fully-grown mustaches and go tee’s only are permitted.

Employees working in patient care areas are not permitted to have facial hair that interferes with the proper seal of their OSHA / NIOSH approved masks per OSHA and NIOSH standards, rules, regulations and recommendations.

When an employee reports to work they must be bathed and, if male, clean-shaven. (By “clean shaven” we are referring to facial areas not covered by fully-grown facial hair.) Frequent hand washing is required, especially employees involved in-patient care situations and medical equipment / medical waste handling.

152 Uniforms

Uniforms and name tags will be provided and paid for by the Company as needed. The Company does not provide for cleaning, but uniforms are expected to be clean and pressed at all times. Boots should be cleaned and polished.

If the employee desires more uniforms than the company provides, they can be obtained at the employee’s expense. As with other deductions, the employee’s responsibility

25 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 26 ======does not end with leaves of absence or resignation. These will not be eligible for payroll deduction.

All uniforms issued by the company are the property of the Company and must be returned at the conclusion of employment.

The following is a list of approved uniforms and accessories:

Uniform; Company issued red/pink polo shirt Navy blue ems pants Black belt Black boots

Accessories; Company issued red jacket Company issued navy blue job shirt Company issued knit/fleece beanie Company issued cap (After midnight or precipitating) White or navy blue undershirt

All ems and wheelchair van drivers are required to wear company approved uniforms, and name badge(s), while on duty. Accessory items may be worn in addition to, not as a replacement for, the duty uniform. Crewmembers (partners) must wear identical uniforms at all times while on duty.

EMS personnel should consider bringing an extra uniform with them in case of exposure to body fluids, dirt, etc.

On special duty assignments, the Director may allow other variations from the uniform but both partners must still be identical.

153 Business Office Dress Code

Dispatch and Office personnel are to wear “Business Casual.” This is dress slacks, dress, or skirt with a professional shirts or blouse. When wearing skirts or dresses they are to be no shorter than 3 inches above the knee, and when above the knee nylons will be required. No jeans may be worn except on “casual” dress day. No shorts. No mid-drifts, backless, spaghetti straps. No printed T-Shirts or sweatshirts. No tennis shoes or flip flops allowed.

Any requests for a variance from this dress code must be directed to the Operations Director.

154 Disciplinary Action

26 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 27 ======If an employee reports to work improperly dressed or groomed, they will be instructed to leave the premises to change clothing or to take other appropriate corrective action. The employee will not be compensated during such time away from work, and repeated violations of this policy will be cause for disciplinary action, up to and including termination.

Directors shall have final discretion on whether dress conforms to general uniform policy.

155 Employee Safety and Health Protection

It is the policy of Heartland Ambulance Service to provide a safe and healthy work environment for all employees. It is expected that each employee will comply with all safety and health requirements established by management and/or by federal, state or local law, regulations, standards and/or guidelines.

OSHA The Occupational Safety and Health Act of 1970 requires employers to ensure, so far as possible, every working woman and man in the nation, safe working conditions. The Act also requires employees to comply with occupational safety and health standards, since the purpose of the Act cannot be obtained without the fullest cooperation of the employees.

Safety Director A Director will be named for the Company. In such capacity, they are responsible for ensuring compliance with the requirements of the Act by investigating and eliminating unsafe and unhealthy working conditions.

Reporting All observed safety and health standards and any incidents resulting in injuries to employees or customers will be reported immediately to the duty supervisor and Director. In addition, all employees are encouraged to submit suggestions to the Director concerning safety and health matters.

Records The Company will maintain a log and summary of all recordable occupational injuries and illness for each calendar year. The records are retained by the Director and are available to employees, former employees, and their representatives for examination. Employees requesting to review their records must notify the Director in writing at least twenty-four (24) hours in advance.

Non-Discrimination No employee will be terminated or discriminated against in any manner because they have instituted a proceeding with OSHA, has testified in such a proceeding or otherwise exercised any right afforded by OSHA.

156 Exposure Control Plan

The Company offers training in protection from, and control of, contagious diseases. Employees must take these precautions for the safety of themselves and their patients

27 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 28 ======by using all protective gear and employing safety practices/regulations as provided by the Company. Employees are further encouraged to use available vaccinations for additional protection. An exposure or suspected exposure to a contagious disease must be reported to the Duty Supervisor immediately. Both the employee and the Duty Supervisor will require proper documentation of the incident. All documentation must be directed to the Director within 12 hours of the incident.

