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 571-20 adopted 6/18/20)
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 nonemergency 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 to provide independent medical oversight for 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 571-20 adopted 6/18/20)
For the purposes of this article, the following words and phrases
shall have the meanings respectively ascribed to them by this section:
Advanced life support.
Out-of-hospital care that uses invasive medical acts (as
defined in Texas Health and Safety Code section 773.003(1)).
Aeromedical transportation unit.
Any rotary or fixed wing aircraft providing basic or advanced
life support services and patient transportation that originates within
the service area.
Ambulance mutual aid agreement.
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.
Associate medical director.
A licensed physician who assists the medical director in
carrying out his or her duties under this article and the restated
and amended interlocal cooperative agreement.
Authority (metropolitan area EMS authority).
The public administrative agency established to administer
and operate the medical transportation and prehospital emergency medical
services system and the program for MIH (as hereinafter defined) established
by this article.
Basic life support.
Out-of-hospital care that uses noninvasive medical acts (as
defined in section 773.003(2), Texas Health and Safety Code).
Board.
The board of directors of the authority.
Emergency care attendant.
A person certified as an “emergency care attendant”
under section 773.046 of the Texas Health and Safety Code.
Emergency medical technician (EMT).
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.
EMS communications center.
The facility designated by the authority as the central communications
center from which all services offered by the authority shall be dispatched
and controlled.
First responder.
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.
Medical director.
The licensed physician retained through a contract with or
employed by the board who is responsible for carrying out his or her
duties under this article and the restated and amended interlocal
cooperative agreement and for directing the office of the medical
director.
Medical transportation.
The transportation of patients by ambulance, specialized
mobile intensive care unit, specialty care transport, or aeromedical
transportation unit, including both emergency and nonemergency transports,
where such transportation originates within the service area.
Mobile integrated healthcare (MIH).
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.
Office of medical director.
The clinical office of the authority through which the medical
director carries out his/her rights and duties under this article
and the restated and amended interlocal cooperative agreement. The
office of the medical director is comprised of the medical director,
and any associate medical directors, and the employees of the authority
in the office of the medical director to assist the medical directors
in carrying out the medical director’s rights and duties under
this article and the restated and amended interlocal cooperative agreement.
Paramedic.
A person qualified as a certified or licensed “paramedic”
as defined by Texas Health and Safety Code sections 773.049 and 773.0495.
Patient.
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.
Person.
Any individual, firm, association, partnership, corporation,
governmental entity, or other group, or a combination of the same
acting as a unit.
Restated and amended interlocal cooperative agreement.
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).
Service area.
That geographical area which is contained within the boundaries
of all the jurisdictions which become members of the authority by
adopting this uniform EMS article and executing the restated and amended
interlocal cooperative agreement.
Special event.
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.
Specialty care transport.
The transportation of a critically injured or ill patient
at a level of service beyond the scope of the EMT-paramedic when the
patient’s condition requires ongoing care that must be furnished
by one or more health professionals in an appropriate specialty area;
for example, emergency or critical care nursing, emergency medicine,
respiratory care, cardiovascular care, or a paramedic with additional
training.
Specialized mobile intensive care unit.
A vehicle which is specially constructed, equipped, staffed,
and employed in the inter-facility transport of patients whose requirements
for en route medical support are likely to exceed the clinical capabilities
of an advanced life support ambulance.
(Ordinance 571-20 adopted 6/18/20)
(a) There
is hereby created an emergency physicians advisory board (“EPAB”)
which shall, on behalf of this jurisdiction, provide independent medical
oversight for and advise and inform the authority on 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) EPAB’s
membership and other matters relating to EPAB shall be set forth in
the restated and amended interlocal cooperative agreement and in the
bylaws adopted by EPAB.
(Ordinance 571-20 adopted 6/18/20)
By adopting this article and executing and approving the restated
and amended interlocal cooperative agreement, this jurisdiction has
joined the authority, which shall now be known as the metropolitan
area EMS authority.
(Ordinance 571-20 adopted 6/18/20)
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 and amended interlocal cooperative agreement, except for those services exempted by section
6.02.009(b).
(2) The
authority shall comply with all terms of the restated and amended
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 law, rules and regulations,
as well as all patient care standards that the medical director 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 medical director and subject
to rights of appeal to the board.
(6) The
authority shall adopt standards approved by the medical director 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 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 medical director 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 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 medical director governing the provision of special event ambulance standby service within the service area, and, subject to the credentialing process by the medical director, may issue, suspend, revoke, and renew permits for the provision of such ambulance standby service; provided, however, nothing contained in this article
6.02 establishes the authority as the sole provider of non-ambulance standby emergency medical services, nor shall it limit the authority of the city to regulate, manage, or govern standby emergency medical services and the provider(s) thereof.
(Ordinance 571-20 adopted 6/18/20)
The authority board’s membership and other matters relating
to the authority shall be set forth in the restated and amended interlocal
cooperative agreement and in the bylaws adopted by the authority’s
board.
(Ordinance 571-20 adopted 6/18/20)
(a) There
is hereby created a first responder advisory board (“FRAB”)
which shall advise and inform the authority and 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 and amended interlocal cooperative agreement
and in the bylaws adopted by the FRAB.
(Ordinance 571-20 adopted 6/18/20)
(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 571-20 adopted 6/18/20)
(a) Any person convicted of violating the provisions of section
6.02.009 shall be guilty of a class C misdemeanor and shall be punished by a fine not to exceed $500.00 (Texas Penal Code section 12.23).
(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 571-20 adopted 6/18/20)
When the driver of an emergency medical response vehicle has
reasonable grounds to believe that an emergency exists, as determined
by the EMS communication center, the vehicle shall be treated as an
“authorized emergency vehicle” within the meaning of chapter
546 of the Texas Transportation Code and shall be exempt from traffic
laws as provided therein.
(Ordinance 571-20 adopted 6/18/20)