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HomeMy WebLinkAboutO-2007-2273 -B (original done 1998) B REQUEST FOR CITY COUNCIL AGENDA ITEM Agenda Date Reqnested: December 3. 2007 ~ed By: Roy H.... eJ Department: ENS ADDrollriation Source of Funds: N/A Account Number: Amount Budgeted: Report: Resolution: Ordinance: x Amount Requested: Exhibits: A - Current & Proposed Chapter 30 Ordinance Budgeted Item: YES NO Exhibits: B - Attorney Final Demand Letter - SamDle Exhibits: SUMMARY & RECOMMENDATION An ordinance amending the Code of Ordinances of the City of La Porte, Texas by amending Chapter 30 "Emergency Services", Article III "Emergency Medical Services" by adding new Division 1 'Generally", Division 2 "Billing Policy and Procedures". and Division 3 "Private Ambulance Service Licensing"~ adding new Sections 30- 94 through 30-98~ Designating the City of La Porte E.M.S. as the primary provider of Emergency Medical Service in the City. Code of Ordinance, Article III "Emergency Medical Services" has been updated and realigned to correspond with the standard format of the City of La Porte, Texas Code of Ordinances. Ordinance update includes the following items, most of which have been presented to mayor & council during previous council retreats: · Non-Member Fee - per event charge for EMS response to businesses located outside the City of La Porte that elect to not enter into an agreement or contract for EMS services. · Negotiations - authorizes the EMS Chief to negotiate exclusively with a patient's legal representative on behalf of the patient's financial obligations for a reduced payoff · Write-offs - authorizes the EMS Chief to write-off outstanding accounts which have been detennined to not be suitable for further collection efforts. · Attorney Final Demand Letter -letter from Asst. City Attorney requesting the immediate payment of the remaining amount owed in full. (See attached) · Increase Ambulance Stand-by Rate to $75/hour (2 Hour Minimum) - current rate is $401hr. Research shows that the average rate is $75/hour. Recommend that council: Approve the ordinance amending Ordinance Chapter 30 "Emergency Services", Article III "Emergency Medical Services", of the Code of Ordinances of the City of La Porte. Texas to include adding the Billing Policy and Procedures division. ATTACHMENTS: Current Chapter 30. Article III "Emergency Medical Services" ordinance. Proposed Chapter 30. Article III "Emergency Medical Services" ordinance - Billing Policy and Procedures Attorney Final Demand Letter - Sample Action Required bv Council: Approve Ordinance amending Code of Ordinance Chapter 30, Article III "Emergency Medical .ces" to include the addition of Division 2 "Billing Policy and Procedures" \1 01 Date ORDINANCE NO. 2007 - :;2~ ') ~ - B AN ORDINANCE AMENDING THE CODE OF ORDINANCES OF THE CITY OF LA PORTE, TEXAS BY AMENDING CHAPTER 30 "EMERGENCY SERVICES", ARTICLE III "EMERGENCY MEDICAL SERVICES" BY ADDING NEW DIVSION 1 "GENERALLY", DIVISION 2 "BILLING POLICY AND PROCEDURES", AND DIVISION 3 "PRIVATE AMBULANCE SERVICE LICENSING"; ADDING NEW SECTIONS 30-94 THROUGH 30-107; DESIGNATING LA PROTE E.M.S. AS PRIMARY PROVIDER OF EMERGENCY SERVICES IN CITY; PROVIDING MINIMUM STANDARDS FOR EMERGENCY TRANSPORT; ESTABLISHING LA PORTE E.M.S. DEPARTMENT BILLING RATES, PROCEDURES AND POLICIES; CONTAINING A SEVERABLITY CLAUSE; CONTAINING A REPEALING CLAUSE; CONTAINING AN OPEN MEETINGS CLAUSE; AND PROVIDING AN EFFECTIVE DATE HEREOF; BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF LA PORTE: Section 1. Chapter 30 "Emergency Services", Article III "Emergency Medical Services", of the Code of Ordinances of the City of La Porte, Texas is hereby amended by adding new Division 1, with new sections 30-78 through 30-85, inclusive, which said Division shall read as follows: "Division 1. Generally Sec. 30-78. Designation of Primary Provider. The City of La Porte hereby recognizes the City's Emergency Medical Services ("EMS") department as the primary provider of pre-hospital emergency medical services within the corporate limits of the City. All persons in need of such services are entitled to receive them without prior determination of the ability to pay. Sec. 30-79. Definitions. Unless otherwise specified, the term: Accept Assignment: a process through which a provider agrees to accept the Medicare- allowed amount as payment in full. A provider who agrees to this amount is said to "accept assignment. " Advanced Life Support (ALS): ALS assessment by ALS personnel or the provision of at least one ALS intervention. Ambulance means any motor vehicle that is specially designed or constructed and equipped and is intended to be used for and is maintained or operated for the treatment and transportation of patients. Balance Billing is the practice of charging a Medicare beneficiary more than the difference between the amount provided by Medicare and the provider's actual charge. Certification means that which meets the requirements of the Texas Department of State Health Services. Chief EMS Officer means the chief of emergency medical services of the City of La Porte or his duly authorized representative. City means the City of La Porte, Texas City Council means the City of La Porte, Texas, City Council. Drivers License means the license issued by the Department of Public Safety, State of Texas. Emergency means any circumstance that calls for immediate response (emergency lights and/or siren) in which the essential element of time in transporting the sick, wounded or injured for medical treatment is essential to the health or life of the person. Said circumstances include, but are not limited to, accidents generally, traffic accidents, acts of violence resulting in personal injury and sudden illness. Emergency Call means any request for ambulance service that is made by telephone or other means of communication in circumstances which are, or have been represented to be, an emergency requiring immediate ambulance service. Emergency Medical Technician ("EMT'')- Paramedic: an individual having special, well-defined skills and knowledge in emergency medicine, who has training to provide pre- hospital emergency medical treatment at an advanced level and is certified or licensed by the Texas Department of State Health Services in accordance with the current EMT -paramedic National standards curriculum. Emergency Medical Service ("EMS"): means the City of La Porte Emergency Medical Service, City of La Porte, Texas. Emergency Medical Technician means any person currently registered by the Texas Department of State Health Services as an EMT, EMT-intermediate, and/or EMT-paramedic. Emergency Run means the emergency ambulance trip to the place where the emergency exists or from the place of such emergency to the emergency room of a receiving hospital. License means a license or permit issued by the City of La Porte Emergency Medical Services pursuant to this Chapter. Loaded Miles: see "Mileage". Mayor means the Mayor of La Porte, Texas Medical Director means any licensed physician who serves in an advisory capacity to any ambulance for the purposed of providing medical direction under the terms of the Medical Practice Act (Texas Occupations Code, Subtitle B) and rules promulgated by the Texas State Board of Medical Examiners pursuant to the terms of the Medical Practice Act. Mileage: the distance traveled by an ambulance from the point where the patient is picked up, to the hospital or to a rendezvous point. No Treatment / No Transport: means a response by EMS that required no treatment and no transport of any patients. Non-Emergency means any request for ambulance service response (no emergency lights and/or siren) that is made by telephone, or other means of communication in circumstances which are or have been represented to be of a non-emergent nature requiring non-emergent servIce. Non- Resident: an individual domiciled outside the City of La Porte. Non Member: is any facility or business / industrial entity located outside of the corporate geographical boundaries of the City of La Porte that utilizes the city's emergency medical service (EMS), but either elects not to or has not executed a contractual agreement with the City of La Porte for the provision of emergency medical services by the City of La Porte EMS Department. Non-Member Fee: is a per event charge for a La Porte EMS Department response to any facility or business / industrial entity located outside of the corporate geographical boundaries of the City of La Porte that has either elected not to or has not executed a contractual agreement with the City of La Porte for the provision of emergency medical services by the City of La Porte EMS Department. This charge is independent of any patient charges that apply as a result of the response. Officer means the Chief EMS Officer, any Chief EMS Officer designee or a police officer of the City of La Porte, Texas Patient: a person who receives an EMS response or a person who receives emergency medical services from the City of La Porte EMS. Person means any