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HomeMy WebLinkAboutbocc.ord.002.2001 AN ORDINANCE OF THE BOARD OF COUNTY COMMISSINERS OF PITKIN COUNTY, COLORADO,ESTABLISHING THE COUNTY'S EMERGENCY MEDICAL SERVICES AND TRAUMA COUNCIL AND ESTABLISHING THE COUNTY'S EMERGENCY MEDICAL SERVICES REGULATIONS PERTAINING TO AMBULANCE LICENSING. ORDINANCE#01 - Qb RECITALS 1. The Board of County Commissioners of Pitkin County, in its ordinance #97-28, adopted regulations pertaining to ambulance licensing and established the Emergency Medical Services Council. 2. The General Assembly of the State of Colorado enacted the Colorado Trauma Care System Act, Section 25-3.5-701,et seq.,CRS(hereinafter"Act")-June 5, 1995. 3. The Act requires that the Board of County Commissioners of each County establish an Area Trauma Advisory Council within each County by July 1997. 4. The Board of County Commissioners of Pitkin County, in its Resolution #97-120, agreed to enter into an intergovernmental agreement with Eagle County to form a multi-county Area Trauma Advisory Council. This resolution approved the intergovernmental agreement C97-73. 5. The current Pitkin County Roaring Fork Area Trauma Advisory Council is being dissolved and replaced by the Central Mountains Regional Emergency and Trauma Advisory Council. The members of the local Emergency Medical Service (EMS) Council desire to create a Pitkin County EMS and Trauma Council (EMTAC) to maintain local input into the County's emergency medical services and accident prevention programs in order to make the most efficient use of the existing shared resources, equipment, and facilities that provide trauma and emergency medical services. NOW THEREFORE BE IT ORDAINED that the provisions of Ordinance #97-28 Resolution#97-120 and Intergovernmental Agreement C97-73, are hereby repealed and reenacted as follows: Section 1 Emergency Medical and Trauma Advisory Council (EMTACI 1. There is hereby recognized the EMTAC,the composition of which Council is as follows: 1 representative of the Aspen Fire Protection District 1 representative of the Basalt Fire Protection District 1 representative of the Carbondale Fire Protection District 1 representative of the Snowmass-Wildcat Fire Protection District 1 representative of the Aspen Ambulance District 1 representative of the Pitkin County Sheriffs Office 1 representative of the Aspen Ski Company Ski Patrols 1 representative of the Aspen Valley Hospital Emergency Room 1 representative of the Aspen Valley Hospital Trauma Coordinator Office 1 representative of the Aspen Valley Hospital Trauma Surgeons 1 representative of the Pitkin County Disaster Coordinator Office This EMTAC shall represent Piddn County's interests to the Central Mountains Regional Emergency and Trauma Advisory Council consisting of Pitkin, Eagle,Lake,Park, Chaffee and Summit Counties. 2. Members from each of the listed agencies shall be proposed to the Board of County Commissioners in April of each year for appointment to the EMTAC. Each term shall be for one year. In the event new appointments are not approved at that time, the existing members shall continue to serve until appointments are made. Ordinance No./0�-1001 3. The Council shall hold public meetings as appropriate. Quorum shall consist of at least 6 members. Action taken shall be by majority vote of the members present at regular meetings. The Council shall elect at each September meeting, a President, Vice President, Treasurer, and Secretary. 4. The President of the Council and the County Disaster Coordinator shall provide the Board of County Commissioners an update on the Council's activities and progress twice each year. 5. The purpose and duties of the Council shall include: a. Overseeing the annual inspection and licensing process for county ambulances (See Annex A). b. Coordinating emergency medical and trauma services among the county ambulances services, first responder agencies,and Aspen Valley Hospital. . c. Providing direction and recommendations to our representatives on the Central Mountain Regional Emergency and Trauma Advisory Council d. Administering the required State Annual EMS plan and the state subsidy monies e. Implementing and coordinate accident prevention programs on a countywide basis. 6. Any three members of the Council must attend the Central Mountains Regional Emergency and Trauma Advisory Council and vote on behalf of the council. The Pitkin County Disaster Coordinator shall act as the point of contact (POC) for communication purposes between the EMTAC and the RETAC. Section 2-Ambulance Licensing and Inspection Process 1. No person shall operate a public or private ambulance service within Pitkin County unless he/she shall hold a valid license to do so, issued by a Board of County Commissioners in the State of Colorado, pursuant to the authority granted in 1973, C.R.S. 25-3.5-301, et seq., as amended and supplemental to the requirements of that statute. This provision does not apply to those services that may be specifically exempted by proper authority. 2. Applications for licenses shall be trade to the Board, which shall approve the operation of each ambulance service upon its being satisfied that each service meets all of the requirements of the Emergency Medical Services Act, as amended, the Colorado Motor Vehicle Code and all Federal vehicle requirements. For purposes of this ordinance regarding ambulance licensing, the Board's responsibility is hereby delegated to the EMTAC or his/her designees, who shall recommend licensing actions to the Boards for final approval. Anyone adversely affected by a recommendation of the EMTAC may appeal such a recommendation to its BOCC. 3. In addition to the minimum equipment required by the Colorado Code of Regulations 6-CCR- 1015-3, Section 12, as it may from time to time be amended, each ambulance shall be required to carry the following equipment and will comply with the Colorado Code of Regulations as listed in Annex A. (Any references to items already on the state list shall include the numbers required by the state). 4. Whenever the provisions of paragraph 5 will create a practical difficulty or undue hardship for any licensee, the Board of County Commissioners may, on the receipt of a recommendation by the EMTAC, waive any requirement, except as otherwise provided by state statute. Any waiver granted may be accorripanied by a restriction by the Board as to the scope of the applicant's license and/or the length of time for which is valid. Request for waiver of any requirement shall be evaluated upon consideration of the location and type of ambulance service provided and any other relevant condition. 5. Each ambulance will be staffed by at least two persons at every scene of a call for medical assistance, and at all times that a driver and an attendant are transporting a patient. Each 2 Ordinance No.Og-2001 ambulance driver shall have a valid Colorado Driver's License for ambulance operation and current Cardio-Pulmonary Resuscitation (CPR). Any person responsible for providing direct medical care and treatment of patients transported in an ambulance licensed in Pitkin County, known as the attendant, shall have a current CPR Card and shall be an Emergency Medical Technician with a current certificate issued by the Colorado Department of Health. For inter- facility transport,the attendant may be a Registered Nurse with a current CPR card. 6. Each ambulance service licensed in Pitkin County shall have a Physician Advisor on retainer at all times that operations take place under the license. Each Physician Advisor shall meet any and all requirements set forth by the Colorado State Legislature, the Colorado Department of Health and the Colorado Board of Medical Examiners. Each Physician Advisor shall establish protocols for any medical acts to be performed by EMTs and Emergency Responders and shall be responsible for the competency and performance of all members of that ambulance service. Each ambulance service shall include the name, Colorado certification.number and signature of its Physician Advisor with the annual license application. 7. All licensed ambulance services and their personnel shall have the responsibility for realizing their medical and practical limitations in the transport or care of all patients. They must examine all options for patient transport and care, both within and outside of their service, and they shall take the initiative to upgrade that care when necessary, and if possible, for the welfare of the patient. S. The Board of County Commissioners shall issue a license to the applicant to provide ambulance service and a permit for each ambulance used, upon recommendation by the EMTAC and a finding by the Board that the applicant's staff, vehicle and equipment comply with the foregoing requirements. Both the license and permit shall be valid for twelve(12)months from January 1 to December 31 of each licensing year. Each application shall be accompanied by a fee of$50 per vehicle and submitted to the EMTAC for inspections and recommendation. Any license or permit, unless revoked by the Board of County Commissioners, may be renewed by the Board upon filing an application, as in the case of an original application. Applications for renewal shall be filed annually but not less than sixty(60) days before the date the license or permit expires. No license or permit issued pursuant to this regulation shall be sold, assigned or otherwise transferred. No individual may operate an ambulance or represent themselves to the public as an ambulance provider without a valid ambulance service license. 