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Home My WebLink AboutPO 6062: EMERGENCY MEDICAL VEHICLESPORT ARTHUR FIRE DEPARTMENT MEMORANDUM TO: City Manager Stephen Fitzgibbons CC: Fire Chief Larry Richard FROM: Deputy Chief John Avery DATE: 1/26/2010 SUBJECT: Proposed Ordinance 6062 Attached is a proposed re-write of the city ambulance ordinance. The re-write was undertaken to bring Port Arthur's ordinance into line with recognized standazds and practices as w=ell as to address the need to more efficiently utilize ambulance resources. Authoritative standards and practices consulted were the National Fire Protection Association Standard (NFPA) 1710, the National Highway Traffic Safety Administration`s (NHTSA) "EMD Program Implementation and Administration, .Manager's Guide" and the National Association of Emergency Medical Services Physicians'(NAEMSP) position paper on response time goals. Additionally, many meetings were held with the representatives of local ambulance companies. The substantive changes in the ordinance are outlined in the following pazagraphs: The quarterly fees paid to the city are eliminated, however, liquidated damages for failure to meet response parameters or equipment and sanitation requirements aze added. The provision of emergency medical ambulance service is a money losing enterprise. For instance, the public EMS service in Beaumont is subsidized from general revenues. Attached is a copy of the Beaumont city budget showing revenues and expenditures, and the extent of the subsidy for emergency ambulance service to that city. It is reasonable to assume that if Port Arthur were operate a public emergency medical service that its subsidy would be at least half as much as Beaumont's. Therefore, to the extent that any fees or liquidated damages are imposed, they should be done so with the goal of achieving the desired response and service outcomes. The proposed re-write takes that approach. The average response time requirement of 6 minutes is replaced with apercentile/fractile performance measurement. Ambulance providers will be required, instead, to respond with a travel time not to exceed 480 seconds (8 minutes) to 90% of priority one calls. This performance measurement is consistent with NFPA Standazd 1710. It is also consistent with the approach taken by the NAEMSP as stated in its `'Remember, we are here to serve the citizens of Port Arthur" PORT ARTHUR FIRE DEPARTMENT MEMORANDUM position paper Number 3, Volume 7, titled `'Consideration In Establishing Emergency Medical Services Response Time Goals" which advocates use of fractile response intervals instead of average response intervals to assess performance. Additionally, the three mid-county cities are currently using the percentile/fractile performance measurement. The requirement that ambulance providers maintain a fixed number of ambulances available for 911 service around the clock is eliminated. The rationale being that response time outcomes as outlined above should be the criteria used rather than an azbitrary number of ambulances. The current requirement also ignores the reality that 911 call demand varies by time of day and day of the week. The requirement that all ambulances be staffed with a pazamedic is eliminated. The ambulance provider may continue to staff ambulances with a pazamedic or it may choose to have a paramedic respond in a separate vehicle. In any event, any call received that presents as a priority one call will have a paramedic response, either on the ambulance or by separate vehicle. This approach is referred to in the industry as a tiered approach. When either the ambulance, paramedic, or fire personnel arrive, if a call which presented as a priority one call is determined not to be, the call may be downgraded to a lower priority. The overwhelming majority of calls which aze represented. as priority one calls by the caller turn out to be a lower priority. By not using a tiered system, the city is requiring the ambulance provider to commit a paramedic to all calls from the initiation of the call all the way through transport to a hospital. The practice further exacerbates the misuse of the paramedic resource because of the problem of ambulance personnel being held on the wall at local hospitals while waiting for patient admittance to the emergency department. A patient needing BLS services attended to by BLS certified personnel frees-up ALS certified personnel to attend to those patients needing ALS interventions. I believe that theproposed changes to the ambulance ordinance will result in a better allocation of resources and therefore, improved service. Attachment: FY 2010 Beaumont City Budget, Revenues and Expenditure pages for public EMS "Remember, we are here to serve the citizens of Port Arthur" PORT ARTHUR FIRE DEPARTMENT MEMORANDUM Ciry of Beaumont '~~~eiam~ ~~~.' *_,~~-.GENERA FUND~EXPENDI'PtFRES ~,~,_~ .,;.~~,r,~;~z~g FY 2009 2010 P.000UNT NUMBER ACCOUNT DESCRIPTION BuDCeT GENERAL FUND PUBLIC HEALT3 EMERGENCY MEDICAE$uC ~.~F 001-6545-5531005 FULL TIME WAGES 001-6545-5531012 CASUAL W2 GES 001-6545-5531020 OVERTIME-CIVILIAN 001-6545-5531022 OVERTIME-SCHEDOLED - EMS 001-6545-5531205 LONGEVITY CO1-6545-5531210 AUTO ALLOWANCE CO1-6595-5531225 INCENTIVE PAY-CIVILIAN 001-6595-5531405 FICA-REGULAR 001-6595-5531406 FICA-MED 001-6595-5531410 PENSION-TMRS--CIVILIAN 001-6595-5531413 PENSION - ARS FOR PSTS 001-6595-5531605 EMPLOYEE INS BENEFITS 001-6545-5531805 TERh1INATING VACATION 001-6595-5531810 TERFII NATING PERS- LEAVE 001-6595-5532010 ?OSTAGE 001-v'S 95-5532015 HEALTH SU?PLIES 001-0'S 45-5532020 UNIFORMS b WEARING APP. OG1-o'S 95-5532025 OPER SOPFLPtS b EQUIPMENT 001-6595-5532035 FUEL/CUBE-ZNTERFONO 001-6595-5532205 VEHZCLE MAINT-iNTEAFUND GO1-6595-5532210 EQUI PPfENT MAINTENANCE 001-6595-5533025 TELEPHONE/COMMUNICATIONS 001-6545-5533210 PAI NmING 001-6545-5533215 LEASE d RENT 001-6545-5533225 TRP.VEL b TRAINING 001-6545-5533230 FROF. FEES, DUES b SUB SCR 001-6545-5533235 CONTRACT SERVICES 001-0""545-5535920 FLEET AENTAL CHARGES. 001-6595-5536010 EQUIPMENT < $10,000 * EMERGENCY MEDICAL SVC ** ?UBLIC HEALTH FY 2008 ADJUSTED FY 2009 FY ACTUAL BUDGET EST II9ATED 1,233,942 2,053,200 1,401,000 2,139,900 4,88@ 15,000 900 .15,000 439,822 526,400 998,200 527,900 973,071 436,200 508,800 461,900 6,383 8,400 9,300 9, 3G0 3,628 3,600 3,0'00 3,600 8,970 9,100 10,200 10,400 131,121 186,300 150,900 210,100 30,665 93,600 35,300 99,400 289,190 365,800 961,900 659,400 0 0 0 200 450,000 972,500 972,500 972,500 633 0 700 0 502 0 1,100 0 1,220 500 1,200 1,200 200,26'0 230,000 190,000 200,000 13,967 29,500 20,000 20,000 16,779 23,000 15,000 11,500 161,178 175,000 120,000 160,000 153,238 130,000 180,000 180,000 6,055 7,000 5,000 5,000 16, 619 20,000 20,000 20,000 1,761 2,000 2,000 2,000 49,996 47,000 97, OOG 47,000 2,756 9,000 9,000 2,000 2,459 3,000 3,000 3,000 53,430 52,900 52,900 52,900 64,900 113,200 113,200 129,600 35 8 9 3~ 000 35 000 0 3'8;A5 208 ~~~ 5 042, 2:OP]--c 4,362,'200~r X5;363; B00, 7,000,329 8,066,900 7,403,100 8,328,500 "Remember, we are here to serve the citizens of Port Arthur" PORT ARTHUR FIRE DEPARTMENT MEMORANDUM Fr zoa9 FY 2008 ADNSTED FY 2009 FY 2010 ACCOUNT ACCOUNT DESCRi PT ION ACTUAL BUDGET EST r[RATED BUDGET GENERAL BUND LICENSES AND PERMITS 23-401-1010 ALCGHOiIC 3EVEPAGE PERMIT 38,938 50,000 52,000 52,000 0'S-901-1015 RESTAURANT/GROG. PERPffT 209,595 215, 100 195,100 215,1C0 70-901-1020 OIL WELL PERMIT 42,300 1,000 182,000 2,000 35-901-1025 WRECKER PERMIT 1,170 1, 20G 1, 2C0 1,200 70-901-1026 SOLICITATION 0. FUNDS 200 200 100 100 70-401-1035 STORAGE TAN{ pggpfI TB 2,645 2,200 2,700 2,500 70-401-1040 PRECIOUS ?FETAL PERMIT 20 - 0 100 0 23-901-1095 TAXI LICENSES 625 - 900 300 300 70-501-1050 BUS BENCH ADVEBT. PEiLMIT 0 0 2,300 0 35-901-1060 ALARM PERMIT 65,980 70,000 00,000 60,000 35-901-1065 S. ORIENTED BUSINESS PRMT 11,270 11,600 11,600 11,0'00 35-901--1070 PARADE PERMIT 1,800 1,000 3,000 1,000 20-901-1075 CROCKETT ST-SPEC EVNT FEE 1,440 0 0 G 70-901-1110 BUILDING PERMITS 923,639 669,000 705,000 679, 9G0 70-901-1115 ELECTRICAL PERMITS 105,029 72,000 55,300 55,000 70-401-1120 PLUMBING PERMITS 55,638 44,800 35,500 35,000 70-401-1125 GAS INSPECTIONS 9,0'39 10,000 9,0'00 8,700 70-901-1130 DEMOLITION PERMTTS 14,791 19, OOD 19,000 14,000 70-901-1135 MECHANICAL PERMITS 47,086 30,900 33, v'00 30,400 70-901-1190 FIRE ALARM SYSTPM PERMIT 28,963 17,000 19,000 19,000 70-901-1145 FIBER OPTIC CABLE 199,222 200,000 152,400 152,500 70-401-1150 SEISMOGRAPH PERMITS 0 500 0 500 70-401-1155 PIPELINE AGREEDfENTS 10,222 B, 500 9,300 9,000 70-901-1175 DRIVEWAY PERMITS. 