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HomeMy WebLinkAboutItem 6 - Ambulance ServicesEUGENE CITY COUNCIL AGENDA ITEM SUMMARY Action: An Ordinance Concerning Ambulance Services; Amending Sections 2.606, 2.1990, 3.005, 3.862, 3.864, 3.866, and 3.990 of the Eugene Code, 1971; and Repealing Sections 3.850, 3.852, 3.854, 3.856, and 3.858 of that Code Meeting Date: May 10, 2004 Agenda Item Number: 6 Department: Fire and Emergency Medical Services Staff Contact: Tom Tallon www. cl. eugene, or. us Contact Telephone Number: 682-7105 AGENDA ITEM SUMMARY The council will consider final action on the proposed update language to the existing code provisions regulating the provision of ambulance services in Eugene. Staff is requesting City Council approval of the proposed modifications. If approved, the changes would simplify current regulatory requirements by reducing redundant and unnecessary language, eliminating out-of-date references, and making the City's code more consistent with existing Oregon Revised Statutes. In addition, the proposed modifications would enhance the City's ability to regulate all medical transport vehicles, and allow for subcontracted arrangements. BACKGROUND Council Action History The original ordinance language regulating ambulance services in Eugene was drafted in the early 1980s, as the City assumed responsibility for this vital public safety service. Since that time, minor changes have been made periodically to update the ordinance language. Policy Issues None. Council Goal Action Priority The FY03-04 Council Goal of"Safe Community," includes an action priority that calls for steps to be taken to enhance readiness for major emergencies. The creation of a public/private agreement to address the growing demand for low priority, non-essential ambulance transport service could help to preserve available advanced life support (ALS) paramedic ambulance crews for true life-threatening emergencies more often. Also, Council Goal "Fair, Stable and Adequate Financial Resources," states prioritize available revenue and resource allocation to preserve and protect infrastructure and essential assets, including operations, maintenance and preservation. L:\CMO\2004 Council Agendas\M040510\S0405106.doc Financial and/or Resource Considerations The FY04 budget document refers to the ongoing operating deficit facing the Ambulance Transport Fund (#592), and discusses the implementation of a multi-phased plan to address the issue. This proposal represents an additional strategy for developing further service efficiencies and cost savings within the system. Other Background Information In addition to emergent and immediate ambulance response, Eugene also operates a non- emergency, pre-scheduled transfer service that regularly picks up and delivers patients for dialysis, cancer treatment, and other routine appointments for which they are too sick to travel by other modes of transportation. Staff believes a provision to allow the potential for sub- contracting some basic low priority, non-essential transport services could help to preserve needed paramedic ambulance capacity, and augment the area's overall ambulance inventory without additional public cost. The recently completed Standards of Response Coverage study described the challenges facing the stability of the Ambulance Transport Fund and made several recommendations. One of these is to consolidate the improvements made by the first two phases, and then investigate a full slate of new process efficiencies and cost recovery methods. A key step in meeting this goal is represented by the proposal now before the council to update the ordinance language regulating ambulance operations in Eugene. Timing For budgeting and statistical consistency, it would be optimal to have the proposal receive approval in time to allow the Fire & EMS Department to implement the incorporated changes at the beginning of the fiscal year. OPTIONS Staff is asking for approval to proceed with this portion of the EMS Redesign Project. The options are: 1. Direct staff to process the proposed ordinance language changes; or 2. Make no ordinance language changes at this time. STAFF RECOMMENDATION The staff recommendation is Option #1 above, to implement the proposed ordinance changes. SUGGESTED MOTION Move to adopt an ordinance concerning ambulance services; amending sections 2.606, 2.1990, 3.005, 3.862, 3.864, 3.866, and 3.990 of the Eugene Code, 1971; and repealing sections 3.850, 3.852, 3.854, 3.856, and 3.858 of that code. L:\CMO\2004 Council Agendas\M040510\S0405106.doc ATTACHMENTS A. Updated Ambulance Services Ordinance FOR MORE INFORMATION Staff Comact: Tom Tallon, Fire Chief Telephone: 682-7105 Staff E-Mail: Thomas. J.Tallon~ci.eugene.or.us L:\CMO\2004 Council Agendas\M040510\S0405106.doc DRAFT ATTACHMENT A ORDINANCE NO. AN ORDINANCE CONCERNING AMBULANCE SERVICES; AMENDING SECTIONS 2.606, 2.1990, 3.005, 3.862, 3.864, 3.866, AND 3.990 OF THE EUGENE CODE, 1971; AND REPEALING SECTIONS 3.850, 3.852, 3.854, 3.856, AND 3.858 OF THAT CODE. (CB #4870) THE CITY OF EUGENE DOES ORDAIN AS FOLLOWS: Section 1. Section 2.606 of the Eugene Code, 1971, is amended to provide: 2.606 Ambulance Service. (1) As used in sections 2.606 and 2.608 of this chapter, "ambulance service" r ..... ~'~""-' ,., ..... ~ .... ~] the transportation of means LP' ........ ~ ~r'~rr~r,x~ ' ill, ....... ... ....~.~, .. .j.~. ~ ... .~..~.~.....~ .. ..~..~.. .~. ..~ ...~..~..~.. .. ... .~..~ ........~j an injured or disabled individual and, in connection therewith, the administration of pre-hospital and out-of-hospital medical, emergency or non-emergency care, if necessary. (2) As used in sections 2.606 and 2.608 of this chapter, "emergency care" means the performance of acts or procedures under emergency conditions in the observation, care and counsel of the ill, injured or disabled, or in the administration of care or medications as prescribed by a licensed physician, insofar as any of those acts is based upon knowledge and application of the principles of biological, physical and social science. Ordinance 1 L:\CMO~2004 Council Agendas\M040510\S0405106-attA.doc(02/20/04) DRAFT (3) As used in section 2.606 and 2.608 of this chapter, "non- emergency care" means the performance of acts or procedures on a patient who is not expected to die, become permanently disabled or suffer permanent harm within the next 24 hours, including but not limited to observation, care and counsel of a patient and the administration of medications prescribed by a licensed physician, insofar as any of those acts are based upon knowledge and application of the principles of biological, physical and social science. (24) In the event [ .... ~'. ,~ .........,,-.r, .... ~o,ro,~,-.., ~ ....... ~o ..... ~,~,4 , ,.,,4,~. ,.~o,-,,,~. 3 '''~ *~° ,.,-,,4,~ ] by ity .................... ~ .............. or it is determined the c manager that the community is or will imminently be without ambulance service, the city manager is authorized to expend public funds from whatever source to provide ambulance service to the community until directed by the council to cease the expenditures, until the council adopts a supplemental budget under the Oregon Local Budget Law, or until 60 days, whichever is less. (5) No person shall operate an ambulance vehicle or provide ambulance services within the corporate limits of the city unless such person is designated as the ambulance service provider for the city under the Lane County Ambulance Service Area Plan, or Ordinance 2 L:\CMO~2004 Council Agendas\M040510\S0405106-attA.doc(02/20/04) DRAFT is operating as a subcontractor to the designated service provider. The provisions of this subsection do not apply to: (a) Vehicles and ambulances exempt from ambulance licensing requirements of state law; (b) Vehicles being used to render temporary assistance to the city's designated ambulance service provider under the terms of a mutual aid agreement, or under the supervision of the city's designated service provider; or (c) Vehicles operating from a business location, office or headquarters outside the city, that are transporting a patient from outside the city to a health care facility within the city or are picking up a patient from within the city for transport outside the city, or vehicles which are passing through without destination in the city. Section 2. Section 2.1990 of the Eugene Code, 1971 is amended by adding a new Subsection (11 ) thereto, to provide: 2.1990 Penalties - Specific. (11) Violation of section 2.606 is punishable by a fine not to exceed $5,000 or confinement in jail not to exceed 100 days, or both a fine and imprisonment. Section 3. Section 3.005 of the Eugene Code, 1971 is amended by deleting the Ordinance 3 L:\CMO~2004 Council Agendas\M040510\S0405106-attA.doc(02/20/04) DRAFT caption and definitions under the "Ambulance" heading of the Uniform Business Practices definitions, and combining and amending the "First Aid Vehicle" and "Medical Transport Vehicle" definitions of the Uniform Business Practices definitions to provide: 3.005 For the purposes of this chapter, the following words and phrases mean: UNIFORM BUSINESS PRACTICES First Aid and Medical Transport Vehicles: Ambulance services. The transportation of an ill, injured or disabled individual and, in connection therewith, the administration of pre-hospital and out-of-hospital medical, emergency or non-emergency care, if necessary. Ordinance 4 L:\CMO~2004 Council Agendas\M040510\S0405106-attA.doc(02/20/04) DRAFT Emergency care. The performance of acts or procedures under emergency conditions in the observation, care and counsel of the ill, injured or disabled, or in the administration of care or medications as prescribed by a licensed physician, insofar as any of those acts is based upon knowledge and application of the principles of biological, physical and social science. First aid care. The performance of non-emergency care of a type not requiring consultation with a physician, on a patient whose medical condition will not require evaluation or observation during transport. First aid vehicle. Any motor vehicle for hire that is constructed, equipped or regularly provided for the [,non e,mergency] transportation in the sitting or non-recumbent position of persons, ro..m~.