It is the intent of this chapter to establish general operating
procedures and standards for medical transportation services operating
within the incorporated areas of the City in both emergency and other
situations, to provide a fair and impartial means of allowing responsible
private operators to provide such services in the public interest
and to provide a means for the designation of emergency response areas.
(1961 § 1, 1986; 2808 § 1, 2012)
For purposes of this chapter, the following terms are defined:
mean the same as defined in the California Health and Safety
Code.
means a motor vehicle, helicopter, or similar vehicle, specifically
constricted, modified, equipped, or arranged and operated for the
purpose of transporting patients requiring immediate or ongoing medical
services, excluding the transportation of such persons to or from
locations not providing services as defined in this chapter.
means the activity, business or service, for hire, profit,
or otherwise of transporting one or more persons by ambulance; provided,
however, ambulance service shall not include the transportation by
ambulance by an employer of his or her own employees in an ambulance
owned and operated by the employer solely for this purpose.
means any person who operates or owns an ambulance service.
means a trained, qualified individual who, regardless of
whether he or she also serves as driver, is responsible for the care
of patients.
means the Orange County Board of Supervisors.
means the City of Garden Grove, County of Orange, State of
California.
means the Garden Grove City Council.
means the Orange County Fire Authority.
means the County of Orange, State of California.
means the Emergency Medical Services Agency of the County
of Orange or the Health Care Agency of the County of Orange, or as
otherwise designated by the Board of Supervisors.
means an individual employed by an ambulance service operator
responsible for sending an ambulance, to provide ambulance service
to a patient.
means an attendant who drives or pilots an ambulance.
means a sudden, unforeseen event giving rise to a need for
ambulance service with basic or advanced life support services.
means a geographical location specified by the Fire Chief
within which emergency service may be provided under a license.
means ambulance service performed in response to an emergency.
means the Fire Chief designated by the Orange County Fire
Authority for the City of Garden Grove.
means the Orange County Health Officer or other official
designated by the Board of Supervisors of Orange County to perform
the Health Officer's functions under this chapter.
means an ambulance service operator that has been granted
a license under this chapter to provide ambulance service.
means services provided by health care professionals licensed
pursuant to the California Business and Professions Code or as specified
by regulations adopted pursuant to this chapter.
means the same as defined in the California Health and Safety
Code.
means a wounded, injured, sick, invalid, or otherwise incapacitated
person.
means any individual, firm, corporation, partnership, association,
or other group or combination acting as a unit.
means a medical doctor or osteopath holding the appropriate
license or certificate to practice as such with the State of California
pursuant to the Business and Professions Code.
means any public law enforcement agency or fire protection
agency operating in the County.
(1961 § 1, 1986; 2808 § 1, 2012; 2911 § 3, 2019)
A.
Applications
for licenses are obtained and processed through County Health Officer
and shall be accompanied by fees set by the Board of Supervisors.
This license is in addition to and not in lieu of any business operation
tax certificate that is required by the City.
B.
A license
may specify the specific geographical area within the City in which
it is valid; provided, however, with respect to emergency response
areas, reference to the emergency response area by a specific number
or similar identification shall be sufficient description of geographic
limitation. A license shall be valid for not more than one calendar
year or the expiration of the calendar year in which it was issued,
whichever is shorter.
C.
The
provisions of this chapter shall not apply to:
1.
Ambulances
operated at the request of a public safety agency during any "state
of war emergency," "state of emergency," or "local emergency," as
defined in the Government Code;
2.
Ambulance
service transporting a patient from a location outside of Orange County
regardless of destination; and
3.
Ambulance
service transporting a patient by a fixed-wing airplane.
(1961 § 1, 1986; 2808 § 1, 2012)
A.
No license
issued pursuant to this chapter can be transferred by operation of
law or otherwise. The following shall be considered transfers for
purposes of this section:
B.
A licensee
may apply to the Health Officer for an amendment to the terms of the
license, which request shall be processed in the same manner as an
original application.
C.
Notwithstanding
anything in this section to the contrary, licenses may be suspended,
revoked, or terminated prior to the expiration date, pursuant to the
provisions of this chapter.
(1961 § 1, 1986; 2808 § 1, 2012)
A.
Each
application for a license shall be accompanied by an application fee,
if any, set by the Board of Supervisors, and be made upon forms prescribed
by the Health Officer.
B.
