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WC CWF Health District Board Minutes - 03/25/2011.i WICHITA FALLS - WICHITA COUNTY PUBLIC HEALTH BOARD MINUTES March 25, 2011 Wichita Falls- Wichita County Public Health District RECEIVED IN CITY CLERK'S OFFIC 1700 Third Street - Parker Conference Room Wichita Falls, Texas DATE BY; _ JA___�TIME.: g ME MBERS PRESENT: Board Members Richard Sutton, M.D., Chair Bryan Press, Vice Chair Robin Moreno, M.T., Secretary David Carlston, Ph.D. Tracy Hill, D.D.S. Clay Clark, D.V.M. Lauren Jansen, Ph.D. MEMBERS ABSENCE EXCUSED: None Lou Franklin, R.N., B.S.N. Director of Health Amy Cone, M.P.A. Assistant Director of Health Ahmed Mattar, M.D. Health Authority Not Present Assistant City Manager Dorothy Roberts -Burns Council Liaison Not Present County Judge I. CALL TO ORDER & INTRODUCTIONS Chair Dr. Sutton called the Board of Health meeting to order at 12:15 pm after a quorum of members was attained. II. APPROVAL OF JANUARY MEETING MINUTES AND ABSENCES Dr. Sutton called for the review and approval of minutes from the last meeting held on January 28, 2011. Dr. Jansen introduced a motion to approve the minutes as presented and Dr. Carlston seconded the motion. Motion passed unanimously. At this time it was noted all members were in attendance. III. AMBULANCE ORDINANCE AND TATTOO ORDINANCE REVISIONS Environmental Health Administrator Susan Morris presented the history of the Ambulance Ordinance and why it was time for a revision of the local ordinance, including the following information: • Emergency services were provided through funeral homes with use of a hearse from the mid 1930's through 1970. • Amb`ulance operators were first regulated by the State in 1947; Red Cross certified in first aid carried minimum first aid equipment such as a traction splint and oxygen. • The National Highway Safety Act set criteria for state and local governments to provide quality emergency care for people injured on highways in 1966. • Wichita Falls passed an "Invalid Coach" Ordinance in 1967 written when there was little or no state oversight and regulation. • In the late 1960's advancements in trauma (Vietnam War) proved that well trained non - doctors could save lives. The first 80 hour course for pre - hospital emergency care called EMT was created. • Texas created the EMS Division with the Texas Department of Health in 1973; they established guidelines that were voluntary and unenforceable. • The City Ordinance was amended in 1974 to require steel - belted 6 ply tires. • The City Ordinance was amended in 1981 because of problems with a local company. • In 1983 the Texas Legislature mandated minimum requirements for training, certification, staffing, vehicle design, equipment standards and licensing of ambulance operators. • The Ordinance has remained virtually unchanged with small amendments in 1987, 1996, and 2006. The Texas Legislature requirement mandated in 1983 essentially made the local ordinance obsolete but no revision was initiated so the ordinance remained unchanged. In review of the ordinance, consideration was made of what needed to be accomplished such as the inter - local agreement with private providers, 911 calls versus private calls, helicopter, airplanes, non - emergency transportation, and inspections. Eliminations in need are the First Aid cards for attendants, Health Department sign -off on attendants license, duplication of inspections, and the out -dated equipment inspection list since the state monitors. Recommendation from City Attorney Kinley Hegglund was to start anew and determine what should constitute a good Ambulance Ordinance. The first step was to collaborate with personnel that would be affected by the ordinance. The City's Fire, Police, City Clerk, Legal, Transportation, and Aviation Departments furnished valuable input along with Jerry Bradshaw, the North Texas DSHS EMS Specialist, and Ryan Matthews of Trans Star, who is also on the State Board for Ambulance Company. Comments are also being solicited from AMR, the EMS Committee, and City /County leaders involved with the Inter -Local Agreement. The Inter -Local Agreement now is with AMR that includes; Wichita Falls, Wichita County, Burkburnett, and Iowa Park. The Draft Ordinance amending Chapter 42. Emergency Services, Article I. Ambulances. was condensed to 7 pages by Kinley Hegglund, structured as follows: Division 1. Definitions 42 -1. Definitions. The change of Ambulance for regulation purpose to mean any privately -owned motor vehicle that is specially designed or constructed, staffed, equipped and is intended to be used for and is maintained or operated for the transportation of medical patients and shall include transfer ambulances. Director was changed to mean the Director of the Wichita Falls Wichita County Public Health District or his/her designee. Division 2. Franchise Certificates. It is the City's policy to provide for and to promote adequate and efficient ambulance service in the city. To this end, this article provides for the regulation of ambulance rates and services, to be carried out in a manner that protects the public health and safety, promotes the public convenience and necessity, and respects the concept of free enterprise. More than one franchise can be permitted currently the major contract is with AMR and Trans Star handles the back up and non emergency calls. 42 -2. Required, Franchise. It shall be unlawful to operate an ambulance in the city except under authority of a franchise for ambulance service granted by the City Council. 42 -3. Qualifications for Franchise Holder. Intentions are to add more qualifications once discussed with stake holders. 42 -4. Franchise Application 42 -5. Investigation of Application and Approval 2 42 -6. Hearing on Application; Requirement for Issuance 42 -7. Multiple franchises must be disclosed. 42 -8. Transferability 42 -9. Revocation of Franchise 42 -10. Annual Franchise Fee Division 3. Regulation of Franchise. 42 -20. Holder's and Operator's Duty to Comply 42 -21. Insurance — Ambulances Division 4. Reserved Division 5. Vehicle Requirements 42 -30. Vehicle Permit Required. It shall be unlawful to operate an ambulance unless it is permitted by the city. 42 -31. Vehicle Permit 42 -32. Vehicle Permits; Expiration Division 6. Enforcement 42 -40. Suspension 42 -41. Appeal Procedure To reduce confusion and simplify procedures, all licensing of the program would be moved from the City Clerk's office to the Health District. The revised process originates at the Health District and, once investigated, the item would be placed on the City Council Agenda, and then based on the outcome of the investigation, the Health District recommends whether or not the company should be allowed to operate in Wichita Falls. The investigation looks at the company's financial stability, history whether any complaints filed, and background checks. Another addition other towns do that is non enforceable is require the company to show the need and necessity for an additional ambulance transporter in town. Lou Franklin explained that to abide by State requirements and State law, the Franchise Permit Application needs to include additional requirements. The additions would be to require copies of the franchise state inspections, vehicle safety inspections, and all employees' certifications that provide proof of the minimum requirements required by the State submitted on an annual basis with their franchise. Board members were asked to e-mail or call Ms. Franklin with any suggestions or comments on the proposed changes. The final ordinance revision will be presented to the board at a later date for final comments and recommendations prior to being presented to the City Council. IV. NEXT MEETING DATE May 20, 2011 V. ADJOURN Dr. Sutton requested a motion to adjourn. The motion was made by Dr. Clark and seconded by Dr. Carlston. The motion carried and the meeting was adjourned at 12:45 p.m. Richard Sutton, M. S, Chair, Bryan Press,Yice Chair, or Robin Moreno, M.T., Secretary 3