Alameda County Municipal Code Art. III Certificate of Operation and Permits

A. Advanced life support (ALS) emergency ambulance services shall only be provided under a 9-1-1 contract with the county under provisions of the Health and Safety Code 1797.200, 201, and 224.

B. Basic life support (BLS) emergency and non-emergency transport service shall be provided under the provisions of this chapter.

C. Critical care transport (CCT) ALS emergency and non-emergency transport service, either CCT-P or CCT-RN, shall be provided under the provisions of this chapter and the county's CCT and administrative policies.

D. Nothing in this chapter shall be construed as regulating the clinical work of registered nurses (RN) working in a CCT-RN ambulance.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A. No person (either as owner, agent or otherwise) shall furnish, operate, conduct, maintain or otherwise engage in or advertise, offer or profess to engage in ambulance service within Alameda County unless the person holds (and is entitled to hold) a currently valid ambulance certificate of operation issued by the county.

B. No person (either as owner, agent or otherwise) shall furnish and operate an ambulance within Alameda County unless that ambulance has a currently valid ambulance permit issued by the county displayed on the left-bottom portion of the driver's side rear window.

C. Gurney and wheelchair van transport providers are not required to hold an ambulance certificate of operation.

D. No certificate of operation or ambulance permit is required for the delivery into Alameda County of persons picked up outside the county boundaries. No certificate of operation or ambulance permit is required for specialized teams (e.g. CCT and neonatal intensive care unit teams) that are permitted by another emergency medical services agency and that pick up patients in Alameda County for transportation to an acute care hospital based outside of the county.

E. Exclusive Operating Areas. The county has not established exclusive operating areas (EOA) for BLS, and/or CCT emergency and/or non-emergency transport, but retains its option to do so in the future.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A. Application forms for an ambulance service certificate of operation shall be supplied by the county.

B. The applicant should be a licensed CHP ambulance service prior to submitting an application.

C. Required Data. Each applicant who desires an ambulance service certificate of operation shall submit the following on, or as attachments, with their application:

1. The names and addresses of the applicant(s), registered owner(s), partner(s), officer(s), director(s) and controlling shareholder(s), hereafter called "applicant";

2. The name under which the applicant has engaged, does, or proposes to engage in ambulance service;

3. The ambulance service level requested—BLS, CCT, or both;

4. A statement that the applicant understands and will comply with the ambulance inspection process, including the required fees;

5. A statement that the applicant will abide by the regulations of the California Vehicle Code and the California Code of Regulations, Title 13, Motor Vehicles;

6. A statement that the applicant will adhere to all applicable federal, state, and local rules, regulations and laws; and all county prehospital policies and protocols;

7. A statement that the applicant understands and will comply with the county's staffing, and equipment and supply specifications policies regarding equipment carried in each ambulance, including AEDs;

8. A statement specifying whether the applicant has provided ambulance service in Alameda County and if so, what type and for how long;

9. A statement specifying whether the applicant has previously operated an ambulance company outside of Alameda County, and if so, under what name, what type, where and for how long;

10. A copy of a current CHP emergency ambulance non-transferable license;

11. An assets and liabilities statement or a letter prepared by a certified public accountant showing proof of financial solvency. The statement shall demonstrate that the applicant has adequate financial health, based on liquidity, profitability, and sustainability, to maintain ambulance service operations;

12. A copy of the business license for the city in which the applicant is doing business;

13. A statement of the legal history of the applicant, including criminal and civil convictions, pending criminal proceedings; and whether the applicant has ever had any licenses revoked and/or been investigated by any governmental agency and disclosure of the nature of the investigation;

14. A statement or resume specifying the education, training, and experience of the applicant in the care and transportation of patients;

15. A statement that the applicant owns or has under his control, in good mechanical condition, required equipment to consistently provide quality ambulance service in the area for which he is applying, and that the applicant owns or has access to suitable facilities for maintaining equipment in a clean and sanitary condition;

16. A list of the actual number of ambulances and for each: the make and model, year, the vehicle identification number (VIN), state vehicle license number and copies of current Department of Motor Vehicle registration, California Highway Patrol Ambulance Inspection Report and Ambulance Identification Certificate, and proof of vehicle insurance;

17. A statement that the applicant has or will have sufficient personnel adequately trained and available to deliver ambulance service of good quality at all times, including copies of their certifications/licenses on file;

18. A statement detailing the applicant's training and orientation programs for EMTs and/or paramedics, and dispatchers;

19. A description of the number and type, frequency and private line codes of the vehicle's radios, and if used, phone numbers of the vehicle's cellular phones;

20. A description of the company's program for maintenance of the vehicles;

21. A description and photo/image of the company's logo and color scheme to be used to designate the ambulances of the applicant;

22. The number of ambulances to be deployed on each shift;

23. A description of the locations from which ambulance services will be offered, noting the hours of operation and phone numbers;

24. Evidence of insurance coverage compliance under Section 6.114.130;

25. A certificate of consent to self insure issued by the California State Director of Industrial Relations or a certificate of workman's compensation insurance;

26. A quality improvement program as specified in Section 6.114.410;

27. A disaster response plan as specified in Section 6.114.460;

28. All service charges and rates to be charged, showing compliance with any maximum charges established by the county;

29. The application fee for a certificate of operation as set forth in the county's administration manual;

30. In a separate payment, the ambulance inspection fee for each ambulance to be inspected as set forth in the county's administration manual. This fee may be returned if the permittee does not meet the basic requirements of Section 6.114.080(C) and ambulances are not inspected.

