Savvik: Save Big on Grainger!

Check out the new contracts and specials from Savvik Buying Group’s contract with Grainger!

Savvik, formerly the North Central EMS Corporation (NCEMSC), was founded in 1997 as a nonprofit coop that negotiates best prices on millions of items ranging from fully-loaded ambulances to stretchers to office supplies to boots for individual employees.

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Savvik: New Vendor Buying Programs!

Check out the new contracts and specials from Savvik Buying Group! Savvik, formerly the North Central EMS Corporation (NCEMSC), was founded in 1997 as a nonprofit coop that negotiates best prices on millions of items ranging from fully-loaded ambulances to stretchers to office supplies to boots for individual employees.

Get started today, with great deals like these!


Shop Savvik Now

Share With Your Team: Taking Care of You

Taking care of yourself means paying attention to both your physical and your emotional needs. It means eating nutritious foods, getting enough exercise and sleep, and carving out time for activities you enjoy and people you care about. Here are a few tips and ideas to help you take better care of yourself.

  • Eat a healthy diet. There’s no question that the foods we eat affect how we feel and look. You don’t have to follow a strict diet, but it‘s important to follow a healthy diet. A nutritious, well-balanced diet gives you energy, protects against disease, and helps you maintain a healthy weight.One easy rule to follow is what some experts refer to as the “80/20 rule”: If 80 percent of what you eat is healthy — with a nutritious mix of fruits, vegetables, and whole grains — then you can let yourself eat what you want for the other 20 percent.
  • Avoid multitasking at mealtimes. If you always watch television at meals or eat on the run a lot, you may not realize how much you are eating. If you’re on the go a lot, keep healthy snacks in the car and eat a little while you’re out, then a little more once you get home. Avoid eating big meals just before going to bed.
  • Get exercise. People who exercise even moderately have much lower rates of heart disease and other medical problems, and regular exercise helps to reduce stress. But exercise is often the first thing to go when schedules get busy or during difficult times. Experts recommend that adults get a minimum of 30 minutes of exercise that makes you breathe harder on all or most days of the week.
  • Turn family time into exercise time. Try exploring a local park, going for a hike or bike ride, or just walking around the block with your family instead of going to the movies or shopping.
  • Stretch for just a minute or two when you wake up each day. In addition to helping you ease into your day, a brief stretching routine can restore or build flexibility and energize your body.
  • Get a good night’s sleep. Sleep experts say most adults need between seven and nine hours of sleep each night to be their best.  Sleep difficulties can take a toll on your health and well-being, especially if they persist. According to the Division of Sleep Medicine at Harvard Medical School, people who are sleep-deprived are more likely to experience poor concentration and irritability, have accidents, and even suffer from depression.
  • Establish a bedtime routine. Even adults need a bedtime routine. By adopting a routine and then sticking with it, you can train your mind and body to feel relaxed and ready to fall asleep when you start the routine. A bedtime routine can be as simple as listening to soft music, drinking a cup of herbal tea, or taking a bath and then turning out the lights at the same time every night. If you watch TV before bed, try not to watch programs that are violent or make you think too much, as it may then be difficult to turn off your brain.
  • Learn some relaxation techniques. Deep breathing and meditation are two of the most widely used relaxation techniques. To do deep breathing, try inhaling as you count to five slowly, and exhaling as you reverse the count. It may also help to relax each part of their body in succession, starting with the right foot, right leg, right shoulder, right hand, and so on, back down the left side.
  • Express your emotions. Talking with a trusted friend or writing in a journal can help you release strong feelings instead of keeping them bottled up, which can lead to more stress.
  • Do things that make you feel good. Whether it’s going to a movie, spending time with a relative or friend, or going for a walk, it’s important that you schedule time to do things that you enjoy and make you feel good so that you can cope with the pressures that cause you stress.

Want more ideas? Visit (username: theaaa; password: lifeworks) and explore our wide range of wellbeing resources, from a new podcast, Losing Weight Together! to articles like Taking Care of Yourself, and Getting Past Obstacles to Personal Change. You can also practice some of the guided exercises in our new Mindfulness Toolkit to help reduce stress and improve focus and well-being.

Call LifeWorks at 888-267-8126 or visit (username: theaaa; password: lifeworks). 

Fasten Your Seatbelts for Paid Leave

Want to learn more?

Join Scott Moore for a 6o minute webinar on Managing Employee Leave.
December 7, 2016 at 2:00 PM EASTERN

A few days ago, something big happened in the State of New York that is going to have an enormous impact on employers.  The New York State Legislature finalized a budget that will increase the State Minimum Wage to $15.00 per hour, and will provide for paid Family and Medical Leave to all employees over the next few years.  While there are a few states in the country that currently provide for some form of paid leave, this is by far the most aggressive plan to phase in twelve weeks of paid leave to all employees by 2021.  This continues a trend that is sweeping the country to provide more paid leave to all employees.

