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HomeMy WebLinkAboutOrdinance 8409_, z ~..,~ ~~ ORDINANCE NO .~~®-- AN ORDINANCE AMENDING CHAPTER 6 "AMBULANCES' OF THE FORT WORTH CITY CODE (1964) AS AMENDED BY SUBSTANTIALLY REWRITING THE PROVISIONS OF SAID CHAPTER 6 AND SUBSTITUTING THE NEW TEXT THEREFORE MAKING THIS ORDINANCE CUMULATIVE OF PRIOR ORDINANCES PROVIDING THAT ALL PRESENT PERMITS AND ACTS OF OFFICIALS ARE TO REMAIN IN EFFECT WITH THEIR PRESENT DATES OF EXPIRATION REPEALING ALL CONFLICTING ORDINANCES PROVIDING A SEVERABILITY CLAUSE AND PROVIDING AN EFFECTIVE DATE ti BE IT ORDAINED OR ENACTED BY THE CITY COUNCIL OF THE CITY OF FORT WORTH TEXAS SECTION 1 That Chapter 6 Ambulances of the Code of the City of Fort Worth Texas (1964) as amended is hereby amended in its entirety and is to read as is set out in Exhibit A--'New Text of Chapter 6 Ambulances said Exhibit A which is attached hereto and incorporated herein as if set out in full The former Chapter 6 is replaced entirely by the material set out in Exhibit A. SECTION 2 That all of the permits presently in effect and all of the acts of the officials of the City of Fort Worth legally done under the now amended ordinance are to remain in force and effect until they expire or until they are ratified cancelled or modified by acts done under the new terms of this Ordinance SECTION 3 That this ordinance shall be cumulative of all provisions of the Code of the City of Fort Worth (1964) as amended and all other ordinances and laws of the City of Fort Worth except in those instances where the provisions of this ordinance are in direct conflict with the provisions of said Code or other ordinances in which instances said conflicting provisions of said Code or other ordinances are hereby repealed SECTION 4 It is hereby declared to be the intention of the City Council that 'the sections paragraphs sentences clauses and phrases of this ordinance are severable and if any phrase clause sentence y ,,;o-;~: paragraph or section of this ordinance shall be declared unconstitu- tional by the valid judgment or decree of any court of competent ~'~ jurisdiction such unconstiutionality shall not affect any of the remaining phrases clauses sentences paragraphs and sections of this ordinance since the same would have been enacted by the City Council without the incorporation in this ordinance of any such un- constitutional phrase clause sentence paragraph or section SECTION 5 That this ordinance shall become effective and be in full force and effect from and after the date of its passage and publica- tion as required by law and it is so ordained APPROVED AS TO FORM AND LEGALITY City Attorney ADOPTED ~~~~. $, /~l'~ I EFFECTIVE ,~ i~~ l ~, / 1 ~ I -2- ,,,... ~_ EXHIBIT A New Text of Chapter 6 AMBULANCES/EMERGENCY MEDICAL SERVICES Sec 6-1 Definitions .~. For the purpose of this chapter the following words and phrases shall have the meanings respectively ascribed to them by this section (a) Ambulance Any motor vehicle constructed reconstructed, arranged equipped or used for the purpose of transporting ill sick or injured persons For the purpose of this chapter the term ambulance shall include only emergency ambulance and/or "invalid coach', as herein- after defined (b) Ambulance call The act of proceeding with an ambulance for the pur- pose of transporting any patient (c) Applicant Any person partnership corporation or other operator that makes application to obtain a certificate of public convenience and necessity If the applicant is a corporation or partnership this definition will include all-officers or partners (d) Attendant Any person who has the duty of performing or assisting in the performance of an ambulance call and is certified as an Emergency Medical Technician as hereinafter provided (e) Certificate A certificate of public convenience and necessity (f) City All areas within the corporate limits of the City of Fort Worth Texas (g) City council The Fort Worth City Council (h) Code I calls The nonemergency type of calls such as slow run sick or convalescent call No red lights or siren. are used (i) Code III calls The term "Code III calls" shall mean the emergency type call and shall include all calls involving serious injuries or illnesses which could result in loss of life or permanent injury Red lights and siren are used 1 r" (j) Driver Every individual who drives or attempts to drive any ambu- lance as herein defined (k) Emergency ambulance Any ambulance designed for emergency care which provides a driver compartment and a patient compartment Such patient compartment shall accomodate two (2) attendants and one or more litter patients so positioned that at least one patient can be given inten- sive life-support care during transit Such ambulance shall carry equipment and supplies for optimal emergency care at the scene as well as during transit for two-way radio communication for safeguarding personnel and patients under hazardous conditions and for light rescue procedures and shall be designed and constructed to afford maximum safety and comfort and to avoid aggravation of the patient's condition exposure to complications, and threat to survival The patient com- partment of such ambulance. shall have not less than fifty-three (53) inches of headroom measured from the floorboard the cot rests upon to the ceiling with a minimum of twenty-five (25) inches of unemcum- bered floor space beside the top thirty (30) inches of the head of the cot Such compartment shall be not less than one hundred (116) inches in length Such ambulance shall be equipped with warning devices and signal devices in addition to the stock organic vehicle horn (1) Invalid coach Any ambulance which provides space for a driver one attendant and provides supplies for optimal patient care during trans- port Such ambulance shall be designed and constructed to afford maximum safety and comfort, to avoid aggravation of the patient's con- dition and exposure to complications and threat to survival The patient section of such ambulance shall have not less than thirty-seven (37) inches of headroom measured from the floorboard upon which the cot rests twelve (12) inches from each side of the center line of the vehicle Such section shall be not less than eighty-four (84) inches in length and shall have not less than forty-eight (48) inches of usa- ble floor width