individual, corporation, organization, government or governmental subdivision of agency, business, trust, partnership, association, or any other legal entity. Police means any officer of the City of La Porte Police Department. Private Ambulance: means any privately owned motor vehicle that is specially designed or constructed and equipped and is intended to be used for and is maintained or operated for the transportation of patients. Protocol means written medial orders signed by a licensed physician serving as medical director for an ambulance giving medical direction to provide treatment for certain emergencies or other pre-hospital situations requiring a physician's orders. These orders must conform to all applicable laws. Reasonable Collection Efforts: the issuance of a bill to the patient or to the party responsible for the patient's personal financial obligations, and subsequent billings, collection letters and telephone calls or personal contacts which constitute a genuine, rather than token, collection effort. Resident: an individual domiciled within the City of La Porte. A resident for the purposes of this Article, includes but is not limited to, full time residents of the City of La Porte, full time students residing within the City limits, long term guests of a resident of the City, and employees on duty with City business. Standby Service Fee (2 Hour Minimum): an hourly charge for having dedicated EMS personnel and equipment standby at an event or function for purposes of providing emergency medical services as needed. If a patient is treated and transported from the standby event, the patient will be billed normal rates. In the event of an emergency, the standby may be canceled or equipment may be recalled from the standby event without notice. Street means any street, alley, avenue, boulevard, drive or highway commonly used for the purpose of travel within the corporate limits of the city. Third Party Payer: insurance carrier or other coverage provided, having the responsibility to pay for medical services rendered to a patient as a result of that patient's accident, injury or illness. Transfer Ambulance means any motor vehicle constructed, equipped and used for the purpose of travel within the corporate limits of the city. Transfer Call means any request for ambulance service that is made by telephone, or other means of communication in circumstances which are or have been represented to be of a non-emergency nature requiring non-emergent service. Treat with Air Transport: a charge to a patient who has received ALS assessment by ALS personnel or the provision of at least one ALS intervention and has been transported by an Air Ambulance due to the severity of their injury or illness. Treat with Private Transport: a charge to a patient who has received ALS assessment or treatment and has been transported by a Private Ambulance. Treat with Transport: a charge to a patient who has received ALS assessment by ALS personnel or the provision of at least one ALS intervention and has been transported by the City of La Porte EMS. Treat with No Transport (Service Charge): a charge to a patient who has received evaluation or treatment but who has not been transported by EMS due to the refusal of care or for other reasons. This charge applies ONLY if the patient or a family member requested the EMS response. Sec. 30-80. Advanced Life Support Services Required. (a) The City of La Porte hereby mandates Advanced Life Support (ALS) with a minimum crew of one EMT-Paramedic and one EMT-Basic as the minimum standard of care for all 9-1-1 ambulance calls and emergency ambulance transports arising in the City of La Porte, and shall bill accordingly at only an ALS level. The provisions of this paragraph shall apply to all services provided by the City to mutual aid and contractual response areas. (b) Exceptions to the provision of ALS with one EMT-Paramedic and one EMT-Basic crew may be made only in the case of disaster or mass casualty incidents. Sees. 30-81 - 30.85. Reserved. " Section 2. Chapter 30 "Emergency Services", Article III "Emergency Medical Services", of the Code of Ordinances of the City of La Porte, Texas is hereby amended by adding new Division 2, with new sections 30-86 through 30-93, inclusive, which said Division shall read as follows: "Division 2. Billing Policy and Procedures Sec. 30-86. Policy for EMS Billing. (a) The City of La Porte recognizes the need to bill for these services to aid in the provision of Emergency Medical Services. (b) No person requiring EMS shall be denied services due to a lack of insurance or ability to pay. (c) Any applicable charges for EMS rendered shall be billed directly to the patient or to the patient's third party payer. (d) A patient who receives emergency medical services from the City of La Porte is obligated, at the time of service or as soon as practicable thereafter, to provide to the City of La Porte with all pertinent insurance and payment information to facilitate the City of La Porte in the billing of third party payment sources for services rendered. The City of La Porte may, at its option, and shall, where required by law, bill insurers or carriers on a patient's behalf and may accept payment on an assignment basis. (e) All patients, whether or not domiciled in the City of La Porte, and/or their financially responsible parties, insurers or carriers, will be billed for emergency medical services provided by the City of La Porte according to the Fee Schedule established herein or at rates established by the City of La Porte - City Council from time to time. (t) All patients, whether or not domiciled in the City of La Porte, shall be liable for any co-payment or deductible amounts not satisfied by public or private insurance, and the City of La Porte shall make reasonable collection efforts for all such balances according to the most current rules or regulations set forth by applicable Health Care Financing Administration federal policies and regulations. (g) The City of La Porte may bill any applicable coinsurance carriers for such amounts. (h) Exceptions include only those instances where the City of La Porte has knowledge of a particular patient's indigence or where the City of La Porte has made a determination that the cost of billing and collecting such co-payments or deductibles exceeds or is disproportionate to the amounts to be collected. (i) The City of La Porte shall not balance bill when prohibited by law. G) A patient for whom the City of La Porte does not bill on assignment and who receives payment directly from a third party payer for emergency medical services rendered by the City of La Porte is obligated to remit such monies to the City of La Porte in the event the City of La Porte has not been paid for services rendered. Patients who do not remit such monies may be held liable for costs of collection in addition to the charges for emergency medical services rendered. (k) The City of La Porte may, either directly or through any third party billing agency with which it has contracted for billing and/or collections for emergency medical services, make arrangements with patients and/or their financially responsible party for installment payments of bills so long as the City of La Porte determines that: (1) the financial condition of the patient requires such an arrangement; and (2) the patient and/or financially responsible party has demonstrated a willingness to make good faith efforts towards payment of the bill." Sec. 30-87. Procedure for EMS Billing. (a) The City of La Porte - EMS is hereby authorized to perform all EMS billing and/or collection services. (b) Funds payable to the City of La Porte by third party payers and/or carriers will NOT be routinely negotiated and will be deposited directly into a designated City of La Porte account, through a lock box or similar arrangement. (c) Exceptions to funds payable to the City of La Porte for EMS services will be limited to negotiations agreed upon between a legal representative of a patient or the party responsible for the patient's personal financial obligations and the Chief EMS Officer. (d) A detailed listing of patients who utilize Emergency Medical Services will be compiled by the City of La Porte EMS Department. This information will be collected for billing and documentation purposes only. The information will be subject to the confidentiality requirements of applicable law. This information will include, at a minimum, the following: (1) Name, address, and telephone number of patient. (2) Name, address and claim number of insurance carrier, if applicable. (3) Date, time and EMS chart number. (4) Point of origin and destination. (5) Odometer reading at point of pick up and destination. (6) Reason for transport! patient's complaint! current condition. (7) Itemization and description of services provided and charges. (8) Signature ofthe patient, when possible, or authorized decision maker. (9) Name of receiving physician. (10) Names, titles, and signatures of EMS personnel, when possible. ( e) All fees for