VTS STANDARD OPERATING PROCEDURE.pdf

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

VTS

STANDARD OPERATING PROCEDURE

1. PURPOSE: To establish definitions, guidelines, and procedures for the daily operations of the VTS (Veterans Transportation Service) at the James J. Peters VA Medical Center.

A. Program objectives are:

1. Provide Veterans with convenient and timely access to transportation services and overcome access barriers to increase transportation resources and options for all Veterans.

2. Apply transportation best practices/strong practices.

3. Support facility and VISN leadership VTS objectives.

4. Establish Driver training standards and requirements

5. Establish Driver duties, responsibilities, and responsibilities.

2. POLICY: It is the policy of the James J. Peters VAMC that VTS will safely transport

Veterans to and from their scheduled VAMC or CBOC (Community Based Outpatient Clinics) appointments and discharge and appointment outside community using all available resources to improve mobility, improve efficiencies, and reduce cost at the JJPVAMC. Transportation

Coordinator or Mobility Manager will use Veterans eligibility and location to properly match

Veteran with best modes of transportation (DAV, VTS, Wheelchair bus, Ambulance, Public

Transportation, Access-A-Ride etc.…). Improve the quality of life for veterans by increasing access to health care through integrated and cost-effective transportation solutions.

3. RESPONSIBILITIES:

A. Business Office Manager has overall responsibility for oversight of and compliance with this SOP.

B. Mobility Manager: The MM, (Mobility Manager), is responsible for the overall management and accountability of the entire program. The Mobility Manager’s duties include:

• Direct supervision of all VTS Staff including Drivers, Escorts, and Coordinators.

• Recording and reporting all VTS Board of Directors meetings.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

• Provide training and keep updated personnel records on all VTS Staff.

• Develop educational programs such as rider training materials, travel trainer program and community forums.

• Develop new ways to remove barriers for transportation to VA Medical Facilities.

Maintain communication with appropriate local, state, and federal agencies, as well as private interest.

• Make presentations to and attend meetings of a variety of groups, cities, counties, organizations, boards and committees with passenger transportation links to promote coordination amongst agencies.

• The incumbent must be familiar with time keeping procedures, both manual and electronic and pay regulations governing title 5 employees. The incumbent must be able to identify, analyze and resolve time keeping and special pay issues as these arise.

• Responsible for leave administration, incentive awards programs, motivation and morale, administrative disciplinary actions, recruitment and placement, position management and classification, preparing position descriptions, overseeing semiannual and annual evaluations, counseling employees whose performance is marginal or unsatisfactory and implementing continuing education activities.

• The incumbent serves as the authorizing official for the Veteran Transportation Service and Beneficiary Travel fund control points. The incumbent monitors, audits, reconciles and administers all accounts, including annual equipment inventory and authorizes expenditures for supplies and schedule maintenance of all assigned Vehicles to the VTS program. The incumbent collaborates with the Business Office Section Chief to project budget requirements.

C. Voluntary Service Manager is responsible for overall coordination of the VTN/VTS.

Voluntary Service arranges for screening, processing, orientation, training, and assigning of new VTN/VTS volunteers, as well as and gives final approval for dismissal when deemed necessary. Volunteer Service Manager will work with an assigned board of directors to provide direction to the VTS program.

1. Directs the VTS program in accordance with (IAW) the VTS guidebook.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

2. Provides and monitors training requirements for VTS vehicle operators.

3. Provides administrative oversight and operational control for VTS vehicle operators.

4. Take actions crucial to the VTS daily business operations with emphasis on arranging accurate and timely movement of VA patients.

5. Performs data analysis, reports, and tracks data.

6. Interacts with patients, family members, coworkers, volunteers, and management in a professional manner contributing to the effective operation of the VTS program and organization.

5. PROCEDURES:

A. RESERVATION PROCEDURE

1. Veteran or provider calls the TC (Transportation Coordinator) or MM for a reservation or schedule transportation for Veteran. Beneficiary Travel Consult must be completed on CPRS for all veterans before requiring Special Mode Travel can be provided.

2 Eligibility for VTS transportation the Veteran must meet the following criteria:

a. Traveling in connection for treatment of any service-connected disability

b. 30% or more service-connected traveling for any treatment

c. Receives VA pension benefits

d. Traveling to VA for a C&P Exam

e. Under the threshold income

f. Needs Special Mode Transportation

g. Veterans not eligible will receive Temporary services under special

Circumstances approved by Mobility Manager for 6 weeks with the coordination of the SW. ex Access-A-Ride, DAV.

