APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT

Position Applying For:

Chief Officer, Kootenai County Emergency Medical Services System

Date:

Last Name:

First:

Middle:

Present Address:

City:

State:

Zip:

Home Phone Number:

Other Contact Number:

Email Address:

Have you ever worked under a different name from that which appears on this application? Yes No ___

If yes, list the different name (s):

PERSONAL HISTORY

Do you have a valid drivers license? Yes

No

Driver’s License No.:

State:

Endorsement:

If hired, can you prove that you may legally work without restrictions in the United States? Yes No

Military Status: Have you served in the U.S. Armed Forces? Yes No

When:

Branch:

Are you presently a member of a U.S. Reserve or National Guard Organization: Yes

No

If yes, complete present grade and Service:

Have you ever been convicted of a felony? Yes

No

If yes, please explain:

Joint Powers Board

Kootenai County Emergency Medical Services PO Box 2823

EDUCATION

High School:

Location:

Years Completed:

Graduated? Yes

No

or did you receive a GED? Yes

No

College or University:

Location:

Credits:

Did you obtain a college degree or vocational certificate? Yes

No

Type of degree or certificate:

What discipline was your degree or certificate in?

Which college or university did you obtain your degree or certificate from?

*

Please

LIST AND ATTACH A COPY

of any professional or vocational licenses and/or certifications, which

you have obtained:

Please list any special qualifications or skills, which you possess:

WORK HISTORY

Present or Most Recent Employer:

Supervisor Name & Title:

Phone:

Address:

City:

State:

Zip:

Hours per week:

Start Date:

End Date:

Job Title:

Duties Performed:

Reason for Leaving:

PAST THREE EMPLOYERS

Employer:

Supervisor Name & Title:

Phone:

Address:

City:

State:

Zip:

Hours per week:

Start Date:

End Date:

Job Title:

Duties Performed:

Reason for Leaving:

May we contact this employer for a reference?

Yes

No

Employer:

Supervisor Name & Title:

Phone:

Address:

City:

State:

Zip:

Hours per week:

Start Date:

End Date:

Job Title:

Duties Performed:

Reason for Leaving:

May we contact this employer for a reference?

Yes

No

Employer:

Supervisor Name & Title:

Phone:

Address:

City:

State:

Zip:

Hours per week:

Start Date:

End Date:

Job Title:

Duties Performed:

Reason for Leaving:

REFERENCES

Give the information requested below on three (3) persons not related to you whom you have known for at least

one (1) year:

Name:

Relationship:

Phone:

Address:

City:

State:

Zip

Name:

Relationship:

Phone:

Address:

City:

State:

Zip

Name:

Relationship:

Phone:

Address:

City:

State:

Zip

Have you ever held a position of employment with any other fire -based emergency medical service system?

Yes

No

If yes, list name, location and dates you applied:

Have you read the essential functions for the position to which you have applied? Yes

No

Can you perform the essential functions of the position to which you have applied? Yes

No

Do you require reasonable accommodations to perform the essential functions for the position to which you

have applied? Yes

No

Desired Salary: $__________________

P

I do hereby authorize the Joint Powers Board (hereinafter JPB) or designee to thoroughly investigate my character references, work records, education, military, criminal background, police records, traffic offenses of record and other matters related to my suitability for employment and further authorize my current and former employers to disclose to JPB or designee any and all letters, reports and other information pertaining to my employment with them, without giving me prior notice of such disclosure. In addition, I hereby release the JPB or their designee, my current and former employers, and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

If applicable, I understand that the following documents must be attached to the front of my application packet:

1. Completed Job Application 2. Resume (no more than two pages)

3. Supplemental Questionnaire: nor more than one page (approximately 250 words) per question.

4. Legible copies of any medical licensure or certification relevant to the position as indicated in the job description.

I understand that if offered employment, the offer may be contingent on my passing a pre-employment drug screen By signing this application, I voluntarily agree to submit a pre-employment drug screen and pre-employment medical physical exam upon request. I understand that failure to pass the drug screen and/or medical physical exam will result in withdrawal of the employment offer.