Such ambulance shall be equipped with neither warn- ing nor signal devices except the stock organic vehicle horn The term "invalid coach includes "transfer vehicZ 2 (m) Emergency Medical Services (EMS) Coordinator The individual responsible to the City Manager for coordinating and monitoring emergency medical services for the City of Fort Worth The EMS Coordinator will conduct such inspections as are necessary and monitor operations of ambulance services operating in the city to ensure compliance with applicable laws and medical standards The EMS Coordinator will closely monitor the performance of the con- tractor providing emergency ambulance service to the city to ensure that all provisions of the contract are fulfilled The Coordinator will also function as licensing officer for all permits and licenses required by this chapter and will serve as Executive Secretary for the Emergency Medical Service Advisory Council (n) Emergency Medical Services Advisory Council (EMS Advisory Council) An advisory and decision-making body appointed by .the City Council to work with all involved parties in all issues of the Emergency Medical Services program in the city with such a makeup and such authority as set out herein (o) Operator Any person engaged in business as the owner manager or proprietor of a company firm or organization providing ambulance service (p) Permit The written authorization issued by the EMS Coordinator for a designated and inspected vehicle to be operated upon the city streets (q) Person Any individual firm association partnership corpora- tion or other group or combination of individuals (r) Police chief The chief of police of the city or his duly authorized representatives (s) Police department The police department of the city (t) Victim of violent acts Any ill sick or injured person who has been or who is believed to have been shot stabbed poisoned bludgeoned beaten or otherwise physically assaulted 3 Sec 6-2 Certificate of Public Convenience and Necessity--Required excep- tions No person shall operate an ambulance on any street of the city without first having obtained from the city council a certificate declaring that the public convenience and necessity require such an operation provided however that no such certificate shall be required for any person operating an ambu- lance or other vehicle who (a) Renders assistance during any catastrophe or major emergency when the ambulances authorized to operate in Fort Worth by certificate are insufficient in number or for any other reason inadequate or (b) Operates from a location outside the city and transports any patients from a paint of origin outside the city to destination inside the city or (c) Operates from a location outside the city and transports any patient from a point of origin within the city to destination outside the city Sec 6-3 Sau=e--Application Applications for a certificate of public convenience and necessity for the operation of an ambulance within the city shall be in writing signed and sworn to by the applicant and shall be filed with the EMS Coordinator The appli- cation shall be on a form prescribed by the ENS Coordinator and shall contain at least the following The name and address of the applicant the address and phone number of the central place of business the address or addresses from which the service will operate the trade name under which the applicant does or proposes to do business if the applicant is an individual the name age and address of the applicant and the length of time the applicant has re- sided in the city or if a partnership or association the business name thereof and the name age and address of each partner and the length of time each partner has resided in the city of if a corporation the names and addresses of all officers and directors of such corporation the number of vehicles the applicant desires to operate the class size design and color 4 1 r. scheme of each vehicle whether or not the applicant has been finally convicted of any felony or other offense involving moral turpitude and whether or not the applicant has any claims or judgments against him for damages resulting from the negligent operation of an ambulance the financial ability and responsibility of the applicant the nature and character of the service that the applicant proposes to render the facts showing the demand for such service the experience that the applicant has had in rendering such service and the period of time that he has rendered it in the city The applicant shall attach to such application a letter from a duly auth- orized agent of applicant s insurance carrier stating that the insurance re- quired hereunder is available to applicant and that such coverage is or will be provided prior to the issuance by the EMS Coordinator of the certificate to operate hereunder and such applicant shall furnish such other information as may be required by the city council Sec 6-4 Same--Investigation of applicant Upon receipt by the EMS Coordinator of an application for a certificate to operate hereunder the EMS Coordinator shall make or cause to be made an inves- tigation of the character and reputation of the applicant and his ability to perform the services of an operator the financial responsibility of the appli- cant to respond in damages or to pay claims for personal injury death and property damage claims arising from his operation and such investigation of other pertinent facts which the council shall deem relevant in determining the fitness of the applicant to become an operator hereunder The EMS Coordinator shall make a written report to the city council of the results of his investi- gation Sec 6-5 Same--Public hearing Upon receipt of such written report the council shall schedule a public hearing on the application Notice of such public hearing by the council shall be given to the applicant and all certificate holders affected thereby by depositing such written notice in the United States Postal Service in an enve- lope properly addressed to each such person at his respective address on file with the EMS Coordinator and bearing sufficient postage at least ten (10) days 5 a prior to the date set for such hearing Such notice shall also be published once in the official newspaper of the city at least ten (10) days prior to the date set for such hearing The purpose of such public hearing