19 - ORDINANCE REGARDING PROVISION OF EMS SERVICES IN THE CITY OF PARISItem No. 19
memorandum
TO: Mayor & City Council
FROM: John Godwin, City Manager
SUBJECT: Ordinance regarding provision of EMS services in the City of Paris
DATE: June 23, 2016
BACKGROUND: As you know, the City of Paris operates a highly regarded emergency medical
service (Paris EMS) which provides a high level of care to the citizens of Paris and Lamar
County. From time to time, other EMS services will attempt to come into Paris to provide non-
emergency transport services (transferring patients from nursing homes to doctor appointments,
etc.). The state, for the most part, regulates ambulance operations and the provision of
emergency medical services; however, in 2013, in response to significant fraud by providers of
non - emergency ambulance transfer services, the legislature passed Health & Safety Code Sec.
773.0573 to help counties and municipalities combat this fraud. Pursuant to Sec. 773.0573, any
emergency medical services provider seeking to move into a municipality must obtain a letter
from the municipality's governing body stating that (1) the addition of another licensed
emergency medical services provider will not interfere with or adversely affect the provision of
emergency services providers operating in the municipality, (2) the addition of another licensed
emergency medical services provider will remedy an existing provider shortage that cannot be
resolved through the use of the licensed emergency medical services providers operating in the
municipality, (3) and the addition of another licensed emergency medical services provider will
not cause an oversupply of licensed emergency medical services providers in the municipality.
In other words, the legislature has provided local control to municipalities regarding the
operation of emergency medical services providers /ambulance services.
STATUS OF ISSUE: The proposed ordinance makes legislative findings that none of the three
factors required for the operation of any emergency services provider other that Paris EMS are
present in the City, and therefore creates an offense for any other EMS service to provide
emergency medical services (which includes the types of non - emergency transfers set forth
above) within the City of Paris. There is a defense to prosecution for air ambulances and for
non - emergency transports that either originate or end outside the city limits, as such a restriction
would likely impact interstate commerce concerns.
As Paris EMS is presently the sole provider of these services operating in the city, this ordinance
will maintain the status quo. The ordinance, by allowing Paris EMS to continue to provide all
in -City ambulance transfers, will ensure that Paris EMS remains financially stable, which is
critical to its ability to continue to provide top -level EMS services to our citizens.
BUDGET: Passage of the ordinance will have no budgetary consequences.
RECOMMENDATION: Approve attached ordinance.
ORDINANCE NO.
AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF PARIS, TEXAS,
PROVIDING FOR THE PROVISION OF EMERGENCY MEDICAL SERVICES IN
THE CITY OF PARIS; CREATING AN OFFENSE FOR PROVISION OF
EMERGENCY MEDICAL SERVICES BY ANY EMERGENCY MEDICAL
SERVICES PROVIDER OTHER THAN CITY OF PARIS EMS; MAKING OTHER
FINDINGS AND PROVISIONS RELATED TO THE SUBJECT; PROVIDING A
PENALTY CLAUSE; PROVIDING A SAVING CLAUSE; PROVIDING A
SEVERABILITY CLAUSE; AND PROVIDING AN EFFECTIVE DATE
WHEREAS, the City of Paris operates an emergency medical service ( "City of Paris
EMS ") which provides exclusive emergency medical services within the City; and
WHEREAS, the provision of emergency medical services is primarily a
governmental function of the City of Paris; and
WHEREAS, emergency medical services and the operation of ambulances is
regulated by Chapter 773 of the Texas Health & Safety Code; and
WHEREAS, the Texas Legislative, in enacting Sec. 773.0573, Texas Health & Safety
Code, has required that a governing body of a municipality must determine whether there
is a need for additional emergency medical services providers prior to authorizing any such
providers to operate within the municipality; and
WHEREAS, pursuant to Sec. 773.0573, the governing body of a municipality may not
authorize additional emergency medical services providers to begin providing emergency
medical services in the municipality unless the governing body (1) finds that the addition
of another licensed emergency medical services provider will not interfere with or
adversely affect the provision of emergency services providers operating in the
municipality, (2) the addition of another licensed emergency medical services provider will
remedy an existing provider shortage that cannot be resolved through the use of the
licensed emergency medical services providers operating in the municipality, (3) and the
addition of another licensed emergency medical services provider will not cause an
oversupply of licensed emergency medical services providers in the municipality; and
WHEREAS, the City Council has determined that the three conditions set forth in
Sec. 773.0537 necessary to authorize additional emergency medical services providers to
provide emergency medical services in the City do not exist; and
WHEREAS, because, those conditions do not exist, it is in the best interest of the
citizens of the City that City of Paris EMS remain the exclusive provider of emergency
medical services as defined herein in the City;
NOW THEREFORE, BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF
PARIS, TEXAS:
Section 1. That the findings set out in the preamble to this ordinance is hereby in
all things approved.
