08. Ordinance 1594 - Advanced Life Support - 1st ReadingKALISPELL FIR-E DEPARTMEN"i"
Randy Brodehl - Fire Chief_ 312 First Avenue East
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Daniel Diehl --- Assistant Chief/Operations _==r- __- Kalispell, Montana 59941
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Brent Christopherson -Assistant Chief/Prevention .-Ham.- -=F- Phone: 406 758-7764
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10/11 /2gg5
TO:
Mayer Pamela B. Kennedy
and Kalispell City Council
FROM: Randy Brodehl, Fire Chief
James H. Patrick, City Manager
SUBJECT: Advanced Life Support Ordinance
COUNCIL MEETING DATE: 11/20/2006
BACKGROUND: On September 25th, Council reviewed a letter from Fire Chief Randy
Brodehl to City Manager James H. Patrick. This letter outlined ambulance response
changes in the Smith Valley community. Until that time, all ambulance service provided to
this area was by the Kalispell Fire Department advanced life support (ALS) service. Now,
as noted in the letter, Marion Ambulance Service, an for profit company, has moved a basic
life support (BLS) ambulance into a Smith Valley fire station, and has begun responding to
all medical emergencies in the Smith Valley community, including BLS and ALS
emergencies. (See Addendum A, Definitions)
Marion Ambulance Service does not have paramedics, and is not certified to provide ALS
service. All of Kalispell Fire Department operations personnel are certified paramedics and
the Department is certified to provide ALS and BLS service. It should also be noted that
the decision whether an emergency ambulance call is ALS or BLS is made by a dispatcher,
based on the information that is provided by the caller. Since neither the caller nor the
dispatcher is a paramedic or medically trained person, calls can receive inappropriate
responses. This can mean that patients are without paramedic care for an immediately life
threatening situation.
These changes and issues in the Smith Valley community have made it very evident that
an ambulance service, regardless of their medical training and certification, could begin
responding into any area now served by the Kalispell Fire Department. This could easily
mean that patients could receive a significantly less qualified response, without the full
advance life support capabilities currently provided by the Kalispell Fire Department. The
quality of treatment would be compromised and confusion would reduce response
capabilities.
"Assisting our community in reducing, preventing, and mitigating emergencies. "
Without an ordinance defining emergency medical response criteria, the State of Montana
becomes the default regulator of ambulance service providers in the city. Since by law, the
state limits it's responsibilities to certification of services as either BLS or ALS, and does
not establish minimum response capabilities, a lesser provider is not restricted from
responding, unless the local authority having jurisdiction, requires a certain standard.
Recommendation
To assure the current level of service, council should consider an ordinance requiring that
all emergency ambulance services in the city of Kalispell be certified by the State of
Montana as Advanced Life Support Service providers. This will assure that the quality of
ambulance service is not compromised and that city residents can expect the same
emergency medical care that they currently receive.
Fiscal Impact
The Kalispell Fire Department provides an ALS paramedic ambulance service that
operates as an enterprise fund. This means that the ambulance service does not receive
tax funds to operate. Twenty percent of personnel costs and a portion of all facilities and
administrative costs have been assigned to this fund. Should the number of medical
responses by the department decreases, the funds available for personnel, facilities, and
administrative costs would be reduced commensurately.
F t
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Ratdy Brodehl, Fire c (ef James H. Patrick, city Manager
Addendum A
Definitions
According to the State of Montana EMS Service Licensing Rules, the following defines the certifications for
ambulance services:
BASIC LIFE SUPPORT -Any provider (including non -transport medical unit) that functions at the
endorsement level of:
a. EMT-F; (first responder)
b. EMT-F with any endorsements; or
C. EMT-B without any endorsements
ADVANCED LIFE SUPPORT SERVICE- An ambulance service or non -transporting medical unit that has the
capacity and is licensed by the department to provide cares at the EMT -Paramedic equivalent level 24 hours
a day, seven days a week.
Additional definitions for clarification of skill levels
+ Advanced life support (ALS) is medical care provided by paramedics trained to assess a patient's
condition, administer drugs, defibrillate and provide advanced airway management prior to
transportation to the hospital.
+ (BLS) Also referred to as Emergency Medical Technician (EMT) level care. Basic Life Support can
be accomplished with a minimum of equipment. The term encompasses any provider or citizen who is
trained in CPR and First Aid. BLS does not include extensive medical supervision or treatment,
including the use of drugs and invasive procedures.
ORDINANCE NO. 1594
AN ORDINANCE ESTABLISHINNG THAT THE MINIMUM STANDARD OF
EMERGENCY MEDICAL SERVICES THAT MAY BE PROVIDED IN THE CITY OF
KALISPELL SHALL MEET ALL OF THE NATIONAL STANDARDS OF ADVANCED
LIFE SUPPORT SERVICES AND DECLARING AN EFFECTIVE DATE.
WHEREAS, the City of Kalispell currently provides emergency medical services to its citizens
that meets all of the national standards of an Advance Life Support Service; and
WHEREAS, the Advance Life Support Service that the City of Kalispell provides to its citizens is
the best level of service that can be provided and meets all of the paramedic care
required in all immediately life threatening situations; and
WHEREAS, it is anticipated that private ambulance services may wish to provide emergency
medical services within the City of Kalispell, but which may not be certified to meet
the national standards of an Advance Life Support Service; and
WHEREAS, the Kalispell City Council finds that it is in the best interests of the health and safety
of its citizens that it establish that the minimum standards required for any emergency
medical service provided in the City of Kalispell shall meet or exceed the national
standards of an Advance Life Support Service.
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF KALISPELL, MONTANA, AS
FOLLOWS:
SECTION I No emergency medical services may be provided within the city limits of the
City of Kalispell unless the provider of those services has provided adequate proof to the City
of Kalispell Fare Chief that the provider and all personnel employed by and providing
emergency services for that service hold current national certifications of an Advance Life
Support Service; EXCEPT that the ALS level of service will not be required for basic
medical transportation services of a nonernergent nature; AND EXCEPT that in a mutual aid
event, a Basic Life Support Service provider may be called upon by the Flathead County 911
dispatch center to provide mutual aid to augment an ALS service.
SECTION II In the event that an emergency medical service violates the above -described
standard, the City may seek relief from the District Court to enjoin such non -authorized
provision of emergency medical services and obtain a cease and desist order.
SECTION III This Ordinance shall be effective thirty (30) days from and after the date of
its final passage and approval.
PASSED AND APPROVED BY THE CITY COUNCIL AND SIGNED BY THE MAYOR THIS
20TH DAY OF NOVEMBER 2006.
Pamela B . Kennedy
Mayor
Attest:
Theresa White
City Clerk