HomeMy WebLinkAbout021031 ORD - 11/27/1990A RESOLUTION
FINDING THAT THE CITY EMERGENCY MEDICAL SERVICES
PROGRAM IS AN ESSENTIAL MUNICIPAL SERVICE, AND
INSTRUCTING THE CITY MANAGER TO MAKE CHANGES BASED
ON RECENT STUDIES.
WHEREAS, the City Emergency Medical Services Program was established
in 1973, in response to public concern about the deteriorating, inadequate, and unacceptable
condition of private ambulance services, which resulted in part from poor collections of
accounts receivable; and
WHEREAS, the City and the Nueces County Hospital District entered into
a joint funding agreement in 1973 to support the Program, by which each agency was
responsible for one-half the operating deficit; and
WHEREAS, the operating deficit of the Program was increased incrementally
in 1982 when a sixth ambulance was added in response to increased calls, and non-
emergency calls were eliminated to allow for additional training and improved maintenance,
and in 1987 when the Program was expanded through a decision to add a seventh
ambulance; and
WHEREAS, the Nueces County Hospital District terminated the joint funding
agreement in 1988, and a new agreement was approved reducing the contribution to
$800,000 annually expiring July 31, 1990; and
WHEREAS, in response to the reduction of funding from the Nueces County
Hospital District, the Chamber of Commerce, its Foundation, and twenty governmental
entities included in a study entitled "Inter -governmental Cooperation Project," a review of
emergency medical services, which produced six recommendations:
1. Investigate implementing a subscription service in the cities of Port Aransas and
Corpus Christi immediately to help reduce public subsidy of the Program;
2. Consider planning for a region -wide emergency medical system with only first
response by public entities and contracting for transfer services with a private
company or companies;
3. Evaluate alternative funding mechanisms;
4. Mutual aid agreements and formal cooperative arrangements should be established
between the various entities currently providing emergency medical services;
\ORD-RESW0203
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5. Fee structures need to be monitored and more closely tied to the cost of service;
6. Public education about emergency medical service should be increased with perhaps
a greater emphasis on the need to charge for this public service; and,
WHEREAS, Consultant Jack Stout, President, The Fourth Party, Inc., made
presentations to the Nueces County Commissioners' Court on April 18, 1990, and to the
Ambulance Advisory Committee on April 19, 1990, recommending that two actions be taken
if the Program's subsidy is to be reduced:
1. Ambulance personnel currently working 24 hour shifts must be scheduled to work
shorter shifts;
2. A separate work force should be established to provide routine or non -emergency
transfers; and
WHEREAS, Consultant James O. Page, J.D., prepared a report dated July
1990 entitled "A Study of Emergency Medical Services in Nueces County and Corpus Christi,
Texas," containing sixteen recommendations for improvement of the Program, which
recommendations are listed on Exhibit A attached hereto; and
WHEREAS, Texas Department of Health EMS Program Manager Jay Garner
transmitted a report on October 31, 1990, recommending that the City recognize the
Program as an essential municipal service that requires subsidy, and that the studies
conducted since 1985 be used to design and implement changes in local emergency medical
services provision; and
WHEREAS, the City Council adopted a resolution requesting the Texas
Legislature to enact legislation providing for one-fourth of sales tax revenue received by the
Regional Transit Authority to be used for emergency medical transportation; and
WHEREAS, the City Council desires to proceed to implement appropriate
improvements in the Program;
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF
THE CITY OF CORPUS CHRISTI:
SECTION 1. The City Council finds that the City Emergency Medical Services
Program is an essential municipal service, maintained at high quality, and requiring a subsidy.
SECTION 2. The City Manager is hereby instructed to proceed to design
changes in the City Emergency Medical Services Program addressing common issues and
recommendations presented in recent studies.
\ORD-RES\90203
ATTEST:
City Secretary
?EAYOR
J L i y�tiP�
THE CITY OF CORPUS CHRISTI
APPROVED:244 DAY OF , 199a
HAL GEORGE, CITY ATTORNEY
By • _V
A sAataat City Attorney
C
Consultant Report — Corpus Christi
July, 1990
page 27
SUMMARY OF RECOMMENDATIONS
See referenced pages for complete text of recommendations
1. Enjoin Hospital District from its cessation of financial
support and seek judicial declaration regarding District's
financial responsibility for prehospital emergency medical
services (page 5).
2. Provide resources and implement expanded public education and
CPR training programs (page 6).
3. Train all 911 dispatchers as emergency medical dispatchers
(EMD's) and implement priority dispatching system (page 7).
4. Continue fire company first responder services utlizing.
automatic external defibrillators, but improve those services
with a comprehensive quality assurance program (page 8).
5. Evaluate CCFD's present capabilities for heavy rescue,
physical extrication, and urban search and rescue in disaster
conditions, and correct deficits (page 8).
6. Continue to formulate educational and certification policies
based on patient outcomes, and.conduct cost—benefit analyses on
supplemental certification programs before adopting them (page
10).
7. Continue to measure response times by the fractile method,
pursue strategies for reducing response times to the lowest
possible levels, and create methods for measuring response times
by geographical district or area (page 11).
8. Develop procedures for electronically capturing and recording
call processing times, monitor those times on a continuous basis,
and consider those times in setting response time standards (page
11).
9. Create a medical control board to oversee and regulate
clinical aspects of the EMS system (page 12).
10. Employ consulting assistance to design and implement a
comprehensive EMS quality assurance program (page 13).
11. Consider reorganization of the Corpus Christi Fire
Department to eliminate excessive levels of supervision in the
upper management ranks (page 14).
454/Q/7" A, for et
Consultant Report — Corpus Christi
July, 1990
page 28
12. Create a new entry—level position within CCFD and assign
those personnel to staff non—emergency ambulances. As a new
source of revenue, implement a county—wide non—emergency
ambulance system to be operated by CCFD (page 17).
13. Evaluate ambulance and "no transport" fee schedules and
consider increasing ambulance rates to more closely approximate
the cost of delivering those services (page 19).
14. Employ a consultant who is an expert on ambulance
reimbursement, and evaluate the current system for possible fine—
tuning and improvement (page 20).
15. Develop and implement an ambulance membership program (page
24).
16. Consider implementing an independent management entity as a
means of assuring efficient performance and accountability from
all elements of the EMS system (page 26).
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Corpus Christi, Texas
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The above resolution was passed by the following vote:
Betty N. Turner Je 0 J
Cezar Galindo ai��p ,,
a'p
Leo Guerrero
Tom Hunt
Edward A. Martin -
Joe McComb
Clif Moss
Mary Rhodes
Frank Schwing, Jr.
066