services rendered are payable to the City of La Porte Emergency Medical Service. The fee schedule for emergency medical services shall be as established and printed in Appendix A--Fees, Chapter 30, Emergency Services, Article III, Emergency Medical Services. (f) The fees established above may be increased periodically, with EMS Chief Officer recommendation and subsequent approval by City Council. (g) The City may, in its discretion, bill additionally for material, vehicle and personnel costs in the case of major or unique incidents. (h) EMS may promulgate rules and regulations pursuant to and not inconsistent with this ordinance, state and federal law, such rules and regulations to be approved by City Council. (i) Due to the complex nature of the Health Care Industry and associated billing for related services, the City of La Porte EMS may utilize a claims processing procedure based upon the patient's payer type. Each payer type requires a unique claims process and time frame. When a patient contracts with a combination of payer types, the claims process must be extended to accommodate a claim submission to each payer and a prescribed amount of time for repayment. (j) The following policy establishes guidelines that will address the billing process, collection and bad debt for the City of La Porte EMS: (1) Major Payer Types: Patient (uninsured) Medicare Medicaid Private Health Insurance (commercial) Workman's Compensation (work related injuries) Third Party Liability (auto) (k) It is important to note that the patient may present several combinations of payer types. Although specific rules apply to identify the primary payer when multiple insurance carriers are presented, failure to identify the correct primary payer will extend the billing process; additionally, the number of insurance carriers presented will have a direct bearing on the billing time frame. (1) EMS billing will be completed as soon as possible or within 10 days of the date of service. Subsequent billings and collection guidelines are based on the various payer types as follows: (1) Patient Payer (no insurance): 1 st Invoice 2nd Invoice 3rd Invoice Patient Final Invoice (10 days to pay) Attorney Final Demand Letter 30 days 60 days 90 days 120 days 130 days (2) MedicarelMedicaid Only Payer: 1 st Invoice Denial Received (prompts review) 2nd Denial (prompt patient billing) Patient Final Invoice (10 days to pay) Attorney Final Demand Letter 30 days 60 days 90 days 120 days 130 days (3) Medicare with Supplemental Health Insurance Payer: 1 st Invoice Denial Received (prompts review) 2nd Denial (prompt patient billing) Patient Final Invoice (10 days to pay) Attorney Final Demand Letter 30 days 60 days 90 days 120 days 130 days (4) Worker's Compensation: 1 st Invoice Denial Received (prompt third party billing) 2nd Denial Received Patient Final Invoice (10 days to pay) Attorney Final Demand Letter 30 days 60 days 90 days 120 days 130 days Worker's Compensation has sixty (60) days to approve or deny a claim. A Worker's Compensation denial will transfer the billing process to a third party payment type (employer). The patient cannot be billed until both the employer and Worker's Compensation have both denied the claim as a non-industrial related injury (following an appeal process). (5) Third Party Liability: 1 st Invoice to Insurance and/or Patient 2nd Invoice 3rd Invoice Patient Final Invoice (10 days to pay) Attorney Final Demand Letter 30 days 60 days 90 days 120 days 130 days Patients must resolve litigation matters (i.e., auto accidents) outside of this billing process due to the length of time involved in typical civil claims dispute process. The patient will be held responsible for payment. (6) Private Insurance - No Supplemental: 1 st Invoice to Insurance or Patient 2nd Invoice 3rd Invoice Patient Final Invoice (10 days to pay) Attorney Final Demand Letter 30 days 60 days 90 days 120 days 130 days (m) Periodic payment agreements shall be based upon an agreement 30 days from the date of provision of services. A failure of a debtor to make three (3) periodic payments within a twelve (12) month period under a repayment agreement, either consecutive or intermittent, is to be considered a breech of agreement resulting in the patient receiving an Attorney Final Demand Letter requesting the immediate payment of the remaining amount owed in full. (n) The Chief EMS Officer reserves the right to review all outstanding accounts and to fully discharge or otherwise write-off delinquent accounts which in his or her determination are not suitable for further collection efforts. Sees. 30-88 - 30.93. Reserved. " Section 3. Chapter 30 "Emergency Services", Article III "Emergency Medical Services", of the Code of Ordinances of the City of La Porte, Texas is hereby amended by adding new Division 3, with newly renumbered sections 30-94 through 30-107, inclusive, which said Division shall read as follows: "Division 3. Private Ambulance Service Licensing Sec. 30-94. Licenses Required. (a) No person, either as owner, agent or otherwise shall operate, conduct, maintain, advertise or otherwise be engaged in or profess to be engaged in the business of ambulance service upon the streets, alleys or any public way or place of La Porte, Texas, unless he holds a currently valid license for an ambulance vehicle and an ambulance company, issued pursuant to this chapter. (b) Ambulance vehicle licenses, ambulance company licenses, and attendant-driver's licenses shall be issued for one year or any part thereof during which an ambulance service is maintained. License fees of $200.00 per company; $50.00 per ambulance unit or $500.00 per fleet for 15 or more vehicles; $50.00 per attendant-driver shall be due and payable at the time of application. The licensure period shall be from October 1 st of each year to the 30th day of September of the subsequent year. Fees will not be prorated. (c) No person shall act as an attendant-driver on any ambulance operated under this chapter unless he or she holds a valid attendant-driver license issued pursuant to this chapter. A 21-day temporary permit may be issued at the time of application for license. It shall be the responsibility of the chief EMS officer to verify the applicant's certification status through the Texas Department of State Health Services. (d) All licenses issued pursuant to this chapter are not assignable or transferable and remain the property of the city. (e) No official entry made upon a license may be defaced, removed or obliterated. (t) All licenses shall be available for inspection by any officer of the city at all times. Sec. 30-95. Application for Ambulance License. (a) Application for an ambulance vehicle license and ambulance company license shall be made upon a form furnished by the chief EMS officer who shall issue such a license to an applicant only upon proof by the applicant that the applicant has satisfied all provisions and conditions provided for and has given complete and truthful information to all requirements stated herein. The application shall contain the following information: (1) Name and address of the applicant and of the owner of the ambulance. (2) The trade or other fictitious name, if any, under which the applicant does business or proposes to do business. (3) A complete report on whether or not the applicant has any claims or judgments against him for damages resulting from the negligent operation of the applicant's ambulance(s). (4) A report that the applicant business has paid all city taxes if applicable. (5) Business address, medical license number and DEA number of applicant services medical director. (6) A description of each ambulance, including the make, model, year of manufacture, VIN, motor vehicle registration, current TDSHS license number, the length of time the ambulance has been in use, and the color scheme, insignia, name, monogram, or other distinguishing characteristics to be used to designate applicant's ambulance. (7) Any such other information as may be applicable. (8) No application will be considered before it is complete. (9) Falsification of information on applications will be grounds for revocation of license. Sec. 30-96. Standards for Ambulance License. (a) Each ambulance shall, at all times when in use as such, be suitable for the transportation of patient from the standpoint of health, sanitation and safety. (b) Minimum equipment requirements for each ambulance shall be those established by the Texas Department of State Health Services. (c) When an ambulance permit is issued or renewed under provisions of this chapter, the chief EMS officer will affix to each vehicle two decals, which indicate the vehicle meets all requirements established by this chapter. The color of such decals shall be changed annually. ( d) The chief EMS officer shall cause all ambulances to be inspected before being placed in service and shall thereafter inspect such ambulances no less than once each year. All permitted ambulances and or vehicles are subject to spot inspections with no notice. In the event an ambulance