Each and every occurrence of exposure and contamination will be reported immediately to your Station Manager. Failure to report will result in disciplinary action, up to and including termination.

The Incident Review Board will review each exposure and contamination. These reviews will include recommendations on carelessness, negligence, or lack of training.

Any exposure or contamination, which occurs and is ruled as a cause of negligence or carelessness may result in disciplinary action, up to and including termination.

157 On the Job Injury or Illness

The Company treats very seriously the occurrence of an injury or illness on-the-job. Should an employee become ill or injured, it must be reported to the Duty Supervisor immediately, so appropriate action can be taken.

Care of the employee is the first priority when a work related injury/illness occurs. Prompt care and prompt reporting will reduce both the severity and cost of injuries and illnesses.

In the manual and this policy the term “injury” and “illness” may be used interchangeably. In order to provide prompt and adequate medical care and ensure timely payment of benefits for an on the job injury or illness, you must use the following procedures:

Notice of Injury/Illness: In the event of an on the job injury, the Department Supervisor/Manager must be notified immediately. The Department Supervisor/Manager will in turn notify the Director and other management as appropriate.

Documentation In the event of an on the job injury, the Supervisor/Manager will make sure the appropriate report forms are completed by the injured employee and any witness(s).

Outside Investigation The Company may utilize outside vendors for claims adjusting, etc. These outside vendors may, at their discretion, conduct their own investigation of any employee injury, illness or vehicle collision.

Employees are required to notify the Director within two (2) business days of any correspondence received from anyone concerning an incident they have been involved in before responding to the correspondence.

28 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 29 ======Employees are required to cooperate with any outside vendor requesting information about the incident. You must advise the Director of any request by an outside vendor for information about an incident you have been involved in. The Director will authorize you to speak with these outside vendors.

Treatment of Injury/Illness In the event of an on the job injury and the employee wishes to receive medical attention, the Director will authorize the employee to be evaluated/treated at a designated industrial medicine provider. The Supervisor/Manager will see to it the employee receives prompt and appropriate medical attention consistent with the injury, using Company approved medical facilities. All employees will be referred to the Company designated industrial medicine provider for appropriate treatment.

During normal business hours, all employees will be referred to the Company designated industrial medicine provider for appropriate treatment. After normal business hours, for injuries/illnesses needing immediate attention, employees will be referred to the designated after hours industrial medicine provider.

If the injured employee admits themselves without specific prior authorization by the Director even at designated industrial medical providers, the employee will be responsible for payment of charges incurred for the injury.

The names and addresses of the designated industrial medicine provider will be posted in appropriate areas of each operation and will be available in the Director’s office.

Follow up evaluations, treatment, referrals to another physician; the Director must approve specialist or physical therapy.

The Director will schedule initial appointments for further evaluations, treatment or referrals with a company approved physician, specialist or medical facility. All follow up appointments with any physician, specialist or facility must be reported to the Director for approval before appointments are confirmed or the employee assumes all responsibility for payment of charges incurred.

Appointments with any physician, specialist or facility on scheduled days off will not be considered as paid time. Appointments while on scheduled modified duty hours will be considered as paid time. All appointments must be pre-approved by the Director. Unauthorized appointments will not be considered for paid time and the employee will be responsible for payment of charges incurred for the appointment.

Any scheduled surgery will require a second opinion from a company-approved physician. The Director will schedule the second opinion.

Injured employees must maintain contact with the risk manager once each week while off duty. Contact should be made in person, however, in the event that such contact is not possible, a telephone call is acceptable. Voice or e-mail notification is not acceptable. It is the responsibility of the injured employee to present a copy of any reports from the attending physician regarding patient

29 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 30 ======progress and work status. A work status report is required after each visit of the attending physician.

Prescriptions must be filled at an approved pharmacy.

Receipts for prescriptions must be turned in to the Director for approval of payment.

The designated carrier of the company will pay charges for hospital, clinic or physician visits, medical treatment, required surgery, physical therapy, and prescriptions.

The Company will audit all charges and reserves the right to refuse payment of all previously unauthorized or un-approved charges from any facility of person.

