EMS DRC
Policy Manual
Effective August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
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TABLE OF CONTENTS
Background
………………………………………………………………………
4
Introduction
………………………………………………………………………
4
101
Equal Opportunity Statement ………………………….........................
4
102
Mission Statement
5
103
Job Performance Expectations
..………………..........................
5
104
DRC Communication …………………………………………………….
5
105
Role of the Louisiana Ambulance Alliance
………………………….
7
106
Role of the Bureau of EMS
……………………………………………
7
107
Role of Emergency Support Function-8 and Supporting Agencies …
7
108
DRC Selection
…………………………………………………….
7
109
EMS DRC Terms of Service ……………………………………………
8
110
DRC Conduct …………………………………………………………….
8
111
DRC Resignation
9
112
Sexual and Other Unlawful Harassment
113
DRC Safety and Health Protection
114
…………………………………………………….
……………………………………………………
…………………………
9
………………………………….
10
Conflict of Interest
……………………………………………………
10
115
EMS DRC Property
……………………………………………………
11
116
Damaged Equipment ……………………………………………………
11
117
Leasing Louisiana Ambulance Alliance HHS Purchased Equipment
11
118
DRC Expense Reimbursement
………………………………….
12
…………………………………………………………….
13
Acknowledgement
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ATTACHMENTS
A
National Response Framework
B
Louisianan Emergency Support Function-8 ……………………
15
103a
EMS DRC Job Description
………………………….................
16
103b
EMS DRC Shirt Order Form ……………………………………..
18
104a
DRC Communication Process
………………...................
19
104b
EMS DRC Contact List
.……………………………………..
21
104c
State Radio Roll Call List
……………………………………..
23
105
Administrative DRC Job Description ……….……………………
42
106a
BEMS Responsibilities 2010 ……………………………………….
44
106b
Emergency Response Coordinator Job Description …………….. 45
106c
BEMS Contact List
113
State Volunteer Liability Form
116
Damaged Equipment Form
117a
Lease Request Form ………………………………………………… 50
117b
Asset Request/Lease Check List
118a
State Pocket Guide
118b
DRC Reimbursement Form …….……………………………….
Acronyms
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46
47
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56
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Background
The Department of Health and Hospitals is designated as the lead state agency for Emergency
Support Function-8: Health and Medical Services as per the National Response Framework
established by the Office of Homeland Security. The DHH Office of Emergency Preparedness
(State Health Officer, Dr. Jimmy Guidry and the Executive Director, Dr. Rosanne Prats) has
been given the responsibility to insure compliance of the Emergency Support Function (ESF)-8,
Health and Medical Services in the State of Louisiana response activities in support of the
guidelines set forth in the National Response Framework. Please see Attachment A for
information regarding the National Response Framework and ESF 8 .
Under the leadership of the DHH Office of Emergency Preparedness and funding through the
Emergency Preparedness Grant, regional network infrastructures/ Designated Regional
Coordinators Networks have been established to assist with regional and state ESF 8
responsibilities. As subject matter experts, each of these networks provides a unique response
capability to support the State’s ESF 8 mission and an EMS DRC Network was established.
Introduction
The following volunteer policies and procedures have been prepared in order to provide the
EMS-Designated Regional Coordinator (DRC) with a description of the EMS DRC’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 EMS
DRC. It is designed to be a positive tool and aid in your volunteer duties as an EMS DRC.
The policies and procedures presented in this manual shall be in effect until changed by the
EMS DRC Network. Since DRC duties are constantly changing, the DRC Network reserves the
right to change any of their policies, including those set forth below, at any time. All DRCs will
be notified, in writing, of those changes and their effective date. Changes will be effective on
dates determined by the DRCs, and you may not rely on policies that have been superseded.
Only the DRCs by majority vote have any authority to alter the foregoing.
Unless otherwise indicated in a separate written contract, the volunteer service of all EMS
DRCs continues to be on a volunteer, at-will basis. The service of all DRCs is entered into
voluntarily, and DRCs are free to resign at any time, for any reason. Similarly, DRC Network by
majority vote is free to conclude the volunteer relationship at any time, for any reason not
prohibited by law, with notice.
Nothing herein shall be construed as an expressed or implied promise of continued DRC
service if you adhere to the policies stated herein.
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101
Equal Opportunity Statement
DRCs will be selected on the basis of experience, training, personal background, and the
potential for growth for the continued success of the EMS DRC Network. There shall be no
discrimination based on religion, age, sex, race or national origin.
102
Mission Statement
The EMS Designated Regional Coordinators prepare for, respond to, recover from, and mitigate
disasters, both natural and man-made, while providing excellence of care and continuum of
support and coordination for the citizens of the State of Louisiana in support of the ESF 8
mission.
103
Job Performance Expectations
Regarding DRC relationships with other stakeholders, State and regional partners, the EMS
DRC operates on the basis that every individual deserves to be treated with respect, courtesy,
tact and consideration. Therefore, DRCs are expected to treat our State and ESF 8 partners,
and fellow volunteers accordingly. The DRC volunteer will, at all times, portray the highest
ethical standards. Please refer to Attachment 103a for the EMS DRC Job Description.
The volunteer will be courteous and will endeavor to conduct himself/herself in a highly
professional manner at all times. DRCs should be aware of and sensitive to any behavior that is
offensive to others.
It is expected that EMS DRCs will maintain the highest standards of personal cleanliness and
grooming. Volunteers must present a neat, businesslike and professional appearance at all
times during DRC functions. Every volunteer has some contact with the public, and therefore,
represents the EMS DRC Network in their appearance and actions. The properly attired DRC
helps to create a favorable image for the EMS DRC Network as well as reflecting his or her
personal professionalism. The EMS DRC is expected to wear the EMS attire to all functions
unless otherwise specified. Please see Attachment 103b for information EMS DRC attire.
This policy is to provide a standard for DRCs in regard to personal safety and grooming.
Personal hygiene and good personal health habits are essential elements of an effective
infection control program.
104
DRC Communications
During a response, communications regarding the incident or event, resources needed, etc. will
be provided through communication linkages at the State and regional levels as the event or
incident requires. The Communication Process will be directed by Louisiana ESF 8 leadership,
BEMS, and regional partnerships.
Attachment 104a provides:
1) Identifies of the communication processes for an incident requiring regional and state
ESF 8 response; and
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2) The communication process for the specific responsibility of EMS DRC coordination of
surge ambulances during a major incident requiring evacuation of hospitals utilizing
federal and state ambulance surge ambulances.
EMS DRCs are required to communicate and notify all EMS providers and emergency partners
as needed in their regions. DRCs coordinate EMS response activities on a regional basis and
assist other DRCs and state partners as needed.
EMS DRCs should strive for professionalism in all communications. Communications are to be
clear and concise, both in content and verbiage. DRCs are asked to monitor their cell phones
and emails for DRC notifications and communications during normal DRC operations. Under
emergency situations, DRCs are asked to closely monitor their 700/800 MHz Radios, cell
phones and emails. During emergency situations, the Admin DRC will strive to send multiple
forms of communication (email, text, telephone calls, etc.) and notifications to ensure all EMS
DRCs receive needed information in a timely manner.
DRCs are asked to provide and update as needed the following information to the Admin DRC:
 DRC Full Name
 DRC Employer
 Mailing Address
 Physical Address (if different from the Mailing Address)
 Work Phone
 Cell Phone
 Fax Number
 Home Phone
 Pager Number
 Email Address
Bulletins/Memorandums
EMS DRCs are required to read all memorandums related to their duties and
responsibilities.
The EMS Admin DRC acts as the EMS DRC point-of-contact and will disseminate
information from individual EMS DRCs, BEMS, State, Regional and ESF 8 Partners and
other DRC Networks and distribute this information to the entire EMS DRC Network.
The EMS DRC is responsible for distributing appropriate communications to the providers
and emergency response partners in their respective region.
Attachment 104b contains EMS DRC Contact Lists and on the Alliance website under the DRC
tab at: http://www.louisianaambulancealliance.org/
EMS DRCs participate in the monthly State Radio Roll Call. The State Radio Roll Call
information can be found under Attachment 104c.
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105
Role of the Louisiana Ambulance Alliance
The Louisiana Ambulance Alliance (the Alliance) provides the administration and facilitation of
the EMS DRC Network and employer to the Administrative DRC (Admin DRC). The Admin DRC
works under the direction of the EMS DRCs and the Alliance Executive Director. Functions of
the Admin DRC are outlined in the EMS Administrative Job Description in Attachment 105.
The Alliance by DRC recommendation and approval by the HHS Advisory Board
receives HHS funds to employ the Admin DRC, maintain HHS purchased assets and pay for
EMS DRC training and expenses. In addition, the Alliance acts as the recipient of unspent EMS
HHS funds and spends these monies according to DRC recommendation and HHS Advisory
approval as required by grant deliverables.
The Alliance serves on the HHS Advisory Board and provides leadership and guidance in the
planning of emergency preparedness grants.
106
Role of the Bureau of EMS with the DRC Network
The Department of Health and Hospitals has designated the Bureau of Emergency Medical
Services (BEMS) to support various responsibilities of the Louisiana ESF 8 response. The
Bureau of EMS utilizes the EMS DRC Network as one of the most significant assets to assist
the Bureau in fulfilling these responsibilities. Please see Attachment 106a for BEMS
Responsibilities, 2010, and Attachment 106b, BEMS Emergency Response Coordinator Job
Description, and 106c, BEMS Contact List.
107
Role of ESF 8 and Supporting Agencies
The Department of Health and Hospitals is designated as the lead state agency for Emergency
Support Function-8, Health and Medical Services as per the National Response Framework
established by the Office of Homeland Security. The DHH Office of Emergency Preparedness
(State Health Officer, Dr. Jimmy Guidry and the Executive Director, Dr. Rosanne Prats) has
been given the responsibility to insure compliance of the ESF 8 , Health and Medical Services in
the State of Louisiana response activities in support of the guidelines set forth in the National
Response Framework. (See Attachment A for information regarding the National Response
Framework and ESF 8 ). Private organizations such as the Louisiana Ambulance Alliance,
Louisiana Hospital Association, and Louisiana Nursing Home Association provide support to the
DRC Networks.
108
DRC Selection
There is to be one (1) Primary and one (1) Alternate EMS DRC per Department of Health &
Hospital Regions in the State, except in Region 5 where there is 1 Primary and 2 Alternate
DRCs*.
Identification of Candidate(s):
When there is an open primary and alternate DRC position in a Region,
recommendations to fill the position are requested from the following:
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1) EMS providers within that Region;
2) Requested from the other DRCs in that Region;
3) Other DRCs throughout the State.
At the preference of the Primary and 1st Alternate DRCs, additional Alternate DRCs can
be selected. The selection of these additional DRCs is an internal process with that
Region’s Primary and Alternate DRCs and need not be brought to the entire DRC
Network for approval. These Additional DRCs may attend DRC Functions only at the
request of their Primary and/or 1st Alternate DRC should they both be unable to attend.
These additional Alternate DRC, have no DRC voting authority unless voting by proxy
for their Primary DRC, no HHS funding for their position and only receive reimbursement
for their DRC travel if they were attending a DRC function at the request of their Primary
DRC.
Selection of DRC Candidate(s):
Interested DRC candidate(s) will submit an electronic copy of their resume to the
Administrative DRC or their designee that will be forwarded on to the DRC Network for
review and approval.
Approval of DRC Candidate(s):
Upon approval of the candidate by the DRC Network that candidate’s resume is sent on
to the BEMS designee for final approval. Once approved, a letter from BEMS confirming
the candidate’s selection will be sent to the approved candidate.
Addition to the DRC Network:
Newly selected DRCs will provide the Admin DRC with all contact information outlined in
Section 104 and the Admin DRC will add the new EMS DRC to all DRC communication
distribution lists.
109
EMS DRC Terms of Service
All Primary and Alternate DRCs are required to attend monthly EMS DRC Meetings and other
official EMS DRC functions. Should a DRC need to miss a scheduled meeting or function, that
DRC should contact his/her other DRC to ensure Regional coverage at all EMS DRC meetings
and functions. If both/all DRCs in a Region are unable to attend a DRC meeting or function,
those DRCs should send a delegate to represent that Region.
EMS DRCs missing more than 3 DRC Meetings consecutively and/or 5 DRC Meetings per year,
at the vote of the DRC Network can be removed from volunteer service. DRCs with excessive
absences and voted by the DRC Network for removal from service, will be sent a certified letter
from the EMS DRC Chair asking for corrective action from the DRC or the DRCs resignation,
see below, Section 110, DRC Resignation.
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110
DRC Resignation
For a voluntary resignation, DRCs are asked to give at least two (2) week notice to the Admin
DRC to distribute to the DRC Network. Resigning DRCs in good standing with the EMS DRC
Network are also asked to assist the DRC Network in suggesting possible replacements for