I understand that nothing contained in the application or conveyed to me during any interview, which may be granted, is intended to create an employment contract, implied or explicit, between the JPB and me. In addition, I understand and agree that if I am

employed, my employment relationship with KCEMSS is strictly voluntary and at our mutual will. I understand that if employed, my employment is for no definite period and I may terminate it at any time, with or without prior notice, with or without cause or reason. Likewise, JPB has the right to terminate my employment, or otherwise discipline, transfer, or demote me at any time, with or without reason during my probationary period, at the discretion of the JPB.

I herby certify that I have not withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct. Unless otherwise stated, I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement on this application or on any documents used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

My signature below certifies that I have read and understand this complete page, and agree to the terms and conditions outlined in this document.

Applicant’s Printed Name

Applicant’s Signature Date

F

Application Received On:

Received By:

Applicant has met minimum requirements: Yes

No

Date Reviewed:

Background Check Completed On:

Satisfactory:

Yes

No

Status Letter sent: Yes No

Date sent:

Chief Officer

Kootenai County Emergency Medical Services System

Supplemental Essay Questions

In an effort to gain additional insight into your writing skills and leadership style, please answer the following

questions and submit with your application; maximum one page per question.

1. Describe your background in working with an EMS System?

2. Describe your background in managing and preparing budgets?

3. Describe your background in working with Medicare, Medicaid and HIPPA regulations?

4. What brings you to Kootenai County Emergency Medical Services System? And, what attracts you to

move to the area?

Job Description for:

Chief Officer

Kootenai County Emergency Medical Services System

Classification: Chief Officer FLSA Status: Exempt

Reports to: KCEMSS Joint Powers Board Revised: 6/24/2013

Supervises: All System Employees

Job Definition

The Chief Officer is the executive position for Kootenai County EMS. This position oversees and directs all agency EMS services, personnel, and operations; represents agency interests with local, state and national 9-1-1, Emergency Management, EMS and technical organizations and association meetings. Work involves overall direction for budgeting, contract negotiations, system performance, and policy and procedural directives.

Distinguishing Characteristics

This critical position works under the policy direction of the KCEMSS Joint Powers Board. The Chief Officer performs a full range of administrative functions, and determines short and long range planning for KCEMSS and all the contracting EMS partners for the county-wide EMS system. The Chief Officer coordinates and collaborates with the various fire and emergency medical services departments and advising physicians throughout Kootenai County, establishing and fostering a team rapport toward consensus in meeting goals and protocols.

Essential Duties and Responsibilities:

The following duties are representative of the general functions of the position. They are not intended to represent the entire function capacity of the position. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 EMS Services - Oversee effective delivery of EMS services through the work of contracted fire departments, contracted private EMS providers, KCEMSS staff, and in cooperation with the Sheriff’s 9-1-1 call center.

 System Improvement - Continuously evaluate, develop, and recommend changes and/or policies to the Joint Powers Board that will improve the overall county wide system in the delivery of EMS services, quality assurance, data collection, efficiencies in System resources, and improved relations with external resources, in light of budgetary limitations, technical practices, and governing laws and regulations.

 Emergency Management - In conjunction with the Office of Emergency Management, evaluates, develops, and implements a coordinated emergency response/disaster management plan that includes community, EMS, and facilities for each area and overall region. Applies for federal funding for emergency management related needs, administers such grants and reports on their progress. Maintains the Mass Casualty Incident vehicle and trailer. Serves on the Health Care Coalition Board for Region 1 Healthcare preparedness representing EMS agencies.

 Contract negotiations and management - includes provider contracts, medical director contract, ambulance billing contract, insurance and facility contracts, and various MOU’s.

 Supervision - Performs immediate supervision of all key staff and staff activities including budget preparation, financial management and investments, Human Resource management, office and field data collection systems and processes, quality assurance and all other administrative functions.

 Ambulance Billing Services - Oversight of the contracted ambulance billing service company including: creating and maintaining billing and collection policies, providing the fee schedule, review questionable PCR’s for billing direction and follow-up crew training, review and respond to billing denials and complaints, and assure the billers are adhering to all Federal, State, Local and Medicare/Medicaid guidelines.

 Medical Director - Oversee the medical director’s participation and medical supervision including protocols, QA/QI, training, crew licensure, credentialing and report reviews.

