Palm Desert Municipal Code Ch. 10.84 Ambulance Service

Whenever in this chapter the following terms are used, they shall have the meanings respectively ascribed to them in this section:

"ALS or LALS ambulance"

means an advanced life support or limited advanced life support ambulance which has additional equipment and supplies as specified by the health officer.

"Ambulance"

means any vehicle or boat specifically designed, constructed, modified, equipped, arranged, maintained and operated for the sole purpose of transporting any sick, injured, wounded, invalid, incapacitated or convalescent person, or expectant mother.

"Ambulance service"

means the operation for monetary or other consideration of ambulances for the purpose of transporting any sick, injured, wounded, invalid, incapacitated or convalescent person, or expectant mother, from any location in the incorporated city of Palm Desert to any destination regardless of location.

"Ambulance service areas"

means all of those portions of the incorporated area of the city divided into ambulance service areas as shown on the map entitled "Ambulance Service Areas of the City of Palm Desert" on file in the office of the city clerk and in the office of the health officer of the county.

"BLS ambulance"

means a basic life support ambulance which has equipment and supplies as specified by Title 13, California Administrative Code.

"Class of service"

means the level or levels of complexity of field emergency medical services that may be provided by a permittee, and shall be specified as basic life support provided by MET-1A personnel conforming to Section 1760.5 of the Health and Safety Code, full advanced life support provided by California licensed physicians or by paramedics and mobile intensive care nurses certified by the Health Office under Section 1481 of the Health and Safety Code, or limited advanced life support provided by EMT-II personnel authorized under Section 429.73 or 1760.5 of the Health and Safety Code.

"Emergency call"

means a request for the dispatch of an ambulance to transport or provide other assistance to a person who has an apparent sudden or unforeseen need of medical attention.

"Emergency service"

means the functions performed in response to an emergency call.

"EMT-II"

means an emergency medical technician II certified by the state as authorized to provide limited advanced life support (LALS) under Section 429.73 or 1760(g) of the Health and Safety Code.

"Health officer"

means the health officer of the city or his designated representative.

"MIC nurse"

means a mobile intensive care nurse who has been certified by the health officer as qualified in emergency cardiac and noncardiac care in the issuance of emergency instructions to MIC paramedics.

"MIC paramedic"

means a mobile intensive care paramedic trained in emergency cardiac and noncardiac care certified by the health officer.

"Patient"

means a sick, injured, wounded, invalid, incapacitated or convalescent person, or expectant mother.

"Permittee"

means any person who has been issued a permit to operate an ambulance service in the city.

"Person"

means any individual, firm, partnership, joint venture, corporation, association, club or organization.

(Ord. 316 § 1, 1982)

It is unlawful for any person to operate, conduct, advertise, or otherwise engage in or profess to be engaged in an ambulance service within the incorporated territory of the city except in conformance with the current, unrevoked permit issued pursuant to the provisions of this chapter.

(Ord. 316 § 2, 1982)

A. The provisions of Sections 10.84.020 and 10.84.040 relating to permits and fees shall not apply to:

1. Ambulances operated by a public entity;

2. Vehicles operated as ambulances at the request of local authorities during any "state of war emergency," duly proclaimed "state of emergency" or "local emergency," as defined in Section 8558 of the Government Code.

B. With the exception of permits and fees, all other provisions of this chapter shall be applicable to such entities and vehicles.

(Ord. 316 § 3, 1982)

A. Permits shall be issued to expire at the end of the calendar year, and the annual fee therefor shall be two hundred fifty dollars plus fifty dollars for each ambulance to be operated under a permit, which may be prorated on a quarterly basis for the first year.

B. Temporary permits shall be issued in accordance with the provisions contained in Section 10.84.230 and the fee therefor shall be twenty-five dollars plus five dollars for each ambulance to be operated under a permit.