Compensation after Injury/Illness In the event of an on the job injury, resulting in lost time, compensation of lost wages will begin after a seven day qualifying period beginning the first day following the injury date. Compensation of wages will be based in accordance with the rules and regulations of the State of Indiana Department of Insurance. Questions regarding benefits should be directed to the Director. Said benefits shall be paid by the insurance carrier of the Company as outlined in the current policy coverage at the time of the injury.

Modified Duty The Company may have available modified duty. If, after evaluation by the industrial medicine provider, you are unable to return to your regularly assigned position you may be reassigned to modified duty. Job assignments while on modified duty will be based on the restrictions determined by the industrial medicine provider.

If available, we require our employees to return to modified duty whenever possible. We will make attempts to accommodate any restriction concerning sitting, standing, bending, kneeling, lifting, walking, climbing, pushing, pulling, lying down, etc.

It is the employee’s responsibility to notify the industrial medicine provider and any attending physician, P.A., etc., modified duty is available and required by the Company.

Employees assigned to modified duty are required to follow all policies and procedures and are responsible for performing duties satisfactorily. Employees will have an evaluation on their performance while assigned to modified duty.

Employees assigned to modified duty are subject to the same disciplinary procedures as other employees, up to and including termination.

Employees assigned for modified duty will report to the Director for all assignments of duties.

30 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 31 ======Employee’s normal wages will be paid on a scheduled 40-hour office rate for the duration of modified duty.

Modified duty is scheduled for Monday through Friday, 0800 to 1700 with a one (1) hour lunch from 1200 to 1300.

The Director may make required changes to a modified duty schedule as necessary.

Employees assigned to modified duty will work a maximum of 40-hour per week, including approved doctors appointments or treatments. No overtime will be approved.

Employees assigned to modified duty will accrue banked hours as if on your regular shift unless otherwise changed by the Director.

Employees assigned to modified duty will not be cleared for field ride outs, stand by’s or other field assignments.

Employees assigned to modified duty are required to clock in and out as outlined in policy.

Uniformed employees assigned to modified duty must wear their field uniform. All other employees will wear the appropriate office attire.

Proper notification of an absence or tardy is required.

Part time employees will only be compensated for missed shifts that were previously scheduled prior to the injury.

Should an employee become injured or ill, it must be reported to the appropriate Supervisor/Manager immediately, so appropriate action can be taken. Failure to report an injury or illness by the end of your shift can result in no payment of benefits and disciplinary action, up to and including termination.

An employee is required to obey all company safety rules and to exercise care and reasonable caution in the performance of their duties to prevent injury to themselves and fellow employees as outlined in the policy and procedure manual, safety manual and operational directives.

Additional forms may be required to be completed by the injured employee while assigned to modified duty.

Employees not released to modified duty are required to follow the above policies with respect to getting prior approval and authorization for medications, treatments, and/or evaluations.

Employees not released to modified duty are required to meet with the Director after each visit for treatment or evaluation to discuss the injury, progress, treatments and/or evaluations.

31 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 32 ======Additional forms may be required to be completed by the injured employee while on a lost time injury.

Premises Restrictions In the event an employee is expected to be off duty for an extended time due to an on the job injury, they are to remain off the premises until released back to work.

If the employee has business matters to conduct while on medical leave they should first call the Director who will in turn set up an appointment with the appropriate Supervisor.

On the date and time of the appointment the injured employee will report to the Director who will escort the employee to their appointment.

Return to Work Physical and Drug Screen Employees released from an on the job injury/illness may be required to take and pass a physical and drug screen regardless if that employee has previously taken and passed the pre-placement physical and drug screen.

158 Driving Policy

The Company believes that its success is greatly affected by the manner and competency of its employees while operating Company vehicles. Responsibility and safe driving is as much of an employee’s duty as providing competent medical care, or performing any other aspect of their job description/duties. Therefore, it is important and required that drivers of Company vehicles exercise due regard for the safety pf themselves, passengers, patients, all persons and vehicle drivers using the street, highways and freeways.

The State of Indiana emergency vehicle law provides that privileges granted to emergency vehicles does not relieve the driver from the duty to drive with due regard for the safety of all persons using streets, highways and freeways. A determination as to whether or not someone exercised due regard would be to compare the actions of a “reasonably careful person, performing similar duties, under similar conditions, to the acts of the person in question.”

The employee should recognize the value of having a good public image and conduct their driving accordingly. They should respect the rights of others to use the roadways and extend courtesy at all times. Company vehicles will not be used to “bully” other drivers out of a lane or off the road by tailgating, manipulating the siren or emergency lights, flashing the headlights, by hand gestures, or any other means of intimidation.

