HomeMy WebLinkAboutContract 63096CSC No. 63096
CITY OF FORT WORTH-CITY OF RICHLAND BILLS EMERGENCY MEDICAL :SERVICES (EMS) INTERLOCAL AGREEMENT
This EMS Interlocal Agreement (the "Agreement') is entered into by and between the City of Fort Worth, Texas, hereafter referred to as .,.mt Worth", aeting by and through its duly authorizedassistant city manager, and the City of Richland Hills, a unit of local government, hereafter referred to as the "CUent." Fort Worth and the Client may collectively be referred to herein as the "Parties1' or individually as a '1Party."
WHEREAS, Fort Worth, and other units of government, were parties to an intedocal agreement that created a sovermnental administrative agency for the provision ofout of hospital emergen.cy medical services ("EMS"),. non..omer:gency medioal servicest unsoheduled medical transportation and ambulanoe ,service, m�ile integrated healthQare (1'MIH")(collectively the"EMS System"), and scheduled interfacility medical transportation (''IFT");
WHEREAS, that governmental agency and interlocal agreement have been dissolved andFort Worth has elected to establish an EMS division through the City of Fort Worth Fire Department f�FWFD'') to operate a new EMS System and provide services to the people of the Parties' jurisdictions;
WHEREAS, the Parties agree that it is in the best interests of the public health and welfareof the people of the Parties' jurisdictions. to have available to them a regulated EMS System withan exclusively eontracted EMS Provider;
WHEREAS. Fort Worth is engaging a physician who is liclmSed in Texas and board certified in emergency medicine to serve as the Chief Medical. Officer and Medical Director for the EMS System (the '"Medical Director");
WHEREAS, pursuant to Chapter 791 ofthe Texas Government Code, the Texas ImedocalCooperation Act, and section 774.003 ef the Texas Health and Safety Code, the Parties may agree to regulate and provide governmental services for the publie health and w•lfare, and .suoh services include those provided by the EMS System;
WHEREAS, the Client wishes to ellgage with Fort Worth &0 that Fort WQrth. may provideEMS System $el'Vices to the Client and the public within their oorperate limits through the FWFD and its EMS division ("PW EMS u}; and
WHEREAS, the Parties will pay for services to be provided pursuant to this Agreement from current revenues available to the paying Party.
NOW, THEREFORE, the Parties .. agree to the following:
S#flon l; DEFINITIONS
The following index of definitions includes terms that may not appear in this Agreement but are used in the Uniform EMS Ordinance or in the ordinary eourse of descrt'bing the services of the
EMS lnterlocal Agreement Page1
EMS System. Therefore, the full index is included herein foc ease of reference by the Parties.
I. Advanced Life Support (ALS). Out-of-hospital care th�t uses invasive medical
acts (as def ned in Tex. Health and Safety Code 5 773.003(1)).
2. Aeromedical Transportation Unit. Any rotary oc fxed wing aircraft providing
basic or advailced life s�ipport services anci Patient transportation that originates
within the Secvice Area.
3. Ambulance. A vehicle for transportation oF sick or injured person to, feom, or
between places of treatment for an illness or injury, and provide out of hospital
medical care to the P�tient.
4. Ambulance Mutual Aid Agreement. A written contract between Fort Worth and
one or moce entities whereby the signing parties agree to provide bacl<up
ambulance se��vice to one another under the terms and conditions specifiied therein.
5. Ambulance Service. The transportation of Patients by emergency or non-
emergency ambulanee; foc purposes of this Agreetnent, Ambullnce Service does
not include 1TT services as defned herein.
6. Associ�te Medieal Director. A licensed physician who assists the Medical
Director in carrying out his or her duties under the CMS Interlocal Agreements,
the Unifocm CMS Ordinance, and any Medical Director's agreement with Fort
Worth.
7. Basic Life Support (13LS). Out-oP-hospital c�re that uses noninvasive medic�l
acts (as de�l�ined in § 773.003(2), Tex. He�lth and Safety Code).
8. �mergency Care Attendant (ECA). A person certified as an "emergency care
attendanY' under � 773.046 of the Tex. [-lealth a��d Safety Code.
9. Emergency Medical Services (I:1VIS). Services used to respond to an individual's
perceived need Por immediate medical care and ta prevent death or aggravation of
physiological or psychological illness oc injury.
l0. Emergency Medical Technician (EMT). A person certified as an "emergency
medical technician" under § 773.047 oc an "advanced emergency medicaC
technician" under § 773.048 oP the Tex. Health and Safety Code, and 1ny otl�ec
class of CMT recognized by state 11w or regulation.
1 l. EIVIS Communications Center. The facility designated by Fort Worth as the
central communications centec from which all EMS System services offered by
Fort Worth sh�ll be dispatched and coordinated.
12. �MS Interlocal Agreement. The secvice leve( interlocll agreements executed by
Fort Worth and Clients to designate I'ort Wo►•th as the exclusively contracted EMS
Provider of tlle CMS System within tlle Service Area.
13. EMS Provider. Tlle entity that has received a Texas CMS Providec Lic;ense, as
requiced by relev�nt state law, tio pcovide the EMS System services anci is the
exclusively contracted provider oi� the EMS System services within the Service
Area. �oc purposes of this Agreement, the EMS Provider is F'ort Worth.
14. EMS System. The ��egulated out-of-hospital LMS, non-emergency medical
services, unscheduled tnedical transport�tion and ambulance services, and mobile
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integrated healthcare system provided by Fort Worth within the Service Area, not
including those first response services Client chooses to provide itself as a First
Responder.
15. First Responder. Any agency that, in cooperation with the EMS Provider,
provides initial response to requests for EMS and, on its own or in cooperation
with the EMS Provider, provides immediate on-scene care to ill or injured persons
but does not transport those persons to healthcare facilities.
16. FW �MS. The EMS division of the Fort Worth Fire Department responsible for
providing the EMS System services.
17.Interfacility Transportation (IFT). The provision of scheduled, or by
appointment, medical transportation services by a person or entity between
hospitals or medical facilities originating within the Service Area.
18. Medical Director. The licensed physician einployed or contracted by Fort Worth
who is responsible for carrying out his or her duties under the terms of their
engagement with Fort Worth, the Uniform EMS Ordinance, and the EMS
Interlocal Agreements and for directing the Offce of the Medical Director.
19. Medical Transportation. The transportation of Patients by ambulance,
Specialized Mobile Intensive Care Unit, Specialty Care Transport, or Aeromedical
Transportation Unit, including both emergency and low-acuity emergency
transports, where such transportation originates within the Service Area.
20. Mobile Integrated Healthcare (MIH). Services provided by Foi-t Worth, as
requested by Client, that are designed to enhance, coordinate, effectively inanage,
and integrate out of hospital care, in order to improve outcoines, enhance the
participating individual's experience of care, and improve the efficiency and
effectiveness of healthcare services provided to the enrolled individuals.
21. Office of Medical Director. The department or division through which the
Medical Director carries out his or her functions. The Office of the Medical
Director is comprised ofthe Medical Director, any Associate Medical Director(s),
and other individuals assigned to the Office to assist the Medical Director in
carrying out the Medical Director's functions.
22. Paramedic. A person qualified as a certified or licensed "paramedic" as defined
by Tex. Health and Safety Code Sections 773.049 and 773.0495.
23. Patient. A person: who requests EMS, or for whom EMS has been requested; and
who has any medical or psychological complaint, obvious injury/distress, or has a
significant mechanism of injury.
24. Service Area. That geographical area which is contained within the corporate
limits of the Parties and other local jurisdictions who have entered into an EMS
Interlocal Agreement with Fort Worth and adopted the Uniform EMS Ordinance.
25. Specialty Care Transport. The transportation of a critically injured or ill patient
requiring a level of service beyond the scope of an EMT or Paramedic due to the
patient's condition requiring ongoing specialized care that must be furnished by
one ar moce health professionals, such as emergency or critical care nursing,
emergency medicine, respiratory care, cardiovascular care, or a paramedic with
additional training.
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26. Specialized Mobile Intensive Care Unit. A vehicle which is specially
constructed, equippeci, st�ffed, and employed in the inter-facility transport of
patients whose requirements for en rouce medical supporl are likely to exceed the
clinical capabilities of an Advanced Life Support ambullnce.