3. The TC or MM or completes a VTS Call Screening Checklist by asking for the following information:

h. Veterans Name and last 4 digits of the Social Security Number

i. Appointment Date and Time

j. Location of Appointment

k. Pick-up location of Veteran

l. How does the Veteran get transported normally

m. Can Veteran stand and walk by themselves

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

n. Is the Veteran in a wheelchair or motor scooter.

o. Does the Veteran need an aid?

p. Phone Number to return Unit or patient calls

4. The TC or MM takes all of this information and does the following:

q. Access CPRS for travel consult and/or VISTA

r. Verify Veterans personal information

s. Verify Veterans appointment date and time

t. Determine type of Bene Travel eligibility (30% - 100% SC Disability, Appointment is for SC disability, VA Pension, Traveling for C&P Exam, etc.…)

u. Use Veterans eligibility and location to properly match Veteran with best modes of transportation (DAV, VTS, Wheelchair bus, Ambulance, Public

Transportation, etc.…)

v. Once patient is verified load veteran for scheduling purposes in the Vet-Ride program.

5. The Transportation Coordinator or Mobility Manager will contact each Veteran to be transported 24 hours in advance to ensure proper directions, time and place of pick-up and drop-off, to ensure Veteran is still in need of transportation to their appointment.

6. Every day at 3:30 PM the TC or MM must prepare and send an e-mail containing all

VTS Passengers to the BT Department to ensure none of the passengers try to receive travel pay.

7. TC or MM will hand off transportation operations to the HAC. The TC or MM will continue to close out all the VTS or third party contracted runs in Vet-ride and complete the new pick-up schedule for the VTS drivers and Third party contracted services.

B. TRANSPORTATION PROCEDURE

1. The Transportation Coordinator (TC) or Mobility Manager (MM) assigns the drivers a vehicle and update the Vet ride program with Passenger List on each driver tablet with directions to every pick-up and drop-off location.

2. The Transportation Coordinator (TC) or Mobility Manager (MM) assigns the third party contracted service with a Passenger List of patients they have assign with directions and times to every pick-up and drop-off location.

3. Third party Contracted service will have Access to the VetRide program to close, update transportation requests during afterhours, Holidays and weekends and to submit their monthly bill for review purposes.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

4. The Drivers perform a Pre-trip inspection every morning on their assigned vehicle and completes the Pre-Trip Inspection Form.

5. Once the vehicle is cleared to operate, the driver proceeds to his destination. When arriving at the first location the driver ensures the van is correctly parked, (if an MOU is established), picks-up the passenger, and ensures they are seated and properly wearing a seatbelt. The driver then records the passenger’s information required on the VTS Passenger List to be turned in to the TC or MM at end of the day. The driver will then call the TC or MM and verify ALL passengers are boarded in the vehicle.

6. Drivers must screen all Veterans when boarding to identify any potentially hazardous materials or objects. If any hazardous materials are found a request will be made to the

Veteran to leave the object with the driver until you arrive at your destination or leave it at the current location. It is up to the Drivers discretion as to what materials are considered hazardous to others.

C. VTS DRIVERS ARE RESPONSIBLE

Attachment 1 – Vehicle Operator Training (per VHA DIRECTIVE 2008-020)

A. All drivers must meet the minimum VA and VHA medical requirements for the operation of vehicles. Medical evaluations of motor vehicle operators and incidental operators must be conducted in accordance with VA Handbook 5019, Part IV, Appendix B.

B. Program Training - Program training is to be conducted as follows:

1. All drivers transporting patients shall receive initial basic safe driver training and annual refresher to include defensive driving techniques, use of safety belts, medical center policy, patient safety and emergency response procedures.

2. VTP, contractors and incidental operators must receive training on basic first aid, cardiopulmonary resuscitation (CPR), blood borne pathogens, and the use of personal protective equipment. Training for DAV volunteer drivers must comply with VHA Handbook 1620.02. (May 24, 2007)

3. VTP drivers shall be trained in methods for securing patients including use of wheelchair lifts, restraint systems and other assistive devices during transportation. Driver training may only address the specific equipment of the

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019 assigned vehicle. As an example, only drivers assigned to vehicles with wheel chair lifts are required to complete lift operation training.

4. Drivers transporting Department of Transportation (DOT) Division 6.2 substances with patients must be informed of the presence of the hazardous material

(including whether the package contains a reportable quantity) and must be informed of the requirements of DOT 49 CFR 173.6.

