SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
MONROE COMMUNITY AMBULANCE
 
Employer identification number

02-0753921
Return Reference Explanation
FORM 990, PAGE 1, PART I, LINE 6 UNPAID BOARD MEMBERS.
FORM 990, PAGE 2, PART III, LINE 4A GUIDELINES. THE ESTIMATED UNREIMBURSED COST OF SERVICES PROVIDED TO THE ELDERLY,UNINSURED, AND THE UNDERINSURED TOTALED 704,450. THE COMPANY PROVIDED CHARITY CARE OF AN ADDITIONAL 69,577. PATIENT TRANSPORT SERVICES THE COMPANY SERVES ONE COUNTY WITH A MEDICAL STAFF OF MORE THAN 38 EMERGENCY MEDICAL TECHNICIANS AND PARAMEDICS WITH A TOTAL OF 11 AMBULANCES. COMMUNITY BENEFIT ACTIVITIES AS A COMMUNITY-OWNED NONPROFIT, MONROE COMMUNITY AMBULANCE RECOGNIZES THAT PART OF THEIR MISSION IS TO GIVE BACK TO THE COMMUNITY. THE COMPANY COORDINATES VARIOUS PROGRAMS AND OFFERS THEM FREE OF CHARGE TO THE COMMUNITY. OUR GOALS FOR THESE PROGRAMS, WHICH ARE TARGETED TO VARIOUS AGE GROUPS, ARE THE FOLLOWING: TO PROVIDE INFORMATION ON EMS IN GENERAL AND MCA SPECIFICALLY AND TO PROVIDE PROGRAMS ON SAFETY, INJURY PREVENTION AND HEALTH IMPROVEMENT. THE TYPES OF PROGRAMS, EVENTS AND APPEARANCES ARE ILLUSTRATED BELOW: CAMP 911 (SINCE 2006) - FREE DAY CAMP FOR 8 TO 12 YEAR OLDS, WHERE THEY LEARN CPR, FIRST AID, INJURY PREVENTION AND ALL ABOUT EMS CAREERS. THE 2- DAY CAMPS ARE HELD THROUGHOUT THE SERVICE AREA DURING THE SUMMER. ANNUAL EMS RECOGNITION AWARDS (SINCE 2006) - PRESENTING COMMUNITY MEMBERS WITH LIFETIME ACHIEVEMENT AWARDS, SPECIAL RECOGNITION AWARDS AND LIFE SAVING AWARDS. ALL HONOREES AND FAMILY ARE INVITED TO THE DINNER CEREMONY. OTHER PROGRAMS ONLINE NEWSLETTERS (E-MAILED TO THE COMMUNITY) - TO PROVIDE MCA NEWS AND INFORMATION. ANDY THE AMBULANCE PRESENTATIONS FOR PRESCHOOL AND KINDERGARTEN AGES - HOW TO CALL 9-1-1, SIMPLE SAFETY MESSAGES. PRESENTATIONS TO YOUNG CHILDREN - CALLING 9-1-1 AND WHAT DO PARAMEDICS DO, PLUS AMBULANCE TOURS. PRESENTATIONS TO OLDER CHILDREN AND YOUNG ADULTS - EMS CAREER INFORMATION AND AMBULANCE TOURS; HELP SCOUT TROOPS RECEIVE FIRST AID BADGES. PRESENTATIONS TO ADULT GROUPS - WHO MCA IS, MCA SERVICES, HOW EMS WORKS, EMERGENCY PREPAREDNESS. PRESENTATIONS TO SENIORS - ANY OR ALL OF THE FOLLOWING TOPICS: WHO MCA IS, MCA SERVICES, HOW EMS WORKS, EMERGENCY PREPAREDNESS, ADVANCE MEDICAL DIRECTIVES, PREVENTING FALLS. STAFFING EXHIBITS AT BUSINESS EXPOS, HEALTH FAIRS AND CAREER FAIRS WHERE WE ANSWER QUESTIONS AND DISTRIBUTE LITERATURE, SOMETIMES DEMONSTRATE AUTOMATED EXTERNAL DEFIBRILLATORS (AEDS). EMS STANDBY COVERAGE FOR LARGE COMMUNITY EVENTS, HIGH SCHOOL SPORTS, ETC. PUTTING ANDY THE AMBULANCE AND/OR AN AMBULANCE IN COMMUNITY PARADES THROUGHOUT THE YEAR. PARTICIPATING IN COMMUNITY SAFETYTOWNS THROUGHOUT OUR SERVICE AREA, WHERE PRESCHOOL CHILDREN LEARN ABOUT FIRE, POLICE AND EMS. PROVIDING CREW AND AMBULANCE TO HIGH SCHOOL "MOCK CRASHES" FOR DRIVER EDUCATION THROUGHOUT OUR SERVICE AREA.
FORM 990, PAGE 6, PART VI, LINE 11B ALL BOARD MEMBERS ARE PROVIDED WITH A COPY OF THE 990 TO REVIEW PRIOR TO FILING OF THE RETURN.
FORM 990, PAGE 6, PART VI, LINE 12C EACH YEAR BOARD MEMBERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE THAT IS THEN REVIEWED BY THE PRESIDENT AND CEO.
FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION OF THE PRESIDENT AND CEO IS REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES OF THE AFFILIATED ORGANIZATION WHO PAYS THE COMPENSATION. THE COMMITTEE REVIEWS THE FORM 990 OF OTHER AMBULANCE COMPANIES ALONG WITH VARIOUS PUBLIC COMPENSATION SURVEY INFORMATION THAT IS AVAILABLE. PERIODICALLY THE EXECUTIVE COMMITTEE HAS A FORMAL SURVEY DONE BY AN INDEPENDENT THIRD PARTY TO ENSURE THAT THE COMPENSATION OF THE PRESIDENT AND CEO IS REASONABLE. THE CONCLUSIONS ARE APPROVED BY THE EXECUTIVE COMMITTEE AND DOCUMENTED VIA A WRITTEN EMPLOYMENT CONTRACT.
FORM 990, PAGE 6, PART VI, LINE 15B COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE DETERMINED BY THE PRESIDENT AND CEO OF THE AFFILIATED ORGANIZATION THAT PAYS THE COMPENSATION, BASED ON COMPARABLE DATA.
FORM 990, PAGE 6, PART VI, LINE 19 COPIES ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9 TEMPORARILY RESTRICTED 505 RELEASE FROM TEMP RESTRICTED -455 TOTAL 50
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


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