27. Uniform �MS Ordinance. The ordinance adopted by the P�rties and other units
of local goverr�ment to establish standards for the provision of the CMS System
secvices and designate F'ort Worth as the CMS Pcovider for the CMS System.
28. Unscheduled Medical Transportation. The transportation of Patients by
ambulance service, Specialized Mobile Intensive Care Unit, Specialty Care
Ti�ansport, or Aecomedical Transportation Unit, IIICIUCIIIl� bO1:Il elll0l'��l'lCy 111CI
low-acuiCy einecgency tcansports, where such transportation originates within the
Service Area and is not previously scheduled or made by appointment.
Section 2: �L�CTION TO BE CLIENT
2.1 As evidenced by the execution of this Agceement and the concur�•ent adoption oi' the
Uniform EMS Ordinance (which is attached heceto as Cxhibit A and incorporated herein by
reference), the Client has elected to designate i'oct Worth as the CMS Provider and the exclusively
contracted provider of the CMS System services Por the Client's jurisdiction, other than those iirst
cesponse services the Client chooses to provide itself as a First Responder, and to receive CMS
System services from Fort Worth pursuant to the terms of this Agreement.
Section 3: RESPONSII3ILITIES OF CLIENT
3. l The Client agrees to:
3. L I Properly adopt and enforce the Uniform EMS Ot-dinance and this flgreement;
3.1.2 Cstablish, oper�te, and fund 1 rirst Responder Program, as provided by Texas
Administcative Code 157.14, to repcesent the interests and needs of rart Worth and the Client,
which may range from an Cmergency Care Attendant Program up to an Advanced Life Support
Program ldopted by Fort Worth �nd the Medical Director anci as �pproved in collaboration
between Client, �o�-t Worth, �nd the Medical Di�•ecto�;
3.13 Participate, via the CMS Advisory Bo�rd ("CAI3"), in the development of and abide
by the medical protocols, credentialing requirements, �tnci medical policies for the EMS System
1nd First Res�onders, as established by the Medical Directoe;
3.1.4 Provide a mechanism for transferring 91 1 calls requesting medical assistance from
the Client's 9l I center to f ort Worth's designated CMS Communications Center and tcansfer 91 1
callers in accordance with system performance standards adopted by �ort Worth;
3.1.5 Designate a cepcesent�tive of Client to serve as a member ofi the CAQ, who shall
then be appointed by the Fort Wocth City Council in accocdance with the conditions of this
Agreement. The designated CAB representative of the Client sh�ll not be removed from the CAB
without Client's consent. The Client retains the exclusive rigl�t to remove and name a replacement
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for its designated EAB representative at any time, and Fort Worth shall appoint the representative
as so designated by the Client;
3.1.6 Provide funding for the provision of the EMS System as required by this
Agreement; and
3.1.7 Provide additional inforination, as may reasonably be needed by Fort Worth, to
assure the success of Fort Worth's EMS System such as, but not limited to: updated jurisdictional
boundaries or response plans that are unique to the Client.
3.2 Pursuant to Texas Administrative Code 157.11(m), Client authorizes Fort Worth to
opei�ate subscription ambulance services within the Client's corporate limits.
Section 4: RESPONSIBILITIES OF FORT WORTH
4.1 Fot-t Worth agrees to use the personnel and equipment of Fort Worth for the purpose of
providing the EMS System seivices for Client's jurisdiction including coordinating with Client to
create a mechanism for dispatch services and transferring 91 I calls requesting medical assistance
from the Client's 911 center to Fort Worth's EMS Communication Center. The equipment and
personnel of Fort Worth shall be undec the control and supervision of Fort Worth employees during
an emergency medical response pursuant to this Agreement.
4.2 Fort Worth will serve as the EMS Provider for the Client and provide the EMS System
services within the Service Area. It is recognized and understood that Fort Worth does not assume
responsibility for the provision of the EMS System services in Client's extraterritorial jurisdiction
or other areas outside of the Service Area.
4.3 Fort Worth's EMS System services will be provided in accordance with the procedures and
pcotocols of Fort Worth, the Fort Worth Fire Chief, and the Medical Director for the EMS System
and under the direction of the Fort Woi-th Fire Chief.
4.4 Foct Worth agrees to:
4.4.1 Set System Performance standards for the Service Area in compliance with the
clinical and inedical protocols and standards established by the Medical Director and adopted by
Fort Worth and the Client.
4.4.2 Provide the Client with EMS System services including: out-of-hospital emergency
medical services, non-emergency medical services, life, or limb, threatening emergency, low
acuity emergency, and Advanced Life Suppot-t ("ALS") and Basic Life Support (`BLS")
Unscheduled Medical Transportation and Ambulance Seivice, and MIH with such service to
comply with all applicable laws, rules, and regulations, and with the clinical standards,
credentialing requirements and inedical policies that may be promulgated from time to time by the
Medical Director, including the following commitments:
4.4.2.1: To Provide, on a 24-hour daily basis, a mobile intensive care unit
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("MICU")-capable CMS response and medicll transportation service wiHi a
minim�nn staPfing as required by relevant state law, wllich inay be amended from
time to time, for a QLS Ambulance and an ALS ambulance;
4.4.2.2: f'ort Woelh's CMS System resources shall respond to incidents in the
Service Area th►-ough rW CMS dispatch, using the same algorithms in pllce for
responses within f oct Worth. F'W L;MS will respond to calls for CMS System
services throughout the entice Service Area in less than or equal to 8:00 total tcavel
time 90% of the time for high acuity incidents, as delined by the Medicll Directoi•,
measured from the time CMS System resources are en route until the time a unit
arrives on scene. FW EMS will respond to cllls for CMS System services
tllrougllout the entire Service Area in less than or equal to 11:00 total travel time
90% of the time for low acuity incidents, as defined by the Medical Director,
measured from the time CMS System resources are en route until the time a unit
arrives on scene. Fort Worth will calculate the total travel time, and the relevant
factors to be considered, in accordance with the informltion in the attached �xhibit
B;
4.4.2.3: rW EMS will transport patients to the closest or �nost appropriate receiving
he11t11 cace l:acility as determined by C'W EMS. lf the patient is incapacitated,
otherwise unable to make a choice I<nown, or unable to go to the chosen facility
due to diversion status, TW LMS will trai�sport the patient to the facility best able
to meet the patient's needs;
4.4.2.4: I� W CMS will Iceep the CMS System resources stocl<ed at all times in
accordlnce with normal FW CMS operlting proceduces and local, state, and federal
requirements, as applicable;
4.4.2.5: F'�V L;MS will maintain third-party or self-insured vehicfe liability
insurance on its ambulances and its drivers;
4.4.2.6: �W CMS will provide all maintenance for the ambulances and assume all
ope►-ational costs of the ambulances, including fuel;
4.4.2.7: i'W CMS shall equip the ambulances at all times with cucrent technological
advancements in etnetgency equipmenl, whether poctlble or fixed in place on or
about the vehicle, as are adopted throughoul the �W CMS ambulance fleet.
4.4.3 Obtain the services of a Medicll Director that are sufficient to i�ulfill the Medical
Director's powers �nd duties as identilieci in the engagement between �ort Worth and the Medical
Dicector, the tenns o[�which will be provided to the Client upon request.
4.4.4 Provide the Client the opportunity to participate in Fort WorNl's EMS, or tirst
responde�•, related continuing education training without charge to the Client to obt�in or maintain
certitic�tions as agreed upon.
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4.4.5 Provide, at least quarterly, written reports of the operational performance of the
EMS System to the Fort Worth City Council, EAB, the Medical Control Advisory Board
("MCAB") and by email to the City Manager, or their designee, of the Client, and as reasonably
determined to be necessary by Fort Worth.
4.4.6 Prepare and provide to the Client, at least quarterly, a comprehensive review and
summary of the financial budget, and clinical and operational performance of the EMS System.
4.4.7 Manage accounts, subscriptions, payments, and billing practices related to the EMS
System. Foct Worth may, in its sole discretion and at the EMS System's expense, elect to engage
one or more contractors to provide these services.
4.4.8 Create and maintain the EAB and MCAB to ensure coordination and
communication between first responder agencies in the Service Area and independent medical
oversight related to patient care protocols for Fort Worth's EMS System.
