Texas Street Medics

Policies, Guidelines, and Code of Conduct

Table of Contents

Section I. Code of Conduct

Section II. Policies

Section III. Guidelines

Section IV. Points of Contact

Appendix A. Texas Good Samaritan Law

Appendix B. HIPAA Quick Explanation

Introduction

This document details the Texas Street Medics (TSM) Code of Conduct, Policies, and Guidelines, in addition to a section with Points of Contact for the organization, and links to Appendixes that expand upon the information within this document. TSM Directors (see Section I, Item 1a) reserve the right to change the contents and implementation of this document as necessary for the benefit of TSM.

Section I. Code of Conduct

All members of TSM are expected to adhere to the Code of Conduct without compromise. Failure to do so will result in disciplinary action. The following rules are not in order of priority and should be considered all equally paramount. For the purposes of this section, “TSM activities” is defined as anything done by TSM or any presence of TSM at an event.

  1. All members are expected to be familiar with the Texas Good Samaritan Law (see Appendix A, available separately upon request) as well as how it applies to TSM’s mission. Actions that violate the protections of the Texas Good Samaritan Law are grounds for immediate removal from TSM.
  2. Any consumption of alcohol or other drugs during TSM activities is strictly forbidden.
  3. Impairment as a result of the use of alcohol or other drugs prior to TSM activities is strictly forbidden.
  4. All members are required to be familiar with HIPAA policies and to follow HIPAA guidelines in the interest of maintaining people’s privacy. See Appendix B, available separately upon request. Violation of privacy is grounds for immediate removal from TSM.
  5. All members must have the express or implied consent of a person in order to render aid, and must respect refusal of treatment. Failure to respect a person’s consent to care is grounds for immediate removal from TSM and potential legal action. See American CPR for more information concerning consent.
  6. All members are forbidden to give anything to a non-TSM person outside those items and services related to the scope of the organization’s work - that is, first aid care, purpose-brought food and water, and other things used for the promotion of health and safety. Examples of violations include sharing a cigarette with a passerby, or giving food that was not part of TSM supplies - such as fast food - to those outside the organization.
  7. Insubordination is not tolerated. All members must follow the chain of command given in Section II.
  8. All members are expected to show respect to all of their fellow humans.
  9. Clean up after yourself and others. If you create waste, dispose of it. If you see waste, dispose of it. There is very little tolerance for breaking this rule.
  10. The Directors of TSM reserve the right to remove any member from TSM should it be necessary for the effectiveness of the organization.
  11. Discrimination – If there is unequal treatment of persons, for a reason that has nothing to do with legal rights or ability, then disciplinary action will be taken. Discrimination is not tolerated in the field. As medics, we are required to provide aid to all sides of a conflict.
  12. Harassment - If the act of systematic and/or continued unwanted and annoying actions of one party or a group, including threats and demands, is reported, then disciplinary action will be taken. The board of directors will hear every case of harassment that is reported.
  13. Embezzlement - The crime of embezzlement occurs when a person within an organization has the possession of property or funds that does not belong to them, converts or takes these properties or funds for their own use, and has no intention of giving it back. Embezzlement and misuse of funds will not be tolerated.
  14. Violence – Violence will not be tolerated. This includes violence or any acts of aggression towards individuals within or outside of the organization and the possession of weapons. Prohibited weapons include knives, swords, and guns (license to carry is not exempt), etc. Weapons that are allowed but must be concealed include pepper spray and defensive keychains.

Section II. Policies

Organizational structures and other policies are listed in this section.