his/her vacated position.
111
DRC Conduct
It is essential for orderly, safe, and efficient operations that certain rules and regulations be
established for the guidance of all. The EMS DRC Network will take appropriate action with any
volunteers who violate any of the following rules while conducting EMS DRC duties, which may
include immediate dismissal. This list is not intended to be all-inclusive.
a. Immoral or illegal conduct.
b. Theft of monies or EMS DRC property or the monies or properties of another person
or EMS DRC.
c. Intoxication or the use of any intoxicants, illegal drugs, or narcotics.
d. Use of any prescribed or over the counter medication that would impair the ability to
perform DRC duties must be reported.
e. Excessive or unexcused absences from DRC functions.
f. Abandonment of DRC duties.
g. Falsification of EMS DRC records, skills certificates, credentials, etc.
h. Unauthorized dissemination of confidential or sensitive information as spelled out in
the EMS DRC’s Confidentiality Agreement.
i. Willfully destroying or defacing EMS DRC property.
j. Any act that seriously injures or tends to injure the best interest of the EMS DRC
Network
112
Sexual and Other Unlawful Harassment
Sexual harassment is unlawful and is against the EMS DRC Networks policy. If you feel that
you have been the subject of sexual harassment, you will be protected by this policy. We are
committed to providing a work environment that is free of all discrimination and unlawful
harassment. Actions, words, jokes, or comments based on an individual’s sex, race, ethnicity,
age, religion, or any other legally protected characteristic will not be tolerated.
Sexual harassment includes, but is not limited to, unwelcome sexual advances, requests for
sexual favors, or other verbal or physical contact of a sexual nature. Sexual
harassment occurs when submission to or rejection of unwanted sexual conduct is used as the
basis for employment decisions, or when unwelcome sexual conduct creates an intimidating,
offensive, or hostile working environment.
Any volunteer who wants to report an incident of sexual or other unlawful harassment should
promptly report the matter to the DRC Network and BEMS. Volunteers may raise concerns and
make reports without fear of reprisal. Any DRC who becomes aware of possible sexual or other
unlawful harassment should promptly advise the DRC Network and the appropriate person at
BEMS.
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Anyone engaging in sexual or other unlawful harassment will be subject to termination of
volunteer status. In general, all volunteers will be expected to provide a positive image and
conduct themselves in a professional manner at all times.
113
DRC Safety and Health Protection
It is the policy of EMS DRC Network to provide a safe and healthy work environment for DRC
volunteers. It is expected that each volunteer will comply with all safety and health requirements
established by the DRC Network and/or by federal, state or local law, regulations, standards
and/or guidelines.
All DRCs are required to sign a State Volunteer Liability Form, see Attachment 113.
Reporting
All observed safety and health standards and any incidents resulting in injuries to DRCs
will be reported immediately to the Admin DRC to send to BEMS and the DRC Network.
In addition, all EMS DRCs are encouraged to submit suggestions to the Admin DRC
concerning safety and health matters.
Records
The Admin DRC will maintain a log and summary of all record-able occupational injuries
and illness for each calendar year. The records are retained by the Admin DRC and are
available to volunteers, former volunteers, and their representatives for examination.
Exposure to Disease, Contamination, and Communicable Diseases
EMS DRCs are expected to adhere to federal and state guidelines in regards to
contagious diseases for the safety of themselves and others by using appropriate
protective gear and employing safety practices/regulations.
114
Conflict of Interest
As a volunteer of the State of Louisiana, the DRC’s primary responsibilities are to the State, the
EMS DRC Network and ESF 8. It is essential that DRC volunteers treat information about any
EMS provider, ESF 8, DRC’s, suppliers, internal operations, and internal records, with absolute
confidentiality. Additionally, the DRC’s personal relationships should in no way compete with, or
compromise, the State, the EMS DRC Network or ESF 8 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 as an EMS DRC.
b. Do not divulge internal information, statistics, records, or operating methods to
anyone outside of the EMS DRC Network.
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c. Cooperate with the EMS DRC Network in resolving any possible conflict situation
involving yourself or your family.
By observing these guidelines, you will protect yourself and the EMS DRC Network from
difficulties and/or legal repercussions, which naturally result from a conflict of interest.
115
EMS DRC Property
Every EMS DRC will be working with assigned HHS purchased equipment, using supplies, and
handling EMS DRC property. All DRCs will be required to sign lease forms for their DRC issued
equipment per State guidance requirements. The Administrative DRC will be responsible for
executing and maintaining lease forms for all equipment and supplies.
Resigning and/or terminated DRCs must return all assigned EMS DRC equipment to the Admin
DRC or designee within 30 days of resignation/termination.
Equipment may be reassigned as needed at the request of the lessor.
116
Damaged Equipment
DRCs are to inspect all assigned equipment prior to use. If damage is found, note it on the
Damaged Equipment Form and submit this completed form to the Admin DRC. If you damage
any equipment, notify the Admin DRC using the Damaged Equipment Form. See Attachment
116 for the Damaged Equipment Form or download this form under the DRC tab of the
Louisiana Ambulance Alliance Website at: http://www.louisianaambulancealliance.org/
117
Leasing Louisiana Ambulance Alliance HHS Purchased Equipment
DRCs may request Alliance HHS Purchased Assets by contacting the Admin DRC or designee.
DRCs complete the Lease Request Form, found in Attachment 117a or on Alliance Web Site at:
http://www.louisianaambulancealliance.org/ The Admin DRC will check asset availability and
will send the DRC a Lease Agreement if Asset is available. Both parties will execute the lease.
Original leases are held by the Alliance Office.
Availability of Assets are determined based on need for that asset (i.e.: Emergency use is given
a higher priority than day to day or special event use). If the need for that asset is equal, then
the assets are allocated on a first come, first served basis. This language is included on Asset
Request/Lease Check List, see Attachment 117b, and Lease Request Form.
Assets are picked up, transported and returned by the lessee. Again, this language is included
on Asset Request/Lease Check List and Lease Request Form. Lessee/lessor will complete a
written pre-event asset inspection and upon return of the asset both parties will complete a post
event written asset inspection of the asset(s). Some larger assets will have specific care and
maintenance tasks for the lessee to complete before asset return.
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118 DRC Expense Reimbursement
EMS DRCs can be reimbursed for their travel expenses for DRC related travel. DRCs follow the
State’s travel policy for reimbursement.
These guidelines are detailed on the State’s Pocket Guide, Attachment 118a or at
http://doa.louisiana.gov/osp/travel/travelpolicy/pocketguide.pdf
DRC Reimbursement Forms to print out and compete by hand can be found in Attachment 118b
or at the Alliance web site: http://www.louisianaambulancealliance.org/ .
For expense reimbursement, DRCs must include receipts and driving directions (MapQuest:
http://www.mapquest.com/directions, Google Maps:
http://maps.google.com/maps?f=d&utm_campaign=en&utm_source=en-ha-na-us-googledd&utm_medium=ha) for mileage reimbursement. Completed Expense Reimbursement are
returned to the Admin DRC or designee. The Admin DRC verifies and processes the expense
request. Please refer to Attachment 104b for Admin DRC contact information.
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Acknowledgment
EMS DRC EMS Policy and Procedure Manual (Initiated August 20, 2014)
Volunteer Acknowledgement:
I acknowledge that I have received a copy of the DRC Policies and Procedures Manual. 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
volunteer service, as it relates to our at-will policy. The EMS DRC Network at its sole discretion
may modify the statements made herein at any time. I further understand that the DRC Network
has the sole discretion to determine the duration of my volunteer service and may terminate my
volunteer status without notice and without reason and any oral representations to the EMS
DRC are null and void.
This policy manual replaces and supersedes all earlier versions.
SIGNED:
__________________________________________
DATE:
__________________________________________
PRINT NAME:
__________________________________________
PRINT TITLE:
__________________________________________
This acknowledgment is to be signed by each EMS DRC volunteer.
Original signed acknowledgment is to be filed in the Administrative DRCs files.
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Attachment A - National Response Framework
National Response Framework
Following September 11, 2001, the federal government has been hard at work to improve the
response to local, multi-jurisdictional and multi-state events and incidents.
Some of the many significant federal initiatives are:
 National Response Framework
• Key Principles
• Emergency Support Functions
 National Incident Management System
 Massive grant funding to state and local organizations to increase
response resources
National Response Framework – Key Principles
1. Engaged partnership
2. Tiered response
3. Scalable, Flexible, and Adaptable Operational Capabilities
4. Unity of Effort through Unified Command
5. Readiness to Act
National Response Framework – Emergency Support Functions
Emergency Support Functions (ESF) are the grouping of governmental and certain private
sector capabilities into organizational structure to:
• provide support, resources, program implementation, and services that
are most likely needed to save lives,
• protect property and the environment,
• restore essential services and critical infrastructure, and
• help victims and communities return to normal following domestic
incidents.
There are 15 federal Emergency Support Functions (Louisiana has added a sixteenth ESF –
Louisiana National Guard.
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Attachment B - Louisiana Emergency Support Function 8 (ESF 8)
Louisiana State Emergency Operations Plan, June, 2009
ESF 8: Purposes
ESF 8 provides public health and sanitation, emergency medical and hospital services, crisis
counseling and mental health services to disaster victims and workers, to supplement and
support disrupted or overburdened local medical personnel and facilities and relieves personal
suffering and trauma.
In addition, ESF 8 provides coordination of the State’s Catastrophic Mass Fatality Plan which
may be enacted during a state declaration.
ESF 8: Scope
Medical care refers to emergency and resident medical care; doctors, technicians, supplies,
equipment, ambulance and emergency medical services, hospitals, clinics, and units, planning
and operation of facilities and services.
Pre-hospital emergency services and medical transport refers to the coordination of Emergency
Medical Services (EMS) professionals, equipment and supplies to address disaster response
surge, triage, treatment and transport.
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Attachment 103a – EMS DRC Job Description
HEALTH & HUMAN SERVICES ADMINISTRATION GRANT
BIOTERRORISM PREPAREDNESS PROGRAM
EMS DESIGNATED REGIONAL COORDINATOR
JOB DESCRIPTION
Position Title: EMS Designated Regional Coordinator
Objective: To facilitate the development and implementation of an Inter-EMS Emergency
Preparedness Plan for designated DHH regions in the State of Louisiana. To lead the regions’
process for development of, testing of, continuous improvement of and management of
Regional EMS Response to Emergency situation: specifically to facilitate the Emergency plan
for your DHH Region; to participate in tabletop exercises to test the integrity of the Regional
Inter-EMS Emergency Preparedness Plan; and to be the leader for your region in the event of a
statewide Emergency in which EMSs are tasked to respond in the State of Louisiana.
Qualifications: Identified by representatives of EMS within the region. Previous experience in
Emergency Management, EMS preparedness and a working knowledge of EMS within the
designated region are basic requirements for the position. Must have a working knowledge of
the Incident Command System including National Incident Management System course IS
100, 200, 300, 400, 700, and 800 and knowledge of all federal, state, and local regulations and
guidelines regarding emergency operations plans and programs. Knowledge of Microsoft Office
applications, experience in operational problem solving/decision making and a desire to perform
the functions and duties of the role is critical.
Essential Job Functions:
Serve as the voice of regional EMS in real-time decision-making:
 Regional Coordinator will respond to a declared state of emergency to the OEP office
designated for response.
 Regional Coordinator will serve as the voice of all participating EMS in the region and
make decisions about the deployment of regional EMS resources during the incident.
 Regional Coordinator will communicate with the EOC critical information concerning the
availability of EMS resources within the region. In turn, the EOC will disseminate critical
information to the coordinator that will be shared with designated EMS coordinators.
 Regional Coordinator will collect vital facility information on all EMS in their region to
pass on to the EOC and/or to the State Emergency Operations Center during an
incident.
 Develop and maintain regional EMS response organizational chart.
Coordinate the delivery of essential supplies, including pharmaceuticals within the
region:
 Regional Coordinator will facilitate the delivery of resources needed for individual EMS
Provider within the region.
 Regional Coordinator will coordinate with the local EOC according to plans developed
for the region.
Coordinate the assignment of staffing resources:
 Redeployment of personnel and volunteers arriving from inside and outside the region
will need to be coordinated with the State Emergency Operations Center. Assigned
responsibilities within the region will be further defined for each region.
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Attachment 103a (continued) – EMS DRC Job Description