8,205 0 7,800 0 70-901-1130 CONSTRUCTION INSPECTIONS 0 200 200 200 * LICENSES AND PERMITS 1,772,817 1,409,600 1,552,100 1,350,000 CHARGES FOR SERVICES ES 902 0010 LITTER REMOVAL EE 397 189 260 C00 271 000 275 000 G S .~ ~^2 5 ~ 7 Y 2 ' ~'~ 5 7 ~2 ~ 5 0 A ' 70,Q ~ z 19 22 000` 19 00 ~ FEE~C ~ 20 2 09 65 902- 81 5 vEMS OTHcR .~._---mob •0 ~'~a..tr ~3 Y t. , 3'2 £ ~ ~~ E~ ,_, , ~„ 23-902-1015' , ~FI LING/NOTARY FEES _ , . _a.. 850 ~ s ~ _ 1,000 . 600 600 OS-402-1020 STATE COURT TAX COLL FEE 165,302 150,000 150,000 150,000 65-402-1210 POUND VACINE/BDAADING FEE 27, o'C3 34,000 25,300 27,000 0'S-902-1215 FOOD SVC MANAGER CERT FEE 13,200 19000 13,100 13 000 0`5-402-1220 WEED P.RP.TEMENT CHARGER 78,152 92,000 230,000 100,000 0'S-402-1230 LITTER ABATEMENT CHARGES 19,910- 3,000 5,500 3,000 '05-402-1235 ANIMAL DISPOSP.L FEE 680 800 1, 1C0 800 65-402-1240 CAT TRAP USAGE FEE 170 300 400 300 35-902-1250 POLICE CERT/DEFENSE RPTS -91,481 103,000 52,500 40,000 35-902-1270 ARRESTING AGENCY FEE 6, 099 6,000 6,100 6, G00 70-902-1315 PARKING METER COLLECTIONS 16,861 16,500 12,000 10, G00 70-902-1320 STREET/DRAINAGE SERVICES -96,948 15,000 95,000 15,000 65-902-1910 VITAL STATISTICS FEE 266,552 290,000 300,000 290,000 65-902-1925 INNOCOLATION FEE 13,195 10,000 8,000 8,000 65-902-1928 FLU VACCINE FEE 5,630 12,000 16,900 12,000 00"5-902-1935 V.D. CLINK FEES 15,770 16,700 17,000 16,700 65-902-1450 DII SC HEP.LTH FEES 230 200 200 200 0'S-402-1555 TB - XRAY FEES 1,0'35 1, 60C 1,600 1,600 70-402-1510 SALES OF DLAPS d CODES 67 200 900 200 OS-402-1515 ZONING FEEB 92,690 90,000 0 38,000 70-402-1515 ZONING FEES 0 0 38,000 0 81-4G2-2050 COPIER USE FEES 12,765 13,000 19,500 "-3,000 31-902-2055 LIBRARY MEETING ROOMS 3,005 3, OGO 4,300 3,000 OS-902-2060 CITY CLERK SERVICES 2,213 2,000 2,700 2,000 CHARGES F03 SERVICES 9,026,717 3,589,000 3,822,700 3,600,000 FINES AND FORFEITS OS-903-1010 MOVING VIOLATION FIVES 982,333 1,100,000 1,100,000 1,100,000 OS-403-1015 CRIMINAL VIOLATIONS 221,353 230, 000 250,000 230,000 OS-903-1020 ILLEGAL PARSING FINES 159,966 120,000 127,000 120,000 0>-903-1025 BAIL BOND FORFEITS 90,110 90,000 60,000 50,000 OS-903-1030 NGN-COMPLIANCE FEES 650,363 665,000 693,000 650,000 OS-403-1035 SCHOOL 20NE VIOLATIONS 4,699 5,000 5,000 5,000 OS-803-1050 ALL COURT-FINES `0,696 7,800 8,300 7,800 23-903-1110 CHECK SERVICE CHARGES 35,021 32,000 20"", 9C0 30,000 81-903-1120 EOOK CHEC{OUT FINES 28,478 25,000 28,000 26,000 FIVE S AND FORFEITS 2,178,959 2,225,800 2,298,200 2,218,800 "Remember, we aze here to serve the citizens of Port Arthur" P. O. No. 6062 01/22/10 is/ja ORDINANCE N0. AN ORDINANCE .AMENDING SECTIONS .114-31, 114-33, '114-34, 114-35, 114-36, 114-37, 114-39, 114- 41, AND ADDING SECTION 114-42 OF THE CODE OF ORDINANCES OF THE CITY OF PORT ARTHIIR AS IT .PERTAINS TO EMERGENCY MEDICAL VEHICLES; .PROVIDING FOR A MAXIMUM .FINE OF $500 PER DAY OR PER INCIDENT, AND PROVIDING FOR EFFECTIVE DATES. WHEREAS, it is recommended by the Fire Chief that various changes be made to the Code of Ordinances as it pertains to emergency medical vehicles as follows: • Amend Section 114-31 Definitions: amend various of the definitions in regard to ambulances, emergency call, emergency care attendant, emergency medical dispatch, emergency medical services, non-emergency call, and adding a definition and training standard for priority one dispatch. • .Amend Section 114-33 Ambulance agreement: eliminating the quarterly payments; eliminating the requirement for the release of three dispatch consoles to the city fire and police departments; eliminating the requirement that the provider be able to communicate by radio with "a11 public emergency agencies in Jefferson County" and substituting communicating with "the Port Arthur Fire Department" by radio; eliminating the requirement that the provider make available one frequency for the fire department and one .for-the police department; eliminating the anachronism po6062 1 "PBX"; eliminating the requirement that the provider make available one backup server for the police and fire po6062 departments; eliminating the anachronism "tape backup"; eliminating the requirements as to geographical location of the provider's dispatch office and the requirement that providers with dispatch offices outside Jefferson County must provide aircraft; eliminating the requirement of an "emergency response time of six minutes" and substituting "480 seconds. travel time to a minimum of 90 percent of the incidents" and adding"' performance objectives for call processing times; providing for the use of the response option of an MICU capable ambulance and paramedic by separate .vehicle; providing the authority for the Fire Chief to restrict the practice of rolling calls where the practice degrades response; and eliminating the .requirement for a minimum number of ambulances dedicated to 911 service relying instead upon response time parameters. • Amend Section 114-34 Conditions for issuance of an ambulance agreement: substituting "state license" for "state permit"; substituting "Department of State Health Services" for various references to "state department of health"; adding the requirement for the use of an emergency medical dispatch system; and eliminating the requirement for a minimum number of ambulances and substituting a.reference to response time parameters. -_ • Amend Section 114-35 Equipment inspection: requiring the 2 posting of an inspection permit on a window of the ambulance; providing the Fire Chief with the authority to enter into cooperative inspection arrangements with other local governmental entities; providing for the issuance of citations for permit violations; eliminating the reference to a particular frequency and mode of communication for provider-to-hospital communication and substituting the .requirement that the provider be capable of communicating with area hospitals; and requiring that each permitted unit be equipped with a mobile radio. • Amend Section .114-36 Personnel: eliminating the reference to "MICU" and the requirement of at least one paramedic and one emergency medical technician; and adding a reference to the "Department of State Health Services." • Amend Section 114-37 Transport of injured or ill patients: eliminating the requirement of a six minute average response time; eliminating a reference to "Medical Priority Consultants, Inc."; and eliminating an average response time for non-emergency transports. • Amend Section 114-39 Revocation of ambulance agreement: eliminating the response time requirements of six minutes and thirty minutes and substituting a reference to .response time parameters delineated elsewhere in the ordinance; and