This article shall be known and may be cited as the “City of Lufkin Ordinance Regulating Emergency Medical Service and Private Ambulance Service.”
(Ordinance 2716 adopted 4/18/1989; Ordinance 4689 adopted 5/16/2017; Ordinance 4809 adopted 4/7/2020)
For the purpose of this article, the following words, terms, phrases and their derivations shall have the meanings respectively ascribed thereto by this section:
Emergency pre-hospital care using invasive medical acts. An emergency medical technician advanced or a paramedic emergency medical technician shall provide this level of care under medical supervision and control of a licensed physician.
Any motor vehicle constructed, reconstructed, arranged, equipped or used for the purpose of transporting the sick or injured which meets or exceeds requirements set forth by the Texas Health and Safety Code, chapter 773, as one of the following:
The act of proceeding with an ambulance for the purpose of transporting any patient.
Any person who has the duty of performing or assisting in the performance of an ambulance call who holds a current valid certification by the Texas Department of State Health Services as one of the following:
Emergency care attendant (ECA)/emergency medical responder (EMR).
Basic emergency medical technician (EMT-B).
EMT)/emergency medical technicianemergency medical technician – intermediate.
Paramedic emergency medical technician (EMT-P).
A certificate of public convenience and necessity.
All areas within the corporate limits of the City of Lufkin, Texas.
The city council of the City of Lufkin.
The central communications center from which all ambulances responding to an emergency scene, operating under emergency conditions shall be dispatched.
An incident that may involve serious illness or injury which could result in loss of life or permanent disability.
The chief of the city fire department or authorized representative of the chief.
The fire department of the city.
The fire chief of the city or the chiefs duly authorized representative serving as licensing officer for certification of private nonemergency ambulance services under standards set forth in this article.
An agreement between two neighboring political jurisdictions in which they mutually agree to provide limited emergency services to one another during times of disaster.
An incident that does not involve serious illness or injury which could result in loss of life or permanent disability.
A person engaged in business as the owner, manager, officer or proprietor of a company, firm or organization providing private ambulance service.
Any individual, firm, association, partnership, corporation, or other group or combination of individuals.
A licensed physician employed by the city to provide medical direction to emergency medical services personnel under the terms of the Medical Practices Act, Texas Occupations Code, title 3, subtitle B, and rules promulgated by the state board of medical examiners pursuant to the terms of the Medical Practice Act.
Any ambulance not owned by the city or another governmental entity.
The location of a request for ambulance transport where a patient has a complaint or condition that has the possibility of being life, limb, or organ threatening, and the location is not a hospital.
The act of transporting a patient between two facilities of similar care. i.e. hospital to hospital, nursing home to nursing home, etc.
For the purpose of this article “transport” is defined as the act of moving a patient from a scene to a destination using an ambulance.
(Ordinance 2716 adopted 4/18/1989; Ordinance adopting Code; Ordinance 4689 adopted 5/16/2017; Ordinance 4809 adopted 4/7/2020)
Texas Health and Safety Code, chapter 773, titled “Emergency Medical Services Act” is hereby adopted by the city council and shall be deemed a part of this article as if fully contained herein.
(Ordinance 2716 adopted 4/18/1989; Ordinance adopting Code; Ordinance 4689 adopted 5/16/2017; Ordinance 4809 adopted 4/7/2020)
(a)
Provider.
It shall be unlawful for any person or entity other than the city fire department to operate an emergency ambulance or provide emergency ambulance services as a business, except as specifically permitted in section 6.08.005(c) below.
(b)
Fees.
Fees for fire department emergency medical services shall be as established by the city council.
(c)
Area of service.
(1)
The area served by the city fire department EMS shall consist of the corporate limits of the city and other entities or political subdivisions which do not have this type of service available for emergencies within the county.
(2)
Level of service. The city fire department EMS shall provide advanced life support capabilities and transport by EMT-advanced or EMT-paramedics acting under the supervision of a physician director.
(Ordinance 2716 adopted 4/18/1989; Ordinance adopting Code; Ordinance 4689 adopted 5/16/2017; Ordinance 4809 adopted 4/7/2020)
(a)
Certificate required.
No person or entity shall operate a nonemergency ambulance for hire on any street of the city without first having obtained from the city council a certificate declaring that the public convenience and necessity (“certificate”) require such an operation, except as provided in subsection (b) hereof.
(b)
Exceptions.
No certificate shall be required for any person or entity operating an ambulance or other vehicle who:
(1)
Renders assistance during any disaster or major emergency when the city’s emergency ambulance service and all certificate holding private nonemergency ambulance service authorized to operate in the city by certificate are either insufficient in number or inadequate for any other reason, as determined by the fire chief.