or vehicle fails to pass inspection, the chief EMS officer shall notify the ambulance operator to correct the defects noted in the inspection and, after such notification, the chief EMS officer shall cause such ambulance to be re-inspected within 48 hours. If upon such re-inspection the defects noted in the original inspection have not been corrected, the permit decal shall be removed from the ambulance or vehicle and shall only be replaced upon such ambulance or vehicle after the defects have been corrected. The license fee shall be paid in full for the balance of current year of the original vehicle decal provided. (e) No ambulance that has been substantially damaged or altered, or has received damage where the repair costs exceeds $1,000.00, shall be again placed in service until it has been repaired and re-inspected by the chief EMS officer. There will be no charge for re- inspection. (f) Every ambulance must be maintained in a clean and sanitary condition. (g) All emergency medical calls that originate in the City of La Porte will be responded to by the City of La Porte Emergency Medical Service. In the event that a private ambulance service receives a direct call requesting an ambulance that originates within the City of La Porte, it will be the duty of the private ambulance service to immediately refer the emergency medical call to the City of La Porte Emergency Medical Service (EMS). Sec. 30-97. Requirements for Business Location. If the business location of the ambulance service, firm or organization is located within the city limits, the building must be in compliance with all city ordinances, state and federal laws. Pursuant to this specific chapter, no such ambulance service, firm or organization can operate as its main place of business or a storage facility in a private residence. The chief EMS officer has the right to inspect such locations as often as he deems necessary to make sure all provisions of this chapter are in effect. Refusal of any privately owned ambulance service provided with a business office located within the city limits to allow the chief EMS officer to inspect such premises shall be considered a violation ofthis chapter. Sec. 30-98. Insurance Requirements. (a) No ambulance license shall be issued under this chapter, nor shall such license be valid after issuance, nor shall any ambulance be operated for any reason in the city, unless there is at all times in force and effect insurance coverage, issued by an insurance company licensed to do business in the State of Texas, for each and every ambulance owned and/or operated by or for the applicant for license providing for the payment of damages: (1) For injury to or death of individuals in accident resulting from any cause for which the owner of said vehicle would be liable on account of liability imposed on him by law, regardless of whether the ambulance was being driven by the owner or his agent. (2) For the loss of or damages to the property of another, including personal property, under like circumstances, in the following sums: Not less that $100,000.00 for each person, $300,000.00 for each accident and $10,000.00 for property damage. A written statement from an authorized agent of the ambulance operator(s) insurance carrier verifying the issuance of such insurance shall be filed with the chief EMS officer before any permit may be issued. All such verifications of insurance shall provide for a 30-daycancellation notice to the chief EMS officer. (3) Every insurance policy required hereunder shall contain a provision for a continuing liability thereunder to the full amount thereof not withstanding any recovery thereon, that the liability of the insurer shall not be affected by the insolvency or the bankruptcy of the assured, in that until the policy is revoked the insurance company will not be relieved from liability on account of nonpayment of premium, failure to renew license at the end of the year, or any act or admission of the named assured. Such policy of insurance shall be further conditioned for the payment of any judgments up to the limits of said policy, recovered against any person other than the owner, by his agent or employee, who may operate the same with the consent or acquiescence ofthe owner. (b) Each attendant-driver involved in the operation of an ambulance within the city limits shall be required to carry at all times professional liability insurance. This policy may be provided by the applicant company for all its employees or individual policies issued to all personnel employed by the company. (1 ) This coverage must be from an insurance company licensed to do business in the State of Texas for each and every person operating within the city limits of La Porte. (2) The limits of liability required are no less than $500,000.00 per claim and a $1,000,000.00 aggregate umbrella policy. (3) It shall be the responsibility of each person to provide to the chief EMS officer proof of such insurance. (4) Failure to provide proof of insurance will be justification to suspend andlor not issue any attendant-driver andlor ambulance permit. (5) The chief EMS officer must be notified within 24 hours of any cancellation of Insurance coverage. Sec. 30-99. Application for Attendant-Driver License. (a) Applications for attendant-driver licenses hereunder shall be made upon such form as may be prepared by the chief EMS officer and shall contain the following information which is a requirement for the issuance of a license: (1) The applicant's full name, current address, how long he has lived at current address, previous address, how long he lived at previous address, home telephone number, and social security number. (2) The applicant's age, date of birth, height, place of birth, hair and eye color. (3) The applicant's valid Texas driver's license number, and expiration date. (4) The applicant's present EMS certification level, appropriate Texas Department of State Health Services registration number and expiration date. (5) Two recent photographs of a size designated by the chief EMS officer, which shall be attached to the license application. (6) A report from a duly licensed physician of the State of Texas of a recent physical examination which attests that the person has vision in both eyes correctable to 20120 and has no physical defects which would impair his or her ability to perform the duties of an ambulance attendant-driver. (7) Such other information as the chief EMS officer shall deem reasonably necessary to a fair determination of compliance with this chapter. (b) The chief EMS officer shall within 21 days of receipt of a completed application for an attendant-driver license investigate the application and issue the license or notify the applicant that the application is denied. Sec. 30-100. Standards for Attendant-Driver License. (a) All attendant-driver applicants must be able to read, write and speak the English language. (b) All drivers must have a valid Texas driver's license. (Class A, B, or C). ( c) All attendant-drivers must hold current certification from the Texas Department of State Health Services as an emergency medical technician. (d) No attendant-driver shall have a final conviction for theft, robbery, state or federal controlled substances acts, rape, sexual abuse, indecency with a child, or abuse of a corpse. (e) No attendant-driver shall have been convicted of three or more moving violations within the preceding two-year period. (t) All attendant-drivers shall be able to pass the vision test as prescribed by the Texas Department of Public Safety. Sec. 30-101. Renewal of License. Renewal of any license hereunder, upon expiration or after revocation, shall require conformance with all requirements of this chapter as upon original licensing. Sec. 30-102. Revocation of License. (a) The chief EMS officer may, and is hereby authorized to, suspend or revoke a license issued hereunder for failure of a licensee to comply and to maintain compliance with, or for his violation of, any applicable provisions, standards or requirements of this chapter, or of regulations promulgated hereunder, or of any other applicable laws or ordinances, but only after warning and such reasonable time for compliance as may be set by the chief EMS officer. Any applicant denied a license or any licensee whose license is suspended or revoked shall have the right of appeal to the city manager. Such appeal shall be submitted to the city manager in writing within ten days of the action being appealed. The city manager shall, within ten days after appeal is filed, consider all the evidence in support of or against the ruling appealed from and render a decision either sustaining, reversing, or modifying the determination of the chief EMS officer. (b) If the city manager's decision is not acceptable to the applicant or licensee, he may, within ten days of that decision, file an appeal in writing with the city secretary to the city council. Such a written appeal shall set forth the specific grounds therefore. The city secretary shall notify the appellant