~,.,-, ¢.,-,,.,. ~ .... ~,.~ ....... '~oo~'~*" ~ and L~,,~.,,,,,~ ,,,,..,,,, ,,,,,~.,~ ,,,j~,.y ,,..,, ,,.~,,.,~,,...,,,%y~j oink, ,, .... ~ in connection therewith the r,.,-,, .,~,...;.;,.,-, ,~,~ o,~.,,;,-,~o ,-,~ o,. ............ J LI IgJ I ~ll Il I~ Jl I~ g~l J IV~g gl ~l I rendering of first aid care as defined in this chapter. First aid vehicle operator. Any person engaged in the operation of a first aid vehicle. First aid vehicle owner. Any person engaged in the business of providing first aid vehicle services. Non-emergency care. The performance of acts or procedures on a patient who is not expected to die, become permanently disabled or suffer permanent harm within the next 24 hours, including but not limited to observation, care and counsel of a patient and the administration of Ordinance 5 L:\CMO~2004 Council Agendas\M040510\S0405106-attA.doc(02/20/04) DRAFT medications prescribed by a licensed physician, insofar as any of those acts are based upon knowledge and application of the principles of biological, physical and social science. Medical transport vehicle. Any motor vehicle for hire that is constructed, equipped or regularly provided for the,,r ............. ,.~,, ...,, ,..., u..., ,.~ j~ transportation in the sitting or non-recumbent position of non-ambulatory[,-] or medically impaired persons not requiring [tho] ambulance services [of .... h, ,~ .... ~ ............... j as defined in this chapter. Medical transport vehicle operator. Any person engaged in the operation of a medical transport vehicle. Medical transport vehicle owner. Any person engaged in the business of providing medical transport vehicle services. Section 4. The caption preceding Section 3.850, and Sections 3.850, 3.852, 3.854, 3.856 and 3.858 of the Eugene Code, 1971, are repealed. r, ,1~ oM~foM ,,~Mor fhi~ ~ho~for Ordinanco 6 LXCMO~004 Council A~endasXM0405~ 0XS0405~ 0~-attA.doc(02/20/04) DRAFT Ordinance 7 L:\CMO~2004 Council Agendas\M040510\S0405106-attA.doc(02/20/04) DRAFT Section 5. Sections 3.862, 3.864 and 3.866 of the Eugene Code, 1971, are amended to provide: 3.862 First Aid and Medical Transport Vehicles - Responsibilities of Owner. Ordinance 8 L:\CMO~2004 Council Agendas\M040510\S0405106-attA.doc(02/20/04) DRAFT (1) No person shall operate a first aid or medical transport vehicle or business within the jurisdictional limits of the city of Eugene, including the Eugene Airport, without first registering with the city and paying the required fees. The provisions of this section shall not apply to first aid and medical transport vehicles operating from a business location, office or headquarters outside the cities of Eugene or Springfield, that are transporting a person from outside the Eugene-Springfield area to a health care facility within the city or are picking up persons from within the city for transport outside the Eugene-Springfield area, or vehicles that are passing through the city of Eugene without a destination within the city. First aid and medical transport vehicle owners shall: (a) Ensure that vehicles are clean, present a good appearance, are equipped as required herein, and maintained in a safe condition and according to manufacturer's instructions; (b) Maintain for a period of three years and make available to the city upon request: 1. Records of the supplies and equipment carried in each first aid or medical transport vehicle; 2. Complete maintenance records for each vehicle; and 3. Customer service records including the name of the customer Ordinance - 9 L:\CMO\2004 COUNCIL AGENDAS\M040510\S0405106-ATTA. DOC(06/27/03) DRAFT the date and time of transport, and the origin and destination of transport. First aid vehicle owners shall also indicate the nature of the injury, illness or disability, and the assistance rendered. (c) Equip each first aid and medical transport vehicle only with supplies and equipment that fully comply with state and local law; (d) Equip each medical transport vehicle with a fire extinguisher, of a 1A10BC or 2A10BC, 2 1/2 pound type, readily accessible to the driver in the area of the front seat, which shall be serviced annually and immediately after each use; (re) Not use or permit to be used a first aid or medical transport vehicle which: 1. Is equipped with rotating beacons, light bars, sirens, or any other type of emergency warning device except standard four-way hazard flashers; 2. Is equipped to provide oxygen administration. A first aid or medical transport vehicle may transport persons requiring constant oxygen administration due to chronic respiratory Ordinance- 10 L:\CMO\2004 COUNCIL AG-ENDAS\M040510\S0405106-ATTA. DOC(06/27/03) DRAFT conditions who use their own oxygen apparatus but who do not require [~] any observation, care or services that the vehicle is not permitted to provide under this chapter, 3. Is equipped with any type of