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HomeMy WebLinkAbout2199 Procedures for Permitting Ambulance ServicesDRAFT 7/17/90~ ORDINANCE NO. ~9~ AN ORDINANCE CREATING PORT TOWNSEND MUNICIPAL CODE CHAPTER 5.90 ESTABLISHING PROCEDURES FOR PERMITTING AMBULANCE SERVICES WITHIN THE CITY AND SETTING AN EFFECTIVE DATE THEREFOR The City Council for the City of Port Townsend, after review and study, finds that: (1) The current provisions of Port Townsend Municipal Code do not govern the delivery and administration of ambulance services; and (2) The City has determined that the delivery of emergency medical services is an essential service and is best provided by a public agency and is not adequately provided by a private or com- mercial ambulance service within the City; and (3) The City has designated the Port Townsend Fire Department as the agency responsible for the delivery of pre-hospital and post-hospital emergency transportation and care for all citizens within the City limits, and the Department is also responsible to oversee quality control and operations of all ambulance services; and (4) The Port Townsend Fire Department has an ambulance crew available at a known location on a 24-hour basis and can respond to calls in time within nationally accepted norms; and (5) It is advisable to clearly delineate between the delivery of emergency and non-emergency ambulance services; and (6) Licensing is an effective method of regulating businesses and service providers which carry some potential public harm or nuisance; and (7) Changes in State law require an update of current City requirements for non-emergency ambulance services; and (8) Rates to be charged by the Fire Department (Medic-One) for emergency ambulance service can more appropriately place in Title 3 of the Code (Revenue and Finance). NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF PORT TOWNSEND, IN REGULAR SESSION ASSEMBLED, DO ORDAIN AS FOLLOWS: ORDINANCE ~l q~ 1 Section 1. Chapter 5.90 (Ambulances) of the Port Townsend Municipal Code is hereby established and the following language is hereby adopted: 5.90.010 Definitions. For the purposes of this Chapter, the following definitions shall apply: A. "Ambulance" means a ground vehicle designed and used to transport the ill and injured and to provide personnel, facilities and equipment to treat patients before and during transportation where it is not anticipated that emergency medical care will be required during transportation. B. "Emergency medical care" or "emer- gency'' means a sudden and/or unexpected medical problem which re- quires the immediate assistance of an agency trained in and desig- nated to provide pre-hospital medical care. C. "Non-emergency medical care" means a medical condition which is not sudden and/or unexpected, there- fore not requiring immediate assistance and results in a scheduled response. Pre-hospital initiation of drug therapy (with the ex- ception of oxygen) or field intravenous fluid lines would not be expected for non-emergency patients. D. "Post-hospital interfacility criti- cal care transports" refers to patients transported from one hos- pital to another hospital for specialized critical care and shall also be considered included within "non-emergency medical care." E. "Emergency Medical Technician" (EMT) means a person who is certified as such by the Secretary, pursuant to RCW 18.73, and regulations promulgated thereunder. F. "Mutual aid" refers to situations in which a licensed non-emergency ambulance service is required, as determined by the Fire Department, to make ambulances and per- sonnel available for emergency response under the City's direction. G. "Secretary" means the Secretary of the Washington State Department of Health, Emergency Medical Services Division. 5.90. 020 Applicability. A. Ail emergency medical service is and shall be provided in the City of Port Townsend by its Fire De- partment. The provisions of this Chapter shall apply to non-emer- gency ambulance services based within the City and also to those whose vehicles enter the City on a regular basis to deliver or pick up patients. ORDINANCE B. Nothing herein shall prohibit the Fire Department from operating non-emergency ambulance services. 5.90.030 License Required - Application - Fee. A. It shall be unlawful for any person, firm or corporation to operate or cause to be operated (as described in Section 5.90.020(A) within the City limits an ambulance or ambu- lance service without f±rst being issued a license therefor by the City. B. It shall be unlawful for any person, firm or corporation to violate any of the provisions of this Chapter. C. It shall be unlawful for any person, firm or corporation (other than the City of Port Townsend Fire De- partment) to operate or cause to be operated (as described in Sec- tion 5.90.020(A) emergency ambulance services within the City limits, except as provided in Section 5.90.100. D. Such license may be obtained by ap- plying therefor at the office of the City Treasurer on forms pro- vided. E. The fee for such license shall be $100 per ambulance, and it shall be renewable annually, and $25 for each EMT (may be assessed on the individual EMT). The fee shall be payable in January of each year for the ensuing year, and there shall be no proration for new applications during the year. F. To the extent not inconsistent with other provisions of this Chapter, the provisions of Section~5.04, dealing with general issuance of City licenses, shall also be ap- plicable to this Chapter and are hereby incorporated. 