Contra Costa County Municipal Code Ch. 48-2 General Provisions

This division is known as the "Emergency Medical Services and Ambulance Ordinance of Contra Costa County."

(Ord. No. 2022-21, §§ II, III, 6-21-22).

The purposes of this division are as follows:

(1) Enact procedures for issuing certificates of operation and permits to regulate the operation of ambulances in Contra Costa County.

(2) Allow for the orderly and lawful operation of a local emergency medical services (EMS) system pursuant to the Emergency Medical Services System and the Prehospital Emergency Medical Care Personnel Act, Health and Safety Code section 1797 et seq.

(3) Protect the public health, safety and welfare by ensuring that ambulance services operate safely and meet established standards for equipment, staffing and mechanical reliability.

(4) Allow for adequate emergency ambulance services and non-emergency ambulance services, and medical oversight and direction of ambulance and non-ambulance prehospital personnel, in all areas of the county.

(5) Allow for the integration of all ambulance service providers into the county emergency medical system by establishing minimum medical equipment and training standards, policies, guidelines and procedures and communication systems.

(Ord. No. 2022-21, §§ II, III, 6-21-22).

(a) It is the intent of the board of supervisors to regulate ambulances and emergency medical services as authorized by its police power, by the State of California pursuant to Health and Safety Code sections 1443 and 1797 et seq., Welfare and Institutions Code section 17000, and Vehicle Code section 2512; and to regulate prehospital personnel.

(b) It is the board's further intent in enacting this division to exercise, to the fullest extent allowed under the laws of the State of California, its discretion and authority to regulate all ground and air medical transportation service throughout the county except as specified in Section 48-2.010.

(Ord. No. 2022-21, §§ II, III, 6-21-22).

This division does not apply to or during any of the following:

(1) To vehicles operated as ambulances and to persons engaged in ambulance services where ambulance services are rendered at the request of any county communications center or at the request of any law enforcement or fire protection agency during any "state of war emergency," "state of emergency," or "local emergency," as defined in Government Code section 8558; or to ambulance services provided in response to a mutual aid request by Contra Costa County.

(2) During any period of up to 30 days, unless that period is renewed or extended, when the county health officer has determined in writing that adequate emergency ambulance service will not be available from existing ambulance service providers who hold a current certificate of operation.

(3) To an ambulance service transporting a patient through Contra Costa County or to a location within Contra Costa County when the patient transport originated outside Contra Costa County.

(4) This division does not prevent any peace officer, firefighter, or physician licensed to practice medicine in California from transporting or arranging for the transportation of an individual in need of emergency medical care when no ambulance with a certificate of operation is available and the transportation is required immediately.

(Ord. No. 2022-21, §§ II, III, 6-21-22).

(a) If the ordinance codified in this division is adopted by incorporated cities or towns in the county, the provisions of Section 48-2.012 (f) shall be extended to include the streets, roads, highways, alleys, or any public or private way or place within the incorporated area of that city or town. The permit officer shall be authorized to enforce this division within that jurisdiction.

(b) The lack of adoption of all or part of this ordinance by a city or town shall not be interpreted as limiting any authority granted to the local emergency medical services agency by Division 2.5 of the Health and Safety Code and California Code of Regulations, Title 22, Division 9.

(Ord. No. 2022-21, §§ II, III, 6-21-22).

For purposes of this division, the following terms have the following meanings.

(a) "9-1-1 EMS and ambulance service" means emergency medical services provided in response to calls made to a LEMSA-designated emergency medical dispatch center.

(b) "Act" means the Emergency Medical Services System and the Prehospital Medical Care Personnel Act, codified as Health and Safety Code section 1797 et seq.

(c) "Advanced emergency medical technician" or "AEMT" has the same meaning as set forth in Health and Safety Code section 1797.82.

(d) "ALS" or "advanced life support" has the same meaning as set forth in Health and Safety Code section 1797.52.

(e) "Ambulance" means any vehicle or aircraft constructed, modified, equipped, and operated to transport individuals in need of medical care, whether operated on public or private property."

(f) "Ambulance service" means the activity, business, or service, for hire, profit, or otherwise, of transporting one or more persons by ambulance on or in any of the streets, roads, highways, alleys, or any public or private way or place.

(g) "Ambulance service provider" means the person, firm, partnership, corporation or other organization that operates an ambulance in Contra Costa County.

(h) "Ambulance permit" means the permit issued by the permit officer to a specific ambulance.

