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HomeMy WebLinkAbout25. 21-127 FEBRUARY 23, 2021 MARCH 9, 2021 21-102 21-127 ORDINANCE FIRST READING SECOND READING MEDICAL TRANSPORT SERVICES INITIATED BY: OSHKOSH FIRE DEPARTMENT A GENERAL ORDINANCE OF THE CITY OF OSHKOSH CREATING ARTICLE IX. SECTION 8-69 OF THE CITY OF OSHKOSH MUNICIPAL CODE PERTAINING TO AMBULANCE AND MEDICAL TRANSPORT SERVICES WHEREAS, the Common Council desires to assure that all persons within the municipal boundaries are properly served in emergency circumstances with a high standard of care and has determined that limiting emergency response to the Oshkosh Fire Department and providing for additional emergency response services through mutual aid at the discretion of the Oshkosh Fire Department, whose members are specially and highly trained in emergency response will provide for a more orderly health care process and chain of command in emergency situations; and WHEREAS, the Council hereby determines that it is in the best interests of the citizens of the City of Oshkosh as well as others who may work or visit the City to declare that the City of Oshkosh Fire Department is the exclusive provider of emergency services for medical emergencies within the City of Oshkosh; and WHEREAS, the Council recognizes that Oshkosh Fire Department’s high level of equipment and training results in inefficient use of these investments and higher costs related to non-emergency transports by the Oshkosh Fire Department; and WHEREAS, the Council hereby determines that a registration system for non- emergency transport providers is reasonable and necessary to make the Oshkosh Fire and Police Departments as well as the Winnebago County Sheriff’s Department and Dispatchers aware of the names and contact information for those who are providing non-emergency transportation services within the City, to assure that those providing such services have the necessary licenses to perform such transports, and to facilitate communication in case of emergency occurring during transports or for mutual aid purposes. (CARRIED__6-0____ LOST_______ LAID OVER_______ WITHDRAWN_______) PURPOSE: CREATE ORDINANCE TO REGULATE AMBULANCE AND FEBRUARY 23, 2021 MARCH 9, 2021 21-102 21-127 ORDINANCE FIRST READING SECOND READING CONT’D The Common Council of the City of Oshkosh do ordain as follows: SECTION 1. That Article IX. Section 8-69 pertaining to Ambulance and Medical Transport Services of the Oshkosh Municipal Code is hereby created to read as shown on the Attachment to this Ordinance. SECTION 2. This ordinance shall be in full force and effect from and after its passage, and publication. SECTION 3. Publication Notice. Please take notice that the City of Oshkosh enacted ordinance #21-127 on March 9th, 2021 CREATE ORDINANCE TO REGULATE AMBULANCE AND MEDICAL TRANSPORT SERVICES (A GENERAL ORDINANCE OF THE CITY OF OSHKOSH CREATING ARTICLE IX. SECTION 8-69 OF THE CITY OF OSHKOSH MUNICIPAL CODE PERTAINING TO AMBULANCE AND MEDICAL TRANSPORT SERVICES). The ordinance declares the Oshkosh Fire Department as the exclusive provider for emergency medical services for medical emergencies occurring within the City’s boundaries and creates a system of registration for non-emergency transportation providers picking up patients for transport within the City’s boundaries. The full text of the ordinance may be obtained at the Office of the City Clerk, 215 Church Avenue and through the City’s website at www.ci.oshkosh.wi.us. Clerk’s phone: 920/236- 5011. City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 920.236.5000 http://www.ci.oshkosh.wi.us TO: Honorable Mayor and Members of the Common Council FROM: Lynn A. Lorenson, City Attorney and Mike Stanley, Fire Chief DATE: February 17, 2021 RE: Create Ordinance Pertaining to Medical Transport Services within the City BACKGROUND The City’s Fire Department has for many years been the sole provider of emergency and non- emergency medical transports within the City boundaries. The Council has been very supportive of the Fire Department’s medical transportation services over the years through their generous investment in both equipment and paramedic training. As has been discussed with the Council over the past few years, the Fire Department’s high level of equipment and train ing has resulted in the inefficient use of these investments when undertaking non -emergency transports. Therefore, the Fire Department has been in discussions with the local health providers over the past few years regarding the City’s transition away fro m providing non- emergency services and has now moved away from providing non-emergency transportation of patients between health care facilities. As a result of this change, staff expects that other medical transport services will enter the City to take care of those services no longer provided by the Fire Department. Due to the City going from having essentially one medical transport provider in the City to potentially several, staff believes it is advisable for the Council to form some type of structure to the provision of these services within the City so that we can ensure that emergency services continue to serve Oshkosh citizens at a high level as well as ensuring that we are aware of and can monitor those providing non-emergency medical transports. ANALYSIS The overall