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HomeMy WebLinkAboutORD 2015-36 - Emergency Med & Med TransferAN ORDINANCE ADDING CHAPTER 2.29 ENTITLED 44EMERGENCY MEDICAL AND MEDICAL TRANSFER SERVICES" TO THE CODE OF ORDINANCES OF THE CITY OF GEORGETOWN, REPEALING CONFLICTING ORDINANCES AND IXESOLUTIONS; PROVIDING A SEVERABILITY CLAUSE; PROVIDING FOR PUBLICATION AND SETTING AN EFFECTIVE DATE. WHEREAS, the City of Georgetown has a growing population in need of emergency medical and medical transfer set -vices; and WHEREAS, adoption of this ordinance will help protect the health and safety of the community and citizens; and WHEREAS, adoption of this ordinance will enhance predictability and accountability with emergency and non -emergent ambulance transport services; and WHEREAS, adoption of this ordinance will help protect the financial interests of the residents and City; and NOW, THEREFORE, BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF GEORGETOWN, TEXAS THAT: Section 1. The meeting at which this ordinance was approved was in all things conducted in compliance with the Texas Open Meetings Act, Texas Government Code, Chapter 551. Section 2. The facts and recitations contained in the preamble of this ordinance are hereby found and declared to be true and correct and are incorporated by reference herein and expressly made a part hereof, as if copied verbatim. Section 3. Chapter 2.29 of the Code of Ordinances is added as follows in Exhibit A. Section 4. All ordinances that are in conflict with the provisions of this ordinance be and the same are hereby repealed and all other ordinances of the City not in conflict with the provisions of this ordinance shall remain in full force and effect. Section 5. If any provision of this ordinance or application thereof to any person or circumstance shall be held invalid, such invalidity shall not affect the other provisions, or application thereof, of this ordinance which can be given effect without the invalid provision or application, and to this end the provisions of this ordinance are hereby declared to be severable. Ordinance Number: 001S—Me Page I of 2 Description: Adding Chapter 2.29 "Emergency Medical and Medical Transfer Services" Exhibits: Date Approved: NAmit '1"0. v Section 6. The Mayor is hereby authorized to sign this ordinance and the City Secretary to attest. This Ordinance shall become effective in accordance with the provisions of the Charter of the City of Georgetown on October 1, 2015. PASSED AND APPROVED on First Reading on the __[g� dayofMA-)(,2015. ATTEST: Je is Brettle, City Secretary APPROVED AS T RM: 8ridget Chapmak Ci @ Attorney THE CITY OF GEORGETOWN: Dale Ross, Mayor Ordinance Number: 0j 5-3k0 Page 2 of 2 Description: Adding Chapter 2.29 "Emergency Medical and Medical Transfer Services" Exhibits: Date Approved: 884A N A tf i ;;Ln 'T Chapter 2.29. - EMERGENCY MEDICAL AND MEDICAL TRANSFER SERVICES Article I. - General Provisions 2.29.010. - Definitions. The following words shall have the following meanings: "Ambulance" means any motor vehicle especially designed, constructed, equipped and used to transport sick or injured persons. "City" means the City of Georgetown. "City Communication Center" means the City facility from which emergency medical service is radio -dispatched. "Emergency" means any circumstance that calls for immediate action and in which the element of time in transporting the sick, wounded or injured for medical treatment is essential to the health or life of the person. "Emergency call" means any request for an emergency medical ambulance made by telephone or other means of corninunication in circumstances which are, or have been represented to be, an emergency requiring immediate ambulance service. "Emergency medical ambulance" means any ambulance including a transitional response vehicle that is equipped with warning lights and horns or sirens for use in responding to emergency calls. "Fire Chief" means the chief of the fire department of the City of Georgetown or designee. "Medical transfer service" means a response made by an ambulance or ambulance for transportation of individuals to or from a medical facility, nursing home or residence under circumstances that do not constitute an emergency. "Provider" means an organization, person, business or entity providing medical transfer services and a holding a valid medical transfer services franchise. "Response time" means the time from which a call is received until the time of arrival at the scene. "Street" means any street, alley, avenue, boulevard, drive or highway commonly used for the purpose of travel within the corporate limits of the city. "Transfer call" means any request for an ambulance that is represented as not constituting an emergency. Article 11 — Emergency Medical Services The City of Georgetown, through the Fire Department, shall provide emergency medical services, including transport services, within the City. The City Communication Center is designated to handle calls for emergency medical services and shall be available by telephone at all hours. 2.29.030. - Private service. A. It shall be unlawful for any person, including a provider, other than an employee of the Fire Department officially on duty, or an agency of the United States, to furnish, operate, conduct, maintain, advertise for, or otherwise engage in the operation of an emergency medical ambulance or the provision of emergency medical service in the City. A provider shall place its equipment and personnel at the disposal of the City Manager in the event of a public calamity or major disaster. B. If a provider receives an emergency call from any source to respond to in the City, it shall immediately notify the City Communication Center and shall not respond unless requested to do so by the City Communication Center. C. If a provider discovers an emergency situation in the City, it shall immediately notify City communication center and shall remain to render aid until an emergency medical ambulance arrives. D. The following exceptions apply: 1. It shall not be unlawful for a person to operate an air ambulance that is regulated and certified by the U.S. Federal Aviation Administration and that is operating in compliance with state licensing requirements. 