(i) "Attendant" means an EMT or advanced EMT certified in California, or paramedic, physician, registered nurse or physician's assistant licensed in California, who is acting in the capacity of a required ambulance attendant, is responsible for the care of ambulance patients, and has met all license and other requirements in applicable state laws and regulations. "Attendant" may include an attendant serving as a driver.

(j) "BLS" or "basic life support" has the same meaning as set forth in Health and Safety Code section 1797.60.

(k) "Certificated ambulance" is an ambulance that is operated by an ambulance service provider who holds a valid certificate of operation.

(l) "Certificate of operation" is the written authorization issued by Contra Costa County to an ambulance service provider that has met all requirements to operate an emergency or non-emergency ambulance service in Contra Costa County.

(m) "Critical care transport" or "CCT" means a transport during which a patient requires a level of medical care and/or observation that exceeds the standard scope of practice for EMTs and paramedics and where services are rendered by registered nurses.

(n) "Dispatcher" means an individual who answers telephone or radio calls for requests for ambulance or emergency medical services.

(o) "Driver" means an individual who drives an ambulance or emergency response vehicle.

(p) "Emergency ambulance service provider" means an ambulance service that (1) contracts with the County for the provision of 9-1-1 ambulance service pursuant to Health and Safety Code section 1797.224; (2) has entered into a written agreement with the County for the provision of 9-1-1 emergency ambulance service; or (3) is otherwise authorized by the LEMSA to provide 9-1-1 emergency ambulance services in Contra Costa County.

(q) "Emergency medical technician" or "EMT" has the same meaning as set forth in Health and Safety Code section 1797.80.

(r) "Emergency response vehicle" means any privately owned ground transportation vehicle constructed, modified, equipped, or arranged and operated for the transportation of medical or first aid supplies or equipment, or medical personnel trained in emergency medical procedures or first aid, whether on public or private property.

(s) "Exclusive operating area" or "BOA" means an area or subarea defined by the current EMS plan in which the LEMSA restricts operations to one or more emergency ambulance service provider of ALS or BLS service.

(t) "Health officer" means the county health officer, or designee(s), or other official designated by the board of supervisors, to perform the health officer's functions under this division.

(u) "Inspection decal" means the physical decal issued bythe permit officer attesting to the successful inspection of an ambulance with respect to its medical, communications or other equipment that may be required by law or LEMSA policy.

(v) "LALS" or "limited advanced life support" has the same meaning as set forth in Health and Safety Code section 1797.92.

(w) "LEMSA" means the Contra Costa County local emergency medical services agency

(x) "LEMSA director" means the Director of the Contra Costa County Emergency Medical Services Agency.

(y) "MCI" or "multi-casualty incident" or "multi-patient incident" means any incident that meets criteria set forth in Contra Costa County MCI Plan.

(z) "Medical director" means the full-time or part-time licensed physician and surgeon designated by the County pursuant to Health and Safety Code section 1797.202 to provide medical control and to assure medical accountability throughout the planning, implementation and evaluation of the EMS system.

(aa) "Mutual aid request" means a request for ambulances, equipment and persons fit for service received from another county within the state or from an adjoining state when the health officer of the other county or adjoining state determines that their resources are inadequate to respond to a county emergency or disaster.

(bb) "Non-emergency ambulance service provider" means an ambulance service that (1) does not contract with the County for the provision of 9-1-1 ambulance service pursuant to Health and Safety Code section 1797.224; (2) has not entered into a written agreement with the County for the provision of 9-1-1 emergency ambulance service; or (3) is not otherwise authorized by the LEMSA to provide 9-1-1 emergency ambulance services in Contra Costa County.

(cc) "Permit officer" means the health officer or their designee(s).

(dd) "Special event" means, but is not limited to, sporting events, off-road vehicle races, fundraisers, marathons, concerts, fairs, bicycle races or other physical competition, parades, festivals, stage or movie productions, contests, or other commercial or non­ commercial special events occurring on a specific date and time at a specific location or that place a group or gathering of people in one general locale. "Special event" does not include conferences, symposiums or other indoor events.

(ee) "Special event medical standby services" means medical-aid or first-aid services provided or offered by persons who are employed or volunteer to provide medical aid or first aid to participants or members of the public at a special event.

(ff) "Vehicle" has the same meaning as set forth in Vehicle Code section 670.

(Ord. No. 2022-21, §§ II, III, 6-21-22).