It is the city’s intent to:
(1) Establish
a regulated ambulance service system, which can provide clinical quality
of care, with reasonable, reliable response time standards, and with
the goal of furnishing the best possible chance of survival, without
disability or preventable complication, to each ambulance patient.
(2) Establish
a sole provider ambulance system, because it is unreasonable to have
unnecessarily high rates and/or public subsidy to make needed improvements
to ambulance service in the service area, when a more efficiently
designed system can achieve the same results at a lower cost. The
most efficient design to achieve the goals of high-quality service,
at the lowest cost, consistent with the quality of care required,
is the implementation of the system described herein.
(3) Provide
a method to develop specific performance standards, adequate review,
and either a continuation of service or an appropriate procedure to
obtain alternate proposals from other providers.
(4) To
provide more effective medical oversight and supervision by designating
a medical director, a licensed physician with experience in emergency
medicine, care and related specialties as the individual directed
to oversee all clinical aspects of the emergency medical system that
affect patient care within this jurisdiction.
(Ordinance 10-023, sec. A, adopted 8/9/10)
The following words and phrases as used in this article shall
have the following meanings:
Advanced life support ambulance.
Any vehicle that is equipped to provide treatment of life
threatening emergencies through the use of advanced airway management,
intravenous therapy, and other advanced pre-hospital care procedures.
Ambulance.
Any privately or publicly owned motor vehicle that is specially
designed or constructed and equipped and is intended to be used for
and is maintained or operated for the transportation of patients.
Ambulance patient or patient.
Any person being transported in a reclining position, whose
transport originates within the city limits, to or from a health care
facility.
Ambulance service contractor.
That entity which is then currently under contract to provide all ambulance and ambulance patient services within the city limits, except those services specifically exempted by section
6.05.003 of this article.
Base station physician.
A physician licensed to practice medicine in the state, and
knowledgeable of pre-hospital protocols, EMS radio procedures and
the general operating policies of the ambulance service contractor,
and from whom ambulance personnel may take direction by radio or other
remote communications device.
City council.
That group of officials elected to govern the affairs of
the city.
Contract/regulated service area.
The geographic area encompassing the city, and other such
areas where the city may be responsible for the provision of public
safety service, including ambulance service. This includes and is
defined as the geographical area within the city limits.
EMS system.
That network of individuals, organizations, facilities and
equipment whose participation is required to generate a clinically
appropriate, pre-planned system wide response for pre-hospital care
and transport or inter-facility transport, so as to provide each patient
the best possible chance of survival without disability, given available
financial resources and EMS technology.
Extraordinary adjustment.
A increase in either the rate or subsidy structure which
is not a scheduled cost of living adjustment, but is instead an adjustment
justified on the basis of either an increase in the system standard
of care, or on the basis of an unusual increase in the cost of a factor
or production when such increase in cost is industry wide and the
result of causes beyond the ambulance service contractor’s reasonable
control.
First responder.
Any person, fire department vehicles, police vehicle, or
other vehicle not normally used for purposes of patient transport,
but which vehicle and onboard personnel are capable of providing services
in medical emergencies.
Medical control.
That direction given ambulance personnel by a base station
physician through direct voice contact, with or without vital sign
telemetry, as required by applicable medical protocols promulgated
by the medical director and/or by chapter 773, Texas Health and Safety
code, or its successors.
Medical director.
An emergency physician, expert in the pre-hospital practice
of emergency medicine, appointed by the ambulance service contractor.
Medical protocol.
Any diagnosis specific or problem oriented written statement
of standard procedures, or algorithm, promulgated by the medical director
as the proper standard of pre-hospital care for a given clinical condition.
Mutual aid agreement.
A written agreement between one or more providers of ambulance
service whereby the signing parties agree to provide backup ambulance
service to one another under conditions and pursuant to terms specified
in the agreement.
Paramedic.
A person qualified as a certified “paramedic emergency
medical technician”: as defined by chapter 773, Texas Health
and Safety Code or its successor.