9. The provisions of this regulation do not apply to any of the following: a. The exceptional emergency use of a privately or publicly owned vehicle, including search and rescue unit vehicles or aircraft not ordinarily used in the formal act of transporting patients (provided that nothing herein shall be construed to exempt application of this regulation to those ambulances servicing industrial operations located in Pitkin County) b. A vehicle rendering services as an ambulance in case of a major catastrophe or emergency when ambulances with permits based in the area of the catastrophe or emergency are insufficient to render the services required. 10. An EMTAC representative shall inspect, at least annually, each vehicle utilized by a service licensed under these regulations. Any EMTAC representative may conduct unannounced inspections at any time, provided that such inspection does not interfere with response ability or provide an unreasonable hardship for the service involved. 11. The loss of services of a Physician Advisor will be cause for the revocation of any license issued pursuant hereto: and the following actions are specifically forbidden and without limitation by this listing and may be cause for the revocation of any license issued pursuant hereto: a. Staff member under the influence of alcohol or drugs during an ambulance call b. Unnecessary use of emergency vehicle privileges 3 Ordinance No.aja�2001 Section 3-EMS Plan 1. Each ambulance service licensed by Pitkin County is required to provide the EMTAC with such information,as the EMTAC may deem necessary to update the County's annual EMS plan. 2. Each ambulance service is required to comply with all provisions of said EMS plan that pertain to each drill and/or actual EMS situation endorsed by the Pitkin County EMTAC. 3. In the event of a declared disaster, all sections of this ordinance pertaining to training or equipment requirements shall be waived for the duration of the disaster declaration. However,it is the intent of this ordinance that each service provides the maximum achievable level of medical care during periods or emergency. Section 4-Suspension/Revocation/Hearings 1. Upon a determination by the Board of County Commissioners that any person has violated or failed to comply with any provisions of this regulation, the Board may temporarily suspend any license or permit issued pursuant to this ordinance, for a period not to exceed thirty(30)days. The license or individual alleged to be in violation of this ordinance shall receive written notice of such violation or temporary suspension, and a hearing shall be held not later than ten (10) days after such notice. After such hearing, the Board may suspend any license or permit issued pursuant to this ordinance, for any portion of or for the remainder of its life. At the end of such period, the person whose license or permit was suspended may apply for a new license or permit as in the case of an original application. 2. Upon a second violation or failure to comply with any provision of this regulation by any licensee, the Board of County Commissioners may permanently revoke such license or permit. Section 5-Violation/Penalty Any person who violates any provision of this ordinance commits a class 3 misdemeanor and shall be punished as provided in section 18-1-106,C.R.S. 4 Ordinance No.0_0111�2001 ANNEX A The following list of items may change to comply with Colorado Code of Regulations 6-CCR-1015-3, Section 12 and other state or county requirements: SAFETY EQUIPMENT ❑ One 2 '/2 lb. Or larger ABC fire extinguisher, accessible from the patient compartment and having been serviced within the last year per NFPA 10,Section 4. ❑ One 5 lb. Or larger ABC fire extinguisher,accessible from outside the vehicle and having been serviced within the last year per NFPA 10, Section 4 ❑ Two"NO SMOKING—OXYGEN IN USE"signs,one in the cab and one in the patient compartment ❑ One flashlight,2-D cell equivalent or better,with spare bulb and batteries or charger ❑ One