4.4.9 Engage participating organizations on best practices in service delivery, as
determined to be necessary or prudent by Fort Worth.
4.4.10 Implement an ambulance subscription program (unless otherwise prohibited by
law) and offer metnberships in the program to all residents of the Client's corporate limits.
Section 5: TERM AND TERMINATION
5.1 This Agreement will be effective beginning July 1, 2025 and will continue for a term of 10
years, unless earlier terminated in accordance with the terms of this Agreement. Thereafter, the
Agreement will renew automatically for successive 10-year terms unless earlier terminated in
accordance witli the terms of this Agreement.
5.2 Termination by Client: The Client may terminate this Agreement and withdraw from the
EMS System by providing ninety (90) days' written notice to Fort Worth.
5.4 Termination by Fort Worth: Fort Worth may terminate this Agreement for Repeated
Uncured Events of Default by the Client, as defined herein.
5.4.1 Event of Default: An Event of Default includes a material breach of this
Agreement. A material breach includes any failure by the Client to perform a significant obligation
under this Agreement that unreasonably interferes with Fort Worth's ability to provide EMS
System services. For example, a material breach includes, but is not limited to: Client's failure to
make payments to Fort Worth, as required under Section 6, within 30 days of its due date; Client's
failure to enforce any provision of the Uniform EMS Ordinance; Client's failure to abide by the
directives, credentialing, and policies of the Medical Director; Client's failure to fund and operate
a First Responder Program; and Client's failure to transfer 911 calls to Fort Worth. Fort Worth
shall provide the Client with written notice of any Event of Default and allow the Client 60 days
to cure it. If the Client fails to cure the Event of Default within the 60-day period, it will be
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considered an Uncured Cvent of Default.
5.4.2 If two or more Uncured Events oi' Default occur in a single fiscal year, or five �r
more occur over �ny sin�le term of this Agreement, the Uncured Cvents of Def�ult will be
consideced Repeated Uncured Events oi' Default. In sucl� case, F'oct Worth may terminate this
Agreement, witllout penalty, atter pcoviding Client with 6 montlls' written notice of Forl Wo►-th's
intent to terminate the Agreement pursuant to this provision.
5.5 Upon the efPective date of te►-mination of this Agceement, �ort Worlh will cease being the
CMS Provider to the Client and the Client will be responsible for all CMS System services within
its jurisdiction from the effective date of termination.
Section G: PAYMENT
6.1 The Parties agree that the long-tei�m sustainability oP the CMS System requices public
funding. The Plrties agree to Ftmd the EMS System using tlle fully loaded unit hour cost (Ul-[C)
allocation strategy as its annull cost �Ilocation method. This method will require Foct Woeth to:
(I) detecmine the total number oP consumed unit houis in the CMS System; (2) cietecinine the
public funding needed by calculating the total expenditures less total revenues; (3) detecmine the
residual consumed UI-IC by dividing the total public Punding required for the EMS System (step
2) by the tot�l consumed hours in the entire EMS System; (4) determine the consumed units hours
by each jurisdiction; and (5) determine tl�e cost allocation Por each jurisdiction by mtiltiplying the
total consumed unit hours in the jurisdiction (step 4) by the cesidual consumed UHC (step 3).
For purposes of this Section, the actual unit hours consumed on a 91 1 call will be based on the
number of minutes spent on the call, not including time spent posting or stationed, in a particullr
jurisdiction. The total time for calls within Client's jurisdiction will be aggregated on a liscal year
basis (October 1 through Septembec 30) anci for purposes of calculating the annu�l U[-IC for Client,
the annual houcs consumed by the Client will be rounded up oc down to the nelrest one (I) hour
increment. As detailed below, payment for each tiscal year shall initially be based on a projected
budget and projected utilization with a true-up process in the subsequent fiscal year to ensure fiinal
payment �Por each year ultimately reflects act�ial costs 1nd ut;ilization.
6.2 Beginning in Fiscal Year 2026, on oc be[-oce March IS`�' oFeacll yea►�, Foct Worth will
communicate to the Client: (I) the projected budget for total public funding for the CMS System
1or tlze coming fisc�l year (based on l�ort Worth's projected costs and projected third-party-
payment oCfset), expressed 1s a UI-IC; (2) Client's projected utilizatian c�te for the coming year,
which will be the same as the lctual utilization rate (number of UI-IC hours consumed) for the most
recently completed fiscal yeai; and (3) the total budgeted payment for the Client for the coming
fiscal year (product of (I) multiplied by (2)). Unless otllerwise agreed in writing by the Parties,
payment oi� budgeted costs sh�ll be divided into semi-annual payments with the (irst payment o1�
iifty peccent due on or be1'ore October 15`�' and the remaining payment due on oc bePore June Is�,
which payment will reflect any true-up adjustment dete�•mined in accordance with Sections 6.3
and 6.4.
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For purposes of determining costs for Fiscal Year 2025, Client's projected unit hours consumed
are 1,270, and Client's projected annual funding obligation is $130,695.70. For Fiscal Year 2025,
Client's payment obligation has been prorated to $32,673.93 and is due no later than July 1, 2025.
6.3 Beginning in Fiscal Year 2027, on or before December 15t�' of each year, Fort Worth will
conduct a true up of actual costs and utilization for the preceding fiscal year. As part of this
process, Fort Worth will communicate to the Client: (1) the actual total public funding for the
EMS System for the preceding fiscal year (based on actual costs and actual third-party-payment
offset, expressed as a UHC; (2) the Client's actual utilization rate (number of UHC hours
consumed) for the preceding fiscal year; and (3) the total actual cost for the Client for the preceding
fiscal year (product of (] ) multiplied by (2)).
6.4 The notice pcovided to Client by Fort Worth on or before March 15��' each fiscal year will
account for the results of the true up process described by section 6.3 above. Any adjustment that
may be required to Client's payment obligations as a result of that true up will be reconciled in the
fiscal year immediately following the fiscal year in which the March I St�' notice is provided. For
the sake of clarity, if the true up reveals the budgeted payment exceeded the actual costs
attributable to the Client, then the overpayment amount will be deducted from the frst annual
payment of the next fiscal year. If the budgeted payment obligation was less than the actual costs
attt•ibutable to the Client, then the extra costs will be added to the first annual payment of the next
fisca] year. Should the Parties seek to tern�inate this Agreement before the costs may be reconciled
the next fiscal year, the Parties agree to reconcile that obligation, subject to approval and
appropriation by their respective governing bodies, before either Party may tertninate this
Agreement.
6.5 Fort Worth shall be responsible for billing patients and third parties for services and shall
have the right to retain all funds received fi�om such billing for services rendered as long as this
Agreement is in place. The actual costs for operating the EMS System will be offset by revenues
ceceived to ensure the public subsidy accurately reflects unreimbursed costs only.
Section 7: EM5 SYST�M GOVERNANCE
7.1 Fort Worth will have direct oversight and budgetary authority over the EMS System. The
Fort Worth City Council, by and through the Fort Worth City Manager or Assistant City Managers,
will assume control and responsibility of all operations, oversight, revenues, and expenditures to
ensure long-term fiscal sustainability that is publicly accountable.
7.2 The Fort Worth Fire Chief, acting under the direction of the City Manager or their designee,
shall be responsible for providing direct management and day-to-day oversight of FW EMS and
the EMS System and will have the powers and duties afforded and required of fire chiefs under
state law.
7.3 The Parties agree that both an EMS advisory board and a medical control advisory board
composed of relevant stakeholders and medical experts are necessary to ensure medical best
practices and Client representation and to facilitate community engagement. Therefore, an EMS
Advisory Board and a Medical Control Advisory Board will be created by Fort Worth. Such
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advisory boards are subject to the l-ollowing conditions at all times:
7.3.1 The EMS Adviso�y Board (CAB):
7.3.1.1: The CAB shall be created by l�ort Worth for the purpose of performing
review of and providing advice to rort Woclh on matters related to the LMS
System, budget, and service to the Client's jurisdiction.
7.3.1.2: The CAB's membership will consist ofthe following voting members: ane
cepresentative designated by the Client 1nd by each ofthe other units of government
that is a party to an CMS Inteclocal Agreement; and the f'orC Worth fire Chief, or
their designee, who shall serve as the I3oard Chair. The Medical Director, or their
designee, shall serve as a non-voting member.
