This article is enacted by the city (“this jurisdiction”),
pursuant to Texas Health and Safety Code section 773.051, which provides
that local governments may establish standards for ambulances, and
pursuant to Texas Government Code chapter 791, which authorizes combinations
of local governmental units to contract for the provision of governmental
services, including the creation of administrative agencies to promote
public health and welfare.
(Ordinance 1075, sec. 1, adopted 2/14/17; 2004 Code, sec. 1.1201)
It is the purpose of this article:
(1)
To
establish a regulated prehospital emergency medical services and medical
transportation system which can provide quality clinical care with
performance measures and standards, with the goal of facilitating
the best possible outcomes for each patient;
(2)
To
establish a mobile integrated healthcare program with effective medical
direction and quality assurance and review;
(3)
To
form an administrative agency to administer and operate the prehospital
emergency medical services and medical transportation system in a
service area comprised of member jurisdictions and to administer and
operate the mobile integrated healthcare program;
(4)
To
designate the administrative agency as the sole provider of emergency
and non-emergency ambulance service within this jurisdiction to maintain
consistent, high-quality service while controlling costs through efficiencies
and economies of scale;
(5)
To
provide for effective medical direction by establishing a multi-jurisdictional
emergency physicians advisory board to advise the administrative agency’s
board and, through the agency’s office of the medical director,
to oversee and regulate all clinical aspects of prehospital emergency
medical services, the administrative agency’s mobile integrated
healthcare program, and medical transportation which affect patient
care in the service area; and
(6)
To
provide for effective coordination and communication between first
responder agencies in the service area, the emergency physicians advisory
board, and the board of the administrative agency by establishing
a multi-jurisdictional first responder advisory board.
(Ordinance 1075, sec. 1, adopted 2/14/17; 2004 Code, sec. 1.1202)
For the purposes of this article, the following words and phrases
shall have the meanings respectively ascribed to them by this section:
Out-of-hospital care that uses invasive medical acts (as
defined in Texas Health and Safety Code section 773.003(1)).
Any rotary or fixed wing aircraft providing basic or advanced
life support services and patient transportation that originates within
the service area.
A written agreement between the authority and one or more
entities whereby the signing parties agree to provide backup ambulance
service to one another under the terms and conditions specified in
the agreement.
The transportation of patients by emergency or non-emergency
ambulance.
A licensed physician who assists the medical director in
carrying out the EPAB’s duties under this article through the
OMD.
The public administrative agency, formerly known as the area
metropolitan ambulance authority, established to administer and operate
the medical transportation and prehospital emergency medical services
system and the MIH program established by this article.
Out-of-hospital care that uses noninvasive medical acts (as
defined in section 773.003(2), Texas Health and Safety Code).
The board of directors of the authority.
A person certified as an “emergency care attendant”
under section 773.046 of the Texas Health and Safety Code.
A person certified as an “emergency medical technician”
under section 773.047 or an “advanced emergency medical technician”
under section 773.048 of the Texas Health and Safety Code, and any
other class of EMT recognized by state law or regulation.
The single facility designated by the authority as the central
communications center from which all services offered by the authority
shall be dispatched and controlled.
Any agency that provides first response to requests for emergency
medical services and, in cooperation with the ambulance service, provides
immediate on-scene care to ill or injured persons but does not transport
those persons to healthcare facilities.
The licensed physician appointed by the EPAB who is responsible
for carrying out the EPAB’s duties and for directing the office
of the medical director.
The transportation of patients by ambulance, specialized
mobile intensive care unit, specialty care transport, or aeromedical
transportation unit, including both emergency and non-emergency transports,
where such transportation originates within the service area.
An associate medical director who is specifically tasked
with assisting the medical director in overseeing the clinical aspects
of the authority’s MIH program.
Services provided by the authority that are designed to enhance,
coordinate, effectively manage, and integrate out-of-hospital care,
in order to improve outcomes, enhance the client’s experience
of care, and improve the efficiency and effectiveness of healthcare
services provided to the enrolled clients.
