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

A. ALS emergency ambulance services shall only be provided under a 9-1-1 contract with the LEMSA pursuant to the provisions of the Health and Safety Code Sections 1797, et seq.

B. BLS emergency and non-emergency transport service shall be regulated by the provisions of this ordinance.

C. CCT emergency and non-emergency transport service, either CCT-P or CCT-RN, shall be regulated by the provisions of this ordinance and the LEMSA Administrative Policy and Field Treatment Guideline Manual.

D. Nothing in this ordinance shall be construed as regulating the clinical scope of practice of Registered Nurses (RN) working in a CCT-RN ambulance.

(Ord. No. 1464, § 1, 12-8-2020)

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 providing prehospital emergency medical service or ambulance service within Napa County unless the person holds (and is entitled to hold) a current valid ambulance Certificate of Operation issued by the county or is recognized as an authorized public safety agency.

B. No person (either as owner, agent or otherwise) shall furnish and operate an ambulance unless that ambulance has a current valid Ambulance Permit issued by the county.

C. Litter 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 Napa County of persons picked up outside the county boundaries. No Certificate of Operation or Ambulance Permit is required for specialized teams (e.g., neonatal intensive care unit teams) that are permitted by another emergency medical services agency and that pick up patients in Napa County for transportation to an acute care hospital based outside of the county.

E. The county has not established EOA's for BLS, and/or CCT emergency and/or non-emergency transport, but retains its option to do so in the future.

(Ord. No. 1464, § 1, 12-8-2020)

A. Application forms for an ambulance service Certificate of Operation shall be supplied by the county.

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

C. 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 - ALS, BLS, CCT, or all three service levels;

4. A statement specifying whether the applicant has provided ambulance service in Napa County prior to the establishment of this ordinance, and if so, what type and for how long;

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

6. A copy of a current CHP Emergency Ambulance Non-Transferable License;

7. A copy of the business license for the city or cities in which the applicant is doing business;

8. A statement of the legal history of the applicant, including criminal and civil convictions;

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

10. 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;

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

12. A statement that the applicant understands and will comply with the LEMSA's staffing, and equipment and supply specifications policies regarding equipment carried in each ambulance, including automated external defibrillators (AEDs);

13. A list of the actual number of ambulances and for each: the make and model, year, the vehicle identification number, State vehicle license number and proof of current Department of Motor Vehicle registration and proof of CHP ambulance inspection report and Ambulance Identification Certificate;

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

15. 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;

16. A statement of the applicant's training and orientation programs for EMTs and/or paramedics, CCT nurses, and dispatchers;

17. A statement that applicant's ambulances are equipped with radios capable of communicating with designated dispatch center and hospital, and the radios are in good working order;

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

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

20. A description of the locations (posts, bases, stations, offices) from which ambulances will be dispatched to provide the services offered in the county, noting the hours of operation and phone numbers;

21. Evidence of insurance coverage compliance under Section 8.70.040;

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

23. A disaster response plan including a personnel call-back plan;

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

25. The application fee for a Certificate of Operation as set forth in LEMSA Administrative Policy and Field Treatment Guideline Manual;

26. An ambulance inspection fee for each ambulance to be inspected as set forth in the LEMSA Fee Schedule. This fee may be returned if the permittee does not meet the basic requirements of subsection (C) of Section 8.70.022 and ambulances are not inspected; and

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

D. Within sixty days of receipt of a complete application and the required fee, the county shall review the application taking into consideration the following:

1. Whether the applicant meets the requirements of this ordinance and other applicable laws, ordinances, and regulations, and

2. Whether the applicant's vehicles, equipment, including radios, are in good working order and the ambulances pass an inspection, according to the provisions of Section 8.70.043.

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.

F. 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 according to the provisions of Section 8.70.065.

G. The decision of the county rendered pursuant to this chapter shall be final, unless appealed to the board within thirty 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 one year from the date of issuance.

2. Certificates of Operation shall be continued upon conditions of Section 8.70.022 unless earlier suspended, revoked or terminated for cause.

3. A permittee providing ambulance service may discontinue such services only after providing sixty days notice in writing of intent to discontinue services to the county or upon mutual written agreement.

I. Existing ambulance companies:

1. Within one hundred eighty days of the effective date of this ordinance, ambulance companies that have been providing BLS and CCT emergency and non-emergency transport services in the unincorporated County areas shall apply for a Certificate of Operation and Ambulance Permits. The county shall issue or deny a Certificate of Operation to each existing company, based on their ability to meet the requirements as set forth in this ordinance. The fees for the initial Certificate of Operation and Ambulance Permits for existing companies shall be the fee set for new applicants.

2. The county may issue a provisional sixty day Certificate of Operation to an existing non-emergency ambulance company to allow for required ambulance inspections. Upon a satisfactory completion of the inspections, the provisional status will be made permanent.

J. 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.

(Ord. No. 1464, § 1, 12-8-2020)

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) on file; at least fifteen days prior to such changes.

(Ord. No. 1464, § 1, 12-8-2020)

If a permittee desires to include additional ambulance units under its Certificate of Operation, the permittee shall submit a vehicle description form for each additional unit 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.

(Ord. No. 1464, § 1, 12-8-2020)

A. Applicants for renewal of an ambulance service Certificate of Operation under this ordinance shall file with the county an application in writing, which shall include the following information:

1. An application in electronic format, on a form furnished by the LEMSA, which shall include any changes in the information required in Section 8.70.022. The application for renewal may be filed with the LEMSA ninety days prior to the expiration date, but no later than forty-five days prior to the expiration date of the current permit, and be accompanied by the appropriate renewal fee.

2. Renewal of a Certificate of Operation shall require conformance with all requirements of this ordinance as upon issuance of an initial certificate. Nothing in this ordinance shall be construed as requiring the automatic renewal of a Certificate of Operation upon its expiration and the burden of proof respecting compliance of all the requirements of this division and of entitlement of a certificate shall be with the applicant for renewal.

B. Late renewal applications received less than forty-five days prior to the expiration of the Certificate of Operation shall pay an additional twenty-five percent of all certification fees due.

C. All ambulances specified by the permittee shall be inspected and have their permits renewed in accordance with the provisions of Section 8.70.044, Ambulance Inspection and Permit Process. The issuance of a renewed Certificate of Operation shall be based on all ambulances having been inspected.

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.

(Ord. No. 1464, § 1, 12-8-2020)