Article V — Operational Requirements

A.

Each ambulance permittee, at its sole cost and expense, shall obtain, maintain, and comply with all county insurance coverage(s) and requirements. Types of insurance coverage include commercial general liability, commercial or business automobile liability, worker's compensation and employers liability, professional liability/errors and omissions, and endorsements and conditions. This is detailed in county certificate C- 13A, which can be obtained from county.

B.

Lack of coverage as required at any time shall automatically suspend the certificate of operation. Failure of the permittee to notify the county of lack of coverage for any reason shall be deemed a violation of regulation subject to fine.

C.

As a condition of being issued a permit, permittee shall be required to indemnify and hold harmless the county of Alameda from any and all claims or actions for property damage, personal injury, sickness, disease, caused by the permittee's acts or omissions and will pay any and all judgment decrees, costs, attorney's fees which may be rendered against the county of Alameda, its directors, officers, agents, employees and volunteers in any and all such actions or proceedings.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

Each permittee shall provide the county with information in reference to any pending action or unpaid judgments or liens against the permittee, and the notice of the transactions or acts giving rise to the judgments or liens. The permittee shall notify the county in writing of the actions within one week of the notification from the levying agency. The reported information will be reviewed by the county who will make a determination regarding the effect this information will have on the agency's ability to provide continuous service in accordance with this division.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

Permittee shall maintain sufficient ambulances, operational procedures and personnel, with valid certifications and licenses to meet performance standards and permit specifications.

B.

Permittee shall follow the county's policies.

C.

Permittee and their personnel shall follow the regulations of the California Vehicle Code and the California Code or Regulations, Title 13, Motor Vehicles.

D.

Permittee shall maintain supervisory or management personnel, available on a twenty-four (24) hour basis on site or on-call, authorized to make operational decisions, direct personnel and commit resources for use.

E.

Permittee shall maintain a quality improvement program and perform quality assurance activities in accordance with article VII of this chapter.

F.

Permittee shall maintain a disaster response plan that includes a personnel call-back plan for disasters and mass casualty incidents in accordance with Section 6.114.460 of this chapter.

G.

Permittee shall ensure that all management, supervisory, dispatch and field personnel maintain knowledge and familiarity with multi-casualty and mass casualty incident medical operations, staging, and incident command structure.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

Each ambulance shall be equipped according to the standard vehicle safety and equipment requirements of the California Vehicle Code and the California Code or Regulations, Title 13, Motor Vehicles.

B.

Each ambulance shall carry a photocopy or original current vehicle registration, current insurance identification, current CHP ambulance identification card (or CHP inspection report valid for thirty (30) days after an initial inspection), and current county issued ambulance permit.

C.

Each ambulance and supervisor's vehicle shall have its contractor identifier and unit number on the roof of the vehicle in an identification system defined by the county.

D.

Each ambulance shall carry standard patient carrying fixtures and restraints necessary for the comfort and safety of patients.

E.

Each ambulance shall be equipped with no less than the standardized equipment and supplies as established according to the county's equipment and supply specifications policy for the level of service provided. CCT ambulances shall be equipped according to the county's critical care transport policy.

F.

Permittee shall maintain its vehicles, equipment, and supplies in a clean, sanitary, and safe mechanical condition at all times.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

No person, firm, partnership, corporation or other organization, except as identified in Section 6.114.070, shall operate or cause an ambulance to be operated in Alameda County unless holding an Alameda County certificate of operation and an ambulance permit has been issued for that ambulance in accordance with these regulations.

B.

The county shall inspect each ambulance for which it receives an application to ensure compliance with this chapter and the county's policies, protocols, and regulations as they pertain to the ambulance service applied for, according to the provisions of Sections 6.114.160 and 6.114.170.

C.

No ambulance shall be permitted without all documentation on file with the county according to Section 6.114.080(C)(16) and (19).

D.

The bi-annual inspection for permit renewal shall be based on the list of ambulances submitted by the permittee and a status report of ambulances permitted in the previous permit period, which are not included in the new permit period application.

E.