7.3.1.3: The �AB shall review and advise on matters related to the periormance of
the CMS System and advise f ort Worth regarding issues related to the CMS
System's goals and standacds, including medical direction and clinical oversight
and selection oi'tl�e Medical Directoc.
7.3.1.4: The CAB will recommend performance stand�rds for the CMS System,
111CIUCIIII� response travel tii��es, call processing time, and data collection and
reporting �tandards.
7.3.1.5: The Cn[3 may, as determined by a majority vote of its members, establish
various subcommittees for purposes that the E�1Q deems necessary and that are
consistent with its general role as provided by this �greement, the resolution
creating the CA[3, and the CAB's governing documents.
7.3.1.6: To ensure lonb term Fiscal sustainability oPthe CMS System, the E�Q will
review the CMS System budget and conduct an annual budget workshop to �dvise
l�ort Woeth concerning revenue and expenditures for the CMS System.
7.3.2 The Medical Contcol Advisoiy Bo1rd (MCAB):
73.2.1: The MC.AB will serve as an adviso�y body to rort Worth. The MCAB's
tasks consist of:
• advising Fort Worth about the clinical perCocmance of the CMS System;
• reviewing medical protocols and clinicll policies and proceduces for the CMS
System and making recommendations to the Medical Director;
• representing the interests of the medical community and first Responders,
Medical Tcansportation Providers and ambulance standby providers by making
cecammendations foc improvements to the CMS System as needed;
• recommending and reviewing research conducted within the Service Area; a►�d
• participating in the selection of the Medical Director and review of the Medical
Director's clinical perfo��mance through processes established by Fort Worth,
pcovided, however, that tlle then-curcent Medical Director will not partici��te
EMS Interlocal Agreement Page 10
in matters related to his cucrent duties and performance.
7.3.2.2: The MCAB's membership shall be composed of the following voting
members: (1) the Medical Director (or a designated associate medical director),
wlio shall serve as the Board Chaii; (2) tlle Emergency Department physician
medical director, or designee, from each full-service Emergency Department
located in the Service Area; and (3) at least four physician members to represent
relevant specialties or sub-specialties of benefit in developing standards for
emergency out-of-hospital care, with broad representation fcom different hospital
systems, with such members to be recommended by a majority of the then-existing
membecs of MCAB and to be appointed by Fort Worth. The Fort Worth Fire Chief,
or theit• designee, shall serve as a non-voting member. A majority of the voting
members of the MCAB must be physicians who are board certified in Emergency
Medicine or Pediatric Emergency Medicine, or a related medical field.
7.3.2.3: The MCAB may, by an afficmative vote of two-thirds of its voting
members, elect to add other non-voting members as it deems appropriate.
Section & MEDICAL DIRECTOR
8.l The Medical Director for the EMS System will be retained by Fort Worth. The Medical
Director must be a licensed physician in the state of Texas who is board-certified in EMS and
emergency medicine and meets all state requirements.
8.2 When necessary, Fort Worth shall conduct a hiring and selection process for an EMS
System Medical Director and/or Associate Medical Director(s) that will be inclusive, and the EAB
and MCAB shall advise Fort Worth and make recommendations concerning selection of a Medical
Director for the EMS System.
8.3 The Medical Director is the Chief Medical Officer of the EMS System, will report to the
City Manager of Fort Worth or their designee, and will have the powers and duties afforded and
required of EMS medical directo�•s under state law. The Medical Director will provide all
independent medical direction and clinical oversight for the EMS System. The Medical Director's
powers and duties concerning the EMS System will be established by agreement between Fort
Worth and the Medical Director, which shall include tliose afforded and required under state law
with the resources necessary to fulfill such requirements.
8.4 Fort Worth, by resolution or ordinance, will establish a new department or division for the
Office of the Medical Director ("OMD"). The OMD will serve as the clinical office of Fort Worth
through which the Medical Director will carry out their rights and duties.
Section 9: FORCE MAJ�URE
9.1 It is expressly understood and agreed by the Parties to this Agreement that if the
performance of any obligations hereunder is delayed by reason of war; civil commotion; acts of
God; incleinent weather; epidemics or pandemics; governmental restrictions, regulations, or
EMS Interlocal Agreement Page 11
interferences; fces; strikes; lockouts, national disasters; riots; material or labor restrictions;
transportation problems; or any othe►• circumstances which are reasonlbly beyond the contcol of
the Party obligated or �ermitted under the terms ol this Agreement to do or nerform tl�e same,
regardless of�whethec any sucll circ�nnstance is similar to any o['those enumerated or not (each, �
"Force Majeure Cvent"), the Party so oblig�ted or permitted shall be excused (rom doing or
perlorming the s�me during such period oI' delay, so that the time period applicable to sucli
requicement shall be extended foc a period oPtime equal to the period such Party was delayed. To
invoke this section, a Party must provide written notice of the alleged Force Majeure Cvent to the
impacted Parties within a reasonable time after the occurrence of a Force Majeui•e Cvent,
explaining tlle �orce Majeuce Event and the extent to which the P1rty's performance of obligations
are hindered.
Section 10: RIGHT TO AUDIT
10.1 The Parties will have the right to audit each other's financial and business reco�•ds that
relate to the services provided (collectively "Records") at any time during the Term oP this
Agreement and for three (3) yea�s thereafter in order to deter�nine compliance with this Agreement.
Throughout the Term of this Agreeinent and �for three (3) yelrs the�-eafter, each Party shall mal<e
all relevant records avlilable following reasonable advance notice by the other �nd shall otherwise
cooperate fully with each other d�n�ing any audit. Notwithstanding anything to the contrary herein,
this Section 10 shall sucvive expiration or eacliec termin�tion of this Agreement.
Section 11: STANDBY �MS, 1NTCRFACILITY TRANSPO1tT (IrT), AND MUTUAL
A1D ACRC�M�NTS
I I.I This Agceeinent is not inte�lded to designate l�ort Worth as the exclusive, sole, or single
provider of standby CMS for the Client. Nothing 1lerein prohibits the Client from contracting for,
regulating, managing, and governing standby EMS and the provider(s) thereof in its own
jucisdiction.
l 1.2 This Agreement is not intended to designate rort Word� as the exclusive, sole, or single
provider of IPT services I-or any hospital or medical facility. Nothing hecein prohibits any hospitll
or medic�l l-acility Prom privately contracting for interfacility transporl secvices as deemed
necessa�y by that facility. Provided, however, each IrT provider must meet the requirements
pcovided by the UniPorm CMS Ordinance.
1 1.3 This Agreement is not intended to prevent the Client from p�rlicipating in mutual aid
agreements as is typical and ordinary for the Client.
Section l2: GOV�RNIVI�NTAL POW�,RS
12.1 ]t is undecstood and agreed that by execution of t11is Agreement, the Parties do not waive
or surrender any of their governmental powers or immunities.
Section 13: ELCCTRONIC SIGNATU.RES
EMS Interlocal Agreement Page 12
13.1 This Agi•eement may be executed by electronic signature, which will be considered as an
original signature for all purposes and have the same force and effect as an original signature. For
these puiposes, "electronic signature" means electronically scanned and trans�nitted versions (e.g.
via pdf file or facsimile transmission) of an original signature, or signatures electronically inserted
via software suc11 as Adobe Sign.
Section 14: COUNTERPARTS
14.1 This Agreement may be executed in one or moce counterparts and each countet�part will,
for all purposes, be deemed an original, but all such counterparts will together constitute one and
the same instrument.
Section 15: LIABILITY
15.1 Each party agrees to be solely liable for the actions, omissions, and negligent acts of its
own employees, agents, and representatives engaged in the provision of secvices through the EMS
System under this Agreement. Except as expressly provided herein, neither party shall be liable to
the other for any indirect, incidental, consequential, special, punitive, or exemplary damages
arising out of or in connection with this Agreement, regardless of the form of action, whether in
contract, tort, strict liability, or otherwise, even if advised of the possibility of such damages.
15.2 The Client assumes no responsibility or liability for payments, wages, income, and
employment tax payments, pensions, benefits, ar other payments accrued by or owed to Fort Worth
employees who provide services pursuant to this Agreement.