adding the wording "liquidated damages." • Amend. Section 114-41 Ambulance company reports: eliminating the requirement for a biannual report from no6062 3 the provider on its rates and substituting "on initial issuance of its permit"; and adding the requirement that the monthly response time reports be submitted electronically in a format specified by the Fire Chief. • Adding in entirety Section 114-42 Liquidated damages as remedy: providing for the assessment of damages for failure to meet or comply with certain requirements of the ordinance; providing for notice of assessment and an appeals process; and providing that collection of liquidated damages may be in addition to other remedies. WHEREAS, the City Council deems it in the public interest to amend Sections 114-31, 114-33, 114-34, 114-35, 114-36, 114-37, 114- 39, 114-41, and add Section 114-42 of the Code of Ordinances. NOW THEREFORE, BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF PORT ARTHUR: Section 1. That the-facts and opinions in the preamble are true and correct. Section 2. That Section 114.31 is amended as follows: "The terms used in this article shall have the meaning ascribed to the same terms in V.T.C.A., Health and Safety Code § 773.003 et seq., unless otherwise defined as follows: Ambulance means any motor vehicle constructed, reconstructed, arranged or equipped or used for the purpose of transporting sick or injured persons. Ambulances shall be classified as mobile intensive care unit capable (MICU-capable) when transporting other than Do6062 4 priority one patients and mobile intensive care units (MICU) when transporting priority one ,patients. Arrive means at the scene of an incident and the vehicle not moving. Emergency call means a request for ambulance service as defined by the Texas Administrative Code, Rule 157.2 Emergency care attendant (ECA) means a person licensed by the Department of State Health Services as an emergency care attendant. .Emergency Medical Dispatch means a system of call management, the provision of medical instructions via telephone, and emergency medical resource allocation by dispatchers who have been trained using standards developed by, or equivalent to, the National Highway Traffic Safety Administration. Emergency medical services means services as defined by the Texas Administrative Code, Rule 157.2. Emergency medical services personnel means: (1) Emergency care attendant; (2) Emergency medical technician, basic; (3) Emergency medical technician, intermediate; or (4) Emergency medical technician, paramedic. Emergency medical technician--basic means a person certified by the state as a basic emergency medical technician. Emergency medical technician--intermediate means a no6062 5 person certified by 'the state as an intermediate emergency medical technician. Emergency medical technician--paramedic means a person certified by the state as a paramedic emergency medical technician. Emergency pre-hospital care means care provided to the sick and injured before or during transportation to a medical facility, including any necessary stabilization of the sick or injured in connection with that transportation. Licensed paramedic means a person licensed by the state as a licensed paramedic. Medical direction means direction given to emergency medical services personnel by a licensed physician in the state. Medical director means a licensed physician in the state giving direction to emergency medical services personnel. Medical protocol means any diagnosis-specific or problem-oriented written statement of standard procedure, algorithm, standing medical order or standing delegation order promulgated by the medical director as the normal standard of emergency pre-hospital care for a given clinical condition. Medical supervision means direction given to emergency medical services personnel by a licensed physician under po6062 6 the Medical Practice Act (Vernon's Ann. Civ. St. art. 4495b) and the rules adopted under that act by the state board of medical examiners. Medical. supervisor means a licensed physician giving direction to emergency medical services personnel under the Medical Practices Act (Vernon's Ann. Civ. St. art. 449Sb) and the rules adopted under that act by the state board of medical examiners. MICU ambulance means an ambulance capable of transporting sick or injured persons in need of emergency care and capable of providing MICU level of care. Non-emergency call means a request for ambulance service other than a request for emergency medical service as that term is defined by the Texas Administrative Code, Rule 157.2. Priority one response means a response to a request for service represented as follows: Medical/Illness Related: • Nature of illness may be potentially life threatening. • .Patient status is unknown • Cardiac Arrest • Active labor • Acute abdominal pain • Anaphylaxis • Altered mental status (new onset) 006062 ~ • Bleeding (uncontrolled). • Blood tinged emesis • Carbon monoxide poisoning • Cardiac problems • Chest pain • Child birth/complications + Choking • Cerebral Vascular Accident/Stroke • Cyanosis • Diabetic crisis • Fever high-grade >lO1F with complications • Hyper/hypotension • Hyper/hypoglycemia • Hyper/hypothermia • Overdose • Paralysis sudden onset • Pediatric emergencies • Poisoning • Pregnancy complications • Respiratory arrest • Respiratory distress • Seizures • Unconsciousness • Vomiting uncontrolled • Weakness (profound) po6062 6 Trauma/Injury Related: • Mechanism of injury potentially l ife or limb threatening • Animal bites • Amputation • Attempted suicide • Bleeding uncontrolled • Burns • .Drowning • Electrocutions • Eye injuries • Fall o With potential threat to life or limb, i.e. loss of consciousness, active bleeding or deformity.. • Gun Shot Wound • Lightening strike • Motor Vehicle Accident o With significant mechanism of injury depending on information at the time of call. o Involving pedestrian, bicycle or motorcycle • Pediatric emergencies • Penetrating Injuries • Puncture / Stabbing • Unconsciousness • Unresponsiveness" Section 3. That Section 114.33 is amended as follows: po6062 9 "(a) Application. Every person, partnership or corporation desiring to obtain an ambulance agreement shall make written application to the city secretary in writing. Each application shall be verified under oath and shall provide the city secretary the following information: (1) The name, resident address and telephone number of the owner of the ambulances for which an agreement is desired to be authorized; (2) Business names, telephone and address of the premises which are to serve as the base of operation from which ambulance service will be originated; (3) The make, model, motor number and correct state .license plate number of the ambulances; (4) The experience of the applicant and his employees in the transportation and care of sick or injured persons; (5) The number and type, age and patient capacity of each private ambulance proposed to be operated by the applicant; (6) History of the response time of the owner in other similar cities; (7) Rates to be charged. (b) Fees; period. An application for an ambulance agreement for the operation of an ambulance service within the city shall be accompanied by a nonrefundable application fee of $1,000.00. Each such ambulance agreement shall be valid .for a duration to be approved by the city council, not exceeding three years. With the po6062 10 approval of the city council, an agreement can be transferred to a company that has substantially the same resources, equipment, and personnel in the area to ensure that the response time is