a ~ ~ `~`~
EMS INTERLOCAL AGREEMENT
This Agreement (herein "Agreement")
City of Kerrville (herein "City"), th
"County") and the City of Ingram (herein
ARTICLE I.
PURPOSE
is made by and between the
e County of Kerr (herein
"Ingram").
The City has determined to provide to its citizens ambulance
services, both emergency and transfer, through the Fire Department
of the City; and City has agreed to provide such ambulance services
for the residents of County and Ingram pursuant to the terms of
this Agreement.
ARTICLE II.
TERM
The initial term of this Agreement shall be from January 1,
1994 through September 30, 1994.
This Agreement shall be renewed automatically, without action
by any party hereto, for successive periods of one (1) year each,
commencing October 1, 1994 unless notice of cancellation is given
by any party hereto not less than sixty ( 60 ) days prior to the
commencement of the renewal term in question.
In the event that either the County or Ingram (and not both)
give notice of cancellation, then this Agreement shall continue
between City and the remaining party.
ARTICLE III.
CONTRACTED SERVICES
A. General. City agrees to provide advanced life support
ambulance service, both emergency and transport, originating
in Kerr County, to the residents of County and to the
residents of Ingram pursuant and subject to the further terms
of this Agreement. City reserves the right to not provide
transfer service (non-emergency) outside a 125 mile radius of
the City limits.
B. Estimated Response Times. City agrees to exercise good faith
efforts to meet the estimated response times set forth in
Exhibit "A" to this Agreement. Although the City believes the
estimated response times are obtainable, actual operations may
prove otherwise. Accordingly, no obligation shall exist with
respect to said estimated response times; and City's failure
to meet the estimated response times shall not constitute a
breach of this Agreement and shall not give rise to any claim
nr ran d? of aCY_i_ori aQalnst the City.
The following definitions and protocols shall be employed for
purposes of response time measurement and reporting:
Definition. Response time is defined as the elapsed time
between the moment a request for ambulance service is
received at City's ambulance control center (i.e., the
moment callback number and location are acquired, either
by voice or by ANI/ALI 911 data transmission and
confirmed) and the moment a first-arriving City
ambulance, Mutual Aid unit, 1st Response team, or
advanced life support capable medical helicopter arrives
at the scene; provided that in order to "stop the clock"
such first-arriving unit shall be: operated by City or by
a Mutual Aid unit or 1st Response organization approved
by the Medical Director.
The Mutual Aid/1st Response team need not be paramedic-
level to "stop the clock" so long as such team has been
approved by the Medical Director for such purposes.
For scheduled patient transfers, "time call received"
shall be the agreed-upon appointment time of patient
pickup. To qualify as "scheduled", the request for
service must be made at least 24 hours in advance of the
requested time of pick-up. Response time calculations
shall not include any request for ambulance service that
does not result in transport of a patient.
2. Method of Measurement. Response time standards shall be
established and response time performance shall be
measured in terms of "fractile distributions" ALONG WITH
GRID COORDINATES -- not average response time
measurements. A minimum of 50 patient transports in each
category are required to measure the response time for
such category.
3. Call Classification. For purposes of response time
measurement, the applicable standard shall be based on
each request's presumptive run code classification (i.e.,
life-threatening emergency, non-life-threatening
emergency, unscheduled routine transfer, and scheduled
routine transfer) as established at the time the call is
dispatched by a person trained in the use of and
correctly employing medical priority dispatch protocols
promulgated by the Medical Director. (Retrospective
classification of priority code shall not affect
measurement of response time compliance.)
4. En route Upgrades and Downgrades. If a presumptive run
code classification is upgraded to a higher priority
while the ambulance is en route (as a result of
information provided by a physician, 1st responder or law
enforcement officer at the scene), the applicable run
code designation shall be the upgrade priority, and
response time shall be measured from the moment of
upgrade. On the other hand, if a presumptive run code
classification is downgraded to a lower priority while
the ambulance is en route ( as a result of information
provided by a physician or 1st Responder), the applicable
run code designation shall be the downgraded priority,
and response time shall be measured from the original
time of call receipt.
C. Medical Oversight. The City agrees to provide medical
oversight for the EMS services through its Medical Director.
The Medical Director will be a licensed physician appointed by
the City Council of the City to promulgate and update the
City's EMS system standard of care, subject to City approval,
and to perform medical audits and otherwise monitor system
performance.
D. User Fees and Adjustments. Pursuant to Ordinance No. 93-24,
the City has promulgated rates and fees for EMS services
within its corporate limits, including loaded mileage charges;
and the City is hereby authorized to charge the same rates and
fees (including loaded mileage charges) for each transport of
a patient originating within the County and/or Ingram,
respectively.
