EMS OrdinanceAN ORDINANCE OF THE CITY OF BAYTOWN, TEXAS, AMENDING CHAPTER 30 “EMERGENCY SERVICES” ARTICLE III “EMERGENCY MEDICAL SERVICES” OF THE CODE OF ORDINANCES, CITY OF BAYTOWN, TEXAS; PROVIDING
FOR A PENALTY NOT EXCEEDING FIVE HUNDRED AND NO/100 DOLLARS ($500.00); PROVIDING A REPEALING CLAUSE; CONTAINING A SAVINGS CLAUSE; AND PROVIDING FOR THE PUBLICATION AND EFFECTIVE DATE
THEREOF.
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BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF BAYTOWN, TEXAS:
Section 1: That Chapter
30 “Emergency Services” Article III “Emergency Medical Services” of the Code of Ordinances, City of Baytown, Texas, is hereby amended to read as follows:
CHAPTER 30. EMERGENCY SERVICES
ARTICLE
III. EMERGENCY MEDICAL SERVICES
DIVISION 1. GENERALLY
Sec. 30-91. Definitions.
The following words, terms and phrases, when used in this article, shall have the meanings ascribed
to them in this section, except where the context clearly indicates a different meaning:
Ambulance means any vehicle used, designed or redesigned for the purpose of transporting the
sick and injured.
City limits means that area in the city within its corporate limits, plus the plant sites of those industries that have an industrial district agreement with the city,
whether or not such plant site is
within or without the corporate limits of the city.
Committee means the city’s emergency medical service advisory committee created in division 2 of
this article.
Director means the director of the city’s health department.
Emergency circumstances means the existence of circumstances in which the elements of time and expeditious
transporting of an injured person for medical or surgical treatment are essential to the health or life of such person, in which rescue operations or competent first aid or both at the
place of the emergency may be essential to the health or life of such person.
Emergency medical services means services used to respond to an individual's perceived need for immediate
medical care and to prevent death or aggravation of physiological or psychological
illness or injury, performance of the necessary rescue operations, rendering of any necessary first aid assistance or a trip to the hospital or other place for medical attention.
Emergency
medical services vehicle means:
(1) A basic life-support emergency medical services vehicle;
(2) An advanced life-support emergency medical services vehicle;
(3) A mobile intensive-care
unit; or
(4) A specialized emergency medical services vehicle.
EMS division means the EMS division of the city.
Medical Transfer Service Permit means a certificate of authorization
issued by the city to the owner allowing such owner to operate an ambulance for medical transfer services within the city limits.
Medical Transfer Service means a response made by
an ambulance for the transportation of individuals to or from a medical facility, a nursing home or residence under circumstances which do not constitute an emergency.
Medical Transfer
Service Provider means a person providing medical transfer services and holding a valid medical transfer services permit.
State department of health means Texas Department of Health
as presently constituted, or any successor agency.
Sec. 30-92. Administration and enforcement.
The director is vested with the authority and the responsibility for the administration
and enforcement of this article.
Sec. 30-93. Appeals.
(a) Any person wishing to appeal a decision of the EMS coordinator on the grounds that the decision misconstrues or wrongly
interprets this chapter may, within 15 days after the decision, appeal the decision to the director, the EMS medical director and the city’s health authority by making written request
to the director. Such request must be filed with the city clerk within 15 days after such person has been notified of the decision of the EMS coordinator and must set forth in detail
the basis of the appeal. The appealing party shall comply with the EMS coordinator’s decision pending appeal unless the EMS coordinator shall direct otherwise.
(b) Any person shall have the right to appeal any decision of the officers designated in subsection (a) of this section to the city council by making written request to the city manager.
Such request must be filed with the city clerk within 15 days after such person has been notified of the decision of the officials and must set forth in detail the basis of the appeal.
(c) No
person shall have any right to appeal for relief to any court in regard to any matter covered by this article until after such person has exhausted the appeal procedure provided for
in this section.
Sec. 30-94. Penalty for violation.