met, that patients are transferred in a prompt and safe manner, and that the company will provide ambulance services in accordance with state, federal, and local laws, regulations, and rules. Such transfer can only be effective upon the approval of the city council-and upon the payment of a nonrefundable transfer .fee of $1,000.00. (c) Additional requirements. The company agrees to or provides all six of the following: (1) The company agrees to provide the following in case the company ceases to provide full-time emergency ambulance services to the citizens of the city: a. The company agrees to immediately allow the city to take possession and to use up to five of the company's .fully equipped MICU capable ambulances as determined at the sole discretion of the city for a period of six months. After taking possession of the. ambulances, the city will pay the fair market lease value of the ambulance vehicles and its equipment. If there is a dispute as to .the fair market value, the city will retain the possession and use of the ambulances for six months and the issue as to the amount of rental and accrued interest at six percent per year for overdue payments will be decided by an arbitrator. _. Pending the arbitration, the city will pay monthly po6062 11 payments to the company as to the amount of lease payments the city considers to be the fair market lease value. (2) The company provides a dispatch system as denoted below that has the following specifications and uses or, substantially thereto, as approved by the fire chief: a. Dispatch room. --Three active and ,three standby dispatch consoles each complete with. radio equipment. --CPU networked to server containing dispatch software and a video monitor.. --Maps of all areas covered in case of computer failure. b. Radio equipment. --Radio frequency that is not public. --Provider should, have the ability to talk to the Port Arthur Fire Department. c. Telephone equipment.. --System should be able to transfer calls and .handle a telebranch of no less than five .numbers. d. Server system. --Server redundancy for all server based central processing units. --UPS power backup system for essential equipment with power time of 15 minutes or more. po6062 12 e. Backup generators. --Reliable backup generators. Should be able to operate dispatch and information technology room without public utility power. f. Recorders. --All communications shall be recorded. --Playback shall be available.. g. Dispatch support. --Information technology specialist on staff 24 hours seven days a week or service contract providing the same support. h. Disaster plans. --Disaster recovery plans due to flood, fire, storm, or any other acts of God. i. .Dispatch system provides a redundant radio system for ISO rating of the city. j. Dispatch system can be used by the city at no cost in case of an emergency. k. The. dispatch office must be able to receive local calls without any long distance cost or inconvenience to the citizens of Port Arthur. (3) The company agrees to provide for the arrival of an MICU capable ambulance and a paramedic within 480 .seconds travel time to a minimum of 90 percent of the incidents represented as priority one calls. Travel times will start when the responding ambulance and paramedic receive notification from the provider's dispatch center and will po6052 13 terminate when the ambulance and paramedic have arrived. In the event. that the ambulance unit, paramedic unit, or fire unit arrives before the other .responding units and downgrades the call from an emergency status, then the terminating time will be the first unit's arrival time. The company agrees to set as performance objectives call processing times of not more than 60 seconds for at least 90 percent of the calls represented as priority one calls and not more than 90 seconds for at least 99 percent of the calls represented as priority one calls. Call processing time will begin when the provider's dispatch center picks-up on the call and will terminate when the provider's responding units receive first notification. The company agrees that it will have a turnout time of no more than 60 seconds. Turnout time will begin when the emergency response facility or emergency response unit is notified and will end at the beginning point of travel time. (4) The company agrees that in those instances where a paramedic is responding separately from the ambulance unit, the ambulance unit will be staffed with a minimum of two Emergency Medical Technicians. (5) The company agrees to provide backup assistance to all other permitted companies; however, the company also agrees that should the Fire Chief determine that the practice of rolling calls by'one provider to another is -_ degrading emergency medical response and the Chief po6062 14 imposes restrictions on the practice, the .company shall abide by the restrictions." Section 4. That Section 114.34 is amended as follows: "No ambulance agreement shall be entered into unless the following conditions are satisfied and the agreement is authorized by the city council: (1) Insurance. Unless there is in full force and effect a policy of insurance, issued by insurance companies authorized to do business in the state and in the standard forms approved by the state board of insurance, with coverage provisions in amounts no less than the following: a. Commercial general liability insurance in an amount not less than $500,000.00; b. Comprehensive automobile liability .insurance in an amount not less than $500,000.00; c. Medical malpractice insurance in an amount not less than $500,000.00; d. Liability. insurance coverage required under this section may be arranged under single policies for the full limits required or by a combination of underlying policies with the balance provided by an excess or umbrella liability policy. Every insurance policy required under this article shall remain in effect for the time period to be covered by the agreement, and the insurers shall be po6062 15 obligated by the certificate of insurance filed with. the city secretary to give not less than 30 days' written notice to the city secretary before any modification, cancellation or other termination of any such policy. (2) Taxes. Unless the applicant owes no delinquent taxes to the city. (3) State license. Unless the applicant has been issued a license by Department of State Health Services as an emergency medical services provider. (4) Other requirements. Unless the applicant has received a determination by majority vote of the city council, that it is in the best interests of the citizens of the city that an ambulance agreement is authorized.. (5') State certificate or license. Unless the ambulance shall at all times of operation be operated by personnel licensed or certified by the Department of State Health Services. (6) Dispatch. Unless the applicant staffs and operates a radio and telecommunications ambulance dispatch facility, which uses an emergency medical dispatch system, 24 hours per day to receive emergency calls and, as appropriate, to dispatch an ambulance to respond to emergency calls. po6062 7) Minimum number of ambulances. Unless the applicant - -. agrees to maintain the response capabilities specified 16 in Section 114-33 (c) (3) & (4)." Section. 