 Dispatch and scheduling of transports – works with staff, contract agencies, and dispatch to assure that 9-1-1, NET (Non-Emergent) and CCT (Critical Care) calls are dispatched timely and appropriately. Schedules NET/CCT transports when called

 EMS state licensure and inspections – in cooperation with the contract agencies, assures that all ambulances, agencies and their crew members are in compliance with all the Idaho state EMS regulations for licensure and assures that each agency is in compliance with their monthly reporting.

 Fleet Management – prepares ambulance specifications for bid and construction in accordance with state and federal regulations. Coordinates all ambulance purchases and remounts. Assures that vehicle maintenance and preventative maintenance is taking place in accordance with system policies. Schedules winter/summer tire installation. Coordinates backup unit usage for special events or coverage for maintenance issues. Handles all ambulance accident investigations and follow up issues.

 Equipment Maintenance - Performs PMs on AEDs, GPS Units and Oxygen Generating Systems. Schedules and coordinates PMs on Heart Monitors, gurneys and all other EMS equipment, vehicle cameras, O2 tanks and fire extinguishers.

 Policies and Procedures – creates and maintains policies and procedures for KCEMSS office staff and field operations.

 Other – Other duties include EMS Conference Coordination in conjunction with North Idaho college workforce training center and contracting agencies; light building and ground maintenance, coordination of larger building repairs and projects; prepare and deliver formal presentations before various public and private concerns; attend meetings, conferences, and seminars requiring periodic to frequent travel.

Qualifications

Knowledge of:

 Principles and practices of emergency medical services, public sector organization, public safety communications, emergency management, and program operations.

 General medical services, terminology, equipment, systems, and regulations governing Emergency Medical Services in Idaho.

 Ambulance billing procedures and regulations.

 Regulations imposed by HIPPA, Medicare and Medicaid and its effect on operations and funding.

 Principles and practices of effective budgeting, financial management, personnel management including supervision, training, and performance evaluation.

 Broad knowledge and understanding of EMS and Disaster management.

 Medical dispatch systems.

Ability to:

 Lead, motivate and mentor, create a team player approach, and effectively facilitate stakeholder and/or multi-jurisdiction meetings to reach consensus.

 Apply critical thinking, problem solving, and collaborative approaches to improving program services.

 Effectively plan, assign, direct, and evaluate the work of assigned management and subordinate staff, including delegating responsibility and authority and ensuring Agency directives are accomplished through their work.

 Establish and maintain positive and professional working relationships with employees, contract agencies, elected officials, and other local, state, and federal governmental jurisdictions, vendors and the public.

 Ability to exercise sound judgment in evaluating situations and in making decisions.

Experience and Education:

Any combination of education and experience providing the required skill and knowledge for successful performance would be qualifying. Typical qualifications would be equivalent to:

 Bachelor’s degree from an accredited college or university in public safety, public administration, business management or relevant field of study.

 Five (5) years of progressively responsible and high-level management experience coordinating the operations of a multi-agency public safety organization.

 Five (5) years of progressively responsible personnel management and supervisory experience.

 Demonstrates knowledge, skills, and abilities to effective decision-making, interpersonal communications and conflict resolution, and the ability to successfully supervise, motivate, correct, train, and evaluate staff.

 Preference will go to individuals who currently or in the past held a medical license and practiced in the field; including but not limited to paramedic, nurse, advanced EMT or higher.

 Candidate must successfully pass pre-employment background investigation.

Other Requirements

 Idaho State Drivers License

 Ability to be bonded

 Ability to operate emergency medical vehicles

 The position has been designated safety sensitive and therefore the incumbent is subject to random drug testing

Work Environment (Essential functions)

Work is performed primarily in an office setting, with occasional field work necessary for functional oversight and with moderate travel to and from local and regional trainings, meetings, conferences or similar. Incumbent works with personal computers, telephones, and other general office equipment that requires detailed dexterity. Work involves moderately extensive keyboarding and manual dexterity, and also entails general reaching, stretching, and lifting of standard office supplies, medical supplies, and equipment, such as paper, binders, heart monitors, oxygen bottles, bundles of linen, and more. Some walking, bending and carrying of heavy items is required. In the process of moving equipment around there is a possibility of exposure to blood borne pathogens.