32 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 33 ======Profane, obscene or demeaning gestures or speech will not be transmitted to other drivers under any circumstances by any means. Do not let the actions or in-actions of other drivers frustrate or anger you or cause you to act in an unprofessional manner.

The second crewmember in the front seat of the vehicle will watch for potential hazards as if they were driving and advise the driver of such potential hazards. The second crewmember will not read newspapers, magazines, etc. when the vehicle is in a driving mode. The only exception is when they are reading the map book and directing the driver to the scene of a call. The second crewmember must still be aware of upcoming intersections and assist in clearing the intersection.

Employees are required to attend and successfully complete a CEVO driver training class bi-annually. Employees who violate any Company driving policy(s) or who are involved in any vehicle collision may be required to attend a remedial driver training class.

Responsibility for the safe operation of the vehicles rests with the driver. All collisions and damage to vehicles (or by vehicles) will be investigated, and the information heard by the Incident Review Board regardless of the extent of property damage or personal injury. Incidents having the potential to result in property damage or personal injury will be investigated and the information presented to the Incident Review Board.

159 Emergency Driving

The Company requires all Company vehicles be operated with “due regard” for the safety of yourself, passengers, patients, and all other persons and vehicle drivers using the streets, highways, and freeways. To that end, you are to required come to a complete stop at all stop signs and intersections with red lights.

Personnel are reminded the most important factors contributing to a quick response time are a quick response to the ambulance, a thorough knowledge of the use of a map book and a thorough knowledge of the area.

A Communications Specialist determines authorization for an emergency response to a scene only. No crewmember will determine to respond to a scene with emergency lights and/or siren without the expressed verbal authority from the Communications Center.

Upon being canceled off of an emergency response, never pull into a restaurant or convenience store parking lot.

All employees will utilize the CEVO Driving Standards while driving any Company vehicle under any circumstances.

160 Speed Limits

Never drive at a speed, which is excessive for weather or road conditions regardless of the posted speed. (e.g., rain, sleet/snow, limited visibility, traffic, etc.)

33 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 34 ======During non-emergency operation of any Company vehicle the posted speed limit will be followed with respect to visibility, road/traffic, and weather conditions as well as patient comfort.

The speed limit during emergency mode driving, with emergency lights and siren activated, when driving through a school zone will be maximum of twenty (20) MPH with respect to visibility, road/traffic and weather conditions, regardless of time of day, day of week, or time of the year.

The speed limit during emergency mode driving, with emergency lights and siren activated, when driving through a residential area or construction zone will be limited to the posted speed limit with respect to visibility, road/traffic, and weather conditions.

The speed limit during emergency mode driving, with emergency lights and siren activated, when driving on a secondary street or feeder road will be limited to the posted speed limit or flow of the surrounding traffic to a maximum of forty five (45) MPH with respect to visibility, road/traffic and weather conditions.

The speed limit during emergency mode driving, with emergency lights and siren activated, when driving on a highway or freeway will be limited to the posted speed limit or flow of traffic to a maximum of fifteen (15) MPH over the posted speed limit in a fifty five (55) MPH zone or a maximum of eighty (80) MPH in a seventy (70) MPH zone with respect to visibility, road/traffic and weather conditions.

While transporting a patient accelerating, decelerating, stopping or maneuvering around corners and curves must not interfere with patient care or cause undue discomfort to the patient or to other crewmembers.

161 Backing and Parking

The Company believes backing an ambulance is the responsibility of both the driver and second crewmember. It is mandatory a spotter be used at all times when backing a Company vehicle, regardless of the distance traveled.

162 Parking of Company Vehicles

In general, when parking the ambulance at a residence, it is normally advisable to park the ambulance on the street, out of traffic, with the rear of the ambulance near to the foot of the driveway or sidewalk allowing easier access across the property to the ambulance.

Do not park, idle, or operate any company vehicle in tall grass that may reach the bottom of the vehicle. The high heat generated by the engine and emissions components can start a ground fire.

When parking at an emergency scene, the unit should be parked as to prevent the need to back the vehicle when leaving the scene.

34 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 35 ======When parking at a restaurant or convenience store, or other business the unit will be parked in a parking space (nose out) and not parked perpendicular across multiple parking spaces. Parking in handicapped spaces or in fire lanes is prohibited.