(2)
Operates from a location outside the city and transports any patient from a point of origin outside the city to a destination inside the city.
(3)
Operates an ambulance brought in solely for the purpose of a drill or training exercise which is duly authorized in writing by the fire chief.
(4)
Operates any ambulance rendering requested assistance to ambulances currently authorized by the city in cases of disaster or major emergency pursuant to provisions of a “mutual aid agreement” approved by the city council.
(c)
When certificate holders may make emergency transports.
(1)
If during a nonemergency transport the patient being transported experiences a medical or life-threatening emergency, the holder of a certificate or his authorized representative may transport the patient on an emergency basis provided the ambulance is staffed with at least one EMT-P, that is, with emergency siren and red warning lights operational and at such speeds as will transport the patient to a medical facility in a safe and expeditious manner. This provision shall not operate to relieve the driver of any licensed ambulance from the duty to drive with due regard for the safety of all persons, nor shall it protect the driver from the consequences of his reckless disregard for the safety of others.
(A)
If the ambulance is not staffed with at least one EMT-P, and the scene and destination are both within the fire department area of service, the certificate holder or his authorized representative shall request assistance from the fire department.
(B)
If the ambulance is not staffed with at least one EMT-P, and either the scene or destination are not within the fire department area of service, the ambulance crew may use the resources available to them.
(2)
If due to the quantity of demands for emergency assistance, the city fire department is unable to respond to a specific emergency call, the fire chief, or his designee, may authorize a certificate holder to respond to an emergency and make an emergency transport, with emergency siren and red warning lights operational and at such speeds as will transport the patient to a medical facility in a safe and expeditious manner. This provision shall not operate to relieve the driver of any licensed ambulance from the duty to drive with due regard for the safety of all persons, nor shall it protect the driver from the consequences of his reckless disregard for the safety of others.
(3)
In cases of life-threatening emergency, in which a local medical facility lacks the capability of providing necessary patient care, a certificate holder shall transfer the patient to the nearest medical facility that possesses such capability. The certificate holder may transport with emergency siren and red warning lights operational and at such speeds as will transport the patient to a medical facility in a safe and expeditious manner. This provision shall not operate to relieve the driver of any licensed ambulance from the duty to drive with due regard for the safety of all persons, nor shall it protect the driver from the consequences of his reckless disregard for the safety of others.
(4)
The fire department may make an emergency transfer on a limited basis at the direction of the fire chief or his designee.
(d)
Application for certificate of public convenience and necessity.
Applications for a certificate for the operation of nonemergency service within the city shall be in writing, signed and sworn to by the applicant, and shall be filed with the fire chief of the city or his duly authorized representative, hereinafter designated as the “license officer.” The application shall be on a form prescribed by the license officer and shall contain at least the following:
(1)
The name and address of the applicant and the trade name under which the applicant does or proposes to do business; if the applicant is an individual, the name, age and address of the applicant and the length of time the applicant has resided in the city; or if a partnership or association, the business name thereof and the name, age and address of each partner and the length of time each partner has resided in the city; or if a corporation, the names and addresses of all officers and directors of such corporation.
(2)
The number of vehicles the applicant desires to operate (and will devote exclusively to work in the city), the class, size, design and color scheme of each vehicle.
(3)
Whether or not the applicant has been finally convicted of any felony or misdemeanor if the crime directly relates to the duties and responsibilities of the licensed occupation.
(4)
Whether or not the applicant, his associates or employees have any claims or judgments against them for damages resulting from the negligent operation of an ambulance, or any other vehicle.
(5)
The financial ability and responsibility of the applicant, as established by the latest available audited financial statement (profit and loss statements may prove helpful but will not alone suffice for this requirement).
(6)
The nature and character of the service that the applicant proposes to render; the facts showing the demand for such service (e.g., letters of request for service, facts showing a gap in service within the city, etc.); the experience that the applicant has had in rendering such service and the period of time, if any, that he has rendered that service.
(7)
Whether or not the applicant has a current valid permit from the state department of state health services, as required by the Texas Health and Safety Code, chapter 773.
(8)
Documentation from the applicant’s insurance carrier, stating that the insurance required hereunder is available to the applicant and that such coverage is or will be provided prior to the issuance by the license officer of the certificate to operate hereunder.
(9)
Documentation establishing that the applicant will maintain a physical location (central place of business) within the corporate limits of the city, and that the applicant will at all times maintain at least one ambulance staffed with a minimum of one EMT-Paramedic and one EMT-Basic available and at that physical location capable of being dispatched to any location within the city within twenty (20) minutes of a call from a city fire department dispatcher.
