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Legislation #: 010200 Introduction Date: 2/1/2001
Type: Ordinance Effective Date: none
Sponsor: None
Title: Repealing Chapter 34 Article IX, Code of Ordinances entitled "Ambulance Service" and enacting a new Chapter 34 Article IX entitled "Prehospital Emergency Medical Services System" to implement the recommendations of the City ManagerĀ“s Special EMS Review Committee and of the City Auditor by increasing the authority of the director of health to control elements of the system; establishing a more defined first responder system in the fire department; establishing a 16-member Emergency Medical Services Advisory Committee; requiring the use of MAST at special events in City buildings when stand-by medical care is appropriate; and authorizing the City Manager to enter into negotiations with appropriate labor union representatives to implement aspects of the prehopsital emergency medical services system which may be subject to a Memorandum of Understanding.

Legislation History
DateMinutesDescription
2/1/2001

Prepare to Introduce

2/1/2001

Referred Finance and Audit Committee

2/7/2001

Hold On Agenda

2/20/2001

Hold for Substitute

2/28/2001

Do Pass as a Committee Substitute

3/1/2001

Assigned to Third Read Calendar

3/8/2001

Passed as Substituted


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COMMITTEE SUBSTITUTE FOR ORDINANCE NO. 010200

 

Repealing Chapter 34 Article IX, Code of Ordinances entitled Ambulance Service and enacting a new Chapter 34 Article IX entitled Prehospital Emergency Medical Services System to implement the recommendations of the City Managers Special EMS Review Committee and of the City Auditor by increasing the authority of the director of health to control elements of the system; establishing a more defined first responder system in the fire department; establishing a 16-member Emergency Medical Services Advisory Committee; requiring the use of MAST at special events in City buildings when stand-by medical care is appropriate; and authorizing the City Manager to enter into negotiations with appropriate labor union representatives to implement aspects of the prehopsital emergency medical services system which may be subject to a Memorandum of Understanding.

 

BE IT ORDAINED BY THE COUNCIL OF KANSAS CITY:

 

Section 1. That Chapter 34, Article IX, Code of Ordinances, entitled Ambulance Service is repealed, and a new Chapter 34, Article IX, Code of Ordinances, entitled Prehospital Emergency Medical Services System is enacted to read as follows:

 

CHAPTER 34 - HEALTH

ARTICLE IX. PREHOSPITAL EMERGENCY MEDICAL SERVICES SYSTEM

 

CONTENTS

 

Sec. 34-361. Purpose of article.

 

Sec. 34-362. Definitions.

 

Sec. 34-363. Required permits and licenses.

(a) Personnel.

(b) Ambulances.

(c) Helicopter rescue units.

 

Sec. 34-364. Issuance of permits and licenses; suspension or revocation.

(a) Personnel.

(1) Application.

(2) Probationary license.

(3) Criteria for issuance.

(4) Duty to maintain qualifications.

a. Duty to report loss of qualifications

b. Unlawful to continue to work without current qualifications

(b) Ambulances and helicopter rescue units.

(1) Application.

(2) Criteria for issuance.

(c) Suspension or revocation.

(1) Case review.

(2) Medical director options.

(3) Information to the EPAB.

(4) EPAB options.


(5) Director of health options - no substantial risk of harm.

(6) Director of health options - substantial risk of harm.

(7) Director of health options to suspension or revocation.

(8) Ambulances and helicopter rescue units.

(d) Term; renewal.

(1) Permits and licenses.

(2) Deadline to renew.

(e) Appeals.

 

Sec. 34-365. Powers and duties of director of health.

(a) Role of the director of health.

(b) Promulgation of regulations, standards and rules.

(1) Authority to promulgate.

(2) Standards.

(3) EPAB and EMSAC involvement.

(4) Areas of rulemaking.

(c) Delegation of authority.

(d) Disaster planning and protocol development.

(1) Plan required.

(2) EMS control center.

(e) Public health education and research.

(1) Coordination of activities.

(2) Prevention programs.

(3) Pilot programs.

(f) In-service training.

(1) Training program required.

(2) Mandatory training.

(3) Required areas of training.

(4) Access to training.

(5) Integrated training.

(6) Providers.

(7) Training fees.

(g) Approvals.

(1) Communications systems.

(2) Rates.

(h) Issuance of permits and licenses.

(i) Reports.

(1) Performance Reports.

a. Required information to the director of health by system participants

b. Failure to provide information.

(2) Annual report.

(3) Response time reports.

(4) System financing reports.

Sec. 34-366. Powers and duties of metropolitan ambulance services trust.

(a) Generally.

(b) Procurement of labor and management services.

(1) Authority.

(2) Procedure for securing operations contractor.

a. Determination of market conditions.

b. Selection of method.

c. Decision by city review committee.

(3) Length of contract.

(4) Competitive bidding.

a. Invitation for bids.

b. Performance bonds.

c. Criteria for evaluation.

(c) Ownership of equipment.

(d) Determination of rates; billing and collections.

(e) Records and premises to be open to inspection.

(f) Recommendations to the director of health.

(g) Annual report.

(h) Authority to act as temporary operations contractor.

(i) Contracts for mutual aid and shared services.

 

Sec. 34-367. First responders.

(a) First responder system established.

(1) Primary role of the fire department.

(2) First responder staffing.

(b) Staffing phases.

(1) AED.

(2) EMT.

(3) Advanced life support EMT.

(4) Development of plan to certify as KCFD EMT First Responders all members of the fire department uniformed service.

(c) Medical protocols.

(d) Response time reports.

(e) Medical records.

(f) Expanded first responder system.

 

Sec. 34-368. Emergency physicians advisory board.

(a) Generally.

(b) Appointments to emergency physicians advisory board.

(1) Establishment.

(2) Filling of vacancies; term of office.

(3) Officers.

(c) Recommendations to director of health.

 


(d) Medical audits.

(1) Requests for case audits.

(2) Diagnosis-specific quality improvement review

(e) Annual report.

 

Sec. 34-369. Medical director.

(a) Appointment.

(b) Expenses.

(c) Delegation of duties.

(d) Assistant to the medical director.

(e) Responsibilities.

 

Sec. 34-370. Emergency medical services advisory committee

(a) Established.

