A.
The
Merced County board of supervisors finds that the emergency care,
treatment and/or transportation of persons requiring ambulance services
are matters affecting the health and welfare of Merced County residents.
B.
It is
therefore declared the policy of the Merced County board of supervisors
that emergency ambulance services be available 24 hours per day to
all persons within the county of Merced and that the entities, vehicles
and personnel which provide such services meet certain minimum standards
and qualifications, as set forth in this chapter.
C.
It is
further declared to be the policy of the Merced County board of supervisors
that all persons within the county of Merced have access to emergency
ambulance services, regardless of their location within the county.
This policy shall guide the board of supervisors, the emergency medical
care committee (hereinafter EMCC), and the local emergency medical
services agency (hereinafter LEMSA) in their respective duties under
this chapter, including the designation of exclusive operating areas,
the licensing and regulation of emergency ambulance services and the
letting of any contracts.
D.
It is
further declared to be the policy of the Merced County board of supervisors
in enacting the ordinance codified in this chapter that the local
regulation and licensing/authorization of emergency ambulance services
and specified special event medical services, including the granting
of exclusive operating areas by the LEMSA, all as set forth herein,
is done in recognition of, and pursuant to, the Emergency Medical
Services System and Prehospital Emergency Medical Care Personnel Act
as set forth in Division 2.5 of the California Health and Safety Code.
E.
It is
further declared to be the policy of the Merced County board of supervisors
that, given the balance that exists between the cost of providing
emergency ambulance services and available health care revenues for
such service, the standards affecting the number and location of ambulances
within any exclusive operating area shall be established by the LEMSA.
No movement or positioning of ambulances, external to the selected
provider of any such exclusive operating area, shall influence or
otherwise affect the decisions of the LEMSA.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
As used in this chapter:
for the purpose of this chapter, means a general acute care
hospital as defined in the California Code of Regulations, Title 22,
Division 5, Chapter 1, Article 1, Section 70005, or a similar facility
possessing a license for either comprehensive, basic or standby emergency
services.
means special services designed to provide definitive prehospital
emergency medical care, including, but not limited to, cardiopulmonary
resuscitation, cardiac monitoring, cardiac defibrillation, advanced
airway management, intravenous therapy, administration of specified
drugs and other medicinal preparations, and other specified techniques
and procedures administered by authorized personnel under supervision
of a base hospital as part of a local EMS system at the scene of an
emergency, during transport to an acute care setting or facility,
during interfacility transfer, and while in the emergency department
of an acute care hospital until responsibility is assumed by the emergency
or other medical staff of that hospital or while operating under standing
medical orders as provided by the LEMSA medical director.
means any vehicle specifically constructed, modified, or
equipped and used for the purpose of transporting sick, injured, convalescent,
infirm, or otherwise incapacitated persons and which meets any and
all state or federal licensing requirements and this chapter and contains
the equipment and supplies necessary for the level of care provided.
means any private or public entity or person operating one
or more ambulances.
means an ambulance license issued by the LEMSA certifying
an ambulance as having complied with the provisions of this chapter.
means that operational service provided by an authorized
emergency vehicle, licensed as defined in this section, together with
a crew meeting all qualifications relative to their level and type
of service as defined by LEMSA policy and procedure, as well as Sections
1797.52 and 1797.60 of the California Health and Safety Code including
the use of mandatory supplies and equipment to be carried by the vehicle
as required by LEMSA policy.
means an individual trained and qualified pursuant to state
law, who is responsible for the operation of an ambulance and the
care of the patients.
is a mobile intensive care nurse (MICN) or mobile intensive
care field nurse (MICFN) licensed as a registered nurse (RN), as defined
in California Health and Safety Code Section 1797.56. The authorized
registered nurse functions pursuant to Section 2725 of the California
Business and Professions Code and has been authorized by the medical
director of the LEMSA as qualified to provide prehospital advanced
life support, to issue instructions to prehospital emergency medical
care personnel within an EMS system, or to the public within a LEMSA-approved
emergency medical dispatch (EMD) system according to standardized
procedures developed by the LEMSA consistent with statewide guidelines
established by the California EMS authority.
as defined in California Health and Safety Code Section 1797.60,
means emergency first aid and cardiopulmonary resuscitation procedures
which, as a minimum, include recognizing respiratory and cardiac arrest
and starting the proper application of cardiopulmonary resuscitation
to maintain life without invasive techniques until the victim may
be transported or until advanced life support is available.
is the county of Merced.
