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HomeMy WebLinkAbout11-04-19 City Commission Packet Materials - C13. Ord 2023 Final, Amending Sections of the BMC for Emergency Medical Services Commission Memorandum REPORT TO: Honorable Mayor and City Commission FROM: Josh Waldo, Fire Chief Andrea Surratt, City Manager SUBJECT: Final Adoption of Ordinance 2023, amending multiple sections of Chapter 18, Article 6 of the Bozeman Municipal Code. MEETING DATE: November 4, 2019 AGENDA ITEM TYPE: Consent RECOMMENDATION: City Commission make final adoption of Ordinance 2023, amending multiple sections of Chapter 18, Article 6 of the Bozeman Municipal Code. BACKGROUND: The City of Bozeman issues licenses to operate emergency medical services (EMS) via the requirements found in Chapter 18, Article 6 of the Bozeman Municipal Code. This section of the municipal code was last updated in 1997, thus some components of the ordinance are in need of updating to meet current practices in emergency medical services in the City of Bozeman. During this same time changes have occurred in state statute and state licensing that need to be included in our licensure process. The updates to the ordinance look to address both technological and operational items that have changed since the last update, along with changes in state statute and licensing requirements. Non-emergency transports conducted by ambulance companies have become more regular over the past two decades as a way to transport residents from their primary place of residence to medical appointments. These non-emergency transports are conducted independent of the normal 911 process used for requesting emergency medical services. While these non- emergency transports are conducted independent of the system, they still have an impact on the entire emergency medical system in our community. Currently the muni-code does not speak to these non-emergency transports and requires anyone who wishes to operate an ambulance for any reason to meet all of the requirements of the muni-code. The proposed updates offer an opportunity for services to only provide non-emergency transport services, while also clarifying the ability of providers who provide emergent EMS services to also conduct non-emergent transports. Technology in the emergency services field has improved drastically since 1997 and the proposed updates capture many of those advancements. The proposed updates require that all emergent EMS providers utilize mobile data communications and auto vehicle location technology, similar to what the Fire Department uses. These technology requirements are vital in communications of information, dispatching of the closest available unit, and safety of responders in events where communicating critical information via a public safety radio may not be suitable. The proposed updates require that EMS providers have an agreement in place with 195 Gallatin County 911 for dispatching services. Gallatin County is the primary dispatching agency for all emergency service organizations in Gallatin County, therefore having EMS providers dispatched via Gallatin County is important to response times and communication. The Fire Department moved to a new 800 MHz radio system in 2018 and the proposed updates require that EMS providers have radios capable of communicating directly with Fire Department personnel on Fire Department channels. The current ordinance requires that an EMS providers furnish the City of Bozeman with a performance bond in the amount of $250,000 that could be forfeited to the City if requirements of the issued license are not met. The proposed update increases the amount of the performance bond to $1,000,000, which could be used to cover capital or operational cost for emergency medical services in the event of an unanticipated absences of a service provider. The current ordinance requires that an EMS provider give the City 30 days notice should they desire to no longer provide EMS services. The proposed update changes this notice period to 180 days, giving the Fire Department and City Administration a more adequate time frame to make adjustments to ensure continuity in EMS services for residents. The response time expectations from the current ordinance have not changed and carry over to the proposed update. The expectation is that an EMS provider respond to emergencies within 8 minutes, 90 percent of the time. This standard aligns with the standards found in National Fire Protection Association 1710, Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments. The first reading of this ordinance occurred on October 21, 2019. ALTERNATIVES: As suggested by the City Commission FISCAL EFFECTS: None Attachments: Ordinance 2023 Report compiled on: October 28, 2019 196 Page 1 of 12 ORDINANCE 2023 AN ORDINANCE OF THE CITY COMMISSION OF THE CITY OF BOZEMAN, MONTANA AMENDING MULTIPLE SECTIONS OF CHAPTER 18, ARTICLE 6 (EMERGENCY MEDICAL SERVICES) BOZEMAN MUNICIPAL CODE. WHEREAS, the City of Bozeman (the “City”) is authorized by the City Charter and Montana law to protect public health, safety and welfare of the citizens of Bozeman, and WHEREAS, it is the intent of the City Commission to establish a procedure by which all nonemergency ambulance transport services and emergency medical services are licensed with the City, and WHEREAS, it is the intent of the City Commission to establish requirements for City licensing of providers of nonemergency ambulance transport services and emergency medical services to ensure such providers provide safe, high quality services to the public. NOW THEREFORE, BE IT ORDAINED BY THE CITY COMMISSION OF THE CITY OF BOZEMAN, MONTANA: Section 1 Section 18.06.010 of the Bozeman Municipal Code is revised as follows: Sec. 18.06.010. - Definitions. A. The following words, terms and phrases, when used in this article, shall have the meanings ascribed to them in this section, except where the context clearly indicates a different meaning: 197 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 2 of 12 1. "Ambulance" has the meaning provided in 50-6-302, MCA, and the administrative rules adopted by the Montana Department of Health and Human Services, as amended. means a privately or publicly owned motor vehicle or aircraft that is maintained and used for transportation of patients. 