shall be to determine among other things the following (a) Whether or not the public convenience and necessity require the operation of such ambulance or ambulances (b) Whether the public convenience and necessity require that such ambu- lance or ambulances be operated only for nonemergency code I calls or for both nonemergency code I and emergency code III calls (c) Whether or not the applicant is a fit and proper person to conduct such business including the fitness of the officers and stockhol- ders of any corporation making such application (d) Whether the applicant will be able to afford public service of such permanence and quality as to best serve the public interest (e) The experience that the applicant has had in rendering ambulance ser- vice (f) The past experience of the applicant satisfying judgements if any to claimants as a result of injuries received by reason of negligent operation of ambulances (g) The financial ability of the applicant to respond in damages to property resulting from the negligent operation of an ambulance and (h) Whether or not those vehicles proposed to be used as ambulances qual- ify as emergency ambulances or as invalid coaches as same are herein defined In the event the city council finds that the public convenience and neces- sity require the issuance of such certificate and that the applicant meets the required qualifications to give proper and adequate service to the best interest of the inhabitants of the City of Fort Worth the city council will direct the EMS Coordinator to issue a certificate of public convenience and necessity to such applicant for the number of ambulances which the city council determines are required thereunder 6 f,, Sec 6-6 Same--Form and contents Every certificate issued hereunder shall be signed by the mayor- attested by the city secretary and shall contain in addition to the name and address of the applicant a statement that the operator is authorized to make nonemer- gency code I calls only or to make both nonemergency code I and emergency code III calls a statement of the minimum requirements for motor vehicles used in the rendition of such service the number of vehicles authorized to be operated pursuant to such certificate and the exterior colors of the vehicle so authorized Sec 6-7 Same--Issuance The EMS Coordinator upon receiving directions from the city council to issue a certificate to an applicant for the operation of ambulances hereunder shall issue such certificate to the applicant after payment by the applicant of the annual certificate fee hereinafter prescribed A copy of every cer- tificate shall be filed with the EMS Coordinator Sec 6-8 Same--Causes for revocation alteration or suspension Every certificate issued hereunder shall be subject to revocation altera- tion or suspension by the council where it shall appear that one or more of the following conditions exist (a) The public convenience and necessity no longer warrant such opera- tion (b) The operator has refused or failed to render the full service autho- rized by his certificate (c) The operator has been finally convicted of a felony or other offense involving moral turpitude (d) The certificate was obtained by an application in which any material fact was intentionally omitted or falsely stated (e) The operator has persisted in permitting his motor vehicles to be operated in violation of any law 7 (f) The operator has willfully and knowingly violated or failed to com- ply with any of the provisions hereof or any policies or rules set out pursuant to this chapter (g) The operator has charged in excess of the maximum rate set forth in section 6-17 (h) The operator or his agent has in bad faith induced or sought to in- duce a change of destination to or from a hospital or other place specified by the person hiring the ambulance (i) The operator or his agent has been guilty of willfully operating his service in a negligent manner (j) The operator or his agent has knowingly in bad faith recommended given favor or advantage to any mortuary operating in the city (k) The operator has allowed his insurance as required herein to be cancelled withdrawn or terminated (1) The operator has allowed any of his vehicles or equipment to become damaged deteriorated or unclean to the extent that it is unsatis- factory for public use or (m) The operator fails to show financial ability to maintain services in compliance with the terms hereof Sec 6-9 Same--Manner of revocation alteration or suspension appeal (a) After not less than ten (10) days notice and after hearing the city council may revoke alter or suspend any certificate issued hereunder upon a determination by it that the public convenience and necessity no longer justify such certificate or that the operator has will- fully violated any of the provisions of this chapter (b) The EMS Coordinator is hereby authorized and empowered to revoke alter or suspend any certificate issued hereunder upon his finding that any operator has willfully violated any of the provisions of this chapter such action by the EMS Coordinator shall be effective for not more than fifteen (15) days except as otherwise herein pro- vided and shall take effect upon delivery of written notice thereof 8 to the operator such delivery may be made in .person to the operator or to any of his .agents or any employees or by depositing a written notice in the United States Postal Service in an envelope properly addressed to the operator at his address on file with the EMS Coor- dinator and bearing sufficient postage provided however that the operator shall have the right to appeal to the city council from any such action of the EMS Coordinator by delivering written notice of such appeal to the city secretary not more than five (5) days after the effective date of the action appealed from In the event the operator shall fail to deliver such notice of appeal to the city secretary within the time prescribed the action of the EMS Coordi- nator in revoking altering or suspending the certificate shall be final If the operator timely delivers the notice of appeal to the city secretary the city council shall hear the appeal in a public hearing not more than ten (10) days after the date of filing the notice of appeal with the city secretary Sec 6-10 Same--Original fee duration transferability No certificate shall be issued until the