5. Drivers and patient escort staff must receive training to address specific patient condition and response actions.

C. Vehicle Use, Inspection, and Equipment. Vehicles must be used, inspected, and equipped as follows:

1. Personal (privately-owned) vehicles will not be used for the transport of patients.

2. Operation of GSA vehicles must comply with GSA vehicle inspection, accident reporting, and driver verification requirements. NOTE: Staff are to be encouraged to have their own private insurance when driving Government–owned vehicles.

3. Each driver must enforce the use of seat belts by all vehicle occupants.

4. At no time will a patient be left unattended while in a vehicle.

5. Drivers must lock the vehicle when not in use.

6. Drivers must not leave a vehicle running and unattended.

7. Drivers are responsible for ensuring all equipment and cargo is secured prior to driving of vehicles. All patient support equipment, wheelchairs and supplies shall be fully secured to the vehicle body during transport (lock to body or tie downs).

8. All government-owned, volunteer-driven, and contract vehicles used for the transport of patients must contain emergency roadside and communication equipment.

9. Communication equipment must be isolated from the engine battery.

a. Cellular phones and two-way radios are acceptable communication equipment.

b. Contract vehicles must be furnished with communication equipment by the contractor.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

c. Government-owned, volunteer-driven vehicles are furnished communication equipment by the facility.

10. Fire extinguishers must be inspected and maintained in accordance with National

Fire Protection Association (NFPA) Standard 10 and secured to the vehicle body.

11. Wheelchairs must face forward during transit, when feasible. Wheelchair occupant restraint systems must be integrated by the manufacturer or approved by the manufacturer for use. The use of vehicles with wheelchair lift systems or vehicle retrofit must comply with DOT 49 CFR 571.404, Platform Lift

Installations in Motor Vehicles.

12. Personal protective equipment (gloves) and spill kits must be provided to drivers to ensure they are adequately prepared to address biological fluids.

D. The transfer of clinical specimens with patient passengers must comply with DOT and

OSHA regulations.

1. Clinical staff giving specimens to drivers transporting patients must ensure compliance with the specimen identification, packing and labeling requirements of OSHA 29 CFR 1910.1030, Blood borne Pathogens and the Material of Trade

(MOT) exception for Class 6, Division 6.2 substances of DOT 49 CFR 173.134.

2. All specimen packages shall be packed in a container secured to the vehicle body to prevent movement during driving.

E. Accident and Injury Reporting. Accidents and injuries must be reported as follows:

1. All patient transportation vehicle accidents and injury data are to be reported to the facility Accident Review Board and Patient Safety Manager using VA Form

2162, Report of Accident.

2. The facility Director, or designee, must notify the VISN Director, Union representative, and OSHA regional office upon verification of vehicle fatality or hospitalization of three or more employees.

3. Patient injury reporting and investigation must conform to VHA Handbook

1050.1 (dated March 4, 2011, review March 2016).

4. Accident data involving transportation contractors must be reported to the

Contracting Officer.

5. Accident data for volunteer drivers must be reported as required by VHA

Handbook 1620.02.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

6. All motor vehicle accidents must be documented on GSA Standard Form 91, Vehicle Accident Report.

7. All patient transportation vehicle accidents for the fiscal year must be entered by the Transportation Program Manager, or designee, Current electronic Patient

Safety Reporting Tool System.

F. Patient Safety. Patient safety must be provided as follows:

1. A policy requiring patient seat belt use, patient lifts, and security of patient care equipment must be implemented.

2. Procedures identifying the Medical Officer, Registered Nurse, or designee as responsible for patient assessment, healthcare requirements, and determination of escort level required for safe transportation, must be developed and implemented.

3. Clinical staff responsible for management of patient condition and behavior must be available during transit.

4. Investigation and reporting of patient adverse events or close calls must conform to VHA Handbook 1050.1.

5. Consideration must be given to potentially aggressive patients, as to vehicle type and seating configuration. Potentially aggressive patients are not to be seated behind the driver; a specialized contract or VA-retrofitted vehicles may be required.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

Attachment 2 – Vehicle Operator Briefing Acknowledgement

Items below have been briefed to: _________________________________. Print name, sign and date below list of briefed items acknowledging you have read items and verbally briefed on items:

A. When entering and exiting the Veterans Transportation Services 14/15 pax Vans, to observe the head clearance and take proper precautions not to hit your head. This is especially true when entering the Van. The Van body overhang is in such a position the driver can bump their head when stepping up and in to driver’s seat.

B. Things You Must NOT Do:

1. Do not smoke at any time when in the vehicle.

2. Do not operate a cell phone when operating the vehicle.

3. Do not drive a motor vehicle while using a wireless communications device to write, send, or read text-based communications.

4. Do not wear a headset or earplugs in both ears while driving.

5. Do not drive a vehicle so loaded, either with property or people, that you cannot control it, or see ahead or to the sides of your vehicle.

6. Do not allow anyone to ride on any part of your vehicle not intended for passengers.

7. Do not leave a “service” animal unattended in a hot vehicle.

8. Do not wear eyeglasses with temples wide enough to keep you from seeing clearly to the sides.

9. Do not honk your horn unless it is a safety warning to avoid a collision.

10. If playing a movie on the DVD player ensure the movie played is not objectionable to any passenger. Under no circumstance will pornography movies be played.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

C. Things You Must Do:

1. You must drive as far to the right as reasonably possible on narrow mountain roads. If you cannot see at least 200 feet ahead, honk your horn.

2. You must use your headlights 30 minutes after sunset and leave them on until 30 minutes before sunrise.

3. You must dim your lights to low beams within 500 feet of a vehicle coming toward you or within 300 feet of a vehicle you are following.

4. You must turn on your headlights if snow, rain, fog, dust, or low visibility

(1,000 feet or less) requires the use of windshield wipers.

5. If you are involved in a vehicle accident, you must utilize the GSA MOTOR

VEHICLE ACCIDENT REPORTING KIT located in the driver’s vehicle binder.

6. Prior to initial operation of any government vehicle the driver must utilize the

OPERATOR’S INSPECTION GUIDE AND TROUBLE REPORT. Driver must sign this report clearly and legibly in the appropriate day block. This Form is a legal document.

a. If any SAFETY discrepancies are found, the vehicle is NOT to be driven

b. Notify VTP mobility manager as soon as possible

7. Wheel chair passengers must be secured properly.

8. All VTP vehicle operators acknowledge they have read Executive Order 13043 by signing they have reviewed the contents of each vehicle binder. (Order is available for review in vehicle binder).

9. At the end of each VTS driver shift, Keys, Ezpass, and all issued equipment must be returned to the transportation office for storage and safe keeping.

D. Good Vision for All Drivers:

1. You need good vision to drive safely. If you cannot see clearly, you cannot judge distances or spot trouble, and you will not be able to make the best judgments.

You also need to see peripherally or "out of the corner of your eye" to spot cars coming up beside you while your eyes are on the road ahead.

2. You may see clearly and still not be able to judge distances. You need good distance judgment, so you know how far you are from other cars. Many people who may see clearly in the daytime have trouble seeing clearly at night. Some

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019 people see poorly in dim light. Others may have trouble with the glare of headlights.

3. Have your eyes checked every year or two. You may never know about poor peripheral vision or poor distance judgment, unless you have your eyes checked by a healthcare professional.

E. Hearing:

1. Hearing is more important to driving than many people realize. The sound of horns, a siren, or screeching tires can warn you of danger. Sometimes you can hear a vehicle but cannot see it, especially if it is in your blind spots.

2. Even people with good hearing cannot hear well if the radio or CD player is blaring. Do not wear a headset or earplugs in both ears while driving; it is against the law.

3. Hearing problems, like bad eyesight, can come on so slowly that you do not notice them. Have your hearing checked periodically. Drivers that are deaf or hearing-impaired can adjust their driver safety habits by relying more on their seeing sense and therefore, compensate for the loss of hearing.

F. Alertness:

1. When you are tired, you are less alert. The body naturally wants to sleep at night.

Most drivers are less alert at night, especially after midnight. You may not see hazards as soon or react as quickly as when you are rested and alert; so, your chances of having a crash may be greater. If you are sleepy, the only safe response is to get off the road and get some sleep.

2. To keep from becoming tired on a long trip:

a. Get a normal night’s sleep before you start on your trip.

b. Do not take any drugs that can make you drowsy.

c. Do not drive long hours; try not to drive late at night.

d. Take regular rest stops even if you are not tired.

e. Keep shifting your eyes from one part of the road to another. Look at objects near and far, left and right.

f. Try chewing gum or singing along with the radio/CD.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

g. Roll your window down to get some fresh air.

G. Medications:

1. Remember that all medications, prescription or over-the-counter, are potentially dangerous and can impair your driving. Over-the-counter medicines that you take for colds and allergies can make you drowsy and affect your driving ability. If you must take medication before driving, find out the effects of the medication from your physician or pharmacist. It is your responsibility to know the effects of the medications you take.