Today, employers with 50 or more employees are already required to provide up to twelve weeks of job protected unpaid leave under the Family and Medical Leave Act (FMLA).  However, not all employees are eligible for that leave as they must have worked at least 1250 hours in the preceding twelve month period.  Under this new New York paid leave, both full and part time employees will be eligible for paid leave.

Employers currently struggle with administering FMLA and other forms of job protected leave as a 2007 Society for Human Resource Management (SHRM) study showed that more than half of the employer respondents reported having difficulty administering aspects of the leave including those who take intermittent leave.  Also, four out of ten HR professionals reported approving requests that they believed were illegitimate.  As more states require job protected paid leave, employer struggles will undoubtedly increase.

To learn more about what is happening in New York, read this New York Magazine article.  We will continue to monitor and report changes to the employment law landscape that may impact your organization so that you can prepare.  As always, be sure to utilize the Human Resources and other benefits available to you through the American Ambulance Association.

Is Your Ambulance Service Social Media Savvy?

I am frequently asked what my thoughts are regarding of social media in the workplace.  Not surprising given the popularity and saturation of social media by both employer and employee. Frequently these questions are framed as concerns by management of an employee posting content that places the company in a not-so-flattering light.  Either by criticizing the employer for the way they run the company or by posting inappropriate pictures or comments about patients.  In the early years of EMS, our concerns were generally limited to an employee’s care of our patients or their operation of our ambulances.  However, today social media has created additional exposures for employers that can have real legal and reputational consequences.

As social media has grown in popularity, employers have tried to address these concerns by drafting social media policies that restrict what the employee can post on-line.  Many of these policies were broad, prohibiting the employee from posting negative comments about their employer online.  In 2012, the National Labor Relations Board (NLRB) ruled that employer social media policies would violate the National Labor Relations Act (NLRA) “if the employee can reasonably construe the language (of the policy) to prohibit Section VII activity.” (Karl Knauz Motor, Inc. d/b/a Knauz BMW and Robert Becker. Case 13-CA-046452. September 28, 2012).  Section VII of the NLRA provides that “employees have the right to engage in concerted activities for the purpose of collective bargaining or other mutual aid or protection” (29 U.S.C. § 151-169).  In other words, employees have the right to discuss concerns and opinions about wages, benefits, and working conditions which would be shared by other employees.  Many felt the 2012 NLRB ruling was new law.  However, that the NLRB has simply applied the law that has existed for decades to this new technology.

So what does this mean for employers? If an employee posts a comment about the poor wages or working conditions at their service, this would be protected activity and an employer can do nothing about it.  However, employees cannot simply post anything they wish about their employer.  As the NLRB stated in the Knauz case, an employee’s “mere gripes” about work are not necessarily protected under the NLRA.  The difficulty for employers is determining when a comment is a “mere gripe” and when that gripe rises to the level of “concerted protected activity.”

To date, the NLRB has not defined a list of activities that would constitute “mere gripes”.  However, “concerted protected activity” is defined on the NLRB website as “when two or more employees take action for their mutual aid or protection regarding terms and conditions of employment.  A single employee may also engage in protected concerted activity if he or she is acting on the authority of other employees, bringing group complaints to the employer’s attention, trying to induce group action, or seeking to prepare for group action.”  Examples listed on the website include employees who are addressing issues surrounding pay, safety, and workplace conditions.  These examples are pretty broad and could include nearly all aspects of employment.

However, employers should know that there are several laws that restrict an employee’s right to post information or comments about their work on line.  For example, an employee cannot post personally identifying information about patients that were transported by their service.  Not only is this incredibly distasteful, this would violate the Health Insurance Portability and Accountability Act (HIPAA) which protects patient information.  Additionally, I would include prohibitions of photographs taken by employees on the scene of an emergency that they have responded to.  This poses numerous legal issues including, patient privacy, medical records control, and retention as a photograph taken by a medical provider during the treatment of a patient becomes part of the medical record and is required to be controlled and maintained by the ambulance service.

Additionally, employees do not have the right to post things that would be considered discriminatory, defamatory, or harassing about other employees.  Employees cannot post language that would be threatening or bullying towards coworkers.  If an employer has knowledge of harassing activity that is occurring by coworker through social media, they must act on it immediately.  Not only should your social media policy prohibit this behavior, any anti-harassment or bullying policies should include language addressing this as well.  It is also critical that your management staff, including supervisory personnel understand that they need to address this if it happens as often they are “linked” to line employees or field staff on several social media sites.

Also, employees do not have the right to violate confidentiality agreements as it relates to trade secrets or confidential information.  Aside from protected health information and potentially contractual arrangements, it is challenging to identify what might constitute a “trade secret” in our industry.  As a result, it is important for any policy prohibiting postings of this nature be narrowly drafted, specifically defining what constitutes a trade secret or confidential information.  Additionally, broad sweeping definitions or prohibitions on posting the company logo have been ruled illegal and must be avoided.

The best strategy is to create a culture of respect and professionalism in the workplace that welcomes employee involvement and constructive feedback.  While it is impossible to prevent all negative press, when employees feel that they have an outlet internally for workplace concerns they are far less likely to take their issue to the internet.  This will only occur when supervisors and managers understand the importance of soliciting honest employee feedback and learn to decipher the really important employment issues.  Equally important is to follow up on those employee concerns or suggestions.  The only thing worse than not soliciting employee feedback is asking for feedback or suggestions and never acting upon them.

Employers should manage their online image the same way they manage their overall company image.  Ensure that there are regular positive messages being broadcast in all media outlets about your company and the outstanding services your employees provide.  This way, when there is post that is unflattering, it will be overwhelmed by the positive messages.  Fortunately or unfortunately, the news cycle is so short these days that any positive or negative message about an employer gets moved off the front page pretty quickly.

Lastly, if an employee decides to post a comment that violates your carefully drafted social media or harassment policy, investigate the issue immediately, and discipline it consistently.  Often I find that employers ask employees to sign an acknowledgement stating that they have read and understand the company’s policies and procedures with the full knowledge that most employees don’t ever read them.  If your policies are supposed to be a resource to your employees on what the company expects from them and how you want them to perform their job, employers should place more emphasis on making sure that employees actually know and understand them.

Member Bonus Resource: Sample Social Media Policy

Download this sample Social Media Policy that I believe complies with all current NLRB rulings.  However, I would suggest that services consult with their company attorneys prior to implementation.  For those that have purchased the American Ambulance Association 2015 Human Resources Policies and Procedure Manual, this is an updated version of the Social Media Policy within that document.  As always, the American Ambulance Association is regularly monitoring the legal landscape to help ambulance services stay in compliance.




Choosing a Credit Card Processor for Your Ambulance Service

In the fast-paced life of an American Ambulance Association member, taking the time to evaluate credit card processing needs for can feel like a daunting task.  The idea alone is enough to make some emergency vehicle businesses stick with the same old merchant processor when, unbeknownst to them, they are likely losing out on value added services and low rates that could help their business grow. Here are a few tips for choosing a credit card processor for your organization that will enhance your business operations:

  • Understand Credit Card Processing 101

    Credit card processing can seem like a complicated industry, and while it’s true that payments aren’t always black and white, a quality payment processor will help you understand the gray area. Credit card processing is essentially the backend work that occurs every time your business runs a credit or debit card transaction. The first part of the transaction is known as authorization (getting approval from the bank for the transaction) and the second part is settlement (processing of the actual sale, in which funds are transferred from the issuing bank to the merchant account). What it boils down to is this: payment processing is the expansion of your commerce reach as a business, and having one is necessary to optimize your business’s growth. (MORE: Read AAA’s EMS Card Payment Processing Guide)

  • Make sure your processor is advocating for you and your business

    It’s no secret that finding a best-fit business solution for your business takes time and careful consideration. It’s likely that there are many players are involved in helping you make business decisions, so it’s important to have a merchant advocate when selecting a payment processor. A quality payment processor for your business will provide you with an analysis of your recent processing statements and pinpoint where you might be able to cut costs. Money saved on processing can in turn be invested into growing your business and expanding your client reach.

  • Find a processor with cutting-edge solutions

    Any business that accesses debit and credit cards for payment is equally affected by the threat of fraud. A credit card processor that is truly beneficial to your business will seek out the right value added services that can assist you in the fight against fraud. With the new EMV chip cards that are being circulated, it’s important to consider the need for a terminal that can accept all types of cards. Other services offered by the best processors include ACH processing, USB readers, mobile readers, and cloud-based solutions. As commerce rapidly adapts to today’s merchant and consumer needs, your business needs a processor that will offer these solutions and more.

Sticking with a processor that isn’t providing you with the support your business needs isn’t worth your time. To learn more about credit card processing solutions that can help your business grow, contact Steve Marshall at Payline.

Contact us today via email or by phone (800) 284-7401 and we would be glad to run a statement analysis to show you how you can save money and cut costs on processing fees for the betterment and growth of your business.

Share With Your Team: Substance Abuse Resources

Find out how AAA’s LifeWorks Employee Assistance Program, automatically covers all member organizations’ employees, can help your staff that is struggling with addiction.

Download our Substance Abuse PDF, then share electronically with employees. Articles covered include:

  • If You Suspect an Employee Has a Substance Abuse Problem
  • Recognizing a Substance Abuse Problem and What to Do
  • Drug and Alcohol Abuse: Warning Signs
  • Prescription Drug Abuse
  • Quick Facts About Alcohol Abuse
  • Support Groups for Family and Friends of Substance Abusers
  • What to Do If You Suspect a Co-Worker Has a Substance Abuse Problem
  • What is Reasonable Suspicion?
  • How to Help Someone Getting Past Resistance to Drug and Alcohol Treatment
  • Treating Addiction
  • How to Use the Employee Assistance Program
  • and many more!

Download Substance Abuse PDF

As always, you and your team can call our dedicated hotline, 1-800-929-0068, 24/7 to set appointments for FREE IN-PERSON COUNSELING in your area. Learn more on our AAA Employee Assistance Program page (membership required.)

FDA Issues First Responder Drug Dispenser Guidance

In accordance with the Drug Supply Chain Security Act of 2013, the FDA issued regulations last year to require drug dispensaries to build an electronic system to identify and track the distribution of drugs. Many small dispensaries do not have the ability currently to electronically trace small quantities of drugs. The AAA became concerned that hospital and other small dispensers would no longer provide first responders with critical drugs in fear of not being compliant with the new regulations. The AAA joined a coalition of dispensaries, pharmacists and others that also had concerns with the new regulations.

As a result of the efforts of the coalition and the AAA, we were able to delay enforcement of the requirements until today, March 1. The AAA then worked directly with the FDA to educate them about the unique nature that small dispensaries sometimes play in restocking certain ambulance service providers. Upon learning of these transactions, the FDA shared our concerns and worked quickly to release the guidance.

The guidance states that the FDA will not take action against drug dispensaries in providing drugs to first responders if the dispensary follows certain basic recording keeping policies. The agency will also not take any action against the first responder. The guidance is entitled “Requirements for Transactions with First Responders under Section 582 of the Federal Food, Drug, and Cosmetic Act — Compliance Policy Guidance for Industry“.

Performance Reviews, Feedback from the Court

One of the hottest debates in Human Resources is the efficacy or usefulness performing Annual Performance Evaluations on employees. For the most part, many employees feel that the process is not a true reflection of their performance. At many companies Performance Evaluations are months behind and when they are finally done, little effort is committed to the process to make it worthwhile. Despite this, almost every ambulance company has some form of performance evaluation process. However, a recent decision from the US Court of Appeals for the 1st Circuit has elevated the importance Performance Evaluations and should serve as an alert to employers to pay more attention to the process.

John Ray III was an eight year associate with the law firm Ropes & Gray in Boston in 2008 when the firm informed him that he would not be considered for partner and was given six months to find a new job. Ray filed charges with the Equal Employment Opportunity Commission alleging racial discrimination for not advancing him to partner. This past August the court found that Ropes & Gray had not illegally discriminated against Ray and that he had not been promoted to partner because of a clearly defined and consistently practiced process for advancing attorneys within the firm. One of the deciding pieces of evidence were his performance evaluations which were “predominantly negative” during the majority of his time with Ropes and Gray. These evaluations literally saved the employer hundreds of thousands of dollars.

[quote_right]For supervisory staff, it is very challenging to provide honest meaningful feedback for employees as they generally don’t actually see the employee working or multiple supervisors are responsible for a particular employee over the course of the week.[/quote_right]This decision places employers on notice that performance review documents will be examined and can be key in the sustainability of a discrimination case. In our industry, the Performance Review or Evaluation process is generally more challenging due to the nomadic nature of our employees. Our employees are constantly on the move and generally work very independently, making it difficult to observe actual performance. For supervisory staff, it is very challenging to provide honest meaningful feedback for employees as they generally don’t actually see the employee working or multiple supervisors are responsible for a particular employee over the course of the week. As a result, those tasked with completing the Performance Evaluation Forms will often make their best guess and do not seek feedback from all stakeholders. With another list of reviews coming every month, shortcuts are often taken.

So what should ambulance providers do? Providers need to evaluate their current Performance Review process to determine if it is working. Is the supervisor/manager that is completing the Performance Review the individual best suited to evaluate the employee’s performance? Is the Performance Evaluation Form actually designed to measure performance for the essential functions of the position? Are there objective benchmarks that all supervisors are using when evaluating a particular job function?

As with most things in employment practices, consistency is key. Every ambulance provider should provide training to individuals who conduct Performance Evaluations and should refresh that training annually. We often promote field personnel into supervisory roles and then do not provide them with the necessary training to perform certain aspects of that job. Performance management is no different.

During the supervisory training period, individuals should be educated on the entire performance management process, including how to compile performance data, how to interpret the information for utilization of the grading system, even how they should interact with the employee during actual Performance Evaluation. Providing feedback to employees is the single most important thing a supervisor or manager can do. Do not expect those skills to be innate in your new or existing management personnel.

Frequently, we in Human Resources are approached by a supervisor or manager that tells you that a particular employee’s performance is historically terrible and that they need to be terminated immediately. Only to find when inspecting their personnel record that there are several years of glowing performance evaluations. Imagine the message that a glowing performance evaluation sends to this problem employee. More importantly, what message does it send to the coworkers who he/she will undoubtedly tell?

I strongly recommend that the there be a real quality assessment plan for the performance evaluation process. If the message to supervisors is to “get them done” and there is very little focus on providing meaningful feedback to employees, then the goal will be frustrated and the process becomes useless. I suggest that the process include having someone, a manager or director, review the evaluation when it is turned in. The manager should review the evaluation for:

  • Completeness
  • Validation of the assessment grading
  • Variation in grading from category to category
  • Comparison to prior period evaluations
  • Employee input/comments
  • Employee Signature
  • Supervisor Signature

[quote_left]If there are internal inconsistencies within the performance evaluation or drastic changes in ratings from year to year, you should follow up with both the supervisor and the employee to figure out why that inconsistency exists.[/quote_left]If there are internal inconsistencies within the performance evaluation or drastic changes in ratings from year to year, you should follow up with both the supervisor and the employee to figure out why that inconsistency exists. I also suggest a message to the employee via email or, better yet, a letter to the employee’s home informing them that you appreciated their participation in the Performance Evaluation process and that a copy is being placed in their file. The letter should encourage feedback regarding the process, preferably in questionnaire format. is a great free product that any employer can use to solicit feedback and synthesize that feedback data.

Lastly, I often see a great emphasis placed on ensuring that the field or office staff receive regular performance evaluations. However, frequently the manager or supervisor conducting the evaluation has not received any formal performance feedback in years. Supervisors and managers are employees too and deserve regular performance feedback. Giving the manager or supervisor a thorough and considerate evaluation of their performance will serve as reinforcement of the importance of the process.

Have a question for HR and operations legal eagle Scott Moore? Submit it today!

Audit Alert! USCIS Form I9

One of the most commonly misunderstood compliance issues for any employer is the US Citizenship and Immigration Services (USCIS) Form I9. Form I9 is the document all US employers are required to have completed when hiring a new employee to assure that they are legally eligible to work in the United States. While there has been a reduction in Form I9 Audits from USCIS in 2015, employers should be prepared as the five year trend is on the rise. In fact, I am aware of several ambulance providers currently dealing with audits.

The Law

The Immigration Reform and Control Act (IRCA) of 1986 requires employers to examine documentation from each newly hired employee to prove his or her identity and eligibility to work in the United States. The IRCA led to the Form I-9 Employment Eligibility Verification, which requires employees to attest to their work eligibility, and employers to certify that the individual presented documents to the employer that appeared to for the individual and genuine. The form has very specific rules regarding when the certain section of the form must be completed, which documents the employee can proffer as proof of eligibility, and how information must be present in the different sections of the Form I9.

I believe that most employers understand that they must obtain certain information from every newly hired employee. However, with the Form I9, there are very specific dates upon which the different sections of this form must be completed. This is where the greatest number of compliance issues arise when dealing with I9 Audits.

The Form’s Timing

Section 1 of Form I9 is the Employee Information and Attestation section and must be completed by the employee by the close of business on the employee’s first day of employment. This section consists several mandatory fields of the personal information of the new employee and two optional fields. It includes the employee’s full name, date of birth, address, and social security number, email address (optional), telephone number (optional). In addition, the employee must attest that they are a citizen of United States, a Non-Citizen National, a Lawful Permanent Resident, or an Alien Authorized to Work in the US. The employee must provide an Alien Registration Number or USCIS Number if they check that they are a lawful permanent resident. If they are an Alien Authorized to Work, they must provide the date their authorization expires and their Alien Registration Number. The employee must sign the document and date it. If there is a translator or preparer, they must complete the certification at the end of Section 1.

Section 2 is the Employer or Authorized Representative Review and Verification section and must be completed by the close of business on the third day of employment. This section is where many make a very simple error. First, there is a place at the top of this section where the employer must list the employee’s full name. This frequently gets left blank. Next, the employer must identify the document(s) that the employee is presenting as proof of identity and employment authorization. In Column A, there is a list of acceptable documents, typically a Passport, Permanent Resident Card, or Employment Authorization Document. One or more of these documents can be sufficient. Alternatively, the employee can present one document from each List B and C. These are typically a driver’s license and a birth certificate. These documents don’t have to be copied, but if they are, they must be kept with the Form I9.