applicant shall have paid a cer- tificate fee of one-hundred dollars ($100 00) to the city for the right to engage in the ambulance business in and upon the public streets and thorough- fares of the city Each certificate issued hereunder shall be valid for one calendar year Any operator desiring to renew the certificate and continue operations hereunder shall make application for renewal of his certificate prior to December first of any year for the privilege of operating during the following calendar year The fee for renewal shall be fifty dollars ($50 00) The amount of the certificate fee herein prescribed shall not be pro- rated for fractional parts of a calendar year nor shall it relieve the opera- for from the necessity of obtaining any state or county occupation license or any other requirement established by statute Certificates of public conven- ience and necessity issued hereunder shall not be transferable nor assignable without the consent of the city council Termination or transfer of ownership of such ambulance business shall automatically void such certificate 9 Should the operator desire at any time to make any change in his opera- tion which would increase the number of vehicles to be operated or change the authorized mode of operation i e operate an emergency ambulance when only a transfer ambulance is authorized such change will require application to the city council and the holding of a public hearing prior to council action on the application in the same manner as required for the original applica- tion Issuance of a revised certificate following council approval will not require payment of an additional fee unless the original certificate is due for annual renewal Sec 6-11 Permit--Required for each vehicle application issuance After the operator shall have secured a certificate hereunder no vehicle shall be operated under authority of such certificate until the operator has made application to the EMS Coordinator for and has been issued a permit for each motor vehicle to be operated under such certificate Every application for a permit shall be in writing verified by the operator and shall show the number of the certificate and the make type year of manufacture motor num- ber serial number passenger capacity and exterior color for each motor vehicle for which a permit is desired In the event the EMS Coordinator finds that each vehicle fulfills and complies with the minimum requirements as specified by this chapter that each vehicle is in satisfactory and safe mechanical condition that such vehicle is properly identified with the operator's name and that the color of the vehicle is the same as authorized by the city council he shall then issue to the operator a permit for each vehicle upon the payment of an annual permit fee for each vehicle authorized Sec 6-12 Same--Revocation alteration or suspension No permit shall be issued for the operation of any ambulance which is un- safe or unfit for the transportation of patients and the EMS Coordinator shall have the power to suspend alter or revoke the permit for any ambulance which has become unsafe or which has become so damaged deteriorated or unclean as to render such ambulance unfit for public use The operator who holds any such permit which has been revoked altered or suspended by the EMS Coordinator shall have the same right to appeal such decision to the council as is provided in section 6-9 10 Sec 6-13 Same--Fees No permit for any ambulance shall be issued or continued in operation unless the holder thereof has paid an annual permit fee of twenty-five dollars ($25 00) for each vehicle to be operated The number of ambulances for which permits are issued shall not exceed the number authorized in the certificate of public convenience and necessity issued pursuant to this chapter The permits required herein shall be valid for one calendar year beginning January first and ending December thirty-first of each such year and any operator desiring to continue the operation of any ambulance hereunder shall make application for renewal of any or all permits issued hereunder prior to December first of any year for the privilege of operating during the following calendar year The amount of the permit fees hereunder prescribed shall not be prorated for fractional parts of a calendar year nor shall it relieve the operator of the necessity of obtaining any state or county occupation licenses or complying with any other requirement established by statute Each permit shall designate a specific ambulance and shall not be transferable nor assign- able without the prior written consent of the EMS Coordinator Sec 6-14 Central place of business required Each operator shall maintain a central place of business with at least one properly listed telephone for receiving all calls for ambulance service and where all business records and daily logs herein required shall be main- tained and available for inspection or audit at all times Each operator shall have a person available at all times to answer promptly all calls for service to dispatch promptly all ambulances and to be generally responsi- ble for its conduct of such ambulance operations Prior to changing any ad- dress or addresses from which the operator proposed to operate ambulance ser- vice each such operator shall make written request to and shall receive writ- ten authorization from the EMS Coordinator to continue such service Sec 6-15 Certificate holder's records and reports Each certificate holder shall maintain a daily log upon which shall be recorded the date time of service request time of dispatch time of arrival upon the scene time of arrival at ultimate destination patient s name and address and charges for ear_h trio h c• h. nr~ratoY shad ret n art preserve 11 all daily logs for at least six (6) months and such logs shall be available for inspections by the city council or its duly authorized representatives upon request Each certificate holder hereunder shall keep accurate records of the receipts and expenses from operations and such other operating informa- tion as may be required by the council Each such operator shall maintain such records at a place readily accessible for examination by the EMS Coordinator the city council or their duly authorized representatives Sec 6-16 Liability insurance required Each operator shall purchase and keep in full force