It is the intent of this chapter to establish general operating
procedures and standards for medical transportation services operating
within 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 exclusive operating areas. This chapter is
modeled after Division 9, Article I of Title 4 of the Codified Ordinances
of the County of Orange (County Model Ambulance Ordinance No. 3517;
OCC § 4-9-1).
(Ord. O-2004-04 § 1, 2004)
For purposes of this chapter, the following terms are defined:
"Ambulance"
means a motor vehicle, helicopter or similar vehicle, specifically
constructed, 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.
"Ambulance service"
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.
"Attendant"
means a trained, qualified individual who, regardless of
whether he or she also serves as driver, is responsible for the care
of patients.
"County"
means the county of Orange, state of California.
"City"
means the city of Placentia, California.
"Department"
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 Orange County board of supervisors.
"Dispatcher"
means an individual employed by an ambulance service operator
responsible for sending an ambulance to provide ambulance service
to a patient.
"Driver"
means an attendant who drives or pilots an ambulance.
"Emergency"
means sudden, unforeseen event giving rise to a need for
ambulance service with basic or advanced life support services and
is a condition in which an individual has a need for immediate medical
attention, or where the potential for such need is perceived by emergency
medical personnel or a public safety agency.
"Fire chief"
means the fire chief of the Orange County fire authority.
"Health officer"
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.
"Licensee"
means an ambulance service operator, which has been granted
a license under this chapter to provide ambulance service.
"Paramedic"
means the same as defined in the California Health and Safety
Code.
"Patient"
means a wounded, injured, sick, invalid or otherwise incapacitated
person.
"Person"
means any individual, firm, corporation, partnership, association
or other group or combination acting as a unit.
"Public safety agency"
means any public law enforcement agency, fire protection
agency or forest ranger operating in the county.
(Ord. O-2004-04 § 1, 2004)
(a) It
shall be unlawful for any person to be an ambulance service operator,
or to act in such a capacity either directly or indirectly, within
the city without possession of a license issued pursuant to this chapter.
A license may specify the specific geographical area within the city
in which it is valid; provided, however, with respect to EOAs, reference
to the EOA 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.
(b) 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 the city regardless of destination;
(3) Ambulance service transporting a patient by a fixed-wing airplane.
(Ord. O-2004-04 § 1, 2004)
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:
(a) Any
change in the business structure of a licensee, including, but not
limited to, changes from or to:
(2) A partnership, including any change in the partners; and
(3) A corporation, including any change in the shareholders, whether
by operation of law or otherwise.
(b) Bankruptcy,
an assignment for the benefit of creditors, or the appointment of
a receiver.
(c) A
sale or transfer of over 10% of the assets of a licensee.
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. 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.
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(Ord. O-2004-04 § 1, 2004)
(a) Each
application for a license shall be accompanied by an application fee,
if any, set by the Orange County 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 engage and
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 vehicles, 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 applicant 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
6.32.040 of this chapter, a fingerprint receipt for each principal of the applicant, issued by the Orange County sheriff-coroner indicating 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 which would be violations of the provisions of subsections
6.32.070 (d)(2), (d)(3), (d)(4), (d)(5), (d)(6) or (d)(7) of Section
6.32.070;
(12) A list of all substations or offices where equipment and personnel
are, or will be based, including hours of operation; and
(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:
(A) The number of basic life support service or advanced life support
service units to be deployed on each shift,
(B) The emergency response area(s) to receive basic life support service
or advanced life support service, and
(C) The provisions, if any, for continuing education of attendants;
(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 subsection (B)(11) of Section
6.32.050.
(Ord. O-2004-04 § 1, 2004)
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:
(1) The
applicant is a responsible and proper person to conduct, operate or
engage in the provision of ambulance services;
(2) The
applicant meets the requirements of this chapter and of other applicable
laws, ordinances or regulations.
(Ord. O-2004-04 § 1, 2004)
(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 Orange County board of supervisors,
has been paid.
(b) In
the event of denial, the applicant shall be informed by the health
officer in writing of the reasons therefore.
(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. Said comprehensive
automobile liability policy shall be in the sum of not less than $500,000
for combined single limit, bodily injury and property damage. Said
professional liability insurance shall be in the sum of not less than
one million dollars ($1,000,000) per person and one million dollars
($1,000,000) annual aggregate. Workers' 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 provision of this chapter;
(2) Violation by any principal of an applicant of
Penal Code Section
290;
(3) Use of narcotics or other controlled substances;
(4) Conviction during the preceding seven years of any crime relating
to the use, sale, possession or transportation of narcotics or other
controlled substances;
(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, but
not limited to, 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 person(s) involved. The health
officer shall not consider crimes of which the applicant is, or was,
accused but not convicted.
(Ord. O-2004-04 § 1, 2004)
(a) The
health officer may suspend or revoke a license for failure by the
licensee to comply with, and maintain compliance with, or for violation
of, any applicable provision, standard or requirement of state law
or regulation or this chapter, or of any regulations promulgated hereunder.