It is critical that the employer complete the Certification section of Section 2. This is another area where employers frequently make mistakes. In the Certification, there is a section to mark the date of the employee’s first day of employment. I often find this section blank or find that the employer mistakenly enters the date that they viewed the employee’s documents. The employer needs to complete the Certification section and date it, entering the employer’s business name and address. Failure to complete any of these sections can lead to a Substantive or Technical Violation and fines.

Section 3 of the Form I9 is completed by the employer when re-verifying that an employee is authorized to work or when rehiring an employee within three years of the date on the original Form I9. It is important that employer develop a mechanism for identifying and ensuring any expiring document(s) that requires re-verification. Of course, an employer can always complete a new Form I9 for a returning employee.


Title 8 of the Code of Federal Regulations Section 27a.10 established a fine range from $110 to $1,100 per violation. Fines can be for either a Technical violation, one where an employer fails to ensure that the employee provided all of the personal information, name, DOB, address, etc. or a Substantive violation, where the employer fails to review and verify the required documents or when someone is working without authorization. These fines can be issued for each individual violation and can be substantial.

Other common errors that carry fines include not documenting the title of the document that the employee presented as proof (example, US Passport, State Driver’s License and Social Security Card). Not initialing corrections made to the form when corrections are necessary. Not re-verifying those work authorization documents that require re-verification.


All of the fines are avoidable by ensuring that you clean up the Form I9 process within your organization. First, services should ensure that only individuals trained and knowledgeable in completing the Form I9 are involved in this process.  The USCIS provides great Form I9 training for free on their website. In addition, USCIS has great instructions that accompany the Form I9 and provide for video instruction on their website. Following these instructions carefully will be the best guarantee that you will complete the form correctly.

In addition, every ambulance service should conduct an audit of their Form I9 processes within their organization. I would have one individual, who is knowledgeable about the rules, conduct a review of all Form I9s for current employees and for any employees who were terminated within the last five years. Employers can purge any Form I9 documents for employees who are terminated after one year from termination or three years after the date of hire, whichever date is later. However, employers should have Form I9 documents on all employees who are currently on your payroll.

For purposes of record keeping, it is best to keep all Form I9s in one location so that they can be easily provided in the event of an audit. Employers are not required to make copies of the documents an employee provides to the employer as proof of authorization. However, if the employer does copy the documents, they should be kept with the Form I9. I recommend employers make copies of those documents, store them with the Form I9, and be kept in a secure location. If those documents are stored electronically, it is critical that there are sufficient systems in place to ensure the integrity and security of the documents including an electronic audit trail.

Many employers utilize e-Verify, the online system hosted by the USCIS in partnership with Social Security Administration (SSA) that allows employers to search the linked federal databases to ensure that employees are eligible to work in the US and verifies the employee’s Social Security Number. e-Verify is free to employers and is voluntary throughout the country. However, you should check you state law as many states have passed legislation requiring the use of e-Verify. It is easy to enroll and is a necessary part of any I9 compliance plan.

I can tell you that all of the providers that I have questioned about this issue assured me that they have adequate processes in place to ensure compliance. However, after we discussed the timing and information required for the different sections of the Form I9 that were identified in many of the audits I am aware of, it quickly became apparent that most did not really have safeguards in place.

VIDEO: AAA Experts in Reimbursement, Regulations, Human Resources, Operations

Did you know that your AAA membership includes access to some of the top minds in the ambulance industry today? As the healthcare landscape becomes ever more complex, it’s nice to know you have experts on your side.

Watch the video below to learn more about the attorney-consultants that AAA retains in order to ensure our member organizations are ahead of the curve on human resource, reimbursement, legislative, and regulatory issues.

Attention, AAA Members!
Have a question? Submit it to our experts today!
Ask a reimbursement or Medicare question.
Ask a human resources or operations question.

Not yet a member? Join today to gain access to AAA experts, plus a wealth of other powerful member benefits.

Savvik 10 Minute, 10 Item, 10% Savings Challenge

Savvik Buying Group, formerly North Central EMS Cooperative, is offering AAA members the opportunity to save even more on their first orders for Henry Schein medical supplies. Read below to learn more!


Give Savvik 10 items and 10 minutes of your time, and we will help you save money!
Pick the 10 med supply items that you use the most and we will share with you our Savvik national contract price. We will do all of the comparison work! We will even give you an extra 10% discount* on top of our already low contract price on your first order with our medical supplies provider Henry Schein. No minimum purchase requirement, no long term commitment, no freight charges orders of $150.00 or more.

Start the new year saving money!

Email Savvik Your Top 10 Items!

Good for new Henry Schein customers only thru January 31st 2016. *10% discount offer on first orders not to exceed an order total of $10,000.