5. That Section 114.35 is amended as follows: "(a) Initial inspection, equipment required. Prior to the initial use and operation of any vehicles as an ambulance, the vehicle and the dispatch office shall be thoroughly examined and inspected by the fire .department, and.found to comply with the equipment requirements of state, federal, and local statutes, regulations, rules, and ordinances, and the provider's state approved protocols. Furthermore, the ambulance companies will also have the following equipment on their ambulances: • Fire extinguisher (mounted and accessible). • No smoking signs (one in patient compartment and one in cab). r • One copy "Emergency Response Guide Book" • Medical protocols wit-h a medical supervisor's signature. • An ambulance inspection permit displayed on a window of the unit. (b) Annual and periodic inspections. Every ambulance operating under this article shall be subject to inspection at any time by the fire chief or his designee and shall be inspected at least once every year.. The Fire Chief may enter into cooperative ambulance inspection arrangements with other local governmental entities for an annual inspection. In the case of periodic, non- annual inspections, designated Fire Department employees who observe permit, equipment, supplies, staffing, or sanitation po6062 17 violations may issue a citation for liquidated damages. (c) No ambulance which is unsafe or in any way unsuitable. for ambulance service shall be operated. . (d) Every EMS vehicle shall be equipped with a fully operational two-way radio communications system. EMS vehicles permitted to operate in the city shall be capable of communicating with hospitals in Jefferson County and Orange County having emergency medical facilities. EMS vehicles permitted to operate in the city shall be equipped with radio equipment capable of communication with the city fire department. Each EMS unit providing service to the city will be equipped with a mobile radio. The EMS vehicles shall call enroute and on scene on all 911 and medical emergencies." Section 6. That Section 114.36 is amended as follows: "Every ambulance permitted under this article, when transporting patients, shall be staffed with personnel certified by the Department of State Health Services." Section 7. That Section 114.37 is amended as follows: "(a) Ambulances shall be required to transport patients in a prompt and safe manner. It shall be unlawful to operate or drive an ambulance on an emergency call on the public streets of the city at a rate of speed of more than ten miles per hour in excess of the legal speed limit. (b) It shall be unlawful to operate or drive an ambulance on an emergency call ,in excess of ten miles per hour while entering and passing through an intersection if such intersection is controlled by a stop sign or by a traffic signal. which indicates po6062 - 18 stop by displaying a red light." Section 8. That Section 114.39 is amended as follows: "The city council, prior to the revocation of any ambulance agreement, shall set a time and place for a hearing on such revocation. The city secretary shall be directed to give written notice to the ambulance company by registered mail at least 15. days prior to the date set for such hearing. The following shall be grounds for revocation of an ambulance agreement by the city council. , (1) The ambulance company has violated any provision of this article; (2) The ambulance company is failing to comply and maintain such ambulances in compliance with the requirements set forth in section 114-35 providing for certain. equipment; (3) The ambulance company has violated oity ordinances with respect to the operation and maintenance of its business; (4) That the ambulance agreement was obtained by fraud or misrepresentation; (5) The ambulance company has failed to maintain the interior and equipment of the vehicles; (6) The ambulance company has failed to maintain the .required response times; (7) The ambulance company has failed to produce records for an audit; _ ..... -- (8) The ambulance company has failed to pay fees or po6062 i9 liquidated damages to the city or has otherwise violated the agreement; or (9) The ambulance company has fallen below state, federal, and local laws, regulations and rules in providing ambulance service." Section 9. That Section 114.41 is amended as follows: "The ambulance company shall furnish to the city secretary, on the initial issuance of its permit, a complete schedule of rates, and thereafter, whenever its rates change, a report containing the new rates and justification for the changes. The ambulance company shall also make monthly reports on response times to the fire chief. The monthly. response time report will be submitted electronically in a format specified by the Fire Chief." Section 10. That Section 114.42 is amended as follows: "Liquidated damages as remedy. (a) Because the City of Port Arthur may suffer damages from any violation of this ordinance, which damages may be uncertain and difficult to quantify, the EMS provider by accepting the issued permit agrees to the following schedule of liquidated damages: (1) For failure to meet the response requirements specified in Section 114-33 (c)(3), when the percentages are averaged over a rolling three month period, $2,000 for each whole percentage point below the specified level. (2) For any ambulance unit providing service in the City of Port Arthur found to be non-compliant with the permit, equipment, staffing, supplies, or sanitation po6062 20 requirements of federal statutes, state statutes, local ordinances, and contract requirements, $2.50 per incident. (b) Before assessing liquidated damages against any EMS provider, written notice will be given. (c) The EMS provider will have ten (10) business days from receipt of the notice to appeal the assessment to the Fire Chief. (d) The Fire Chief will meet with the EMS provider to consider the matter and issue. a decision within ten (10) business days of the appeal. The Fire Chief may consider matters such as unusually high demand, extraordinary weather conditions, and other conditions which could contribute to a delayed response. Ih the case of non-compliance with equipment and supply requirements the Fire Chief may consider matters such as multiple calls. occurring in rapid succession which may deplete equipment and delay restocking. The decision of the Fire Chief will be final. (e) When liquidated damages are assessed, the EMS provider will have ten (10) business days from the date of the assessment notice or from the date of receipt of the Fire Chiefs decision if the assessment is appealed, to pay the assessed damages. (f) The collection of liquidated damages, as a remedy, may be in addition to the City of Port Arthur taking other action, including, action to terminate the EMS provider's permit to operate in the-City of Port Arthur." po6062 21 Section 11. That the amendments stated in Sections 1-10 above, as well as the deleted language necessary to effect the amendments, are delineated in Exhibit "A" attached hereto.. Section 12. That any person who violates any provision of this Ordinance or who shall neglect to comply with the terms hereof shall be deemed guilty of a misdemeanor and shall on conviction thereof be fined-in any sum not-more than Five Hundred ($500) dollars per day or per incident. Section 13. That this being an Ordinance amending an Ordinance which imposes a penalty, fine, or forfeiture, its caption and penalty shall be published at least one (1) time within ten (10) days after final passage hereof in the official newspaper of the City of Port Arthur. All provisions of this Ordinance that impose a penalty shall take effect on February 26, 2010. All other provisions shall take effect immediately. Section 14. That a copy of the caption of this Ordinance be spread upon the Minutes of the City Council. READ, ADOPTED AND APPROVED on this day of A.D., 2.010, at a Council Meeting of the City Council of the City of Port Arthur, Texas, by the following vote: AYES: Mayor City Council NOES: MAYOR po6062 22 ATTEST: CITY SECRETARY APPROVED AS TO FORM: CTING CI ATTO E APPROVED FOR ADMINISTRATION: CITY MANAGER po6062 23 EXHIBIT "A" Ambulance Ordinance ARTICLE II. EMERGENCY MEDICAL VEHICLE* *State law references: Emergencymedical services, V.T.C.A., Health and Safety Code § 773.001 et seq. Sec. 114-31. Definitions. The terms used in this article shall have the meaning ascribed to the same terms in V.T.C.A., Health and Safety Code § 773.003 et seq., unless otherwise defined as follows: Ambulance means any motor vehicle constructed, reconstructed, arranged or equipped or used forthe purpose of transporting sick or injured persons Ambulances shall be _.. - classified as mobile intensive caze unit cana6le (MICU caoablel '°~'-~^-u when. _. _ .. "_._. -. _ M Emergency call_ means a request for ambulance service as defined:bythe Tgxas ,, ~ °' _ , Admuiistiattve Co"de, Rule'-157;2 rte to regaire ^°~°• -~° ......