(b) Appointments to emergency medical services advisory committee

(1) Membership.

(2) Term.

(3) Officers.

(c) Recommendations to director of health.

(d) Annual report.

(e) Staff.

 

Sec. 34-371. Response time.

(a) Ambulance response.

(b) First responder.

(c) Response time exceptions.

(d) Response time equity.

(e) Ambulance operations contract requirements.

(f) Financial penalties.

(g) Response time forgiveness.

(h) Counting time.

 

Sec. 34-372. System communication and dispatch.

(a) Performance standards.

(b) System clock synchronization.

(c) Integration of GIS / CAD functions.

(d) Time measurement standards.

 

Sec. 34-373. Exemption of ambulances from traffic regulations.

(a) Traffic laws inapplicable.

(b) Use of lights and siren.

(c) Application to first responders, medical director, supervisors

(d) Safety of all persons.

 

Sec. 34-374. Patient and scene management.

(a) Patient management.

(b) Scene management.

(c) Assumption of medical control by physician.

(d) Retention of medical control by other care providers.

 

Sec. 34-375. Destination determination.

(a) Life-threatening emergency.

(b) Non-life-threatening emergency.

 

Sec. 34-376. Exemptions from article.

(a) Article not applicable.

(1) United States.

(2) Request of MAST.

(3) Certain intercity transfers.

(4) Use by employees.

(5) Private non-for-hire use.

(6) MAST specialized mobile intensive care services.

(b) Request for exemption.

 

Sec. 34-377. Special events coverage.

 

Sec. 34-378. Violation of article; penalty.

(a) Violations.

(1) System participant.

(2) Permit unqualified persons to participate.

(3) Use unlawful service.

(4) Provide service without authorization.

(5) False information to dispatch resources.

(b) Penalty.

 

Sec. 34-379 - Sec. 34-400. Reserved.

 

 

ARTICLE IX. PREHOSPITAL EMERGENCY MEDICAL SERVICES SYSTEM

 

Sec. 34-361. Purpose of article.

 

It is the purpose of this article to complete the integration of the emergency medical system for the provision of a public utility ambulance transport system and a first responder service through the designation of specific responsibilities to the major components of the system, the director of health, the director of fire, the metropolitan ambulance services trust (MAST) and the emergency physicians advisory board (EPAB) and the Emergency Medical Services Advisory Committee (EMSAC), and to set forth the authority of the director of health over all segments of patient care of the prehospital emergency medical services system.

 

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:

 

(a) Ambulance means any motor vehicle equipped with facilities to convey infirm or injured persons in a reclining position.

 

(b) 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.

 

(c) Ambulance Dispatcher means a paramedic certified to dispatch ambulances, and is also known as a system status controller.

 

(d) Ambulance operations contractor means the entity secured by MAST to provide prehospital emergency medical services and transport of patients by ambulance.

 

(e) 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.

 

(f) 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.

 

(g) 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.

 

(h) 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.

 

(i) 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.

 

(j) 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.

 

(k) 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.

 

(l) Helicopter rescue unit means any rotary wing aircraft providing basic or advanced emergency medical service and transportation.

 

(m) 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.

 

(n) 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.

 

(o) 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.

 

(p) 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.

 

(q) 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.

 

(r) 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.

 

(s) Metropolitan ambulance services trust (MAST) means the entity established to oversee and manage the operation of the ambulance transport service system.

 

(t) 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.

 

(u) 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.

 

(v) 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.

 

(w) Patient means any person who is ill, injured or otherwise incapacitated, bedridden or helpless and who requires or requests ambulance services.

 

(x) 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.

 

(y) 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.

 

(z) 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.

 

(aa) 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.

 

(bb) 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.

 

Sec. 34-363. Required permits and licenses.

 

(a) Personnel. No person in the ambulance transport system shall be employed as an attendant, ambulance dispatcher, or other position established by the director of health through regulation and regulated by this article unless the person holds a license issued by the director of health. No person employed by the city shall be assigned or responsible for any patient care activity unless licensed by the director of health. Those persons not employees of the City will also pass an approved physical examination.

 

(b) Ambulances. No ambulance regulated by this article shall be used to provide any ambulance service unless it has been issued a permit by the director of health.

 

(c) Helicopter rescue units. No helicopter rescue unit regulated by this article shall be used to provide any emergency medical service unless it has been issued a permit by the director of health.

 

 

Sec. 34-364. Issuance of permits and licenses; suspension or revocation.

 

(a) Personnel.

 

(1) Application. Applications for licensure as an attendant, dispatcher, first responder, or other positions established by the director of health through regulation, shall be made on forms supplied by the director of health. Applications filed for licensure as a system intern or by those not working within the ambulance system as an employee of the operations contractor, MAST, or the City, shall also be made on forms supplied by the director of health and accompanied by a nonrefundable application charge of $30.00. Nothing in this article shall be construed as requiring the city to be responsible for the cost of any required physical examination. All city employees will be waived from the application fee.

 

(2) Probationary license. The director of health shall issue probationary licenses, except that those presently holding a valid license shall not be required to obtain a probationary license prior to issuing full licenses.

 

(3) Criteria for issuance.

 

a. The director of health shall promulgate regulations setting forth the requirements to obtain a license as an attendant, dispatcher, first responder, or other positions established by the director of health through regulation. The requirements shall include appropriate licensure by the state and an examination testing the applicants knowledge of local medical protocol, special disaster procedures, the city prehospital emergency medical services system in general, and other matters appropriate to determining the applicants fitness. A practical skills examination may also be required.

 

b. All ambulance drivers must maintain certification under the National Registry of EMTs as an EMT or paramedic.

 

c. All ambulance paramedic attendants and dispatchers must maintain certification under the National Registry of EMTs as a paramedic.

 

(4) Duty to maintain qualifications.

 

a. Report of loss of qualifications. A license holder must report to their employer and the director of health whenever the license holder fails to maintain a qualification required for the persons license. A plan of action to regain the expired qualification must also be provided to the director of health at the time of the report.

 

b. Unlawful to continue to render patient care without current qualifications. It is unlawful to render patient care if a required qualification for the position is lost during the period of city license.

 

(b) Ambulances and helicopter rescue units.