C. The provisions of this section shall not be applicable to nonprofit volunteer ambulance services.

(Ord. 316 § 4, 1982)

Applications for a permit or renewal thereof to operate an ambulance service shall be made to the health officer upon the form provided by the health department, which shall include the following information:

A. Name, business and residence address of the applicant, and the fictitious name, if any, under which the applicant proposes to do business;

B. If the applicant is a corporation, joint venture, partnership or limited partnership, the name of all corporate officers, joint venturers or partners, their business and residence addresses and their percentage of participation in such organization;

C. A statement of facts showing the experience of the applicant in the operation of an ambulance service and that the applicant is qualified to render efficient twenty-four-hour ambulance service. With respect to an application for renewal, copies of current valid Emergency Vehicle Permits issued by the California Highway Patrol for each ambulance to be operated by the applicant;

D. The class or classes of service which the applicant proposes to provide;

E. The ambulance service area for which the applicant is requesting a permit, and all facts which the applicant believes will prove that the public health, safety, welfare, convenience and necessity require the granting of a permit to operate an ambulance service in the proposed service area;

F. A statement that the applicant will own or will have under its control equipment to adequately conduct an ambulance service in the service area for which it is applying, which meets the requirements established by the Vehicle Code and Title 13 of the California Administrative Code, and that the applicant owns or has access to suitable and safe facilities in order to maintain its ambulance service in a clean and sanitary condition;

G. A complete description of each ambulance to be operated by applicant, including an itemization of the equipment therein, the patient capacity thereof, and with respect to an application for renewal, a copy of the most recent Ambulance Inspection Report issued by the California Highway Patrol for each vehicle;

H. An affirmation that each ambulance to be operated by the applicant, and the equipment therein, conform to all the applicable provisions of this chapter, the Vehicle Code, the California Administrative Code and other state, county and city directives;

I. A statement that the applicant shall employ sufficient personnel adequately trained and available to deliver ambulance services of good quality at all times within the applicant's proposed service area;

J. With respect to application for renewal, a list containing the description of the level of training for each ambulance employee and a copy of each certification or license issued by the state and the county establishing qualifications of such employees in ambulance operation;

K. The schedule of rates to be charged by the applicant for its ambulance services;

L. A statement signed by the applicant that as a condition of the city's issuing a permit, the applicant shall indemnify and hold the city, its officers, agents and employees free and harmless from any liability whatsoever, based or asserted upon any act or omission of applicant, its officers, agents or employees, relating to or in anywise connected with or arising from the operation of its ambulance service under such permit, and the applicant shall defend at its expense, including attorney fees, the city, its officers, agents and employees in any legal action based upon such alleged acts or omissions;

M. Such other facts or information as the health officer may require.

(Ord. 316 § 5, 1982)

Upon the receipt of a completed application the health officer shall conduct an investigation to determine if the public health, safety, welfare, convenience and necessity require the granting of a new permit for the ambulance service area for which the application has been made and shall further determine if the applicant meets all the requirements of this chapter. Upon completion of his investigation, the health officer shall recommend to the city council that a permit be granted or denied for the requested ambulance service area. No permit shall be issued by the health officer until the city council has determined that the public health, safety, welfare, convenience and necessity require the granting of a new permit for the particular ambulance service area.

(Ord. 316 § 6, 1982)

If the city council determines that a permit shall not be issued, the applicant shall have the right to demand a hearing thereon. A request for a hearing shall be made in writing to the city clerk within fifteen calendar days following the decision of the council to deny the permit. Upon receipt of a written request the city clerk shall set the matter for hearing on a date not more than sixty days following receipt of the written request. At the hearing the applicant shall have the burden of proof to show facts that the public health, safety, welfare, convenience and necessity require the granting of a permit for the requested service area and that the applicant owns or controls equipment meeting the requirements of this chapter, and that the applicant otherwise meets all the requirements of this chapter.

(Ord. 316 § 7, 1982)

Upon approval by the city council of the granting of a permit for a specific ambulance service area, the health officer shall not issue the permit until:

A. The first year's fee or prorated portion thereof, is paid;

B. The permittee delivers to the health officer copies of the most recent Ambulance Inspection Report issued by the California Highway Patrol for each ambulance to be operated by the permittee;

C. The permittee delivers to the health officer copies of the current, valid Emergency Vehicle Permits issued by the California Highway Patrol for each ambulance to be operated by the permittee;

D. The permittee delivers to the health officer copies of policies or certificates of insurance as required by the provisions contained in Section 10.84.150;

E. The permittee delivers to the health officer a list containing the description of the level of training for each ambulance employee and a copy of each certificate or license issued by the state, county and city establishing qualifications of such employees in ambulance operations.

(Ord. 316 § 8, 1982)

A permit shall specify the dates of issuance and an expiration, the geographical limits of the territory within which the permittee may provide ambulance service, the number of ambulances to be used by the permittee, the class or classes of service to be provided, and any special conditions regarding communications, equipment, personnel or waiver of requirements deemed appropriate by the state.

