Write an SOP for every position
The problem
“I can’t keep my drivers and team accountable.”
Count jobs, not people. You do not need a person for every job to start. A small company can begin with four positions holding every job between them:
Reviews the bank and card statements every week
Dispatcher
- Trip intakeCan be a call center
- Confirmation callsCan be a call center
- Dispatch and ETA calls
- Booking maintenance
Never dispatches while driving
Office manager
- Billing and collectionsTouches cash
- Payroll and billsTouches cash
- ComplianceCan be part-time
- Recruiting
Drivers
- Driving, including stretcher attendants
Give a job its own person when it starts slipping, not when the fleet reaches a certain size. These are the signs to watch:
| Job | Give it its own person when |
|---|---|
| Trip intake and confirmation calls | Calls go to voicemail in the morning rush, or confirmations are not done before the day starts |
| Dispatch | Tomorrow’s plan is not finished by the end of the day |
| Billing and collections | Claims stop going out the same day the trip runs |
| Compliance | A credential comes inside its lead time and nobody has started the renewal |
| Recruiting | Applicants wait days for a callback |
Two combinations to avoid at any size: dispatching while driving, and one person who both collects the money and pays it out with nobody checking. The owner reviewing the bank and card statements every week covers the second.
What keeps a position from depending on one person is a written SOP (standard operating procedure), not a second hire. Every position gets one, written by the person who does the job: what they do daily, weekly and monthly, what they decide on their own and what they hand up, and the logins, contacts and quirks, like the facility that only takes calls before ten.
An SOP goes out of date quietly, so test it. Once a quarter, have someone run a day of that position using only the SOP. Every question they have to ask is a line the SOP is missing.
Then name who follows each SOP in a sudden absence, until a replacement starts. In a small company that is usually the owner for almost every position, with the dispatcher as the second name.
When someone gives notice, hire from your pipeline, hand the new hire the SOP, and have them work alongside the person leaving: about a week for most positions, longer for one as involved as billing.
Not every job needs a full-time hire. Phone work (trip intake, confirmation calls, ETA calls) can go to an offshore call center, which gives that job cover without a second hire. If you work with brokers, check those contracts first, because some limit who can handle member information outside the US. Compliance comes in renewal cycles, so it can be a part-time job, as long as one named person owns the calendar in Fleet and tools.
Recruit before someone quits
The problem
“I can’t find good drivers.”
“My drivers quit after a month.”
If you only recruit when someone quits, you are short the day you start looking. Short means overtime, a dispatcher covering routes, and taking whoever applies. The person you settle for is more likely to leave, and the cycle starts again.
Keep the pipeline open instead: a posting that never comes down, applications reviewed on the same day every week, and a warm bench of people you liked but had no opening for. Then call back fast, because good drivers apply to several companies in the same week and take the first credible offer.
When a driver does leave, note how long they stayed. Leaving inside thirty days points to how the job was sold or the first week. Leaving at three to six months points to the hours or the pay. Leaving after a year usually means something changed, like a route or a dispatcher. Ask each one a single question: what would have kept you here?
Write the pay plan down
The problem
“I can’t tie what I paid drivers to the trips they ran.”
“I’m one audit away from a payroll tax bill.”
Driver pay is the largest cost in most NEMT companies, and often the least written down. Rates get agreed one driver at a time, and payroll becomes whatever the spreadsheet said last week.
Write one page per role: what it pays, by the hour, by the trip or both, and what the extras pay for, such as a stretcher, a bariatric rider or waiting time. Everyone in the same role gets the same page.
Every week before payroll goes out, check each driver’s pay against the trips and hours in the dispatch record. A gap nobody can explain is a mistake, an arrangement nobody wrote down, or money leaving that should not, and each one gets harder to untangle the longer it runs.
Once a year, take the plan to an employment lawyer or your accountant. Whether a driver is an employee or a contractor depends on how the work is directed more than on the paperwork, and an employee’s waiting time between trips usually counts toward minimum wage.