within ten days after receipt of appeal as to the time and place of the hearing by the city council, which shall be within 30 days of receipt of such appeal. The determination of the city council on any appeal pursuant to this chapter shall be final. (c) Upon suspension, revocation or termination of an ambulance license hereunder, such ambulance shall cease operation as such and no person shall permit such ambulance to continue operations as such. Upon suspension, revocation or termination of attendant's or driver's license hereunder, such attendant or driver shall cease to drive or attend an ambulance and no person shall employ or permit such individual to drive or attend an ambulance. Sec. 30-103. Medical Director To Serve In An Advisory Capacity. (a) Any ambulance whose attendant receives physicians' orders either by voice communications or written standing orders must have, in an advisory capacity, a physician, licensed in the State of Texas, to serve as medical director. (b) Any ambulance licensed under this chapter must maintain with the chief EMS officer a statement of their current medical director including his or her name, business address, business telephone number, and Texas medical license number; and the federal narcotics license number if any drugs or supplies are prescribed by this physician. Sec. 30-104. Inspection of Ambulances. (a) Subsequent to issuance of any ambulance or vehicle license hereunder, the chief EMS officer shall cause to be inspected each such licensed vehicle, its equipment, premises and personnel, whenever he deemed necessary. All licensed ambulances or vehicles shall be subject to unannounced spot inspections and in any event will be inspected at least once per year. The periodic inspection required hereunder shall be in addition to any other safety or motor vehicle inspection required to be made for ambulance or other motor vehicles in the State of Texas, or other inspections required to be made, under general laws and ordinances, and shall not excuse compliance with any requirements of law and ordinance to display any official certificate of motor vehicle inspection at all times. (b) A copy of each initial, semiannual, spot or other ambulance, equipment, premises and personnel inspection report shall be promptly transmitted to the applicant or licensee to whom it refers. ( c) The chief EMS officer may immediately suspend any of the licenses issued under this chapter if an inspection reveals violations or deficiencies that might endanger a patient or the public. Sec. 30-105. Central Emergency Dispatching System. (a) It shall be unlawful for any ambulance to respond to an emergency call within the City of La Porte. (b) If any person receives any request for an ambulance service response on an emergency basis other than through the city's central dispatching system; it is the obligation of that person to immediately report the same request to the city's central dispatching system at which time a City of La Porte Emergency Medical Service (EMS) unit will be dispatched to respond. (c) It shall not be unlawful for a person operating a licensed ambulance in the city, upon responding to a direct call for non-emergency ambulance service, to operate such ambulance under non-emergency conditions. Notifying the city's central dispatching system is not required for non-emergency ambulance responses. (1) In the event that the senior ambulance attendant-driver makes the determination that a true emergency exists upon arrival, the senior ambulance attendant-driver may then proceed in an emergency status (lights and siren) to the closest appropriate hospital facility only upon notification to the city's central dispatching system. Sec. 30-106. Penalty for Violation of Chapter. (a) A person commits an offense if the person violates this chapter. (b) Any person who violates a provision of this chapter, upon conviction in the municipal court of the city, shall be subject to a fine in an amount established by the city and listed in appendix B of this Code. Sec. 30-107. Variances to Chapter Requirements. (a) An affected person or organization may request a variance from the licensure requirements of this chapter if the person satisfies one or more of the specific criteria listed in subsection (d). (b) It shall be the responsibility of the chief EMS officer to grant such a variance. ( c) The variance must specify the specific licensure requirements and/or fees being waived. (d) The criteria for variance are as follows: (1) The person has transported a sick or injured person to medical care as an individual citizen not ordinarily engaged in that activity; (2) The person transports a sick or injured person in a multiple casualty situation that exceeds the capacity of the city's emergency medical services; (3) The person is a member of an organization and the person's function is to transport members of that same organization to an appropriate medical facility at no charge to the individual being transferred; and that same organization does not solicit business outside itself or provide service to any other organization except in a multiple casualty situation; (4) The vehicle or person is moving through the city on a call that neither originates nor ends within the city; (5) The organization is principally an air transport system; (6) The organization or vehicle is licensed by the state as a "specialized emergency medical services vehicle" and is designed to provide service patients with special needs not easily met by other transport services; (7) The organization is an agency or designated provider of a municipal government. (e) A variance shall not be granted unless it is necessary to assure the availability of quality care to the citizens of the city. (f) A variance shall not be granted unless all ambulance units and personnel meet the minimum standards set by the state health department. (g) The city council reserves the right to reserve the decision of the chief EMS officer in granting or refusing a variance. Section 4. Appendix A-"Fees", Chapter 30 "Emergency Services", Article III "Emergency Medical Services", of the Code of Ordinances of the City of La Porte, Texas is hereby amended, and which said section shall read as follows: Treatment with Transport (ALS) Treatment with Air Transport (ALS) Treatment with Private Transport Treatment with No Transport (Service Charge) Mileage (Loaded Miles) Standby Service Fee (per hour) No TreatmentINo Transport Non-Member Fee (per event) $788.00 $790.00 $396.00 $396.00 $10.00 per mile $75.00 (2 Hour Minimum) No charge $1500.00 Section 5. Open Meetings. The City Council officially finds, determines, recites, and declares that a sufficient written notice of the date, hour, place and subject of this meeting of the City Council was posted at a place convenient to the public at the City Hall of the City for the time required by law preceding this meeting, as required by the Open Meetings Law, Chapter 551, Texas Government Code; and that this meeting has been open to the public as required by law at all times during which this ordinance and the subject matter thereof has been discussed, considered and formally acted upon. The City Council further ratifies, approves and confirms such written notice and the contents and posting thereof. Section 6. Repeal. All ordinances or parts of ordinances of the City of La Porte in conflict with any provision contained herein is hereby repealed, but only to the extent of any conflict. Section 7. Severability. Should any section or part of this ordinance be held unconstitutional, illegal, or invalid, or the application to any person or circumstance for any reasons thereof ineffective or inapplicable, such unconstitutionality, illegality, invalidity, or ineffectiveness of such section or part shall in no way affect, impair or invalidate the remaining portions thereof; but as to such remaining portion or portions, the same shall be and remain in full force and effect and to this end the provisions of this ordinance are declared to be severable. Section 8. Effective Date. This Ordinance shall be effective fourteen (14) days after its passage and approval. The City Secretary shall give notice of the passage of this ordinance by causing the caption hereof to be published in the official newspaper of the City of La Porte at least twice within ten (10) days after the passage of this ordinance. P A~l APPROVED 6ND ADOPTED by the City of La Porte, Texas, City Council on this the day of -1 i CtAiVll tu, 2007. A~ROVED ". ~~y~ Alton E. Porter, Mayor ATTEST: Ltr/4Uk/;4d/I Martha Gillett, City Secretary APPROVED AS TO FORM: U~r~ Clark T. Askins, Assistant City Attorney ARTICLE III. EMERGENCY MEDICAL SERVICES Page 10f9 E'in ~ b;-I ;4 ARTICLE III. EMERGENCY MEDICAL SERVICES Sec. 30-78. Rate structure. The following rate structure as printed in Appendix A--Fees, Chapter 30, Emergency Services, Article III, Emergency Medical Services, has been established by the city council and are payable to the City of La Porte Emergency Medical Service. (Ord. No. 