5.90.040 Standards for License. Ail applicants shall be appropriately certified by the Secretary, and be in good standing, pursuant to RCW 18.73 and regulations adopted from time to time thereunder. Upon receiving an application and the fee, the Clerk/Treasurer shall forward the application to the Fire Chief for review and approval. No license shall be issued unless the Fire Chief is satisfied, pursuant to policies duly adopted, that (a) the applicant is properly certified by the State; (b) the applicant's facilities, ambulances and equipment meet State standards; (c) employees of the applicant are certified and in good standing; (d) a record check of the applicant and employees by the Chief of Police shows no criminal convictions for crimes having a direct adverse relationship to custody of incapacitated persons, custody of narcotic or controlled substances, or safe driving of emergency vehicles; and (e) the applicant is otherwise capable of performing ambulance services. ORDINANCE - 3 - 5.9~.050 Ambulance Personnel. No ambulance shall be operated as such without at least two persons, each of whom shall be an EMT, or licensed or certified by the State as having at least an equivalent or higher level of training. Additionally, the driver must hold a valid Washington State driver's license. 5.90.060 Ambulances and Equipment. A. Ambulances shall be maintained and inspected pursuant to requirements from time to time adopted by the Secretary. Ail licensees shall provide the Fire Department with copies of reports of inspection submitted to the Secretary pursuant to RCW 18.73.145. B. Ambulances shall receive semi-annual mechanical and medical inspections (each January and June). In- spections shall be carried out by a designee of the Fire Chief. The licensee shall pay an inspection fee of $50, but in no case less than the cost of performing said inspection, for each semi- annual inspection required under this Chapter. Each licensee shall further pay an inspection fee of $25, but in no case less than the cost of performing said inspection, for each inspection prompted by a complaint; provided, however, that no complaint-prompted inspec- tion fee shall be paid where the Chief of the Port Townsend Fire De- partment has determined the complaint to be unwarranted and without substantial merit. All inspection fees shall be due and payable within 10 days of the date of the inspection. C. In case of any lack of compliance with any of the requirements of this Ordinance, or any deficiencies, such licensee shall promptly remedy same or be subject to notice of suspension or revocation. D. Ail ambulances and equipment storage and cleaning areas are subject to random inspection by the Fire De- partment, at reasonable times, to ensure that they are maintained in a clean and functional state. Disinfection or chemical sterili- zation of re-usable equipment must meed guidelines established by the National Center for Disease Control. E. Licensees shall take immediate action to eliminate any unsanitary condition when becoming aware of it and shall immediately correct any situation about which the Fire Chief or the Secretary has delivered written notice. F. Ambulances shall not be used without the minimum equipment prescribed by the Secretary and the City Fire Department. In the event any variance from requirements is granted by the State, a licensee must apply for and obtain a similar such variance from the City Fire Department. 5.90.070 Performance Standards - Compliance - Records. A. Ail services performed hereunder shall be in accordance with the standards and principles of the course of instruction given EMTs and pursuant to local medical protocols estab- lished from time to time by the Jefferson County Medical Program Director. B. Each ambulance service licensed under this Chapter shall, immediately upon the issuance of a license, file with the City Clerk/Treasurer its schedule of rates to be charged for its services for the duration of the calendar year in which the li- cense is issued. Thereafter, each ambulance service licensed under this Chapter shall annually file with the City Clerk/Treasurer its schedule of rates to be charged for its services. The annual rate schedule shall be filed on or before the first day of December of the year preceding the year for which the schedule is to be in effect. C. Ail rate schedules filed pursuant to this Section shall be a matter of public record and open to public inspection in the office of the City Clerk during normal business hours. Each licensee shall strictly adhere to its schedule through- out the calendar year for which that schedule has been filed; provided that a licensee may charge and collect rates in accordance with a re- vised rate schedule by filing the revised schedule with the City Clerk not less than one full calendar month prior to the effective date of the revised schedule. D. It is unlawful for anyone driving or operating an ambulance to charge, demand, collect or receive any greater or less rate or fare than those then currently filed with the City Clerk. It is unlawful for any ambulance operator to give directly or indirectly, or cause to be given, any rebates, commissions, reserve rebates or any reduced rates or cash discounts to any person or persons or groups of any nature, except as listed on its then current schedule of rates on file with the City Clerk. E. A Washington State medical incident report (MIR) shall be logged by ambulance crews for each patient transported and shall include the appearance and status of and treatment administered to injured, sick or incapacitated persons treated or transported. Copies of such records shall be mailed or otherwise delivered to the Fire Department on a weekly basis, or more often if requested for good cause. Except as otherwise provided by the requirements of the State Public Disclosure Act, such records are confidential and shall be released only to proper officials of the City. F. Each ambulance operator shall deposit with the City Clerk a certificate of insurance evidencing compre- hensive general liability, auto liability and malpractice insurance issued by a responsible insurance company to be approved by the ORDINANCE City and naming the City as an additional insured. The limits of the policy shall be not less than $1,000,000.00. The insurance certificate shall be submitted to the City Clerk for approval prior to the issuance of each ambulance license. Satisfactory evidence that such insurance is at all times in full force and effect shall be furnished to the City Clerk, in such form as the Clerk may specify, by all licensees required to provide such in- surance under the terms of this Chapter. Every insurance policy required under this Section shall extend for and cover all claims arising during the period to be covered by the license applied for, notwithstanding such claim or claims may actually be made thereafter, and the insurer shall be obliged to give not less than 30 days written notice to the City Clerk and to the insured be- fore any cancellation or termination of the policy earlier than its expiration date. Cancellation or other termination of any such policy shall automatically revoke and terminate any license issued for the ambulances covered by such policy, unless a sub- stitute insurance policy complying with the provisions of this Section shall be provided and be in effect at or prior to the time of such cancellation or termination. 