(Ord. 316 § 9, 1982)

Permits to operate an ambulance service may be renewed annually by the health officer, upon application by a permittee, if the health officer determines that the permittee remains in compliance with the provisions of this chapter.

(Ord. 316 § 10, 1982)

A. Upon written request by the permittee, the health officer may amend the contents of the permit relating to class or classes of service, equipment or personnel.

B. Upon written request by the permittee, the health officer may amend the contents of the permit other than as specified in subsection A of this section, if the health officer finds that such amendment will be in substantial compliance with the provisions of this chapter; provided, however, that no such amendment shall be valid for more than thirty days unless approved by the city council.

(Ord. 316 § 11, 1982)

No permit shall be transferred to another person except upon prior approval of the city council, upon recommendation of the health officer.

(Ord. 316 § 12, 1982)

A permittee shall provide emergency service in connection with the class or classes of service specified in its permit on a continuous twenty-four-hour per day basis, except when causes beyond its control relating to acts of God, labor disputes or other similar acts prevent permittee from providing such service. In the event such service is not provided as specified in this section, permittee shall cause any advertisement of such services to cease and notify the health officer immediately.

(Ord. 316 § 13, 1982)

In addition to the requirements provided in Section 10.84.130, permittee shall notify the health officer immediately, in writing, in the event of any interruption of ambulance service of more than twenty-four hours duration or substantial change in personnel or equipment, which causes the ambulance service to be operated other than as set forth in the permit or as required by the provisions of this chapter.

(Ord. 316 § 14, 1982)

A permittee shall during the term of its permit:

A. Procure and maintain workers' compensation insurance as prescribed by the laws of the state;

B. Procure and maintain comprehensive bodily injury liability, and property damage liability insurance as shall protect permittee from claims for damages for personal injury, including accidental and wrongful death, as well as from claims for property damage, which may arise from the operation of the permittee's ambulance services. Such insurance shall name the city as an additional insured with respect to the operation of such services. Such insurance shall provide combined coverage limits of not less than five hundred thousand dollars per occurrence; provided, however, such limits shall not be deemed as a limitation of the indemnification and hold free and harmless statement contained in the permittee's application referred to in subsection L of Section 10.84.050, and in the event the city becomes liable for an amount in excess of such insurance coverage, the permittee shall indemnify and hold the city free and harmless for the whole thereof;

C. The permittee shall furnish the city with policies or certificates of insurance to demonstrate that the permittee has procured such insurance and that the city is named as an additional insured with respect to the operation of the permittee's ambulance services. Such policies or certificates of insurance shall contain the convenant of the insurance carrier that thirty days' written notice shall be given to the city prior to cancellation, modification or reduction in coverage of such insurance.

(Ord. 316 § 15, 1982)

Each permittee shall establish and maintain radio contact as prescribed in the city communications manual. No permittee shall allow an ambulance to be operated in service unless it is equipped with a two-way (VHF) radio which is compatible with and equivalent to the city emergency medical network as determined by the city manager.

(Ord. 316 § 16, 1982)

A. Subject to the provisions of Section 10.84.140, a permittee shall notify the health officer, in writing, of any changes relating to the ambulances specified in its permit. Such modification shall include descriptions and Ambulance Inspection Reports as specified in subsection G of Section 10.84.050, and any other information pertaining to such changes.

B. A permittee shall notify the health officer, in writing, of any changes relating to its personnel. Such notification shall include descriptions and copies of certificate or licenses as specified in subsection J of Section 10.84.050 and any other information pertaining to such changes.

(Ord. 316 § 17, 1982)

A permittee shall:

A. Maintain its ambulances in good mechanical repair and in a clean and sanitary condition;

B. Equip its ambulances with all the safety and emergency equipment and supplies as required by the Vehicle Code, the California Administrative Code and the regulations prescribed by the health officers, as the same are now written or hereinafter amended;

C. Protect dressings, bandaging, instruments and other medical supplies used for care and treatment of patients in such a manner so that they are sterile when ready for use. Provisions shall be made to assure autoclaving or resterilization of emergency equipment when required.