Any person violating this article shall, upon conviction, be punished as provided in section 1-14. In addition, the city attorney
is authorized to file suit in any court of competent jurisdiction to enjoin any person from violating or causing to be violated any of the sections of this article.
DIVISION 2. EMERGENCY
MEDICAL SERVICE ADVISORY COMMITTEE
Sec. 30-121. Created; composition.
An emergency medical service advisory committee is created, to consist of seven citizens who are residents of
the city. The city council shall appoint the members of the committee and shall initially designate four of their appointments to serve two years and three of their appointments to
serve one year. Thereafter all appointments shall be for two years. However, the city council may remove a member at any time by vote of the city council.
Sec. 30-122. Meetings; recommendations
to council.
The committee shall meet at least two times per year. The committee shall submit to the city council from time to time its recommendations as to any specifications for emergency
medical services vehicles and its recommendations as to revisions to this article.
Sec. 30-123. Duties.
It shall be the duty of the committee to exercise the following powers:
(1) review
and recommend to the city council specifications for construction, equipment and numbers of emergency medical services vehicles necessary to provide service by the city;
(2) perform
such other functions as may be duly delegated to it from time to time by the city council or the city manager.
DIVISION 3. EMERGENCY MEDICAL SERVICES
Sec. 30-151. Response to call.
An emergency medical services vehicle shall be considered on an emergency medical service call when it is responding
to a call for emergency assistance even though, upon arrival of the place of the emergency, it is found no further emergency medical assistance is required or when it is responding to
a call for routine service and during such trip, emergency circumstances develop, whether because the call for assistance was falsely made or otherwise.
Sec. 30-152. Persons authorized
to engage in service.
(a) The operation of emergency medical services vehicles on the city streets for the furnishing of emergency medical service is declared to be a governmental function
of the city to be performed by the EMS division in accordance with this article. It shall be unlawful for any person, including a medical transfer services provider, other than employees
of the EMS division or an agency of the United States government, while driving emergency medical services vehicles operated by the emergency division, to furnish or attempt to furnish
emergency medical service or to operate or drive or cause to be operated or driven any medical services vehicles on the streets of the city for the purpose of furnishing emergency medical
service.
(b) It is an affirmative defense to prosecution under subsection (a) of this section if:
(1) The person operating an ambulance or emergency medical services vehicle, upon
responding to a direct call for ambulance service, determines that an emergency existed requiring the sick or injured person to be transported with all practical speed for medical treatment
and attention and obtained permission to operate such ambulance or emergency medical services vehicle in emergency ambulance service from the public safety communications division;
(2) The
emergency medical service was provided by an emergency medical services vehicle or ambulance based outside the city when not in use and operated by a company having an established place
of business and permanent address outside the city, provided:
a. The sick or injured person was picked up outside the city limits and was transported to a hospital within the city;
b. The
emergency medical services vehicle or ambulance performing such emergency service was, at the time, duly licensed and operated in accordance with V.T.C.A., Health and Safety Code § 773.001
et seq.; and
c. The driver of such emergency medical services vehicle or ambulance complied with all speed and other traffic regulations of the city and the state;
The person operating an emergency medical services vehicle or ambulance within the city was performing a service under contract of maintaining an emergency medical services vehicle
or ambulance at a particular location or event, for the purpose of transporting sick or injured persons for medical or hospital treatment, and determined that a sick or injured person
at such location or event required immediate hospital or medical attention and obtained permission to operate such emergency medical services vehicle or ambulance in emergency service
from the public safety communications division; or
(4) The emergency medical services vehicle service was provided at the request of the public safety communications division due to
unavailability of a city emergency medical services vehicle or ambulance.