 

(1) Application. Applications for permits shall be made on forms supplied by the director of health.

 

(2) Criteria for issuance.

 

a. The director of health shall promulgate regulations setting forth the requirements to obtain a permit for any ambulance or helicopter rescue unit regulated by this article, including special use permits. Helicopter rescue units shall not be subject to regulation of onboard equipment or personnel. Helicopter rescue units shall agree to submit to control by the EMS control center when in the city and not already dispatched to a noncity call. They shall be subject to medical audits.

 

b. Only ambulances meeting at least minimum state requirements and capable of full advanced life support service may receive a permit. Unless the vehicle is owned or leased by MAST, or by an exempt person as described in section 34-376, no permits may be issued.

 

(c) Suspension or revocation. The director of health is authorized to revoke or suspend any permit or license issued pursuant to the provisions of this article if the attendant, dispatcher, first responder, any other positions established by the director of health through regulation, ambulance or helicopter rescue unit fails to maintain the basic qualifications for issuance or otherwise constitutes a danger to the safety and health of patients.

 

(1) Case review. Prior to revocation or suspension of a license, a medical case review or other investigation shall be conducted by the medical director or the directors designee.

 

(2) Medical director options. If the review or investigation results in a recommendation that the license of an attendant, dispatcher, first responder, or other position established by the director of health through regulation, license should be revoked or suspended, the report shall be forwarded to the EPAB or a committee designated by the chairperson of the EPAB for that purpose, for its consideration. If the medical director determines that lesser measures such as additional educational requirements or return to probationary status for a specific period of time with an ongoing review of performance, may appropriately address the identified deficiencies in the persons performance, that determination shall also be submitted to the EPAB or a committee designated by the chairperson of the EPAB for its review.

 

(3) Information to the EPAB. The affected person shall be invited to provide information to the EPAB or a committee designated by the chairperson of the EPAB for consideration. The failure to provide requested information may be considered by the EPAB or committee considering the incident as adverse to the affected person.

 

(4) EPAB options. If the EPAB or a committee designated by the chairperson of the EPAB determines that measures other than suspension or revocation may address the deficiencies in the persons performance, it may impose those requirements. A report of any action will be forwarded to the director of health, and in the case of a fire department first responder to the director of fire and in the case of an employee of the operations contractor to the contractor and MAST. If the EPAB or a committee designated by the chairperson of the EPAB recommends revocation or suspension, a report shall be made to the director of health, and in the case of a fire department first responder to the director of fire and in the case of an employee of the operations contractor to the contractor and MAST. This report shall be in writing. A person may request in writing a hearing before the director of health to challenge any measure imposed by the EPAB or a committee designated by the chairperson of the EPAB.

 

(5) Director of health options - no substantial risk of harm. The director of health may, based upon the results of the review or investigation of the medical director and the proceedings of the EPAB or a committee designated by the chairperson of the EPAB, order a suspension or revocation of a license. In the case of a fire department first responder notice of the action will be provided to the director of fire and in the case of an employee of the operations contractor to the contractor and MAST. Absent a finding that the risk of harm to the public is substantial, the suspension or revocation will become effective no sooner than ten days from the notice of suspension or revocation. If during the time period established by the director of health in the notice of suspension or revocation, the person requests in writing a hearing, a hearing will be held before the director of health. Absent a finding by the director of health that a risk of harm to the public is substantial, the license shall remain in effect until a decision at the hearing is announced, and that suspension or revocation is ordered.

 

(6) Director of health options - substantial risk of harm. If the director of health determines that the risk of harm to the public is substantial, that decision will be transmitted to the affected person and in the case of a fire department first responder to the director of fire and in the case of an employee of the operations contractor to the ambulance operations contractor and MAST. If that decision is transmitted orally by the director of health or any other person delegated that duty by the director of health, written suspension or revocation will be presented to the affected person within three days. If a hearing is requested, the hearing shall be scheduled to convene within seven days of the persons request for a hearing.

 

(7) Director of health options to suspension or revocation. In lieu of suspension or revocation, the director of health may return the nonprobationary license holder to probationary status, or reduce the level of licensure. Lesser measures, such as those contemplated by subsection (c)(2) of this section, may also be imposed by the director of health. A person may request in writing, within ten days from the notice of the directors actions, a hearing before the director of health to challenge any of these lesser actions imposed by the director of health. Notice of these lesser actions will be provided to the operations contractor and MAST or the director of fire.

 

(8) Ambulances and helicopter rescue units. Permits issued by the director of health may be suspended or revoked by the director of health when the conditions allowing the issuance of a permit no longer exist. The director will establish by regulation a procedure to consider the suspension or revocation of a permit.

 

(d) Term; renewal.

 

(1) Permits and licenses. All licenses issued pursuant to this article shall be valid for a period of five years from date of issuance, except that a lesser time may be established by the director of health for system interns to coincide with their period of study. Permits for ambulance and helicopter rescue units will be issued for a period of one year.

 

(2) Deadline to renew. It shall be the responsibility of a permit or license holder to apply for a new permit or license no later than 30 days prior to expiration of the current permit or license. The failure to renew a license by the expiration date renders the license expired. An expired license is neither a revoked or suspended license, but is the absence of a license. It is unlawful for any person to render patient care after a license has expired.

 

(e) Appeals. Adverse decisions of the director of health may be appealed pursuant to the provisions of the Missouri Administrative Procedure and Review Act, RSMo Chapter 536, to the circuit court.

 

Sec. 34-365. Powers and duties of director of health.

 

(a) Role of the director of health. The director of health shall be the primary regulator of the prehospital emergency medical services system defined by this article.

 

(b) Promulgation of regulations, standards and rules.

 

(1) Authority to promulgate. The director of health shall have the authority to promulgate regulations, standards and rules necessary to implement the policy and intent of this article. They shall constitute one volume, to be filed in the office of the city clerk.

 

(2) Standards. The director of health shall consider but not be limited to the following factors when promulgating regulations, standards and rules:

 

a. The protection of the safety and health of the inhabitants of the city;

 

b. Accepted standards of practice for emergency medical care;

 

c. Accepted requirements for equipment and supplies to provide basic and advanced life support services;

 

d. Federal and state requirements; and

 

e. Standards and recommendations of federal, state and local professional organizations interested in the provision of quality emergency medical care.