10 Safety Topics that Will Move EMS Forward in 2016

What are your ambulance services’s safety priorities for 2016? AAA member The Center for Patient Safety has just released 10 Safety Topics that Will Move EMS Forward in 2016, a free download covering:

  • Airway Management
  • Behavior Health Encounters
  • Crashes: Ambulance and Helicopter
  • Device Failures
  • Medication Errors
  • Mobile Integrated Healthcare
  • Pediatric Patients
  • Safety Culture
  • Second Victim Intervention
  • Transition of Care

Get your copy today to learn how to ensure safety for your employees and patients.

Download Now

Savvik: Save on Vehicles, Supplies, and More!

Did you know that your service may be overpaying for everything from new ambulances to computers to staplers?
If you are not already purchasing necessities through the American Ambulance Association’s partnership with Savvik Buying Group, you’re missing out on deeply discounted group purchasing savings.

Watch our video below to learn more from Savvik President and AAA Treasurer Aarron Reinert.


[styled_box title=”Get Started With Savvik” footer=”” icon=”” class=”panel-default”]AAA members, start saving now!

Not yet a member of the AAA? Join today and start saving tomorrow.[/styled_box]

Win for Employers with H.R. 2029, Consolidated Appropriations Act, 2016

On December 18, 2015 President Obama signed into law H.R. 2029, The Consolidated Appropriations Act, 2016, which is a nearly $2 trillion budget deal covering government funding and taxes.  This law provides some relief to employers who offer employer-sponsored health plans from two key provisions of Affordable Care Act (ACA).  The ACA has been one of the most contentious political issues during the Obama administration as its impact on employers is significant.

The first key change effect the “Cadillac Tax”.  The Cadillac Tax is a non-deductible 40% excise tax that applies to the cost of employer-sponsored health coverage whose value exceeds the prescribed thresholds of $10,200 for individual coverage and $27,500 for family coverage.  These thresholds which were established in 2010 were supposed to be implemented starting in 2018.  The purpose of this tax was threefold:

This tax was expected to raise $1.7 billion in 2018.

One of the major criticisms of the Cadillac Tax is that it is indexed to inflation.  Health care expenditures increase at a higher rate than inflation.  As a result, this will cause more employer plans to be subject to the tax over time.  It is predicted that this tax will cause more employers to decrease benefits under their plan in an effort to avoid being subject to the tax.  In turn, this will cause employees to shoulder more of the burden of healthcare costs through increased deductibles and copays, as more employer sponsored plans become consumer-driven health plans.

Under the law signed by President Obama on December 18, 2015, the implementation of the Cadillac Tax has been delayed until 2020.  Also, the 40% tax that was initially not tax-deductible has been changed to tax-deductible permanently.  An additional change under this law will require the commission of a study by the Comptroller of the United States, in consultation with the National Association of Insurance Commissioners.  This study will determine the suitability of the current use of the premium cost of Federal Blue Cross/Blue Shield standard benefit as a benchmark for the age and gender adjustments of the applicable dollar limit with respect to the tax on high cost plans under the Internal Revenue Code. This is an adjustment to the upper dollars limits for the employer’s plan that can be made if a specific employer’s workforce differs from the characteristics of the national workforce.  This study may lead to other possible changes to the thresholds for the Cadillac Tax in the future.

The second change doesn’t directly impact employers, but does indirectly effect employer plan costs.  The new law eliminates the Health Insurer Fee for 2017.  The Health Insurer Fee, which began in 2014, is a fee charged to health insurance carriers based on the insurance premiums they collect on from their share of the market.  This fee in 2014 was approximately $8 billion, and was projected to increase to $13.9 billion in 2017.  While not directed at employers, it is believed that this fee is being passed down to the purchasers of health insurance through increased premiums.  While this fee is being eliminated for 2017, that is temporary and is currently set to return the following year unless other measures are passed.

These changes will shift the impacts of these two provisions until after the next Presidential election in November 2016.  Dependent upon what occurs in the next election, there will likely be other changes to the ACA for employers and employees to contend with.  As always, the American Ambulance Association will continue to monitor the political atmosphere to ensure that you are informed and prepared.


ACA Filing Deadline Extension

In Fall 2015, we alerted you to a deadline for a new employer filings under the Affordable Care Act.  On December 28, 2015 the IRS extended the deadline to furnish and file the required forms for all required filers. The new deadlines are:

  • March 31, 2016, to deliver the 2015 Forms 1095-C to affected employees;
  • May 31, 2016, to manually file the 2015 Forms 1094-C and 1095-C with the IRS — for employers who’re eligible for paper filing; and
  • June 30, 2016, to electronically file the 2015 Forms 1094-C and 1095-C with the IRS.

According to the IRS this is a one-time filing extension and will not be further extended.   This will give employers and payroll companies additional time to prepare for this new requirement.  If you fail to make the required filings by these extended deadlines, you will be subject to penalties.  If you have not yet determined how you will prepare for this deadline, you should be contacting your payroll service or benefits broker for assistance.