Section 2. That Chapter 2, Article IV, Division I of the Code of Ordinances of the
City of Paris, Texas relating to Emergency Medical Services is hereby amended to add the
following sections:
"Sec. 2 -100 - Definitions
"`Emergency medical services' shall mean services used to respond to an
individual's perceived need for immediate medical care and to prevent death
or aggravation of physiological or psychological illness or injury and shall
include transfer of an individual by emergency medical services vehicle
attended by emergency medical services personnel, and any services
provided therewith, in non - emergency situations.
"'Emergency medical services personnel' means:
(a) emergency care attendant;
(b) emergency medical technicians
(c) advanced emergency medical technicians
(d) emergency medical technicians - paramedic; or
(e) licensed paramedic.
"'Emergency medical services vehicle' means:
(a) a basic life - support emergency services vehicle;
(b) an advance life- support emergency services vehicle;
(c) a mobile intensive care unit; or
(d) a specialized emergency medical services vehicle
" `Emergency medical service provider' means a person who uses or
maintains emergency medical services vehicles, medical equipment, and
emergency medical services personnel to provide emergency medical
services.
"Sec. 2 -101- Findings
(a) The provision of emergency medical services is a primarily
governmental function to be performed in accordance with the terms of this
chapter.
(b) The addition of emergency medical services providers in the City of
Paris will interfere with and adversely affect the provision of emergency
medical services as defined herein provided by the licensed medical services
provider operating in the City, to wit: City of Paris EMS.
(c) There is no existing emergency medical services provider shortage
that cannot be resolved through the use of City of Paris EMS.
(d) The addition of licensed emergency medical services providers other
than City of Paris EMS will cause an oversupply of licensed emergency
medical services providers in the City.
"Sec. 2 -102 - Emergency Medical Services Transports - Offense
It shall be unlawful within the territorial limits of the City of Paris for any
person other than an on -duty employee of the City of Paris Emergency
Medical Service department, to furnish, operate, conduct, maintain, or
otherwise be engaged in the operation of an emergency medical services
vehicle or to otherwise engage in the provision of emergency medical
services as defined herein.
"Section 2 -103 - Defenses
(a) It shall be a defense to the prosecution of an offense under Sec. 2 -102
that the person or emergency medical services provider was operating an
air ambulance that is regulated by the U.S. Federal Aviation Administration
and that is operating in compliance with state licensing requirements.
(b) It is a defense to the prosecution of an offense under Sec. 2 -102 that
the person or emergency services provider was providing emergency as
defined herein medical services in an emergency medical services vehicle in
a non - emergency situation if the transport originated from a location
outside the city to any destination within the city, or if the transport
originated from a location inside the city to a destination outside the city
limits.
"Section 2 -104 - Mutual Aid Agreements
The City, at its discretion, from time to time may request assistance through
mutual aid agreements for the emergency and non - emergency
transportation of patients in the city from other emergency medical services
providers. The request for such service, as a failsafe for the protection of the
citizens of the City of Paris, must come from City of Paris EMS or the 911
dispatch center for the City.
"Sec. 2 -105 - Penalty
An offense under this Article is a Class C misdemeanor punishable by a fine
not to exceed $500.00. Each transport provided in violation of this Article
constitutes a separate offense."
Section 3. That all provisions of the ordinances of the City of Paris, Texas in conflict
with the provisions of this ordinance are hereby repealed, and all other provisions of the
ordinances of the City of Paris, Texas not in conflict with the provisions of this ordinance
shall remain in full force and effect.
Section 4. That the repeal of any ordinance or part of ordinances affected by the
enactment of this ordinance shall not be construed as abandoning any action now pending
under or by virtue of such ordinance or as discontinuing, abating, modifying, or altering
any penalty accruing or to accrue, or as affecting any rights of the municipality under any
section or provisions of any ordinance at the time of passage of this ordinance.
Section 5. That it is the intention of the City Council of the City of Paris, Texas, that
this ordinance and every provision hereof, shall be considered severable, and the invalidity
or partial invalidity of any section, clause, or provisions of this ordinance shall not affect
the validity of any other portion of this ordinance.
Section 6. That this ordinance shall take effect upon passage and publication as
required by law, and it is accordingly so ordained.
PASSED AND APPROVED this 27th day of June 2016.
A. J. Hashmi, M.D., Mayor
ATTEST:
Janice Ellis, City Clerk
APPROVED AS TO FORM:
Stephanie H. Harris, City Attorney