2. Before you drive, do not:

a. Mix medications, unless directed by your physician.

b. Take medications prescribed for someone else.

c. Mix alcohol with your medications (prescribed or over-the-counter).

H. Hot Weather Risks:

1. After sitting in the sun, with even a slightly opened window, the temperature can rise rapidly inside a parked vehicle. The temperature inside a vehicle can rise approximately 40-50 degrees higher than the outside temperature.

2. Dehydration, heat stroke, and death can result from overexposure to the heat.

Remember if it’s too hot for you, it’s too hot for your passengers.

I. Health and Emotions:

1. Your personality affects the way you drive. Do not let your emotions interfere with safe driving. Use all of your good judgment, common sense, and courtesy when you drive. Follow all the recommended safe driving rules.

2. Notify the VTP Mobility Manager if you develop a condition that might affect your ability to drive safely.

J. Safety Tips:

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

1. If your vehicle becomes disabled on the freeway:

a. Safely pull to the right shoulder and ideally park in an area with good cell phone reception.

b. If you must exit the vehicle, exit on the right side of your vehicle, away from traffic.

c. Once you arrange for assistance, stay inside your vehicle with the seatbelts on until help arrives.

2. In certain circumstances (when there is not enough shoulder space or if there is a guard rail or an area to safely stay away from the freeway lanes), exit your vehicle and stay away from your vehicle. Use your emergency blinking lights at your discretion according to weather conditions. The lights may be helpful, but they could also attract drunk drivers.

K. Vehicle Theft Prevention Tips:

1. Never leave:

a. Your vehicle running and unattended even to dash into a store.

b. The keys in the ignition.

c. Keys inside a locked garage or a hide-a-key box.

d. Valuables such as purses, laptops, etc., in plain view even if your vehicle is locked. Place them out of sight.

e. Personal identification documents, such as the ownership title or credit cards in the vehicle.

2. Always:

a. Roll up your windows and lock your vehicle.

b. Park in high-traffic, well-lighted areas whenever possible.

L. What a Driver Should Do During an Enforcement Stop:

1. Acknowledge the officer’s presence by turning on your right turn signal.

Activating your signal lets the officer know that you recognize his or her presence. An officer may become alarmed if you fail to recognize him or her, and

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019 might perceive that you have a reason to avoid yielding or that you might be impaired.

2. Move your vehicle to the right shoulder of the road. The officer will guide you using his or her patrol vehicle. Do not move onto the center median. Do not stop in the center median of a freeway or on the opposite side of a two-lane roadway.

This place both the driver and the officer in danger of being hit by oncoming traffic.

3. On a freeway, move completely onto the right shoulder, even if you’re in the carpool lane. Stop in well-lit areas when possible. Pull your vehicle as far off the roadway as possible. When it is dark; look for locations that have more light such as areas with street or freeway lights, near restaurants, or service stations.

4. If you are using your cell phone to contact VTP and the police officer approaches, end your cell phone conversation. The officer needs your full attention to communicate with you to complete the enforcement stop in the least amount of time needed.

5. Remain inside your vehicle unless otherwise directed by the officer. Never step out of your vehicle, unless an officer directs you to do so. During an enforcement stop, the officer’s priorities are your safety, the safety of your passengers, and the officer’s own personal safety. In most situations, the safest place for you and your passengers is inside your vehicle. Exiting your vehicle without first being directed by an officer can increase the risk of being struck by a passing vehicle and/or increase the officer’s level of feeling threatened.

6. Place your hands in clear view, including all passengers’ hands such as on the steering wheel, on top of your lap, etc. During an enforcement stop, an officer’s inability to see the hands of the driver and all occupants in the vehicle increases the officer’s level of feeling threatened. Most violent criminal acts against a law enforcement officer occur through the use of a person’s hands, such as the use of a firearm, sharp object, etc.

M. Alcohol/Drugs while Driving:

1. Alcohol/Drugs and Driving Is Dangerous. Alcohol and/or drugs impair your judgment. Impaired judgment or good sense affects how you react to sounds and what you see.

2. Much of what has been said about alcohol also applies to drugs. New York drunk driving law is also a drug driving law. It refers to "driving under the influence of

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019 alcohol and/or drugs." If an officer suspects that you are under the influence of drugs, the officer can legally require you to take a blood or urine test. Drivers who refuse these tests are subject to longer driver license suspensions and revocations.

