COMMITTEE SUBSTITUTE FOR ORDINANCE NO. 030376
Amending section 34-362,
code of ordinances, entitled Prehospital emergency medical services system
definitions by defining the metropolitan ambulance services trust to include
any successor not-for-profit corporation to MAST; and authorizing the termination
of the MAST trust indenture dated September 11, 1979, for the purpose of
allowing MAST to change its form from a trust to a not-for-profit corporation;
and approving the substitution of the Metropolitan Ambulance Services Trust
Corporation for the Metropolitan Ambulance Services Trust in all contracts,
grants, or agreements between the City and the Metropolitan Ambulance Services
Trust.
WHEREAS, the
Metropolitan Ambulance Services Trust was established through a Trust Indenture
dated September 11, 1979, for the purpose of providing prehospital emergency
medical services to Kansas City, and the metropolitan area; and
WHEREAS, the
legal character of MAST is unique in Missouri local government; and
WHEREAS, the
Metropolitan Ambulance Services Trust Indenture provides that MAST was
established to exist for the term of duration of the beneficiary and until
such time as its purpose shall have been fulfilled or until it shall be
terminated as hereinafter provided; and
WHEREAS,
opportunities for funding and support from agencies and groups outside the City
are available for ambulance services, but that the unique character of MAST as
a trust has precluded participation in those funding sources; and
WHEREAS, MAST and
the City have learned that no source of support for the ambulance system should
be ignored; and
WHEREAS, the
legal character of MAST as a trust or as a not-for-profit corporation does not
alter the mission or functionality of MAST as an integral part of the
prehospital emergency medical services system; NOW, THEREFORE
BE IT ORDAINED BY
THE COUNCIL OF KANSAS CITY:
Section 1. MAST
defined to include a successor not-for-profit corporation. That section 34-362,
code of ordinances, is amended to read as follows:
Sec. 34-362. Definitions.
The following
words, terms and phrases, when used in this article, shall have the meanings
ascribed to them in this section, except where the context clearly indicates a
different meaning:
Ambulance
means any motor vehicle equipped with facilities to convey infirm or injured
persons in a reclining position.
Ambulance
control center means a single facility designated by MAST as the central
communications center from which all ambulances operating in the city subject
to regulations pursuant to this article shall be dispatched and controlled at
all times.
Ambulance
dispatcher means a paramedic certified to dispatch ambulances, and is also
known as a system status controller.
Ambulance
operations contractor means the entity secured by MAST to provide
prehospital
emergency medical services
and transport of patients by ambulance.
Attendant
means a person assigned to provide prehospital emergency medical services to
patients, and includes a first responder, EMT, paramedic, or other authorized person
such as a mobile emergency nurse.
Base station
physician means a physician licensed to practice medicine in the state,
knowledgeable in the medical protocols, radio procedure and general operating
policies of the city emergency medical services system, and a person from whom
attendants may take medical direction.
Emergency
medical services advisory committee means the committee authorized to serve
as an advisory committee to the director of health on all issues affecting the
prehospital emergency medical services system.
Emergency
medical technician (EMT) means a person licensed by the state as an
emergency medical technician, and licensed by the director of health. There may
be multiple levels of EMT licensure.
Emergency
physician advisory board (EPAB) means the board empowered to recommend
various standards, rules and regulations for the operation of the emergency
medical system, and to perform medical audits.
Emergency
physicians foundation (EPF) means a professional and charitable organization
composed of and controlled by full-time emergency physicians presently serving
in an advisory capacity to the director of health.
First
responder means any person or unit capable of providing the appropriate
emergency care, as evidenced by current licensure as designated by regulation
of the director of health.
Helicopter
rescue unit means any rotary wing aircraft providing basic or advanced
emergency medical service and transportation.
KCFD EMT first
responder means an employee of the fire department licensed by the director
of health as an EMT first responder to provide prehospital emergency medical
services to patients.
KCFD first
responder means an employee of the fire department licensed by the director
of health as a first responder to provide prehospital emergency medical
services to patients.
Life-threatening
emergency means a situation posing immediate threat to human life or of
long-term disability, including but not limited to acute respiratory distress,
shock, airway blockage, bleeding beyond control, acute poisoning, acute
cardiovascular distress or central nervous system injury.
Medical audit
means an official inquiry into the circumstances involving an ambulance or
first responder incident or request for service, usually conducted by the EPAB
or an EPAB subcommittee.
Medical
control means direction given prehospital EMS personnel by a base station
physician through direct voice contact, with or without vital sign telemetry,
as required by applicable medical protocols approved by the director of health.
Medical
protocol means any diagnosis-specific or problem-oriented written statement
of standard procedure, or algorithm, approved by the director of health as the
normal standard of pre-hospital care for a given clinical condition.
Metropolitan
ambulance services trust (MAST) means the entity established to oversee and
manage the operation of the ambulance transport service system, including any
successor not-for-profit corporation established for the same purposes with the
consent of the city.
Mobile
emergency nurse means a registered nurse licensed by the state,
knowledgeable of advanced life support ambulance care and certified by the
director of health as a mobile emergency nurse.