Physical Demands typically involved, but are not limited to:

Hearing and Speaking:

 Hear, understand and respond to verbal information in person, by phone, radio and other communications equipment

 Speak clearly and concisely in English to a broad variety of small or large audiences, including verbally presenting information or responding to inquiries at Board meetings, public or political hearings, and related

Seeing and Reading:

 See, read and understand written information and instructions in all forms, including handwritten, hard copy or electronic communication formats

 See and use all related communications equipment including telephones, radios and computer monitors

 Ability to read, analyze, and interpret the most complex documents, manuals, and journals; to respond effectively to the most sensitive inquiries or complaints

 Specific vision abilities include; close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

Mental Acuity and Alertness:

 Understand, research and respond to complex and varied information and instructions, including broad application of policies, procedures, laws, and regulations under complex circumstances

 Manage and accomplish multiple tasks and priorities in a timely manner and with a high level of accomplishment and accuracy

 Think through all aspects relating to issues or problems; identify, recommend and implement solutions

 Balance diverse responsibilities utilizing independent initiative, judgment and discretion

 Be generally available for on-call and/or irregular hours in case of emergency situations, such as activation of the Emergency Operations Center

Manual Dexterity and Typing:

 Moderate use of computers, keyboards, office equipment and similar specialized technical and electronic equipment commonly found in an office or communications center setting

 Performing regular tasks requiring general manual dexterity

Physical Dexterity:

 Sit, stand or walk as necessary

KOOTENAI

COUNTY

EMERGENCY

MEDICAL

SERVICES

CHIEF

OFFICER

$84,000 to $93,000 DOQ

EMPLOYMENT

OPPORTUNITY

K

C

Kootenai County is located in North Idaho and is surrounded by scenic mountains and pristine lakes.

The area is an outdoor enthusiast's dream, offering recreational activities that include hunting, world

class fishing, boating, biking trails, golf, and skiing. The county's physical beauty and "livability" are

partially responsible, especially in recent years, for

an unprecedented population expansion.

An abundance of lakes and rivers, including Lake

Coeur d'Alene, are found throughout the area

offering exceptional outdoor recreation. Fishing and

water sport opportunities are almost endless. The

area has many amenities such as park facilities,

hiking trails, softball fields, tennis courts, ski resorts

and scenery unmatched in the Pacific Northwest.

Bicycle enthusiasts have immediate access to the

Centennial

Trail

that

is

almost

immediately

accessible from the KCEMSS office.

K

C

E

M

S

S

(KCEMSS)

KCEMSS is a fire-based ambulance service providing 9-1-1 emergency and facility to facility transfers

throughout Kootenai County. KCEMSS operates through a network of agencies, including ten fire

departments and three non-profit EMS organizations. KCEMSS provides EMS services up to and

including paramedic services. It also provides Critical Care Transport services to the hospitals within

Kootenai County as well as hospitals in the surrounding counties of North Idaho upon request. For

more information, please the KCEMSS Website at:

www.kcemss.org

.

The BOCC, in its capacity of the governing board of the Kootenai County Ambulance District, is

ultimately responsible for county-wide emergency medical services (EMS). These services are

provided through a joint governed organization known as KCEMSS. As the Ambulance Board, the

BOCC approves the annual KCEMSS operating budget and levies the balance necessary to fund the

approved under the EMS Levy. Additionally, the County Commission appoints a member to the

KCEMSS Joint Powers Board, the joint governing body.

Established in 2001, the Agency is staffed by a Chief Officer, an Office Manager and a Paramedic

assigned to Quality Assurance and Critical Care Transports. The

EMS System in Kootenai County is a model for many counties in

the State of Idaho.

In 2012 KCEMSS ambulances responded to 14,491 calls for

service that includes inter-facility transports. KCEMSS funds

staffing for eight (8) ambulances of which five (5) are at the

Advanced Life Support. Non-emergency facility to facility

transports are a significant source of revenue for the system.