2. "Emergency medical service" means an unplanned or unexpected pre-hospital or inter- hospital emergency medical transportation or treatment service provided by an ambulance or non-transporting medical unit licensed by the state department of health and human services. 3. “Non-emergency ambulance transport” has the meaning in 50-6-302, MCA, as amended. 4. “Fire Chief” means the chief of the city fire department. 35. "Patient" means an individual who is sick, injured, wounded or otherwise incapacitated or helpless as a result of an acute medical or traumatic condition or an acute exacerbation of a chronic medical or traumatic condition requiring unplanned but timely medical evaluation. The term does not include a person who is nonambulatory and who needs nonemergency ambulance transportation assistance solely because that person is confined to a wheelchair as the person's usual mode of mobility. 6. “Person” means an individual, firm, partnership, association, corporation, company, group of individuals acting together for a common purpose, or organization of any kind, including a governmental agency other than the United States. Section 2 Section 18.06.020 of the Bozeman Municipal Code is revised as follows: Sec. 18.06.020. - License required. A. A person licensed by the state department of public health and human services pursuant to title 50, chapter 6, part 3, MCA, may not conduct or operate an nonemergency ambulance transport service or an emergency medical 198 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 3 of 12 service within the corporate limits of the city without first obtaining a license from the city city’s fire chief and otherwise complying with the requirements of this article. B. Applications for a license must be made in writing to the city's department of administrative services fire chief on forms specified by the department fire chief. C. Each license must be issued for a specific term which shall be concurrent with the term for which the applicant is licensed by the state department of public health and human services pursuant to the provisions of title 50, chapter 6, part 1, MCA Montana Code Annotated (MCA 50-6-101 et seq.). Renewal may be obtained by demonstrating renewal of the required license by the state department of public health and human services and ongoing compliance with the requirements of this article. D. A license issued by the city for emergency medical services authorizes the holder of such license to also provide nonemergency ambulance transport within the corporate limits of city. EF. There must be paid to the city, with each application for a license or for renewal of a license, a license fee of $500.00. EF. The license is not transferable. FG. The license is nonexclusive. H. Subject to 18.06.080, the fire chief may deny an application for a license if the applicant does not demonstrate it has the experience, financial resources, and organizational capacity to serve the citizens of the city for the requested license type. Section 3 Section 18.06.030 is revised as follows: Sec. 18.06.030. - Criteria for license. A. Any person desiring to obtain the license required by this article shall demonstrate the ability to meet the following requirements: 1. The applicant must possess a current license from the state department of public 199 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 4 of 12 health and human services to provide emergency medical services, both transport and treatment services, at the advanced life support level. 2. The applicant must provide emergency medical services at the advanced life support level throughout the city, 24 hours per day, seven days per week. 3. The applicant must have adequate personnel, vehicles, equipment and facilities to respond at the advanced life support level to emergency calls to all locations within the corporate limits of the city within eight minutes or less on at least 90 percent of such calls. Ambulance response time to an emergency request shall be calculated as the actual elapsed time in minutes and seconds from the moment the call is received by the applicant to the moment the first capable unit arrives at the scene of the incident. Where multiple ambulances are dispatched to the same emergency incident, only the response time of the first ambulance to arrive at the scene shall be counted. 4. The applicant must have a commercial general liability policy, in a form acceptable to the city, insuring the applicant for not less than the sum of $10,000,000.00, per occurrence, for bodily injury or death and $10,000,000.00, per occurrence, for loss or damage to property. Said policy shall name the city as an additional insured. The applicant must furnish proof of such insurance coverage prior to issuance of the license. 5. The applicant must provide a performance bond, running to the city, in the amount of $250,000.00, conditioned upon applicant's full compliance with all provisions of this article during the entire period that applicant is licensed by the city. Failure to remain in compliance with all requirements of this article for the full license period, without a written variance from the city, may result in cancellation of the license and, at the city's sole option, forfeiture of the performance bond to the city. 6. The applicant must comply with all rules and regulations governing emergency medical services and emergency medical technicians as promulgated by the Montana Department of Public Health and Human Services and the Board of Medical Examiners as contained in the Administrative Rules of Montana. 