goal in creating an Ambulance and Medical Transport Services Ordinance is to ensure that Oshkosh citizens with medical emergencies receive the highest standard of care possible. To that end, the Ordinance accomplishes two basic things. First, the Ordinance acknowledges the high quality of care provided by the Oshkosh Fire Department by declaring that the City’s fire department is the exclusive provider of emergency medical services for medical emergencies that occur within the municipal boundaries. Second, the Ordinance creates a registration system for non-emergency medical transportation providers operating within the City so that the City is aware of who is providing these services. Awareness allows the City Fire Department to coordinate any patient services when necessary, as well as ensure that those providing such services in the City hold the necessary licenses from the State. Staff believes that it is critical to ensure that Oshkosh citizens continue to receive the highest standard of emergency medical care. This goal is best achieved through the singular provision of these services by the Oshkosh Fire Department. There are m any benefits of the Council making the policy choice to designate the Fire Department as the sole provider of emergency medical services within the City. These include ensuring compliance with the National Incident Management System; ensuring that the level of training is appropriate and consistent for emergency incidents; ensuring that the various services are able to communicate with each other effectively using the same radios, frequencies and terminology; and ensuring the use of appropriate medical equipment, and centralized medical direction and emergency care protocols are used. Regarding the registration system for non-emergency transport services, staff also believes that protecting the citizens of Oshkosh includes understanding who is providing these services within the City. It is anticipated that there will need to be some level of communication and coordination between these providers and the Fire Department, 911 operators and other emergency service providers. There may be circumstances where third party providers may be called upon for mutual aid to assist with incidents, where providers may be staffing special events and need to coordinate with city staff or emergency providers, or calls which might be more appropriately referred to a pr ovider or to the City for emergency response. In addition, some of the transports could result in a need for emergency medical services. To be clear, the Ordinance does not regulate these providers, as they are already licensed by the state. The registration would facilitate communication, but also allow the Fire Department to verify that those operators are licensed. The Ordinance provides certain exceptions to these two main provisions. Ambulances transporting patients from outside the City limits to medical facilities within the City, whether on an emergency or non-emergency basis, would not have to comply. Additionally, ambulances responding to mutual aid calls, or other specific requests by the City for help, also be permitted to respond in an emergent manner and would not have to comply with registration requirements. FISCAL IMPACT There is no anticipated fiscal impact associated with this ordinance update. RECOMMENDATION Staff recommends adoption of the ordinance as proposed. Respectfully Submitted, Approved: Lynn A. Lorenson Mike Stanley Mark A. Rohloff City Attorney Fire Chief City Manager CHAPTER 8 - IN GENERAL ARTICLE IX. AMBULANCE AND MEDICAL TRANSPORT SERVICES SECTION 8-69 AMBULANCE AND MEDICAL TRANSPORT SERVICES I. Purpose. The Common Council hereby utilizes its authority identified in Sections 62.11(5) and 62.133, Wisconsin Statutes, and other enabling statutes and regulations, to enact this Ordinance for the purpose of ensuring th at citizens within the municipal; boundaries are properly served in emergency circumstances through the City of Oshkosh’s emergency transport, and all non-emergency transport operators are providing legitimate and transparent services. The Common Council has determined that generally limiting emergency response services to the Oshkosh Fire Department and providing for supplemental emergenc y response services to be controlled by the Oshkosh Fire Department, whose members are specially and highly trained in emergency response, will provide for a more orderly health care process and chain of command at the location of emergency situations that will best serve the health, safety, and welfare interests of the public. In addition, the Common Council has determined that a system of registration and requiring other ambulance service providers operating with this City of Oshkosh to meet certain standards and requirements for service as set forth within this ordinance will also promote an orderly health care process as well as clarity and transparency in services which will best serve the health, safety, and welfare interests of the public. II. Definitions. a. Ambulance: any privately owned motor vehicle or aircraft that is specially designed or constructed, equipped, and intended to be used for and maintained or operated for transportation of patients, except that such motor vehicle owned by, or operated under the direct control of the United States