is the Merced County department of public health, referred
to in this chapter as the local emergency medical services agency
(LEMSA).
means an interfacility transport of a patient that, due to
the nature of their illness or injury, requires special procedures
or medication during the transport which exceeds the paramedic scope
of practice.
means the emergency medical care committee as appointed by
the board of supervisors pursuant to California Health and Safety
Code Section 1797.272.
means "emergency medical TI," as defined in California Health
and Safety Code Section 1797.80.
as defined in California Health and Safety Code Section 1797.84
means an individual whose scope of practice is to provide advanced
life support as defined in California Health and Safety Code Section
1797.52.
as defined in California Health and Safety Code Section 1797.85
means an EMS area or subarea defined by the Emergency Medical Services
Plan for which a local EMS agency, upon the recommendation of the
county, restricts operations to one or more emergency ambulance services
or providers of limited advanced life support or advanced life support
as shown on the map depicting "Exclusive Operating Areas" on file
in the office of the LEMSA.
means the transportation of a patient between acute care
facilities or between an acute care facility and a non-acute care
setting. Interfacility transports shall only be performed by an emergency
ambulance service, licensed and authorized as described in this chapter,
unless an alternate form of transport is authorized by a policy of
the LEMSA.
means the Merced County director of public health or other
designated official as determined by the Merced County director of
public health.
means any person to whom a county ambulance license to operate
has been issued by the LEMSA pursuant to the provisions of this chapter.
as defined in California Health and Safety Code Section 1797.94,
means the agency, department, or office having primary responsibility
for administration of emergency medical services in a county and which
is designated pursuant to California Health and Safety Code Section
1797.200.
means the medical management of the emergency medical services
system pursuant to California Health and Safety Code Section 1798
et seq.
as defined in California Health and Safety Code Section 1797.202
means the medical director of the LEMSA, a full or part-time California
licensed physician employed or contracted by the county for the purpose
of providing medical control and direction to the EMS system.
means a physician's office, clinic, convalescent or extended
care facility, care home, patient's residence, or a freestanding diagnostic
or therapeutic facility.
means the usual and customary hours of operation in which
a business is operated, and may include any time for those businesses
operating 24 hours a day, seven days a week.
means any individual, firm, partnership, association, corporation,
company, or group of individuals acting together for a common purpose
or organization of any kind, including any governmental agency other
than the United States.
means guidelines promulgated by the California Emergency
Medical Services Authority (hereinafter EMSA) regarding recommendations
and minimum standards for operation of an emergency medical services
system.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
The
Merced County department of public health is designated as the LEMSA.
B.
The
LEMSA and its director shall have the powers and duties as set forth
in the Emergency Medical Services System and Prehospital Emergency
Medical Care Personnel Act, as set forth in Division 2.5 of the California
Health and Safety Code.
C.
The
EMCC shall serve as an advisory committee to the board of supervisors
and the LEMSA on emergency medical services related matters.
D.
Pursuant
to California Health and Safety Code Section 1797.274 the EMCC shall,
at least annually, review the operations of the emergency ambulance
services operating within the county and the medical care offered
within the county, including programs for training large numbers of
people in cardiopulmonary resuscitation and lifesaving first aid techniques
and the first aid practices in the county.
E.
Pursuant
to California Health and Safety Code Section 1797.276 the EMCC shall,
at least annually, report to the California EMS authority, and the
LEMSA its observations and recommendations relative to its review
of the ambulance services, emergency medical care, and first aid practices,
and programs for training people in cardiopulmonary resuscitation
and lifesaving first aid techniques, and public participation in such
programs in that county. The emergency medical care committee shall
submit its observations and recommendations to the county board of
supervisors which it serves and shall act in an advisory capacity
to the county board of supervisors which it serves, and to the LEMSA,
on all matters relating to emergency medical services as directed
by the board of supervisors.
F.
The
EMCC shall engage in other advisory duties outlined in the EMCC bylaws
as adopted by the board of supervisors.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
The LEMSA shall, pursuant to, and in compliance with, California Health and Safety Code Sections 1797.85 and 1797.224 and subsection B of this section, designate one or more exclusive operating area (hereinafter EOA) within the county wherein all emergency ambulance services are restricted to one provider thereof.
B.
The
LEMSA shall periodically review the designated EOA and recommend to
the board of supervisors changes in the EOA as may be required to
assure the policies of this chapter are carried out. The board of
supervisors shall, after receiving the recommendation, forward its
recommendations regarding the EOA to the LEMSA director.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
An emergency
ambulance service provider operating or proposed to operate within
an EOA shall enter into an authorizing provider agreement with the
LEMSA. Such agreement shall delineate the responsibilities, conditions,
stipulations and performance standards upon which their authorization
to provide such services shall be contingent.
B.
The
LEMSA director, in consultation with the LEMSA medical director, shall
approve a dispatch protocol under which all calls for ambulance service
shall be medically prioritized with the ambulance dispatch priority
coordinated so that appropriate Advanced Life Support (ALS) or Basic
Life Support (BLS) ambulance coverage to all exclusive operating areas
is achieved. The ambulance service shall observe and follow this protocol.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
Periodically
at a time interval determined by the LEMSA, and in accordance with
state regulations and the California EMS authority's responsibility
to review and approve procurement documents consistent with its legal
authority, the LEMSA shall undertake a competitive process to select
the ambulance service provider for any EOA established within the
county. The LEMSA shall enter into a performance-based provider agreement
with the selected ambulance service provider.
B.
The
procurement process and documents used in the procurement shall provide
for a definitive process for protests and appeals. Only entities which
were non-successful proposers shall have standing to file protests.
C.
A competitive
process may be initiated at any time that a current EOA provider fails
to meet the requirements of its provider agreement with the LEMSA
and formal action is taken by the LEMSA director to terminate said
agreement.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
The
LEMSA director or designee shall have the right to perform unannounced
inspections of the ambulance vehicle(s), and/or equipment, of any
applicant for a license, or of a licensee, during normal business
hours for the purpose of determining compliance with the provisions
of this chapter, and/or any other applicable state, federal or local
laws or regulations. No new ambulance units shall be placed in service
prior to a satisfactory inspection performed by the LEMSA.
B.
The
LEMSA director or designee shall have the right to inspect any and
all records of ambulance service providers to ensure compliance with
the provisions of this chapter, and/or any other applicable state,
federal or local laws or regulations.
C.
The
LEMSA director shall inform the EMCC of any incident where a licensee
has been deemed to be substantially out of compliance with the provisions
of this chapter and has failed to take corrective action after being
requested to do so by the LEMSA director.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
It is unlawful for any person or entity to engage in, or represent
themselves to be engaged in, the ambulance service business, or to
provide emergency ambulance service unless such person or entity has
executed an authorizing provider agreement with the LEMSA and been
issued and possesses a valid emergency ambulance service license issued
by the LEMSA pursuant to this chapter and applicable federal and/or
state laws and regulations.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
Any person or entity required by this chapter to possess an
ambulance license who transports a person by ambulance without a valid
ambulance license issued by the LEMSA pursuant to this chapter is
guilty of a misdemeanor, the penalty for which shall not exceed six
months in jail or a fine of $1,000, and/or an infraction, the penalty
for which shall be a fine, to be assessed and levied by the LEMSA,
equal to the total amount charged by the person or entity for all
transports made while the person or entity was not licensed.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
The
licensing requirements of this chapter shall not apply to an owner
or operator of an ambulance company or to a driver or attendant thereof,
when:
1.
The
ambulance business or service is rendering assistance to licensed
ambulances during a major catastrophe or emergency and the licensed
ambulances of the county are insufficient or unable to cope with the
emergency medical needs of county residents and/or visitors.
2.
The
ambulance service is operated by an agency of the United States or
the county of Merced.
B.
In addition,
any person or entity required to be licensed pursuant to this chapter
who is under the jurisdiction of another LEMSA and who provides only
intermittent services within Merced County, may apply to the LEMSA
for an exemption from the licensing requirements of this chapter.
If, in the judgment of the LEMSA, the operations of the applicant
within Merced County are not significant enough to warrant the issuance
of a license under this chapter, in such instances, the LEMSA director
may grant an exemption from the license requirements of this chapter.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
Any person or entity licensed to provide ambulance services
at the time the ordinance in this chapter is enacted shall, within
90 days after the effective date of said ordinance, comply with all
applicable provisions of this chapter. Any violation of any of the
standards or other regulatory provisions set forth in this chapter
or of any federal or state law or regulation during the above 90 day
period may be grounds to deny the issuance or reissuance of a license
sought pursuant to this chapter.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
Any person or entity providing medical coverage at special events
within Merced County utilizing ambulances or personnel licensed or
certified in accordance with California Health and Safety Code, Division
2.5 shall ensure that they are licensed in accordance with and are
in compliance with the policies and procedures of the LEMSA regarding
such special event operations.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
Application
for an ambulance transport license shall be made by providing such
information and data as may be required by the LEMSA on forms supplied
by that agency and paying to the LEMSA a license application fee,
as established by a fee schedule ordinance adopted by the county board
of supervisors.
1.
Providers
operating under an authorizing contract with the LEMSA that perform
services infrequently within this jurisdiction, and whose services
are considered to be critical to the provision of emergency medical
services, may make a request to the LEMSA director for a waiver of
the above referenced license fee. The LEMSA director shall either
grant or deny the request for waiver.
B.
The
LEMSA shall issue the appropriate license to the applicant if the
LEMSA determines, upon reasonable investigation and inquiry, that
the applicant, its personnel, equipment, vehicles and proposed areas
of service meet the requirements of this chapter, and all applicable
federal, state and/or local standards or regulations and are not in
conflict with the provisions of existing EOA specifications.
C.
All
licenses issued under this chapter by the LEMSA shall be valid until
revoked or voluntarily surrendered. Provided the licensee remains
in compliance with all contractual requirements and federal, state
and local laws, regulations and policies and procedures, the licensee
shall pay to the LEMSA an annual license renewal fee as established
by a fee schedule ordinance adopted by the county board of supervisors.
D.
Annually,
the LEMSA shall review the performance of all licensees and shall
conduct whatever further inquiry or investigation it deems appropriate
to determine whether the licensee's operations, personnel, equipment,
and vehicles continue to be in compliance with the policy and requirements
of this chapter, their contractual agreement with the LEMSA, and all
applicable federal, state and local laws, standards and regulations.
E.
If the
LEMSA determines that a licensee has not been, or is not, in substantial
compliance with this chapter, their contractual agreement with the
LEMSA and/or all applicable, federal, state and local laws and regulations,
the LEMSA shall take whatever steps it deems necessary, including
license revocation, to address the licensee's deficiencies. In such
event, the licensee shall have the appeal rights set forth in this
chapter or their contractual agreement with the LEMSA.
F.
Nothing
in this chapter is intended to, and shall not, prevent the LEMSA from
revoking a license issued pursuant to this chapter if the LEMSA director
determines that the continued operation by the licensee threatens
or jeopardizes the public health and safety in Merced County.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
Standards
for Ambulances and Equipment. All vehicles and equipment utilized
in the provision of emergency medical care, treatment and transportation
within the county shall meet the applicable requirement of this chapter
and all applicable federal, state and local regulations, statutes,
policies and procedures. No license may be issued until the LEMSA
determines the vehicle and equipment used, or intended to be used,
by the applicant or licensee and the providing of emergency medical
care, treatment and transportation meets the requirements of this
chapter and all applicable federal, state and local regulations, statutes,
policies and procedures.
B.
Standards
for Critical Care Transport Ambulances (CCTA). For the purpose of
this chapter, a CCTA shall be considered an ALS ambulance, subject
to the same provisions and restrictions for emergency ambulance service
as provided herein. In addition, CCTA provider services shall be in
compliance with the policies and procedures required by the LEMSA
for their operation.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
No provider of emergency ambulance service shall operate within
the county and no license will be issued by the LEMSA pursuant to
this chapter to such provider, unless:
A.
The
persons employed or authorized by the provider to operate the vehicles
used to provide such services have been licensed or certified by the
appropriate licensing or certifying authority to operate said vehicles
and possess valid licenses or certificates.
B.
The
persons employed or authorized to act as attendants in the vehicles
providing emergency ambulance services are licensed at the paramedic
level and certified at the emergency medical technician I level as
those terms are respectively defined in Sections 1797.84 and 1797.80
of the California Health and Safety Code.
C.
The
provider or license applicant has the capability and resources to
provide its services at the advanced life support level, unless otherwise
allowed by this chapter or authorized by the LEMSA.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
The
LEMSA shall establish performance standards for ambulance services
operating within the county. Part of the performance requirements
will include ambulance response times based on call and population
density (call volume and population density in a defined area), road
infrastructure, and the acuity level of the call. The response time
performance requirements, population density zones (i.e., rural, urban,
high call density, low call density, etc.), and maps of the affected
areas will be maintained on file at the LEMSA.
B.
The
LEMSA shall establish other performance requirements regarding provider
reporting, quality improvement activities, etc. These performance
requirements will be incorporated in the ambulance provider agreement
with the LEMSA.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
No ambulance
transport service license shall be issued under this chapter, and
no ambulance transport service shall operate in the county, unless
there is at all times in force and effect insurance coverage, issued
by an insurance company licensed to do business in the state of California,
covering each and every ambulance transport vehicle owned or operated
by or for, the applicant or licensee, providing for the payment of
damages as follows:
1.