3. The use of any drug (the law does not distinguish between prescription, over-the-counter, or illegal drugs) which impairs your ability to drive safely is illegal.

Check with your physician or pharmacist and read the warning label if you are not sure that taking the medication will affect your driving.

4. Here are some facts:

a. Most drugs taken for colds, hay fever, allergy, or to calm nerves or muscles can make a person drowsy.

b. Medicines taken together or used with alcohol can be dangerous. Many drugs have unexpected side effects when taken with alcohol.

c. Pep pills, "uppers," and diet pills can make a driver more alert for a short time. Later, however, they can cause a person to be nervous, dizzy, and not able to concentrate. They can also affect the vision.

d. Any drug that "may cause drowsiness or dizziness" is one you should not take before driving. Make sure you read the label and know the effects of any drug you use.

N. A valid New York driver’s commercial license with passenger endorsement is required to operate a VTP vehicle. If for any reason, you the driver lose your driving privileges in the state of New York, your employment with the JJP VA would be jeopardized

Attachment 3 - What to do if you are involved in a crash.

If you are involved in a crash and you are injured, it is important to stay calm and quiet to protect yourself from further injury while awaiting help. If you are not injured, or are otherwise able, take the following actions:

A. Take Necessary Emergency Action.

B. Immediately get to a safe location out of the flow of traffic.

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C. Warn other traffic and bystanders and ask people to be careful with matches and cigarettes in the presence of spilled gasoline.

D. Call for Police and Emergency Services. Notify state, county or municipal authorities, as required by law.

E. DO NOT accept or sign or make a statement as to responsibility at the accident scene.

The investigating officer will determine who is at fault.

F. Any formal statement should be made to your supervisor or to the Government investigator.

G. You may provide your valid motor vehicle operator’s license or permit information if requested by police investigating officials or other drivers involved in the crash.

H. Be aware that registration, licensing and insurance requirements differ from requirements for privately owned vehicles.

I. Information pertaining to self-insurance can be found on the Motor Vehicle Accident

Reporting Kit, GSA Form 1627, (white envelope with metal clasp) supplied in your vehicle. The AMC 21 22 and your FSR will be able to assist you if you have questions.

J. Get the facts. Having all the facts is essential when reporting a crash. The best time to collect these facts is at the scene of a crash after all necessary emergency actions have been taken. Use the forms described below included in your Vehicle Accident Reporting

Kit (GSA Form 1627) which is located in the vehicle’s assigned binder.

1. Get name and address of each witness.

2. Ask the witnesses to complete Standard Form 94, Statement of Witness, contained in the Motor Vehicle Accident Reporting Kit.

K. Complete Standard Form 91, Motor Vehicle Accident Report (or reporting form required by your agency) at the scene. If conditions prevent this, make notes of the following:

1. Registration information for other vehicle(s), (owner’s name and address, tag number, VIN, and vehicle description).

2. Information on other driver (name, address, operator’s permit number, and expiration date).

3. Name and address of each person involved and extent of injury, if any.

4. Name and address of company insuring other vehicle(s) and insurance policy number.

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BRONX, NY 10468 ISSUE DATE: 29 August 2019

5. General information such as location, time, measurements, weather, damage, etc.

L. If possible, take photographs of the crash scene and try to include license tag numbers.

M. Notify state, county or local authorities as required by law and CALL GSA’s Accident

Management Center (AMC) toll free at (866) 400-0411, Option 2. (7:00 am– 7:00 pm ET).

1. If the vehicle is unsafe to operate, call the AMC at (866) 400-0411, Option 2.

(7:00 am – 7:00 pm ET)

2. After hours call our Emergency toll free number, (866) 400-0411 and follow the prompts. A customer service representative will authorize towing expenses and any other after hour’s emergency services up to $500.00.

N. Submit all reports and data to your supervisor within one working day. If you are injured, have the police notify your agency, which will report the crash to GSA Fleet.

O. Injury claims should be processed through your agency personnel office using a Federal

Employee’s Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation, (Form CA-1). This form is not included in this kit but is available from your supervisor.

This form should be completed by the injured party or by someone acting on the person’s behalf and submitted to the immediate supervisor within 24 hours. Forms required by state, county or municipal authorities are not included in this kit. It is your responsibility to know and comply with local laws.

P. If you are injured always carry complete personal identification, including names, addresses, and telephone numbers of your supervisor and someone who should be notified in the event of a serious injury. This will permit police to provide prompt notification if necessary.