The permittee shall be notified in a timely manner of the results of the inspection and any corrective action required if an ambulance fails the inspection.

F.

Upon passage of the ambulance inspection, the county shall issue an ambulance permit to the permittee.

G.

The ambulance inspection will be for all equipment identified in the county's policies, which has not been inspected by the CHP under the California Code of Regulations, Title 13, Vehicle Code, Division 2, Chapter 2, Article 1, Sections 1103 and 1103.2.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

Each ambulance shall have a radio for establishing and maintaining radio contact with county dispatch and county hospitals as prescribed by the county and in compliance with F.C.C. regulations.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

At the time of initial application, permittee shall submit their specific color scheme and design and, upon approval by the county, shall apply such color scheme and design to each ambulance receiving an ambulance permit.

B.

The color scheme and design shall not imitate or conflict with any other color scheme authorized by this chapter in a manner that is misleading or would tend to deceive the public.

C.

No sign, letter, color, appliance or thing of decorative or distinguishing nature shall be attached or applied to any ambulance unless it has first been approved in the color scheme authorized for each ambulance company.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

Each BLS ambulance shall be staffed with a minimum of two California certified EMTs. Paramedics licensed in California may also staff BLS ambulances but may not utilize the paramedic scope of practice. CCT ambulances shall be staffed according to the county's CCT policy.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

All personnel while on duty must carry all applicable certificates and permittee identification, and comply with the county's policies and procedures.

B.

All EMT and paramedic personnel must have and carry during working hours, an EMT certificate or paramedic license, a current California driver's license, California ambulance driver's certificate, and a medical examiner's certificate. EMTs hired to solely provide patient care duties are exempt from this requirement. In these cases, the permittee is required to inform the county of these personnel and of any changes to their work status. Failure to provide current documentation upon request to county representatives during ambulance service working hours shall result in removal of personnel from service until all documentation is in his or her possession and verified by the county representative.

C.

Permittee's EMT personnel assigned to provide BLS service under this chapter must meet the minimum qualifications:

1.

EMTs must hold current, valid EMT certification in the state of California.

2.

EMTs shall be certified in cardiopulmonary resuscitation (CPR/AED) according to the policies of the county and state.

3.

EMTs assigned to provide CCT driver/assistant service must meet the additional qualifications specified in the county's CCT policy.

D.

Permittee's paramedic personnel assigned to provide cct service under this chapter must meet the minimum qualifications:

1.

Paramedics must hold current, valid paramedic licensure in the state of California.

2.

Paramedics assigned to provide CCT patient care must meet the additional qualifications specified in the county's CCT policy.

E.

Permittee's registered nurse (RN) personnel assigned to provide CCT service under this chapter must meet the minimum qualifications specified in the county's CCT policy.

F.

All drivers must complete an emergency vehicle operation course (EVOC) driver training course, or its equivalent, related to responding to calls for emergency medical service that includes, but is not limited to, the following didactic and practical components: legal aspects of the emergency ambulance operation, the practice of defensive driving, accident avoidance, principles of vehicle control, routine vehicle safety checks, breaking and stopping, acceleration, and steering.

G.

The permittee shall retain on file at all times, copies of all current and valid licenses, certifications, and/or accreditations of all emergency medical personnel performing services under this chapter. In addition, permittee shall be responsible for promulgating and enforcing employee rules to ensure compliance with this section.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

Ambulance companies shall maintain personnel standards that include orientation to the county policies and procedures, special training (as deemed necessary by the EMS medical director), uniforms and appearances, safety apparel, identification, driver training, work-hour scheduling limitations, with due consideration for collective bargaining agreements and/or state and federal regulations where they apply.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

All ambulance EMT and paramedic personnel are to provide patient care in accordance with the county's policies and as directed by standing or specific orders issued by the EMS medical director, or his or her designee. RN's working on CCT ambulances are to provide patient care in accordance with the standing or specific orders issued by the permitee's medical director, or his or her designee.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

Permittee shall supply and maintain standardized personal protective equipment and supplies to ensure safety and readiness, according to Cal/OSHA guidelines.

B.