(c) In each instance set out in subsections (b)(1) through (4) of this section, the driver or operator of such
emergency medical services vehicle or ambulance shall, prior to commencement of each emergency medical services vehicle or ambulance run, notify the public safety communications division
of the conditions requiring the operation of the vehicle in emergency medical service or ambulance service, the location in which he is proceeding under emergency medical services vehicle
or ambulance service and shall obtain permission for such trip from the public safety communications division. Each emergency medical services vehicle or ambulance operated under subsections
(b)(1) and (2) of this section shall comply with the requirements of this article regarding emergency medical services vehicles or ambulances, insofar as traffic safety is concerned.
Each ambulance being operated under subsections (b)(3) and (4) of this section shall comply with all requirements of this article regarding emergency medical services vehicles or ambulances
of every nature. Upon arriving at the destination, the driver or operator will again notify the public safety communications division that he has arrived and is no longer in emergency
medical services vehicle or ambulance service. When the driver or operator of an emergency medical services vehicle or ambulance is responding to a direct call for emergency medical
services vehicle or ambulance service under emergency conditions, he shall inform the public safety communications division of the location of such call and all information as he may
have concerning the circumstances surrounding the request for service. If the public safety communications division reports that an emergency services vehicle is either in route to the
same location or has arrived there and instructs such driver or operator not to respond to such call, it shall be unlawful for such driver or operator to so respond when instructed not
to do so by the public safety communications center.
Sec. 30-153. Fees.
(a) To partially defer the cost incurred by the city in providing emergency medical service, a basic fee of
$325.00 is established to be collected from the user of emergency medical service provided by the city. In addition, the following fees are established to be collected as applicable:
Mileage (per patient mile) $ 6.50
Extra attendant 50.00
Oxygen 30.00
Defibrillation supplies 35.00
Endotracheal tube 25.00
IV fluid D5W 20.00
IV fluid normal saline
20.00
IV administration set 25.00
Gauze pad 4 X 4 1.00
Gauze pad 5 X 9 3.00
Gauze pad 10 X 30 7.00
Kerlix 4" 5.00
Cold pack 5.00
Burn sheet 20.00
Dextrostix
15.00
EKG pads 10.00
Pacing pads 100.00
Suction tip 15.00
Blood tube 10.00
Auto ventilation supplies 25.00
Bag valve mask 50.00
Bandaging per site 20.00
CPR 50.00
Chest decompression 50.00
External cardiac pacing 75.00
ECG monitor 50.00
Infection control 50.00
Interosseous cannulation 75.00
Nebulizer 35.00
OB kit 25.00
Pulse
oximeter supplies 20.00
Spinal immobilization 40.00
Splinting per site 20.00
Stand by per hour 40.00
Suctioning 25.00
Surgical airway 120.00
Adenosine (6 mg) 30.00
Atropine
sulphate 15.00
Atrovent (2 mg) 15.00
Benadryl (50 mg) 15.00
Bretylol 15.00
Calcium chloride 15.00
Dextrose 50% 15.00
Dexamethasone 15.00
Dobutamine 15.00
Dopamine
30.00
Epinephrine 1:1000 15.00
Epinephrine 1:10,000 15.00
Glucagon 50.00
Isuprel 15.00
Lasix 20.00
Lidocaine (100 mg) 15.00
Lidocaine drip 15.00
Magnesuim sulphate 15.00
Mannitol
50.00
Methylprednisolone 15.00
Morphine sulphate 15.00
Narcan 15.00
Nitro spray 15.00
Norcuron 15.00
Norepinephrine 15.00
Oxytocin 15.00
Phenegran 15.00
Procainamide
15.00
Provental 15.00
Sodium bicarbonate 15.00
Succsycholine 15.00
Thiamine 15.00
Valium (10 mg) 15.00
Versed 50.00
(b) Bills for emergency medical service that have not been paid within 30 days of the date that such bill was mailed by the city shall be deemed delinquent. Delinquent
bills for emergency medical service shall be charged ten percent interest, plus reasonable attorney's fees if a lawsuit is filed to collect the delinquency.
Sec. 30-158. False call
or request for service.