Mutual aid
call means a request for emergency ambulance service issued by an ambulance
dispatcher in one political jurisdiction to an ambulance dispatcher or
ambulance crew normally operating in a neighboring jurisdiction with a licensed
ambulance system.
Paramedic
means a person licensed by the state as a paramedic and licensed by the
director of health as knowledgeable of and competent to perform advanced life
support procedures and the medical protocols established by the director of
health. There may be multiple levels of paramedic licensure.
Patient
means any person who is ill, injured or otherwise incapacitated, bedridden or
helpless and who requires or requests ambulance services.
Public utility
model means that strategy for the organization, financing, management and
regulation of ambulance transport service operation which employs the use of a
single level of advanced life support capability for the conduct of all
emergency and nonemergency service within a geographical area, including
mechanisms of payment which neutralize the "fee-for-service
incentive" to overserve or underserve any given patient or geographic
area, optimum economics of scale to spread fixed costs of sophisticated
ambulance service operations over a wider range of production, competitive
procurement of facilities management services from a qualified private firm,
financing strategies which minimize or allow minimization of local tax subsidy,
ownership or direct control of all major systems hardware by the public sector,
and other features intended to promote clinical excellence, reliable response
time performance, disaster readiness, long range stability of service and cost
containment.
Response time
means the actual elapsed time between receipt of notification at the dispatch
point that an ambulance or first responder unit is needed at a location and the
arrival of that ambulance or first responder unit at the location.
Senior EMS
provider in charge means that individual responding to an incident holding
the highest level of city licensure, as designated by regulation of the
director of health.
Special use
permit means a permit issued by the director of health to hospitals, and
other institutions serving the public, for the provision of specialized mobile
intensive care services.
Specialized
mobile intensive care services means services provided to patients, as
defined in regulations promulgated by the director of health, being transported
between hospitals and other health care institutions, whose critical conditions
necessitate the use of specially equipped mobile intensive care units crewed by
specialized teams of health care personnel, whose clinical capabilities exceed
the capabilities of advanced life support ambulance crews.
Section 2.
Finding that purposes of MAST have been fulfilled. That MAST has served as the
seminal element of the ambulance system since its inception, but that MAST has
the potential to secure alternative sources of funding and support only if it
is not organized as a trust. Termination of the trust under the terms of
Article IX of the Trust Indenture is not appropriate since the work of MAST,
and its obligations and rights are not intended to be ended, but MAST is
intended to continue its role in the prehospital emergency medical services
system as a not-for-profit corporation. Therefore, the Council finds that the
purpose of MAST has been fulfilled since it has reached the end of its
potential for continuing to participate in the provision of prehospital
emergency medical services with new and alternative sources of funding, since
those sources of funds are available only to not-for-profit institutions.
Section 3.
Approval of establishment of a not-for-profit corporation. The important factor
in the prehospital emergency medical services system is that high quality
service is provided to all citizens at the best cost possible. The organization
of MAST as a trust does not provide benefits to the public that are not
available if MAST is organized as a not-for-profit corporation. The
organization of MAST as a not-for-profit corporation provides benefits to the
public that are not available to MAST if it is organized as a trust. Therefore,
the Council approves of the establishment of the Metropolitan Ambulance
Services Trust Corporation to assume all rights, responsibilities and
liabilities of the current Metropolitan Ambulance Services Trust.
Section 4.
Approval contingent on specific elements of a corporate structure. The approval
for the transformation of MAST from a trust to a not-for-profit corporation is
contingent on the corporation retaining the following basic elements:
A. The
corporation shall be a not-for-profit corporation which is tax exempt under the
terms of section 501(c)(3) of the Internal Revenue Code.
B. Upon
dissolution of the corporation all available assets will be transferred
pursuant to a plan of distribution to the City of Kansas City, Missouri.
C. No
agreement with any jurisdiction outside the City of Kansas City, Missouri, will
reduce or otherwise adversely affect the level of services provided to the
people of Kansas City, Missouri.
D. At
least seven directors will constitute the Board of Directors. These seven
directors will be appointed by the Mayor of Kansas City, Missouri.
E. Directors
appointed by the Mayor of Kansas City, Missouri will hold these minimum
qualifications:
1. Two elected members of the Kansas City,
Missouri, City Council.
2. Two licensed physicians, clinically
experienced and currently involved in the full-time practice of emergency medicine.
3. One person experienced in health care
administration or public administration.
4. One person with a background in finance and
banking.
5. One licensed attorney with a background in
legal aspects of the health care industry.
F. The
Kansas City, Missouri, director of health and director of finance are ex
officio members of the Board of Directors.
G. The
number of directors will not be expanded by the board beyond nine voting
members without the approval of the Mayor of Kansas City, Missouri.
Section 5.
Substitution of MAST Corporation for MAST. Effective upon the incorporation of
the Metropolitan Ambulance Services Trust Corporation and the acceptance by the
Corporation of all rights, responsibilities and liabilities held by the
Metropolitan Ambulance Services Trust, the City authorizes and approves the
continuance of all contracts, grants, agreements or other legal obligations
between the City and MAST by the Metropolitan Ambulance Services Trust
Corporation without further approval or action of the City Council or any
officer, official, employee or department.
_______________________________________________________
Approved
as to form and legality:
____________________________________
Assistant
City Attorney