Section 16: INSURANCE
16.1 Each party shall maintain adequate insurance coverage to protect against claims arising
from the provision of EMS provided by its own employees and contractors; including but not
limited to general liability, professional liability, including malpractice insurance, and worker's
compensation insucance.
162 Each party may, at its discretion, elect to self-insure against claims arising from the
provision of EMS, provided that such self-insurance meets the applicable statutory requirements
and guidelines set forth by state law, including but not limited to chapter 2259 of the Texas
Goveininent Code.
16.3 Regardless of whether a party chooses to self-insure or obtain commercial insurance
coverage, each party shall provide proof of insurance or self-insurance to the other party upon
request. Such proof shall include details of coverage limits, deductibles, and any relevant policy
exclusions. Each party shall maintain continuous insurance coverage or self-insurance throughout
the term of this Agreement and any extensions thereo£ Any substantive changes to insurance
coverage or self-insurance arrangements shall be promptly communicated to the other Party in
writing.
16.4 In the event of any claim, lawsuit, or demand arising under this Agreement, each party
EMS Interlocal Agreement Page 13
shall be responsible foc minaging and defending its own claims, whether through its insurance
pcovider or seli=insurance program. However, parties may collabocate as necessary to resolve
claims efticiently and f�icly.
Section 17: GOVERNING LAW ANll VI:NU�
17.1 This Agreement shall be construed in accordance with the laws of the State of Texas. lf
any action, wllether real or asserted, at law or in equity, is brought o�1 tlle basis of this Agi•eement,
venue for such action shall lie in stlte coucls located in Tarrant County, Texas or the United States
District Court for the Northern District of Texas, �ort Woctl� Division.
Section 18: NOTIC�S
18.1 Notices required pursuant to the provisions of this ngceement shall be conclusively
determined to have been delivered when (1) hand-delivered to the other party, its agents,
employees, servants or cepresentatives, or (2) received by the other party by United St�tes Mail,
registered, return receipt requested, addt•essed as follows:
TO FORT WORT[-I:
City of rort Worth
Ath�: Assistant City Manager
TO CLICNT
City of Richland 1-lills
Atitn: City Manager
ioo ra►-� w���-ti, rr�����i
I�ort Worth TX 76102
With Copy to tihe City Attorney
al same addcess
3200 Diana Drive
Richland 1-lills TX 76l 18
A��y notices given pursuant to this section shall be contirmed by email sent to the following
addresses:
IP TO FORT WORTI-1:
Ashley.Clement@fortworthtexas.gov
IF TO CLIENT
rshelley@richlandhills.com
Section 19: CONFID�NTIALITY
19.1 Fort Worth sh111 comply with all applicable fedecal and state laws and regul2tions
regarding the privacy and contidentiality of ��tient records, including the federal I-[ealth Insurance
Porlabi(ity 1nd Accountability Act af 1996 (I-IIPAA). Upon cequest, Fort Warth will provide the
Client with utilization reviews, but all patient information shall be de-identified. Fort Worth, and
the FW�D, in providing the CMS System secvices, and directly related activity such as billing,
EMS Interlocal Agreement Page 14
will be considered a"covered entity" under the HIPAA Privacy Rule and the Texas Medical
Privacy Act. 45 C.F.R. § 160.103; Tex. Health & Safety Code § 181.001(b)(2). The Parties agree
to execute business associate agreements, and any other additional agreements concerning
protected health information ("PHI"), as may be necessary, to ensure compliance with the relevant
data privacy rules.
Section 20: ACCESS TO RECORDS
20.1 The parties agree that until the expiration of six years after the last date of furnishing of
services provided under this Agreement, the parties will make available to the Secretary of the
United States Department of Health and Human Services ("the Secretary") and the United States
Comptroller General, and their duly authorized representatives, this Agreement and all books,
documents, and records necessary to certify the nature and extent of the costs of those services. If
a Party carries out the duties of this Agreement through a subcontract worth $10,000 or more over
a twelve-month period, the subcontract will also contain an access clause to permit access by the
Secretary, the United States Comptroller General and their representatives to the related
organization's books and records.
Section 21: NO WAIV�R
21.1 No course of conduct or verbal waiver or consent shall be deemed a waiver by a Party of
its rights under this Agreement. The waiver by a Party of a breach or violation of any provision
of this Agreement shall not operate as, or be construed to be, a waiver of any subsequent breach
of the same or other provision of this Agreetnent
Section 22: ASSIGNMENT AND DELEGATION
22.1 The Agceement shall be binding upon and inure to the benefit of the Parties and their
respective successors and permitted assigns. No party may assign or transfer any of its rights or
obligations under this Agreement without prior written consent of the other Party.
Section 23: ENTIRE AGREEMENT
23.1 This Agreement, including any exhibits attached hereto and any documents incorporated
herein by reference, contains the entire understanding and agreeinent between the Parties, their
assigns and successors in interest, as to the matters contained herein. Any prior or
contemporaneous oral or w1•itten agreement is hereby declared null and void to the extent in
conflict with any provision of this Agreement.
(signature paae follows)
EMS Interlocal Agreement Page 15
____________________________________________________________________________________
EMS Interlocal Agreement Page 17
[Executed effective as of the date signed by the Assistant City Manager below.] / [ACCEPTED
AND AGREED:]
City of Fort Worth:
By: ___________________________
Name: Valerie Washington
Title: Assistant City Manager
Date: ___________________
CITY OF FORT WORTH INTERNAL ROUTING PROCESS:
Approved as to Form and Legality:
By: ______________________________
Name: Taylor C. Paris
Title: Assistant City Attorney
Contract Authorization:
M&C No. 25-0172
Contract Compliance Manager:
By signing I acknowledge that I am the person
responsible for the monitoring and administration
of this contract, including ensuring all
performance and reporting requirements.
By: ______________________________
Name: Ashley Clement
Title: Deputy Fire Director
City Secretary:
By: ______________________________
Name: Jannette S. Goodall
Title: City Secretary
City of Richland Hms:
-1 9 By: { 'JM (Lc£/11Mw--Name: Ca'iidice Edmondson
Title: City Manager
Date: 1-1-d/!J:5
EMS lnterlocal Agreement
Attest
B:
T
Date: 4-l · �Cj
Page 17
Ordinance No. _____ 1
ORDINANCE NO.___________________
AN ORDINANCE AMENDING CHAPTER [INSERT NUMBER]
“AMBULANCES/EMERGENCY MEDICAL SERVICES,” OF THE CODE
OF THE CITY OF [NAME], TEXAS (YEAR), AS AMENDED, BY
REPEALING ARTICLE I “IN GENERAL,” ARTICLE II “BOARDS; THE
AUTHORITY,” AND ARTICLE III “VIOLATIONS; PENALTIES; TRAFFIC
LAW EXEMPTION”;” AND ENACTING A NEW ARTICLE I “IN
GENERAL,” ARTICLE II “FORT WORTH EMS SYSTEM AND
INTERFACILITY TRANSPORTATION,” AND ARTICLE III
“VIOLATIONS, PENALTIES, TRAFFIC LAW EXEMPTION;” PROVIDING
THAT THIS ORDINANCE SHALL BE CUMULATIVE OF ALL PRIOR
ORDINANCES AND REPEAL CONFLICTING ORDINANCES;
PROVIDING FOR A SEVERABILITY CLAUSE; PROVIDING FOR A
SAVINGS CLAUSE; PROVIDING A PENALTY CLAUSE; PROVIDING
FOR PUBLICATION IN THE OFFICIAL NEWSPAPER OF THE CITY;
AND PROVIDING AN EFFECTIVE DATE.