As a courtesy to the general public, units will be parked away from restaurant or convenience store entrances.

As a courtesy at post locations, restaurants, businesses, etc., remember the heat and exhaust from the tailpipe can damage plants, painted surfaces, etc.

When the vehicle is parked, the emergency brake will be engaged. The only exception to this is when the temperature reaches thirty-five (35) degrees or lower. (During low temperatures the brake can freeze in position)

When being first to arrive on the scene of a collision not on the roadway, do not park in lanes of traffic, down stream of a hill, curve or other “blind” area. Approaching traffic may not have time to see your vehicle; even when emergency lights are activated, possibly resulting in your vehicle being struck by the oncoming vehicle(s).

You may be forced, for safety of yourselves and the patients, to go around the “block” giving the police or fire department time to make the scene and block any other oncoming traffic.

163 Vehicle/Property Damage

During emergency or Non Emergency ambulance (or any other company owned vehicle) operation, any/all vehicle and/or property damage must be reported immediately to the on-duty supervisor.

Proper documentation of incident will include:

Date Time Location Names and address of driver of both vehicles Driver’s license numbers (if applicable) Insurance information (if applicable) Description of property damaged Unit number involved

Pictures will be required for all damage to vehicles and/or property. On-duty supervisor will contact the Director as soon as possible to ensure proper claim handling.

35 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 36 ======

Glossary

Biohazard Label – a label attached to containers of regulated waste or containers used to store, transport or ship blood and/or other potentially infectious materials. The label will be red or orange-red in color with the biohazard symbol and the word biohazard on it. Blood – human blood, human blood components, and products made from human blood. Bloodborne Pathogens – pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, hepatitis B virus (HBV) and human immunodeficiency virus (HIV). Body Substance Isolation (B.S.I.) – an approach to infection control by considering all body fluids and substances as infectious for HBV, HIV, and other bloodborne pathogens. CDC – Centers for Disease Control. Contaminated – the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface. Contaminated Laundry – laundry, which has been soiled with blood or other potentially infectious materials or may contain sharps. Contaminated Sharps – any contaminated object that can penetrate the skin including, but not limited to, needles, scalpels, broken glass, broken capillary tubes and exposed ends of dental wires. Decontamination – the use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles and the surface or item is rendered safe for handling, use, or disposal. Engineering Controls – controls (e.g., sharps disposal container, self-sheathing needles) that isolate or remove the bloodborne pathogens hazard from the workplace. Exposure Control Plan – a written manual, which, at a minimum, outlines the specific equipment and procedures utilized by a health care facility to minimize and/or eliminate a health care employee’s exposure to bloodborne pathogens. Exposure Incident - a specific eye, mouth, other mucous membrane, non-intact skin, or contact with blood

Conclusion

Heartland Ambulance Service retains inherent rights to determine the number, location, and manner of operations, number of employees, and assignments of work, transfer, promote, demote, layoff, or terminate for lack of work or other reasons; and to set rules, suspend, discharge, or take other disciplinary measures.

Heartland Ambulance Service can amend benefits at the employer’s discretion.

36 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 37 ======The information contained in this handbook is to be used as a simple guideline and does not create a contract between Heartland Ambulance Service and any of its employees.

Heartland Ambulance Service reserves the right to modify employee handbooks, policies, or any other procedural documents at anytime, for any reason, without prior notice.

37 Standard Procedure Subject: Employee Policies & Procedures Manual Page: 38 ======

Employee Acknowledgment

Heartland Ambulance Service Policy and Procedure Manual (revised July 1, 2014)

Employee Acknowledgement:

I acknowledge that I have received a copy of the policies and procedures manual in printed format, or in electronic format, or that it is available to me on the corporate intranet. I have read, understand, and agree to be bound by the contents of this policy and procedures manual. I understand that this handbook is descriptive only and is not intended to create a contract of employment, as it relates to our at-will policy. Heartland Ambulance Service is an employer at will and, the Company at its sole discretion may modify the statements made herein at any time. I further understand that the company has the sole discretion to determine the duration of my employment and may terminate my employment without notice and without reason and any oral representations to the company are null and void.

This policy manual replaces and supersedes all earlier versions.

SIGNED: ______

DATE: ______

PRINT NAME: ______

This acknowledgment is to be signed by each employee.

Original signed acknowledgment is to be filed in the employee’s personnel file.

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