Provide appropriate after action support to other regions.
Lead role in developing surge capacity resources:
 Regional Coordinator will take the lead in developing a real time plan for surge capacity
based on the incident and resources available within the region and communicate with
BEMS at Emergency Operations Center.
 Regional Coordinator will determine extraordinary demands for specific resources and
expertise and communicate with BEMS at the Emergency Operations Center so that
resources around the state can be better deployed.
Assist in the development of a vehicle inventory by type and organization for the region:
 Regional Coordinator will provide real time information to the EOC during an incident
addressing truck inventory, resources, and staffing.
Attend DRC emergency preparedness committee and other related sub-committee
meetings
 Regional Coordinator will contribute ideas to the HHS grant planning process.
Coordinator will identify inconsistencies among plans and proposes corrective
measures.
Assist with the Coordination and execution of Emergency Preparedness Regional
EMSwide drills
 Regional Coordinator will assist with the coordination and execution of regional EMSwide drills.
Page 17 of 58
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
Attachment 103b – EMS DRC ESF 8 Shirt Order Form
DRC Name:
________________________________________________________________
DRC Contact #:
__________________________________________________________
DRC Mailing Address: __________________________________________________________
City, State, Zip:
__________________________________________________________
ORDER FORM
Style
Gender
Color
Size
(Please check
one style/line)
(Please check one
gender type/line)
(please quantity for each
colors wanted)
(Please enter one size/line)
Men’s
Red
Polo
Oxford
Ladies
White
Navy
S
M
L
XL
Price*
2X
3X
Submit Order Form to:
Karla Long Houston
Administrative DRC
Fax: 225-906-3866
Email: [email protected]
*Price: Admin DRC will place order and give the DRC a total cost of their order.
Detach here ………………………………………………………………………………………………
Sample Form:
Style
Gender
Color
Size
(Please check
one style/line)
(Please check one
gender type/line)
(please quantity for each
colors wanted)
(Please enter one size/line)
Polo
Oxford
Men’s
Ladies
X
X
X
X
Red
White
Navy
1
0
2
0
1
0
S
M
L
XL
2X
3X
X
X
Ordered:
Men’s Polos, 1 Red, 2 Navy, Size XL
Ladies Oxford, 1 white, size M
Page 18 of 58
Revision Date: August 20, 2014
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
Attachment 104a – DRC Communication Process
Louisiana ESF 8 Communication Structures, 2009
Page 19 of 58
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Subject: EMS DRC Policies & Procedures Manual
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Attachment 104a (continued) – DRC Communication Process
Page 20 of 58
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Subject: EMS DRC Policies & Procedures Manual
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Attachment 104b – EMS DRC Contact List
REGION 1 Frank Graff III, NREMT‐P, LEM Region 1 Primary DRC Care Ambulance Service, Inc. 1901 Westbank Expressway, Suite 200 Harvey, LA 70056 frank.graff@careambulance‐la.com Work: 504‐367‐4231 Cell: 504‐234‐7193 Fax: 504‐361‐5917 Thomas A. Hartley, NREMT‐P East Jefferson General Hospital EMS 3120 Lime St. Metairie, LA, 70006 [email protected] Work: 504‐889‐7152 Cell: 504‐905‐7000 Fax: 504‐889‐7159 REGION 2 Chryal Honore, NREMT‐P Region 2 Primary DRC Louisiana State Penitentiary 18480 Tunica Trace (Highway 66) Angola, LA 70712 [email protected] Work: 225‐655‐2569 Cell: 225‐933‐1677 Fax: 225‐655‐2445 Lauri Scivicque, NREMT‐P East Baton Rouge Parish Department of EMS 704 Mayflower Baton Rouge, LA 70802 [email protected] Work: 225‐389‐5155 Cell: 225‐202‐0789 Fax:225‐389‐5235 REGION 3 Chad Davis, NREMT‐P Region Primary 3 DRC Acadian Ambulance & Air Med Services, Inc. 7130 Third Street Lockport, LA 70374 [email protected] Work: 800‐259‐1111 Cell: 985‐637‐0695 Fax: 985‐876‐8719 Ken Rousseau, BA, NREMT‐P St.Charles Hospital EMS Page 21 of 58
PO Box 87 Luling, LA 70070‐0087 [email protected] Work: 985‐307‐8719 Cell: 504‐415‐4780 REGION 4 Donald Simon Jr., NREMT‐P Region 4 Primary DRC Acadian Ambulance & Air Med Services, Inc. PO Box 98000 Lafayette, LA 70509‐8000 [email protected] Work: 800‐259‐3333 Cell: 337‐319‐7710 Fax: 337‐706‐1855 Kirk Coussan, NREMT‐P Acadian Ambulance & Air Med Services, Inc. PO Box 98000 Lafayette, LA 70509‐8000 [email protected] Work: 800‐259‐3333 Cell: 337‐316‐1767 Fax: 337‐291‐4472 REGION 5 Robert E. Daughdril, BS, NREMT‐P Region 5 Primary DRC & DRC Chair Office of Homeland Security Emergency Preparedness Calcasieu Parish Police Jury P O Box 3287 Lake Charles, LA 70602‐3287 [email protected] Work: 337‐721‐3806 Cell: 337‐540‐4157 Fax: 337‐437‐3583 Lane W. Owers, NREMT‐P Acadian Ambulance Service, Inc. 2827 4th Avenue, Ste. 245 Lake Charles, LA 70601 [email protected] Work: 800‐259‐3333 Cell: 337‐316‐2974 Fax: 337‐291‐2273 REGION 5 Continued Stephen C. Kershaw, NREMT‐P MedExpress Ambulance Service 7525 Highway 71 Revision Date: August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
============================================================================
Alexandria, LA 71302 [email protected] Work: 318‐473‐1895 Cell: 337‐496‐5557 Fax: 800‐475‐9771 REGION 6 Mark Majors, BS, NREMT‐P Region 6 Primary DRC MedExpress Ambulance Service 7525 Highway 71 Alexandria, LA 71302 [email protected] Work: 318‐473‐1895 Cell: 337‐523‐5201 Fax: 800‐475‐9771 Dustin Etheridge (EMS DRC Candidate) Acadian Ambulance & Air Med Services, Inc. 702 Monroe Street Alexandria, LA 71301 [email protected] Work: 800‐259‐3333 Cell: 318‐541‐6395 Fax: 800‐259‐5600 pause 9 pause 3635# REGION 7 Craig Edwards, NREMT‐P Region 7 Primary DRC Balentine Ambulance Service 3516 Mansfield Road Shreveport, LA 71103 [email protected] Work: 318‐222‐5358 Cell: 318‐272‐6593 Fax: 318‐221‐2340 Jeff Watson, NREMT‐P Bossier City Fire Department 620 Benton Road Bossier City, LA 71111 [email protected] Work: 318‐741‐8714 Cell: 318‐453‐8775 Fax: 318‐741‐8739 REGION 8 Gary Peters Region 8 Primary DRC Advanced EMS 900 Shreveport Road Minden, LA 71055 Page 22 of 58
[email protected] Work: 318‐382‐0380 Cell: 318‐669‐0185 Fax: 318‐382‐0383 Jim Holt, NREMT‐P East Carroll Parish Hospital Ambulance Service 500 Lake Street Lake Providence, LA 71254 [email protected] Work: 318‐559‐4092 Cell: 318‐418‐1140 Fax: 318‐559‐0909 REGION 9 David Marcus, NREMT‐P Region 9 Primary DRC Northshore EMS 74153 Wyndotte Road Kentwood, LA 70444 [email protected] Work: 985‐735‐9507 Cell: 985‐514‐0540 Fax: 985‐735‐0955 Frank Jordan St. Tammany Fire District #4 709 Girod Street Mandeville, LA 70448 [email protected] Work: 985‐626‐8671 Cell: 985‐789‐2700 Fax: 985‐626‐8082 ADMINISTRATIVE DRC Karla Long Houston Louisiana Ambulance Alliance 2045 North 3rd Street, Suite 224 Baton Rouge, LA 70802 [email protected] Cell: 225‐933‐1616 Fax: 225‐906‐3866 Louisiana Ambulance Alliance Donna Newchurch Executive Director 5010 Highway 1 Napoleonville, LA 70390 [email protected] Work: 225‐612‐3177 Fax: 225‐612‐7466 Cell: 985‐513‐0952 Revision Date: August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
============================================================================
Attachment 104c – State Radio Roll Call List
CALL SIGN
DESCRIPTION
SCHEDULED TIME
10:00AM - 10:05AM
OAAS 1
BRAY
OAAS 2
GUILLOT
OAAS 3
OLIVIER, TINA
OAAS 4
ANDERSON
OAAS 5
RYLAND
OAAS 6
BURNS
10:05AM - 10:10AM
OAAS 7
OLIVIER, ANNE
OAAS 8
ELEY
OAAS 9
BALES
OAAS 10
LEBIEN
MIS1
PERILLOUX
OAD 01
Trudy Gallman
OAD 02
Ken Saucier
10:10AM - 10:15AM
OAD 03
Teresa Hardin
OAD 04
Joyce Ben
OAD 05
Laurie BeaughHebert
OAD 06
Egan Jones
OAD 07
Trudie Abner
Page 23 of 58
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OAD 08
Jerri Parks
OAD 09
Springs of Recovery
OAD 10
Galen Schum
OAD 11
Rochelle Dunham
10:15AM - 10:20AM
OAD 12
George Sewell
OAD 13
Misty Hebert
OAD 14
Ingrid King
OAD 15
Tanya McGee
OAD 16
Eddie Cantebury
OAD 17
Don Pledger
OAD 18
Richard Barfoot
OCDD 1
Greg Andrus
OCDD 2
Kathy Kliebert
OCDD 3
Mark A. Thomas
OCDD 4
Roslyn Matthews
OCDD 5
Peter Calamari
OCDD 6
Jeffernier Shorts
OCDD 7
David Colvin
OCDD 8
John Hall
Page 24 of 58
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Subject: EMS DRC Policies & Procedures Manual
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OCDD 9
Richard Landry
10:20AM - 10:25AM
OCDD 10
Connie Mead
OCDD 11
Nora Dorsey
OCDD 12
Rebecca Thomas
OCDD 13
Deanne Groves
OCDD 14
Kin Hodge
OCDD 15
Randy Waguespack
OCDD 16
Samuel McDaniel
OCDD 17
Ronald Williams
OCDD 18
David Gill
OCDD 19
April Lee
OCDD 20
Jim Plank
OCDD 21
Kim Rushing
OCDD 22
Herman Bignar
New Orleans
Adolescent Hospital
(NOAH)
New Orleans
Adolescent Hospital
(NOAH)
Jefferson Parish
Human Service
Authority
Jefferson Parish
Human Service
Authority
OMH 1-10
OMH 1-20
OMH 1-30
OMH 1-40
Page 25 of 58
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Subject: EMS DRC Policies & Procedures Manual
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OMH 1-50
Metropolitan Human
Service District
OMH 2-20
Metropolitan Human
Service District
Eastern Louisiana
Mental System
(ELMHS)
Eastern Louisiana
Mental System (GS)
OMH 2-30
Eastern Louisiana
Mental System
OMH 2-40
Eastern Louisiana
Mental System
OMH 3-10
Region 3 - Mental
Health
OMH 3-20
Region 3 - Mental
Health
OMH 3-30
Region 3 - Mental
Health
OMH 4-10
Region 4 - Mental
Health
OMH 4-20
Region 4 - Mental
Health
OMH 4-30
Region 4 - Mental
Health
OMH 4-40
Region 4 - Mental
Health
OMH 5-10
Region 5 - Mental
Health
OMH 5-20
Region 5 - Mental
Health
OMH 5-30
Region 5 - Mental
Health
OMH 5-40
Region 5 - Mental
Health
OMH 6-10
Central Louisiana
State Hospital
OMH 6-20
Central Louisiana
State Hospital
OMH 1-60
OMH 2-10
Page 26 of 58
10:25AM - 10:30AM
Revision Date: August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
============================================================================