As always, the American Ambulance Association can assist you with any ACA questions.

Active Shooter/Violence Resources for EMS

Updated December 22, 2015

In the sad wake of many recent mass shooting incidents, the AAA wants to ensure you and your team have all of the best information possible about handling these scenarios.

Are there other resources you use with your team to prepare for active shooters? Please share with us in the comments and we will augment this list. Thank you, and stay safe!

Preventing and Surviving Violence

Recovering from Active Shooter Incidents


Special thanks to Scott Moore of EMS Resource Advisors, Steve Delahousey of AMR, Aarron Reinert of Lakes Region EMS, John Peterson of Sunstar Paramedics, and Christopher Eisenhardt of Pinellas County Sheriff’s Office SWAT Team for their assistance.

Spotlight: Randy Strozyk

Randy Strozyk
Tukwila, WA, USA
Senior Vice President of Operations, American Medical Response (AMR)
Secretary, AAA Board of Directors
Randy’s LinkedIn Profile

Tell us a little about yourself, please.

My life-long automobile obsession continues, but that’s old news. Something people may not know about me is that I’m a relatively new and incredibly proud grandfather. My grandson, Samuel, was born in April 2014. Samuel’s parents are brilliant—our son, Terrell, is an attorney and the deputy director of the Oregon insurance commission; Sophie, our daughter-in-law, is Taiwanese and took her final exam for her MBA just a few days before Samuel was born (despite being dilated and having some minor contractions, she aced the test)—so we assume Samuel will develop a cure for cancer, broker peace in the Middle East or do something else to change the world. Samuel is learning English and Taiwanese, which means that when he goes through his awful adolescence period, he’ll be able to hurl insults at me in a language I don’t understand.

My wife, Karma, and I are excited to meet our second grandchild—Samuel’s cousin, and the first child of our other son, Todd, and his lovely wife, Julie—in November. I don’t expect my granddaughter to be speaking a language I don’t understand before she’s potty-trained, but stranger things have happened. What I do know is that this baby is going to have Grandpa wrapped around her little finger in no time.

Our youngest child, Erin, just got married to a great guy, Keith, this summer. No kids in that household, but they have four-legged babies and a shared passion for helping the underprivileged by expanding access to affordable, reliable solar energy.

Our children are unique, interesting and, with six degrees between the three of them, highly learned individuals. I couldn’t be prouder of my family.

How did you come to work in the industry? How long have you been involved?

Becoming a paramedic and healthcare executive wasn’t my initial game plan, but I was bitten by the EMS bug. I had the chance to ride out with ambulance crews as a medical explorer scout in high school. I enjoyed the medicine and quick pace, so I earned my EMT certification while studying microbiology at Washington State University and worked on the ambulance during the summers before my junior and senior years. After earning my bachelor’s degree, I went to paramedic school. I planned to do it for only a short while. That was back when the Phillies were a championship baseball team and the only Madonna anyone had heard of wore a serene expression and hung out in mangers. Nearly 36 years later, I’m still here.

What do you enjoy most about your job?

Over the past 15 years at AMR, I’ve had the opportunity to work on many different projects. In the course of a single month, you might find me in Oklahoma at EMSA, in Denver at our National Resource Center and AMR-Air headquarters, in Washington on AAA business and in Hawaii with our air operation there. I love seeing how EMS functions across the country. I won’t say that I’ve “seen it all” just yet, but if there’s something I don’t know, there’s someone I know with an answer.

What is your biggest professional challenge?

Some people may think that the biggest challenges I’ve faced have to do with specific tough projects or some of the legendary personalities I’ve worked with or for over the past 36 years. But I’d say the biggest challenge for me—and probably for others—is more internalized. People with deep experience in one field have to work at remaining enthusiastic and engaged. We can’t become attenuated to our circumstances and accept “that’s how it’s always been” as acceptable answers. EMS is a dynamic industry. Many of the tools and techniques that were considered cutting-edge when I first started in the business have already gone the way of the dinosaurs; likewise, the next generation of paramedics are going to look at some of the things we’re doing now with utter disbelief. To remain relevant, leaders must stay informed and be open to new opportunities and alternative viewpoints.

What is your typical day like?

There is no “typical” day in my world. I might be in Oklahoma working with our operations team at EMSA, in Denver at our corporate headquarters or working with the AMR-Air folks, or in any number of other places. No two days are the same.

How has participation in AAA membership and advocacy helped your organization?

AMR has been a part of the American Ambulance Association since the beginning. Involvement—not just paying dues to have a name on the membership roll, but serving on committees, attending meetings and being part of the conversation—provides a platform for professional networking and shared learning. It gives us a chance to uncover about new solutions, hear different perspectives and see the big picture.