200 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 5 of 12 A. Any person desiring to obtain any license required by this article must meet the following requirements: 1. Possess a current license pursuant to title 50, chpt. 6, part 3, MCA from the state department of public health and human services at a minimum the basic life support with advanced life support authorization level and maintain in compliance with all rules established for their license as promulgated by the state; 2. Provide the city fire department with a copy of medical protocols if such protocols differ from than those established by the city’s fire department. B. In addition to subsection A, an applicant desiring to provide emergency medical services must comply with the following: 1. Provide emergency medical services at the advanced life support level throughout the city, 24 hours per day, seven days per week. 2. Have adequate personnel, vehicles, equipment and facilities to respond at the advanced life support level to emergency calls to all locations within the corporate limits of the city within eight minutes or less on at least 90 percent of such calls. The city fire chief may establish the types of calls which are subject to this emergency call standard. Ambulance response time shall be calculated as the actual elapsed time in minutes and seconds from the moment the call is received by the applicant to the moment the first capable unit arrives at the scene of the incident. Where multiple ambulances are dispatched to the same emergency incident, only the response time of the first ambulance to arrive at the scene shall be counted. 3. Provide the city fire chief a monthly time compliance report in a format as determined by the fire chief. 4. Have and maintain for the duration of the license period a contract with a physician licensed pursuant to the laws of the state to provide medical direction. The physician providing medical direction to a person licensed under this article who conducts emergency medical transport must practice medicine or reside in Gallatin County. 201 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 6 of 12 5. Carry commercial general liability insurance, in a form acceptable to the city, insuring the applicant for not less than the sum of $10,000,000.00, per occurrence, for bodily injury or death and $10,000,000.00, per occurrence, for loss or damage to property. Said policy shall name the city as an additional insured on a primary non-contributory basis. The applicant must furnish proof of such insurance coverage prior to issuance of the license. 6. Provide a performance bond, running to the city, in the amount of $1,000,000.00, conditioned upon applicant's full compliance with all provisions of this article during the entire period that applicant is licensed by the city and for ensuring that should applicant fail to comply with the cancellation notice required by 18.060.050 that such bond shall be forfeit to the city. Failure to remain in compliance with all requirements of this article for the full license period, without a written variance from the city, may result in cancellation of the license and, at the city's sole option, forfeiture of the performance bond to the city. 7. Have an agreement in place with Gallatin County 911 to receive and acknowledge request for emergency medical services via radio on all frequencies as determined by Gallatin County 911. 8. Ensure its ambulances operating within the city have installed automatic vehicle location technology compatible with Gallatin County 911 and that such technology complies with all city fire department protocols for dispatch of the closest available ambulance. 9. Have proper equipment for communicating on the city fire department’s dispatch and tactical radio channels. C. In addition to subsection A, an applicant desiring to conduct only nonemergency ambulance transport services must comply with the following: 1. Provide proof to the city fire department of general and vehicle liability insurance at levels commercially reasonable for the type of service being provided for all operations conducted within the city and keep such insurance in good standing. 202 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 7 of 12 2. Be licensed by the state at a minimum level of basic life support with advanced life support authorization. Section 4 Section 18.06.040 of the Bozeman Municipal Code is revised as follows: Sec. 18.06.040. – Exemptions from standards for response time. A. Applicant An applicant seeking to provide emergency medical service shall is be exempt from the response time and performance requirements of section 18.06.030.B.2, only under the following circumstances as follows: 1. Weather conditions. In the event of an onset of such inclement weather that the city fire chief, in the chief's sole discretion, believes that the threat to system-wide patient care. 2. outweighs the threat to the individual patient care from a delayed response time, the city fire chief may declare a weather emergency, thus suspending response time requirements. A weather emergency will be declared only in times of unusually hazardous driving conditions. 3. System overload. During periods of unusual system overload, which shall mean that at least more than two emergency responses are occurring simultaneously within the incorporated city limits, applicants shall be exempt from the requirements of this article and shall use "best efforts" to maintain coverage and performance throughout the incorporated city limits. 4. Declared disaster. During a declared disaster either within the incorporated city limits or in a neighboring community, and confirmed by the city fire chief, applicants shall be are exempt from the requirements of this article and shall but shall use “best efforts” to maintain coverage and performance throughout the incorporated city limits. 203 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 8 of 12 Section 5 Section 18.06.050 of the Bozeman Municipal Code is revised as follows: Sec. 18.06.050. – Cancellation of license/termination by licensee. A. The city fire chief may suspend a license without notice for an alleged violation of this article for a period of no more than 90 days. Should the fire chief suspend a license, the fire chief must notify the licensee whether the fire chief intends to cancel the license. The fire chief may cancel a license after providing notice of intent to cancel and providing the licensee an opportunity to be heard pursuant to 18.06.060 if it the fire chief finds that the licensee, its officers or employees has have: 1. Violated any provision of this article, any other local, state, or federal law, or of the rules promulgated by the state department of public health and human services or the state board of medical examiners, as contained in the Administrative Rules of Montana. 