Each
applicant shall submit the following:
1.
The
names and addresses of the applicant(s) and the owner(s) of the ambulance(s)
and the business and any interest therein.
2.
The
applicant's training and experience in the transportation and care
of patients.
3.
The
names under which the applicant has engaged, does, or proposes to
engage in ambulance service.
4.
A
description of each ambulance including the make, model, year of manufacture,
vehicle identification number, current state license number, the length
of time the vehicle has been in use, and the color scheme, insignia,
name, monogram, and other distinguishing characteristics of the vehicle,
a description of the company's program for maintenance of the vehicle,
and a description of the vehicle's radio(s).
5.
Proof
that the applicant has obtained all licenses and permits required
by state or local law or regulation for the type of ambulance service
proposed, excluding only a license to provide the service for which
application is made.
6.
The
names and qualifications of each attendant, driver, or dispatcher
employed, or to be employed, in providing ambulance service.
7.
Proof
that the applicant possesses and maintains currently valid California
Highway Patrol inspection reports for each vehicle listed in the application.
8.
A
description of the company's training and orientation programs for
attendants, drivers, and dispatchers.
9.
Evidence
of such financial responsibility and insurance coverage as may be
required by the Health Officer pursuant to regulations adopted in
accordance with this chapter.
10.
Identification of the geographical area to be served by the applicant,
if required by the department.
11.
As to new applications or transfers as specified in Section 5.10.040, a fingerprint receipt for each principal of the applicant, issued by the Orange County Sheriff-Coroner and indicating that each principal of the applicant has undergone a complete criminal history check, followed by a report from the Orange County Sheriff-Coroner showing no conviction of crimes that would be violations of the provisions of Section 5.10.070(D) (1), (2), (3), (4), (5), (6), or (7).
12.
A list of all substations or offices where equipment and personnel
are, or will be based, including hours of operation.
13.
A description of whether the service proposed by the applicant will
include basic life support services or advanced life support service,
and, if so:
14.
Such other information as the Health Officer may require in regulations
adopted pursuant to this chapter.
C.
Renewal applications shall be submitted in the same form and require the same materials as original applications except the requirement of Section 5.10.050(B)(11).
(1961 § 1, 1986; 2808 § 1, 2012)
Upon receipt of a completed application and the required fee,
if any, the Health Officer shall make, or cause to be made, such investigation
as the Health Officer deems necessary to determine if:
A.
The
applicant is a responsible and proper person to conduct, operate or
engage in the provision of ambulance services.
B.
The
applicant meets the requirements of this chapter and of other applicable
law, ordinances or regulations.
(1961 § 1, 1986; 2808 § 1, 2012)
A.
The
Health Officer shall issue a license to an applicant if the Health
Officer, after completing any investigation required pursuant to this
chapter, determines all requirements of this chapter have been met
and the license fee, if any, set by the Board of Supervisors, has
been paid.
B.
In event
of denial, the applicant shall be informed in writing of the reasons
therefor.
C.
The
licensee shall obtain and keep in force, during the term of a license,
comprehensive automobile liability insurance and professional liability
insurance issued by a company authorized to do business in the State
of California, acceptable to the Health Officer, insuring the owner
against loss by reason of injury or damage that may result to persons
or property from negligent operation or defective construction of
such ambulance or from violation of this chapter or any other law
of the State of California, or the United States. The comprehensive
automobile liability policy shall be in the sum of not less than $500,000.00
for combined single limit, bodily injury and property damage. The
professional liability insurance shall be in the sum of not less than
$1,000,000.00 per person and $1,000,000.00 annual aggregate. Worker's
compensation insurance shall be carried covering all employees of
the license holder. Before the Health Officer shall issue a license,
copies of the policies, or certificates evidencing such policies,
shall be filed with the Health Officer. All policies shall contain
a provision requiring a 30-day notice to be given to the department
prior to cancellation, modification, or reduction in limits. The amount
of comprehensive automobile liability insurance shall be subject to
review and adjustment by the Health Officer pursuant to regulations
adopted under this chapter. In the use of helicopters, the equivalent
insurance requirements shall apply.
D.
Grounds
for denial of a license application shall be:
1.
Failure
to meet the requirements of any provisions of this chapter.
2.
Violation
by any principal of an applicant of Penal Code Section 290.
3.
Habitual
or excessive use of narcotics or dangerous drugs.