set of(3)reflective warning devices ❑ One reflective vest,coat or equivalent for each crew member normally assigned ❑ At least one"SHARPS"container, clearly labeled and easily accessible in the patient compartment ❑ Restraining devices for all items not in a secure cabinet EMERGENCY WARNING EQUIPMENT ❑ Audible warning device(siren) with at least 2 different tones ❑ Visual warning devices(lights)with alternating red and/or blue flashing or rotating lights, visible from all sides simultaneously and clear flashing or oscillating lights,visible from the front. COMMUNICATIONS EQUIPMENT ❑ Mobile VHF radio with appropriate State,Pitkin County and individual frequencies ❑ Mobile UHF radio with appropriate State,Pitkin County, hospital and individual agency frequencies ❑ Portable radio with charger and/or cellular phone for back-up communications with dispatch and hospitals MEDICAL EQUIPMENT AND SUPPLIES Airway Equipment: ❑ Fixed suction system with wide bore tubing, rigid pharyngeal curved suction tip and soft catheter suction tip with sizes from 5 Fr.To 14 Fr. ❑ Portable Suction system with wide bore tubing,rigid pharyngeal curved suction tip and soft catheter suction tip with sizes from 5 Fr.To 14 Fr. ❑ Bulb Syringe ❑ Nasopharyngeal airways in pediatric and adult sizes ❑ Ooopharyngeal airways in pediatric and adult sizes ❑ Bite stick or equivalent(oropharyngeal airway) ❑ Portable oxygen system with a minimum storage capacity of 15 cubic feet(D cylinder)and a minimum delivery capability for one patient at flows of at least 1 — 15 LPM ❑ Fixed oxygen system with a minimum storage capacity of 125 cubic feet(M cylinder) and a minimum delivery capability for three patients simultaneously at flows of at least 1 — 15 LPM ❑ Infant Bag-Valve-Mask with 500 cc bag,reservoir and newborn,infant and child masks ❑ Adult Bag-Valve-Mask with 1000 cc bag,reservoir and adult mask. All mask attachments must be 15 mm ❑ Oxygen masks and cannulas capable of delivering oxygen to adult and infants at flows of at least 1 — 15 LPM 5 Ordinance No.Oga-2001 Diagnostic Equipment ❑ Blood pressure cuffs in large adult,adult, child, infant and neonatal sizes ❑ Stethescope in adult and pediatric sizes ❑ Pulse oximeter with adult and pediatric sensors Immobilization&Splinting ❑ One lower extremity traction splint ❑ Upper and lower extremity splints of any type(vacuum,air, SAM,wire,board, etc.) ❑ Long spineboard, vacuum mattress or equivalent with appropriate accessories to immobilize patient from head to heels. ❑ One orthopedic stretcher(scoop) ❑ Short spineboard,KED or equivalent with appropriate accessories to immobilize patient from head to pelvis ❑ Pediatric spineboard or adult spineboard adaptable to pediatric use ❑ Adult and pediatric sized head immobilization equipment for each long spineboard and/or scoop stretcher carried ❑ Rigid cervical immobilization collars in tall adult through infant sizes Wound Care ❑ Bandages, including but not limited to,trauma,ABD,gauze, occlusive and bandaids per agency needs ❑ Sterile bum sheets ❑ Providine swabs and alcohol swabs or equivalent ❑ Adhesive tape,including but not limited to 1"and 2"per agency needs ❑ Sterile irrigation solution Obstetrical Supplies ❑ Sterile OB kit to include: towels,4x4s,umbilical tape or cord clamps,scissors,bulb syringe, sterile blanket and sterile gloves ❑ Silver Swaddler and stocking cap or equivalent Infection Control ❑ Exam gloves in small,medium and large sizes ❑ Face and eye shields ❑ Fluid proof gowns with full length sleeves or equivalent ❑ Disinfectant spray or wipes for personnel and equipment Miscellaneous ❑ Oral Glucose ❑ Activated Charcoal ❑ Heavy Duty bandage scissors or shears capable of cutting clothing,belts,boots,etc. ❑ Spill proof emesis container with at least 1 liter capacity ❑ Universal or separate male and female urinals ❑ Multi-level wheeled gamey ❑ Stair Chair or equivalent ❑ Blankets ❑ Patient compartment heater 6 Ordinance No.002001 INTRODUCED, FIRST READ,AND SET FOR PUBLIC HEARING ON THE 10 DAY OF JANUARY,2001. NOTICE OF PUBLIC HEARING PUBLISHED IN THE WEEKEND EDITION OF THE ASPEN ES ON 13 DAY OF JANUARY, 2001. R VED UPO SECOND READING AND PUBLIC HEARING ON THE ltx DAY OF 2001. P LISHED A ER ADOPTIONPIN �E WEEKEND EDITION OF THE ASPEN TIMES(�N THE � -� Dqy OF�i_���� U ,2001. ATTEST: BOARD OF COUNTY COMMISSIONERS OF PITKIN COUNTY, COLORADO J nett!ones �/ K 6 cry,q eputy Clerk&Reco er Date: APPROVED AS TO FORM: APPROVED AS TO CONTENT: Deborah Quimt �� Rich Walker Assistant County Attorney Aspen Ambulance District Director 7