(10)
Such other information as may be required by the city council.
(e)
Investigation of applications.
Upon receipt of a properly filed application for a certificate, the license officer shall cause an investigation to be made of the information provided in the application to determine its accuracy and completeness. The license officer shall make a written report to the city manager of the results of this investigation.
(f)
Public hearings upon the public convenience and necessity.
(1)
Upon receipt of the written report provided for in subsection (e), and a positive recommendation by the license officer, the city council will schedule a public hearing on an original and fully completed application. Notice of such public hearing by the city council shall be given to the applicant and all certificate holders affected thereby by depositing such written notice in the United States Mail, in an envelope, properly addressed to each such person at his respective address on file with the license officer, and bearing sufficient postage, at least ten (10) days prior to such public hearing. Such notice shall also be published once in the official newspaper of the city at least ten (10) days prior to the date set for such hearing. The purpose of such public hearing shall be to determine, among other things, the following:
(A)
Whether the public convenience and necessity require that such ambulance or ambulances be operated for nonemergency calls;
(B)
Whether or not the applicant is a fit and proper person to conduct such business, including the fitness of the officers and stockholders of any corporation making such application;
(C)
Whether the applicant possesses the financial capability and stability necessary to provide public service of such permanence and quality as to best serve the public interest;
(D)
Whether the applicant has the demonstrated experience in other contexts to indicate a likelihood of success in rendering ambulance service in the city;
(E)
The past experience of the applicant in satisfying judgments, if any, to claimants as a result of injuries received by reason of negligent operation of the ambulance;
(F)
The financial ability of the applicant to respond to damages to property resulting from the negligent operation of an ambulance;
(G)
The quality and condition of the ambulance or ambulances to be used; and
(H)
Whether the resources (e.g., physical location, ambulances and skilled personnel) of the applicant dedicated to the city demonstrate a likelihood that the applicant will be able to render ambulances within the city within twenty (20) minutes of dispatch.
(2)
In the event the city council finds that the public convenience and necessity require the issuance of such a certificate and that the applicant meets the required qualifications and will be able to give proper and adequate service in the best interest of the inhabitants of the city, the city council shall direct the city secretary to issue a certificate to the applicant with any restrictions, including but not limited to the number of ambulances which the city council finds are required thereunder.
(g)
Form and contents of certificate.
Every certificate issued hereunder shall be signed by the mayor, attested by the city secretary, and shall contain, in addition to the name and address of the applicant, a statement that the operator is authorized to make nonemergency calls only, and the number of vehicles authorized to be operated pursuant to such certificate.
(h)
Issuance of certificate.
The license officer, upon receiving direction from the city council to issue a certificate to an applicant for the operation of ambulances hereunder, shall issue such certificate to the applicant. No certificate shall be issued until satisfactory evidence of compliance with subsection (l) of this article is filed with the license officer. A copy of every certificate shall be filed with the fire chief of the city.
(i)
Revocation alteration or suspension of certificate; causes for.
Every certificate issued hereunder shall be subject to revocation, alteration or suspension by the city council when it shall appear that one or more of the following conditions exist:
(1)
The public convenience and necessity no longer warrant such operation;
(2)
The operator has refused or proven unable to render the full service authorized by his certificate;
(3)
The operator has been finally convicted of a felony or misdemeanor if the crime directly relates to the duties and responsibilities of the licensed occupation;
(4)
The certificate was obtained by an application in which any material fact was intentionally omitted or falsely stated;
(5)
The operator has permitted his motor vehicles to be operated in violation of any law;
(6)
The operator has knowingly violated or failed to comply with any of the provisions of this article;
(7)
The operator or his agent has, without good cause, induced or sought to induce a change of destination to or from a hospital or other place specified by the person hiring the ambulance;
(8)
The operator or his agent has allowed the service to be operated in a negligent manner;
(9)
The insurance coverage required herein has been cancelled, reduced, withdrawn, suspended or terminated;
(10)
The operator has allowed any of his vehicles or equipment to become damaged, deteriorated or unclean to the extent that it is unsatisfactory for public use;
(11)
The operator fails to show financial ability to maintain services in compliance with the terms of this article;
(12)
The operator has failed to comply with the limitations imposed by the city council in the certificate.
(j)
Revocation, alteration or suspension of certificate.
