Title 4 — HEALTH AND SAFETY›Division 48 — EMERGENCY MEDICAL SERVICES
Chapter 48-20 — MISCELLANEOUS PROVISIONS
Contra Costa County Municipal Code · 2026-09 edition · updated 2026-10-02 · Contra Costa County
48-20.002 - General performance standards.¶
An ambulance service provider shall adhere to the general performance standards established by LEMSA regulation and policy.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.004 - Quality management program—Required.¶
(a)
An ambulance service holding a non-emergency ambulance service certificate of operation must establish and maintain a quality management program. The program must include all of the following:
(1)
Utilize a physician, registered nurse or paramedic with experience in quality management to direct and coordinate quality improvement activities that meet the requirements of the State Emergency Medical Services Authority's Quality Improvement Program contained in the California Code of Regulations, Title 22, Division 9, except that a non-emergency ambulance service that employs registered nurses for critical care nurse transport operations shall utilize an individual who possesses no less than a registered nurse license.
(2)
Meet the requirements of the LEMSA Emergency Medical Services Quality Improvement Plan program (EMSQIP).
(3)
Identify problems or issues regarding patient care, propose solutions for corrective action, and facilitate implementation of those solutions.
(4)
Provide for the systematic and comprehensive review of clinical care provided to patients.
(5)
Maintain a radio recording of all calls for ambulance services requested, all dispatch instructions given, and all communications between the dispatch center and the ambulance unit until the ambulance run is completed. All radio recordings must be kept at least one hundred-eighty days after being recorded.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.006 - Critical care transport nurse unit.¶
Ambulance service providers that provide medical transportation with critical care transport nurses shall comply with all of the requirements for non-emergency ambulances as set forth in this division and by LEMSA regulation and policy, including the requirement that registered nurses attend an EMS system orientation. Failure to do so may result in the suspension or revocation of the provider's certificate of operation, the imposition of administrative fines, or other enforcement action allowed by this code.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.008 - Physician medical director for CCT transport nurse units—Required.¶
(a)
An ambulance service provider that provides medical transportation with critical care transport nurses shall have a physician medical director who oversees the critical care nurse transport program and establishes clinical standards, policies and standing orders for registered nurses who provide critical care transport.
(b)
Nothing in this division shall be construed as regulating the clinical care provided by critical care transport nurses.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.010 - Critical care transport nurse training—Required.¶
Critical care transport nurses shall be trained to the same standard as emergency medical technicians and paramedics, as required by the LEMSA's policies and as required by this division, including training in LEMSA's quality assurance and quality improvement processes.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.012 - Unauthorized response.¶
No ambulance service provider shall cause or allow any ambulance to respond to a location without first receiving a specific request for the service at that location.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.014 - Personal protective equipment.¶
An ambulance service provider shall supply and maintain standardized and properly fitted personal protective equipment and supplies to ensure safety and readiness according to Cal/OSHA regulations.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.016 - Responsible advertising.¶
(a)
No ambulance service provider shall display on any ambulance or emergency response vehicle, or otherwise announce, advertise, offer, publish or claim, that it provides either emergency or non-emergency ambulance service unless it possesses a current, valid certificate of operation for the service.
(b)
No ambulance service provider under this division shall display on any ambulance or emergency response vehicle, or otherwise advertise, offer, publish or claim, that it provides paramedic service or ALS service, unless it provides the service twenty-four hours per day.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.018 - Enforcement of judgment—Reporting required.¶
(a)
An ambulance service provider shall provide LEMSA with information regarding any unpaid judgments or liens against the ambulance service provider, and notice of the transactions or acts giving rise to the judgment(s) or lien(s).
(b)
The ambulance service provider shall notify the LEMSA in writing within forty-eight hours after the notice of any levy or other action taken by a creditor to enforce a judgment or lien so that the permit officer may make a determination regarding the effect the enforcement action may have on the ambulance service provider's ability to provide continuous service in accordance with this division.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.020 - Non-emergency ambulance EMS system support.¶
(a)
A non-emergency ambulance service provider holding a valid certificate of operation shall, at the request and direction of the permit officer, provide mutual aid ambulance services or assist with disaster, multi- patient, or mass casualty incidents within the county.
(b)
If a non-emergency ambulance service provider holding a valid certificate of operation is requested to provide mutual aid ambulance services or assist with disaster, multi-patient, or mass casualty incidents, the non-emergency ambulance service provider shall make available, and place into service, all available permitted ambulances without delay.
(c)
A non-emergency ambulance service provider shall file its disaster response plan annually with the LEMSA for approval. This plan must comply with LEMSA's disaster response plan policy, including a personnel
call-back plan to facilitate staffing of ambulance vehicles in the event the ambulance service provider is requested to provide mutual aid ambulance services or assist with a disaster or a mass casualty incident within the county.
(d)
A non-emergency ambulance service provider shall participate in at least one in-county LEMSA-approved multi-agency disaster exercise each year by sending at least one fully-staffed ambulance to each organized event. All costs associated with participating in the disaster exercise are the sole responsibility of the ambulance service provider.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.022 - Compliance with multi-casualty incident (MCI) plan.¶
All management, attendants and drivers of an ambulance service provider shall follow the county's multi- casualty incident plan and the LEMSA policies concerning multi-patient events.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.024 - Transport of cadavers—Prohibited.¶
No person shall transport a cadaver by ambulance or privately owned emergency response vehicle.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
48-20.026 - Security of ambulance vehicles.¶
No person shall leave an ambulance unlocked or otherwise unsecured when it is not occupied, or actively involved or participating in an emergency response.
(Ord. No. 2022-21, §§ II, III, 6-21-22).
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