31. If applying for a CCT certificate of operation, copies of all paperwork for interfacility transport as identified in the county's CCT and administrative policies.

32. Any other information the county deems necessary for determination of compliance with this division.

D. Within sixty (60) days of receipt of a complete application and the required fee, the county shall determine subsections (D)(1)—(D)(8) (below) or if an extension is necessary:

1. Whether the applicant is a licensed CHP ambulance service;

2. Whether the applicant meets the requirements of this chapter and of other applicable laws, ordinances, and regulations;

3. Whether the applicant is able to provide the requested service;

4. Whether the applicant has knowingly made a false statement of fact in such application;

5. Whether the applicant has knowingly failed to disclose facts pertinent to the application process;

6. Whether the applicant was previously a provider of ambulance service prior to the establishment of this chapter, which has not been renewed by the CHP;

7. Whether the applicant was previously a holder of a certificate of operation issued under this chapter, which has been revoked or not renewed based on the provisions of this chapter; and

8. Whether the applicant's vehicles, equipment, and appurtenances, including radios, are in good working order and the ambulances pass an inspection, according to the provisions of Sections 6.114.160 and 6.114.170.

E. Approval or Denial.

1. If it is determined that the applicant does not meet all requirements within this division, then the county shall deny the application and notify the applicant in writing by certified mail of the receipt of the application.

2. If it is determined that the applicant meets all requirements within this division, the county shall approve the application and issue a certificate of operation and, upon a positive inspection, appropriate ambulance permits (a permit decal to be affixed to the left-bottom portion of the driver's side rear window and a paper permit to be retained in the unit).

F. Appeal from Denial of Issuance. Whenever the county denies an application for a permit, the applicant may request a hearing on the denial at which the applicant will have the burden of proof. The appeal will be made to the board of supervisors according to the provisions of Section 6.114.110.

G. Decisions—Finality. The decision of the county rendered pursuant to this chapter shall be final, unless appealed to the board of supervisors within thirty (30) days after such decision is rendered in writing, and notice of the same is given to the applicant by certified mail.

H. Term.

1. Certificates of operation shall be valid for two years from the date of issuance.

2. Certificates of operation shall be continued upon conditions of Section 6.114.370 unless earlier suspended, revoked or terminated for cause.

3. Notice of Intent to Discontinue Service. A permittee providing ambulance service may discontinue such services only after providing sixty (60) days notice in writing of intent to discontinue services to the county or upon mutual written agreement. If the permittee discontinues service without the sixty (60) days notice or without mutual agreement with the county, the county will immediately void their certificate of operation and ambulance permits.

I. Transfer of Certificate of Operation or Ambulance Permit. Application for transfer of any permittee's certificate of operation shall be subject to the same terms, conditions, and requirements as if the application were for an original certificate. No ambulance permit shall be transferred to another person(s), or company or corporation, except upon prior approval of the county. Ambulance permits are not transferable between ambulances.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

The permittee shall notify the county about changes to business location and phone numbers; ambulance stations and phone numbers; hours of operations; service charges and rates; insurance coverage; and changes to applicant(s), registered owner(s), partner(s), officer(s), director(s) and controlling shareholder(s) within fifteen (15) days of such changes.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

If a permittee desires to include additional ambulance units under its certificate of operation, the permittee shall submit vehicle information for each additional unit according to Section 6.114.080(C)(16) and (19) and provide the designated fee per unit to the county, and schedule an ambulance inspection. The term of the ambulance permit for additional authorized units shall run concurrently with the last authorized permit period. The fee paid for each additional unit will be prorated according to the amount of time remaining during the last authorized permit period. Prorating will be based on the number of quarters left in the permit period. Adding new ambulances requires inspection and permitting prior to their being placed in service.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)

A. Applicants for renewal of an ambulance service certificate of operation under this chapter shall file with the county an application in writing, which shall include information required in Section 6.114.080(C). A renewal fee shall accompany the application for renewal. Renewal applications may be submitted ninety (90) days prior to the expiration date but no later than thirty (30) days prior to the expiration date.

B. Late renewal applications received less than thirty (30) days prior to the expiration of the certificate of operation shall pay an additional twenty (20) percent of all fees due.

C. All ambulances specified by the permittee shall be inspected and have their permits renewed in accordance with the provisions of Section 6.114.170, ambulance inspection and permit process. The issuance of a renewed certificate of operation shall be based on all ambulances having been permitted.

D. Renewal of a certificate of operation shall require conformance with all requirements of this division as upon issuance of an initial certificate. Nothing in this division shall be construed as requiring the granting of a certificate upon expiration of a previous certificate, and the burden of proof respecting compliance with all the requirements for a period and of entitlement of a certificate shall remain at all times with the applicant for renewal.

E. An ambulance provider shall submit, with their renewal application, a financial statement of its business activities or a letter showing proof of financial solvency, prepared by a certified public accountant. Renewal of a certificate is contingent upon proof of financial solvency within the proper time frames.

(Ord. 2007-48 § 2 (part))

(Ord. No. 2012-25, § 2, 6-26-12)