4.
Conviction
during the preceding seven years of any crime relating to the use,
sale, possession, or transportation of narcotics, addictives or dangerous
drugs.
5.
Habitual
or excessive use of intoxicating beverages.
6.
Conviction
during the preceding seven years of any crime punishable as a felony
in the State of California.
7.
Conviction
of any crime involving moral turpitude, including fraud or intentional
dishonesty for personal gain.
E.
In determining
the effect of any criminal acts on the issuance or denial of a license,
the Health Officer shall consider whether the criminal acts are related
to the activities of an ambulance service and shall evaluate the rehabilitation
of the persons involved. The Health Officer shall not consider crimes
of which the applicant is, or was, accused but not convicted.
(1961 § 1, 1986; 2808 § 1, 2012)
A.
The
Health Officer may suspend or revoke a license for failure by the
licensee to comply and maintain compliance with, or for violation
of, any applicable provisions, standards, or requirements of state
law or regulation of this chapter, or of any regulations promulgated
hereunder. Suspension of a license is not a condition precedent to
revocation of a license.
B.
Before
suspension or revocation, the Health Officer shall give written notice
to the licensee. The notice shall:
1.
Specify
the reasons for which the action is to be taken.
2.
Set
a hearing for not more than 15 days nor less than seven days after
the date of the notice.
3.
Specify
the date, time, and place of the hearing.
4.
Be
served on the licensee either by delivery to its principal place of
business or to its designated agent for service of such notices, if
any.
C.
If the
licensee, subsequent to service of a suspension or revocation notice
under this section, remedies some or all of the conditions to which
the notice refers, the Health Officer may rescind a suspension or
revocation at any time.
D.
At the
hearing, the Health Officer has the burden of proof and may present
evidence as to why such action should be taken and to answer the evidence
presented by the licensee.
E.
The
Health Officer may reduce the period of time for hearing under a suspension
or revocation notice to no less than 24 hours when the Health Officer
makes written preliminary findings that such action is necessary to
protect the public health, safety, and welfare. When as a result of
such an emergency proceeding, a license is suspended or revoked, the
licensee may request an additional hearing at which the licensee will
have the burden of establishing renewed compliance justifying reinstatement
of the license. Such additional hearing will be commenced within five
days of the licensee's request. The request for and the scheduling
of an additional hearing shall not stay operation of the suspension
or revocation order.
F.
Hearings
conducted pursuant to this section shall be conducted before a hearing
officer designated by the department. At the conclusion of the hearing,
the hearing officer shall expeditiously prepare a written summary
of the evidence and proposed findings and conclusions for consideration
by the Health Care Agency Director.
G.
The
Health Care Agency Director shall issue a written decision within
30 days after conclusion of the hearing.
(1961 § 1, 1986; 2808 § 1, 2012)
In the event of denial, suspension, or revocation of a license,
the applicant or licensee shall have the right to request a hearing
before the Board of Supervisors, which hearing shall be requested
and conducted in the manner specified in the County's codified ordinances.
(1961 § 1, 1986; 2808 § 1, 2012)
The licensee shall notify the Health Officer within 24 hours
after any change in ownership or management of the licensee, or any
interruption of service of more than 24 hours' duration, or any substantial
change in staffing or equipment. For purposes of this section, "substantial
change" shall be as defined by regulation adopted pursuant to this
chapter.
(1961 § 1, 1986; 2808 § 1, 2012)
A.
A licensee
shall only employ personnel performing tasks described in this chapter
who comply with the requirements of this section.
B.
Attendants
shall be at least 18 years of age and trained and competent in the
proper use of all equipment, and shall hold current "EMT IA" certification
in compliance with all state laws, rules, and regulations. Additionally,
each attendant shall hold a license from the Health Officer indicating
compliance with this section. Applications for such licenses shall
be in a form required by the Health Officer and shall be accompanied
by the fee, if any, established therefor. All applicants for licenses
as an attendant shall be subject to the same criminal history review
as required for principals of ambulance companies pursuant to this
chapter no less than once every four years. Certificates may be denied,
suspended, or revoked in the same form and fashion as that specified
for ambulance service licenses in this chapter. Licenses shall be
valid for two years from the date of issuance or certification as
an emergency medical technician-1A, whichever is less. Renewal of
a license shall be in the same fashion as issuance of a new license.
C.