Person.
Any individual, firm, partnership, association, corporation,
governmental agency, or other group or combination acting as a unit.
Senior paramedic in charge.
That person among the certified or licensed personnel assigned
to an ambulance, which is a certified or licensed paramedic designated
by the ambulance service contractor as the individual in command of
the ambulance.
Special event.
Any public event located within the regulated service area,
for which standby ambulance service is arranged in advance, and for
which an ambulance (or ambulances) are hired by the sponsor of the
event or other interested party.
System standard of care.
The combined compilation of all priority dispatching protocols,
pre-arrival instruction protocols, medical protocols (i.e. for first
responders and ambulance personnel), protocols for selecting a destination
hospital, standards for certification or pre-hospital care personnel
(i.e., system status controllers, first responders, ambulance personnel
and on-line medical control physicians), as well as standards governing
requirements for onboard medical equipment and supplies, and licensure
of ambulance services and first responder agencies. The system standard
of care shall simultaneously serve as both a regulatory and contractual
standard.
(Ordinance 10-023, sec. B, adopted 8/9/10)
(a) No
person shall operate or cause to be operated an ambulance nor furnish,
conduct, maintain, advertise or otherwise be engaged in the business
or service of the transportation of ambulance patients within the
regulated service area, or provide special event standby coverage,
unless such person is the ambulance service contractor. No person
shall knowingly solicit ambulance services regulated herein except
the ambulance service contractor.
(b) However, the prohibitions set forth in subsection
(a), immediately above, shall not be applicable to an ambulance service provider:
(1) Which is rendering assistance to patients in the case of a major
catastrophe or emergency with which the contractor’s ambulances
are insufficient or unable to cope; or is
(2) Transporting a patient who is picked up from a location beyond the
regulated service area and transported to a location within the regulated
service area; or is
(3) Transporting a patient who is picked up from a location beyond the
regulated service area and transported to a location beyond the limits
of the regulated service area and only incidentally passing through
the regulated service area; or is
(4) Transporting a patient who is picked up from a location within the
regulated service area and transported to a location outside the greater
Dallas area. In the event of a long distance transfer (defined as
greater than 75 miles one way) originating within the regulated service
area, the sending facility will be allowed to use another ambulance
or ambulance service for these long distance transports.
(Ordinance 10-023, sec. C, adopted 8/9/10)
All persons and entities regulated under this article shall
comply with the laws of the state and reference to permits, licenses,
minimum equipment and minimum qualifications of operators and attendants
and all state and federal laws and regulations applicable to its ambulance
operation.
(Ordinance 10-023, sec. D, adopted 8/9/10)
(a) It
shall be unlawful for any person, with intent to defraud, to request
or accept the service of any ambulance with the city, having no intention
of paying for such service.
(b) Failure,
by the person requesting or accepting the services of an ambulance,
to pay to the person furnishing such service the approved charges
within ninety (90) days after demand for payment is made, shall be
prima facie evidence of intent to defraud and prima face evidence
that such person had no intention of paying for such services when
the same were requested or accepted.
(c) Demand
for payment, as used in this article, shall be written demand, sent
by registered or certified mail addressed to the person requesting
or accepting such services and to the address given by or on behalf
of such person at the time the services were requested or accepted.
Intent to defraud or intention not to pay for such services may be
shown by direct evidence.
(Ordinance 10-023, sec. E, adopted 8/9/10)
Any person who shall violate any provision of this article shall
be deemed guilty of a misdemeanor and upon conviction thereof shall
be fined an amount not to exceed five hundred dollars ($500.00). Each
incident or call for service shall constitute a separate violation
and shall be deemed a separate offense. It shall not be necessary
for the complaint to negate any exception contained in this article
concerning any prohibited act, but any such exception made in this
article may be used as a defense by any person charged by such complaint.
(Ordinance 10-023, sec. F, adopted 8/9/10)