and effect public lia- bili.ty insurance in the amount of not less than one hundred thousand dollars ($100 000 00) for each person three hundred thousand dollars ($300 000 00) for each accident and fifty thousand dollars ($50 000 00) for property damage to secure payment of all lawful and proper claims arising out of the operations of the ambulance service authorized hereunder A written statement from an authorized agent of the operator's insurance carrier verifying the issuance of such insurance shall be filed with the EMS Coordinator before any certificate or permit may be issued All such verifications of insurance shall provide for a thirty day cancellation notice to the EMS Coordinator Sec 6-17 Rates established No operator shall exceed the maximum rates established by the city council governing charges for emergency calls transfer calls prehospital treatment and medications or supplies used The maximum rates will be set and may be amended from time to time All operators will be provided with current copies of the approved maximum rates Total charges for equivalent service shall be equally divided among those patients transported simultaneously The collection of charges shall be the sole responsibility of the operator Sec 6-18 Same--To be posted in ambulance Each ambulance shall have posted in a conspicuous place readily visible to the occupants a statement showing the rates to be charged Such rates as posted shall not exceed those established by the city council and currently in effect 12 r Sec 6-19 Operating regulations All certificate holders operators attendants and drivers shall comply with the following regulations (a) Every certificate holder shall be required to provide service twenty- four (24) hours daily each and every day Each call for ambulance service shall be promptly answered Patients shall be loaded and transported without being subjected to unreasonable delays (b) Clean and sanitary bed linen shall be provided for each patient car- ried and shall be changed after the discharge of a patient and before any subsequent patient is picked up (c) Each emergency ambulance shall be manned and equipped to provide advanced life support Minimum manning requirements are one (1) certified Emergency Medical Technician-Basic and one (1) certified Emergency Medical Technician-Advanced (Paramedic) (d) Each transfer ambulance (invalid coach) shall be manned and equipped to provide basic life support Minimum qualifications for manning are one (1) driver who is a certified Emergency Care Attendant and one (1) certified Emergency Medical Technician-Basic Pending initiation of the next available training course for Emer- gency Medical Technician the EMS Coordinator of the City of Fort Worth may issue temporary permits for ambulance attendants to ap- plicants other than those employed by the primary contractor of the City of Fort Worth It is the intention of the city council that those applicants employed by the primary contractor of the City of Fort Worth may be issued temporary permits as long as such primary contractor has sufficient qualified personnel to meet the terms of the contract (e) Each operator shall adopt and use after approval by the council a distinctive uniform color scheme for his ambulance and each ambu- lance shall be identified in such a manner as clearly indicates that the vehicle is used for ambulance purposes No other type of adver- tising may be used on the vehicle 13 (f) The ambulance operator's business name shall be shown on a permanent sign appearing on both sides of each vehicle in letters of not less than three (3) inches in height and one-half (2) inch in stroke-width (g) In all calls for ambulance service in which the patient has been a victim of violent acts or in which the ambulance attendant has rea- son to believe that the patient has been a victim of violent acts no persons other than authorized ambulance attendants shall be permitted to ride in the ambulance with the patient except in those cases where a police officer has such patient under arrest in which case the officer may accompany the patient The ambulance attendant may also require the assistance of a fireman on the scene to help with treatment on the way to the hospital (h) In case of catastrophic accident or disaster all ambulance certifi- cate holders are required to respond to any request by the police dispatcher for dispatch of any or all available ambulances to the scene of such catastrophe Sec 6-20 Equipment required No ambulance shall be operated upon the public streets of the city unless all of the following conditions be met (a) All ambulances shall be maintained in good operating condition and all equipment therein shall be capable of rendering satisfactory ser- vice No ambulance shall be driven or operated upon any street in the city unless the same is in safe condition and free from mechan- ical defects with the brakes in good condition (b) All motor vehicles used for the purpose of providing ambulance service hereunder shall be designed and constructed to transport ill sick or injured persons in comfort and safety and shall be maintained in clean sanitary and first class mechanical condition at all times (c) The EMS Coordinator shall cause an inspection to be made of all ambu- lances in the city at least every six (6) months and as often as he deems it appropriate and if an ambulance sl;.all fo ui~.~ or 14 unsafe for operation notice shall be given to the owner and operator thereof and such ambulance shall not be operated thereafter until the same has been put in a safe and fit condition as determined by the EMS Coordinator (d) The EMS Coordinator shall be authorized and directed after public notice and opportunity for public hearings to establish ambulance vehicle standards pertaining to construction equipment and safety features and facilities (e) The EMS Coordinator shall be authorized and directed after public notice and opportunity for public hearings to establish ambulance vehicle standards pertaining to equipment for the administration of patient care (f) The EMS Coordinator shall be responsible for ascertaining the sanita- tion and proper equipment of ambulances prior to the issuance of any permit for any such ambulance Sec 6-21 Drivers and attendants' registration cards--Required No person shall drive manage or control any ambulance on any public street