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 operations to provide such services in the public interest,
and to provide a means for the designation of emergency response areas.
This chapter is intended to be used as a model for adoption by cities
within the county.
(Ord. 1095 § 1, 1985)
For purposes of this chapter, the following terms are defined:
means the same as defined in the California Health and Safety
Code.
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.
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 county of Orange, state of California.
means the city of Laguna Beach, 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 for the city of Laguna Beach.
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 which 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, fire protection
agency, or forest ranger operating in the county.
(Ord. 1095 § 1, 1985)
(a)
(1)
It is unlawful for any person to be an ambulance service operator,
or to act in such a capacity either directly or indirectly, without
possession of a license issued pursuant to this chapter.
(2)
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.
(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 Orange County, regardless of destination;
(3)
Ambulance service transporting a patient by a fixed-wing airplane.
(Ord. 1095 § 1, 1985)
(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. 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.
(Ord. 1095 § 1, 1985)
(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 possess 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 5.83.040, 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 Sections 5.83.070(d)(2), (3), (4), (5), (6), (7);
(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:
(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 5.83.050(b)(11).
(Ord. 1095 § 1, 1985)
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.
(Ord. 1095 § 1, 1985)
(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
the 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. Said comprehensive
automobile liability policy shall be in the sum of not less than five
hundred thousand dollars 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 per person and one
million dollars 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
thirty-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
of intentional dishonesty for personal gain.
(e)
In
determining the affect 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.
(Ord. 1095 § 1, 1985)
(a)
The
health officer may suspend or revoke 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 fifteen 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 chapter, remedies some or all of the conditions
to which the notice refers, the health officer may rescind a suspension
or revocation 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 twenty-four 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 such 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
thirty days after conclusion of the hearing.
(Ord. 1095 § 1, 1985)
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 which hearing shall be requested and conducted
in the manner specified in the city's municipal code.
(Ord. 1095 § 1, 1985)
The licensee shall notify the health officer within twenty-four
hours after any change in ownership or management of the licensee,
or any interruption of service of more than twenty-four 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. 1095 § 1, 1985)
(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 eighteen years of age and trained and competent
in the proper use of all equipment, and shall hold current "EMTIA"
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 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 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 twenty-four 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
beings 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. 1095 § 1, 1985)
No licensees shall charge more than those rates approved by
the board of supervisors for emergency ambulance services.
(Ord. 1095 § 1, 1985)
(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. Said contracts shall provide for one primary contractor
per emergency response area, with such other backup 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
fire chief shall administer the contracts for ambulance service awarded
by the city council under this section. The fire chief shall also
prepare and keep current emergency response area lists specifying
contract providers for each area. The fire chief shall include on
the list for each emergency response area the provider which 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
backup 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 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
chapter. 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.
(e)
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 city of Laguna Beach fire department,
or an appropriate employee of a public safety agency designated by
regulation, directs transportation in the absence of a paramedic.
(Ord. 1095 § 1, 1985)
(a)
As to all sections of this chapter except Section 5.83.130, the health officer shall make such rules and regulations 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 5.83.130, the fire chief shall make such rules and regulations 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 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.
(Ord. 1095 § 1, 1985)
The city, the county, the department, any user, subscriber,
public safety agency or consumer who believes, or has reason to believe,
that he 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 provisions 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 fifteen calendar days after receipt of notification.
(Ord. 1095 § 1, 1985)
As to all but Section 5.83.130, 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 5.83.130, 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 variance shall exceed one hundred eighty days in duration.
(Ord. 1095 § 1, 1985)
Violation of any provision of this chapter by an ambulance service
operator shall be a misdemeanor.
(Ord. 1095 § 1, 1985)