 

(3) EPAB and EMSAC involvement. When promulgating regulations, standards and rules, the director of health shall provide to the emergency physicians advisory board and the emergency medical services advisory committee proposed changes for their recommendations and comments.

 

(4) Areas of rulemaking. The director of health shall promulgate standards controlling the following segments of the prehospital emergency medical services system:

 

a. Production standards related directly or indirectly to clinical performance and patient care, including ambulance response time and effectiveness of all other segments of the prehospital emergency medical services system;

 

b. Diagnosis-specific and problem-oriented medical protocols to serve as the required standard of pre-hospital emergency care;

 

c. Procedures governing the reliable provision of 24-hour medical control;

 

d. Procedures and protocols for the operation of ambulance control centers, which may include but shall not be limited to radio protocols, telephone protocols and other operating standards, and other parts of the prehospital emergency medical services system responsible for communications;

 

e. Procedures for the provision of medical control over the delivery of basic and advanced life support procedures by ambulance personnel and first responders, which may include but shall not be limited to medical control communications standards, radio protocol, medical protocol, and qualifications of base station physicians or emergency department nurses from whom emergency medical personnel may take direction.

 

f. Types and frequency of reports required of participants in the prehospital emergency medical services system to be submitted to the director of health.

 

(c) Delegation of authority. The director of health may delegate functions, but the director shall remain responsible for compliance with this article.

 

(d) Disaster planning and protocol development. The director of health shall be included in planning and protocol development as part of the city's disaster planning processes.

 

(e) Public health education and research.

 

(1) Prevention programs.

 

a. The director of health will identify issues in prehospital emergency medical services, including accident and disease prevention and system availability, requiring additional study and public education. Programs to address the identified issues will be implemented.

 

b. Studies of the probable impact on the public health of the education programs will be conducted.

 

(2) Pilot programs.

 

a. The director of health may conduct other pilot programs to investigate alternative methods of delivering prehospital emergency medical services.

b. The director of health is authorized to develop with the director of fire a pilot program utilizing advanced life support personnel and resources on fire department equipment in difficult to serve areas of the City when qualified personnel and resources are available to support a pilot program. The pilot program will not be included in normal response time calculations measuring ordinance or regulation standards. The director of health may modify response times for ambulance units based upon the delivery of advanced life support first responders. The pilot program will include a study to determine any clinical benefit or detriment to patients.

 

(f) In-service training.

 

(1) Training program required. Components of the prehospital emergency medical services system will establish in-service training programs approved by the director of health for medical personnel, including an attendant, dispatcher, first responder, or other position established by the director of health through regulation.

 

(2) Mandatory training. Maintenance of required licenses will be contingent on the successful completion of in-service training programs.

(3) Required areas of training. In-service training shall include system orientation and management issues, medical audit findings and review, and clinical skill development.

 

(4) Access to training. In-service training shall be scheduled to permit all employees to fulfill their mandatory obligations to attend.

 

(5) Integrated training. When appropriate for the specific training issues, all participants in the prehospital emergency medical services system should have opportunities to study and work in an integrated training program.

 

(6) Providers. Training programs may be operated through the City, schools, hospitals, or other alternative sources of training. Training programs will be conducted under the medical direction and oversight of the director of health through the medical director and the EPAB.

 

(7) Training fees. The director of health is authorized to establish a user fee, not to exceed the cost of training, that may be assessed against the operations contractor for the Citys assumption of its training functions.

 

(g) Approvals.

 

(1) Communications systems. The director of health shall approve the dispatch communications system and the medical control communications system established by MAST and shall be consulted by the fire department to establish close cooperation between the ambulance and first responder medical control communications systems. In reviewing the medical control communications system, the EPAB shall be consulted. Nothing in this section shall prevent the director of health from promulgating regulations or standards concerning EMS communications systems.

 

(2) Rates. The director of health shall have the authority to forbid MAST to bill at a rate deemed too high after considering the public safety, health and welfare and the economic needs of MAST to provide quality ambulance service.

 

(h) Issuance of permits and licenses. The director of health shall issue permits and licenses consistent with the provisions of section 34-363 and section 34-364.

 

(i) Reports.

 

(1) Performance Reports. The director of health shall prepare quarterly reports of the performance of all segments of the prehospital emergency medical services system based upon monthly reports of providers of services to the prehospital emergency medical services system and other information available to the director.

 

a. Required information to the director of health by system participants. The director of fire, operations contractor, MAST, and other participants in the prehopsital emergency medical services system, such as the director of aviation, will provide to the director of health on a periodic basis established by the director of health information required for the quarterly reports. Monthly response times and exception reports for the operations contractor will be included. Additional information provided to the director of health will be designated by the director of health based upon the informations relevance and importance to allow persons to understand the current operation of the system and to determine appropriate areas for improvement.

 

b. Failure to provide information. The failure to receive information for the required quarterly reports will not be a justification to delay issuance of the required reports. The director of health will note in the quarterly report the failure of the system participant to provide the information.

 

(2) Annual report. The director of health shall report annually to the mayor and council the status of the prehospital emergency medical services system, including but not limited to the financial condition of MAST, the subsidy supplied by the city, audits of cases, recommendation for improvement, and regulations promulgated during the year. This report shall incorporate the reports of the EPAB, EMSAC, fire department, KCPD, and MAST made to the director of health.

 

(3) Response time reports. The director of health shall establish prehospital emergency medical services system districts for the purpose of reporting response times by all agencies responding to a call for service, including the operations contractor. The districts will be established in consultation with MAST and the director of fire to endeavor, insofar as possible, that reporting districts are workable for each component of the prehospital emergency medical services system.

 

(4) System financing reports. The director of health shall closely monitor federal and state legislative and administrative actions that may affect the level of reimbursement paid to the participants of the prehospital emergency medical services system by the federal or state governments. The mayor, city council, and city manager will be informed of proposed modifications to the reimbursement expected by MAST and other components of the prehospital emergency medical services system.

 

Sec. 34-366. Powers and duties of metropolitan ambulance services trust.