stretcher, gurney, or cot. (gl) Employ as first aid or medical transport vehicle operators only persons who are currently certified by the State of Oregon at a minimum as an emergency medical technician B, first responder, or certified nursing assistant. (hg) Not use, cause to be used or permit any advertising, signing or other communication relating to a first aid or medical transport vehicle which contains any reference to, or which uses words, symbols or other devices which cause or are likely to cause confusion as to the identity of the vehicle as an ambulance. (ih) Comply with all applicable federal laws and regulations, including the Americans with Disabilities Act, state and local laws and regulations, including rules promulgated by the city manager. Such rules may include, but not be limited to, the type and level of insurance required, the form of hold harmless agreement required, the maintenance and inspection of records, and other inspection or vehicle requirements. (ji) First aid vehicle owners shall retain a Iocalphysician advisorwho is Ordinance - l l L:\CMO\2004 COUNCIL AGENDAS\M040510\S0405106-ATTA. DOC(06/27/03) DRAFT licensed to practice medicine by the State of Oregon and make the physician advisor's name, address and telephone number available to the city upon request. (Nj') Provide the city, at the time of registration, and at least ten days prior to any change thereto, a list setting forth the fares or charges, and post a copy of the same inside the first aid or medical transport vehicle. (2) When transporting persons in wheelchairs, a first aid or medical transport vehicle owner shall: (a) Equip each first aid and medical transport vehicle with wheelchair immobilization apparatus that maintains the wheelchair in a stationary position; (b) Maintain wheelchair immobilization apparatus according to manufacturer's instructions; (c) Maintain records for a period of three years of all repairs and maintenance performed on wheelchair immobilization apparatus and make all records available to the city for inspection upon request; (d) Transport or allow transport of persons only in an upright sitting position or in a reclining position when the angle of recline is not more than 45 degrees. Ordinance- 12 L:\CMO\2004 COUNCIL AGENDAS\M040510\S0405106-ATTA. DOC(06/27/03) DRAFT (3) All owners shall be strictly liable for any violation of this chapter by an agent or employee. 3.864 First Aid and Medical Transport Vehicles - Responsibilities of Operator. A first aid or medical transport vehicle operator shall: (a) At a minimum, be currently certified by the State of Oregon as an emergency medical technician B, first responder, or a certified nursing assistant. (b) If transporting a person in a wheelchair, transport or allow transport of persons only in an upright sitting position or in a reclining position when the angle of recline is not more than 45 degrees. (c)Comply with all applicable federal, state and local laws and regulations. (d) A first aid vehicle operator shall also carry on his or her person while on duty the name, address and telephone number of the physician advisor. 3.866 First Aid and Medical Transport Vehicle - Prohibited Activities. [Nepemen ~hi~l~ ~ ~ro~ ~h~. Dan,,ir~o ~r io li~h~ +~ r~, ,ir~ ~ fr~f~f ~, ,ri~ ,x~,,~ ~, ,~ ,,,x~,y ~ ,~,,~ ~,,y u~u,,~,,~ ~,,,,~ ~,~,,~,~ Ordinance- 13 L:~CMO~2004 CO~CIL AGENDAS~M040510~S0405106-ATTA. DOC(06/27/03) DRAFT I~ ~vr,~ri~r,i~r~ r~ir, r ,~; ,,, ~;,.,v,.,,,., ~,~,, ,~ ~''1 ' '"~'~ "'~'"'""'~ '-" '~"~'~1~''''~'''''' ''"'~J'-" "~'""-"'"'"'~' "'J""Y' J No person who is subject to the provisions of section 3.862 of this code shall: (a) Use a medical transport vehicle to provide ambulance services or to transport a person who requires or may require transportation in the recumbent position. (b) Use a first aid vehicle to provide ambulance services, except forfirst aid care, or to transport a person who requires or may require transportation in the recumbent position. Section 6. Section 3.990 of the Eugene Code, 1971, is amended by adding a new Subsection (5) thereto, to provide: $.990 Penalties - Specific. (5) A first violation of section 3.866 is punishable by a fine of not less than $50, nor more than $100; a second violation of section 3.866 is punishable by a fine of not less than $100, nor more than $500; a Ordinance- 14 L:\CMO\2004 COUNCIL AGENDAS\M040510\S0405106-ATTA. DOC(06/27/03) DRAFT third or subsequent violation of section 3.866 is punishable by a fine of not more than $1,000 or confinement in jail not to exceed 100 days, or both a fine and imprisonment. Section 7. The City Recorder, at the request of, or with the concurrence of the City Attorney, is authorized to administratively correct any reference errors contained herein or in other provisions of the Eugene Code, '197'1, to the provisions added, amended or repealed herein. Passed by the City Council this Approved by the Mayor this ~ day of ,2004 ~ day of ,2004 City Recorder Mayor Ordinance - 15 L:\CMO\2004 COUNCIL AGENDAS\M040510\S0405106-ATTA. DOC(06/27/03)