Any person who shall willfully, in writing or orally or by use of any telephone, telegram, radio or mechanical device or contrivance whatsoever or by any name
known, make, give, send a report or communicate any false call or request for emergency medical service or communicate any false report or falsely report any act or fact situation initially
and voluntarily to the dispatcher or to any person operating an ambulance or emergency medical service vehicle in the city for the purpose of causing or which report or false call or
request for services is calculated to cause an ambulance or emergency medical services vehicle to respond or to do or perform some act or to do or render some service as a result thereof
shall be guilty of an offense. The offense denounced in this section is basically the offense of giving or causing to be given by any means a false emergency medical service alarm or
false emergency medical service request, and nothing in this section shall be construed as including a prohibition against the offense of false alarm or report prohibited by V.T.C.A.,
Penal Code § 42.06.
DIVISION 4. MEDICAL TRANSFER SERVICES
Subdivision 1. Permits
Sec. 30-181. Permit required; exception
(a) Required. No person shall furnish, operate, conduct,
maintain, advertise or otherwise be engaged in the operation of medical transfer services upon or over any public street within the city limits without having first obtained a medical
transfer services permit.
Exception. A medical transfer services permit shall not be required for :
emergency medical service vehicles or ambulances owned and operated by a governmental
entity; or
emergency medical service vehicles or ambulances operating at the request of the city in cases of a mutual aid, disaster or system overload.
Sec. 30-182. Application.
An application for a medical transport service permit shall be filed with the director on a form provided by the director. Application for initial service
may be made at any time. The applicant shall provide at least the following information:
(1) the name, title, business name, business address, and business phone number of the applicant
as well as the following information as applicable:
If the person submitting the application represents a partnership, then the name, title, business name, business address, and business
phone number shall be given on all partners and persons having an interest in the business;
If the person submitting the application represents a corporation, the name and location
of its principal place of business, as well as the name, telephone number and address shall be given on all the officers and directors of the organization;
(2) documentary evidence
from the city’s tax assessor-collector that ad valorem taxes on the property to be used in connection with the operation of the proposed medical transfer service have been paid;
(3) the
names, business addresses, and business phone numbers of organization responsible for dispatching ambulances;
(4) the name, address, and phone numbers for the medical director responsible
for all aspects of the operation of the applicant’s medical transfer services within the city limits;
(5) a description of the make, vehicle identification number and license number
of each ambulance proposed to be utilized in providing medical transfer services within the city limits;
(6) level of care that the applicant proposes to provide according to the state
department of health standards within the city limits;
(7) a certificate of insurance meeting the requirements of section 30-184; and
proof of a current valid state department of health
emergency medical service provider permit.
The application shall include a sworn statement by the applicant that the information provided in the application is true and correct.
Sec. 30-183. Fee.
Each application for permit required by this division shall be accompanied by a nonrefundable permit fee as listed below, to cover the expense of carrying out the
provisions of this article:
Application Fee and one ambulance $250 per year
Each additional ambulance $100 per year
There shall be no proration of fees.
Sec. 30-184. Insurance.
Any
applicant for a permit under this division shall, before the permit can be issued, procure, maintain and furnish proof of financial responsibility as required by law and as prescribed
in this section. The applicant shall keep in full force and effect during the entire term of his permit the following insurance coverages in the minimum limits listed:
Automobile liability
insurance of no less than $20,000.00 for bodily injury to or death of one person in any one accident and, subject to such limit for one person, in the amount of $40,000.00 for bodily
injury to or death of two or more persons in any one accident and in the amount of $15,000.00 for injury to or destruction of property of others in any one accident. This automobile
liability insurance shall not contain a passenger liability exclusion.
Commercial general liability insurance with a minimum aggregate of $500,000.00 and a minimum per occurrence limit
of $250,000.00.
The insurance company shall be of sufficient assets, with an agent in the state upon whom service of process may be made, and shall be approved by the city attorney.
Every insurance policy and certificate of insurance must contain a provision or an endorsement requiring that the city clerk shall be given at least 30 days’ written notice prior to
the date of cancellation before such policy may be cancelled by the insurer for any cause.