~.....,., .equ .,~ .., «.....,...~~. ~, ° vl+°I).°« Q... « °..h :n 1«n«n...:14°rl 1... «...~:.. .. r.4j,°.-w:n° Emergency*care attendant (ECA) means a person licensed by the ~°'^'° ''°^^-h^~°^' ^F h°.~l'a~~; Departmenfof State:Health Seivices as an emergency caze attendant. Emergency medical services means services astdefined_By the Texas Administrative Code,`Rule 1573. • .,ed tc . nd *^ °a ~ "°a ~° °,,:.:~;, ^a~ ~' ~a '^ 'Y" Emergency medical services. personnel means:. (1) Emergency care attendant; (2) Emergency medical technician, basic; (3) Emergency medical technician; intermediate; or (4) Emergency medical technician, paramedic. Emergency medical technician--basic means a person certified by the state as a basic emergencymedical technician. Emergency medical technician--intermediate means a person certified by the state as an intermediate emergency medical technician. Emergency medical technician--paramedic means a person certified by the state as a paramedic emergency medical technician. Emergency pre;hospital care means care provided to the sick and injured before or during transportation to a medical facility, including any necessary stabilization of the sick or injured in connection with that transportation. Licensed paramedic means a person licensed by the state as a licensed paramedic. Medical direction means direction given to emergency medical services personnel by a licensed physician in the state. Medical director means a licensed physician in the state giving direction to emergency medical services personnel. Medical protocol means any diagnosis-specific or problem-oriented written statement of standard procedure, algorithm, standing medical order or standing delegation order promulgated by the medical duector as the normal standazd of emergency pre-hospital care for a given clinical condition. Medical supervision means direction given to emergency medical services personnel by a licensed physician under the Medical Practice Act (Vemon's Ann. Civ. St. art. 4495b) and the rules adopted under that act by the state board of medical examiners. Medical supervisor means a licensed physician giving direction to emergency medical services personnel under the Medical Practices Act (Vemon's Ann. Civ. St. art. 4495b) and the rules adopted under that act by the state board of medical examiners. NACU ambulance means an ambulance capable of transporting sick or injured persons in need of emergency care and capable of providing MICU level of care. _. Non emergency call means a request for ambulance service other than a regiresf for emergency medical service as that term is defined by the ,Texas Adininisti`ative Code; Rule 157.2 ..,.._,,,.,....,,,i . ..:........ .. ........e_:,...,.:n.,e..,. ,._ :..::,....,,.. _o,.,.;~.;,, o:.,o_„o.,,.., ~s , "> ., oriry one response means a response to a request fo'r-service represented as follows: • Nature of illness inay be potentially life threateping: _,,._ • Parient status'is "unknown • (?aTl11aC ArrPCt ~~ • Acute abdommal pain • Altered.mental status (new onset) .5; ,. • Carbon trionoxrde poisoiiuig • C'hilrl'hirth/rmm~liratin • Cerebral Vascular AccrdeaUStroke • Fever hrgfi;grade>lO1F with complications • Hvner/hvrioQlvicer (Code 1961, § 23-1; Ord No. 07-41, § 2, 7-3-2007) Cross references: Definitions generally, § 1-2. Sec. 114-32. Operating ambulance without permit. No person shall drive or operate an ambulance for the purpose of transporting the sick or injured for hire upon the public streets of the city without first entering into an ambulance agreement with the city to do so as provided in this article and paying the fee therefore. There shall be exempted from the provisions of this article those ambulances transporting patients from a location outside the city into the city, those ambulances transporting patients only- passing through the. city, those ambulances requested by the city to respond to emergency, or those ambulances that have already received a permit, for the duration of that permit. (Code 1961,. § 23-2) Sec. 114-33. Ambulance agreement. (a) Application. Every person; partnership or corporation desiring to obtain an ambulance agreement shall make written application to the city secretary in writing. Each application shall be verified under oath and shall provide the city secretary the following information: (1) The name, resident address and telephone number of the owner of the ambulances for which an agreement is desired to be authorized; (2) Business names, telephone and address of the premises which are to serve as the base of operation from which ambulance service will be originated; (3) The make, model, motor number and correct state license plate number of the ambulances: (4) The experience of the applicant and his employees in the transportation and care of sick or injured persons; (5) The number and-type, age and patient capacity of each private ambulance proposed to be operated by the applicant; (6) History of the response time of the owner in other.similaz cities; (7) Rates to be charged. (b) Fees; period. An application for an ambulance agreement forthe operation of an ambulance service within the city shall be accompanied by a nonrefundable application fee of $1,000.00. Each such ambulance agreement shall be valid for a duration to be approved by the city council, not exceeding three years, °~a °"°" ~~°« c' ~ cnn nn ..,,_ dtrarteF. With the approval of the city council, an agreement can be transferred to a company that has substantially the same resources, equipment, and personnel in the area to ensure that the response time is met, that patients are transferred in a prompt and safe manner, and that the company will provide ambulance services in accordance with state, federal, and local laws, regulations, and rules. Such transfer can only be effective upon the approval of the city council and upon the payment of a nonrefundable transfer fee of $1,000.00. (c) Addrttonal requzreznenls. n ~ .. ..~«e_...,.:..e .,..we cee we:..,. ,.:,,._,.va ~..