For
injury to, or death of, individuals which injury or death is the result
of any cause for which the owner of the ambulance transport vehicle
would be liable, regardless of whether the ambulance transport vehicle
was being driven by the owner or his or her agent;
2.
For
the loss of, or damage to, the property of another, including personal
property, under like circumstances, and under such terms as may be
required in regulations promulgated by the LEMSA;
3.
For
injury or death resulting from malpractice, error, or mistake on the
part of the ambulance provider, or their employees or agents in rendering
or failing to render professional services.
B.
Liability
policy limits shall not be less than three million dollars ($3,000,000.00)
combined single limit and the policy shall be endorsed naming the
county, its officers, agents, and employees and the LEMSA as additional
insured's under such policy.
C.
In the
case of air ambulance operations, liability policy limits shall not
be less than twenty million dollars ($20,000,000.00) combined single
limit and the policy shall be endorsed naming the county, its officers,
agents, and employees and the LEMSA as additional insured's under
such policy.
D.
Worker's
compensation insurance in a form and amount as required by state law.
E.
A certificate
of insurance shall be submitted to the LEMSA by the license applicant
prior to issuance of any ambulance transport service license. The
certificate shall show the periods covered, the limits of liability,
the expiration date of the policy, and shall state that the insurer
shall provide the LEMSA with at least 60 days' notice of the cancellation
or non-renewal of the policy.
F.
In the
event a license is issued pursuant to this chapter and thereafter
the licensee's insurance coverage is canceled in whole or in part
or is not renewed, the license shall be deemed automatically suspended
and the licensee shall not operate under said license until the insurance
coverage is restored to the levels set forth above.
G.
Operation of the ambulance service during the time the license is suspended pursuant to this section shall constitute an infraction, the penalty for which shall be the same as set forth in Section 9.44.070, concerning operation without a license.
H.
The
licensee shall immediately notify the LEMSA of such loss of coverage.
If, within 60 days of such cancellation or non-renewal, the licensee
has not regained the insurance coverage required by this chapter,
the LEMSA director shall revoke the license.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
For
the purpose of determining whether a licensee is in compliance with
the provisions and policy of this chapter, the standards adopted pursuant
thereto, and/or any applicable federal, state or local law or regulation,
or the specific provisions of any license issued by the LEMSA, the
licensee shall allow the county or the LEMSA or their designated representatives
access, at reasonable times and places, to whatever books and rec-ords,
financial and/or non-financial, of the licensee that are deemed necessary
by the county or the LEMSA or their representative, to determine the
costs and revenues, actual or projected, incurred in providing services
regulated under this chapter or by Division 2.5 of the California
Health and Safety Code.
B.
For
the purpose of determining the ability of a licensee under this chapter
to fulfill requirements of contracts established between the county
and/or the LEMSA, the licensee shall allow the county or the LEMSA,
or their designated representatives access, at reasonable times and
places, to whatever books and records, financial and/or non-financial,
of the licensee that are deemed necessary by the county or the LEMSA
or their representative.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
In the
event the LEMSA director determines that the health and safety of
the residents of Merced County is threatened or jeopardized, the LEMSA
director shall take such action as he or she determines is reasonably
necessary to alleviate that threat. Such action includes, but is not
limited to, temporary relocation, reassignment, or dissolution of
exclusive operating areas, and temporary substitution of a dispatch
system with another emergency dispatch system, or temporary replacement
of emergency ambulance service providers.
B.
Before
taking any such temporary action, the LEMSA director shall make and
document findings concerning his or her decision and the factors leading
thereto.
C.
When any such temporary order or action remains in effect for more than 48 hours any licensee adversely effected thereby shall have the right to appeal the action pursuant to Section 9.44.190(H). A licensee shall have no right of appeal if the temporary action taken by the LEMSA director is terminated within 48 hours of its imposition.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
A.
Unless an alternate process is specified in a provider agreement between the LEMSA and a provider, the LEMSA director, upon independent investigation, may revoke any license issued pursuant to this chapter, or deny the application for same, of any person or entity who has not complied with all the applicable requirements of this chapter, or of Division 2.5 of the California Health and Safety Code, or of Titles 13 and/or 22 of the California Code of Regulations, or any other applicable federal, state, or local law or regulation.
B.
The LEMSA may revoke or suspend a license issued pursuant to this chapter if any person authorized or required by such license to provide emergency ambulance service does not provide, or is not lawfully certified or licensed to provide, such care at the levels set forth in Section 9.44.130.
C.
The LEMSA may deny the application of any person or entity who is not certified or licensed, or who does not have employees certified or licensed to provide emergency medical care at the levels set forth in Section 9.44.130.
D.
The
LEMSA may revoke or suspend any license issued under this chapter,
or deny any application for any license authorized to be issued under
this chapter, of any person or entity if any vehicle covered, or to
be covered, by such license fails to meet the requirements and standards
of this chapter and of any applicable federal, state, or local law
or regulation.
E.
Emergency Suspension. The LEMSA director may immediately suspend a license for any violation of this chapter or of any applicable state, federal or local law or regulation if the LEMSA director finds that the violation(s) is serious and poses an imminent threat to the public health and safety. Any person or entity adversely affected by such emergency suspension may appeal such action pursuant to Section 9.44.190(H) of this chapter.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
Except in the case of an emergency or temporary license suspension undertaken pursuant to Section 9.44.180(E), or in the case of licensed ambulance providers when an alternate procedure is specified within their provider agreement with the county, a license issued pursuant to the provisions of this chapter may be suspended or revoked only after the following procedures have been followed:
A.
Upon
an alleged violation of any of the provisions of this chapter or other
applicable laws and/or regulations, or provider agreements, the LEMSA
shall file with the board of supervisors a notice of intent to revoke,
suspend or modify license. This notice shall include:
1.
A
statement of charges, specifying that acts or omissions alleged to
constitute the violation(s) has occurred, and a reference to the sections
of this chapter or other law or regulation or provider agreement alleged
to have been violated;
2.
A
recommendation by the LEMSA director whether to revoke, suspend, or
modify the license in question and a statement of reasons for such
recommendation.
3.
A
statement outlining the appeal process.
B.
Within
five working days of receipt of the notice of intent, the board of
supervisors or designee shall serve a copy of the notice of intent
upon the licensee by certified or registered mail addressed to the
licensee at the place of business as shown on the license application.
Service of the notice shall be completed when the notice of intent
is deposited in the mail as set forth above.
C.
If the
licensee wishes to appeal the proposed action, the licensee shall,
within 10 days after service of the notice of intent, file a written
request with the board of supervisors or designee for a hearing with
a designated hearing officer.
D.
Upon
receipt of a timely request for a hearing, the hearing officer shall
arrange a date, time, and place for a hearing on the appeal. Notice
thereof shall be given by the hearing officer to the licensee who
is appealing the proposed action and the LEMSA, by certified or registered
mail.
E.
At a
hearing convened pursuant to this chapter, the hearing officer shall
hear and consider evidence and argument relevant to the matters alleged
by the LEMSA director in the notice of intent as may be presented
by the licensee and the LEMSA director or designee. In receiving such
evidence, the hearing officer shall not be bound by the statutory
laws of evidence but shall, to the degree possible, insure that the
evidence it hears is accurate, credible, and truthful.
F.
At the
conclusion of the presentation of all evidence and argument, the hearing
officer shall retire to consider the merits of the appeal and shall,
within three working days of the hearing, issue a written decision
either upholding, vacating, or modifying the action proposed by LEMSA
director. The decision shall identify the evidence in support of,
and the reason for, the decision rendered. If the hearing officer
has determined that the allegations set forth in the notice of intent
are true or substantially true, the hearing officer shall direct the
LEMSA to revoke, suspend, or modify the license. The determination
of the hearing officer shall be final.
G.
If no
request for an appeal hearing is received by the board of supervisors
or designee from the licensee within 10 days after service of the
notice of intent or in the event of an emergency suspension, within
five days after the suspension, the appeal shall be deemed waived
and the charges admitted. The LEMSA may thereupon suspend or revoke
the license.
H.
Appeals of Emergency Action. In the event a licensee has, and wishes to invoke, the appeal rights set forth in Section 9.44.180(E) of this chapter, the affected licensee shall deliver a written notice of appeal to the LEMSA director within five days after the temporary action of the LEMSA director goes into effect. Upon timely receipt of such notice of appeal, and within three working days therefrom, the LEMSA shall secure a hearing officer who shall proceed in accordance with this section. The hearing officer shall, within three working days following the hearing, render a decision upholding, terminating, or modifying the action taken by the LEMSA director, which decision shall be final.
(Ord. 1911 § 1, 2013; Ord. 1925 § 1, 2014; Ord. 1977 § 1, 2019)