WHEREAS, the City Council of the City of [NAME] ("City Council") seeks to protect the
public safety, preserve the quality of life, and promote efficiency within the City of [NAME] (the
“City”);
WHEREAS, it is in the best interests of the public health and welfare of the people of the
City to have available to them a regulated system for the provision of out of hospital emergency
and non-emergency medical services, unscheduled medical transportation and ambulance service
mobile integrated healthcare (“MIH”)(collectively the “EMS System”) and scheduled interfacility
medical transportation services among and between hospitals and other medical facilities in non-
emergency situations (“interfacility transports or IFT”) with the intent of providing quality clinical
care with performance measures and standards and a goal of facilitating the best possible outcomes
for each patient;
WHEREAS,in 1988 through the adoption of a Uniform EMS Ordinance and Interlocal
Cooperative Agreement between local governments, including the City of Fort Worth (“Fort
Worth”), the Area Metropolitan Ambulance Authority (the “Authority” a/k/a “MedStar”) was
created as a governmental administrative agency to administer and operate an EMS System and
exclusively provide interfacility transports in a service area comprised of the member jurisdictions,
with Fort Worth constituting more than eighty-five percent of the land mass and call volume of
the Authority;
Ordinance No. _____ 2
WHEREAS, the Authority has sustained rising operational and capital costs and flat net
revenues, leading to a dynamic that requires future public funding to ensure the long-term
sustainability of those services;
WHEREAS, the Fort Worth City Council has elected to establish an EMS division through
the Fort Worth Fire Department to operate an EMS System and provide services to the people
within its jurisdiction and people in other jurisdictions, provided each such jurisdiction adopts this
Uniform EMS Ordinance and enters into an EMS Interlocal Agreement with Fort Worth (each a
“Client City”);
WHEREAS, Fort Worth is engaging a physician who is licensed in Texas and board
certified in emergency medicine to serve as the Chief Medical Officer and Medical Director for
the EMS System (the “Medical Director”);
WHEREAS, the member jurisdictions of the Authority have agreed to dissolve the
Authority, and with those adopting this ordinance and executing an EMS Interlocal Agreement
opting to become Client Cities;
WHEREAS, due to the relatively low population and low population density of some areas
at issue and the extremely high, start-up and fixed operating costs of a state-of-the-art EMS
System, it is necessary to designate Fort Worth as the exclusively contracted EMS Provider of
EMS System services within the City in order to maximize clinical proficiency, enhance
operational effectiveness, and maximize economies of scale for providing such services;
WHEREAS, although Fort Worth will not be assuming the Authority’s role as exclusive
provider of interfacility transports, there remains a need to ensure such transports within the City
are only conducted by properly qualified and authorized providers in order to ensure clinical
standards are met and public safety is preserved; and
WHEREAS, the City Council finds this Ordinance to be reasonable and necessary.
NOW, THEREFORE, BE IT ORDAINED BY THE CITY COUNCIL OF [NAME]
TEXAS, THAT:
SECTION 1.
Chapter [NUMBER] “Ambulances/Emergency Medical Services” of the Code of the City
of [NAME] is hereby amended by repealing Article I “In General,” Article II “Boards; The
Authority,” and Article III “Violations; Penalties; Traffic Law Exemption,” and enacting a new
Ordinance No. _____ 3
Article I “In General,” Article II “ Fort Worth EMS System and Interfacility Transportation” and
Article III “Violations; Penalties; Traffic Law Exemption,” the text of which shall read as follows:
“ARTICLE I: GENERAL
§ 5-1 STATUTORY AUTHORITY.
This chapter is enacted by the City pursuant to Tex. Health and Safety Code §
773.051, which provides that local governments may establish standards for
ambulances, and pursuant to Tex. Government Code Chapter 791, which
authorizes combinations of local governmental units to contract for the provision
of governmental services.
§ 5-2 GENERAL PURPOSES AND INTENT OF ORDINANCE.
It is the purpose of this Ordinance:
To establish a regulated out-of-hospital emergency medical services, non-
emergency medical services, unscheduled medical transportation and ambulance
service, and mobile integrated healthcare system (collectively the “EMS System”)
which can provide quality clinical care with performance measures and standards,
with the goal of facilitating the best possible outcomes for each Patient.
To designate Fort Worth as the EMS Provider of the EMS System within the
corporate limits of City as provided by the terms of the EMS Interlocal Agreement
between Fort Worth and the City to maintain consistent, high-quality service while
controlling costs through efficiencies and economies of scale;
§ 5-3 DEFINITIONS.
For the purposes of this Ordinance, the following words and phrases shall have the
meanings respectively ascribed to them by this section:
(a)Advanced Life Support (ALS). Out-of-hospital care that uses invasive medical
acts (as defined in Tex. Health and Safety Code § 773.003(1)).
(b)Aeromedical Transportation Unit. Any rotary or fixed wing aircraft providing
basic or advanced life support services and patient transportation that originates
within the Service Area.
(c)Ambulance. A vehicle for transportation of sick or injured person to, from, or
between places of treatment for an illness or injury, and provide out of hospital
medical care to the Patient.
(d)Ambulance Mutual Aid Agreement. A written contract between Fort Worth and
one or more entities whereby the signing parties agree to provide backup
ambulance service to one another under the terms and conditions specified therein.
Ordinance No. _____ 4
(e) Ambulance Service. The transportation of Patients by emergency or non-
emergency ambulance; for purposes of this Ordinance, Ambulance Service does
not include IFT services as defined herein.
(f)Associate Medical Director.A licensed physician who assists the Medical
Director in carrying out his or her duties under this Ordinance, Fort Worth’s EMS
Interlocal Agreements, and the Medical Director’s agreement with Fort Worth.
(g)Basic Life Support (BLS). Out-of-hospital care that uses noninvasive medical
acts (as defined in § 773.003(2), Tex. Health and Safety Code).
(h) Emergency Care Attendant (ECA). A person certified as an “emergency care
attendant” under § 773.046 of the Tex. Health and Safety Code.
(i) Emergency Medical Services (EMS). 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.
(j) Emergency Medical Technician (EMT). A person certified as an “emergency
medical technician” under § 773.047 or an “advanced emergency medical
technician” under § 773.048 of the Tex. Health and Safety Code, and any other
class of EMT recognized by state law or regulation.
(k)EMS Communications Center. The facility designated by Fort Worth as the
central communications center from which all EMS System services offered by
Fort Worth shall be dispatched and coordinated.
(l) EMS Interlocal Agreements. The service level interlocal agreements executed
by Fort Worth and Client Cities to designate Fort Worth as the exclusively
contracted EMS Provider of the EMS System within the Service Area.
(m) EMS Provider. The entity that has received a Texas EMS Provider License, as
required by relevant state law, to provide the EMS System services and is the
exclusively contracted provider of the EMS System services within the Service
Area. For purposes of this ordinance, the EMS Provider is Fort Worth.
(n)EMS System. The regulated out-of-hospital EMS, non-emergency medical
services, unscheduled medical transportation and ambulance services, and mobile
integrated healthcare system provided by Fort Worth within the Service Area, not
including those first response services City chooses to provide itself as a First
Responder.
(o)First Responder. Any agency that, in cooperation with the EMS Provider,
provides initial response to requests for EMS and, on its own or in cooperation
with the EMS Provider, provides immediate on-scene care to ill or injured persons
but does not transport those persons to healthcare facilities.
(p) FW EMS. The emergency medical services division of the City of Fort Worth Fire
Department responsible for providing the EMS System services.
Ordinance No. _____ 5
(q)Interfacility Transportation (IFT). The provision of scheduled, or by
appointment, medical transportation services by a person or entity between
hospitals or medical facilities originating within the Service Area.
(r)Medical Director. The licensed physician employed or contracted by Fort Worth
who is responsible for carrying out his or her duties under their engagement with
Fort Worth, this Ordinance, and Fort Worth’s EMS Interlocal Agreements with
Client Cities and for directing the Office of the Medical Director.
(s)Medical Transportation.The transportation of Patients by ambulance,
Specialized Mobile Intensive Care Unit, Specialty Care Transport, or Aeromedical
Transportation Unit, including both emergency and low-acuity emergency
transports, where such transportation originates within the Service Area.
(t) Mobile Integrated Healthcare (MIH). Services provided by Fort Worth, as
requested by City, that are designed to enhance, coordinate, effectively manage,
and integrate out of hospital care, in order to improve outcomes, enhance the
client’s experience of care, and improve the efficiency and effectiveness of
healthcare services provided to the enrolled clients.
(u) Office of Medical Director. The department or division through which the
Medical Director carries out his or her functions. The Office of the Medical
Director is comprised of the Medical Director, any Associate Medical Director(s),
and other individuals assigned to the Office to assist the Medical Director in
carrying out the Medical Director’s functions.
(v) Paramedic. A person qualified as a certified or licensed “paramedic" as defined
by Tex. Health and Safety Code Sections 773.049 and 773.0495.