2. It shall not be unlawful for a provider responding to a direct call for medical transfer service to operate an ambulance under emergency conditions, using emergency equipment if the provider attendant makes a determination that an emergency exists requiring the sick or injured person to be transported with all practical speed to a hospital and makes a reasonable attempt to contact the City Communication Center and receive permission to make an emergency run. 3. It shall not be unlawful for a provider performing the service of maintaining an ambulance at a particular location for a sporting event, to operate an ambulance under emergency conditions, using emergency equipment if the provider attendant makes a determination that an emergency exists requiring the sick or injured person to be VA transported with all practical speed to a hospital and makes a reasonable attempt to contact the City Communication Center and receive permission to make an emergency run. 4. It shall not be unlawful for a provider operating an ambulance in the city, if the place of emergency at which the sick or injured person was picked up by such ambulance is outside the city limits and the ambulance making the emergency run is licensed and operated in accordance with all applicable state laws. 5. It shall not be unlawful for a provider operating an ambulance in the city to respond to an emergency call when the City Communication Center requests the provider furnish backup arnbulance service for the City of Georgetown. 6. Any operator who makes an emergency run under the provisions of subsections (D)(2) or (D)(3) of this section, shall, within three business days of each emergency run, submit to the Fire Chief a report which shall describe the circumstances requiring the emergency run. F='M11=iTJM#M M 2.29.040. - Franchise - Required. A. It is unlawful for any person to operate, furnish, advertise, or otherwise engage in the operation of a medical transfer service by operating, driving or causing to be operated or driven an ambulance upon the streets of the city without first having obtained a franchise in accord with the terms and provisions of this chapter and the City Charter. B. Each fi-anchise granted under this Chapter will be a nonexclusive franchise. A medical transfer service franchise shall grant non-exclusive permission to the provider to provide medical transfer services for the service level and category so authorized in the service areas specifically described in the franchise agreement, according to the terms and conditions contained in the franchise agreement. No provision, term of art, map or illustration, nor Section title of this Chapter, nor of any franchise agreement granted under this Chapter, shall imply, suggest, connote or in any way infer that any provider holds any degree of exclusivity to solely provide medical transfer service within the City, nor within any franchise service area within the City, nor any sub -zone thereof. 2.29.050. - Franchise - Application - Contents. A. Whenever the number of providers within the City is less than the maximum number established by the City Council pursuant to this Chapter, or if the City Council has not established a maximum number of such franchises but has determined that a new medical transfer service franchise will serve the public convenience and necessity, a person may apply for a new franchise by submitting an application to the Fire Chief on such form or in such format as the Fire Chief shall require. B. In addition to the items specified within the application form referenced in Paragraph A, the following shall be submitted in writing: I . A statement that the applicant has obtained liability insurance in accordance with the requirements provided by this article before commencing service; 2. A statement of the number of vehicles which the applicant proposes to operate and the make, model and vehicle identification number of each transfer vehicle; 3. A statement that each vehicle is supplied with a first-aid kit and other minimal emergency equipment; 4. A list of persons who will act as attendants and drivers, their current state of Texas registry status, and their date of employment; and 5. A statement that the safety mechanism of the vehicle is operative and is in good repair; including, but not limited to, headlights, tail -lights, turn signals, brakes, brake lights, emergency lights, windshield wipers, wiper blades, handles opening doors, restraint devices, windows, tires and spare tires. C. Copies of each application for medical transfer service shall be forwarded to the Fire Chief, and he shall review applications for medical transfer service and make recommendations to the City Council. 