(1)
The license officer may at any time give notice in writing to the certificate holder or person in control of the operation and maintenance of such ambulance service that the certificate issued for the operation and maintenance of such ambulance service has been revoked. The notice shall outline the reason or reasons for revocation. The notice of revocation shall become a final revocation after the expiration of ten (10) days from the date of the service of same, unless on or before the expiration of such ten days the certificate holder shall file with the city council a written appeal of such revocation. The appeal shall operate as a stay of revocation of the certificate until such time as the city council shall grant a hearing and make a final adjudication. Provided, however, the license officer may require an immediate cessation of all nonemergency service in the notice of revocation. If this requirement is made, the certificate shall be suspended during the period in which the appeal is pending, and the operator may not provide service with the city during this time. The hearing shall be held within thirty (30) days after the date of filing of the appeal, and such action and judgment of the city council, after hearing all the evidence and facts, shall be final and conclusive as to all parties.
(k)
Applications, certificate duration and fees.
(1)
Before a certificate is issued or renewed, an annual fee (as provided by the city secretary) shall be paid. This fee shall not be prorated for fractional parts of a calendar year. The operator making application for renewal of a certificate shall do so prior to October 1st of any year.
(2)
Upon making application to the city for a certificate, an application fee (set from time-to-time by resolution of the city council) shall be paid in addition to the annual certificate fee paid in advance. No application shall be processed until this fee and the fee contained in subsection (1) above are paid.
(3)
The fees described in this section shall be nonrefundable.
(4)
The city council may set the effective dates of the certificate for any period of time not to exceed three (3) years.
(l)
Liability insurance required.
No private ambulance shall be operated in the city unless there is at all times in full force and effect insurance coverage as follows:
(1)
Public liability insurance in an amount not less than one hundred thousand dollars ($100,000.00) for injury to, or death of, each person; three hundred thousand dollars ($300,000.00) for each accident; and fifty thousand dollars ($50,000.00) for property damage to secure payment of all lawful and property claims arising out of the operations of the ambulance service authorized hereunder;
(2)
Uninsured motorist coverage in an amount equal to the bodily injury liability limits set forth in subsection (1) above;
(3)
A one million dollar ($1,000,000.00) umbrella policy providing additional coverage to all underlying liability policies;
(4)
Every insurance policy required hereunder shall extend for the period to be covered by the certificate granted for the operation of ambulance service hereunder, and the insurer shall be obligated to give not less than thirty (30) days’ written notice to the city and the medical director before any cancellation or other termination of any such policy earlier than its termination date.
(m)
Central place of business.
Each operator shall maintain a central place of business with at least one (1) properly listed telephone for receiving all calls for ambulance service and where all business records and daily manifest herein required shall be maintained and available; to answer promptly all calls for service; to dispatch promptly all ambulances; and to be generally responsible for its conduct of all ambulance operations. Each operator shall, in writing, immediately notify the fire chief of any change of the business address or of the telephone number where said operator may be reached at all times.
(n)
Certificate holder’s records and reports.
Each certificate holder shall maintain a daily manifest upon which shall be recorded the time of service request, time of dispatch, time of arrival on scene, place of origin and destination. Each such operator shall retain and preserve all daily manifests for at least eighteen (18) months, and such manifests shall be available for inspection by the city council and/or license officer or their duly authorized representatives upon request. Each such operator shall maintain such records at a place readily accessible for said inspection.
(o)
Operating regulations.
All certificate holders shall comply with the following regulations:
(1)
The certificate holder, operator, ambulance personnel and ambulance vehicles shall be subject to Texas Health and Safety Code, chapter 773.
(2)
In the event an operator receives a private call for ambulance service which is of an emergency nature, within the area served by the city fire department EMS, said operator shall report to the city fire department dispatcher such call, giving the location and nature of the call.
(3)
It shall be unlawful for ambulance personnel or an operator of a private nonemergency service to make an emergency ambulance call on the public streets of the city except as allowed by subsection (c) of this section.
(4)
Certificate holders or their designee shall be responsible for all emergency and nonemergency transports and transfers where the origin is within the fire department area of coverage and the destination is not a hospital emergency department that is located within the fire department area of coverage and to which a 9-1-1 call has not been placed.
(5)
Certificate holders must report quarterly all calls for service within the fire department area of coverage. The report shall include the date and time of request, and time on scene, and type of call (emergency, nonemergency) for each call. The report must provide the average response time (time of request to time on scene), the percentage of calls for service that the response time was more than one (1) hour, and the total number of requests for service. Calls for service where the service was not provided by the certificate holder shall not be included in this report.
(Ordinance 2716 adopted 4/18/1989; Ordinance adopting Code; Ordinance 4689 adopted 5/16/2017; Ordinance 4809 adopted 4/7/2020)