 

(a) Generally. It shall be the duty of MAST to oversee and manage the ambulance / transport component of the prehospital emergency medical services system to provide quality advanced life support single tier ambulance service to all inhabitants of the city.

 

(b) Procurement of labor and management services.

 

(1) Authority. MAST shall contract for the supply of all labor and management services for the operation of its control center and its direct ambulance operations. MAST may obtain an operations contractor through competitive bidding, or through a negotiated process as described in subsection (b)(2) of this section. MAST shall utilize whichever of the procurement methods is more likely to ensure better service for lower cost.

 

(2) Procedure for securing operations contractor.

 

a. Determination of market conditions. MAST shall conduct a study of market conditions to determine the current total annual amount paid to each ambulance operations contractor in all metropolitan units of government that utilize the public utility model to provide and regulate ambulance service. The study shall also break down such amounts on a per capita and per transport basis. The study shall include findings regarding the clinical capability and response time reliability of the ambulance operations contractors and any significant differences between their contractual obligations and the contractual obligations of MASTs current ambulance operations contractor. It also shall include similar information for the ambulance services of any additional units of government recommended by the director of health for inclusion in such a study because of their reputation for high-quality clinical care, quick response time reliability and cost-effectiveness.

 

b. Selection of method. After completing the study of market conditions, MAST shall determine whether competitive bidding or a negotiated process is more likely to ensure better service for lower cost. If MAST is unsuccessful in procuring an operations contractor under terms it deems satisfactory through the method it has selected, MAST may utilize the other method allowed in this section.

 

c. Decision by city review committee. Any contract between MAST and a prospective ambulance operations contractor that is arrived at through a negotiated process rather than through competitive bidding shall be presented by MAST to a city review committee comprised of the director of health, the director of finance and the city manager or the city managers designee. MAST also shall present the results of its study of market conditions to the review committee. If the study of market conditions indicates that either substantial cost savings or substantial improvements in service would result from requiring competitive bidding rather than approving the negotiated contract, competitive bidding shall be required by the review committee. If the study of market conditions indicates that the potential cost savings or improvements in service, if any, that could result from competitive bidding are insufficient to warrant the financial and medical risks associated with competitive bidding for ambulance service, the review committee shall approve the negotiated contract. The review committee shall act within 30 days of receipt of MASTs presentation. If it does not act within that time, MAST may approve the negotiated contract. Actions of the review committee shall be by majority vote.

 

(3) Length of contract. MAST is authorized to contract for a term of not more than five years. If MAST determines a contract term of less than five years is in the public interest, but during the course of the contract MAST determines that it is beneficial to the public to extend the contract, an extension of the contract term may be negotiated by MAST without securing the approval of the review committee; provided, however, that the total length of the extended contract shall not exceed five years. Competitive bidding or negotiations to secure a new ambulance operations contract shall occur at least every five years.

 

(4) Competitive bidding.

 

a. Invitation for bids. If competitive bidding is utilized to select an ambulance operations contractor, MAST shall seek bids nationally and shall place advertisements in national trade publications. It shall comply with all applicable city public notice requirements pertaining to competitive bidding.

 

b. Performance bonds. MAST may require performance bonds or similar alternatives to protect the public interest.

 

c. Criteria for evaluation. In evaluating competitive bids, MAST shall consider but not be limited to the protection of the public safety and health by the provision of high-quality pre-hospital emergency care and ambulance service, and cost containment.

 

(c) Ownership of equipment. MAST shall own or be the primary lessee of all major emergency equipment used in supplying ambulance services.

 

(d) Determination of rates; billing and collections.

 

(1) Generally, MAST shall determine reasonable rates, subject to disapproval by the director of health, and shall perform all billing and collection functions.

 

(2) MAST may permit the operations contractor to collect accounts representing long-distance intercity transfer work and special events coverage.

 

(e) Records and premises to be open to inspection. MAST shall maintain its records and premises open to inspection by the director of health.

 

(f) Recommendations to the director of health. MAST shall provide recommendations to the director of health for the following elements of the prehospital emergency medical services system:

 

(1) Dispatch communication system.

 

(2) Medical control communication system.

 

(3) Any other matter requested by the director of health relative to the operation and status of the ambulance service system.

 

(g) Annual report. MAST shall report in writing to the director of health at least once a year, at a time set by the director of health, detailing the status of its participation in the ambulance service element of the prehospital emergency medical services system, including but not limited to its financial status, billing and collection, services rendered to the EPAB, services rendered to the EMSAC, complaints concerning any element of the system and steps taken to investigate, conclusions and actions taken, response times by EMS districts established by the director of health and type of call, in-service training of all ambulance personnel, and recommendations for improvement of the prehospital emergency medical services system.

 

(h) Authority to act as temporary operations contractor. In the event of an emergency in which the public health and safety are threatened by the inadequate performance of an existing operations contractor, or by the absence of qualified bids at reasonable costs for the performance of the required services, MAST may act as operations contractor for the duration of the emergency, but in no event longer than one year.

 

(i) Contracts for mutual aid and shared services. MAST may contract for advanced life support ambulance services from neighboring providers. Such contractors shall be subject to medical audit by the EPAB. Consideration for such services may be financial or in kind. Nothing in this article shall be construed as prohibiting MAST from receiving or rendering emergency mutual aid without formal agreement.

 

Sec. 34-367. First responders.

 

(a) First responder system established.

 

(1) Primary role of the fire department. The fire department will serve as the primary first responder agency under the medical direction and medical control of the director of health. The director of fire and director of health will cooperate in establishing a first responder system within the fire department. A representative of the director of fire may serve as the primary contact with the director of health, medical director, and other elements of the prehospital emergency medical services system.

 

(2) First responder staffing. The first responder system shall be established in incremental phases based on the achievement of system medical quality goals established by the director of health. The implementation of the first responder system will reflect the following general intentions:

 

a. To make the first responder system an essential element in the prehospital emergency medical services system for providing high-quality critical medical care quickly and efficiently;

 

b. To provide services that provide the best value to the taxpayer in the manner that best serves the interest of the community;

 

c. To establish a system of measurable performance, cost, and efficiency standards;

 

d. To insure City departments and contractors work collaboratively and cooperatively for the collective benefit of the entire system and the taxpayer; and

 

e. To provide opportunities for employee development, automation, process improvements, and management controls that will improve the efficiency of the prehospital emergency medical services system

 

(b) Staffing phases. The director of health is authorized to suspend the implementation of any phase based upon the systems inability to build upon the previous phase without additional training, resources or evidence of performance. These phases will include the following staffing requirements:

 

(1) AED. All fire department emergency units employ automated external defibrillator capability with EMT or first responder personnel licensed by the director of health.