98-2273, S 1, 8-24-98) Sec. 30-79. Definitions. Unless otherwise specified, the term: Ambulance means any privately owned motor vehicle that is specially designed or constructed and equipped and is intended to be used for and is maintained or operated for the transportation of patients. Applicant means any person, partnership, corporation or other operator that makes application to obtain a permit to operate within the city limits of La Porte. If the applicant is a corporation or partnership, this definition will include all officers or partners. Attendant-driver means any person who has the duty of performing or assisting in the performance of an ambulance call and is certified at the minimal level as an emergency medical technician by the Texas Department of State Health Services. The same certification shall be current and valid. Emergency medical service means the City of La Porte Emergency Medical Service, City of La Porte, Texas. Certification means that which meets the requirements of the Texas Department of State Health Services. Chief EMS officer means the chief of emergency medical services, of the City of La Porte or his duly authorized representative. City means the City of La Porte, Texas. City council means the La Porte City Council. Driver's license means the license issued by the Department of Public Safety, State of Texas. Emergency means any circumstance that calls for immediate response (emergency lights and/or siren) in which the element of time in transporting the sick, wounded or injured for medical treatment is essential to the health or life of the person. Said circumstances include, but are not limited to, accidents generally, traffic accidents, acts of violence resulting in personal injury and sudden illness. Emergency call means any request for ambulance service that is made by telephone or other means of communication in circumstances which are, or have been represented to be, an emergency requiring immediate ambulance service. Emergency medical technician means any person currently registered by the Texas Department of State Health Services as an EMT, EMT-intermediate, and/or EMT-paramedic. Emergency run means the emergency ambulance trip to the place where the emergency exists http://library4.municode.com/mcc/DocViewI11102/1/56/59 11/2012007 ARTICLE III. EMERGENCY MEDICAL SERVICES Page 2 of9 or from the place of such emergency to the emergency room of a receiving hospital. License means a license or permit issued by the City of La Porte Emergency Medical Service pursuant to this chapter. Mayor means the Mayor of La Porte, Texas. Medical director means any licensed physician who serves in an advisory capacity to any ambulance for the purpose of providing medical direction under the terms of the Medical Practice Act (Article 4495b, Vernon's Texas Civil Statutes) and rules promulgated by the Texas State Board of Medical Examiners pursuant to terms of the Medical Practice Act. Non-emergency means any request for ambulance service response (no emergency lights and/or siren) that is made by telephone, or other means of communication in circumstances which are or have been represented to be of a non-emergent nature requiring non-emergent service. Officer means the Chief EMS Officer, any Chief EMS Officer designee or a Police Officer of the City of La Porte, Texas. Patient means any person desiring transportation to an appropriate medical facility either on an emergency or transfer basis. Person means an individual, corporation, organization, government or governmental subdivision or agency, business, trust, partnership, association or any other legal entity. Police means any officer of the City of La Porte, Texas, Police Department. Protocol means written medical orders signed by a licensed physician serving as medical director for an ambulance giving medical direction to provide treatment for certain emergencies or other pre-hospital situations requiring physician's orders. These orders must conform to all applicable laws. Street means any street, alley, avenue, boulevard, drive or highway commonly used for the purpose of travel within the corporate limits of the city. Transfer ambulance means any motor vehicle constructed, equipped and used for transferring the sick or injured under circumstances which do not constitute an emergency and which have not been represented as an emergency. Transfer call means any request for ambulance service that is made by telephone, or other means of communication in circumstances which are or have been represented to be of a non- emergent nature requiring non-emergent service. (Ord. No. 2005-2803, S 1 (Exh. A), 1-10-05) Sec. 30-80. Licenses required. (a) No person, either as owner, agent or otherwise shall operate, conduct, maintain, advertise or otherwise be engaged in or profess to be engaged in the business of ambulance service upon the streets, alleys or any public way or place of La Porte, Texas, unless he holds a currently valid license for an ambulance vehicle and an ambulance company, issued pursuant to this chapter. (b) Ambulance vehicle licenses, ambulance company licenses, and attendant-driver's licenses shall be issued for one year or any part thereof during which an ambulance service is maintained. License fees of $200.00 per company; $50.00 per ambulance unit or $500.00 per fleet for 15 or more vehicles; $50.00 per attendant-driver shall be due and payable at the time of application. The licensure period shall be from October 1 st of each year to the 30th day of September of the subsequent year. Fees will not be prorated. (c) No person shall act as an attendant-driver on any ambulance operated under this chapter unless he or she holds a valid attendant-driver license issued pursuant to this chapter. A 21-day http://library4.rnunicode.comlrncc/DocViewI11102/1/56/59 11/20/2007 ARTICLE III. EMERGENCY MEDICAL SERVICES Page 3 of9 temporary permit may be issued at the time of application for license. It shall be the responsibility of the chief EMS officer to verify the applicant's certification status through the Texas Department of State Health Services. (d) All licenses issued pursuant to this chapter are not assignable or transferable and remain the property of the city. (e) No official entry made upon a license may be defaced, removed or obliterated. (f) All licenses shall be available for inspection by any officer of the city at all times. (Ord. No. 2005-2803, ~ 1 (Exh. A), 1-10-05) Sec. 30-81. Application for ambulance license. (a) Application for an ambulance vehicle license and ambulance company license shall be made upon a form furnished by the chief EMS officer who shall issue such a license to an applicant only upon proof by the applicant that the applicant has satisfied all provisions and conditions provided for and has given complete and truthful information to all requirements stated herein. The application shall contain the following information: (1) Name and address of the applicant and of the owner of the ambulance. (2) The trade or other fictitious name, if any, under which the applicant does business or proposes to do business. (3) A complete report on whether or not the applicant has any claims or judgments against him for damages resulting from the negligent operation of the applicant's ambulance(s). (4) A report that the applicant business has paid all city taxes if applicable. (5) Business address, medical license number and DEA number of applicant services medical director. (6) A description of each ambulance, including the make, model, year of manufacture, VIN, motor vehicle registration, current TDSHS license number, the length of time the ambulance has been in use, and the color scheme, insignia, name, monogram, or other distinguishing characteristics to be used to designate applicant's ambulance. (7) Any such other information as may be applicable. (8) No application will be considered before it is complete. (9) Falsification of information on applications will be grounds for revocation of license. (Ord. No. 2005-2803, ~ 1(Exh. A), 1-10-05) Sec. 30-82. Standards for ambulance license. (a) Each ambulance shall, at all times when in use as such, be suitable for the transportation of patient from the standpoint of health, sanitation and safety. (b) Minimum equipment requirements for each ambulance shall be those established by the Texas Department of State Health Services. (c) When an ambulance permit is issued or renewed under provisions of this chapter, the chief EMS officer will affix to each vehicle two decals, which indicate the vehicle meets all http://library4.municode.com/mcc/DocView/11102/1/56/59 11/2012007 ARTICLE III. EMERGENCY MEDICAL SERVICES Page 4 of9 requirements established by this chapter. The color of such decals shall be changed annually. (d) The chief EMS officer shall cause all ambulances to be inspected before being placed in service and shall thereafter inspect such ambulances no less than once each year. All permitted ambulances and or vehicles are subject to spot inspections with no notice. In the event an ambulance or