2.29.060. - Franchise provisions. The following provisions shall apply to franchises issued pursuant to this Chapter: A. The franchise agreement shall incorporate and be subject to the provisions of this Chapter, as it may be amended from time to time, all of which shall be binding upon the provider. In no event shall this Chapter be considered a contract between the City and the provider such that the City would be prohibited from amending any provision hereof. B. All documents provided by the applicant as part of the completed application and all statements, representations, warranties and promises made therein by the applicant and relied upon by the City in granting the franchise shall be binding upon the provider. C. A franchise agreement shall set forth its length of term, up to a maximum of five years. The franchise may be extended or renewed at the discretion of the council under such terms and conditions as may be necessary or desirable. D. No privilege or exemption shall be inferred from the granting of any franchise unless it is specifically mentioned in this Chapter or in the franchise agreement. E. The granting of a franchise pursuant to this Chapter shall not impart to the provider any vested ownership right or ownership interest in any rights-of-way or City property, notwithstanding the right to use City rights -of way or City property to provide its medical transfer service. F. As a condition of the franchise and prior to providing medical transfer service a provider shall provide the City with a detailed statement of the equipment and facilities to be used in providing medical transfer service, including: 1. A current Department of State Health Services (DSHS) license that enables the provision of emergent and non -emergent services; 2. An attestation that the vehicle, staff and equipment will continually meet the DSHS requirements for emergent and non -emergent services. The vehicle identification number, make, type, age, condition and patient capacity of each vehicle available for use within the service area, a detailed description of the equipment thereon; 3. The location and description of the premises which are to be used as the base of operations and any terminals, offices and other facilities to be used in the operations; 4. A description of the provider's procedures related to vehicle maintenance and repair; 5. A copy of the provider's Federal Communications Commission license; and 6. Proof that the provider's AVL and CAD have been tested for compatibility with the City's Communication system and have performed in a manner acceptable to the Fire Chief in his or her sole discretion. 7. Proof of ownership or long-term lease agreements for all capital equipment and inventory items that are necessary for the operation of a viable EMS operation. 8. Proof of an electronic patient care recording system that can integrate into a receiving hospital's electronic medical record, or an acceptable alternative approved by the Fire Chief. 2.29.070. — Franchise fee determination. The franchise fee shall be the amount set forth in a franchise agreement for the cost which the City incurs in administering the franchise agreement, including dispatch processing, providing or C, arranging services, staff costs for inspections, regulatory oversight, use of roads and infrastructure, and any other such service permitted by law. Franchise fees shall be paid according to the provisions of the franchise agreement, and shall be accompanied by such supporting documentation as determined by the City. 2.29.080. — Insurance. A. No ambulance shall be operated by a provider on the public streets of the City, unless the provider submits evidence to the Fire Chief that it has in full force and effect a public liability insurance policy on that transfer vehicle, such insurance policy having been issued by a solvent insurance company licensed to do business in the state. B. Each insurance policy shall provide liability insurance in the amount of not less than $ 1,000,000 for personal injury in any one accident, and not less than $500,000 for property damage for each transfer vehicle, C. Such insurance policies shall not contain a passenger liability exclusion. D. Each liability insurance policy shall contain a provision obligating the insured to give the Fire Chief written notice of cancellation or reduction not less than ten days prior to any cancellation or reduction. E. Each policy shall name the City as an additional insured. FIN A violation of any provision of this Chapter or of the franchise agreement or state or federal law shall be grounds for revocation of the franchise by the City Council. 2.29.100. - Medical transfer operations. A. A provider shall have available at its own expense, and staff 24 hours a day, a telephone for transfer service requests. B. A provider shall respond to any unscheduled request for transfer service within 59 minutes and 59 seconds at any time of time, any day of the week from the time of the request or within 14 minutes and 59 seconds of a scheduled pickup time. C. The books and records of all providers shall be made available at any reasonable time for inspection by the City D. A provider shall not use, encourage, advocate or solicit the use of any telephone number or system of communication in lieu of the 911 emergency telephone system number for the dispatch of an ambulance to any call except for medical transfer service as defined by this Ordinance. E. Unless otherwise specified in its franchise agreement, when a provider receives, through any means, a request for service which if processed through EMS priority dispatch protocols would be determined to be a Category A, B, C, D, or E level call for EMS ambulance service the provider shall electronically transfer information on the call to the City Communication Center, including patient location, condition and call-back number. F. Except with respect to medical transfer service, when a provider is providing special event medical service and a patient's condition requires transport, or a provider is directly called to transport a patient from a special event, the