(2) EMT. All first response vehicles designated by the director of fire staffed by at least one KCFD EMT First Responder.

 

(3) Advanced life support EMT. All first response vehicles operated by the fire department staffed by at least one advanced life support EMT as designated by regulation.

 

(4) Development of plan to certify as KCFD EMT First Responders all members of the fire department uniformed service. A plan to establish KCFD EMT First Responder licensure for all members of the fire department uniformed services will be developed by February 1, 2002, by the director of fire in consultation with the director of health. The plan will call for licensure as a KCFD EMT First Responder by a date certain. The implementation of this plan will be a prerequisite for implementing a requirement that KCFD EMT First Responder licensure must be retained to meet the qualifications as a member of the fire department uniformed service.

 

(c) Medical protocols. System protocols addressing appropriate first responder utilization will be reconsidered by the director of health, with the advice of the EPAB and EMSAC, after the accomplishment of each required improvement of first responder licensure.

 

(d) Response time reports. The director of fire will report response times by fire department district and citywide to the director of health as directed by the director of health. Should the technological resources become available to track first responder response times for areas matching ambulance transport system reporting districts, the director of fire should make appropriate reports available for those districts.

 

(e) Medical records. First responders will maintain medical records on forms approved by the director of health for every EMS patient and/or incident. The director of health, medical director, and their assistants and designees will have access to all first responder medical records and records of the fire department or other first responder agency concerning the first responder system.

 

(f) Expanded first responder system. The director of health will investigate the propriety of expanding first responder capabilities to appropriate organizations in addition to the fire department.

 

Sec. 34-368. Emergency physicians advisory board.

 

(a) Generally. The emergency physicians advisory board (EPAB) is an advisory board of nine licensed physicians engaged in the full-time practice of emergency medicine, serving without compensation which recommends to the director of health actions promoting high-quality pre-hospital emergency care, including first responder services, and ambulance service, and particularly focusing on issues directly impacting the quality of medical care.

 

(b) Appointments to emergency physicians advisory board.

 

(1) Establishment. An emergency physicians advisory board, also known as EPAB, is established consisting of nine licensed physicians engaged in the full-time practice of emergency medicine, to serve without compensation. The membership of the EPAB at the time this ordinance becomes effective shall continue to serve as the EPAB provided by this article.

 

(2) Filling of vacancies; term of office.

 

a. In the event of a vacancy, the mayor shall appoint a physician engaged in the full-time practice of emergency medicine in that portion of the Kansas City, Missouri area served by MAST, or at institutions receiving patients from MAST, whether or not a resident of the City, to the EPAB. Based upon recommendations of the Emergency Physicians Foundation, the director of health shall recommend to the mayor physicians engaged in the full-time practice of emergency medicine to complete a term or serve a full term as a member of the EPAB.

 

b. Terms shall be three years.

 

(3) Officers. The EPAB shall select such officers as necessary to meet its obligations under this article.

 

(c) Recommendations to director of health. The EPAB shall provide to the director of health and system medical director recommendations concerning the following elements of the prehospital emergency medical services system:

 

(1) Criteria for the issuance, renewal, suspension and revocation of permits and licenses.

 

(2) Production standards related directly or indirectly to clinical performance and patient care.

 

(3) Diagnosis-specific and problem-oriented medical protocols to serve as the required standard of pre-hospital emergency care.

 

(4) Procedures governing the relative provision of 24-hour medical control.

 

(5) Procedures and protocols for the operation of the ambulance control center.

 

(6) Procedures for the provision of medical control over the delivery of basic and advanced life support procedures by ambulance personnel and first responders.

 

(7) Standards for the medical control communications system.

 

(8) Elements of a disaster plan designed to provide prompt quality care and rescue of persons in disaster situations, including whether the City should participate in regional plans.

 

(d) Medical audits.

 

(1) Requests for case audits. The EPAB shall perform medical audits when requested by the medical director or a designated base station physician, by any physician on the physicians own patient, by any doctor involved in the case, by the chairperson of MAST, by the MAST executive director, by the director of fire or by the director of health, or when in the boards discretion it is determined that a specific incident merits investigation or an element of the prehospital emergency medical services system may be improved and study is warranted.

 

(2) Diagnosis-specific quality improvement review. Quality improvement reviews shall be performed on a diagnosis-specific basis to determine if there exists areas for improvement of treatment.

 

(e) Annual report. The EPAB shall cause the preparation of a report in writing to the director of health at least once a year, at a time set by the director of health, detailing the status of the prehospital emergency medical services system, including but not limited to a review of medical audits, audit procedures followed, and recommendations for improvement of the system. A copy of this report shall be provided to MAST and the director of fire.

 

Sec. 34-369. Medical director.

 

(a) Appointment. The medical director shall be appointed by the director of health with the advice of the EPAB and EMSAC. The medical director may not be a member of the EPAB while serving as medical director. The director of health may appoint associate medical directors when required to meet the needs of the prehospital emergency medical services system.

 

(b) Expenses. The medical director and expenses approved by the director of health shall be compensated by the department of health.

 

(c) Delegation of duties. The medical director may delegate duties to qualified base station physicians or others whose expertise is necessary for complete and thorough medical audits.

 

(d) Assistant to the medical director. The director of health may appoint assistants to the medical director, who shall be at least a certified paramedic, or have equivalent training and experience.

 

(e) Responsibilities. The medical director will serve as the primary source of day-to-day medical direction and clinical oversight of all elements of the prehospital emergency medical services system, including all the training and practices of all attendants, dispatchers, first responders, or other positions established by the director of health through regulation, and all other participants in the prehospital emergency medical services system. The medical director will report to the director of health. The medical director may delegate responsibilities and duties to one or more associate medical directors who meet the qualifications of medical director.