Such insurance shall be written by an insurance carrier licensed to do business in this state
and which shall be of sufficient assets, with an agent in the state upon whom service of process may be made, and shall be approved by the city attorney. Every insurance policy and
certificate of insurance must contain a provision or an endorsement requiring that the policy will not be canceled, suspended, voided or reduced until at least 30 days' prior written
notice has been given to the city via certified mail, return receipt requested. Additionally, the city shall be added as an additional insured on the policies, and the coverage shall
contain no special limitation on the scope of protection afforded to the city. If the policy does not provide coverage for "any auto," then a schedule of the covered autos
is required to be submitted and filed with the city clerk. Only those covered autos will be permitted to operate within the city.
If the city attorney determines that the insurance
coverages required in subsection (a) of this section has become impaired and requires new and additional insurance, the city attorney shall require such additional insurance in such
company as he may feel is required to ensure a faithful performance by the operator of ambulances and his agents, servants and employees, as well as a payment by such operator of ambulances,
his agents, servants and employees or because of the violation by the operator of ambulances, individually or through his agents, servants or employees, of any city ordinance or any
of the laws of the state or of the United States.
If the insurance policy is cancelled and no insurance policy is filed by the owner or ambulance operators before the cancellation,
the permit to operate ambulances granted to such person shall be automatically revoked.
Sec. 30-185 Inspection.
The director shall have the right to inspect at any time all ambulances
permitted or to be permitted under this division to determine if such vehicles meet the following minimum standards:
(1) Each vehicle shall be equipped according to the state department
of health equipment standards, and as determined by the ambulance service medical director;
(2) Each vehicle shall be free from dirt or rubbish and shall be otherwise clean and sanitary;
(3) Each
vehicle shall meet the general standards and requirements of this article;
(4) Each vehicle shall have the company name displayed on each side of the vehicle and on the rear; and
(5) Each
vehicle shall be inspected each year by a person authorized to conduct vehicle safety inspections by the state.
At no time shall any ambulance that is found to be unsafe by the director
be operated on the streets of the city. Nothing in this section, however, shall prevent the director from inspecting any ambulance at any time and if the director finds that any ambulance
is in a defective condition, the director shall order the use of the ambulance discontinued until the ambulance is reinspected and approved.
Sec. 30-186. Payment of ad valorem taxes.
It shall be the duty of every medical transfer services provider to pay all ad valorem taxes assessed by the city against such vehicle and
all other personal and real property used in such business. The failure to pay such ad valorem taxes before they become 90 days delinquent shall operate as a revocation of the permit
issued in accordance with this division.
Sec. 30-187. Issuance of permits.
(a) Under this division, the director shall issue to each applicant a permit for each vehicle upon the
applicant’s filing of written proof of insurance as required in this division, upon ensuring that all city taxes on each vehicle and on all other personal and real property used in such
business have been paid and upon a determination that all requirements of this article and all applicable state and federal statutes and regulations have been satisfied.
(b) Permits
shall be issued for a 12-month period. Such period shall run from January 1 to December 31 of each year. Any new permit issued during the year shall begin on the date of issuance and
shall end on December 31 of that year. The permit shall state the period for which the permit is issued, the name of the owner, the make of the vehicle, the vehicle identification number,
and the current license number.
Sec. 30-188. Renewal.
(a) An application for renewal of an existing permit shall be filed on or before December 15 of each calendar year. The application
process shall be the same as specified in this subdivision for initial permits.
(b) The director shall issue a medical transfer service permit for each ambulance for which it has received
a renewal application upon the applicant’s filing of written proof of insurance as required in this division, upon ensuring that all city taxes on each vehicle and on all other personal
and real property used in such business have been paid and upon a determination that all requirements of this article and all applicable state and federal statutes and regulations have
been satisfied.
(c) If a permit has been suspended during the permit year, reissuance of such permit will be reviewed by the director, the EMS medical director and the city’s health
authority during December of such year. The awarding of such permit shall be denied if the director, the EMS medical director and the city’s health authority determine that the health,
general public safety and welfare of the citizens of the city demand such a result.