The clinical office of the authority through which the EPAB
carries out its rights and duties under this article. The office of
the medical director is comprised of the medical director, the MIH
associate medical director and any other associate medical directors,
and the employees of the authority who are assigned to the office
of the medical director to assist the medical directors in carrying
out EPAB’s rights and duties under this article.
A person qualified as a certified or licensed “paramedic”
as defined by Texas Health and Safety Code sections 773.049 and 773.0495.
An individual who is ill, sick, injured, wounded, or otherwise
incapacitated, and in need of or at risk of needing medical care at
the scene of a medical emergency or during transport to or from a
healthcare facility.
Any individual, firm, association, partnership, corporation,
governmental entity, or other group, or a combination of the same
acting as a unit.
The interlocal contract, as it may be amended from time to
time, adopted by this jurisdiction concurrently with the passage of
this article pursuant to chapter 791 of the Texas Government Code
(the Interlocal Cooperation Act).
That geographical area which is contained within the boundaries
of all the jurisdictions which become members of the authority by
adopting this uniform EMS ordinance and executing the restated interlocal
cooperative agreement.
Any public event located within the service area for which
standby ambulance service is arranged in advance, and for which an
ambulance is hired by the sponsor of the event or other interested
party.
A vehicle which is specially constructed, equipped, staffed,
and employed in the inter-facility transport of patients whose requirements
for en-route medical support are likely to exceed the clinical capabilities
of an advanced life support ambulance.
The transportation of a critically injured or ill patient
at a level of service beyond the scope of the EMT-paramedic when the
patient’s condition requires ongoing care that must be furnished
by one or more health professionals in an appropriate specialty area;
for example, emergency or critical care nursing, emergency medicine,
respiratory care, cardiovascular care, or a paramedic with additional
training.
(Ordinance 1075, sec. 1, adopted 2/14/17; 2004 Code, sec. 1.1203)
(a)
There
is hereby created an emergency physicians advisory board (EPAB) which,
acting through the office of the medical director, shall, on behalf
of this jurisdiction, oversee and regulate all clinical aspects of
medical transportation, the authority’s MIH program, and prehospital
emergency medical services in this jurisdiction, including such services
provided by the authority and first responders, and shall exercise
independent professional judgment in all matters related to patient
care.
(b)
The
EPAB’s membership and other matters relating to the EPAB shall
be set forth in the restated interlocal cooperative agreement and
in the bylaws adopted by the EPAB.
(Ordinance 1075, sec. 1, adopted 2/14/17; 2004 Code, sec. 1.1204)
(a)
By
adopting this article and executing and approving the restated interlocal
cooperative agreement, this jurisdiction has joined the authority,
which shall now be known as the metropolitan area EMS authority.
(b)
The
authority shall have the following powers and duties:
(1)
The authority is hereby designated as the sole provider of ambulance service and special event ambulance standby service within this jurisdiction, whether directly or indirectly through contractors, pursuant to the terms, conditions and provisions of the restated interlocal cooperative agreement, except for those services exempted by section 6.02.007(b) of this article.
(2)
The authority shall comply with all terms of the restated interlocal
cooperative agreement and have all the powers and duties enumerated
therein.
(3)
The authority is required to provide this jurisdiction with basic
and advanced life support ambulance service in accordance with system
performance standards and all applicable laws, rules and regulations,
as well as all patient care standards that the EPAB may from time
to time promulgate.
(4)
The authority is authorized to operate an MIH program on a nonexclusive
basis in this jurisdiction.
(5)
The authority shall enter into a first responder agreement with this
jurisdiction and may issue, suspend, revoke, and renew permits for
the delivery of first responder services in this jurisdiction by other
agencies, subject to the credentialing process by the EPAB and the
office of the medical director and subject to rights of appeal to
the board.
(6)
The authority shall adopt standards approved by the EPAB governing
the operation of specialized mobile intensive care units and for specialty
care transport within the service area, including standards limiting
the types of patients which may be transported thereby, and, subject
to the credentialing process by the EPAB and the office of the medical
director, may issue, suspend, revoke, and renew permits for the operation
of such units as required by this article.
(7)
The authority shall adopt standards approved by the EPAB governing
the operation of aeromedical transportation units within the service
area, including standards defining the circumstances under which such
units may be deployed to emergency scenes and, subject to the credentialing
process by the EPAB and the office of the medical director, may issue,
suspend, revoke, and renew permits for the operation of such units
as required by this article.