- +r.e ,.:,. :_ ei ~ cnn nn ; ..,...e_i.., cz ncn nn ~ ~ 'FThe company ,-- , agrees to or provides all six of the following: (1) The company agrees to provide the following in case the company ceases to provide full-time emergency ambulance services to the citizens of the city: a. The company agrees to immediately allow the city to take possession and to use up to five of the company's fully equipped MICU capable ambulances as determined at the sole discretion of the city for a period of six months. After taking possession of the ambulances, the city will pay the fair market lease value of the ambulance vehicles and its equipment. If there is a dispute as to the fair market value, the city will retain the possession and use of the ambulances for six months and the issue as to the amount of rental and accrued interest at six percent per yeaz for overdue payments will be decided by an arbitrator. Pending the arbitration, the city will pay monthly payments to the company as to the amount of lease payments the city considers to be the fair mazket lease value. (2) The company provides a dispatch system as denoted below that has the following specifications and uses or; substantially thereto, as approved by the fire chief: a. Dispatch room. --Three active and three standby dispatch consoles each complete with iadio equipment. --CPU networked to server containing dispatch softwaze and a video monitor. --Maps of all azeas covered in case of computer failure. n 1.:1:4.- ~,. ~"1:«,...:.-1. N...°° A:"«.,t"1, ,. .-..1°" t.. rl.° .. «,.1:..° A°«".a«.°«t .,«.i F.~a T7.°",~ ,. "1°" 7.... ° ....] « «.7 " ,...A"1,°°4 .. «.,1.:1:4:°0 b. Radio equipment. --Radio frequency that is not public --Provider should have the ability to talk to thePoit Arthu Ftre Departmentall-p1~Hks -_(1«° F:«° F.°,...°«,... "«,l ,.«° «,.1:,.° ~°....°«.... ...:17 1,° ".-":1 "1.1° f'... 41.0 4;.0 .iot.".w....°«4 r,~...,...... and «,.1:..° ,i°«".w«.°«4 ..C 41,° ..:4.- c. Telephone equipment. Tel°«1.,.«° ° °«t"1.....1,7 1... ,. DDV /«..1.1:,. 1.....«..1. °....1..,«..°\ ..4..I° .,«A «„4 ..£~ - ~~ --System should be able to transfer calls and handle a telebranch of no less than five numbers. d. Server system. --Server redundancy for all server based central processing units. --UT'S power backup system for essential equipment with power time of 15 minutes or more. e. Backup generators. --Reliable backup generators. Should be able tb operate dispatch and information technology room without public utility power. £ Recorders. --All communications shall be recorded. --Playback shall be available. g. Dispatch support. --Information technology specialist on staff 24 hours seven days a week or service contract providing the same support. h. Disaster plans. --Disaster recovery plans due to flood, fire, storm, or any other acts of God. i. Dispatch system provides a redundant radio system for I50 rating of the city. j. Dispatch system can be used by the city at no cost in case of an emergency. k. The dispatch office ~ „ t, T FF ~ 1<7 .+1, 1" "„°'«"'"'° a:""'"'..1, ,.4°........ ., 1.° ...:41.:« ., .7:..4..«.-° ..F 1 :41 .«:1°" f ,.... TOFF .~..« !'..,,«4.. C..;.7 ~Uo,~~o ,7:°«"4"ti, "Fa"° --..."4,..;, °'"4° "`".° "., °«a must be able to receive local calls without any long distance cost or inconvenience to the citizens of Port Arthur. C...wl...«...,.«n a l.n n ..~n +T.nf ,]rn:.., ar 1. r..r n ,l:n«rarl, rFF:rn r„fn;.lo Toff :~o.._[''~..«f.. 3 ( ) «aT.n ««n.: n rl.«nn «,n«al,n n«a « .:ar.. ,, .ri, :«r ...,n.;,,.. ,,, a,e ,.;ty '[']le igrees to: provide-for the arrival of an MICU capable ambulance and a withiri.480 seconds travel time to a rriinimumof 90 percent of the'incidents d as prionty one :calls Travel tunes will start when the responding ambulance edic receive notification ftom the provider's dispatch center and' will terminate unbulairce~and paramedic have arrived. In the-event that the ambulance unit, umt;.orfire unit amves::before the other responding units and dowrigradestlie more than 60 seconds for at east 90 percent of the calls,represented as pnority one calls and iiot mole than`90 seconds for at leasf99 percent of~tlie calls represented as priority one calls: Call processing tune will,begin when the provider's dispatch center picks,up bn the call.and wilT;tai-miriate when the povider''s_'respondirg units receive first notification: The company agrees that it will have a turnout.tune of no` more than 60 seconds Turnout tune will begin when the emergency response facility or` emergency response unit is notrfied'and will end of the beginning point of travel time: .~ >:,. The company agrees that in those instance`s where a paramedic is responding separate_ ly from the'ambulaiice unit, the ambulance unit will be staffed with" a minimum of tiub (~) The company agrees to provideLLbackup assistance to all other permitted companies; however; the company also agrees that should-the Fire Chief determine that the practice of rolling calls by_one provider to another is degrading~emergency medical response and the Chief impose5restrictions on the:practice, the company`shallabide,bythe restrictions r _______.__ ____ _r ~_ . ~ __ .,___ __ r_ _ . ___ __ . _ _____ ______ __ fai.«nr r....l... lr«...,.. «,l : Ffl.r«~ n n al.«nn .. ~ ...,: afn,l r n nnl. r n n t.nll « .',7 Fa...~ ...., l...lr«r o.. « . An . n..i.:rr a ar r .rang: ,.« nnl.nA.,ln uY« !G\ TT.n ,. . n al.na :a ...:11 «.,t .nrn:.,n r «n F..«A F « n .rl.~ '~ a f~\ Tl.n ,. t !.7\ TF n ,. .:1 «n«.- ,],. o 1 « n «n ., al.n ...n,rtn.l., F n ..« f:.« a 1. n..n n 1,: nan.., nF.nn«.. o ' «nr a: «.o : ati,n r:f.. f . p .u. l,o r .,. ~°8fi m na;ii ...nl: F,. C r -J .. al,:n « '. ' «.t fl,.. .n.l..ra:r« rF F oen .,«an. n..l.nnrr.r« /r\ .. ,rc F;r~f n.Ne« ..F n .nti..«n : ~ « at. e n:a.. nn lr o 47.n r n tin 4T,o rf .T iri.,~ l-,o. r e, n1; }:e, Anl:«orar,l ' 1. /r \ Tl.n ,. .,:11 .. n.. .] ar .. «nreA «.,.-a:..« ..F fho F c FNI'1 Gnn nn F 1, F .r.wr. rF al..~:. ,. «nti.. e «n ..«aa al, e eFFnna:..n Anfo nFfl,;n ...,. e ,.t.nn..f:n« .... Q 1 7Gn nn . ,.1,:rL. r. r rrar.. n F+n ~ . rt,n f..nf .. ,n.fe« R. o .,~~- ~. ~.-.«n«.. - ..:11 «or,l ar A , .il. r , «1.- n«A n n an rli .. rFal.r ,. «.7an «n : o„hoe cic... w .,t,... na; ~., f..11 n1..A:«,. 1.., ra 1:....: a ,l a . r o a: n .«n nF n «ann .. n Cpl, . loner ;.. tho r:a.. /..\ A., r,. F '1' 1, , ..:arl:a.. n«A An..o lr«.....«a n F al.n n.., l.. J .ln«ro r 'w w: n«,1 al, n:« nl.a :a.. a,. « « A ..F ,..... ~...,,«,.: en n«.] n :nf :., ,« ....... .. p r;,~.,~_¢, r•r:a., '1 1, 1 , , A' A, r « ArFr. « n «a nF r.«l. ..lr«rr F e .- n a (Code 1961, § 23-3; Ord. No. 00-30, § 2(23-4), 5-16-2000; Ord. No. 00-36, § 2, 6-27- 2000; Ord: No. 02-07, § 2, 2-19-2002; Ord. No. 02-22, § 2, 5-14-2002; Ord. No: 02-27, § 2, ~-28-2002; Ord. No. 02-28, § 2, 5-28-2002; Ord. No. 0~-4~, § 1, 6-21-2005; Ord. No.06-12, § 2, 2-28-06; Ord. No. 06-14, § 2, 3-14-2006; Ord. No. 06-25, § 2, 5-23-2006; Ord. No..07-41, §§ 3--6, 7-3-2007) Sec. 114-34. Conditions for issuance of ambulance agreement. No ambulance agreement shall be entered into unless the following conditions aze satisfied and the agreement is authorized by the city council: (l) Insurance. Unless there is in full force and effect a policy of insurance; issued by insurance companies authorized to do business in the state and in the standazd forms approved.by the state board of insurance, with coverage provisions in amounts no less than the following: a. Commercial general liability insurance in an amount not less than $500,000.00; b. Comprehensive automobile liability insurance in an amount not less than $00,000.00; c. Medical malpractice insurance in an amount not less than $500,000.00; d. Liability insurance coverages required under this section may be arranged under single policies for the full limits required or by a combination of underlying policies with the balance provided by an excess or umbrella liability policy. Every insurance policy required under this article shall remain in effect for the time period to be covered by the agreement, and the insurers shall be obligated by the certificate of insurance filed with the city secretary to give not less than 30 days' written notice to the city secretazy before any modification, cancellation or other termination of any such policy. (2) Taxes. Unless the applicant owes no delinquent taxes to the city _ (3) State i~ license. Unless the apphcant{has been`issued a license byar~rlaxee F°...