OMH 6-30
Central Louisiana
State Hospital
OMH 7-10
Region 7 - Mental
Health
OMH 7-20
Region 7 - Mental
Health
OMH 8-10
Region 8 - Mental
Health
OMH 8-20
Region 8 - Mental
Health
OMH 8-30
Region 8 - Mental
Health
OMH9-10
Southeast Louisiana
Hospital
OMH9-20
Southeast Louisiana
Hospital
OMH9-30
Southeast Louisiana
Hospital
OMH 9-80
Southeast Louisiana
Hospital
Florida Parishes
Human Services
District
Florida Parishes
Human Services
District
Florida Parishes
Human Services
District
OMH-HQ-1
Cassandra Wilson
OMH9-40
OMH 9-60
OMH 9-70
OMH-HQ-2
10:35AM - 10:50AM
Garcia Bodley
MVA 7
Faith Willis
MVA 9
Timothy White
MVA 10
JERRY PHILLLIPS
Page 27 of 58
10:30AM - 10:35AM
Revision Date: August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
============================================================================
CAHSD-1
Jan Kasofsky
CAHSD-2
Carol Nacoste
CAHSD-3
Jamie Roques
CAHSD-4
Becky Decker
CAHSD-5
Shirley Link
CAHSD-6
Stanley Mong
CAHSD-7
John Nosacka
CAHSD-8
Deborah Duckworth
CAHSD-9
Karen Collier
CAHSD-10
Mike Steinkamp
CAHSD-11
Vivian Gettys
BEMS-MD
BEMS-1
PHILLIPPE
BEMS-2
BEMS-3
LAMBERT (ALAN)
BEMS-4
MORRISON
(TIMOTHY)
BEMS-5
ERWIN
EMS-101
Frank Graff III
EMS-102
Tom Hartley
Page 28 of 58
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Subject: EMS DRC Policies & Procedures Manual
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EMS-201
Chryal Honore
EMS-202
Laurie Scivicque
EMS-301
Chad Davis
EMS-302
Ken Rousseau
EMS-401
Donald Simon Jr.
EMS-402
Kirk Coussan
EMS-501
Robert Daughdril
EMS-502
Lane Owers
EMS-503
Stephen Kershaw
EMS-601
Mark Majors
EMS-602
Shannon Mann
EMS-701
Fred Weaver
EMS-702
Craig Edwards
EMS-801
Gary Peters
EMS-901
David Marcus
EMS-902
Frank Jordan
LAA 1
Donna Newchurch
Page 29 of 58
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
LAA 2
Karla Long
CALL SIGN
DESCRIPTION
OAAS 1
BRAY
OAAS 2
GUILLOT
OAAS 3
OLIVIER, TINA
OAAS 4
ANDERSON
OAAS 5
RYLAND
OAAS 6
BURNS
OAAS 7
OLIVIER, ANNE
OAAS 8
ELEY
OAAS 9
BALES
OAAS 10
LEBIEN
MIS1
PERILLOUX
OAD 01
Trudy Gallman
OAD 02
Ken Saucier
OAD 03
Teresa Hardin
Page 30 of 58
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
OAD 04
Joyce Ben
OAD 05
OAD 06
OAD 07
Laurie BeaughHebert
Egan Jones
Trudie Abner
OAD 08
Jerri Parks
OAD 09
Springs of Recovery
OAD 10
Galen Schum
10:50AM - 10:55AM
OAD 11
Rochelle Dunham
OAD 12
George Sewell
OAD 13
Misty Hebert
OAD 14
Ingrid King
OAD 15
Tanya McGee
OAD 16
Eddie Cantebury
OAD 17
Don Pledger
OAD 18
Richard Barfoot
OCDD 1
Greg Andrus
OCDD 2
Kathy Kliebert
10:55AM - 11:00AM
OCDD 3
Mark A. Thomas
OCDD 4
Roslyn Matthews
Page 31 of 58
Revision Date: August 20, 2014
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
OCDD 5
Peter Calamari
OCDD 6
Jeffernier Shorts
OCDD 7
David Colvin
OCDD 8
John Hall
OCDD 9
Richard Landry
OCDD 10
Connie Mead
OCDD 11
Nora Dorsey
OCDD 12
Rebecca Thomas
OCDD 13
Deanne Groves
OCDD 14
Kin Hodge
OCDD 15
Randy Waguespack
OCDD 16
Samuel McDaniel
OCDD 17
Ronald Williams
OCDD 18
David Gill
OCDD 19
April Lee
11:00AM - 11:05AM
OCDD 20
Jim Plank
OCDD 21
Kim Rushing
OCDD 22
Herman Bignar
New Orleans
Adolescent Hospital
(NOAH)
OMH 1-10
Page 32 of 58
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
OMH 1-40
New Orleans
Adolescent Hospital
(NOAH)
Jefferson Parish
Human Service
Authority
Jefferson Parish
Human Service
Authority
OMH 1-50
Metropolitan Human
Service District
OMH 1-20
OMH 1-30
OMH 2-20
Metropolitan Human
Service District
Eastern Louisiana
Mental System
(ELMHS)
Eastern Louisiana
Mental System (GS)
OMH 2-30
Eastern Louisiana
Mental System
OMH 2-40
Eastern Louisiana
Mental System
OMH 3-10
Region 3 - Mental
Health
OMH 3-20
Region 3 - Mental
Health
OMH 3-30
Region 3 - Mental
Health
OMH 4-10
Region 4 - Mental
Health
OMH 4-20
Region 4 - Mental
Health
OMH 4-30
Region 4 - Mental
Health
OMH 4-40
Region 4 - Mental
Health
OMH 5-10
Region 5 - Mental
Health
OMH 5-20
Region 5 - Mental
Health
OMH 1-60
OMH 2-10
Page 33 of 58
11:05AM - 11:10AM
Revision Date: August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
============================================================================
OMH 5-30
Region 5 - Mental
Health
OMH 5-40
Region 5 - Mental
Health
OMH 6-10
Central Louisiana
State Hospital
OMH 6-20
Central Louisiana
State Hospital
OMH 6-30
Central Louisiana
State Hospital
OMH 7-10
Region 7 - Mental
Health
OMH 7-20
Region 7 - Mental
Health
OMH 8-10
Region 8 - Mental
Health
OMH 8-20
Region 8 - Mental
Health
OMH 8-30
Region 8 - Mental
Health
OMH9-10
Southeast Louisiana
Hospital
OMH9-20
Southeast Louisiana
Hospital
OMH9-30
Southeast Louisiana
Hospital
OMH 9-80
Southeast Louisiana
Hospital
Florida Parishes
Human Services
District
Florida Parishes
Human Services
District
Florida Parishes
Human Services
District
OMH-HQ-1
Cassandra Wilson
OMH9-40
OMH 9-60
OMH 9-70
Page 34 of 58
11:10AM - 11:15AM
Revision Date: August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
============================================================================
OMH-HQ-2
Garcia Bodley
MVA 7
Faith Willis
MVA 9
Timothy White
MVA 10
JERRY PHILLLIPS
11:15AM - 11:20AM
CAHSD-1
Jan Kasofsky
CAHSD-2
Carol Nacoste
CAHSD-3
Jamie Roques
CAHSD-4
Becky Decker
CAHSD-5
Shirley Link
CAHSD-6
Stanley Mong
CAHSD-7
John Nosacka
CAHSD-8
Deborah Duckworth
CAHSD-9
Karen Collier
CAHSD-10
Mike Steinkamp
CAHSD-11
Vivian Gettys
BEMS-MD
BEMS-1
PHILLIPPE
BEMS-2
BEMS-3
Page 35 of 58
LAMBERT (ALAN)
Revision Date: August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
============================================================================
BEMS-4
MORRISON
(TIMOTHY)
BEMS-5
ERWIN
11:20AM - 11:25AM
EMS-101
Frank Graff III
EMS-102
Tom Hartley
EMS-201
Chryal Honore
EMS-202
Laurie Scivicque
EMS-301
Chad Davis
EMS-302
Ken Rousseau
EMS-401
Donald Simon Jr.
EMS-402
Kirk Coussan
EMS-501
Robert Daughdril
EMS-502
Lane Owers
EMS-503
Stephen Kershaw
EMS-601
Mark Majors
EMS-602
Shannon Mann
EMS-701
Fred Weaver
EMS-702
Craig Edwards
EMS-801
Gary Peters
EMS-901
David Marcus
Page 36 of 58
Revision Date: August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
============================================================================
EMS-902
Frank Jordan
LAA 1
Donna Newchurch
LAA 2
Karla Long
CALL SIGN
DESCRIPTION
OAAS 1
BRAY
OAAS 2
GUILLOT
OAAS 3
OLIVIER, TINA
OAAS 4
ANDERSON
OAAS 5
RYLAND
OAAS 6
BURNS
OAAS 7
OLIVIER, ANNE
OAAS 8
ELEY
OAAS 9
BALES
OAAS 10
LEBIEN
MIS1
PERILLOUX
OAD 01
Trudy Gallman
OAD 02
Ken Saucier
OAD 03
Teresa Hardin
OAD 04
Joyce Ben
Page 37 of 58
11:25AM - 11:30AM
Revision Date: August 20, 2014
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
OAD 05
Laurie BeaughHebert
OAD 06
Egan Jones
OAD 07
Trudie Abner
OAD 08
Jerri Parks
OAD 09
Springs of Recovery
OAD 10
Galen Schum
11:30AM - 11:35AM
OAD 11
Rochelle Dunham
OAD 12
George Sewell
OAD 13
Misty Hebert
OAD 14
Ingrid King
OAD 15
Tanya McGee
OAD 16
Eddie Cantebury
OAD 17
Don Pledger
OAD 18
Richard Barfoot
OCDD 1
Greg Andrus
OCDD 2
Kathy Kliebert
OCDD 3
Mark A. Thomas
OCDD 4
Roslyn Matthews
OCDD 5
Peter Calamari
Page 38 of 58
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
OCDD 6
Jeffernier Shorts
OCDD 7
David Colvin
OCDD 8
John Hall
11:35AM - 11:40AM
OCDD 9
Richard Landry
OCDD 10
Connie Mead
OCDD 11
Nora Dorsey
OCDD 12
Rebecca Thomas
OCDD 13
Deanne Groves
OCDD 14
Kin Hodge
OCDD 15
Randy Waguespack
OCDD 16
Samuel McDaniel
OCDD 17
Ronald Williams
OCDD 18
David Gill
OCDD 19
April Lee
OCDD 20
Jim Plank
OCDD 21
Kim Rushing
OCDD 22
OMH 1-10
Herman Bignar
New Orleans
Adolescent Hospital
(NOAH)
OMH 1-20
New Orleans
Adolescent Hospital
Page 39 of 58
11:40AM - 11:45AM
Revision Date: August 20, 2014
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
(NOAH)
OMH 1-40
Jefferson Parish
Human Service
Authority
Jefferson Parish
Human Service
Authority
OMH 1-50
Metropolitan Human
Service District
OMH 1-30
OMH 2-20
Metropolitan Human
Service District
Eastern Louisiana
Mental System
(ELMHS)
Eastern Louisiana
Mental System (GS)
OMH 2-30
Eastern Louisiana
Mental System
OMH 2-40
Eastern Louisiana
Mental System
OMH 3-10
Region 3 - Mental
Health
OMH 3-20
Region 3 - Mental
Health
OMH 3-30
Region 3 - Mental
Health
OMH 4-10
Region 4 - Mental
Health
OMH 4-20
Region 4 - Mental
Health
OMH 4-30
Region 4 - Mental
Health
OMH 4-40
Region 4 - Mental
Health
OMH 5-10
Region 5 - Mental
Health
OMH 5-20
Region 5 - Mental
Health
OMH 1-60
OMH 2-10
Page 40 of 58
11:45AM - 11:50AM
Revision Date: August 20, 2014
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
OMH 5-30
Region 5 - Mental
Health
OMH 5-40
Region 5 - Mental
Health
OMH 6-10
Central Louisiana
State Hospital
OMH 6-20
Central Louisiana
State Hospital
OMH 6-30
Central Louisiana
State Hospital
OMH 7-10
Region 7 - Mental
Health
OMH 7-20
Region 7 - Mental
Health
OMH 8-10
Region 8 - Mental
Health
OMH 8-20
Region 8 - Mental
Health
OMH 8-30
Region 8 - Mental
Health
OMH9-10
Southeast Louisiana
Hospital
OMH9-20
Southeast Louisiana
Hospital
OMH9-30
Southeast Louisiana
Hospital
OMH9-40
OMH 9-60
Page 41 of 58
Southeast Louisiana
Hospital
Florida Parishes
Human Services
District
Revision Date: August 20, 2014
Standard Procedure
Subject: EMS DRC Policies & Procedures Manual
============================================================================
Attachment 105 – Administrative DRC Job Description
HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA) GRANT
NATIONAL EMS BIOTERRORISM PEPAREDNESS PROGRAM
ADMINISTRATIVE DESIGNATED REGIONAL COORDINATOR
JOB DESCRIPTION
Position Title: Administrative Medical Regional Coordinator
Position Overview: To support the volunteer Medical Regional Coordinators (MRC) in their efforts to
facilitate the development and implementation of a regional EMS Emergency Preparedness Plan. The
Administrative DRC will assist in meeting the HRSA Grant deliverables as under the direction of the DRC
and the Louisiana Rural Ambulance Alliance staff in the following planning areas. This position must be
funded and renewed annually.
HRSA Grant Specific Objectives:

Administrative functions that support to the MRCs development of regional surge capacity
planning in specific to the areas identified in the HRSA grant guidance

Coordinate the development of the Regional Influenza Plan

Support for the Regional implementation of the CHEMPACK Program
Essential Functions:

Communicate, coordinate and facilitate the region wide HRSA EMS rounds

Coordinate EMS documentation activities that ensure regional responsibilities are met in areas of
participation in HRSA planning activities, expenditure tracking and receipt collection, survey
implementation, and other documentation activities.

Collaborate with local, regional, and state entities in support of strengthening regional
infrastructure (such as but not limited to: Metropolitan Medical Response System, Medical
Reserve Corps, Emergency Medical Service, Office of Public Health, Office of Homeland
Security, etc.)

Represent the regional EMS systems in regional and state emergency planning activities.

Attend and/or represent MRC at HRSA MRC meetings.

Foster the continued development of the Special Needs Sheltering regional plans.

Conduct EMS surveys for needs assessment and planning purposes.

Assist in the development of regional training programs, including seminars, community drills,
and on-site programs when needed.

Develop and Manage and foster the development of inter-EMS two-way radio communications via
weekly roll calls.

Facilitate the development of a 3 day emergency on duty roster

Provide group notifications and updates to regional EMS providers and appropriate entities via
email.

Facilitate regional research in areas of surge capacity planning.

Identify, assess, and log LRAA Preparedness Assets.

Work with GOHSEP on positions of ESF1, ESF8, and Public Safety.
Page 42 of 58
Revision Date: August 20, 2014
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Subject: EMS DRC Policies & Procedures Manual
============================================================================
Emergency Situation Functions: In emergency situations, the Administrative MRC will responsible for:

Acting as a supportive role for the Medical Regional Coordinator in real-time decision-making.

Assist the MRC as they serve as the voice of all participating EMS providers in the region

Assist the MRC in communicating critical information concerning the availability of EMS
resources within the region.

Assist the MRC in collecting vital EMS Provider information on all EMS providers in their
region and collaborate as needed with the regional Emergency Operations Center and/or to the
State Emergency Operations Center during an incident.
Qualifications: Previous experience in Emergency Management, emergency preparedness and a working
knowledge of EMS within the designated region is required. Candidate must have a working knowledge of
the Incident Command System, and knowledge of federal, state, and local regulations and guidelines
regarding emergency operations plans and programs. Knowledge of Microsoft Office applications,
experience in operational problem solving/decision making and a desire to perform the functions and
duties of the role is critical. Strong administrative, presentation and communications skills a must.
Education / Training
 3 Years emergency preparedness and planning experience, preferably in EMS planning.
 Bachelor’s degree or equivalent experience preferred.
 Identified and recommended by representatives from regional EMS systems.
 At least 5 years of work experience within the healthcare field. EMS experience preferred.
Licensure / Certification Requirements
Must have a working knowledge of the Incident Command System including National Incident
Management System course IS 100, 200, 300, 400, 700, and 800 and knowledge of all federal, state, and
local regulations and guidelines regarding emergency operations plans and programs. Knowledge of
Microsoft Office applications, experience in operational problem solving/decision making and a desire to
perform the functions and duties of the role is critical.
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Attachment 106a – BEMS ESF 8 Responsibilities 2010
The Bureau of EMS has been designated as a key support agency to ESF 8. Some of the
BEMS ESF 8 responsibilities include:
• Supporting Hospital Evacuation Process
• Supporting Nursing Home Evacuation Process
• Oversight of surge ambulance contracts including credentialing of
responding ambulances and personnel;
• Supporting Shelter Operations
– Medical Special Needs Shelters (MSNS)
– Critical Transportation Needs Shelters (CTNS
– Federal Medical Shelters (FMS)
• Oversight of the Emergency Preparedness Grant for EMS providers
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Attachment 106b – Emergency Response Coordinator Job Description
This is a highly responsible position to serve as the federally funded statewide HRSA Hospital
Preparedness, CDC Bo-terrorism Program, Emergency Medical Services for Children and Public Access
to Defibrillators grants coordinator in the Office of Public Health/ Emergency Preparedness and
Response / Bureau of Emergency Medical Services. This person coordinates all budget activities of the
federally funded statewide HRSA Hospital Preparedness and CDC Bio- terrorism Program in the Office
of Public Health/ Emergency Preparedness and Response.
The ability to manage multiple tasks simultaneously, problem solve, prioritize project tasks, and work
with little or no supervision. Strong organizational skills are a must. Possess excellent interpersonal skills,
including the ability to prepare and present grant material. Strong communication skills required,
including the ability to convey succinct and concise summaries of grant activities. The ability to design
presentations and create spreadsheets and documents that support project activities is required
40%
Manage internal HHS accounting and reporting system (data and implementation) for allocations
of HRSA monies to individual pre-hospital providers, including tracking of receipts, signatures,
and supporting documentation for spending agreements, reallocations, and special projects.
Ensure that providers are in compliance with Federal grant guidelines and deadlines. Reviews
final spending report and forwards to grant PI. Create grant spending and financial tracking
reports. Review final grant spending reports and forwards to EMS Director and grant PI.
25%
Develop new plans and/or processes within the scope of Emergency Preparedness and Response
section. Communicate and correspond (phones, e-mail, fax, and letters) with providers, DRCs,
DRC Network and local, state and federal entities in support of grant activities. Communicate and
correspond (phones, e-mail, fax, and letters) with and seek approval from HHS Advisory Board
and other HHS subcommittees.
20%
Develop meeting and handouts for HHS DRC, Advisory Board and other HHS meetings.
Collect, compile and manage descriptive data from providers to contribute to developing prehospital emergency response plans including survey development Facilitate requests through the
Incident Command Structures for Emergency Support Function 8 - Health and Medical.
15%
Participate in grant and preparedness updates with EMS Director and Grant PI. Participate in all
GOHSEP directed drills and present at State Emergency Operations Center during emergency
situations, including nights and week-ends if necessary. Manage budget for travel and
reimbursement of statewide volunteers and HHS staff. Develop process for the collection of
NIMS Implementation Compliance Activities and requirements for pre-hospital. Prepares and
submits contract evaluation documents. Prepare and present grant material via PowerPoint to prehospitals as directed by Grant PI. Participate in ESF 8 planning meetings such as CHEMPACK,
Pandemic Flu, and hurricane planning as directed by Grant PI.
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106c
BEMS Contact List
Bureau of Emergency Medical Services Staff Directory 11224 Boardwalk Drive, Suite A1 Baton Rouge, LA 70816 Stephen Phillipe Sr. Bureau of EMS Director/Emergency Response & Preparedness E‐mail: [email protected] Phone: 225‐275‐1761 Fax: 225‐275‐1826 Cell: 225‐485‐5545 Rebecca Harris Program Monitor, Contracts/AED Grant E‐mail: [email protected] Phone: 225‐275‐1448 Fax: 225‐275‐1826 Marcia Fries Program Monitor, HHS Grant E‐mail: [email protected] Phone: 225‐275‐1644 Fax: 225‐275‐1826 Cell: 225‐405‐7584 Debbie Huffman EMSC Grant Coordinator E‐mail: [email protected] Phone: 225‐275‐1532 Fax: 225‐275‐1826 Patsy Covington Certification Coordinator E‐mail: [email protected] Phone: 225‐275‐1598 Fax: 225‐275‐1826 Tina Phagan Exam Coordinator E‐mail: [email protected] Phone: 225‐275‐1533 Fax: 225‐275‐1826 Page 46 of 58
Alan Lambert Deputy Director, Education & Professional Standards E‐mail: [email protected] Phone: 225‐275‐1770 Fax: 225‐275‐1826 Stephanie Price Office Coordinator E‐mail: [email protected] Phone: 225‐275‐1651 Fax: 225‐275‐1826 Timothy B Morrison EMS Tri‐Regional Coordinator E‐mail: [email protected] Phone: 318‐361‐7236 Fax: 318‐362‐3163 Cell: Betty Kerry Receptionist E‐mail: [email protected] Phone: 225‐275‐1782 Fax: 225‐275‐1826 Steve Erwin Ambulance Services Coordinator E‐mail: [email protected] Phone: 225‐342‐9405 Fax: 225‐275‐1826 Cell: 225‐268‐6071 Evon Smith Emergency Medical Planner E‐mail: [email protected] Phone: 225‐342‐7872 Fax: 225‐342‐4497 Cell: 985‐974‐9688 Revision Date: August 20, 2014
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113
State Volunteer Liability Form
AGREEMENT TO VOLUNTEER SERVICES
DURING A DISASTER OR EMERGENCY
This agreement is between the State of Louisiana through the Department of Health and
Hospitals (hereinafter referred to as “LDHH”) and ________________________________
(hereafter referred to as “Volunteer”).
Volunteer agrees to provide services to or on behalf of the State of Louisiana through
LDHH during a state declared disaster or emergency. Volunteer agrees and understands that
he/she will not receive monetary compensation from LDHH for his/her services.
LDHH agrees to accept the services of Volunteer. Volunteer agrees to serve under the
supervision and direction of LDHH, and to abide by all applicable LDHH policies, rules, and
regulations, including policies concerning the HIPAA Privacy Rule. If pre-registered through
the LAVA system, Volunteer acknowledges that s/he has reviewed LDHH HIPAA Privacy
Policy numbers 1-3. Volunteer also agrees to abide by all reasonable rules, restrictions, and
policies of any disaster relief organization or entity to which Volunteer might be assigned or
deployed by LDHH.
Volunteer expressly affirms that, to the best of Volunteer’s knowledge, s/he does not
have any communicable diseases.
If the Volunteer is providing services within his/her given health care professional
discipline and scope of practice, then by signing this agreement the Volunteer acknowledges that
s/he has current credentials and/or professional licenses.
LDHH and Volunteer agree that Volunteer, to the extent allowed by law, shall be
considered as an employee of LDHH for the limited purposes of indemnification and immunity
for any actions that may arise in the course and scope of Volunteer’s assigned duties.
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Volunteer acknowledges receipt of the LDHH handout entitled “Information on Liability
Protection for Volunteers in Emergency Situations” (revised 8/27/2008).
Volunteer agrees to be responsible for any actions that are not directly related to the
performance of his/her volunteer assignment(s).
LDHH and Volunteer agree that the Volunteer’s service may be immediately terminated
at any time by either LDHH or Volunteer.
VOLUNTEER:
Volunteer Name: _________________________________________________________
Volunteer Signature: ____________________________________ Date______________
If Volunteer is under 18 years of age, the Parent/Guardian of Volunteer must consent:
Parent/Guardian Name: ____________________________________________________
Parent/Guardian Signature: ______________________________Date_______________
LDHH REPRESENTATIVE:
Name: __________________________________________________________________
Signature: __________________________________________Date_________________
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116 Damaged Equipment Form
LOST OR DAMAGED EQUIPMENT FORM
Contact Name:
Contact Title:
Company/Provider:
Company Address:
Work Phone:
Fax:
Mobile Phone:
Email:
Date of Asset Damage/Loss:
Alliance Item(s) Damaged/Lost:
Describe Damage/Loss of Item(s):
Location of Loss/Damage:
Can damaged Asset be repaired?
yes
no
If “yes” describe repairs needed:
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117a
Lease Request Form
SHORT TERM LEASE APPLICATION
Contact Name:
Contact Title:
Company/Provider:
Company Address:
Work Phone:
Fax:
Mobile Phone:
Email:
Name/Title of Company Representative Signing Lease:
Alliance Item(s) Requested:
*Event or Proposed Use of Item(s):
Event or Proposed Use Address:
Brief Description of Event or Proposed Use:
Event or Proposed Use Dates:
Begin:
End:
**Item Pick Up & Return Dates:
Pick Up:
Return:
*Alliance Asset Item Availability of is determined based on need for that asset (i.e.:
Emergency use is given a higher priority than day to day or special event use). If the
need for that asset is equal, then the assets are allocated on a first come, first served
basis.
**Lessor is responsible for the safe transport and return as scheduled above of leased
item(s).
Please complete & return this form to Karla Long, Administrative DRC
Fax: 225.906.3866, Email: [email protected]
Short Term Lease Form can be found at: http://www.louisianaambulancealliance.org/
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117b
Asset Request/Lease Check List
ALLIANCE LEASE REQUEST CHECK LIST
 Complete Short Term Lease Application.
 Return competed Short Term Lease Application 2 weeks prior or before Asset is needed
to Karla Long, Administrative DRC, via fax: 225.612.5621, or email:
[email protected].
 Upon lease request approval*, Asset Lease will be emailed to you to print and sign.
 Fax or email signed lease to Karla Long, Administrative DRC, via fax: 225.612.5621, or
email: [email protected].