Such rates and fees (including loaded mileage charges)
may be adjusted from time to time by resolution of the City
Council of the City, and City will notify County and Ingram of
any such adjustments. The rates and fees charged for
transports originating within the County and/or Ingram will be
the same as the rates and fees charged for transports
originating within the corporate limits of the City.
E. Disaster. During a declared disaster, locally or in a
neighboring jurisdiction, (1) no response time measurements
will be required, and (2) during the course of the disaster,
City will use its best efforts to provide emergency coverage
and may suspend non-emergency tranfers.
F. Special Area. City acknowledges that the County presently has
an arrangement with Kendall County EMS with respect to
ambulance service in the 995 telephone exchange in eastern
Kerr County. City agrees to coordinate with the Kendall
County EMS for the provision of the EMS services by the entity
3
(either City or Kendall County EMS) best able to respond
promptly and to provide the necessary services.
ARTICLE IV.
PAYMENTS TO CITY
To assist City with respect to Medical Director and
administration costs, County agrees to pay to City the sum of
$1,975.00 per month, payable in advance on the first day of each
calendar month, commencing January 1, 1994; and Ingram agrees to
pay to City the sum of $200.00 per month, payable in advance on the
first day of each calendar month, also commencing January 1, 1994.
Payments by the County and Ingram pursuant to the foregoing
shall be made only from current revenues available to the paying
jurisdiction. However, failure of any such party to make payment
timely shall constitute a breach of this Agreement, whereupon the
City, at its option, may cancel this Agreement and services
hereunder to the jurisdiction in question.
ARTICLE V.
ORDINANCE
On or before January 1, 1994, Ingram agrees to adopt an EMS
Ordinance in substantially the form attached hereto as Exhibit "B"
and incorporated herein for all purposes; and to maintain such
Ordinance in effect during the term of this Agreement. To the
extent allowed by law, the City is hereby awarded exclusive rights
and responsibilities for provision of all ambulance services, both
emergency and transfer, originating within the corporate limits of
the City of Ingram, regardless of the manner in which the request
for service is conveyed, subject only to the exemptions set forth
in said EMS Ordinance.
ARTICLE VI.
EMS ADVISORY BOARD
A. Creation of Advisory Board. There is hereby created an EMS
Advisory Board ("EMS Board"). The EMS Board shall be advisory
in nature and shall perform the duties hereafter provided.
B. Board.
1. Composition. The EMS Board shall be composed of no more
than five (5) voting members, constituted as follows:
4
(a) Position 1. A resident of the City, Ingram or the
County who is knowledgeable in health care
administration;
(b) Positions 2 and 3. Licensed physicians whose
principal place of practice is in the City of
Kerrville; and
(c) Positions 4 and 5. Residents of the City, Ingram
or the County;
and not more than five (5) ex officio non-voting members, as
follows:
(aa) a Councilperson of the City of Kerrville;
(bb) a Commissioner of Kerr County;
(cc) a Councilperson of the City of Ingram;
(dd) the Medical Director;
(ee) the Fire Chief of the City.
2. Terms. Positions 1, 2, and 3 of the first Board shall
have a term of three years; Positions 4 and 5 shall have
a term of two years. Thereafter, the terms of Positions
1 through 5 shall be for a period of two (2) years;
provided that no such member shall be appointed for more
than two consecutive terms in office.
The terms for the ex officio Councilpersons and
Commissioner members shall be coterminous with the
expiration of such member's term of office with the City,
or the County or Ingram, as the case may be.
The Medical Director's ex officio term shall be
coterminous with his tenure as Medical Director.
3. Election and Aooointment. The membership of the Board
shall be chosen as set forth below in Paragraph 6.
4. Removal. Any member of the Board who fails to attend any
three (3) consecutive, regularly scheduled Board meetings
or who fails to attend at least one-half (~) of the
regularly scheduled meetings in any twelve (12) month
period, without a reasonable and valid reason for such
absence, shall be removed from the Board, and his
position filled as provided in Paragraph 6 below.
Removal of a member pursuant to this provision must be
5
approved by a majority of the members of the Board,
excluding the member in question.
5. Vacancy. Any vacancy in the Board occurring by
resignation or otherwise shall be filled as provided in
Paragraph 6 below.
6. Appointments. The membership of the Board shall be
appointed in the following manner:
(a) The Medical Director shall be appointed by the
City.