or thoroughfare in the city without having been examined and registered by the EMS Coordinator of the city as a driver nor shall any person attend or render first aid to any passenger in any such ambulance without having been examined and registered by the EMS Coordinator for the city as an attendant Only after ascertaining that such person has demonstrated the required degree of proficiency in patient care shall the EMS Coordinator issue to any such person so examined and so registered as a driver or attendant a registration card certifying the same Sec 6-22 Same-®Qualif ications for drivers and attendants' registration Each person applying for registration as an ambulance driver or attendant in the city shall be able to speak read and write the English language Each individual shall furnish satisfactory proof that he/she is a person of good moral character All individuals will be required to show a certificate from the State of Texas showing certification in the level required for the type of city registration requested 15 City permits issued will indicate one of four (4) medical skill levels These will be (a) Emergency Care Attendant - Requires completion of twenty-four (24) hours of first-aid training which shall include six (6) hours of cardiopulmonary resuscitation (CPR) training (b) Emergency Medical Technician (EMT) - Basic - Requires a minimum of one-hundred twenty (120) hours of formal training to include one-hun- Bred (100) hours of classroom training twenty (20) hours of clini- cal experience and participation in three (3) ambulance calls in which care was rendered (c) Emergency Medical Technician (EMT) - Special Skills - Requires EMT- Basic training plus a minimum of an additional sixty (60) classroom hours fifty (50) additional hours of clinical experience and fifty (50) hours of internship with an ambulance operation (d) Emergency Medical Technician (EMT) -_Advanced (Paramedic) - Requires EMT-Basic training plus a minimum of one-hundred sixty (160) addi- tional hours of classroom training one-hundred forty (140) hours additional clinical experience and one-hundred (100) hours of in- ternship with an ambulance operation The above requirements are indentical to those required for registration by the State of Texas They will be amended to reflect any future changes in state requirements Minimum skill levels for ambulance drivers and attendants operating ambu- lances under a City of Fort Worth certificate of public convenience and neces- sity will be (a) Invalid Coach (Transfer Ambulance) Driver - must be an Emergency Care Attendant (b) Invalid Coach (Transfer Ambulance) Attendant - must be an Emergency Medical Technician - Basic (c) Emergency Ambulance Driver - must be an Emergency Medical Technician- Basic (d) Emergency Ambulance Attendant - must be an Emergency Medical Tech- nician - Advanced (Paramedic) 16 Emergency Medical Technicians in all three skill levels will be required to satisfactorily complete refresher courses in their category at no greater than two-year intervals In addition to the minimum skill level requirements for ambulance person- nel each driver must be the holder of a current chauffeur's license issued by the Texas Department of Public Safety At a time in the future the City may on the advice of the EMS Advisory Council establish a local test that must be passed Once such a test is established a driver s or attendant s permit will not be issued by the EMS Coordinator without satisfactory comple- tion of such a test Sec 6-23 Same--Application All applications for drivers' and attendants registrations hereunder shall be made upon forms prescribed by the EMS Coordinator and shall contain the fol- lowing information which shall be signed and sworn to by the applicant (a) The individual's full name current address place of residence for five (5) years previous to moving to his present address and the length of time he has resided in the city (b) Age marital status height weight color of eyes and color of hair (c) Whether or not such individual has ever been finally convicted of a felony or misdemeanor and if so when where and for what cause (d) Training and experience in transportation and care of patients whether he has previously been licensed as a driver or attendant and if so when and where and whether his license has ever been revoked or suspended in any jurisdiction and if so for what cause (e) Such other information as the EMS Coordinator shall deem reasonably necessary to a fair determination of compliance with this chapter and (f) An accompanying registration fee of five dollars ($5 00) Sec 6-24 Same--Duration renewal Registration cards for an ambulance attendant or driver shall be valid 17 for one calendar year beginning January first and ending December thirty- first of any such year Any driver or attendant holding a registration card in good standing and whose status and condition have not changed since obtain- ing such registration may by payment of the renewal registration fee of five dollars ($5 00) and upon a determination by the EMS Coordinator that the appli- cant's status and condition have not changed obtain a renewal thereof prior to January first of any calendar year for the next succeeding calendar year Sec 6-25 Same--Display It shall be the duty and responsibility of each driver and attendant registered hereunder to display his registration card upon demand to the chief of police or the city EMS Coordinator or to their duly authorized representa- tives The registration card of each driver and attendant shall be carried on the person of such driver or attendant at all times while on duty Sec 6-26 Same--Revocation or suspension The EMS Coordinator shall have the authority to suspend or revoke for cause the registration of any driver or attendant Any driver or attendant whose registration has been suspended or revoked hereunder shall have the same right of appeal as is provided in section 6-9 Sec 6-27 Amublance radio dispatch procedures The radio dispatcher for the police department shall have a current list of ambulance operators holding a Fort Worth Certificate of Public Convenience and Necessity This list will specify those operators authorized to accept emergency calls or operate as emergency ambulances When the police dispatcher receives a call requesting emergency ambulance service he will dispatch the city's