provider shall electronically transfer information on patient location, condition, availability of or need for the dispatch of an emergency medical ambulance and call-back number to the City Communication Center. G. Providers shall mark each vehicle distinctly with the name of the company providing medical transport service. The words "Emergency Medical Services" or "EMS" shall not be written on any vehicle, and the vehicle shall not be marked in any way which might cause confusion with City or County EMS vehicles. The name of the provider company shall be prominently displayed so that it accurately conveys the entity that is rendering services. H. Providers shall not hold out to the public in any manner that their personnel are trained EMTs or paramedics unless they have been so certified by the Texas Department of State Health Services, Emergency Services Medical Division. I. Ambulances shall be used only for the purpose of transporting patients, and no other use shall be lawful. J. Provider shall provide critical care transport (CCT) and personnel, or other reasonable specialty needs, when requested by the City. K. Provider shall participate in the City's EMS Continuous Quality Improvement (CQI) and peer review process, when requested by the Fire Chief. 0 W A. A provider shall furnish at its own expense all vehicles and necessary equipment which meet the minimum standards of the Department of State Health Services, in addition to those standards set by all City, county, state, and federal regulations covering automotive equipment and ambulance equipment. B. Each vehicle shall be attended by at least two currently state -certified Emergency Medical Technicians (EMTs), Each EMT shall hold a valid Class A Texas driver's license. C. A provider shall maintain a current personnel file at the local administrative office on each employee. All attendants and drivers shall meet the following minimum criteria: 1. Be currently certified with the Texas Department of State Health Services, Emergency Medical Services Division, as an emergency medical technician, or higher; 2. Must provide evidence showing completion of the National Safety Council approved defensive driving course, or equivalent as approved by the Fire Chief-, and 3. Possess a license valid to operate an emergency vehicle and ambulance in the state; and 4. Must have a written statement from a physician, authorized to practice medicine in the state, stating that the person is free of communicable diseases and is physically capable of performing the required duties. D. The Fire Chief may ride on an ambulance at any time for the purposes of evaluating the medical and/or driving performance of the EMTs. A copy of an evaluation shall be provided to the provider within 72 hours, The evaluation shall indicate performance areas which exceed, meet or do not currently meet expectations. Regarding areas that do not currently meet expectations, the Fire Chief should include in the evaluation what action must be taken to ensure compliance with performance standards. E. EMTs disciplined or failing, as determined by the Texas Department of State Health Services, to meet medical performance standards, shall not continue to render transfer services as an EMT. F. Each vehicle to be used as an ambulance shall comply with the following requirements and such other requirements or modifications as may be established by the department: 1. Ambulances shall comply at all times with the Texas Transportation Code. 2. Each vehicle to be used as an ambulance shall be equipped as required by 25 Texas Administrative Code, § 157.11. 3. Ambulances shall be utilized no more than 250,000 miles if powered by a diesel engine and no more than 150,000 miles if powered by a gasoline engine. The vehicle chassis shall not be utilized more than six years from the year of manufacture. G. A provider shall have a preventive maintenance program and records for each ambulance. The maintenance program shall be based on recommended manufacturer service and inspection intervals. H. A provider shall also rriaintain vehicle service records specifying all unscheduled repairs and break -downs and shall provide the Fire Chief a quarterly report of all ambulance breakdowns and unscheduled repairs. The report shall indicate the vehicle unit number, license plate number, odometer reading, vehicle system and/or component in need of repair or adjustment, and whether or not a patient was on board when the breakdown occurred. I. The Fire Chief shall inspect all provider ambulances. Inspections may occur at any hour and the Fire Chief may require the ambulances to proceed to a specified location for further inspections. Those ambulances which have passed inspection shall have a sticker in the lower left comer of the rear window. Any ambulance found not to be in compliance with this chapter shall be tagged, and the sticker removed. Thereafter, until the vehicle passes inspection, it cannot lawfully operate on the streets of the city. The intent of this Chapter is to reduce the risk of fraudulent billing practices and maintain compliance with the Office of the Inspector General (OIG) and the U.S. Department of Justice. A. Providers shall not charge any patient or any other payer less than the Medicare allowable rate. B. Billing rates will be authorized within the franchise agreement and may be amended upon City approval. C. Non -medically necessary transports, provided by a provider, shall not be less than the minimum amount specified within the franchise agreement. Any violation of any section of this chapter shall constitute a misdemeanor punishable in accordance to the provisions of Chapter 1.08 of the Code of Ordinances.