-r.:,.~..r.° ..°...... ,...,.~.. .,.:>, a a « r.i, r, a t, the state } _. Department of State Health Servrces as an emergency medical. __ _ - _ -. sernces_provider' (4) Other requirements. Unless the applicant has received a determination by majority vote of the city council, that it is in the best interests of the citizens of the city that an ambulance agreement is authorized. (5) State certifcate or license. Unless the ambulance shall at all times of operation be operated.' i .. a .,_.,.,.°a:,. °ra °., °..,°_T°..,..-..,°a:°~, ,°°w ..:...........a do ~~.,ffaa by personnel licensed or certified by the '°'° a°-°-'--•°~' °P1'°°"'' Departmerif of State Health Services. (6) Dispatch. Unless the applicant epeFater staffs and operates a radio and _ telecommunications ambulance dispatch facility, wluchu_ ses an emergency medical dispatcfi~system, 24 hours per day to receive emergency calls and, as appropriate, to dispatch an ambulance to respond to emergency calls x,~ (7) Mimmum number of ambulances. Unlessthe applicant agrees to maintam the (Code 1961, § 23-5 Ord. No. 02-19, § 2, 4-16-2002) Sec. 114-35. Equipment; inspection. (a) Initial inspection, equipment required. Prior to the initial use and operation of any vehicles as an ambulance, the vehicle and the dispatch office shall be thoroughly examined and inspected by the fire department, and found to comply with the equipment requirements of state, federal, and local statutes, regulations, rules, and ordinances, and the provider's state approved protocols. Furtherrrlore, the ambulance companies will also have the following equipment on their ambulances: • Fire extinguisher (mounted and accessible). • No smoking signs (one inpatient compartment and one in cab). • One copy "Emergency Response Guide Book". • Medical protocols with a medical supervisor's sienature. • Hn ambutanceanspecuon;permrt;displayed oii a wdhdow of the unit (b) Annual and periodic inspections. Every ambulance operating under this article shall be subject to a-periedis inspection at any time by the fire chief or lus desrgnee and shall be inspected'°a,-a"~°•'~P at least once every near The Eire Chlefmav enter,nr (c) No ambulance which is unsafe or in any way unsuitable for ambulance service shall be operated. (d) Every EMS vehicle shall be equipped with a fully operational two-way radio COmmllnlCatlOnS Sy Stem. Tl._, ...,.«°.« ,.t.°il 1, ^<._ _ _____________. ~F ... ,, ~' f .. _.1....~. sshif~ ~>_~n ~-~ °•,,<..°a «° «i_° ~. ~ F 1 -c ~~n rR>, rw T fBr~einicabiet3 EMS velucles!=perrrutted_to operate m the city shall lie capable _of commiuucating wrth hospitals in Jefferson County and Orange County having emergency medical facilities. EMS vehicles permitted to operate in the city shall be equipped with radio equipment capable of commumcatlon with the city fire department Each EMS unit providing sernce: to`the clty,~w311 be-egmpped wrtha mobile radio: ~ ~°^°'''° 4nn r`",ru, ~~.. ... ~ An~u Q. mil, 11 1,° ~.. FF:..: °..« -°a:°~ F . ,,,...1.. «:« ~_ .:,J:_.. --- . =° *_~ the city. The EMS vehicles shall call emoute and on scene on all 911 and medical emergencies. (Code 1961, § 23-6; Ord. No. 07-41, § 7, 7-3-2007) Sec.114-36. Personnel. Every M~3 ambulance permitted under this article when transporting patients, shall be staffed with personnel certified by the Department of State Health :Services °~ ... a:,. ,, a~ 1 ~, - :-" (Code 1961, § 23-7) Sec. 114-37. Transport of injured or ill persons. (a) Ambulances shall be required to transfer transport patients in a prompt and safe manner ~vitll an c. e ~ ° « ...° °F ° ..,°° ~; u_ ~. n ° ~e ~ « 1~... ,7 Cu6.7Y J 1^ ^. :d. °.7 TT°d: Wl D.'......:.. C .~.°.... ~~~ ,..~ 6e++~.: o, uTacrmca-zn-mc .....~~ .. .~ ..~ Yu«c~'• ~'rccsr-vT p,re,::,..., u_:,.~., r ..............«.. ,..,. It shall be unlawful to operate or drive an ambulance on an emergency call on the public streets of the city at a rate of speed of more than ten miles per hour in excess of the legal speed limit. (b) It shall be unlawful to operate or drive an ambulance on an emergency- call in excess of ten miles per hour while entering and passing through an intersection if such intersection is controlled by a stop sign or by a traffic signal which iridicates stop by displaying a red light. (Code 1961, § 23-8) Sec. 114-38. Personnel identification. At all times, ambulance drivers and emergency medical services personnel shall be required to weaz personnel identification cards, name tags or other appropriate insignia which will visibly, cleazly and quickly identify them as emergency medical services personnel and identify the degree of their state department of health certification, i.e.; ECA, EMT, EMT-I or EMT-P. (Code 1961, § 23-9) Seca 114-39. Revocation of ambulance agreement. The city council, prior to the revocation of any ambulance agreement, shall set a time and place for a hearing on such revocation. The city secretazy shall be directed to give written notice to the ambulance company- by registered mail at least 15 days prior to the date set for such hearing. The following shall be grounds for revocation of an ambulance agreement by the city council. (1) The ambulance company has violated any provision of this article; (2) The ambulance company is failing to comply and maintain such ambulances in compliance with the requirements set forth in section 114-3~ providing. for certain equipment; (3) The ambulance company has violated-city ordinances with respect to the operation and maintenance of its business; (4) That the ambulance agreement was obtained by fraud or misrepresentation; (5) The ambulance company has failed to maintain the interior and equipment of the vehicles: (6) The ambulance company has failed to maintain arraverage the'e`gmred response times °f six minutes `;r P :.r:,.. n.,e r :Fe -rr._ .........:.... c...o.,.e.,,.:e,. _ ~n .., .. r ..n,. ii.,ii.,.i~~; (7) The ambulance company has failed to produce records for an aud~^uy (8) The ambulance company has failed to pay fees orliqurdated damages to the city or has otherwise violated the agreement; or (9) The ambulance company has fallen below state, federal, and local laws, regulations and rules in providing ambulance service.(Code 1961, § 23-10; Ord. No. 07--41, § 8, 7-3- 2007) Sec. 114-40. 911 emergency rotation system; refusal to render service. (a) Each ambulance company shall respond to a11911 calls referred by the fire department during the company's shift and shall provide adequate ambulances, dispatch facilities, and staffing to respond to such calls. Violation of this provision shall subject the company to revocation of agreement. (b) It shall be unlawful for any ambulance service operator to refuse to render emergency medical service after responding to an emergency call for such service. (Code 1961, § 23-11; Ord. No. 00-66, § 2, 11-14-2000; Ord. No. OS-45, § 3, 6-21-2005; Ord.. No. 07-41, § 9, 7-3-2007) Sec. 114-41. Ambulance company reports The ambulance company shall furnish a3eper# to the city secretary ^~ T°~••°-•~ ~ °~a r••'• ~f °°=za a~~~ , onahe uutaI rssuance~of rts peinut esxta~ing a complete schedule of rates, and thereafter, whenever its rates change, a report containing the new rates and justification for the changes in-rates. The ambulance company shall also make monthly reports on response times to the fire chief. The monthlv'resnonse time ienort'will be (Code 1961, § 23-12) (1) (2) (b) (c) (d) (e) (~ 114-4? 43--14-70. Reserved.