contractor ambulance using the direct ringdown phone and notify the fire department dispatcher in those cases requiring fire department response as outlined in the Standard Operating Procedures for Emergency Medical Services provided by the City Manager's office Emergency ambulance operators includ- ing the city's contract ambulance operator who receive a private call for emergency ambulance service and are responding Code III as defined in section 6-1 are required to notify the police dispatcher immediately after dispatch- ing an ambulance reporting the circumstances the location of the emergency and the name and address of the person calling for the ambulance if available 18 In the event of a major disaster normal dispatch procedures herein set forth will be disregarded and procedures contained in the Fort Worth-Tarrant County Civil Defense Emergency Plan will prevail Ambulance companies not holding a current certificate will not be dis- patched within the City of Fort Worth except as provided in section 6-2 Sec 6-28 Obedience to traffic laws etc The driver of any ambulance operating with a valid certificate and permit issued hereunder when responding to an emergency call or while transporting a patient may exercise the privileges set forth in this section but subject to the conditions herein stated and only when such driver has reasonable grounds to believe that an emergency in fact exists which requires the exer- cise of such privileges Under emergency circumstances such driver may (a) Park or stand irrespective of the otherwise applicable provisions of law ordinance or regulations (b) Proceed past a red or stop signal or stop sign but only after slow- ing down as may be necessary for safe operation (c) Exceed the maximum speed limits permitted by law ordinance or regu- lation provided any governing directives issued by the chief of police are obeyed or (d) Disregard laws ordinances or regulations governing directions or movements or turning in specified directions Provided however that any exemption herein granted shall apply only when such ambulance is operating with siren or red light and when such audible and visual signals meet the requirements of law ordinance or regulation and pro- vided further that the foregoing provision shall not operate to relieve the driver of any ambulance from the duty to drive with due regard for the safety of all persons no shall such provisions protect the driver from the conse- quences of his reckless disregard for the safety of others Sec 6-29 Use of emergency warning equipment After an ambulance has responded to a call and arrived at the point of 19 pickup it shall be unlawful for such ambulance to proceed to the hospital or other destination with the use of emergency warning equipment such as red light and siren except in the case of dire emergency A dire emergency shall be any situation wherein it appears reasonably probable that a condition exists which seriously threatens the victim's life or future well-being and when rapid transport to a medical facility is essential to protect life or prevent perma- nent injury Sec 6-30 Dead on arrival procedure All ambulances shall use the following procedure when the subject of the emergency call is dead on the arrival of the ambulance at the hospital 'Dead on arrival as used herein shall mean the determination of death by a medi- cal examiner or medical doctor Where there is not any instruction given by the next of kin or other responsible person related to the deceased as to where the body shall be delivered the ambulance driver shall deliver the body to a hospital until a medical examiner or licensed medical doctor formally pronounces the subject dead The body shall be removed by the funeral home or mortuary designated by the radio dispatcher of the police department from the rotation list established by the police chief for such removal services It shall be the responsibility of the funeral home or mortuary to register with the police chief for placement on such rotation list Sec 6-31 Operators to be furnished with a copy of chapter All operators shall be furnished with a copy of this chapter and shall keep their drivers and attendants properly informed of same They also will be fur- nished with all policies or rules of the EMS Advisory Council as set out below Sec 6-32 Emergency Medical Services Advisory Council (a) There is hereby established an Emergency Medical Services Advisory Council (EMS Advisory Council) which will serve as a neutral forum for all emergency medical services interests to provide leadership and advice and to have decision making powers in areas of emergency medical services (b) The EMS Advisory Council would be made up of representatives of various agencies and parties involved in the emergency medical ser- __.as Yroces5 sum agc..~les ~ be. designated by the City Council in appointment of places on the EMS Advisory Council The EMS 20 Advisory Council shall be chaired by a representative of the Tarrant County Medical Society The City Council shall also ap- point representatives from various departments within the City government from the primary ambulance contractor from all local hospitals that provide emergency room services and from a citizen s group (c) The EMS Advisory Council will have decision making authority over and will publish and circulate to the City hospitals and all EMS personnel policy decisions and operational procedures in the fol- lowing areas (1) Procedures and protocols for call response on-scene aid and aid within the emergency facility to assure quality patient care (2) Training requirements for all emergency medical personnel that may supplement the state requirements (3) Communications system design and call content (4) Public EMS education and training ~ (5) Emergency facilities classification staffing patterns and equip- ment availability in order to assure correct disposition of patients All City holders of certificates of public convenience and necessity will adhere to the decisions promulgated by the EMS Advisory Council and distributed to them by the City EMS Coordinator in the same man- ner that they must adhere to the provisions of this chapter and the standard operating procedures promulgated by the City Manager s Office (d) The EMS Advisory Council will review any protocols or standing orders promulgated by the Tarrant County Medical Society in accordance with the Revised Civil Statutes of Texas All such orders or protocols will be the responsibility of the medical society and its member ~; ysi~~~..