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HomeMy WebLinkAboutOrdinance 27501-04-2025ORDINANCE NO.27501-02-2025 AN ORDINANCE AMENDING CHAPTER 5 (AMBULANCES/EMERGENCY MEDICAL SERVICES) OF THE CODE OF THE CITY OF FORT WORTH (2015), 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 SEVERABILTTY 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 Fort Worth ("City Council") seeks to protect the public safety, preserve the quality of life, and promote efficiency within the City of Fort Worth ("Fort Worth"); WHEREAS, it is in the best interests of the public health and welfare of the people of Fort Worth 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 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. 2750I-02-2025 _-! 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 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 Fort Worth 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 Fort Worth 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 5 (Ambulances/Emergency Medical Services) of the Code of the City of Fort Worth (2015), as amended, 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 Article I "In General," Article II " Fort Worth EMS System and Interfacility Ordinance No. 27501-02-2025 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 Fort Worth pursuant to Tex. Health and Safety Code § 773.05I, which provides that Iocal 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 Fort Worth as provided by the terms of this Ordinance and the EMS InterIocal Agreements between Fort Worth and the Client Cities 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. 27501-02-2025 (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 Iaw 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. (1) 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. 27501-02-2025 (q) Interfacility Transportation OTT). 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 InterlocaI 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 Client Cities 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. 27501-02-2025 (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 exclusive EMS Provider of the EMS System within Fort Worth's corporate limits as provided by the terms, conditions and provisions of this ordinance and the EMS Interlocal Agreements with the Client Cities. (c) Fort Worth shall comply with all terms of the EMS Interlocal Agreements 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) It shall be unlawful: (1) To knowingly give false information to induce the dispatch of an ambulance or Aeromedical Transportation Unit. Ordinance No. 27501-02-2025 (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 Fort Worth; (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 Fort Worth; (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 Fort Worth 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 Fort Worth; (S) 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, 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 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 Fort Worth; (5) Wheelchair transport services for persons other than Patients, when the service is not provided by ambulance; and (6) Medical Transportation of a Patient where the transport originates outside the Service Area. Ordinance No. 27501-02-2025 (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 Fort Worth 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 Fort Worth, Texas (2015), 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 ofthe City Council that the phrases, clauses, sentences, paragraphs and sections of 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. SECTION 4. Ordinance No. 27501-02-2025 All rights and remedies of the City of Fort Worth, Texas, are expressly saved as to any and all violations of the provisions of the Code of the City of Fort Worth, or any other ordinances of Fort Worth, 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 Fort Worth 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 Fort Worth, 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 Fort Worth, 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 Fort Worth (2015), as amended, shall remain in full force and effect, save and except as amended by this ordinance. SECTION 8. This ordinance shall be effective as of July 1, 2025 after adoption and publication as required by law, and it is so ordained. Ordinance No. 27501-02-2025 APPROVED AS TO FORM AND LEGALITY: Assistant City Attorney ADOPTED: February 25, 2025 EFFECTIVE: UOD,90 ATTEST: Jannette Goodall, City Secretary A f- ORr n co rl v a" o "_ n-n 4 Ordinance No.27501-02-2025 10 • 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 orto 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. bmitted for City Manager's Office bv: Dana Burghdoff 8018 Originating Business Qnit Head: Jim Davis 6801 Additional Information Contact: