Butte County Municipal Code Art. I General Provisions

(a) This Chapter shall be known as the Emergency Medical Response Ordinance ("EMRO") of Butte County.

(b) The purposes of this chapter are to provide for the regulation of all emergency medical transportation services and the emergency medical services connected therewith in order to protect the health, safety and welfare of the residents of the County and to ensure that competent and adequate care is provided to those residents in need of such services. Further, it is the purpose of this chapter to regulate the provision of such services where there is a sudden need of immediate medical attention or, in non-emergency situations, a need for basic or advanced life support services as defined by the California Health and Safety Code.

(c) This Chapter does not apply to wheelchair vans, gurney cars or similar non-emergency vehicles or operations or to vehicles not requiring an emergency vehicle permit from the California Highway Patrol.

(d) Nothing in this chapter shall be limited by an ambulance service's base hospital agreement. Nothing in this chapter shall limit a base hospital from imposing standards higher than those provided in the EMRO; however, the base hospital must apply those standards uniformly to all Providers who have entered into Provider Agreements.

(e) The Butte County EMS system includes the designation of Exclusive Operating Area(s)("EOAs") pertaining to the furnishing of 911 emergency medical services. At periodic intervals, the county Local Emergency Medical Services Agency (LEMSA) may elect to conduct a competitive procurement process for the 911 Provider Agreements within each EOA. All 911 ambulance Providers must have an Advanced Life Support Provider Agreement in place with the LEMSA at the conclusion of the competitive procurement process, prior to beginning ambulance services in an EOA. Each non-911 ground ambulance Provider and each air ambulance Provider is also required to obtain an ALS Provider Agreement with the LEMSA prior to beginning ambulance services in the county.

(f) This chapter shall be liberally construed for the accomplishment of these purposes.

(Ord. No. 4057, § 1, 5-21-13)

This chapter shall supplement and be in addition to other regulating statues and ordinances heretofore or hereafter enacted by the State, the County, or any other legal entity or agency having jurisdiction. This Chapter is not intended to supplant, overlap, or interfere with existing Emergency Medical Services ("EMS") regulations established under the California EMS Act and the operational standards established by the Local EMS Agency, promulgated pursuant to Division 2.5 of the Health and Safety Code. However, in the case of a conflict and where the EMRO calls for a higher level of service, the EMRO shall prevail.

(Ord. No. 4057, § 1, 5-21-13)

The definitions set forth in Health and Safety Code sections 1797.50, et seq., are incorporated herein, and the following definitions are intended to be consistent therewith. Except where the context otherwise requires, all these incorporated and specified definitions shall govern the construction of this chapter.

(a) "Advanced Life Support" or "ALS" shall mean those special services defined by Health and Safety Code section 1797.52 and any amendments thereto and referred to in the Emergency Medical Services System and the Prehospital Medical Care Personnel Act, Health and Safety Code section 1797, et seq., and any amendments thereto, or regulations promulgated thereunder.

(b) "Air Ambulance" shall mean any authorized and approved fixed wing or helicopter aircraft that is equipped and operated for transportation of sick, injured, or otherwise incapacitated persons and emergency medical supplies.

(c) "Ambulance" shall mean any vehicle, including an air ambulance, that is specifically constructed, modified, equipped, designed and primarily used and operated for the provision of emergency medical transportation services to sick, injured, or otherwise incapacitated persons.

(d) "Ambulance Company" shall mean any person, entity, corporation, partnership, association, trust or estate that owns, leases or operates one or more ambulances for the purpose of providing emergency ambulance services within the County.

(e) "Ambulance Services" shall mean any emergency ambulance services as defined by this section provided through an ambulance response to an emergency 911 call.

(f) "Attendant" shall mean any EMT, certified by a LEMSA or Paramedic licensed by the State of California and approved by LEMSA who is responsible to provide prehospital medical care for a sick, injured or otherwise incapacitated person in an ambulance.

(g) "Basic Life Support" or "BLS" shall mean those services defined by Health and Safety Code section 1797.60 and any amendments thereto and referred to in the Emergency Medical Services System and the Prehospital Medical Care Personnel Act, Health and Safety Code section 1797, et seq., and any amendments thereto, or regulation promulgated thereunder.