  1. Leadership Structures and Duty Descriptions
  1. The Board of Directors of Texas Street Medics consists of the following persons:
  1. Michael Bonnet - Responsibilities: Administrative and Paperwork, IT, Human Resources
  2. Kathryn Fehrer - Responsibilities: Public Relations, Event Tactics, Inter-Organizational Relations
  3. Curtis Lee - Responsibilities: Inventory, Donor Outreach
  4. Bryce Madrid - Responsibilities: Logistics, Budgeting
  5. Keaton Tommaney - Responsibilities: Social Media, New Member Processing
  1. Chain of command is as follows:
  1. Medics without a specific role in their Mobile Units or at Triage Stations (the descriptions of which are discussed later) report to and follow the instructions of their Captains.
  2. Mobile Unit Leaders report to and follow the instructions of the Triage Station Commanders in an area of operations.
  3. REHAB Unit Captains report to and follow the instructions of the Triage Station Commanders in an area of operations. REHAB Unit Captains also have the authority to order any unit or medic to enter the REHAB vehicle to recuperate.
  4. Transport Units report to and follow the instructions of the primary REHAB Unit Captain within an area of operations. Any unit leader or communications contact of a unit is authorized to request a Transport Unit.
  5. All Commanders, primarily the Triage Station Commanders, report to and follow the instructions of the Director on site or the Director most immediately available.
  1. Any instruction from a Director is considered to be highest priority and overrides all instructions from anyone else.
  2. A “Medical Captain” is a designation given by Directors to those with proven certifications such as First Aid/CPR/Stop the Bleed or credentials such as EMT/RN/MD and is trusted to make correct calls in victim safety and care.
  3. A “Medic” is a designation given to those who have at least some formal first aid or first aid esque training. The duties of a medic include providing medical support, always having a med kit, always being on comms, reporting to the Medical Captain if an incident occurs, restocking medical supplies during events, staying with their assigned team, and scanning the crowd and medics for exhaustion.
  4. A “Support Staffer”, part of “Support Staff”, is someone who does not have first aid training but offers their time to provide services such as handing out water and food to crowds, reporting unusual activity to command, always staying with a medic, and providing support to medics.
  5. A “Triage Station” is a stationary location used as base of operations in an area and as a facility for receiving the injured. A triage station often is a central location where medical supplies, medics, and command is set up around a structure such as a picnic table or canopy. The leadership structure of a Triage Station is in order as follows:
  1. Triage Station Commander - The tactical leader of the station, who determines the use of resources at the station and coordinates with local authorities and Mobile Units as applicable/necessary. At times when personnel are low, this role may be merged with Triage Medical Commander while the station is in operation. The Triage Station Commander must be a medic.
  2. Triage Medical Captain - The Medical Captain of the section, who determines the best course of action when providing emergency medical care to victims at the station and, if applicable/necessary, in the care of Mobile Units.
  3. Triage Communications Contact - A regular medic who mans communications (comms) between the station and other entities like Mobile Units, allied medical groups, and authorities. The purpose of this role is to take the burden of communications off the Triage Station Commander and determine what information is necessary to forward to the Triage Station Commander while communicating information from the station to the aforementioned entities. This role has the authority (and only this authority) to do whatever they determine is necessary to get information to those who need it, such as calling for quiet at the station.
  4. All other medics present at the station should follow the directions of the Triage Station Commander in non-medical matters such as positioning, supply movement, etc.
  5. All other medics present at the station should follow the directions of the Triage Medical Captain in all medical matters, such as victim care, triage, and aid rendered.
  6. If the Triage Station Commander and the Triage Medical Captain are the same person, all other medics present at the station should follow all directions of that person.
  7. While the station is not actively rendering assistance to a victim, the Triage Station Commander is in command of the station. As soon as the station begins rendering assistance to victims, the Triage Medical Commander is in command of the station.
  1. “Mobile Units” are groups of two or three medics embedded within groups of people to offer immediate and accessible first aid. Mobile Units stay in contact with other Mobile Units, REHAB Units, and Transport Units as applicable, and are subordinate to the Mobile Leader, who is in command of all Mobile Units in an area of operations. The leadership structure of a Mobile Unit, which is part of the overall Mobile Team, is in order as follows:
  1. Mobile Leader - The tactical leader of all Mobile Units, who determines unit actions such as positioning and resource use of the Mobile Units.
  2. Mobile Unit Head Medic - The medical leader of a unit, who determines the best course of action when providing emergency medical care to victims at the station and, if applicable/necessary, in the care of Mobile Units.