 

Sec. 34-370. Emergency medical services advisory committee

 

(a) Established. An emergency medical services advisory committee, also known as EMSAC, is established consisting of 16 people appointed by the mayor to serve without compensation, with the goal of representing the diverse interests of all people and areas of the City, to advise the director of health on matters affecting the operation of the prehospital emergency medical services system.

 

(b) Appointments to emergency medical services advisory committee

 

(1) Membership. The EMSAC will include representatives of the following participants in the prehospital emergency medical services system:

 

a. Three representatives of local health care providers, as the group receiving patients from the prehospital emergency medical services system;

 

b. Three representatives of neighborhood and citizen organizations, as the persons relying on the proper delivery of high quality prehospital emergency medical services for the protection and preservation of their health and safety;

 

c. One management and one labor person from the operations contractor providing ambulance emergency medical services, as those entrusted to treat patients and provide the ultimate prehospital emergency medical care;

 

d. One member of the Emergency Physicians Advisory Board, as the organization providing technical and medical advice to the director of health;

 

e. One representative of the Metropolitan Ambulance Services Trust, as the organization charged with implementing the operations contract;

 

f. One representative of the City Department of Health.

 

g. One management representative from the Fire Department, and two labor representatives from the Fire Department, as first responder, however no more than one representative from any single labor union local representing employees of the Fire Department may serve;

 

h. One management and one labor person from the Police Department, as 911 services provider.

 

In recognition of the involvement of persons residing or working throughout the metropolitan area, in the prehospital emergency medical services system, persons representing all aspects of the system except neighborhood and citizen organizations, may reside outside Kansas City in the metropolitan area.

 

(2) Term. Terms shall be three years. However, of the first appointments the mayor will designate six members to serve one year, five members to serve two years, and five members to serve three years.

 

(3) Officers. The mayor will appoint one member of the EMSAC serving as a representative of local health care providers or a representative of neighborhood or citizen organizations as chair. The EMSAC may establish such other positions as necessary to meet its obligations under this article.

 

(c) Recommendations to director of health. The EMSAC shall provide to the director of health advice and recommendations concerning all elements of the prehospital emergency medical services system, recognizing the role of the EPAB in providing technical and medical recommendations on issues of patient care.

 

(d) Annual report. The EMSAC shall report in writing to the director of health at least once each year, at a time set by the director of health, detailing the work of the committee.

 

(e) Staff. The director of health and city attorney shall provide technical staff support to the EMSAC. The city clerk shall provide clerical support to the EMSAC.

 

Sec. 34-371. Response time.

 

(a) Ambulance response. An advanced life support unit shall be on the scene of each life-threatening emergency call as determined by the dispatcher at the time of the call in accordance with regulations, under nine minutes on 90 percent of all calls.

 

(b) First responder. The director of fire, in consultation with the director of health, shall conduct a study which examines locations of fire stations, authorized licensed personnel, other KCFD missions and pre-call access to the system, and report to the city manager and EMSAC to determine costs and the timetable for the implementation of a first responder life threatening response standard of five minutes or less ninety percent of the time. The study shall be completed by February 1, 2002, and will include estimated costs to reach these response times.

 

(c) Response time exceptions. For all presumptively life-threatening emergency calls equaling or exceeding nine minutes, MAST will provide a general summary and the action it has taken to reduce the number of responses equaling or exceeding nine minutes in its monthly and annual reports to the director of health. The director of health will include in the directors quarterly and annual reports a general summary and the actions taken to reduce the number of responses equaling or exceeding response time requirements.

 

(d) Response time equity. The prehospital emergency medical services system shall be operated to reduce to the lowest figure reasonably attainable any discrepancies in response times throughout the city.

 

(e) Ambulance operations contract requirements. MAST shall contractually establish response times for all non-life-threatening emergency calls, but they shall not be more stringent than that required for life-threatening emergency calls.

 

(f) Financial penalties. MAST shall contractually establish financial penalties for the operation contractors failure to meet the established response times.

 

(g) Response time forgiveness. The director of health may excuse the operation contractors failure to meet the established response times if the operations contractor establishes extraordinary circumstances which prevented, even with the use of contingency planning and with the exercise of reasonable precautions, meeting the specified response times. For purposes of the MAST contract with the operations contractor, it is recognized that the executive director of MAST may also excuse response time exceptions. That action by the MAST executive director for purposes of the contract is not binding on the director of health. Extraordinary circumstances may include but are not limited to unusual and unexpected adverse weather conditions, natural disaster, or unusual and unexpected periods of extraordinary demand.

 

(h) Counting time. All times listed in this section shall be determined by simply referring to a clock, and shall not be determined by reference to any special meaning peculiar to the ambulance industry to mean any time within that minute.

 

Sec. 34-372. System communication and dispatch.

 

(a) Performance standards. The office first answering 911 emergency telephone calls should endeavor to achieve the following minimum standards for answering calls to the 911 system:

 

Answer the call 90% of all calls within 18 seconds of the first ring

Transfer EMS calls 90% of all calls within 45 seconds of the first ring

 

(b) System clock synchronization. All clocks used in the prehospital emergency medical services system to measure responses or activities will be synchronized using technology identified by the director of health, with the assistance of specialized committees established to address computer aided dispatch issues, considering cost, availability and ease of use.

 

(c) Time measurement standards. The director of health will establish definitions for each element of the prehospital emergency medical services system to be followed to measure and record each participants contribution to a call for service. The definitions will be designed to fairly and accurately measure the time devoted to each general aspect of a call for services and should, whenever possible, be consistent with definitions generally accepted by high quality prehospital emergency medical services systems, such as the Utstein protocols.

 

Sec. 34-373. Exemption of ambulances from traffic regulations.

 

(a) Traffic laws inapplicable. When the senior EMS provider in charge of an ambulance has reasonable grounds to believe that an emergency exists, the driver of the ambulance may:

 

(1) Park or stand, irrespective of the otherwise applicable rule of law established by ordinance;

 

(2) Proceed past a red or stop signal or stop sign, but only after slowing as may be necessary for safe operation;

 

(3) Exceed the maximum speed limits permitted by the city so long as life or property is not endangered; or

 

(4) Disregard ordinances or regulations of the city governing the direction of movement or turning in specified directions.