Each
licensee shall have at least one dispatcher. Emergency ambulance service
licensees shall have a dispatcher on a 24-hour-per-day basis and shall
adequately train the dispatcher to radio operation and protocols,
and to the emergency response area(s) served before the dispatcher
begins dispatching emergency calls. For purposes of this section,
"adequate" training of a dispatcher shall be that which meets state
standards, if any, or county requirements.
D.
Ambulance
drivers shall, in addition to the requirements of this chapter for
attendants, maintain an appropriate license issued by the California
Department of Motor Vehicles and, if applicable, the Federal Aviation
Administration.
(1961 § 1, 1986; 2808 § 1, 2012)
No licensees shall charge more than those rates approved by
the City Council for ambulance service.
(1961 § 1, 1986; 2808 § 1, 2012)
A.
The
City shall contract with licensees on a competitive basis for provision
of ambulance service in response to emergencies in each emergency
response area. The contracts shall provide for one primary contractor
per emergency response area, with such other back-up service by other
emergency ambulance service providers as deemed necessary by the City.
In awarding these contracts, the City shall consider the comparative
value of competing proposals in the same fashion as would be the case
were the City evaluating proposals from prospective service providers
for other City activities, including consideration of:
B.
The
City Manager or his/her designee shall administer the contracts for
ambulance service awarded by the City Council under this section.
The City Manager or designee shall also prepare and keep current emergency
response area lists specifying contract providers for each area. The
City Manager or designee shall include on the list for emergency response
area the provider that has entered into an ambulance service agreement
with the City as the primary contractor, as well as the emergency
ambulance service provider(s) who will provide back-up emergency ambulance
service for that area.
C.
In the
event no proposals acceptable to the City under the provisions of
this section are received for one or more emergency response areas,
the City shall designate one or more licensees in that emergency response
area to provide emergency ambulance services. From the date of such
designation until a regular emergency ambulance service agreement
is signed for the affected area(s), provision of emergency ambulance
service shall be an express condition of the license and unreasonable
or unjustified refusal of such calls shall be in violation of this
chapter.
D.
No person
shall provide ambulance service in response to, or as a result of,
an emergency, unless that person is a licensee specified in each instance
by a physician or public safety agency. A licensee thus specified
by a physician need not be a contractor selected pursuant to this
chapter. Any ambulance service operator receiving a request for emergency
ambulance service from other than a public safety agency shall immediately
notify a public safety agency designated by regulation of the request
by telephone.
E.
No licensee
responding to an emergency shall transport a patient unless:
1.
A
paramedic is present at the location of the patient;
2.
A
physician is present at the location of the patient and directs transportation
in the absence of a paramedic; or
3.
A
safety-qualified employee of the City's Fire Department, or an appropriate
employee of a public safety agency designated by regulation, directs
transportation in the absence of a paramedic.
(1961 § 1, 1986; 2808 § 1, 2012; 2911 § 4, 2019)
C.
The
Health Officer or the City Manager or their designee(s) may inspect
the records, facilities, transportation units, equipment, and method
of operations of each licensee whenever necessary and, by the Health
Officer, at least annually.
(1961 § 1, 1986; 2808 § 1, 2012; 2911 § 5, 2019)
The City, the County, the department, any user, subscriber,
public safety agency, or consumer who believes, or has reason to believe,
that he or she or another party has been required to pay an excessive
charge for services, received inadequate services, or services provided
were not in compliance with the provision of this chapter, may file
a written complaint with the department setting forth such allegations.
The department shall notify the ambulance service operator of such
complaint. The ambulance service operator shall file a written response
within 15 calendar days after receipt of notification.
(1961 § 1, 1986; 2808 § 1, 2012)
As to all but Section 5.10.130, the Health Officer may grant variances from the terms of this chapter if he or she finds such action is necessary to protect the public health, safety, or welfare. As to Section 5.10.130, the City Manager or his/her designee may grant variances from the terms of this chapter if he or she finds such action is necessary to protect the public health, safety, or welfare. As to the Health Officer, such variances may include the issuance of a temporary license. No variance shall exceed 180 days in duration.
(1961 § 1, 1986; 2808 § 1, 2012; 2911 § 6, 2019)
Violation of any provision of this chapter by an ambulance service
operator shall be a misdemeanor.
(1961 § 1, 1986; 2808 § 1, 2012)