(w) Patient. A person: who requests EMS, or for whom EMS has been requested; and
who has any medical or psychological complaint, obvious injury/distress, or has a
significant mechanism of injury.
(x) Service Area. That geographical area which is contained within the corporate
limits of the City and other local jurisdictions who have elected to become Client
Cities by entering into an EMS Interlocal Agreement with Fort Worth and
adopting this ordinance.
(y)Specialty Care Transport. The transportation of a critically injured or ill patient
at a level of service beyond the scope of the EMT-Paramedic when the Patient’s
condition requires ongoing care that must be furnished by one or more health
professionals in an appropriate specialty area; for example, emergency or critical
care nursing, emergency medicine, respiratory care, cardiovascular care, or a
paramedic with additional training.
(z)Specialized Mobile Intensive Care Unit. A vehicle which is specially
constructed, equipped, staffed, and employed in the inter-facility transport of
patients whose requirements for en route medical support are likely to exceed the
clinical capabilities of an Advanced Life Support ambulance.
(aa) Uniform EMS Ordinance. This ordinance.
Ordinance No. _____ 6
(bb)Unscheduled Medical Transportation. The transportation of Patients by
ambulance service, Specialized Mobile Intensive Care Unit, Specialty Care
Transport, or Aeromedical Transportation Unit, including both emergency and
low-acuity emergency transports, where such transportation originates within the
Service Area and is not previously scheduled or made by appointment.
§ 5-4-5-15 Reserved
ARTICLE II: FORT WORTH EMS SYSTEM AND INTERFACILITY
TRANSPORTATION
§ 5-16 POWERS AND DUTIES OF FW EMS
(a) Fort Worth, by and through FW EMS, is hereby designated as the
exclusively contracted EMS Provider of the EMS System within the City's
corporate limits as provided by the terms, conditions and provisions of the City’s
EMS Interlocal Agreement with Fort Worth and for so long as Fort Worth is a
party to the City’s EMS Interlocal Agreement.
(c) Fort Worth shall comply with all terms of the EMS Interlocal Agreement
and have all the powers and duties enumerated therein.
§ 5-17 INTERFACILITY TRANSPORTATION
(a) This ordinance is not intended to designate Fort Worth as the sole provider
of interfacility transportation services between hospitals and other medical
facilities within the Service Area.
(b) Notwithstanding the above, any person or entity who wishes to provide
such IFT services within the Service Area must be registered with Fort Worth as
an IFT provider and permitted by Fort Worth and the Medical Director to provide
such services.
(c) Any IFT provider who obtains a permit to provide IFT services from Fort
Worth must comply with the provisions of this ordinance and the directives of the
Medical Director.
§ 5-18-5-30 Reserved
ARTICLE III: VIOLATIONS; PENALTIES; TRAFFIC LAW
EXEMPTION
§ 5-31 VIOLATIONS.
(a) So long as Fort Worth is a party to the City’s EMS Interlocal Agreement, it
shall be unlawful:
Ordinance No. _____ 7
(1) To knowingly give false information to induce the dispatch of an
ambulance or Aeromedical Transportation Unit.
(2) To perform duties as an ECA, EMT, Paramedic or emergency
ambulance dispatcher without current credentials issued by the Office
of the Medical Director, unless participating in a training program
approved by Office of the Medical Director or performing duties as a
First Responder of the City;
(3) To permit a person to work as an ECA, EMT, Paramedic or emergency
ambulance dispatcher without current credentials issued by the Office
of the Medical Director, unless participating in a training program
approved by Office of the Medical Director or performing duties as a
First Responder of the City;
(4) To use, or cause to be used, any Ambulance Service other than FW
EMS, except as permitted in subsection (b) below;
(5) For any person or entity other than Fort Worth and FW EMS to
provide EMS System services within the Service Area, not including
those first response services which City provides itself as a First
Responder and except as permitted by subsection (b) below;
(6) For any person to provide Medical Transportation originating in the
Service Area without a permit issued by Fort Worth;
(7) For any agency to provide First Responder services without a First
Responder Agreement with Fort Worth or a written automatic aid or
mutual aid agreement with the City;
(8) To use an ambulance for the transportation of persons other than in
connection with the transportation of a Patient.
(b) It shall be a defense to any alleged violation of this section that a vehicle is
being used or service is provided solely in any of the following manners:
(1) As a privately-owned vehicle not ordinarily used in the business of
transporting persons who are sick, injured, wounded, incapacitated or
helpless;
(2) Rendering service as an ambulance at the request of the EMS
Communications Center upon the declaration of a disaster by Fort Worth,
the City,another unit of local government, the State of Texas, or the United
States; or a declaration of a major catastrophe or extreme system overload
by the City Fire Chief, or the Fort Worth Fire Chief;
(3) Any ambulance owned or operated by the federal or state government;
(4) Ambulance mutual aid calls when rendered pursuant to an Ambulance
Mutual Aid agreement approved by the City or Fort Worth;
(5) Wheelchair transport services for persons other than Patients, when the
service is not provided by ambulance; and
Ordinance No. _____ 8
(6) Medical Transportation of a Patient where the transport originates outside
the Service Area.
(7) IFT between hospitals or medical facilities within the Service Area if the
provider has first obtained a permit from Fort Worth.
§ 5-32 PENALTIES.
(a) Any person convicted of violating the provisions of Section 5-31 shall be
guilty of a Class C misdemeanor and shall be punished by a fine not to exceed
$500 (Tex. Penal Code §12.23).
(b) This Section does not serve to limit any other remedies available to the
City in law or equity.
(c) Each violation of this Ordinance shall constitute a separate offense.
§ 5-33 TRAFFIC LAWS; EXEMPTION.
When the driver of an emergency medical response vehicle has reasonable grounds
to believe that an emergency exists, as determined by the EMS Communication
Center, the vehicle shall be treated as an “authorized emergency vehicle” within
the meaning of Chapter 546 of the Tex. Transp. Code and shall be exempt from
traffic laws as provided therein.
§ 5-34-5-39 Reserved”
SECTION 2.
This ordinance shall be cumulative of all provisions of ordinances of the Code of the City of
[NAME], Texas (YEAR), as amended, except where the provisions of this ordinance are in direct
conflict with the provisions of such ordinances and such Code, in which event conflicting provisions
of such ordinances and such Code are hereby repealed.
SECTION 3.
It is hereby declared to be the intention of the City Council that the phrases, clauses, sentences,
paragraphs and sectionsof this ordinance are severable, and, if any phrase, clause, sentence, paragraph
or section of this ordinance shall be declared unconstitutional by the valid judgment or decree of any
court of competent jurisdiction, such unconstitutionality 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 unconstitutional phrase,
clause, sentence, paragraph or section.
Ordinance No. _____ 9
SECTION 4.
All rights and remedies of the City of [NAME], Texas, are expressly saved as to any and
all violations of the provisions of the Code of the City of [NAME], or any other ordinances of the
City, that have accrued at the time of the effective date of this ordinance; and, as to such accrued
violations and all pending litigation, both civil and criminal, whether pending in court or not, under
such ordinances, same shall not be affected by this ordinance, but may be prosecuted until final
disposition by the courts.
SECTION 5.
Any person convicted of violating the provisions of the Code of the City of [NAME]
Section 5-31 as enacted by this Ordinance shall be guilty of a Class C misdemeanor and shall be
punished by a fine not to exceed $500 (Tex. Penal Code §.12.23). This Section does not serve to
limit any other remedies available to the Jurisdiction in law or equity. Each violation of this
Ordinance shall constitute a separate offense.
SECTION 6.
The City Secretary of the City of [NAME], Texas is hereby directed to publish the caption,
penalty clause and effective date of this ordinance for two (2) days in the official newspaper of the
City of [NAME], Texas, as authorized by Texas Local Government Code, Section 52.013.
SECTION 7.
All other provisions of Chapter 5 of the Code of the City of [Name], as amended, shall
remain in full force and effect, save and except as amended by this ordinance.
SECTION 8.
This ordinance shall take effect upon adoption and publication as required by law, and it is
so ordained.