or the State of Wisconsin. b. Ambulance Service Operator: A person engaged in the business of transporting patients by ambulance to or from facilities or institutions providing health services. The term does not include the Oshkosh Fire Department for purposes of this ordinance. c. Emergency transport: Any actual or self-perceived event which threatens life, limb, or the well-being of an individual in such a manner that a need for immediate medical care is created or an event that requires emergent or unscheduled medical attention. Any response requiring the use of lights and/or sirens shall be considered emergency service. d. Non-emergency transport: Planned transport of a person in a medically stable condition on a non-emergency or scheduled basis. The term does not include services of the Oshkosh Fire Department for purposes of this ordinance. e. Paramedic: A person who is specially trained in emergency cardiac, trauma, and other lifesaving or emergency procedures in a training program or course of instruction resulting in certification as an Emergency Medical Technician – Advanced or Emergency Medical Technician – Paramedic by the National Registry of Emergency Medical Technicians or the Wisconsin Division of Health. Any Emergency Medical Technician – Paramedic must also be CPR-certified, which means they are certified in cardiopulmonary resuscitation according to standards set by the American Heart Association. f. Patient: A person who is sick, injured, wounded, or otherwise incapacitated or helpless, and in need of transportation and/or medical treatment. g. Person: Any individual, firm, partnership, association, corporation, company, group of individuals acting together for a common purpose, or organization of any kind, including government agency other than the United States or State of Wisconsin. III. Ambulance Service Within Municipal Boundaries a. The City of Oshkosh Shall be the Sole Provider of Emergency Transports within the Oshkosh Municipal Boundaries. i. Except for the City of Oshkosh and/or its agents, no person, either as owner, agent, or otherwise, shall furnish, operate, conduct, maintain, advertise, or otherwise be engaged in, or profess to be engaged in, the business or service of the emergency transports of patients originating within the municipal boundaries of the City of Oshkosh. ii. Non-emergency transports of patients or persons within the municipal boundaries of the City of Oshkosh may occur subject to the rules and standards set forth herein. b. Exceptions: The following Ambulance Service Operators may operate within, or respond to calls within, the Oshkosh municipal boundaries: i. Ambulances or similar emergency vehicles operated by or under the direct control of the United States or the State of Wisconsin; ii. Ambulances transporting patients from locations outside the municipal boundaries of the City of Oshkosh into the City of Oshkosh; iii. Ambulances providing assistance to licensed Ambulance Service Operators in the case of a Mutual Aid request by the City of Oshkosh, or a major catastrophe or emergency in which the licensed Ambulance Service Operators of the City of Oshkosh are unable to address the extent of the health needs of the catastrophe, emergency, or extreme system overload; iv. Ambulance transports passing through the City of Oshkosh which originated from a point outside the City and having a destination point also outside the City; v. Aircraft, including “Flight for Life” or similar services, that transport patients to or from hospitals within the City of Oshkosh. Such aircraft must be licensed by the State of Wisconsin to perform such services. IV. Registration. All Ambulance Service Operators providing non-emergency transports originating within the municipal boundaries of the City of Oshkosh shall register with the City. Registrations shall be filed with the City Clerk’s office. The Clerk shall maintain the Registrations with the official records of the City, and shall transmit copies of all Registrations, including any supporting documents, to the Fire Chief. The Fire Chief or their designee shall have the authority to enforce the requirements of this Section. The Registration shall be on such forms provided by the City and shall include, at a minimum, the following information: a. Name and complete contact information for Registrant. This includes name, address, telephone numbers, and email addresses. b. Names and contact information for at least one (1) primary and one (1) secondary agent for the Registrant. c. If the Registrant is an entity, identify the state of formation. d. All trade or other corporate names, if any, under which the Registrant does business or proposes to do business. e. A copy of all licenses and/or certificates issued by the State of Wisconsin Department of Health Services or other regulatory body that the Registrant believes enables it to lawfully perform the proposed services within the City of Oshkosh. f. The signature of the Registrant or the Registrant’s authorized representative. g. There shall be no charge for filing the Registration with the City. V. Standards for Operation of Non-Emergency Transports a. Each transport vehicle proposed to be used within the City of Oshkosh by an Ambulance Service Operator shall comply with the following: i. The color scheme, lettering, messaging, and