1. Generally, emergency first-aid treatment and hospital care are provided by local facilities supported by the community.

2. Your Government identification and/or travel authorization may be used to establish that you are a Government employee on official business.

3. Upon notification, your supervisor and the Office of Workers’ Compensation

Programs, Department of Labor, are responsible for arranging for any treatment or care you may require.

4. Prepare Form CA-1 describing fully how you were injured and the nature of the injury.

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5. If you are physically unable to prepare the form, have someone acting on your behalf prepare the form for you.

Q. Insurance:

1. U.S. and U.S. Territories:

Within the United States and its territories, the U.S. government is self-insured for loss or damage to government property and the liability of government employees for actions within the scope of their duties. This “Proof of Insurance” is explained on the GSA Motor Vehicle Accident Reporting Kit (GSA Form 1627) located in

Vehicle Binder for your GSA Fleet vehicle.

2. Foreign Countries: N/A

3. Claims for Damages:

a. Refer any persons wanting to file a claim for damages or injury against the

Government to your supervisor. Any claim made by a non-Government person is called a “third-party claim.” GSA Fleet is not responsible for reimbursing third-party claims for damages unless the driver is a GSA employee. All third parties should file Standard Form 95, Claim for Damage or Injury, with your agency, NOT with GSA Fleet.

b. A lawsuit for property damage, personal injury, or death resulting from your operation of a motor vehicle becomes a suit against the Government rather than against you as an individual, provided operation of the motor vehicle was within the scope of your employment. You must establish to the satisfaction of the United States Attorney for the jurisdiction in which the crash occurred that you were acting within the scope of your employment and not for your personal benefit or pleasure at the time of the crash.

4. In the event you receive a legal notice or summons to answer questions on the crash, promptly notify your supervisor and deliver all legal processes, pleadings and other papers to him or her.

5. The agency employing the vehicle operator is financially responsible for any damage to that GSA vehicle. When a third party is at fault, identifiable based on the information

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

1. Following safe, defensive driving practices and complying with applicable State and Federal highway regulations and VHA policy. All staff operating personal (privately-owned) vehicles for the transfer of patients must comply with State requirements for motor vehicle inspection and minimum insurance coverage.

2. Initiating contact with the receiving VA facility when the transportation schedule has been altered en route.

3. Reporting any changes related to driving record, automobile insurance, and State registration to their supervisor.

4. Reporting any significant events while driving patients to their supervisor, and Travel

Coordinator, if patient safety is involved (i.e., traffic accidents or medical problems).

5. Completing all assigned training and medical examinations.

VTS driver is only permitted to stop the van for rest stops and/or emergencies and to pick up and discharge passengers. The driver will not make side trips to take care of personal business.

C. Passengers are not permitted to smoke, chew tobacco, drink alcohol, use foul language or bring weapons, drugs or any illegal substance on the van.

D. Driver may not provide transportation to any Veteran who is intoxicated, abusive or poses a threat to the driver or other passengers on the van.

E. Passengers should not engage in any activity that will distract the driver’s attention.

F. Passengers are always required to wear seat belts. Any passenger refusing to buckle-up will be denied transportation on the van/bus.

G. All trash must be placed in the proper trash receptacle.

H. Individuals other than the Veteran will be permitted to ride in the van with the Veteran in only two cases:

1. A Veteran’s spouse

2. A caregiver who is authorized by the VA to provide the Veteran with

“Aid and Attendance.”

3. The patient’s attending VA physician must authorize any exceptions to this policy.

4. The VTS MM using discretion may authorize exceptions to this policy.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

I. Patients being discharged or granted passes may be transported on a VTS van during the vehicles trip back to its home city only if space is available. The patient must be ready to leave when the van/bus departs the VA Medical Center.

Note: No irregular or Against Medical Advice (AMA) discharged Veterans are allowed to ride.

However, a Veteran may ride if his/her physician provides a written statement, stating that the

Veteran is no threat to self, driver, or passengers.

J. Patients should be dressed and ready to leave for the hospital at the time specified. The driver cannot wait for patients. It is the responsibility of the

Veteran or his/her family member to contact the DAV HSC/VTP

Transportation Coordinator as soon as possible regarding appointment cancellations or changes.

K. Only articles small enough to be held on the Veteran’s lap or put under the seat will be transported in the VTS van.

L. The VTS van is not an emergency vehicle and will not transport patients needing emergency care. The driver may refuse to transport any veteran who he feels is too ill to ride the van; the driver may request a written statement from a VA physician stating that the involved Veteran is medically capable of traveling.

