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EMERGENCY AND NON-EMERGENCY AMBULANCE SERVICES
For the purpose of this subchapter, the following definitions shall apply unless the context clearly indicates or requires a different meaning.
ADVANCED LIFE SUPPORT (ALS). Emergency pre-hospital care that uses invasive medical acts. The provision of ADVANCED LIFE SUPPORT shall be under the medical supervision and control of a licensed physician.
AMBULANCE. Any privately- or publicly-owned motor vehicle constructed, reconstructed, arranged, equipped, used or otherwise intended to be used for transportation of sick, injured or otherwise incapacitated persons from one place to another. The term shall be construed to mean either EMERGENCY AMBULANCES or TRANSFER AMBULANCES.
AMBULANCE SERVICE. The providing or making available to the public or to any person of a motor vehicle and any personnel required by this subchapter for transportation of and/or the provision of pre-hospital emergency medical services to an individual who is sick, injured or incapacitated, whether in emergency circumstances or in a transfer situation.
BASIC LIFE SUPPORT. Emergency pre-hospital care that uses non-invasive medical acts. The provision of BASIC LIFE SUPPORT may be under the medical supervision and control of a licensed physician.
EMERGENCY. Any combination of events or circumstances which results in life- or body-threatening injury or illness requiring immediate emergency medical services.
EMERGENCY AMBULANCE OR RESCUE VEHICLE. Any motor vehicle constructed or designed for transporting the sick or injured, and which meets all of the existing requirements established by the State Department of Transportation, GSA Bulletin KKK-A-1822, as referenced by State Department of Health, and the provisions of this subchapter.
EMERGENCY AMBULANCE SERVICE. Any organization or operation which utilizes an emergency ambulance to respond to the scene of an emergency for the purpose of rendering emergency
medical services and/or providing transportation of the sick and injured to a hospital or other place for medical attention.
EMERGENCY CALL. Any request for ambulance service that is made in circumstances which are, or have been represented to be, an emergency and require immediate pre-hospital emergency medical service.
EMERGENCY CARE ATTENDANT (ECA). Any person who has met all the minimum requirements established by this subchapter, and who has completed all of the training requirements established by the State Department of Transportation’s Emergency Care Attendant Outline and who has met all of the requirements established by the State Emergency Care Attendant Registry.
EMERGENCY MEDICAL SERVICE (EMS). The emergency medical service system established for the purpose of providing to the citizens of the city an emergency medical service utilizing emergency medical technicians (EMTs) and emergency vehicles in compliance with the regulations outlined in this subchapter.
EMERGENCY MEDICAL TECHNICIAN (EMT). Any person who has met all the minimum requirements established by this subchapter, and who has completed all of the training requirements established by the State Department of Transportation’s Emergency Medical Technician Outline and who has met all of the requirements established by the State Emergency Medical Technician Registry.
EMERGENCY TRANSFER. Any transportation provided for a patient by an emergency vehicle from one hospital or other place of treatment, after initial stabilization, to another hospital or other place of treatment for definitive care, under emergency circumstances.
INDUSTRIAL AMBULANCE. Any vehicle owned and operated by an industrial facility at industrial sites used for the initial transport or transfer of the unstable urgently sick persons at those sites who become sick, injured, wounded or otherwise incapacitated in the course of their employment from the job site to an appropriate medical facility; provided, however, that, the vehicle is not available for hire or use by the general public, except when assisting the local community in disaster situations or related emergencies.
MEDICAL SUPERVISION. Direction given to emergency medical services personnel by a licensed physician under the terms of the Medical Practice Act (Tex. Occupations Code § 151.001) and rules promulgated by the State Board of Medical Examiners pursuant to the terms of the Medical Practice Act.
NON-EMERGENCY. Any situation not classified as an emergency.
PATIENT. Any person who is sick, injured or incapacitated and who becomes subject to transportation or care by an emergency medical technician (EMT) attendant, driver or attendant-driver pursuant to the terms of this subchapter.
PATIENT DROP-OFF. The act of unloading a stretcher-bound patient from the back of the ambulance and moving patient into a hospital or other place for medical attention.
PATIENT PICK-UP. The act of loading a stretcher-bound patient into the back of an ambulance providing transport/transfer from a hospital or other place that medical care was obtained or requested.