Suspension of a license is not a condition precedent to revocation
of a license.
(b) Before
issuing a suspension or revocation, the health officer shall give
written notice to the licensee. Said notice shall:
(1) Specify the reason(s) for which the proposed 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; and
(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 the 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 proceedings, 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 said 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 receiving the hearing officer's findings and conclusions.
(Ord. O-2004-04 § 1, 2004)
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 city council. Such hearing shall be a noticed public hearing
and conducted at a regular council meeting. The decision of the city
council shall be final and binding.
(Ord. O-2004-04 § 1, 2004)
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, the
term "substantial change" shall be as defined by regulation
adopted pursuant to this chapter.
(Ord. O-2004-04 § 1, 2004)
(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 emergency medical
technician-1A (EMT-1A), or state educational equivalent, 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 therefore. 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 manner as that specified
for ambulance service licensees 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 manner 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 said 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.
(Ord. O-2004-04 § 1, 2004)
No licensee shall charge more than the maximum BLS rates approved
by the Orange County board of supervisors. No licensee shall charge
more than the maximum ALS rates approved by the Orange County board
of supervisors or the Orange County fire authority.
(Ord. O-2004-04 § 1, 2004)
(a) The
Orange County fire authority shall administer the competitive process,
on behalf of the local EMS agency, for the award of EOA contracts
within the city. The Orange County fire authority shall select and
shall enter into contracts with licensees for the provision of ambulance
service in response to emergencies in each EOA, unless the city has
provided written notification to the Orange County fire authority
of its intention to retain licensee selection and contracting authority
for itself. Such contracts shall provide for one primary contractor
per EOA, with such other back-up service by other emergency ambulance
service providers as deemed necessary by the fire chief. In awarding
these contracts, the Orange County fire authority, or city if it elects
to retain licensee selection and contracting authority, shall consider
the comparative value of competing proposals in the same fashion as
would be the case were the county evaluating proposals from prospective
service providers for other governmental activities, including consideration
of:
(1) The quality of service to be provided;
(2) The level of service to be provided;
(3) The rates charged for services to be provided; and
(4) The cost, if any, to the awarding agency.
(b) The
fire chief shall administer the contracts for ambulance service awarded
by the Orange County fire authority, or by the city if applicable,
under this section. The fire chief shall also prepare and keep current.
EOA lists specifying contract providers for each EOA. The fire chief
shall include on the list for each EOA the provider that has entered
into an ambulance service agreement with the Orange County fire authority,
or the city if applicable, 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 Orange County fire authority,
or to the city if it elects to retain licensee selection and contracting
authority under the provisions of this section, are received for one
or more EOAs, the Orange County fire authority, or the city if applicable,
shall designate one or more licensees to provide emergency ambulance
services for the EOA. 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 a 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
section. Any ambulance service operator receiving a request for emergency
ambulance service from other than a public safety agency shall immediately,
by telephone, notify a public safety agency designated by regulation
of the request.
No licensee responding to an emergency shall transport a patient
unless:
(1) A paramedic is present at the location of the patient; or
(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 Orange County fire authority,
or an appropriate employee of a public safety agency designated by
regulation, directs transportation in the absence of a paramedic.
Unless otherwise directed by a physician present at the location of the patient, a licensee shall transport a patient pursuant to regulations adopted under Section 6.32.140 of this chapter.
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(Ord. O-2004-04 § 1, 2004)
(a) As to all sections of this chapter except Section
6.32.130, the health officer shall make such rules and regulations and as may be necessary to implement this chapter. Prior to adoption, proposed rules and regulations shall be submitted to the Orange County emergency medical care committee for comment.
(b) As to Section
6.32.130 of this chapter, the fire chief shall make such rules and regulations and as may be necessary to implement this chapter. Prior to adoption, the fire chief's rules and regulations shall be submitted to the Orange County emergency medical care committee for comment.
(c) The
health officer or the fire chief or respective designee(s) may inspect
the records, facilities, transportation units, equipment and method
of operating of each licensee whenever necessary and, by the health
officer, at least annually.
(Ord. O-2004-04 § 1, 2004)
The department, the city, any user, subscriber, public safety
agency or consumer who believes, or has reason to believe, that an
individual has been required to pay an excessive charge for services,
received inadequate services or services provided were not in compliance
with the provisions of this chapter, may file a written complaint
with the department and the fire chief setting forth such allegations.
The department and fire chief 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 the notification.
(Ord. O-2004-04 § 1, 2004)
As to all but Section
6.32.130 of this chapter, 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
6.32.130 of this chapter, the fire chief 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 temporary license shall exceed 180 days in duration.
(Ord. O-2004-04 § 1, 2004)
Violation of any provision of this chapter by an ambulance service
operator shall be a misdemeanor.
(Ord. O-2004-04 § 1, 2004)