(Ord. 316 § 18, 1982)

No permittee shall allow an ambulance to be operated in service unless:

A. The driver meets the qualifications and training required by the California Administrative Code, as the same is now written or hereafter amended. The driver shall be trained and competent in the proper use of all the safety and emergency equipment and supplies referred to in subsection B of Section 10.84.180. The driver shall hold a certificate as an emergency medical technician 1A (EMT-1A), unless the permittee has been specifically exempted from this requirement by the state and the city;

B. The driver is accompanied by an attendant, unless the permittee has been specifically exempted from this requirement by the health officer. The ambulance attendant shall be trained and competent in the proper use of all safety and emergency equipment and supplies referred to in subsection B of Section 10.84.180, and shall hold a certificate as an emergency medical technician 1A (EMT-1A). The ambulance attendant shall occupy the patient compartment while transporting any person in apparent need of medical attention;

C. At least one attendant holds a certificate as a MIC paramedic issued by the health officer, if the vehicle is being used as an ALS ambulance;

D. At least one attendant holds a certificate as an EMT II, if the vehicle is being used as a LALS ambulance.

(Ord. 316 § 19, 1982)

A. An ambulance driver or ambulance attendant who is a California licensed physician or an MIC nurse certified by the health officer shall be exempt from the emergency medical training requirement set forth in Section 10.84.190.

B. The provisions of Section 10.84.190 shall not apply during any state of war emergency," duly proclaimed "state of emergency" or "local emergency" as defined in Section 8558 of the Government Code.

(Ord. 316 § 20, 1982)

A. Each permittee shall post a current schedule of rates for its ambulance services in a conspicuous place within each of its ambulances and in its office, and furnish one copy to the city clerk.

B. In the event the schedule of rates is changed or modified, the permittee shall deliver a copy of such changes or modifications to the health officer and the city clerk forthwith.

(Ord. 316 § 21, 1982)

An ambulance service based and properly licensed by the California Highway Patrol outside the unincorporated territory of the city shall be authorized to transport a patient to or through the incorporated territory of the city, but shall not be authorized to transport patients from the incorporated territory of the city, except as prescribed under Sections 10.84.030 and 10.84.040. In order to maintain proper medical support, such ambulance service shall maintain communications with the ambulance coordination center for the city. If such ambulance service is operating an ALS ambulance, it shall establish and maintain communications with a telementry base station for medical control in compliance with the regulations prescribed by the health officer.

(Ord. 316 § 22, 1982)

The health officer may issue a temporary permit to an ambulance service based and properly licensed by the California Highway Patrol outside the incorporated territory of the city for a period not to exceed thirty days. Such temporary permit shall include the contents required by Section 10.84.090 and such additional conditions as deemed appropriate by the health officer.

(Ord. 316 § 23, 1982)

Any user of or subscriber to an ambulance service operating within the incorporated area of the city alleging that he or she has received unsatisfactory service may file a written complaint with the health officer setting forth such allegations. The health officer shall notify the ambulance service of such complaint and investigate the matter to determine whether or not there has been a violation of any of the provisions of this chapter. In the event it is determined that there has been such a violation, the health officer shall take appropriate action to insure compliance as authorized by this chapter.

(Ord. 316 § 24, 1982)

The health officer shall prescribe reasonable regulations regulating ambulance service operations, ambulance equipment and ambulance personnel. Any such regulation shall be submitted to the city council for approval before taking effect, and thereafter, filed in the health officer's office and made available for public inspection.

(Ord. 316 § 25, 1982)

The health officer shall inspect the records, facilities, ambulances, equipment and methods of operation of each permittee at least annually and whenever such inspections are deemed necessary by the health officer.

(Ord. 316 § 26, 1982)

An application for a permit, or a renewal thereof, may be denied and an existing permit may be revoked or suspended for any of the following grounds:

A. The permittee or applicant has knowingly made a false statement or fails to disclose facts in a material matter either in its application or in any reports or other documents furnished by it to the city;

B. The permittee does not maintain and operate its ambulances and other equipment in the manner and in the condition required by this chapter;

C. The permittee knowingly employs employees who do not meet the standards or requirements or have the licenses required by this chapter;

D. The permittee or applicant is not the real party in interest in the business;

E. Any other grounds or conduct which materially affect permittee's or applicant's ability or qualifications to properly operate an ambulance service or serve the public;

F. If the permittee or applicant:

1. Is required to register as a sex offender under the provisions of Section 290 of the California Penal Code, or

2. Habitually or excessively uses or is addicted to the use of narcotics or dangerous drugs, or has been convicted of any offense relating to the use, sale, possession, or transportation of narcotics or habit-forming drugs, or