~ «e i,i~~~ Advisory l,ouncil will publish such orders and 21 protocols and distribute them to the appropriate agencies Orders or protocols are not however subject to approval or endorsement by the council as a whole (e) The EMS Advisory Council will be aided by several subcommittees that they may establish The subcommittees will be composed of repre- sentatives of agencies or organizations working within the emergency medical services field and may consist of organizations not having membership on the EMS Advisory Council The areas of interest and the makeup of the subcommittees shall be determined by the EMS Advisory Council at a later date (f) The EMS Coordinator of the City of Fort Worth shall serve as Executive Secretary of the EMS Advisory Council and shall provide support and serve as liaison between the City the ambulance companies and the EMS Advisory Council LZ MAXIMUM ALLCIWAB~~E,P~sIENT CHARGES FOR EMERGENCY MEDICAL SERVICES IN -ACCORDANCE WITH CHAPTER 6 CODE OF THE CITY OF FORT WORTH Emergency Ambulance Transport------------------------$78 00 Transfer Ambulance Transport-------------------------Unrestricted-competitive On Scene Medical Treatment Without Transport---------$39 00 Medical Service and Supply Charges Aminophylline (500)------------------------$ 3 00 Aminophylline (250)------------------------ 2 50 Angio-caths----------. _- --------.._._------ 3 00 Antilirium--------------------------------- 2 50 Atropine Sulphate-------------------------- 8 50 Bandaging----------------------------------- 5 00 Benedryl---------------------- ~- ------- 3 50 Betadine Helafoam-------------------------- 33 00 Burn Sheet--------------------------------- 24 00 Butterfly----------------------------------- 2 50 Calcium Chloride-----~---------------------- 8 00 Cervical Colla•r---------------------------- 12 00 D50W--------------------------------------- 11 00 D5W (500)---------------------------------- 12 00 Decadron Syringe--------------------------- 11 50 Decadron 24mg/M1 Sml----------------------- 70 00 Defibrillation----------------------------- 24 00 Dextro-Stix-------------------------------- 5 00 EKG Monitor-------------------------------- 18 00 Endotracheal Intubation-------------------- 30 00 Epinephrine 1 10 000----------------------- 8 50 Epinephrine 1 1 000------------------------ 2 00 Esophageal Intubation---------------------- 18 00 Hyperstat I V ----------------------------- 30 00 Intropin----------------------------------- 30 00 Ipecac------------------------------------- 2 00 Isoproteranol------------------------------ 9 00 I V Prep---------------------------------- 3 50 Kwik-Kold (Cold Pack)--------=------------- 2 50 Lactated Ringers 1000cc-------------------- 14 00 Lasix-----------.. -•- -- ----- --------- 14 00 Lidocaine 100mg---------------------------- 8 50 Lidocaine 2gm Bristoject------------------- 15 00 Mast Trousers------- ---------------------- 30 00 Morphine Sulphate-------------------------- 3 0~ Multi-trauma Dressing---------------------- 3 00 Narcan------------------------------------- 8 00 Nitroglycerine Tablet---------------------- 1 25 Normal Saline Irrigation 1000-------------- 8 50 Normal Saline Irrigation 500--------------- 6 00 Obstetrical Kit---------------------------- 15 00 Oropharyngeal Airway----------------------- 3 00 Orthopedic (Splinting)--------------------- 15 00 Oxygen-------------------------------------- 15 00 Sodium Bicarb (Pediatric)------------------ 8 50 Sodium Bicarb (Adult)---------------------- 11 50 Suction--------• -• --- ---------- - - 5 00 Syringes all sizes------------------------ 1 00 Valium------------------------------------- 5 00 .~ ~' ~ ~F <~.. w,,l .11~7ayo~° and Coun~a,l ~or~~.~.~,aa~.~~cttaon DATE REFERENCE SUBJECT RHV1SlOri t0 Chapter 6 Of the PAGE NUMBER City Code 1 ~~ ~g~l *~~-509?+_ - _ The attached proposed ordinance and new text of Chapter 6 of the City Code are necessary to update the code and incorporate changes that will make the code compatible with the ambulance contract presently in effect Most of the proposed changes will improve the quality and level of pre-hospital emergency care provided the citizens of Fort Worth Ths draft has been reviewed and approved by the Tarrant County Medical Society Emergency Medical Services Committee and appr~~priate Police and Fire bff~„c~.aals The following are the major changes to Chapter 6 contained in the new text 1 Section 6-1(m) adds a definition of 'Emergency Medical Services (EMS) Coordinator and briefly outlines some of the duties and responsibilities of that individual 2 Section 6-10 changes the fee from $50 to $100 for the initial Certificate of Public Convenience and Necessity This was necessary to cover the expense of the investigation required 3 Section 6-19(c) and (d) upgrade the required skill levels for drivers and attendants for both emergency and transfer ambulances 4 Section 6-22 changes the qualifications required for Cs.ty registration of ambulance drivers and attendants to conform to the changes in Section 6-19 5 Section 6-27 changes ambulance radio dispatch procedures to require ambu- lance operators to clear emergency runs with the police dis;~atcher immediately after dispatching their ambulance instead of before dispatching Compliance with the present code would result in a delayed response time 6 Makes the .maximum ger~rnssible ra.tES charged for ambulance service and life support medications and supplies subject to periodic review, adjust- ment and approval of the City Council 7 Section 6-32 provides for a permanent Emergency Medical Services Council a neutral forum for all emergency medical service interests, with advisory and decisa:an-making powers Recommendation Tt is recommended that the City Council approve the new text for Chapt~.er 6 and p~~'~tOVt~u ~~~ ' the ordinance im lementin it p g ~ ~ COUNCIL , , CITY GG plg Attachment cc~a R 1981 ti r ------ ~ ~,--rn. SiJpMITYE!) FOR THE CITY MANAGEP.'S DISPOSITION BY CO NCII~ ~~ ~1 ecs:etary f th E`~ PROCE S O BY nFFICE SY: ^ APPRO ^ ~ XC Wotths ?~~ ORIGINATING a ^ OTHER ([lES~RiBE) DffPARTMENT HERO: Fred eish CITY SECRETARY TIONAL INFORMATK] E t 5170 t C DOPTED ORDINANCE N L ars®n, x CONTACT DATE Oq