PERMIT OFFICER. The Fire Chief or his or her duly authorized representative.
PERSON. Any individual, firm, partnership, association, corporation, company, group of individuals acting together for a common purpose, or organization of any kind. The term shall not include any governmental agency.
STORE FRONT. Building used to house office, personnel, and provide parking area for ambulances.
TRANSFER/TRANSPORT. Movement, in a transfer vehicle, of pre-scheduled non-emergency patients from place to place.
TRANSFER AMBULANCE. Any motor vehicle constructed, arranged and equipped for transporting non-emergency patients from place to place, and which meets the requirements of Texas Revised Civil Statutes, the requirements of the State Department of Health and the provisions of this subchapter.
TRANSFER AMBULANCE SERVICE. Any organization or operation utilizing a transfer vehicle for the purpose of transporting non-emergency patients from one place to another.
(1998 Code, § 46-32) (Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
(A) Except as may otherwise be provided for in this subchapter, it shall be unlawful for any person to operate, conduct, maintain or otherwise engage in the furnishing of an emergency ambulance service or non-emergency ambulance service within the limits of the city. This includes the drop off of a patient at a hospital or other place for medical attention inside the city with the intention to pick up the same patient for transport back out from the city.
(B) The provisions of division (A) above shall not apply to the following:
(1) The United States government and its agencies, the state, the county or the city;
(2) Persons who operate an ambulance service, including their ambulance vehicles and personnel, from a location or headquarters outside the limits of the city and who are transporting patients from a location outside the limits of the city to a location within the city, or through the city to some other location;
(3) Persons furnishing, at the city’s request, a permitted emergency or non-emergency ambulance service;
(4) Non-emergency vehicles used to provide or make available, on a volunteer or non-profit basis, transportation for routine non-emergency medical examination or treatment; and/or
(5) Any vehicle owned and operated by an industrial facility at industrial sites used for the initial transport or transfer of the unstable urgently sick or injured and ground vehicles at industrial sites used to transport persons at those sites who become sick, injured, wounded or otherwise incapacitated
in the course of their employment from the job site to an appropriate medical facility; provided, however, that, the vehicle is not available for hire or used by the general public except when assisting the local community in disaster situations or like emergencies.
(6) Persons transporting sick or injured during a mass casualty incident that exceeds the capacity of the city’s emergency medical services.
(7) Any vehicle that is owned/leased and operated with hospital staff providing patient care from a hospital site including free-standing emergency room within the city and used for the transport of a critically sick or injured patient to a higher level of care at another hospital that is owned and operated under the same name as the transferring hospital or free-standing emergency room; provided, however, the vehicle is not available for hire or use by the general public. This section shall not be construed as permitted by the city to perform patient pickup or operate in the city for any other purpose.
(C) The City Commission may contract for the provision of sole provider of ambulance services for emergency medical services and/or non-emergency transport services. If a sole provider of ambulance services is granted, it shall be unlawful for any person, firm or organization to provide ambulance service within the city or to provide point-to-point transport services to and from health care facilities, except as hereinabove provided in division (B) above.
(1998 Code, § 46-33) (Ord. 98-64, passed 12-16-1998; Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
Penalty, see § 35.99
(A) Operation of emergency ambulances. The driver of an emergency ambulance, when responding to an authorized emergency call or transporting an emergency patient, shall comply with all applicable state laws and city ordinances pertaining to operation of emergency vehicles.
(B) Use of emergency signals by transfer ambulances. It shall be unlawful for any operator of a transfer ambulance to utilize audible and visual emergency signals, except where circumstances reasonably dictate that the transfer of a non-emergency patient has suddenly without warning become an emergency, in which situation such driver may exercise all of the privileges set forth in division (A) above.
(C) Response requirements. The holder of a non-emergency transfer permit shall not deny timely response, treatment or transportation to an appropriate medical facility to anyone or any facility in the city due to age, sex, race, religion, ethnicity, medical condition or based on an actual or perceived inability to pay for services rendered pursuant to the permit. In addition, the holder of a non-emergency transfer permit shall make available to the city, upon the city’s request, ambulances and personnel necessary for standby and assistance during emergencies occurring in the city, and shall:
(1) Maintain 24-hour transfer service; and
(2) Own or lease, and operate a store front within the city limits, available for storage of permitted ambulance(s). Only one business per store front shall be allowed.