(b) The City shall appoint (i) three (3) voting
members, and (ii) one Councilperson of the City as
an ex officio member. Except for its ex officio
member, no City Councilperson will serve on the
Board.
(c) The County shall appoint (i) one (1) voting member,
and (ii) one Commissioner as an ex officio member.
Except for its ex officio member, no Commissioner
of the County will serve on the Board.
Appointments by the County shall be made from
nominations by the City as hereinafter provided in
subsection (e) of this Paragraph 6. It is
preferred, but not required, that such member
resides in the County of Kerr, but outside the city
limits of the City or Ingram.
(d) Ingram shall appoint (i) one (1) voting member and
(ii) one Councilperson for its ex officio member.
Except for its ex officio member, no Councilperson
of Ingram will serve on the Board. Appointments by
Ingram shall be made from nominations by the City
as hereinafter provided in subsection (e) of this
Paragraph 6. It is preferred, but not required,
that such member resides in the city limits of
Ingram.
(e) All members of the Board other than those selected
by the City shall be chosen as follows:
For each position, the City will nominate one (1)
person. If the appointing jurisdiction(s) does not
act upon such nomination within thirty (30) days
after submission of the nomination in writing by
the City, then the City shall nominate one (1)
additional person for the position to be filled.
If the appointing jurisdiction(s) does not act upon
such additional nomination within thirty (30) days
after submission of such additional nomination, the
City shall be empowered to fill such position.
(f) The filling of vacancies in the Board (whether by
expulsion, resignation or otherwise) shall be made
in the same manner as the original appointment (or
nomination and appointment) process as set forth
hereinabove for the vacated position in question.
C. Duties. The Board shall be advisory in nature only, and shall
have the following specific duties:
1. On or before November 1 of each year, commencing November
1, 1994, the Board shall provide a written report
evaluating response time performance and training and
certification programs for City EMS employees, and such
other aspects of the EMS system as may be directed by the
City Council of the City of Kerrville.
2. Advise the City as to the entire emergency medical
services system (i.e. County-wide and not limited to the
City corporate limits), including first responder
programs, public CPR and other programs, etc., and assist
in the implementation of same.
3. Advise the City from time to time as to any recommended
changes in equipment needs or estimated response times.
4. Advise and make recommendations to the City with respect
to resolution of issues, if any, that may develop between
the Medical Director and the Fire Chief of the City as to
protocols, licensing and related or unrelated EMS issues.
ARTICLE VII.
INDEPENDENT CONTRACTOR
In the performance of its obligations hereunder, the City is
an independent contractor with the exclusive right to supervise,
manage, control and direct the performance of transport and
emergency medical services.
The County and Ingram shall look to the City for results only
and neither the County nor Ingram shall have any right at any time
to direct or supervise the City or its Fire Department or any of
its personnel, agents or employees in the performance of such
services or as to the manner, means or methods in which the
services are performed.
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ARTICLE VIII.
TERMINATION OF 1992 AGREEMENT
That certain EMS Interlocal Cooperative Agreement dated
September Z Z , 1992, by and between the parties hereto, is hereby
terminated and the KEMSA Board created thereby is hereby dissolved.
ARTICLE IX.
GENERAL
In case any one or more of the provisions contained in this
Agreement shall for any reason be held to be invalid, illegal or
unenforceable in any respect, such invalidity, illegality or
unenforceability shall not affect any other provision hereof and
this Agreement shall be construed as if such invalid, illegal or
unenforceable provision had never been contained herein.
This Agreement constitutes the sole and only agreement of the
parties hereto and supersedes any prior understandings or written
or oral agreements between the parties with respect to the subject
matter hereof.
LIST OF EXHIBITS
Exhibit A. Estimated Response Times
Exhibit B. EMS Ordinance (For City of Ingram only)
APPROVAL
Approved and adopted by the Cit Council of the City of
Kerrville, Texas, this ~~ day of ~o 1993.
CITY OF KERRVILLE
By:
J HERRING, JR. r ^
ATTEST:
By: ~o~ ~ ~( i .~~
SH ILA L. , City Cle
APPROVED AS TO FORM:
WALLACE, MOSTY, MACHANN,
JACKSON & WILLIAMS
E. DWAINE MACHANN
Approved and a ted by the Commissioners Court of Kerr County
this ~ day of , 1993.
COUNTY O K
By:
WILLIAM G. STACY, County Judge
Approved and adopted by the City Council of the City of Ingram
this ~_ day of Januarv , X 1994.
APPROVED AS TQIFORM:
CITY OF INGRAM
I ~
~`~
By : ~ -- ~.«~~ .