(8)
The authority shall adopt standards approved by the EPAB governing
the provision of special event ambulance standby service within the
service area and, subject to the credentialing process by the EPAB
and the office of the medical director, may issue, suspend, revoke,
and renew permits for the provision of such ambulance standby service.
(c)
The
authority board’s membership and other matters relating to the
authority shall be set forth in the restated interlocal cooperative
agreement and in the bylaws adopted by the authority’s board.
(Ordinance 1075, sec. 1, adopted 2/14/17; 2004 Code, sec. 1.1205)
(a)
There
is hereby created a first responder advisory board (FRAB) which shall
advise and inform the authority and the EPAB on matters related to
first response and prehospital emergency medical services in the service
area.
(b)
The
FRAB’s membership and other matters relating to the board shall
be set forth in the restated interlocal cooperative agreement and
in the bylaws adopted by the FRAB.
(Ordinance 1075, sec. 1, adopted 2/14/17; 2004 Code, sec. 1.1206)
(a)
It
shall be unlawful:
(1)
To knowingly give false information to induce the dispatch of an
ambulance or aeromedical transportation unit;
(2)
To perform duties as an ECA, EMT, paramedic or emergency ambulance
dispatcher without current credentials issued by the office of the
medical director, unless participating in a training program approved
by office of the medical director;
(3)
To permit a person to work as an ECA, EMT, paramedic or emergency
ambulance dispatcher without current credentials issued by the office
of the medical director, unless participating in a training program
approved by office of the medical director;
(4)
To use, or cause to be used, any ambulance service other than the authority, except as permitted in subsection (b) below;
(5)
For any person or entity other than the authority to provide ambulance
service within this jurisdiction, unless pursuant to a written agreement
with the authority;
(6)
For any person to provide medical transportation originating in the
service area without a permit issued by the authority;
(7)
For any agency to provide first responder services without a first
responder permit issued by the authority, unless pursuant to a first
responder agreement with the authority or a written automatic aid
or mutual aid agreement with this jurisdiction;
(8)
To use an ambulance for the transportation of persons other than
in connection with the transportation of a patient.
(b)
It
shall be a defense to any alleged violation of this section that a
vehicle is being used or service is provided solely in any of the
following manners:
(1)
As a privately owned vehicle not ordinarily used in the business
of transporting persons who are sick, injured, wounded, incapacitated
or helpless;
(2)
Rendering service as an ambulance at the request of the EMS communications
center upon the declaration of a disaster by this jurisdiction, the
state, or the United States; or a declaration of a major catastrophe
or extreme system overload by the chief executive officer of the authority;
(3)
Any ambulance owned or operated by the federal or state government;
(4)
Ambulance mutual aid calls when rendered pursuant to an ambulance
mutual aid agreement approved by the authority;
(5)
Special event ambulance standby coverage, so long as such service
is provided without charge by an emergency medical services volunteer
provider, as defined in Texas Health and Safety Code section 773.003(13),
or the authority has first declined to provide coverage and the entity
providing coverage has been issued a permit by the authority;
(6)
Wheelchair transport services for persons other than patients, when
the service is not provided by ambulance; and
(7)
Medical transportation of a patient where the transport originates
outside the service area.
(Ordinance 1075, sec. 1, adopted 2/14/17; 2004 Code, sec. 1.1207)
(b)
This
section does not serve to limit any other remedies available to the
jurisdiction in law or equity.
(c)
Each
violation of this article shall constitute a separate offense.
(Ordinance 1075, sec. 1, adopted 2/14/17; 2004 Code, sec. 1.1208; Ordinance adopting 2021 Code)
When the driver of ans emergency medical response vehicle has
reasonable grounds to believe that an emergency exists, as determined
by the EMS communications center, the vehicle shall be treated as
an “authorized emergency vehicle” within the meaning of
chapter 546 of the Texas Transportation Code and shall be exempt from
traffic laws as provided therein.
(Ordinance 1075, sec. 1, adopted 2/14/17; 2004 Code, sec. 1.1209)