 Mail original signed lease to address above for the Alliance office to keep on file.
 Alliance office will assist you with needed Asset pick up and Return information. Lessor
is responsible for the safe transport and return as scheduled of leased item(s).
* Alliance Asset Item Availability is determined based on need for that asset (i.e.:
Emergency use is given a higher priority than day to day or special event use). If the
need for that asset is equal, then the assets are allocated on a first come, first served
basis.
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118b
DRC Reimbursement Form
GENERAL:
TRAVEL AUTHORIZATION:
All non-routine travel must be authorized and approved in writing by the head of the department ,board, or commission from whose funds the
traveler is paid.
Routine Lodging Overage Allowances: (Receipt required)
A Department Head or his/her designee has the authority to approve actual cost for routine lodging provisions on a case by case basis not to
exceed fifty percent over PPM-49 current listed rates. Justification must be maintained in the file to show that attempts were made with hotels in
the area to receive the state/best rate. In areas where the Governor has declared an emergency, a Department Head or his/her designee will have
the authority to approve actual routine lodging provisions on a case by case basis not to exceed seventy-five percent over PPM-49 current listed
rates.
Single Day Travel: Meals are not eligible for reimbursements on single day travel. This means that when an authorized traveler of the State is
in travel status where no overnight stay is required, no meals are eligible for reimbursement. Each Department Head or their designees are to
determine the reasonableness of when an overnight stay is justified. However, the Department Head will be allowed to authorize Single Day meal
reimbursements on a case-by-case basis or by type(s) of single day travel when it is determined to be in the best interest of the department. In
those cases, the department must keep the approvals in the travel file and must be responsible to take appropriate steps to report the
reimbursement as wages to the employee. If a Department Head or his/her designee determines that Single Day Meals will be provided for, they
must follow the following allowances:
To receive any meal reimbursement on single day travel, an employee must be in travel status for a minimum of 12 hours.
The maximum allowance for meal reimbursement for single day travel will be $30.00.
Breakfast and Lunch: ($20.00) The 12 hour travel duration must
begin at or before 6 a.m.
Lunch: ($12.00) Requires 12 hours duration in travel status.
Lunch and Dinner: ($30.00) The 12 hour travel duration must end at or after 8 p.m.
Travel with Overnight Stay: Travelers may be reimbursed for meals according to the following schedule.
Breakfast: When travel begins at/or before 6 a.m. of the first day of travel or extends beyond 9 a.m. on the last day of travel, and for any
intervening days.
Lunch: When travel begins at/or before 10 a.m. of the first day of travel or extends beyond 2 p.m on the last day of travel, and for any
intervening days.
Dinner: When travel begins at/or before 4p.m. of the first day of travel or extends beyond 8 p.m. on the last day of travel, and for any
intervening days.
Meals Allowance – Including Tax and Tips
Receipts are not required for routine meals within these allowances.
Partial meals such as continental breakfast or airline meals are not considered meals. If meals of state officials on actual exceed these allowances,
receipts are required. Inclusion of suburbs is allowed for meals on a case by case basis.
Routine Lodging Allowances – Employees will be reimbursed lodging rate, plus tax and any mandatory surcharge. ( Receipts are
Required )For lodging rates, the inclusion of suburbs shall be determined by the department head on a case-by-case basis. When two or more
employees on official state business share a lodging room, the State will reimburse the actual cost of the room; subject to a maximum amount
allowed for an individual traveler times the number of employees.
Department head approval must be provided to allow lodging expenses to be direct billed to an agency.
Breakfast
Lunch
Dinner
Tier I
$ 8
$12
$18
$38
LODGING:
In-State Cities (except as listed)
Baton Rouge – EBR
Covington/Slidell – St. Tammany
Lake Charles – Calcasieu
Lafayette
Breakfast
Lunch
Dinner
Routine Lodging
$70__
$103_
$99_ _
$82 __
$89 _
Tier II
$10
$14
$24
$48
LODGING:
Routine Lodging
New Orleans, Orleans, St. Bernard, Jefferson,
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Plaquemines Parishes (July 1 – Sept. 30)____________$104__________
New Orleans, Orleans, St. Bernard, Jefferson,
Plaquemines Parishes (Oct.1 – June 30)
$133_________
Out-of-State (Except Cities listed in Tier III & IV)
$85_________
Breakfast
Lunch
Dinner
Tier III
$12
$16
$24
$52
LODGING :
Routine Lodging__
Atlanta, Austin, Cleveland, Dallas/Fort Worth
$135
Denver, Detroit, Fort Lauderdale, Galveston, Hartford, Houston, Kansas City, Las Vegas, Los Angeles, Miami, Minneapolis/ST. Paul, Nashville,
Oakland. CA., Orlando, Philadelphia, Phoenix, Pittsburgh, Portland, Me, Portland, OR., Sacramento, San Antonio, San Diego, St. Louis, Tampa,
Wilmington, DE, Puerto Rico, Virgin Islands, all of Alaska and Hawaii, Guam, American Samoa
Breakfast
Lunch
Dinner
Tier IV
$13
$18
$29
$60
LODGING:
Routine Lodging__ Baltimore MD, Seattle, WA, San Francisco, CA $175_______
Alexandria, VA, Arlington, VA, Boston, MA,
New York City, Washington, DC
$225
__ Chicago, IL, International Cities
$200_______
AIRFARE: Remember, while use of the contract travel agency is mandatory: purchase of state contract airfare is not mandatory.
The State Travel Office strongly encourages use of lowest logical airfares, NOT state contract fares. The State always supports purchasing the
“best value” ticket. You should ask the state’s contracted travel agency to check for the lowest logical rates based on your personal needs.
Remember, PPM49, Section 1504 B2 (d) states “The policy regarding airfare penalties is that the State will pay for the airfare and/or penalty
incurred for a change or cancellation if required by the State or other unavoidable situations approved by the agency’s department head.
State contract airfares are for official business only. No personal use.
When Selecting State Contract Airfare, traveler must pay by either the State’s Corporate Travel Card or the agency’s CBA (Controlled
Billing Account).
REMEMBER– A ticket is not purchased until you confirm your reservations with a credit card.
MILEAGE:
Reimbursement from official domicile to area of travel based on most direct route. Mileage shall be reimbursable on the basis of $0.48 per the
following:
For official In-State business travel
1. Employee should utilize a state vehicle when available
2. Employee may rent a vehicle from Enterprise Rent-A-Car’s State Motor Pool Rental Contract, if state vehicle is not available;
3. If an employee elects to use his/her personal vehicle, reimbursement may not exceed a maximum of 99 miles per round trip and/or day at $0.48
cents per mile.
RENTAL CARS ( Receipt Required)
In-State Vehicle Rental. The State has contracted with Enterprise Rent-A- Car for the State Motor Pool Rental Contract which use is
mandatory
In-State Motor Pool Rentals
Compact$ 32.00 $176.00 weekly $640.00 monthly
Mid-size/Intermediate
$34.00 $187.00 weekly $680.00 monthly
Only the rental of compact or mid-intermediate model is reimbursable, unless non-availability is documented, or the vehicle will be used to
transport more than two persons. Refer to PPM49 for additional rates/information and to determine the insurance coverage that is reimbursable.
Written approval from the department head prior to departure is required
Gasoline (Receipt Required)
Reimbursements require a receipt for regular unleaded gasoline, or diesel when applicable. This applies for both state owned vehicles and rental
vehicles, as mid-grade, super, plus or premium gasoline is typically not necessary.
ENTERPRISE CAR RENTAL: National Account Number: NA1403
RESERVATIONS (24/7) 1-800-RENT-A-CAR OR ENTERPRISE .COM
Out-of–State
Avis
Budget
Dollar
Enterprise
Hertz
National
Thrifty
Phone Number
1-800-331-1212
1-800-527-0700
1-800-800-3665
1-800-736-8222
1-800-654-3131
1-800-227-7368
1-800-847-4389
Corporate Discount #’s
A628000
T243800
TA8565
XZ14070
70592
5004172
0010176533
TAXI: (Shuttles, Airport limousines, etc.)
The cost of public ground transportation such as buses, subways, airport shuttle/limousines, and taxis are reimbursable when the expenses are
incurred as part of approved state travel. Airport Shuttle/limousines and taxi reimbursements, including tip, requires a receipt to account for total
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daily amount claimed. A driver’s tip for shuttles/limousines and taxis may be given and must not exceed 15% of total charge. Amount of tip
must be included on receipt received from driver/company. All other forms of public ground transportation are limited to $15 per day without
a receipt, claims in excess of $15 per day requires a receipt. At the agency’s discretion, the department head may implement an agency wide
policy requiring receipts for all public transportation request less than $15 per day.
PARKING:
Airport Parking Contracts:
Baton Rouge Airport: the state’s current contract rate is $3.50 per day (no receipt required). for parking in the indoor parking garage as well as
the outside fenced parking lot at the airport. Documentation required to receive the contract price is either state ID or travel itinerary issued by
the state contracted travel agency designating the employee is on “official state business”. At the agency discretion an employee may be paid
actual expenses up to $5.00 per day with receipt.
New Orleans Airport – Park‘N Fly: The state’s contract rate is $6.00 per day, $36.00 weekly at Park’ N Fly (no receipt required). Park’ N Fly
requires agency issued photo ID, business card, state issued corporate card or flight itinerary. At the agency discretion an employee may be paid
actual expenses up to $8.00 per day with a receipt.
For areas other than the above contracts:
Up to $5.00 can be reimbursed without a receipt. Anything over this amount must have a receipt.
REIMBURSEMENT FOR OTHER EXPENSES
TELEPHONE:
Official State Business:
All charges must have a receipt. All communication expenses shall be relative to official state business and should be so indicated on the travel
expense voucher.
Internet Access charges for official state business from hotels or other travel locations are treated the same as business telephone charges.
(Receipts Required)
Personal Calls:
Domestic Overnight Travel: up to $3.00 in personal calls upon arrival at each destination and up to $3.00 for personal calls every second night
after the first night if the travel extends several days.
International Travel: up to $10 in personal calls upon arrival at each destination and up to $10 for personal calls every second night after the
first night if the travel extends several days.
BAGGAGE TIPS:
Hotel Allowances – Not to exceed $3 tip per hotel check-in and $3 tip per hotel checkout, if applicable.
Airport Allowances – Not to exceed $3 tip for airport outbound departure trip and $3 tip for inbound departure trip.
LUGGAGE ALLOWANCE: (Receipt Required)
A Department Head or his designee may approve reimbursement to a traveler for airline charges for first checked bag for a business trip of 5
days or less and for a second checked bag for a 6 – 10 day business trip and/or any additional baggage which is business related and required by
the department. The traveler must present a receipt to substantiate these charges.
Travelers will be reimbursed for excess baggage charges (overweight baggage) only in the following circumstances:

When traveling with heavy or bulky materials or equipment necessary for business.

The excess baggage consists of organization records or property.
INTERNATIONAL TRAVEL
International travel must be approved by the Commissioner of Administration, or the entity head or his designee for Higher Education entities
prior to departure, unless specific authority for approval has been delegated to a department head. Request for approval must be accompanied by
a detailed account of expected expenditures (such as room rate/date, meals, local transportation, etc.) and an assessment of the adequacy of this
source to meet such expenditures without curtailing subsequent travel plans.
International travelers will be reimbursed the Tier IV area rates for meals and lodging, unless U.S. State Department rates are requested and
approved by the Commissioner of Administration prior to departure. Itemized Receipts are required for meals and lodging claimed at the U.S.
State Department rates.
WAIVERS
The Commissioner of Administration may waive in writing any provision in PPM 49 when the best interest of the state will be served.
PLEASE
REVIEW PPM 49 THOROUGHLY BEFORE MAKING YOUR TRAVEL ARRANGEMENTS TO ENSURE
COMPLIANCE AND FOR PROPER REIMBURSEMENTS.
TRAVEL TIPS:
1. Plan ahead. If you have a unique situation coming up and unsure what is the proper protocol or method to handle something, call your Travel
Coordinator and ask. Many questions can be answered by visiting our web site.
2. Submit Travel Authorization and request special approvals prior to travel taking place.
3. Obtain all necessary signatures before submitting the expense account for processing.
4. Attach all required receipts to the expense account.
5. Adequate justification should be provided for any unusual expense.
6. Foreign exchange rate should be provided for any unusual expense.
7 . Turn in Travel Expense Account immediately upon returning from trip to ensure timely reimbursement.
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8. Attach a copy of the Travel Authorization if single trip or conference/convention.
Web Site:
www. doa.louisiana.gov/osp/travel
Prepared by:
Division of Administration
La. State Travel Office
225-342-6322
LOUISIANA STATE EMPLOYEES
FISCAL YEAR
2010-2011
POCKET GUIDE TO
TRAVEL REGULATIONS
For more detailed guidelines,
refer to PPM No. 49 - General
Travel Regulations
(Effective July 1, 2010)
ALL AIRFARE MUST BE BOOKED THROUGH SHORT’S TRAVEL AGENCY. SEE BELOW
CONTRACTED TRAVEL AGENCY
SHORT’S TRAVEL MANAGEMENT d/b/a
SHORTS TRAVEL SERVICE
Waterloo, IA
Toll free
(888) 846-6810
Fax:
(319) 433-0847
Email:
[email protected]
Website: www.shortstravel.com/la
** PLEASE NOTE THAT THERE IS A $15 CHARGE
PER CALL FOR AFTER HOUR EMERGENCY
SERVICE 1-888-846-6810
After 5 p.m. and on weekends. This service is for emergency travel only and not for booking advanced travel.
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Attachment 118b – DRC Reimbursement Form
TRAVEL EXPENSE ACCOUNT
Page 1 of 2
DATE OF CLAIM
BA-12 (3/97)
DEPARTMENT
The statement on the reverse side must be completely filled in by the payee prior to
signature. Receipts must be attached as required by travel regulations.
NAME OF OFFICER OR EMPLOYEE
DIVISION
ADDRESS
SECTION
CITY
FOR PERIOD
Expense Summary
Lump-Sum Allowance
$
Per Mile Cost:
Automobile:
mi. @ .48
$
mi. @ .48
$
Lodging
Subsistence:
Meals
$
$
(SEE PPM 49 FOR RECEIPTS REQUIRED
FOR SPECIAL AND HIGH COST AREA MEALS)
$
$
Tolls and Parking
$
Tips (for baggage handling only)
$
Other Expenses
$
Less: Travel Advance
$
Total
Costs
$
Reimbursable
Certificate of Payee
I certify that this expense account is just and true in all respects; that the distances shown were actually and necessarily traveled on the dates
specified on official business only; that the expenses charged were incurred on official business of the State and none of the expenses have
been paid by the State; and that the full amount is justly due.
SIGNED BY PAYEE
TITLE OR POSITION
OFFICIAL DOMICILE
Certificate of Head of Budget Unit
I certify that the charges set forth on this expense account have been examined by me; that the services for which the charges are made were
necessary and proper; and that, in my opinion, the amounts claimed are just and reasonable.
NAME
SIGNED BY:
TITLE
REMARKS BY HEAD OF BUDGET UNIT IN EXPLANATION OF UNUSUAL ITEMS, ETC.
Agency No.
Page 56 of 58
Orgn.
Object
Sub
Obj.
Amount
Rptg. Category
Revision Date: August 20, 2014
Document Reference
DATE
SUBSISTENCE
HOUR
DEP.
ARR.
MEALS
ODOMETER
READING
(SPECIFY AM/PM)
TERRITORY TRAVELED
SHOW ALL POINTS VISITED
TOTALS
DEPART
ARRIVE
MILES
TRAV.
LODGIN
G
$
NO.
COST
TOLLS
AND
PARK.
TIPS
$
$
$
OTHER EXPENSES
DESCRIPTION
COST
$
Attachment – Acronyms
BEMS – Bureau of Emergency Medical Services
DHH EOC – Louisiana Department of Health and Hospitals Emergency Operations
Center
DRC – Designated Regional Coordinator
EMS – Emergency Medical Services
Louisiana ESF 8 – Louisiana Emergency Support Function 8 – Health and Medical
Services
LAA – Louisiana Ambulance Alliance
LHA – Louisiana Hospital Association
LNHA – Louisiana Nursing Home Association
NH – Nursing Home
PHERC – Office of Public Health Public Health Emergency Response Coordinator
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