GERALD JOHNS ON Mayor
ATTEST:
~ '~ ~ G ~01.,, ~~ ~;~(c ~2 ~(-.~
City A orne
C134\67AG5
B1'_--- -- _ ~~__ _
Candyce R Snyder
~~~v p,v w~ n ~ 72 ~'~
~.~iL~~ls. ~.`"_~h~ry.___Cep.ry
EXHIBIT "A"
Area
Classification
County 0-5 mi.
County 5-10 mi.
County 10-15 mi.
County > 15 mi.
Ingram
C134/67AG5
Life
Threatening
Emeraencv
?908 - llm
?908 - 15m
?908 - 19m
Best Effort
>_908 - 12m
Non-Life
Threatening
Emeraencv
>_908 - 13m
>_908 - 17m
>_908 - 21m
Best Effort
>_908 - 13m
Unscheduled
Routine
Transfer
>_908 - 60m
?908 - 60m
?908 - 60m
>_908 - 60m
?908 - 60m
Scheduled
Routine
Transfer
>_908 - lOm
>_908 - lOm
>_908 - lOm
>_908 - lOm
>_908 - 15m
10

C Y
fXNTRTT "R"
ORDINANCE NO. 94-01-04A
EMS ORDINANCE
AN ORDINANCE TO ESTABLISH FOR THE CITY OF
INGRAM AN AMBULANCE SERVICE WITH MEDICAL
OVERSIGHT THROUGH AN EMS INTERLOCAL AGREEMENT
WITH THE CITY OF KERRVILLE; ESTABLISHING AN
EMS ADVISORY BOARD; PROVIDING CERTAIN FEES AND
PENALTIES; VOIDING ORDINANCE NO. 92-10-20: AND
CONTAINING A SAVINGS CLAUSE (as amended)
BE IT ORDAINED by the City Council of the City of Ingram, Kerr
County, Texas:
SEC. 1 GENERAL PURPOSES AND INTENT OF ORDINANCE.
It is the general purpose of this Ordinance:
A. To establish for the City, an ambulance service system,
for both emergency and transfer service, such service to
be provided by and through an EMS Interlocal Agreement
with the City of Kerrville.
B. To provide medical control of such ambulance service
system by means of a Medical Director to oversee and
regulate all clinical aspects of the emergency medical
system which affect patient care.
SEC. 2 DEFINITIONS.
For the purposes of this Ordinance, the following words and
phrases shall have the meanings respectively ascribed to them by
this section:
A. Ambulance. Any vehicle used, designed or redesigned for
the transport of a patient, whether in emergency or
transfer service.
B. Base Station Physician. A physician licensed to practice
medicine in the State of Texas, certified by the Medical
Director, knowledgeable in the pre-hospital emergency
medical protocols, EMS radio procedure and the general
operating policies of the ambulance system, and a person
from whom ambulance personnel may take medical direction
by radio or other remote communications device.
C. City. The City of Ingram, Texas.
D. Emergency Medical Service Personnel. Individuals who are
qualified as basic, specially skilled or paramedic
emergency medical technicians under the Texas Health and
Safety Code.
E. EMS Control Center or Control Center. The single
facility designated by the Medical Director as the
central communications center from which all ambulances
operating in the Service Area shall be dispatched and
controlled.
F. First Responder. Any person, fire department vehicle,
police vehicle, or other vehicle not normally used for
purposes of patient transport, but which vehicle and on-
board personnel are capable of providing first responder
services in medical emergencies.
G. Helicopter Rescue Unit. Any rotary wing aircraft
providing basic or advanced life support services and
patient transportation originating from the scene of
emergency incidents which occur within the Service Area.
H. EMS Interlocal Agreement ("interlocal Agreement"). That
contract between the City, the County of Kerr and the
City of Kerrville with respect to the provision of EMS
services by the City of Kerrville to such other entities.
I. Medical Audit. An official inquiry into the
circumstances involving an ambulance run or request for
ambulance service, conducted by the Medical Director or
a licensed physician designated by the Medical Director.
J. Medical Control. Direction given ambulance personnel by
a base station physician through direct voice contact,
with or without vital sign telemetry, as required by
applicable medical protocols promulgated by the Medical
Director, and by the Texas Health and Safety Code.
K. Medical Director. The licensed physician appointed by
the City Council of the City of Kerrville to promulgate
and update the System Standard of Care and to perform
medical audits and otherwise monitor system performance.
L. Medical Protocol. Any diagnosis-specific or problem-
oriented written statement of standard procedure, or
algorithm, promulgated by the Medical Director as the
normal standard of pre-hospital care for a given clinical
condition.