 

(b) Use of lights and siren. The exemptions listed in subsections (a)(2) through (4) of this section shall apply only when such ambulance is making use of audible and visual signals meeting the requirements of the regulations promulgated by the director of health. The exemption listed in subsection (a)(1) of this section shall apply only when such ambulance is making use of visual signals meeting those requirements.

 

(c) Application to first responders, medical director, supervisors.

 

(1) Non-fire department personnel. The restrictions and exemptions listed in this section shall apply to non-fire department first responders when participating in the prehospital emergency medical services system and not otherwise controlled by regulations promulgated by the supervising authority, the medical director and his assistants or associates, and MAST or operations contractor supervisors or other responding personnel.

 

(2) Fire department. First responders of the fire department will follow rules established by the director of fire.

 

(d) Safety of all persons. The exemptions listed in subsection (a) do not relieve the driver from the duty to drive with regard for the safety of all persons.

 

Sec. 34-374. Patient and scene management.

 

(a) Patient management. The senior EMS provider in charge shall have the authority for patient management, including medical management of the patient, at the scene of an emergency. Whenever the medical director or an associate medical director is in attendance at a scene of an emergency, the medical director or associate medical director may assume authority for patient management.

 

(b) Scene management. Authority for management of the emergency scene, exclusive of medical control over patients, shall rest with public safety officials.

 

(c) Assumption of medical control by physician. If a licensed physician appears on the scene and desires to assume direction and control of patient care, the physician shall execute a form which declares the physician has assumed responsibility for patient care.

 

(d) Retention of medical control by other care providers. Should MAST arrange with other health care providers, such as helicopter rescue units, hospitals or clinics, to provide ambulance service in conjunction with specialized medical treatment being provided by the health care provider, and the health care provider retains responsibility for the patient, the senior EMS provider in charge may report that patient management rests with the health care provider.

 

Sec. 34-375. Destination determination.

 

(a) Life-threatening emergency. For all life-threatening emergency calls, the patient shall be taken to the nearest appropriate facility for that clinical condition in accordance with approved medical protocols, unless otherwise directed by a base station physician.

 

(b) Non-life-threatening emergency. For all non-life-threatening emergency calls, the patient shall be taken to the nearest appropriate facility considering the patients choice and availability of facilities, in accordance with approved medical protocols, unless otherwise directed by a base station physician.

 

Sec. 34-376. Exemptions from article.

 

(a) Article not applicable. The provisions of this article shall not apply to helicopter rescue units, ambulances and their personnel which are:

 

(1) United States. Owned and operated by an agency of the United States government.

 

(2) Request of MAST. Rendering assistance at the request of the ambulance control center in cases of disaster or major emergency too great for MAST resources, or in response to the provisions of a written mutual aid agreement.

 

(3) Certain intercity transfers. Engaged in the process of an intercity transfer originating outside the city; provided that, for this exception to be applicable to the patients return trip, the ambulance that transports the patient to a destination within the city must wait for the patient at the destination.

 

(4) Use by employees. Operated by private businesses using ambulances solely for the transportation of their employees for injury or illness sustained while performing their work.

 

(5) Private non-for-hire use. Privately owned and designed for the transportation of the infirm or physically handicapped, and used solely for the benefit of their owner and family, and which are not for hire.

 

(6) MAST specialized mobile intensive care services. Owned and operated by a hospital, or by a not-for-profit corporation of which MAST is a member, and used exclusively to provide specialized mobile intensive care services, provided the ambulance or helicopter rescue unit has a valid special use permit issued pursuant to section 34-364.

 

(b) Request for exemption. An owner or operator of an ambulance not exempted by the provisions of subsection (a) of this section may request exemption from the director of health. The director of health shall determine whether or not the ambulance is to be used for the sole benefit of the owner or his family in permitting use of the privately owned vehicle. Appeals of this decision may be taken as provided in section 34-364(e).

 

Sec. 34-377. Special events coverage.

 

Contracts for use of City owned or operated buildings negotiated after May 1, 2002 will require utilization of components of the prehospital emergency medical services system to provide first aid/ paramedical stand-by services when EMS service is prudently required for the safety of the public attending the event or when the event involves a significant element of physical danger. Contracts for all events involving a significant element of physical danger or public events expected to attract 15,000 or more attendees at any one time will require ambulance stand-by services. Contracts for all public events not involving a significant element of physical danger and expected to attract at least 10,000 at any one time but less than 15,000 attendees at any one time will require a minimum of paramedical stand-by services. Contracts for all public events not involving a significant element of physical danger and expected to attract at least 5,000 at any one time but less than 10,000 attendees at any one time will require a minimum of EMT stand-by services. Persons working as fire guards, security police or other required positions are not preempted by this section from providing EMS service within the level of their training when it may be necessary to protect the life or safety of another person.

 

Sec. 34-378. Violation of article; penalty.

 

(a) Violations. It shall be unlawful to:

 

(1) System participant. Perform duties as an attendant, dispatcher, first responder, or other position established by the director of health through regulation without a current license issued by the director of health.

 

(2) Permit unqualified persons to participate. Permit a person to work as an attendant, dispatcher, first responder, or other position established by the director of health through regulation without a current license issued by the director of health.

 

(3) Use unlawful service. Use or cause to be used any ambulance service other than that established by this article unless exempted by the provisions of section 34-376.

 

(4) Provide service without authorization. Provide ambulance services, emergency or transfer, within the city unless authorized by this article or exempted by the provisions of section 34-376.

 

(5) False information to dispatch resources. Knowingly give false information to induce the dispatch of an ambulance or helicopter rescue unit.

 

(b) Penalty. Any person convicted of violating the provisions of this article shall be fined no more than $500.00 or imprisoned for a period not to exceed six months, or punished by both such fine and imprisonment. This does not serve to limit any other remedies available to the city in law or equity.

Section 34-379 - Section 34-400, Reserved.

 

Section 2. That the City Manager is authorized to enter into negotiations with appropriate labor union representatives to implement aspects of the prehopsital emergency medical services system which may be subject to a Memorandum of Understanding.

 

__________________________________________________________________

 

Approved as to form and legality:

 

 

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Assistant City Attorney