vehicle fails to pass inspection, the chief EMS officer shall notify the ambulance operator to correct the defects noted in the inspection and, after such notification, the chief EMS officer shall cause such ambulance to bere-inspected within 48 hours. If upon such re- inspection the defects noted in the original inspection have not been corrected, the permit decal shall be removed from the ambulance or vehicle and shall only be replaced upon such ambulance or vehicle after the defects have been corrected. The license fee shall be paid in full for the balance of current year of the original vehicle decal provided. (e) No ambulance that has been substantially damaged or altered, or has received damage where the repair costs exceeds $1,000.00, shall be again placed in service until it has been repaired and re-inspected by the chief EMS officer. There will be no charge for re-inspection. (f) Every ambulance must be maintained in a clean and sanitary condition. (g) All emergency medical calls that originate in the City of La Porte will be responded to by the City of La Porte Emergency Medical Service. In the event that a private ambulance service receives a direct call requesting an ambulance that originates within the City of La Porte, it will be the duty of the private ambulance service to immediately refer the emergency medical call to the City of La Porte Emergency Medical Service (EMS). (Ord. No. 2005-2803, 9 1 (Exh. A), 1-10-05) Sec. 30-83. Requirements for business location. If the business location of the ambulance service, firm or organization is located within the city limits, the building must be in compliance with all city ordinances, state and federal laws. Pursuant to this specific chapter, no such ambulance service, firm or organization can operate as its main place of business or a storage facility in a private residence. The chief EMS officer has the right to inspect such locations as often as he deems necessary to make sure all provisions of this chapter are in effect. Refusal of any privately owned ambulance service provided with a business office located within the city limits to allow the chief EMS officer to inspect such premises shall be considered a violation of this chapter. (Ord. No. 2005-2803, 9 1 (Exh. A), 1-10-05) Sec. 30-84. Insurance requirements. (a) No ambulance license shall be issued under this chapter, nor shall such license be valid after issuance, nor shall any ambulance be operated for any reason in the city, unless there is at all times in force and effect insurance coverage, issued by an insurance company licensed to do business in the State of Texas, for each and every ambulance owned and/or operated by or for the applicant for license providing for the payment of damages: (1) For injury to or death of individuals in accident resulting from any cause for which the owner of said vehicle would be liable on account of liability imposed on him by law, regardless of whether the ambulance was being driven by the owner or his agent. (2) For the loss of or damages to the property of another, including personal property, under like circumstances, in the following sums: Not less that $100,000.00 for each person, $300,000.00 for each accident and $10,000.00 for property damage. A written statement from an authorized agent of the ambulance operator(s) insurance carrier http://library4.municode.comlmcc/Doc View/Ill 02/1/56/59 11/20/2007 ARTICLE III. EMERGENCY MEDICAL SERVICES Page 5 of9 verifying the issuance of such insurance shall be filed with the chief EMS officer before any permit may be issued. All such verifications of insurance shall provide for a 30- daycancellation notice to the chief EMS officer. (3) Every insurance policy required hereunder shall contain a provision for a continuing liability thereunder to the full amount thereof not withstanding any recovery thereon, that the liability of the insurer shall not be affected by the insolvency or the bankruptcy of the assured, in that until the policy is revoked the insurance company will not be relieved from liability on account of nonpayment of premium, failure to renew license at the end of the year, or any act or admission of the named assured. Such policy of insurance shall be further conditioned for the payment of any judgments up to the limits of said policy, recovered against any person other than the owner, by his agent or employee, who may operate the same with the consent or acquiescence of the owner. (b) Each attendant-driver involved in the operation of an ambulance within the city limits shall be required to carry at all times professional liability insurance. This policy may be provided by the applicant company for all its employees or individual policies issued to all personnel employed by the company. (1) This coverage must be from an insurance company licensed to do business in the State of Texas for each and every person operating within the city limits of La Porte. (2) The limits of liability required are no less than $500,000.00 per claim and a $1,000,000.00 aggregate umbrella policy. (3) It shall be the responsibility of each person to provide to the chief EMS officer proof of such insurance. (4) Failure to provide proof of insurance will be justification to suspend and/or not issue any attendant-driver and/or ambulance permit. (5) The chief EMS officer must be notified within 24 hours of any cancellation of insurance coverage. (Ord. No. 2005-2803, S 1 (Exh. A), 1-10-05) Sec. 30-85. Application for attendant-driver license. (a) Applications for attendant-driver licenses hereunder shall be made upon such form as may be prepared by the chief EMS officer and shall contain the following information which is a requirement for the issuance of a license: (1) The applicant's full name, current address, how long he has lived at current address, previous address, how long he lived at previous address, home telephone number, and social security number. (2) The applicant's age, date of birth, height, place of birth, hair and eye color. (3) The applicant's valid Texas driver's license number, and expiration date. (4) The applicant's present EMS certification level, appropriate Texas Department of State Health Services registration number and expiration date. (5) Two recent photographs of a size designated by the chief EMS officer, which shall be attached to the license application. (6) A report from a duly licensed physician of the State of Texas of a recent physical examination which attests that the person has vision in both eyes correctable to 20/20 and has no physical defects which would impair his or her ability to perform the duties of an ambulance attendant-driver. http://library4.municode.comlmcc/DocView/11102/1/56/59 11120/2007 ARTICLE III. EMERGENCY MEDICAL SERVICES Page 6 of9 (7) Such other information as the chief EMS officer shall deem reasonably necessary to a fair determination of compliance with this chapter. (b) The chief EMS officer shall within 21 days of receipt of a completed application for an attendant-driver license investigate the application and issue the license or notify the applicant that the application is denied. (Ord. No. 2005-2803, 9 1 (Exh. A), 1-10-05) Sec. 30-86. Standards for attendant-driver license. (a) All attendant-driver applicants must be able to read, write and speak the English language. (b) All drivers must have a valid Texas driver's license. (Class A, 8, or C). (c) All attendant-drivers must hold current certification from the Texas Department of State Health Services as an emergency medical technician. (d) No attendant-driver shall have a final conviction for theft, robbery, state or federal controlled substances acts, rape, sexual abuse, indecency with a child, or abuse of a corpse. (e) No attendant-driver shall have been convicted of three or more moving violations within the preceding two-year period. (f) All attendant-drivers shall be able to pass the vision test as prescribed by the Texas Department of Public Safety. (Ord. No. 2005-2803, 9 1(Exh. A), 1-10-05) Sec. 30-87. Renewal of license. Renewal of any license hereunder, upon expiration or after revocation, shall require conformance with all requirements of this chapter as upon original licensing. (Ord. No. 2005-2803, 9 1(Exh. A), 1-10-05) Sec. 30-88. Revocation of license. (a) The chief EMS officer may, and is hereby authorized to, suspend or revoke a license issued hereunder for failure of a licensee to comply and to maintain compliance with, or for his violation of, any applicable provisions, standards or requirements of this chapter, or of regulations promulgated hereunder, or of any other applicable laws or ordinances, but only after warning and such reasonable time for compliance as may be set by the chief EMS officer. Any applicant denied a license or any licensee whose license is suspended or revoked shall have the right of appeal to the city manager. Such appeal shall be submitted to the city manager in writing within ten days of the action being appealed. The city manager shall, within ten days after appeal is filed, consider