  3. Mobile Unit Communications Contact - A regular medic who mans communications (comms) between the unit and other entities like Triage Stations, allied groups, and authorities. The purpose of this role is to take the burden of communications off the Mobile Unit Leader and determine what information is necessary to forward to the Mobile Unit Leader while communicating information from the unit to the aforementioned entities. This role has the authority (and only this authority) to do whatever they determine is necessary to get information to those who need it, such as calling for quiet within the team.
  4. All other medics in the unit should follow the directions of the Mobile Unit Head Medic in all medical matters, such as victim care, triage, and aid rendered.
  5. (Not Part of Chain of Command Explanation) All members of a Mobile Unit MUST stay within arm’s length of each other, unless caring for a victim requires something different. It is key that Mobile Unit members stay together no matter what, as it is very easy to get separated from one another and lost within a crowd. There are NO EXCEPTIONS to this rule. If a Mobile Unit member stops, their team stops. If a Mobile Unit member moves, their team moves with them.
  1. “REHAB Units” are groups of two medics in a vehicle - designated as a REHAB vehicle - trailing a crowd to provide opportunities to rest and recuperate within the vehicle to members of the crowd and medics. REHAB Units stay in contact with other REHAB Units, Mobile Units, and Transport Units as applicable, and are subordinate to the Triage Station Commander. The leadership structure of a REHAB Unit is in order as follows:
  1. REHAB Unit Leader - the primary driver of the REHAB vehicle who determines unit actions such as positioning and resource use. Has the authority to order any medic to enter the vehicle to rest and recuperate.
  2. REHAB Unit Auxiliary - Medic riding in the front passenger seat of the REHAB vehicle whose job is to remain wired into communications channels and keep the REHAB Unit Captain informed. The REHAB Unit Auxiliary also is tasked with rendering aid to anyone within the vehicle, including medical care, food, water, and providing conversation. The REHAB Unit Auxiliary is also authorized to drive the REHAB vehicle should the REHAB Unit Captain need a break.
  3. (Not Part of Chain of Command Explanation) REHAB Vehicles require the following qualifications: Reliable; full gas tank at start of operations; able to carry significant amounts of food, water, and medical supplies; able to accommodate at least two victims within the vehicle in addition to the REHAB Unit Captain and REHAB Unit Auxiliary; driven by a competent, licensed driver with no significant history of poor driving; be properly registered, licensed, and insured. Examples range from Curtis’ Acura to large SUVs and trucks driven by similarly reliable drivers.
  1. A “Transport Unit” is a single qualified medic driving a vehicle within an area of operations, either trailing a crowd or parked at a designated location, who can be called upon to transport medics or victims to locations such as their personal vehicles or emergency rooms.
  1. It must be understood that a Transport Unit does not replace a REHAB Unit or EMT transport; a Transport Unit should be used only in situations that do not require REHAB Units or EMTs, such as taking a tired protestor back to their vehicle, or transporting someone with an emergency room worthy but not EMT transport worthy injury to emergency rooms.
  2. Transport Unit vehicles require the same qualifications as REHAB vehicles, and should also aim to be able to transport as many victims as possible. An apt comparison would be “an Uber driven by a medic”.
  3. Sometimes, in situations where an area of operations has a REHAB Unit but no Transport Unit, REHAB can act as an ad-hoc Transport Unit, but only in extreme cases. In areas of operation where there is just a REHAB Unit, medics should default to trying to find something along the lines of a friend able to pick them up, or an Uber/Lyft, for a victim in need of a Transport Unit.
  1. Within an area of operations supported by a triage station, the Triage Station Commander is the commander of all operations in that area and has final say.
  2. Within a Mobile Unit or a Triage Station, Directors may be present either as Captains or lower in the chain of command. When a Director is lower in the chain of command, they may still overrule the unit or station captains, but will generally not do so unless absolutely necessary; otherwise, they will perform the role they have taken on within the regular unit chain of command.
  3. REHAB Unit Captains are by default above the Mobile Units in the chain of command within an area of operations, but rarely need to exercise this authority.
  4. All members must act upon orders received from up the chain of command immediately. If a member is uncomfortable doing something asked of them, they may inform the asker with no repercussions, and the asker will find somebody else to do it.
  5. It is the responsibility of everyone within a unit or Triage Station to ensure the unit is in communication with command and other units.
  6. There is one role external to the chain of command - Incident Manager. Within each area of operations - from an entire structure with a triage station, to a team of two or three operating on their own - there will be a designated Incident Manager. Any instance of rendering aid beyond handing out food, water, or a bandaid, by any medic, must be reported to the Incident Manager, with time, date, aid rendered, and location recorded. If a major incident happens - such as requiring significant supplies, EMT call, or transport - an incident report must be filled out by the leader of the unit that experienced the major incident. The Incident Manager within an area of operations with a triage station is the same person as the Triage Station Communications Contact.