Permittee shall ensure that all personnel receive training in all available equipment, including fit testing, according to Cal/OSHA guidelines.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

Ambulance company stations shall meet the minimum standards in Section 8 of the Federal Housing Authority, and include an EMS bulletin board, provisions for storage, and protection of ambulance(s). Stations shall comply with all applicable zoning, building, and occupational health and safety regulations.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

The permittee shall be approved by the county prior to beginning BLS or CCT service.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

Any private call of a life threatening nature or a call requiring ALS level care where ALS care is timely, appropriate and available shall be immediately referred to the 9-1-1 emergency operators.

B.

If an ambulance responds to a patient who appears to have a medical emergency, the crew shall call 9-1-1 and request a 9-1-1 response, and render appropriate care within their scope of practice until the ALS ambulance is on-scene.

C.

Permittee shall dispatch an ambulance to a non-emergency BLS call within fifteen (15) minutes unless the caller is immediately advised of a delay in responding to the call or the unavailability of an ambulance. The exception to this is for calls that have been prescheduled.

D.

Permittee shall provide prompt transportation of the patient to the most appropriate medical facility, licensed, equipped, and staffed to meet the needs of the patient in accordance with applicable laws, rules, regulations, and policies.

E.

The permittee or their employees shall report any response to a non-emergency request for ambulance service that is responded to by a unit not staffed and equipped at the appropriate service level to the county on an unusual occurrence form within ten days of the incident.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

Each ambulance company providing service under this chapter shall assign at least one person or an agency to be responsible for receiving calls and dispatching ambulances. The permittee shall have a dispatcher training program that includes prioritizing tasks including, but not limited to, call intake, unit assignment, crew utilization and computer input; documentation and reporting; communication equipment; and compliance with the county's policies, procedures, and/or protocols covering ambulance service operation, ambulance transport, equipment, ambulance personnel, and standards of dispatch. Dispatchers shall be certified in CPR/AED.

B.

Each permittee ambulance dispatch center shall have access to ReddiNet for the purpose of county system status updates. This ReddiNet access does not apply to permittees based outside of Alameda County.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

Ambulance companies are hereby prohibited from engaging in the following activities:

A.

Permitting the operation of an ambulance in any manner contrary to the provisions of this chapter or contrary to any applicable statue, rule, or regulation.

B.

Responding to a call when not requested to respond to that call by an individual requesting that service or the appropriate dispatch center.

C.

Causing or allowing its ambulances to respond to a 9-1-1 emergency call location without first receiving a specific request from an Alameda County approved dispatch center.

D.

Providing ALS service without being authorized by the county to provide such service.

E.

Providing critical care transport services without possessing a current and valid critical care transport certificate of operation and associated ambulance permit(s).

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

No person or organization shall announce, advertise, offer, or in any way claim that it provides non-9-1-1 ambulance service unless it possesses a current, valid, BLS or CCT ambulance certificate of operation.

B.

No person or organization shall announce, advertise, offer, or in any way claim that it provides emergency 9-1-1 service unless it has been approved as an emergency 9-1-1 provider by the county.

C.

Any use of a telephone number on an ambulance for non-emergency ambulance service shall include the phrase "FOR EMERGENCIES, CALL 9-1-1" in capital letters that are at least as big as the letters used for the telephone number.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

The permittee shall submit their service charges and rates to the county with their application for a certificate of operation and with each renewal. All service charges and rates must be defined in sufficient detail so as to be understandable to the public. The county reserves the option, with board of supervisor approval, to set base rates for ambulance calls.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A.

The permittee shall submit a system update to the county at the one year mark in their two year certificate of operation period. The update shall identify:

1.

Ambulance station locations.

2.

Posting locations.

3.

The number of ambulances normally available for response by time of day and day of week, with any seasonal variations.

B.

The permittee shall, at the start of each calendar year, submit to the county, in an electronic form, a list of all EMTs and paramedics employed along with their certificate or license numbers. In addition, the permittee shall notify the county within thirty (30) days of any EMTs and/or paramedics who have been newly hired, terminated, retired, or have quit their employment.