5.90.080 Emer~encM Notification. A. In the event a licensee or its per- sonnel, in responding to a non-emergency call, discovers the existence of an emergency situation, he or she shall immediately notify Jefferson County Emergency Dispatch Center (9-1-1) of that fact and the circumstances and request dispatch of Port Townsend Medic-One. Unless otherwise notified by the dispatcher or a re- sponding medic unit from Port Townsend Medic-One, personnel on the scene shall take measures reasonably necessary to maintain the health and safety of the patient. B. In the event an emergency call for medical assistance is received by the licensee, the caller shall immediately be directed to call 9-1-1 for emergency medical re- sponse by Port Townsend Medic-One. 5.90.090 Response to Calls. A. It is unlawful for a licensee in responding to any call to use emergency lighting or siren unless responding to emergencies or transporting a patient in accordance with the mutual aid provision of this Chapter. B. In the event a licensee is required to respond Code Red per the mutual aid provisions of this Chapter, the responding crew shall notify Jefferson County Emergency Dis- patch Center (9-1-1) of the same. 5.90.100 Mutual Aid. A. A licensee is required to cooperate ORDINANCE %197 - 6 - with any request by the Fire Department for mutual aid assistance. At such times, the City will have operational control of all equip- ment and personnel for all purposes and may dispatch ambulances to any point within the City of Port Townsend. However, in the event of any suit or claim arising out of activities under this Section, the City and licensee shall each be responsible for, and to the ex- tent of, their own respective liability. B. Licensees shall equip vehicles with City Fire Department frequencies which, however, shall only be used by licensees in the event of a mutual aid situation described herein. 5.90.110 Advisory Committee. A. The Mayor shall appoint with the concurrence of the City Council an advisory committee composed of seven persons. Such advisory committee shall include the Mayor, the director of the Emergency Room or the administrator of Jeffer- son General Hospital or his or her designee, one citizen of the City of Port Townsend, the chiefs of the Port Townsend Fire and Police Departments, and a representative of at least one ambu- lance company, if any, licensed under the provisions of this Ordinance. B. The terms of the members of the advisory committee shall be as follows: 1. The Mayor, Police Chief and Fire Chief, their respective terms of office; 2. The hospital representative, four years, provided that the first representative appointed shall be appointed for a period of two years; The citizen of the City, two years; and 4. The representatives of the re- spective ambulance services, the period of the license granted to the ambulance services under this Chapter. C. The advisory committee shall meet as needed, and at least annually, to review and recommend standards and regulations related to emergency medical services and submit its recommendations in writing at least once a year to the City Council for its approval.~ Such review may include recommendations for new or different equipment and regulations relating to para- medical emergency service and may recommend new or different training procedures and the development of new rules and regula- tions relating to any operation licensed under this Chapter. ORDINANCE 2lqq - 7 - 5.90.120 Penalty for Violation. A. In the event of a violation of any provision of this Chapter, the Fire Department shall promptly notify the licensee thereof and, if the situation warrants it, give said licensee a reasonable opportunity to take corrective action. B. Any person, corporation or entity who violates any provision of this Chapter shall be subject to revocation of license pursuant to the procedure set forth in Sec- tion 5.04.440. Any person, corporation or entity violating any provision of this Chapter shall be guilty of a misdemeanor and, upon conviction, shall be punished by a fine not exceeding $1,000.00, or by a jail sentence not exceeding 90 days, or by both such fine and jail sentence. 5.90.130 Appeals. Any person applying for or holding a license under this Chapter who believes he or she is aggrieved by an action of any City official in connection with a license may appeal the matter to the City Council for resolution by filing a written request for appeal with the City Clerk no later than 15 days after the date of action being appealed. The request shall state and describe the action appealed from and grounds therefor. The City Council will conduct an investigation and render a decision. Section 2. The effective date of this Ordinance shall be ~6/Tf~-~ ! , 1990, or following its passage, approval and publication in the form and manner provided by law, whichever date is later. Read for the first, second and third times, passed by the City Council fo the City of Port Townsend this 77~ day of /~/- , ~90, and signed and approved by the Mayor of the City this7v~ day of /~f~(~--- , 1990. Attest: vied A~.' ~y~ Da ' Clerk Aiiii Cd ii~iy AttorneyK~ Passed by City Council: Published: Effective Date: ayor Brent Shirley , 1990 , 1990 , 1990 ORDINANCE - 8 -