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M. Mutual Aid Agreement. A written agreement between one or
more entities whereby the signing parties agree to
provide backup ambulance service to one another under
conditions and pursuant to terms specified in the
agreement.
N. Patient. Any person being transported in a reclining
position from or to a health care facility from any point
within the Service Area.
O. Person. Any individual, firm, association, partnership,
corporation, governmental entity, or other group or
combination acting as a unit.
P. Response Time. The actual elapsed time between receipt
of notification at the EMS Control Center that an
ambulance is needed and the actual arrival of an
ambulance, as more particularly defined in the Interlocal
Agreement.
Q. Service Area. That geographic area which is contained
within the corporate limit of the City.
R. Special Event. Any public event located within the
Service Area, for which standby ambulance service is
arranged in advance, and for which an ambulance (or
ambulances) are hired by the sponsor of the event or
other interested party.
S. System Standard of Care. The combined compilation of all
priority-dispatching protocols, pre-arrival instruction
protocols, medical protocols (i.e., first responders and
ambulances), standards for certification of pre-hospital
care personnel (i.e., telephone call-takers, 1st
responders, ambulance personnel, and on-line medical
control physicians), as well as standards governing
requirements for on-board medical equipment and supplies,
and licensure of ambulance services and 1st responder
agencies.
SEC. 3 PROVIDING OF SERVICE.
There is hereby provided an ambulance service, emergency and
transfer, to the citizens of the City of Ingram, which service
shall be operated within the Fire Department of the City of
Kerrville.
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The ambulance service shall be available to the citizens of
the City of Ingram, in accordance with the terms of this Ordinance,
and pursuant to the terms of the EMS Interlocal Agreement (or such
other and subsequent agreement that may be entered into by the City
and such other parties, as approved by the City Council and the
governing body of such other jurisdictions).
The business of providing ambulance service, both emergency
and transfer, is declared to be a business affected with the public
interest, and no person, firm or organization other than the Fire
Department of the City of Kerrville shall operate said business (or
part thereof) within the Service Area, except as may be exempted in
accordance with Section 9.D. of this Ordinance.
SEC. 4 MEDICAL DIRECTOR.
A. General. The City Council of the City of Kerrville shall
appoint a Medical Director. The Medical Director shall be a
licensed physician and, at the option of the City Council of the
City of Kerrville, may be required to be board-certified in
emergency medicine. The Medical Director shall serve at the
pleasure of the City Council of the City of Kerrville.
In the event of the resignation, removal, death or disability
of the Medical Director, a successor Medical Director shall be
appointed by the City Council of the City of Kerrville.
B. Duties. The Medical Director shall have the following
powers and duties (with administrative assistance from the City of
Kerrvillej, subject to such changes in such powers and duties as
may be required by the City Council of the City of Kerrville:
(1) To recommend to the City of Kerrville and to the EMS
Advisory Board medically appropriate response time
standards and any necessary revisions;
(2) To establish and update the System Standard of Care,
including without limitation standards for ambulance,
transfer and first responder vehicles and on-board
equipment; provided that no requirements for new or
additional equipment may be made without the consent of
the City Council of the City of Kerrville;
(3) To develop medical protocols and standing orders for
ambulance and first responder services and periodically
revise same;
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(4) To develop control center protocols and periodically
revise same;
(5) To conduct medical audits and develop standards and
procedures for the conduct of such audits;
(6) To develop and periodically revise and administer both
written and practical tests for the certification and
licensing of the base station physician, emergency
medical services personnel, including ambulance
personnel, first responders, and EMS control center
personnel;
(7) To monitor response time performance and to provide
monthly reports to the EMS Advisory Board; in this
regard, the City of Kerrville is to furnish such
statistical information regarding response time
performance as may be requested by the Medical Director;
(8) To authorize the issuance, restriction, suspension,
denial, revocation and renewal by the City of (a) permits
for first responder vehicles and (b) certificates for
emergency medical service personnel and first responders;
all subject to published procedures as may be developed
by the Medical Director and the EMS Advisory Board and
approved by the City Council of the City of Kerrville.
(9) To periodically conduct intensive reviews of the system's
performance relative to specific clinical types and to
revise medical protocols and such other standards of the
system as may be appropriate in light of the findings;
(10) To conduct medical audits of individual cases as
requested by the EMS Advisory Board, by any elected
official of the City of Kerrville, or by any licensed
physician regarding a patient of such physician;
(11) To approve, where possible, 911 protocols within the
Service Area for "Medical Priority Dispatch" (including
pre-arrival instructions, priority code classifications
and whether or not to dispatch a first responder) and to
insure that 911 medical requests are immediately
transferred, while the caller is still on the line, to
the EMS Control Center;
(12) To present monthly a written performance report to the
EMS Advisory Board; and to present annually a written and
oral report to the EMS Advisory Board concerning the
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state of clinical and response time performance of the
ambulance system; and
(13) To develop approval standards governing the operation of
helicopter rescue units, including standards defining the
circumstances under which such units may be deployed to
emergency scenes;
SEC. 5 EMS ADVISORY BOARD.
