Recently Mayor Cole the attached letter from American Medical Response (AMR) through the Billings Fire Department (BFD). Due to the current COVID-19 nation-wide emergency, this letter summarizes the need for a temporary modification of the City's licensing ordinance so that emergency medical response resources may be more efficiently directed to particular calls for service. Based upon the Mayor's review of the request from AMR as supported by the BFD, it was his opinion that the request was appropriate and necessary under the COVID-19 emergency circumstances. The Mayor determined that there was a need to temporarily permit and authorize a Basic Life Support (BLS) emergency response by AMR when the local Medical Control physician determines that such a response is appropriate for specific emergency calls. This BLS response is a supplement to and not a replacement of the Advanced Life Support (ALS) services requirement and ALS license issued to AMR.

 Currently City ordinance Sections 15-703(2) and (3) (BMCC) require that any licensed emergency medical service providing such services within the City of Billings must do so 24 hours per day/7 days per week services to the City ”at the advanced life support level” (ALS) in order for an ambulance service to be licensed by the City. In order to authorize supplemental  BLS response by AMR in certain defined and specified emergency medical service calls , the City ordinance must be temporarily amended as the Mayor has directed pursuant to Section 2-903(2), BMCC, as further explained below. There is authorization for an emergency ordinance under state law at Section 7-5-104, Montana Code Annotated (MCA) which allows for one reading of such an emergency ordinance. However, this statute only authorizes such an emergency ordinance to exist for ninety (90) days. It is unlikely that the COVID-19 emergency will be resolved in ninety days.

Under other Montana Code Annotated sections and BMCC section, the Mayor is authorized  to make temporary emergency determinations and directives such as this one. Section 10-3-402, MCA and Section 2-903 permit the mayor to issue emergency declarations and related directives. Specifically, Section 2-903(2), BMCC, authorizes the Mayor to “issue proper directives which in the event of emergency shall have the effect of an ordinance of the City of Billings, but shall be subject to confirmation by city council…”Similarly, section 2-905 authorizes the Mayor to make such emergency directives to the City Administrator or designee whom shall implement the specific directive.

Based upon the authority above and subject to City Council confirmation, the Mayor has directed the City Administrator to proceed with ensuring Section 15-703 (2) and (3) be immediately and temporarily amended and expanded to permit both an ALS and BLS level of response to emergency calls for service within the City as determined by AMR and BFD Medical Control. A copy of this directive is attached.

Section 2-903(2), BMCC, requires the City Council to confirm this directive. A proposed Resolution confirming the Mayor's directive is attached to this memo.
 
 

City Council may:

• Approve the proposed Resolution and confirm the Mayor's directive, or;
• Disapprove the proposed Resolution and thereby revoke the Mayor's directive

There is no financial impact to the City for this temporary, emergency change in emergency medical services licensing.

Staff recommends that the Council approve the attached Resolution confirming the Mayor's emergency directive.