2. Failed or refused to remedy or correct the violation within the time and in the manner directed by the city. B. Should a person licensed under this chapter for emergency medical services seek to no longer provide services such licensee must provide written notice to the fire chief no less than 180 days prior to the date such person will no longer provide emergency medical service within the city. Failure of a licensee to provide such notice to the city’s fire chief within the required time frame will be grounds for the licensee to forfeit the licensee’s performance bond. Section 6 Section 18.06.060 of the Bozeman Municipal Code is revised as follows: Sec. 18.06.060. - Notice and hearing required. A. The city fire chief shall may not deny an application for a license or cancel a license without: 1. Delivery to the applicant or licensee of a written statement of the grounds for 204 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 9 of 12 denial or cancellation or the charge involved. 2. An opportunity to be heard answer at a public hearing before the city commission to show cause, if any, why the license should not be denied or cancelled. After receipt of written notice of grounds for denial or cancellation or charges, any applicant or licensee desiring a hearing before the city commission must make written application to the city clerk within ten days following the date of mailing of the written notice stating the reasons the applicant or license holder believes denial or cancellation of a license is in error. The commission may affirm the decision of the fire chief or, if the commission determines the fire chief’s decision was arbitrary or capricious, overturn the decision of the fire chief. Section 7 Section 18.06.070 of the Bozeman Municipal Code is revised as follows: Sec. 18.06.070. - Existing services. Any person providing emergency medical services or nonemergency ambulance transport within the city as of the effective date of the ordinance from which this article is derived shall have a period of 120 days to meet the requirements and obtain the license required by this article. Section 8 Section 18.06.080 of the Bozeman Municipal Code is revised as follows: Sec. 18.06.080. - Exemptions. A. The provisions and requirements of this article shall not apply to: 1. The fire department of the city. 2. Any person providing emergency medical services outside the city who, in the course of providing such services, transports a patient from outside the city into or through the city. 3. Any person providing emergency medical services within the city who is 205 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 10 of 12 providing such services at the request of the city pursuant to a written mutual aid agreement between the city and the person. 4. Any person providing emergency medical services using an aircraft such as a helicopter from a health care facility inside the city to a health care facility outside the city. Section 9 A new Section 18.06.090 is added to the Bozeman Municipal Code as follows: Sec. 18.06.090. - Violation; penalty. Any person, firm or corporation, their agents or servants, who violates any of the provisions of this article, including conducting emergency medical services while only holding a license for nonemergency medical transport, shall be deemed guilty of a misdemeanor and, upon conviction thereof, shall be punished by a fine in any sum not exceeding $500 and in addition shall pay all costs and expenses of the case. A separate offense shall be deemed committed upon each day during or on which a violation occurs or continues. Section 10 Repealer. All provisions of the ordinances of the City of Bozeman in conflict with the provisions of this ordinance are, and the same are hereby, repealed and all other provisions of the ordinances of the City of Bozeman not in conflict with the provisions of this ordinance shall remain in full force and effect. Section 11 Savings Provision. Any person providing emergency medical services or nonemergency ambulance transport within the city as of the effective date of the ordinance from which this article is derived shall have a period of 120 days to meet the requirements and obtain the license required by this ordinance. Other than for compliance with the above, this ordinance does 206 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 11 of 12 not affect the rights and duties that matured, penalties that were incurred or proceedings that were begun before the effective date of this ordinance. All other provisions of the Bozeman Municipal Code not amended by this Ordinance shall remain in full force and effect. Section 12 Severability. That should any sentence, paragraph, subdivision, clause, phrase or section of this ordinance be adjudged or held to be unconstitutional, illegal, or invalid, the same shall not affect the validity of this Ordinance as a whole, or any part or provision thereof, other than the part so decided to be invalid, illegal or unconstitutional, and shall not affect the validity of the Bozeman Municipal Code as a whole. Section 13 Codification. This Ordinance shall be codified as indicated in Section 1 – 9. Section 14 Effective Date. This ordinance shall be in full force and effect 30 days after final passage and approval. 207 Ordinance 2023, Amending Multiple Sections of Chapter 18, Article 6 of the BMC Page 12 of 12 PROVISIONALLY ADOPTED by the City Commission of the City of Bozeman, Montana, on first reading at a regular session held on the 21st day of October, 2019. CYNTHIA L. ANDRUS Mayor ATTEST: ROBIN CROUGH City Clerk FINALLY PASSED, ADOPTED AND APPROVED by the City Commission of the City of Bozeman, Montana on second reading at a regular session thereof held on the 4th day of November, 2019. The effective date of this ordinance is December 4, 2019. CYNTHIA L. ANDRUS Mayor ATTEST: ROBIN CROUGH City Clerk APPROVED AS TO FORM: GREG SULLIVAN City Attorney 208