By adopting this Ordinance, and by executing and approving the
EMS Interlocal Agreement, there is established the EMS Advisory
Board. The EMS Advisory Board shall be advisory in nature only and
shall have the following specific duties:
A. On or before November 1 of each year, commencing November
1, 1994, provide a written report evaluating response
time performance and training and certification programs
for City of Kerrville emergency medical service
personnel, and such other aspects of the EMS system as
may be directed by the City Council of the City of
Kerrville.
B. Advise the City of Kerrville as to the entire emergency
medical services system (i.e. County-wide and not limited
to its corporate limits), including first responder
programs, public CPR and other programs, etc., and assist
in the implementation of same.
C. Advise the City of Kerrville from time to time as to any
recommended changes in equipment needs or estimated
response times.
D. Advise and make recommendations to the City of Kerrville
with respect to resolution of issues, if any, that may
develop between the Medical Director and the Fire Chief
of the City of Kerrville as to protocols, licensing and
related or unrelated EMS issues.
SEC. 6 LICENSES, ETC.
Upon authorization by the Medical Director, the City of
Kerrville, acting through its City Manager or City Clerk or other
employee of the City designated by the City Manager, and acting as
agent for the City, shall be responsible for the actual issuance,
restriction, suspension revocation and renewal of all licenses,
permits and certificates required under this Ordinance.
-6-
SEC. 7 FEES FOR SERVICE.
Any person who utilizes the ambulance service provided
hereunder, whether such person requested the same or not, shall pay
for such services the amounts specified below.
(a) Each Emergency Transfer $ 255.00
(b) Each Basic Transfer (no supplies) 60.00
Return Trip - Basic Transfer (no supplies) 50.00
(c) Additional Fees and Charges:
General•
Aid Only, No Transport $ 54.00
Dedicated Standby (per hour) 50.00
Assist Airflight N/C
Mileage (per loaded mile) 3.60
Suooly Charces:
Bandages	$ 10.00
Splinting/Traction	7.00
Suction	10.00
Oxygen	15.00
Burn Cooled/Dressed	10.00
Neck/Spine	25.00
Emergency Childbirth	20.00
Airway Maintenance	25.00
Shock Management	25.00
Intubation	35.00
EKG/Defibrillation	30.00
External Pacing	50.00
I.V. Therapy	20.00
Pulse Oximetry	25.00
Dextrose Stix	10.00
The fees and charges set forth and/or established herein may
be changed and amended from time to time by resolution of the City
Council of the City of Kerrville and such fees and charges (and any
changes or amendments) shall be set forth in and made a part of the
City of Kerrville Fee Schedule.
SEC. 8 FAILURE TO PAY FOR SERVICES.
A. Any person who utilizes the ambulance service provided
hereunder and who fails to pay for said service within
sixty (60) days after a statement of costs for such
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service has been mailed to the address of the user (or
parent, in the event a minor is the user), which address
for the purpose of this Section will be the address which
is supplied to the operator of the ambulance or which is
obtained from the hospital where such person is
delivered, shall be in violation of this Ordinance.
B. It shall be prima facie evidence that the person
utilizing such service did so with the intent to defraud
upon (1) a showing that such person was notified in
writing of the indebtedness for such service, which
notice in writing shall be by certified or registered
mail to the address as is set forth in Subsection A
hereof or by personal service of a peace officer of the
City, and ( 2 ) failure of such person to pay for such
indebtedness within ten (10) days after receipt of the
notice. A copy of the caption of this Section shall
accompany the notice forwarded to the user of such
services by certified or registered mail.
SEC. 9 VIOLATIONS.
It shall be unlawful:
A. To knowingly use or cause to be used any ambulance
service other than that of the City of Kerrville, as
provided herein, except those services described in
Paragraph D of this Section 9.
B. For any person to provide ambulance service within the
Service Area, other than the City of Kerrville Fire
Department; or to provide helicopter rescue services, or
specialized mobile intensive care services except in
accordance with regulations governing the delivery of
such services promulgated by the Medical Director, and
then only pursuant to a permit issued by the Medical
Director or this Jurisdiction for the operation of such
units; or to provide first responder services without a
first responder permit issued by the Medical Director or
this Jurisdiction. All such special permits when issued
shall be valid for a period of two (2) years, and then
shall be subject to provisions governing renewal, such
provisions to be developed by the Medical Director.