3. Is a habitual user of intoxicating beverages to excess, or

4. Within the three-year period immediately preceding the application, has been under suspension, revocation or probation by the Department of Motor Vehicles for a cause involving the safe operation of a motor vehicle, or has been convicted of any of the following offenses: failure to stop and render aid in an accident involving injury or death; driving while intoxicated or under the influence of drugs; or reckless driving involving bodily injury, or

5. Has been convicted of any offense involving moral turpitude, or

6. Has been convicted of any offense punishable as a felony, or has been convicted within the immediate preceding 10-year period of the crime of theft in either degree, or

7. Has been involved within the two years immediately preceding the application in any motor vehicle accident causing death or personal injury, or

8. Has been involved in three or more motor vehicle accidents within the year immediately preceding the application, or

9. Has operated an authorized emergency vehicle in violation of the rules and regulations relating to authorized emergency vehicles as promulgated by the Commissioner of the California Highway Patrol;

G. The applicant was previously a holder of a permit issued under this chapter which has been revoked or not renewed based on any of the grounds set forth in this section;

H. The permittee has failed to make and retain records showing its transactions, or fails to make such records available for inspection by the health officer;

I. The permittee accepts an emergency call when it is either unable or unwilling to provide the requested service or fails to inform the person requesting such service of any delay and fails to obtain the consent of such person before causing an ambulance to respond from a location more distant than the one to which the request was directed;

J. The permittee or applicant has violated any of the provisions of this chapter or has failed to comply with any of the requirements of this chapter.

(Ord. 316 § 27, 1982)

The health officer shall be empowered to deny an application for renewal of a permit or to suspend or revoke a permit on any of the grounds set forth in Section 10.84.270. The health officer shall give the permittee written notice of such denial, suspension or revocation as follows:

A. In the event an application for renewal of a permit is denied the notice shall set forth the reasons for such denial and shall be served as provided in subsection C of this section.

B. In the event a permit is suspended or revoked, the notice shall set forth the reasons for such suspension or revocation and the effective dates thereof, and shall be served as provided in subsection C of this section. Such notice shall not be effective until ten days after service has been made or such later date as the health officer deems appropriate.

C. The notice shall be served personally on the permittee, or sent by registered or certified mail, postage prepaid, return receipt requested, to the permittee at its business address.

(Ord. 316 § 28, 1982)

A. In the event an application to renew a permit is denied or a permit has been suspended or revoked, the permittee shall be entitled to a hearing before the health officer, by submitting a written request therefor to the health officer setting forth briefly the reasons why such denial, suspension or revocation is not proper. Such request shall be submitted within ten days after service of the notice of denial, suspension or revocation was made. The hearing shall be held prior to the effective date of the suspension or revocation, or if it relates to a denial, the hearing shall be held within ten days after the request was made. The health officer shall give written notice of the time, date and place of the hearing to the permittee. After the hearing, the health officer may deny the application to renew the permit, or suspend or revoke the permit, if he finds that grounds exist therefor.

B. If the health officer denies the application to renew a permit, or suspend or revoke a permit, after a hearing had been held as provided in subsection A of this section, the permittee may appeal the decision of the health officer by filing with the city clerk, within fifteen calendar days following the date of such decision, a written notice of appeal briefly setting forth the reasons why such denial, suspension or revocation is not proper. Upon receipt of such appeal, the clerk shall set the matter for hearing on a date not more than sixty days following receipt of such appeal and give notice to the appellant and the health officer of the date, time and place for the hearing. At the hearing, the city council shall hear the appellant, the health officer and any other interested person who may present evidence relevant to the decision of the health officer. In conducting the hearing, the city council shall not be limited by the technical rules of evidence. Within thirty days following the conclusion of the hearing, the city council shall issue its order as to whether or not the permit should be renewed or the suspension or revocation sustained.

(Ord. 316 § 29, 1982)

Any person violating any of the provisions of this chapter shall be guilty of a misdemeanor and upon conviction thereof, shall be punishable by a fine not to exceed five hundred dollars, or by imprisonment in the County Jail for a period of not more than six months, or by such fine and imprisonment.

(Ord. 316 § 30, 1982)

If any provision, clause, sentence or paragraph of this ordinance or the application thereof to any person or circumstance shall be held invalid, such invalidity shall not affect the other provisions or applications of the provisions of this ordinance which can be given effect without the invalid provision or application, and to this end, the provisions of this ordinance are hereby declared to be severable.

(Ord. 316 § 31, 1982)