T

P

The EMS Chief Officer reports to a five-member Joint Powers Board (JPB) and oversees the support

staff employed by KCEMSS. The Chief Officer coordinates and collaborates with the various fire and

emergency medical services departments and advising physicians throughout Kootenai County,

establishing and fostering a team rapport toward consensus in meeting goals and protocols in a

transparent manner.

The EMS Chief Officer directs and participates in the ongoing development and implementation of the

KCEMSS Master Plan or other document that guides the strategic direction for the EMS System. In

addition the Chief Officer guides general, financial, and personnel administration, and the quality

assurance, quality improvement, and risk management programs for KCEMSS (see job description

for more detail) while working closely with the Board of County Commissioners (BOCC).

C

F

T

N

C

O

 KCEMSS Budget: The 2013-2014 budget process will be well underway by the time the new

Chief Officer arrives. The new chief officer will be required to carry the budget to its completion

with the Board of County Commissioners who has final approval, and responsibility for

establishing the EMS Levy rate for the next fiscal year.

o FY2013 Budget: $6,388,390 (income) is projected of which $2,092,360 is from taxes

generated by the EMS Levy (32.8%).

o FY2012 Actuals: $5,917,786 (income) of which $2,104,245 was from taxes generated

by the EMS Levy (35.6%).

 Relationships with the Communities Served: KCEMSS provides a leadership role in the delivery of

ambulance transport services. Working closely with the KCEMSS Medical Director, the new EMS Chief

Officer will interact on a regular basis with area fire chiefs and EMS chiefs on day-to-day operations,

continuing education, and funding.

 Strategic Planning: KCEMSS has recently completed a strategic planning effort that will identify

priorities for the county wide system for the next five years. The new Chief Officer will be responsible

for implementation of the same.

I

C

P

Kootenai County Emergency Medical Services System is looking for an experienced senior level EMS

professional with excellent executive management and leadership skills. The ideal candidate will have

a background and knowledge of principles and practices of emergency medical services, public

sector organizations, public safety communications, emergency management, and program

operations.

The ideal candidate will have knowledge of ambulance billing procedures and regulations including

an understanding of Medicare and Medicaid rules, regulations and limitations; HIPPA regulations;

general medical services terminology, equipment, systems, and regulations governing Idaho

Emergency Medical Services. A background as a medical provider in a fire-based EMS system

would be a plus.

The ideal candidate must have a history of progressive and proactive program development, as well

as a track record for delivering results, building accountability characterized by teamwork and

innovation. The ideal candidate will have a demonstrated ability to formulate, implement and manage

operating and capital budgets and meet goals and protocols in a transparent manner.

The ideal candidate will lead by example setting a high standard for all that they come in contact with

from the public and the system’s stakeholders. The new Chief Officer will exhibit the ability to develop

partnerships that are critical to the success of the EMS System.

The new Chief Officer will be a good listener, accessible, transparent, and understand the importance

of maintaining close and consistent communication with staff, stakeholders, and the Joint Powers

Board. The ideal candidate will demonstrate effective communication skills demonstrated by willing

participation in open discussions and presentation to a variety of audiences; city councils, fire

commissioners, and stakeholders.

The new Chief Officer will demonstrate personal and professional integrity and will have a proven

track record of honesty within the work place. He or she will have a confident presence and must be

open and approachable. The preferred candidate will be team-oriented, have a flexible “can-do”

attitude, and an appropriate sense of humor.

E

&

E

In combination with higher education, an individual with background and experience in EMS

Transport service and management within a Fire based EMS transport system that bills for

ambulance service will set the ideal candidate apart from others. A bachelor’s degree from an

accredited college or university in Business Administration, Public Administration or related field is

desirable.

C

&

B

(TBD)



$84,000 to 93,000 DOQ



Medical, Dental & Vision coverage



Voluntary contributions to 401K plan



Sick leave



Vacation



Holidays



Staff Vehicle Provided

Kootenai County Emergency Medical Services System is an Equal Opportunity Employer. Applications will be accepted until the close of business on Friday 8/2/2013. To apply, please send a letter of interest, résumé,

completed application, and answers to the supplemental questions by e-mail to the address below with hard copies mailed to Kootenai County HR. The application can be found on the Kootenai County Human Resources website at