(D) Public storage. No permittees shall store any vehicle or ambulance on public streets or public rights-of-way in the city or operate its main place of business or storage facility in a private residence.
(E) Firearms prohibited on transfer ambulances. Firearms are prohibited aboard all transfer ambulance vehicles, except when in the possession of a certified law enforcement officer who is not an employee of the permitted company and who may be required to accompany a patient to a medical facility.
(F) Staffing of emergency ambulances. Each permitted emergency ambulance vehicle shall be staffed on every call by at least two persons having EMT certification, one of whom shall be certified at the EMT-paramedic level.
(1998 Code, § 46-34) (Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
Penalty, see § 35.99
(A) Staffing. No transfer ambulance vehicle shall ever be operated upon the streets, highways or other public places of the city unless such vehicle is operated by at least two ambulance attendants, one of whom must possess a current emergency care attendant certificate as required by the state, and the other attendant must be certified by the state as at least an EMT-basic.
(B) Identification on vehicles. Transfer ambulance vehicles shall have lettering, six inches in height, attached to each side of the vehicle, indicating that the vehicle is in fact a transfer ambulance.
(C) Posting of fee schedule. All transfer ambulance vehicles shall have a current fee schedule conspicuously posted in the patient’s compartment.
(D) Applicability. The requirements listed in this section are not applicable to permitted emergency ambulance vehicles.
(1998 Code, § 46-35) (Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
Penalty, see § 35.99
(A) On receiving the first communication that the patient has specifically designated no preference, the telecommunications operator receiving the communication shall call the first transfer company on the rotation list. If the transfer company does not timely respond within 30 minutes (absent exigent circumstances), the next transfer company on the rotation list will be called.
(B) On each succeeding communication that the patient has specifically designated no preference, the next company on the rotation list shall be called, and so on, calling each transfer company on the list in rotation, and proper notation of each call shall be made on the master list.
(C) The city reserves the right to cancel the “next-out” transfer unit as warranted by the situation on scene. If the city cancels the “next-out” for any reason other than the company’s failure to arrive within the allocated time limit, or the equipment does not meet the requirements of the situation, the company shall be placed on top of the rotation list and shall receive the subsequent “next-out” call.
(D) The transfer ambulance rotation list shall be limited to four slots and the total number of ambulance service permits issued by the city at any one time shall therefore be limited to four.
(Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
(A) Each holder of an ambulance service permit shall maintain in effect at all times a policy for:
(1) Public liability;
(2) Property damage;
(3) Automobile liability insurance; and
(4) Professional liability insurance, identifying the city and its agents as additional insured parties, with a company authorized to do business in the state and approved by the City Attorney, in amounts not less than $500,000 on account of injury to or death of one or more persons, and $100,000 for damage to or destruction of property.
(B) Each permittee shall furnish the permit officer a valid certificate of insurance showing compliance with this section and any such policy shall contain the usual non-cancellation clause, except upon 30-days’ advance written notice to the city.
(1998 Code, § 46-36) (Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
(A) The holder of a transfer ambulance service permit shall submit to the permit officer, on such forms as may be prescribed for the purpose, a report setting forth the fact of the occurrence of either of
the following events and fully setting forth all circumstances surrounding the event, such report to be submitted within 24 hours following the event:
(1) A non-emergency transfer became an emergency situation suddenly and without warning;
(2) A death occurred during the course of a non-emergency transfer; and/or
(3) A permitted vehicle became involved in a traffic accident.
(B) The holder of a non-emergency ambulance permit shall submit a response summary for all activities in the city to the city annually at the close of each permitted year. In addition, the permittee shall be subject to operational and medical audits conducted by the city.
(C) Any hospital site including a free-standing emergency room operating under § 35.03(B) shall submit a monthly response summary for all activities in the city to the Permit Officer.
(D) The holder of an emergency ambulance permit shall submit to the permit officer, on such forms as may be prescribed for the purpose, a copy of all response reports setting forth all circumstances surrounding the event and applicable patient information and pre-hospital care rendered.