  1. Chain of Command at Solo Events - defined as events with no triage station base set up. This will include events such as high risk protests, events that require additional mobility, and events in which we coordinate with other medic organizations.
  1. “Team Leader” - Solo Event equivalent to a Triage Station Commander; has final authority over all units present at a Solo Event. Acts as ambassador on behalf of Texas Street Medics to all other organizations present; is a medic; keeps incident reports; in charge of comms. Reports to leadership after the event.
  2. All other chains of command for Solo Events are as defined in Item 1.
  3. No vehicle units (REHAB, Transport) will be present at Solo Events for reasons of safety and feasibility.
  4. Medics will have heavier-than-usual loads, sometimes carrying backpacks with medical and supplies that would usually be kept at a Triage Station.

  1. Logistics Structure - to understand this structure, it is critical to know that primary supplies - medical supplies, electronics, and furniture (canopies, chairs) - MUST stay with a leader, and auxiliary supplies (food, water) can stay with anybody.
  1. Any location where supplies are stored permanently or semi-permanently is referred to as a Primary Depot.
  2. The main Primary Depots are currently at the residences of Curtis Lee and Keaton Tommaney.
  3. Supplies explicitly meant for Fort Worth or Arlington operations are currently stored at the Primary Depot at the residence of Michael Bonnet.
  4. Donated supplies or supplies mistakenly not returned after an operation can be dropped off at any member’s residence before being handed over to a leader whose residence is a Depot at their next meeting.

  1. Disciplinary Procedures - in the event of rule/policy breaking by members.
  1. Escalation of Infractions
  1. Verbal Warning - upon first infraction, the member who committed the infraction will be given a verbal warning in private by a Director at the discretion of any one or many Directors.
  2. Written Warning - Upon second infraction, the member who committed the infraction will be given a written warning by a Director at the discretion of any one or many Directors, spelling out the infraction, an action plan for improvement, and potential future consequences
  3. Disciplinary Hearing - Upon a third infraction, the member who committed the infraction will go before the Directors to discuss their behavior and determine what action will be taken, up to and including removal from TSM.
  4. Removal from Organization - Depending on the severity of the action, the board reserves the right to terminate at any time. Instances requiring discipline include violations of policies, endangering others, refusal to follow chain of command, lack of communication in the field, providing false information to command or other volunteers, and other actions determined by the board of directors to be hazardous to the organization and others.

  1. Board of Directors
  1. Responsibilities
  1. Budget
  2. Inventory
  3. Logistics and Event Planning
  4. Coordination of Supplies and Volunteers
  5. Safety and Accountability Training
  6. Community Outreach
  7. Public Relations with groups such as police, donors, organizers, press, etc
  8. All board responsibilities are exclusive to the board unless explicitly stated.
  1. Board Actions
  1. Majority Rules Votes - All votes, unless otherwise stated, will require a majority approval.
  2. Motions - Any board member may make a motion to either bring a topic of discussion to the table or address an existing topic.
  3. Admittance of Board Members - Board members should be on the lookout for new members within the organization who could bring additional skills to the board of directors. New board members must be nominated by a current board member, and admittance will be determined by a board vote.
  4. Removal of Board Members - In the instance of any policy violation or other discretion by a board member, a board member can be removed by a majority vote by the board of directors.
  5. Financial Management - Board members have a responsibility to monitor funds and all transactions for the organization. Any spending must be approved by the board.
  6. Outreach – Board members should actively network with figures such as community organizers for the benefit of the organization. Board members should actively recruit new volunteers and spread word about the organization.

Section III. Guidelines

While members are required to adhere to the Code of Conduct in Section I and conduct themselves within the chains of command and other structures listed in Section II, the following guidelines are not required to be followed. They are simply recommendations for TSM members as determined by the Directors with input from the members of the organization.

  1. While our status as a 501(c)4 nonprofit allows political actions by on-the-job members such as chanting at protests and raising fists, we recommend keeping such action to a minimum, such as only raising fists and not chanting. This is in the interest of our own safety and the safety of those we treat; we do not want to make ourselves more of a target for those with bad intentions (and therefore draw that ire to those we treat), and excessive political actions may make certain potential victims not feel safe receiving care from us.
  2. As an organization, we occasionally work with local authorities to ensure we can provide prompt and quality care to event attendees. We are also capable of working without those authorities.
  3. In a protest situation, take time to assess the mood of the crowd and tone of the rhetoric from the crowd and its leaders before deciding whether to alert organizers or authorities of your presence. For example, if the rhetoric at a protest is highly anti-law enforcement, speaking with law enforcement officers may make those in the crowd less inclined to come to you for help.
  4. Always consider your actions in light of the fact that you represent our organization to countless people. Please conduct yourself in such a way that reflects positively on your fellow members and the organization itself.
  5. It is recommended to not use tobacco or nicotine products in view of event attendees.