Sec. 30-189. Transferability.
A permit issued under this division shall be personal to the permittee and shall not be transferable.
Sec. 30-190. Alteration of terms by city council.
The
city council expressly reserves the right to modify, amend, change, or eliminate any of the provisions of any permit issued under this division, during the life of the permit, to:
Eliminate
or delegate any conditions that might prove obsolete or impractical; or
Impose any additional conditions upon any owner, as may be just and reasonable, and which are deemed necessary
for the purpose of promoting adequate, efficient, and safe ambulance service to the public.
Sec. 30-192. Revocation.
In addition to the penalties as provided in this code for violations
of this article, a medical transfer service provider or any of its officers agents and/or employees who violate any section of this article, including allowing drivers to operate or
drive any vehicle while not properly licensed, is subject to immediate cancellation of its medical transfer service permit to operate within the city limits by the director. However,
not less than ten days before such cancellation, the owner shall be given written notice and an opportunity to be heard before the to the director, the EMS medical director and the city’s
health authority as to why the permit should not be cancelled. No such notice or hearing shall be deemed necessary prior to the revocation of a permit for failure to maintain proper
insurance as required in section 30-184.
Subdivision 2. Services and Regulations
Sec. 30-201. Operation of ambulances.
The driver or operator of any ambulance of a medical transfer
service provider shall comply with all of the state traffic laws and city ordinances, including this article, in furnishing medical transfer service. Any such driver or operator shall
not permit the ambulance of a medical transfer service provider to be used as an emergency medical services vehicle or for emergency medical services without compliance with all requirements
of this article regarding emergency medical services vehicle or ambulance service.
Sec. 30-203. Structural and licensing requirements.
No emergency medical services vehicle or ambulance shall be operated on the public streets of the city unless it is free of structural
defects and unless it has no serious impairment of any safety feature resulting from an accident or otherwise.
No emergency medical services vehicle or ambulance shall be operated
upon the streets of the city for the purpose of furnishing emergency ambulance service unless and until such vehicle or ambulance has been licensed in accordance with V.T.C.A., Health
and Safety Code § 773.001 et seq.
Sec. 30-204. Required equipment.
No emergency medical services vehicle or ambulance shall be operated upon the city streets for the purpose of furnishing
ambulance service, unless such vehicle or ambulance is equipped in accordance with V.T.C.A., Health and Safety Code § 773.001 et seq. and all regulations of the state department of health.
Sec.
30-205. Display of name.
Under this article, every emergency medical services vehicle or ambulance shall have the name of the ambulance or emergency medical service displayed on both
exterior sides.
Section 2: All ordinances or parts of ordinances inconsistent with the terms of this ordinance are hereby repealed; provided, however, that such repeal shall be only
to the extent of such inconsistency and in all other respects this ordinance shall be cumulative of other ordinances regulating and governing the subject matter covered by this ordinance.
Section
3: If any provision, section, exception, subsection, paragraph, sentence, clause or phrase of this ordinance or the application of same to any person or the set of circumstances, shall
for any reason be held unconstitutional, void or invalid, such invalidity shall not affect the validity of the remaining provisions of this ordinance or their application to other persons
or sets of circumstances and to this end all provisions of this ordinance are declared to be severable.
Section 4: This ordinance shall take effect from and after ten days from its
passage by the City Council. The City Clerk is hereby directed to give notice hereof by causing the caption of this ordinance to be published in the official newspaper of the City of
Baytown at least twice within ten days after passage of this ordinance.
INTRODUCED, READ, and PASSED by the affirmative vote of the City Council of the City of Baytown, this the 24th day of February, 2000.
____________________________________ PETE
C. ALFARO, Mayor
ATTEST:
_____________________________________
GARY W. SMITH, City Clerk
APPROVED AS TO FORM:
_____________________________________
IGNACIO RAMIREZ, SR., City
Attorney
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