(1998 Code, § 46-38) (Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
The permit officer shall have the following duties:
(A) Receive applications for permits issued pursuant to this subchapter, cause such investigation as he or she deems necessary to be made of the applicant and approve or deny issuance of any permit;
(B) Issue permits authorized under this subchapter upon his or her making the findings required in this subchapter;
(C) Examine or cause to be examined all applications for renewal permits so as to determine that each such applicant is in full compliance with all requirements of this subchapter and the State Department of Health;
(D) Reinspect and reexamine all applications for renewal permits so as to determine that each such applicant is in full compliance with all requirements of this subchapter and the State Department of Health;
(E) Conduct or cause to be conducted an inspection of the ambulance, equipment and business records and the premises from which such ambulance service operates;
(F) When a permit is issued or renewed under provisions of this subchapter, affix one permit to the back window, passenger side, and one to the front window, passenger side, which indicates the vehicle meets all requirements established by this subchapter.
(G) Subject to appeals provided for in this subchapter, revoke or suspend any permit issued pursuant to this subchapter; and
(H) Develop such reasonable regulations subject to the approval of the City Commission as may be necessary for the proper enforcement and implementation of the provisions of this subchapter, and to maintain the highest standard of pre-hospital emergency medical services and delivery thereof.
(1998 Code, § 46-39) (Ord. 14-11, passed 5-21-2014)
(A) It shall be unlawful for any person to furnish, operate, conduct, maintain, advertise or otherwise engage in or profess to be engaged in an ambulance service or the business or service of transporting emergency or non-emergency patients upon the streets, alleys or public ways of the city unless such person holds a valid ambulance service permit issued pursuant to the terms of this subchapter.
(B) Each applicant for an ambulance service permit shall submit application therefor upon such forms as may be prescribed by the permit officer, and in addition shall furnish the following:
(1) Acceptable proof, in binder or other suitable form, that all insurance requirements of this subchapter have been met or will be met upon issuance of the permit; and
(2) A complete listing of the names of personnel who will be employed, together with satisfactory proof that all of such personnel meet the standards of qualifications set forth in the permit and training requirements for ambulance attendants pursuant to the terms of this subchapter and State Department of Health.
(3) Acceptable proof that provider is licensed with the State Department of Health as an EMS provider.
(1998 Code, § 46-40) (Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
Penalty, see § 35.99
(A) It shall be unlawful for any person to drive or operate any ambulance vehicle upon the public streets, alleys or other public ways of the city unless such vehicle shall have lawfully affixed thereto a valid ambulance vehicle permit issued pursuant to the terms of this subchapter for all vehicles utilized, deployed, housed or stationed in the city.
(B) Each applicant for an ambulance vehicle permit shall submit application therefor upon such forms as may be prescribed by the permit officer, together with satisfactory proof of compliance with the requisites of Tex. Rev. Civ. Stat. Art. 4590b, and all other applicable state statutes.
(C) Each permit holder shall maintain a minimum of six permitted ambulances.
(1998 Code, § 46-41) (Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
Penalty, see § 35.99
(A) Upon payment of the fee prescribed therefor, and after the applicant has complied with all provisions of this subchapter, the permit officer shall be authorized to issue the permit applicant a permit under this subchapter upon finding to his or her satisfaction and ascertaining that:
(1) The public convenience and necessity require the proposed ambulance service;
(2) Each ambulance and its required equipment meet acceptable standards set forth by applicable state statutes and this subchapter;
(3) The applicant demonstrates an acceptable standard of responsibility for conducting or for being employed in furnishing ambulance service; and
(4) Operating a service with an expired permit constitutes a violation of this subchapter.
(B) Permits issued pursuant to this subchapter shall be renewable on an annual basis upon the applicant’s compliance with all requirements of this subchapter, including payment of the fees required in this subchapter.
(1) Annual renewal applications may be submitted to the Department between December 1 and January 31 of each year.
(2) A company that fails to renew their permit before January 31 of each year shall have their permit declared vacant and the company removed from the transfer service rotation master list.
(3) Should more companies apply for a vacant service permit than available a lottery drawing shall be implemented.
(C) In the event of a vacancy during the permit period, the Permit Officer shall be authorized to issue a permit for the remainder of the year to another provider by advertisement for a two-week period and should more companies apply for the permit vacancy than available a lottery drawing shall be implemented.
(1998 Code, § 46-43) (Ord. 14-11, passed 5-21-2014; Ord. 2022-12, passed 7-6-2022)
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