C. To knowingly give false information to induce the
dispatch of an ambulance or helicopter rescue unit.
-8-
D. It shall be a defense to any alleged violation of this
Section 9 that the ambulance, first responder or transfer
vehicle or service is being used solely in any of the
following manners:
(1) A privately owned vehicle not ordinarily used in
the business of transporting a Patient.
(Z) A vehicle rendering service as an ambulance in the
event of a major catastrophe or extreme system
overload when such condition is declared by the
Medical Director, or by the Fire Chief of the City
of Kerrville, or by the Mayor of the City of
Kerrville, or by the Mayor of the City;
(3) Any ambulance owned or operated by the federal
government or any agency thereof or state
government or any political subdivision thereof.
(4) Any transport to a location within the Service
Area, which transport originated from a point
outside the Service Area.
(5) Transporting a Patient who is picked up from a
location within the Service Area and transported to
a location beyond the Service Area, provided said
ambulance or ambulance service initially
transported said Patient into the Service Area and
is making the return trip.
(6) Mutual aid calls when rendered pursuant to a mutual
aid agreement executed by the City and approved by
the Medical Director as to equivalency of services.
(7) Special events coverage, so long as such service is
provided without charge by an emergency medical
services volunteer provider, as defined in Sec.
773.003 of the Texas Health and Safety Code.
(B) Wheelchair transport services.
(9) Medical transports by helicopter where such
transports originate outside the Service Area or at
a hospital location within the Service Area.
(10) A person in favor of which the City Council of the
City of Kerrville has issued a certificate of
public convenience and necessity, permitting the
-9-
provision of ambulance service by such person
within the Service Area as being necessary for the
benefit and general welfare of the City and its
citizens.
(11) Any transfer (non-emergency) to a location more
than 125 miles outside the corporate limits of the
City of Kerrville, if approved by the Fire Chief of
the City of Kerrville Fire Department or his
designated representative.
Violations of this Section are hereby declared to be public
nuisances and shall be prohibited and abated in actions at law or
in equity.
It shall not be necessary for the complaint to negate any
exception contained in this Section concerning any prohibited act,
but any such exception made in this Section may be urged as a
defense by any Person charged by such complaint.
SEC. 10 PENALTIES.
The following provisions for application of penalties for
violation of this Ordinance shall apply:
A. Any person convicted of violating the provisions of this
Ordinance shall be fined no more than five hundred
dollars ($500.00). This does not serve to limit any
other remedies available in law or equity.
B. Each day that any violation of this Ordinance is
committed or permitted to continue shall constitute a
separate offense.
SEC. 11 TRAFFIC LAWS; EXEMPTION.
When the driver of an ambulance has reasonable grounds to
believe that an emergency exists, as determined by the EMS Control
Center, the driver of the ambulance may:
A. Park or stand, irrespective of the otherwise applicable
provisions of law, ordinance or regulation;
B. Proceed past a red or stop signal or stop sign, but only
after slowing down as may be necessary for safe
operation;
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C. Exceed the maximum speed
ordinance or regulation; pro
property are not endangered
D. Disregard laws, ordinances
directions or movements
directions;
limits permitted by law,
vided, however, that life and
thereby; and
and regulations governing
or turning in specified
provided, however, (1) that any exemption herein granted shall
apply only when such ambulance is operating with siren and
emergency lights in operation, and when such audible and visual
signals meet the requirements of law, ordinance or regulation; and
(2) that the foregoing provisions shall not operate to relieve the
driver of any ambulance from the duty to drive with due regard for
the safety of all persons, nor shall such provisions protect the
driver from the consequences of his reckless disregard for the
safety of others.
SEC. 12 SAVINGS CLAUSE.
If any section, subsection, sentence, clause, phrase or
portion of this Ordinance is for any reason held to be invalid,
unenforceable or unconstitutional by the decision of any court of
competent jurisdiction, such decision shall not affect the validity
of the remaining portions of this Ordinance. The City hereby
declares that it would have adopted this Ordinance and each
section, subsection, sentence, clause, phrase or portion thereof,
irrespective of the fact that any one or more sections,
subsections, clauses, phrases or portions be declared invalid or
unconstitutional.
SEC. 13
Upon
92-10-20,
(as amended)
SEC. 14
This
approval.