all the evidence in support of or against the ruling appealed from and render a decision either sustaining, reversing, or modifying the determination of the chief EMS officer. (b) If the city manager's decision is not acceptable to the applicant or licensee, he may, within ten days of that decision, file an appeal in writing with the city secretary to the city council. Such a written appeal shall set forth the specific grounds therefore. The city secretary shall notify the appellant within ten days after receipt of appeal as to the time and place of the hearing by the city council, which shall be within 30 days of receipt of such appeal. The determination of the city council on any appeal pursuant to this chapter shall be final. http://library4.municode.com/mcc/DocView/ll102/1/56/59 11/20/2007 ARTICLE III. EMERGENCY MEDICAL SERVICES Page 7 of9 (c) Upon suspension, revocation or termination of an ambulance license hereunder, such ambulance shall cease operation as such and no person shall permit such ambulance to continue operations as such. Upon suspension, revocation or termination of attendant's or driver's license hereunder, such attendant or driver shall cease to drive or attend an ambulance and no person shall employ or permit such individual to drive or attend an ambulance. (Ord. No. 2005-2803, 9 1(Exh. A), 1-10-05) Sec. 30-89. Medical director to serve in an advisory capacity. (a) Any ambulance whose attendant receives physicians' orders either by voice communications or written standing orders must have, in an advisory capacity, a physician, licensed in the State of Texas, to serve as medical director. (b) Any ambulance licensed under this chapter must maintain with the chief EMS officer a statement of their current medical director including his or her name, business address, business telephone number, and Texas medical license number; and the federal narcotics license number if any drugs or supplies are prescribed by this physician. (Ord. No. 2005-2803, 9 1 (Exh. A), 1-10-05) Sec. 30-90. Inspection of ambulances. (a) Subsequent to issuance of any ambulance or vehicle license hereunder, the chief EMS officer shall cause to be inspected each such licensed vehicle, its equipment, premises and personnel, whenever he deemed necessary. All licensed ambulances or vehicles shall be subject to unannounced spot inspections and in any event will be inspected at least once per year. The periodic inspection required hereunder shall be in addition to any other safety or motor vehicle inspection required to be made for ambulance or other motor vehicles in the State of Texas, or other inspections required to be made, under general laws and ordinances, and shall not excuse compliance with any requirements of law and ordinance to display any official certificate of motor vehicle inspection at all times. (b) A copy of each initial, semiannual, spot or other ambulance, equipment, premises and personnel inspection report shall be promptly transmitted to the applicant or licensee to whom it refers. (c) The chief EMS officer may immediately suspend any of the licenses issued under this chapter if an inspection reveals violations or deficiencies that might endanger a patient or the public. (Ord. No. 2005-2803, 9 1 (Exh. A), 1-10-05) Sec. 30-91. Central emergency dispatching system. (a) It shall be unlawful for any ambulance to respond to an emergency call within the City of La Porte. (b) If any person receives any request for an ambulance service response on an emergency basis other than through the city's central dispatching system; it is the obligation of that person to immediately report the same request to the city's central dispatching system at which time a City of La Porte Emergency Medical Service (EMS) unit will be dispatched to respond. (c) It shall not be unlawful for a person operating a licensed ambulance in the city, upon responding to a direct call for non-emergency ambulance service, to operate such ambulance http://library4.municode.comlmcc/DocView/11102/1/56/59 11/20/2007 ARTICLE III. EMERGENCY MEDICAL SERVICES Page 8 of9 under non-emergency conditions. Notifying the city's central dispatching system is not required for non-emergency ambulance responses. (1) In the event that the senior ambulance attendant-driver makes the determination that a true emergency exists upon arrival, the senior ambulance attendant-driver may then proceed in an emergency status (lights and siren) to the closest appropriate hospital facility only upon notification to the city's central dispatching system. (Ord. No. 2005-2803, 9 1 (Exh. A), 1-10-05) Sec. 30-92. Penalty for violation of chapter. (a) A person commits an offense if the person violates this chapter. (b) Any person who violates a provision of this chapter, upon conviction in the municipal court of the city, shall be subject to a fine in an amount established by the city and listed in appendix B of this Code. (Ord. No. 2005-2803, 9 1 (Exh. A), 1-10-05) Sec. 30-93. Variances to chapter requirements. (a) An affected person or organization may request a variance from the licensure requirements of this chapter if the person satisfies one or more of the specific criteria listed in subsection (d). (b) It shall be the responsibility of the chief EMS officer to grant such a variance. (c) The variance must specify the specific licensure requirements and/or fees being waived. (d) The criteria for variance are as follows: (1) The person has transported a sick or injured person to medical care as an individual citizen not ordinarily engaged in that activity; (2) The person transports a sick or injured person in a multiple casualty situation that exceeds the capacity of the city's emergency medical services; (3) The person is a member of an organization and the person's function is to transport members of that same organization to an appropriate medical facility at no charge to the individual being transferred; and that same organization does not solicit business outside itself or provide service to any other organization except in a multiple casualty situation; (4) The vehicle or person is moving through the city on a call that neither originates nor ends within the city; (5) The organization is principally an air transport system; (6) The organization or vehicle is licensed by the state as a "specialized emergency medical services vehicle" and is designed to provide service patients with special needs not easily met by other transport services; (7) The organization is an agency or designated provider of a municipal government. (e) A variance shall not be granted unless it is necessary to assure the availability of quality care to the citizens of the city. (1) A variance shall not be granted unless all ambulance units and personnel meet the minimum standards set by the state health department. (g) The city council reserves the right to reserve the decision of the chief EMS officer in http://library4.municode.com/mcc/DocView/11102/1/56/59 11/20/2007 ARTICLE III. EMERGENCY MEDICAL SERVICES Page 9 of9 granting or refusing a variance. (Ord. No. 2005-2803, S 1(Exh. A), 1-10-05) http://library4.municode.com/mcclDocView/11102/1/56/59 11/20/2007 ASKINS & ARMSTRONG, P.C. ATTORNEYS AT LAW 702 W. FAIRMONT PARKWAY P. O. BOX 1218 LA PORTE, TEXAS 77572-1218 IE ~A ; D ;-+ 15 KNOX W. ASKINS 471-1886 JOHN D. ARMSTRONG 471-2047 TELEPHONE 281 TELECOP1ER 281 CLARK T. ASKINS E-MAIL: kwaskinsllilaol.com iohn-allilswbell.net ctaskinsllilswbell.net (Name and address) Date: RE: Account Please be advised that our firm represents the City of La Porte, Texas, as city attorneys. Your outstanding account balance with the City of La Porte EMS has been referred to us with instructions that we make final demand for payment of this debt. As of the date of this letter, your current outstanding balance for services rendered to you by the La Porte EMS, is $ I urge you to immediately contact the City of La Porte EMS billing office at 281-470-0054 to either pay the account in full or to make payment plan arrangements as a method to retire the account balance, in weekly or monthly installment, until final payoff. This offer is being made to you as an expression of the City's desire to settle your account in an amicable manner, and we would urge you to respond. This letter serves as the City of La Porte's final demand for payment and resolution of this matter. If, at the expiration of thirty (30) days after the date of this letter payment has not been received, or this matter has not been resolved through a payment plan arrangement, or you have not contacted our office in writing or by phone disputing the validity of this claim or to seek a compromise, we will assume you are disputing this claim and proceed with formal legal proceedings, without further notice to you. We do not wish to pursue legal proceeding in the court system, or take any action that might impair your credit rating, and therefore we request that you give this matter your most immediate attention. Sincerely, Clark Askins Assistant City Attorney City of La Porte, Texas