M. Oxygen Bottles

1. VTS Vans: Portable oxygen and respirators may accompany a patient. A maximum of two (2) canisters may travel with the patient. The maximum dimension for each container may not exceed 4.5 inches in diameter and 26 inches in length. Patients are responsible for ensuring that they have enough oxygen to complete their travel and are responsible for making arrangements for refills while en route. Canisters must be secure in sling type holders.

7. In the event of a deviation from the Passenger List – (Someone is a no show or has an extra person with them) – The driver must notify the TC or MM immediately and get confirmation on how to proceed.

8. Once the driver has completed all of his passengers’ pick-ups he will call the TC and verify all passengers on the Passenger List are actually on the vehicle.

9. Once the Passenger List is verified the dispatcher will again email and/or send a hard copy to all BT Clerks with the Passengers Names – Appointment Times – Appointment Locations &

Times of Transportation to eliminate any inconsistencies in travel reimbursements. (Veterans who use VTS transportation are not eligible for travel reimbursement)

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

10. The driver will then transport the passengers to their destination. If there is a Wheel

Chair bound Veteran in the vehicle, the driver will unload them and ensure they are able to get to their destination safely by themselves or with the help of a volunteer or family member.

(The VTS driver is not allowed to assist veterans to get to their appointment. Drivers responsibility is to drop off veterans to their destination.)

11. The driver will then perform tasks as instructed by the TC or MM until returning the passengers to their origins and completing the day.

12. Upon completing the assigned trip, the driver will complete the entire VTS Passenger List and close out all their assigned runs in the Vet-ride tablet assigned to their vehicle and perform a post-trip inspection on the vehicle and record any problems that need attention.

13. The Driver must ensure the inside of the vehicle is clean at the end of each shift and is responsible for daily upkeep.

14. At the completion of the drivers shift they will turn in all keys and proper paperwork to the

TC or MM.

15. The TC or MM will then enter all required information on the passengers and vehicles into the Vet-Ride program loading veterans in the system or use proper computer systems –

Metrics, Cars, Fast, etc...

PASSENGERS UNDER THE INFLUENCE OR UNRULY PASSENGERS

The VTS Driver reserves the right to refuse service to any individual that shows signs of being under the influence, mentally unstable, or is believed to pose a threat to others. Upon arriving at a Veterans location, if the Veteran or the attendant is exhibiting signs or symptoms of being under the influence of alcohol or drugs, they will not be allowed to board the vehicle. Signs and symptoms may be:

w. Loss of emotional control

x. Not responding to verbal directions

y. Altered mental status

z. Slurred speech

aa. Poor communication

bb. Impaired motor control – staggering, unable to stay on their feet

cc. Disorderly conduct – verbal or physical aggression

dd. Lethargic or unstable

If a Veteran is displaying any of the above symptoms the VTS Driver will not allow them to board the vehicle. The driver shall call the MM immediately and inform them of the situation.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

The MM will determine the proper course of action and instruct the driver on the proper procedure to handle the problem.

EMERGENCY MANAGEMENT DURING TRANSPORTATION

In the unlikely event of an Emergency situation during transport please follow these guidelines:

➢ IMMEDIATELY FIND A SAFE PLACE TO PULL OVER AND STOP THE

VEHICLE.

➢ CALL 911.

➢ SUPPLY THE MINIMUM FIRST-AID AND BASIC LIFE SUPPORT UNTIL EMS

ARRIVE.

➢ CALL THE MOBILITY MANAGER AND INFORM HIM OF SITUATION AS SOON

AS IT IS SAFE TO DO SO.

A Medical Emergency exists if a Veteran show any of the following signs:

1. Chest Pain 5. Shortness of Breath

2. Decreased level of consciousness 6. Choking / Foreign body in throat

3. Bleeding 7. Severe Pain

4. Seizures 8. Emergency verbal concern from the Veteran

A Psychiatric Emergency exists when a Veteran show any of these signs:

• Verbalized thoughts of suicidal ideas, self-harm, or harming others.

• Driver witnesses actual harm to self or others.

• Psychotic episode, hallucinations, acting bizarre or violent, or disorganized.

• Uncooperative behaviors or easily becoming increasingly agitated.

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

JAMES J. PETERS VAMC MEMORANDUM 003-______

BRONX, NY 10468 ISSUE DATE: 29 August 2019

Sherrie Moore Anthony Maldonado CHIEF Business Office Mobility Manager