VOIDING OF EXISTING UNIFORM EMS ORDINANCE.
the effective date of this Ordinance, Ordinance No.
Uniform EMS Ordinance, shall be rendered null and void.
EFFECTIVE DATE.
Ordinance shall become effective upon passage and
PASSED AND APPROVED on this the ~_ day of ~~~~~~,l;KXX~,
CITY OF INGRAM
By:~ - -
GERALD JOHNSTON M yor
ATTEST: ~"
Candyce R. Snyder
City Secretary -11-
n
APPROVED AS TO F RM:
City At ~ornej~Date
C134\670R6
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CITY OF KERRVILLE, TEXAS
RESOLUTION N0.077 -2007
A RESOLUTION RATIFYING A NOTICE OF CANCELLATION
SENT TO KERB COUNTY AND THE CITY OF INGRAM
REGARDING THE EMS INTERLOCAI. AGREEMENT WHICH
WAS EFFECTIVE JANUARY 1, 1994
WHEREAS, the City entered into an EMS Interlocal Agreement with Kerr County and the City
of Ingram, for a beginning effective date of January 1, 1994 ("1994 Agreement"); and
WHEREAS, the 1994 Agreement was superseded by an Interlocal Agreement for Emergency
Medical Services, as was effective October 1, 2005; and
WHEREAS, because the City and Kerr County entered into a new agreement under which the
City provides EMS into the County, the 1994 Agreement should be canceled pursuant to its terms; and
WHEREAS, the Kerrville Fire Chief, after consulting with the County Judge and the City of
Ingram, forwarded a notice of cancellation to the County and the City of Ingram, with the intent of
canceling the 1994 Agreement; and
WHEREAS, the City Council of the City of Kerrville, Texas, finds it to be in the public interest
to ratify the City's notice of cancellation of the 1994 Agreement, as set forth in Exhibit A, attached
hereto and incorporated herein by reference;
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF
KERRVILLE, KERR COUNTY, TEXAS:
That the City Council hereby ratifies the notice of cancellation as previously forwarded by the
City to the County and the City of Ingram, which thereby has cancelled the EMS Interlocal Agreement
from 1994.
~~
PASSED AND APPROVED ON this the ~ day of , A.D., 2007.
-~G~IY
Euge C. Smith, Mayor
APPROVED AS TO FORM: ATTEST:
~~
Michael C. Hayes, Ci Attorney Brenda G. Craig, ty Clerk
py Ctly ;. ouc;c~~
H-\Legai\FiRE-EMS\RES\County EMS 2007-2008 doc

Oct 09 07 11:54a City Of Kerrville
Exhibit A ~-~
~~-=-~-~ KERRVILLE, TEXAS
August 1, 2007
Judge Pat Tinley
Kerr County Commissioner's Court
700 E Mann Street
Kerrville, Texas 78028
RE: EMS Interlocal Agreement
Dear Judge Tinley;
pursuant to tl~e conversations between you, EMS Coordinator Eric Maloney, and Ingram
City Attorney Danny Edwards concerning the original EMS Interlocal Agreerr~ent, we
came to a consensus to cancel this agreement.
This letter is giving notice of cancellation prior to the sixty {60) days commencement of
the October 1, 2007, renewal terra, as outlined in Article II of the original EMS Interlocal
Agreement, executed 3anuary 1, 1994.
Sincerely,
l
''~
aul A. ofmanrt' ~
City ivlanager
$QO JUNCTION I-AGMNAY • KEf2ftVllL>=, TEXAS 78028-50b9 • 830f257-8000
p.2
L9
;:.;F
;~nl p77--Z~~
Oct 09 07 11:54a City Of Kerrville
I~ ,
crv o-
KERR~TILLE, TEXAS
August 1, 2Q07
Mayor Howard Jackson
City of Ingram
230 H1~+y 39
Ingram, Texas 78025
RE: EMS Interlocal Agreement
Dear Mayor Jackson;
Pursuant to the conversations between you, E1VIS Coordinator Eric Maloney, and Ingram
City Attorney Danny Edwards concerning the original EMS Interlacal Agreement, we
came to a consensus to cancel this agreement.
'Phis letter is giving notice of cancellation prior to the sixty (60} days commencement of
the October 1, 200'7, renewal term, as outlined in Article II of the original EMS Interlocal
Agreement, executed January 1, 1994.
Sincerely,
Paul A. Hofrnann '~
Gity Manager
p.3
~~
$00 JUPICTION HIGH',1NAY • KERf7VILLE, TDCA.S 78028-5069 • 830/257-8000 ~~~ ~ ~~~~ `~~