(h) "Board" shall mean the Board of Supervisors of the County of Butte.

(i) "County" shall mean the County of Butte.

(j) "Days" shall mean calendar days.

(k) "Driver" shall mean a person who is authorized as an ambulance driver and possesses a current ambulance driver's license issued by the California Department of Motor Vehicles and is certified and approved by the LEMSA as an EMT (at least).

(l) "Emergency Medical Dispatching" or "EMD" shall mean dispatching by a person trained, qualified and certified to prioritize 911 calls and give "pre-arrival" first aid instructions to 911 callers.

(m) "Emergency Medical Advisory Group" or "EMAG" shall mean the Group established by Butte County to serve in an advisory capacity to the LEMSA.

(n) "Emergency Medical Services" or "EMS" shall mean all services required to identify, respond to, stabilize and treat all medical and psychiatric emergencies.

(o) "EMS Agency Policies and Procedures Manual" shall mean the policies and procedures of the Emergency Medical Services System that are approved by the Local EMS Agency in accordance with Health and Safety Code section 1798, et seq.

(p) "Emergency call" shall mean a request for the dispatch of an ambulance to transport or provide other assistance to persons in sudden need of immediate medical attention, including the transport of all persons identified in Welfare and Institutions Code section 5150, or, in a medical emergency, as determined by a physician, to transport blood, any therapeutic device, accessory to such device, or tissue or organ for transplant.

(q) "Emergency Medical Services Authority" or "EMSA" shall mean the State of California regulatory agency as defined in section 1997.54 of the California Health and Safety Code.

(r) "Emergency Medical Technician" or "EMT" shall mean an individual defined in Health and Safety Code section 1797.80, trained in basic life support according to standards set forth in the California Code of Regulations, Title 22, Chapter 2, sections 100005 et seq., and certified as such by the Local EMS Agency.

(s) "Emergency service" shall mean any service performed in response to an emergency call.

(t) "Exclusive Operating Area" or "EOA" shall mean any geographic area designated by the LEMSA, pursuant to Health and Safety Code section 1797.224, where the provision of ambulance services in response to 911 calls is restricted to one (1) ambulance Provider.

(u) "Exclusive Operation Area Agreement" or "EOA Agreement" shall mean an agreement between a ground and/or air ambulance service provider and the Local EMS Agency for the provision of ambulance services in response to 911 calls in an EOA.

(v) "Health Director" shall mean the Director of the Department of Public Health of Butte County or his/her authorized representative or designee.

(w) "Local EMS Agency" or "LEMSA" shall mean Sierra Sacramento Valley (S-SV) EMS, or such other agency as designated by the County under Health and Safety Code section 1797.200.

(x) "Paramedic" shall mean an individual defined in Health and Safety Code section 1797.84 with a scope of service set forth in Health and Safety Code section 1797.172, trained in accordance with the California Code of Regulations, Title 22 Chapter 4, section 100139 et seq., and certified as such by the Local EMS Agency.

(y) "Patient" shall mean an injured, sick, or otherwise incapacitated person.

(z) "Person" shall mean any individual, corporation, partnership, association, trust, estate, municipal corporation, city or special district.

(aa) "Provider" shall mean an ambulance company operating pursuant to a valid Provider Agreement.

(ab) "Provider Agreement" shall mean an agreement entered into pursuant to this chapter between an ambulance service Provider and the LEMSA pertaining to providing ambulance services in the county. Such Agreements are of three (3) types:

(1) Agreements for ALS Air ambulance service.

(2) Agreements for ALS non-911 ground ambulance services; and

(3) Agreements for ALS 911 ground ambulance services, which Agreements shall be subject to a competitive bidding procurement process and shall pertain to services within designated Exclusive Operating Areas.

(Ord. No. 4057, § 1, 5-21-13)

Except as otherwise specifically provided in this chapter, the LEMSA shall be responsible for the administration and enforcement of this chapter.

(Ord. No. 4057, § 1, 5-21-13)

The Health Officer shall have the authority to suspend all or part of the EMRO in the case of a local emergency or catastrophe. The suspension shall be withdrawn as soon as is practicable.

(Ord. No. 4057, § 1, 5-21-13)