special markings on transport vehicles shall be significantly different from the vehicles of all other Ambulance Service Providers providing services in the City of Oshkosh so that there can be no confusion between the Registrant and other operators that have also submitted registrations. There shall be no use of the words “Oshkosh Fire Department” or variations thereof, located anywhere on the vehicle. ii. Any telephone number that states or implies that it is an emergency number shall be limited to the nationwide designated number for emergencies, which is “9-1-1”. Any other contact numbers shall clearly designate their use for non-emergencies only. iii. Be equipped with radio equipment, as follows: 1. Each transport vehicle shall be equipped with at least one portable radio capable of transmitting on the Federal Communications Commission assigned emergency medical frequency and shall be capable of transmitting from any patient location within the City of Oshkosh to all Oshkosh hospitals and to 9-1-1 dispatch. 2. Transport vehicle radio operations shall comply with procedures approved by the Federal Communications Commission and is compatible with the system used by the City of Oshkosh Fire Department. Compatibility shall be determined by the Fire Chief, Oshkosh Fire Department. b. Ambulance Service Operators providing services within the City of Oshkosh shall have in effect for all transport vehicles a sufficient policy of insurance issued by an insurance company licensed to do business in the State of Wisconsin, which shall provide that the insurance company shall be liable for damages of up to one million dollars ($1,000,000) for any accident due to the negligent operation of one of the patient transport vehicles. VI. Response to Incidents a. An Ambulance Service Operator shall not respond to a medical emergency incident within the City of Oshkosh unless called to respond by the Winnebago County Communication Center, the Oshkosh Fire Department, or direct telephone call in circumstances described in subsection III.b. of this section. b. An Ambulance Service Operator receiving a request for an Ambulance to respond to any medical emergency within the City of Oshkosh from any source other than the Winnebago County Communication Center or Oshkosh Fire Department, shall immediately, coincident with its response, provide the Winnebago County Communications Center with all available information as to the nature and location of the emergency. VII. Command at Incident Scene a. Incident Scene and Patient Care. i. Upon arrival on the scene of a medical emergency where patient care is being provided by Oshkosh Fire Department personnel, the Fire Department personnel remain in charge of the incident in accordance with state law. ii. In all instances when the Oshkosh Fire Department personnel are called to an incident, they shall be in command of the incident and for all patient care. iii. It is the obligation of the Ambulance Service Operator personnel to seek out the Fire Department personnel in command of the incident and patient care. iv. In the instances where the Oshkosh Fire Department personnel arrive at the incident first, all subsequent Ambulance Service Operators arriving at the scene shall act under the command of the Oshkosh Fire Department personnel. v. Oshkosh Fire Department personnel remain in command of patient care until it is specifically relinquished to the Ambulance Service Operator personnel. vi. In instances where an Ambulance Service Operator arrives at the incident first, the Ambulance Service Operator shall relinquish command of the incident and patient care to the Oshkosh Fire Department personnel upon their arrival and upon their request to assume command of the incident and patient care. b. If the Ambulance Service Operator is at the scene in violation of this Chapter, no action or inaction of the Oshkosh Fire Department at the scene shall be interpreted to release or waive the violation. VIII. Obedience to Traffic Laws, Ordinances and Regulations. a. The driver of an Ambulance shall comply with all traffic laws relating to the operation of emergency vehicles, as provided by Section 346.03, Wisconsin Statute. b. No siren shall be used when transporting stabilized patients, unless a known additional emergency response situation exists. IX. Severability. The provisions of this Ordinance shall be severable and if any of the provisions shall be held in contravention of the Constitution and laws of the State of Wisconsin, or the United States, the validity of the rest of the Ordinance shall not be affected. It is hereby declared to be the intent of this Ordinance that the same would have been adopted had such unconstitutional or unlawful provisions, if any, not been included herein. X. Effective Date. This Ordinance shall become effective ninety (90) days from the date of publication. XI. Penalties a. Any Person that violates any provision of this Section shall be subject to a forfeiture of not less than One Hundred Dollars ($100.00) but not more than Five Hundred Dollars ($500.00), together with prosecution. b. Each day the violation exists shall constitute a separate offense. c. Nothing in this Section shall preclude the City from taking any other lawful action in addition to seeking a forfeiture in the event of a violation of this Section.