Section IV. Points of Contact

This section contains contact information for the organization itself and important people within the organization.

Texas Street Medics

Texas Street Medics Local Chapters

  • (insert local chapter contact info here)

Texas Street Medics Leadership

  • (insert leadership contact info here)

Appendix A. Texas Good Samaritan Law

Credit to HG.org, https://www.hg.org/legal-articles/texas-good-samaritan-law-18803

Like many other states, Texas has a Good Samaritan Law that protects citizens in the event that they provide emergency medical assistance. This law is meant to shield people acting in good faith and in their best efforts from civil liability and to protect the public by creating an incentive for others to help in a time of emergency.

Overview

The premise of this law is that if an individual voluntarily and in good faith attempts to provide medical assistance to another individual involved in an emergency situation, he or she will not be held civilly liable for any damages that providing such care caused. The law applies to common situations, such as a witness seeing someone injured in an automotive accident and rendering emergency medical aid. It specifically applies to any damages that result from using an automated external defibrillator. Additionally, it provides protection to volunteer first responders and to unlicensed medical personnel who are not licensed or certified in the healing arts who act in good faith.

Public policy considerations are the guiding force behind such laws. The state values human life and does not want a bystander to be discouraged from rendering necessary aid because he or she is afraid of being sued if the care he or she provides causes harm to the victim. The Texas Good Samaritan Law has been revised many times, so it is important that individuals who are seeking protection under it be familiar with the most recent rendition, as well as the law that applied at the time when such aid was administered.

Exceptions

Like with many laws, there are a number of exceptions for when civil liability will not be minimized. These exceptions include:

Willful or Wanton Conduct

The protection does not apply if the person rendering aid acted in a willfully or wantonly negligent manner. Making a determination regarding willful or wanton misconduct depends on a careful analysis of the particular facts of the case.

Expectation of Remuneration

This protection also does not apply if the person rendering aid was expecting to be paid for these emergency services. For example, if a physician provided care after the injured party promised to pay for services, this protection would not apply. This exception applies even if the individual providing the aid had no legal right to receive such compensation. The legal question is whether the individual expected remuneration. Additionally, if the individual was simply at the scene of the emergency situation was soliciting business or seeking to otherwise perform a service for remuneration, the protection does not apply.

In cases involving a health care provider who rendered aid in a hospital emergency department or surgical obstetrical unit, the legal analysis for the healthcare provider’s potential liability is whether the health care provider deviated from the accepted medical standards of care from the degree of care that one reasonably expects an ordinarily prudent health care provider to render under the same or similar circumstances. The victim has the burden of proof of establishing all legal elements by a preponderance of the evidence.

In order to make this determination, the jury can evaluate whether the health care provider had the patient’s medical history and was aware of any pre-existing medical conditions, allergies or medication. Additionally, the jury can evaluate whether a previous physician-patient relationship existed between the two parties. The jury can also assess the circumstances causing the emergency and the circumstances surrounding the providing of emergency medical care.

Cause of Harm

Additionally, this civil protection does not extend to an individual who was responsible for causing the emergency situation. For example, if a driver negligently collided with another vehicle and then rendered aid to the second driver, he or she could still be held civilly liable for damages that result from providing emergency aid.

Legal Assistance

Individuals who were injured by someone whom they believe falls under one of the expectations or who acted with willful or wanton negligence may wish to discuss their legal claim with a personal injury attorney. He or she can advise the victim of the possibilities of recovering under the circumstances involved in the case, as well as on any potential legal challenges that may arise because of the Texas Good Samaritan Law.

Appendix B. HIPAA

See https://www.hipaaguide.net/hipaa-for-dummies/ , as HIPAA is too complex to be contained within an appendix to a document such as this.

 

Others outside of Texas Street Medics are free to use this document as a basis for their own procedures. Texas Street Medics is not liable for any damages caused by the use of this document.