APPROVED AS TO FORM AND LEGALITY: ATTEST:
___________________________________ ________________________________
Assistant City Attorney [NAME], City Secretary
Date: ______________________________
Ordinance No. _____ 10
ADOPTED: _________________________
EFFECTIVE: ________________________
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City of Fort Worth,
Mayor and
DATE: 02/25/25
Texas
Council Communication
M&C FILE NUMBER: M&C 25-0172
LOG NAME: 36FD EMS ILA
SUBJECT
(ALL) Adopt a Revised Emergency Medical Services Ordinance to be Effective July 1, 2025, and Authorize Execution of Interlocal Agreements
with Other Local Jurisdictions to Authorize Fort Worth to Operate as the Licensed Emergency Medical Services Provider and Furnish EMS
System Services in Each Jurisdiction
RECOMMENDATION:
It is recommended that City Council:
1. Adopt the attached revised Emergency Medical Services Ordinance, to be effective July 1, 2025, which will replace the City's current
ordinance and serve as the uniform Emergency Medical Services Ordinance for all jurisdictions wishing to receive Emergency Medical
Services from Fort Worth; and
2. Authorize the execution of Interlocal Agreements with each local jurisdiction that elects to receive Emergency Medical Services System
Services from the City of Fort Worth, subject to a requirement that each such jurisdiction adopt the Emergency Medical Services Ordinance
and authorize the City of Fort Worth to operate as that jurisdiction's licensed Emergency Medical Services Provider and to furnish EMS
System Services, within such jurisdictions.
DISCUSSION:
In 1988, the City of Fort Worth (City) and certain other local municipalities came together to create a regional ambulance and emergency medical
services (EMS) agency known as the Area Metropolitan Ambulance Authority, d/b/a Medstar, (Authority) through the adoption of a uniform EMS
ordinance and interlocal cooperative agreement under the provisions of Section 773.051 of the Texas Health and Safety Code and chapter 791 of
the Texas Government Code.
Beginning in 2020, the Authority (now known as the Metropolitan Area EMS Authority and operating under the trade name MedStar Mobile
Healthcare) operated under a Restated and Amended Interlocal Cooperative Agreement (Fort Worth City Secretary Contract No. 54348;
hereinafter, the Agreement) and an updated uniform EMS ordinance. The Agreement provided that the Authority would continue in existence until
all participating units of government (Member Cities) withdrew from the Agreement.
Pursuant to the Memorandum of Understanding and Agreement (MOUA) executed by all Member Cities and effective December 31, 2024, all
Member Cities agreed to: withdraw from and terminate the Agreement; dissolve the Authority; and designate the City as the licensed EMS
Provider for the Member Cities. Pursuant to the MOUA, the Authority continues to exist, operate, and serve as the EMS Provider for the Member
Cities, under the management and control of the City, in a limited, transitional capacity until at least July 1, 2025 (Transition Period).
It remains in the best interests of the public health and welfare of the people of the Member City jurisdictions to have available to them a regulated
EMS System with an exclusively contracted EMS Provider. Therefore, the City has established an EMS division through the City of Fort Worth Fire
Department to operate a new EMS System and provide services to the people of the jurisdictions who execute an EMS Interlocal Agreement with
the City and adopt a new uniform EMS ordinance, each a"Client City."
The City is engaging a physician who is licensed in Texas and board certified in emergency medicine to serve as the Chief Medical Officer and
Medical Director for the City's EMS system (Medical Director). And, by and through Ordinance No. 27372-12-2024, adopted by the City Council
on December 10, 2024, the City established a new department, the Department of Office of the Medical Director, which shall be responsible for
serving as the clinical office through which the Medical Director carries out his or her rights, duties, and obligations under the City's Uniform EMS
Ordinance and the City's EMS Interlocal Agreements.
The purpose of this Mayor & Council Communication (M&C) is to authorize the City to execute the EMS Interlocal Agreements with each Client
City, as contemplated by the MOUA. The EMS Interlocal Agreements will govern the relationship between the City and each Client City and
authorize the City to serve as the licensed EMS Provider and exclusive provider of certain EMS services within each Client City's jurisdiction
beginning July 1, 2025 and upon the City receiving its EMS provider license from the Department of State Health Services, whichever occurs later.
With the approval of this M&C, the City will execute an EMS Interlocal Agreements with the following cities:
• Blue Mound;
• Edgecliff Village;
• Forest Hill;
• Haltom City;
• Haslet;
• Lake Worth;
• Lakeside;
• Richland Hills;
• River Oaks;
• Saginaw;
• Sansom Park;
• Westover Hills;
• Westworth Village; and
• White Settlement.
In addition to serving as the licensed EMS Provider for each Client City, the EMS Interlocal Agreements require the City to, among other things: set
system performance standards in accordance with protocols established by its Medical Director, provide each Client City with "EMS System
services" which include: out-of-hospital EMS, non-emergency medical services, life, or limb, threatening emergency, low acuity emergency, and
Advanced Life Support and Basic Life Support unscheduled Medical Transportation and Ambulance Service, and mobile integrated healthcare
services; obtain the services of an independent medical director; create two advisory boards known as the EMS Advisory Board and Medical
Control Advisory Board; provide quarterly written reports of the operational perFormance of the EMS System to each Client City and the advisory
boards; provide quarterly comprehensive reviews of the budget and clinical performance of the system; and manage the billing, subscriptions, and
payment practices. The City will not be the exclusive provider of interfacility transportation services.
The term of each EMS Interlocal Agreement is for 10 years beginning July 1, 2025 and will renew automatically for successive 10-year terms
unless earlier terminated in accordance with the terms of the EMS Interlocal Agreement. The above notwithstanding, one Client City, Edgecliff
Village, has requested an initial term of 5 years, with successive 5 year renewal terms.
The EMS Interlocal Agreements obligate the City and each Client City to fund the EMS System using the fully loaded unit hour cost (UHC)
allocation strategy. This method will require the City to: (1) determine the total number of consumed unit hours in the EMS System; (2) determine
the public funding needed by calculating the total expenditures less total revenues; (3) determine the residual consumed UHC by dividing the total
public funding required for the EMS System (step 2) by the total consumed hours in the entire EMS System; (4) determine the consumed unit hours
by each jurisdiction; and (5) determine the cost allocation for each jurisdiction by multiplying the total consumed unit hours in the jurisdiction (step
4) by the residual consumed UHC (step 3). The actual unit hours consumed on a 911 call will be based on the number of minutes spent on the call,
not including time spent posting or stationed, in a particular jurisdiction. The total time for calls within a Client City's jurisdiction will be aggregated
on a fiscal year basis (October 1 through September 30) and for purposes of calculating the annual UHC for a Client City, the annual hours
consumed by the Client City will be rounded up or down to the nearest one (1) hour increment. Payment for each fiscal year shall initially be based
on a projected budget and projected utilization with a true-up process in the subsequent fiscal year to ensure final payment for each year ultimately
reflects actual costs and utilization.
In addition to authorizing the execution of the EMS Interlocal Agreements, approval of this M&C will adopt the attached Uniform EMS Ordinance
(Ordinance). The purpose of the Ordinance is to replace the existing Uniform EMS Ordinance which designates the Authority as the exclusive EMS
Provider within the City. The Ordinance will designate the City as the exclusive EMS Provider of the City's EMS System Services within the City's
corporate limits and of those Client City's who also adopt the Ordinance. In addition to the above, the Ordinance will require other EMS providers
to register with the City and obtain a permit in order to operate interfacility transportation services within the corporate limits of the City and of
those City's who adopt the Ordinance.
Under the Ordinance, it is unlawful, among other things, to knowingly give false information to induce the dispatch of an ambulance or to use or
cause to be used any ambulance service other than the City (except in an expressly authorized manner). If found guilty of a Class C Misdemeanor
for a violation as set out in the Ordinance, a person shall be punished by a fine not to exceed $500.00 per violation.
These contracts will be with a governmental entity, state agency or public institution of higher education: Other local governments.
These agreements will serve ALL COUNCIL DISTRICTS.
A Form 1295 is not required because: This M&C does not request approval of a contract with a business entity.
FISCAL INFORMATION / CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendations and execution of the agreements funds will be deposited into
the Emergency Medical Services Fund. The Fire Department (and Financial Management Services) is responsible for the collection and deposit
of funds due to the City.
Submitted for City Manager's Office bk Dana Burghdoff 8018
Originating Business Unit Head: Jim Davis 6801
Additional Information Contact: