Chapter 7 — OPERATIONAL — San Diego County Municipal Code

GROUND AMBULANCE AND CRITICAL CARE TRANSPORT SERVICES

SEC. 610.701. AMBULANCE DRIVERS AND AMBULANCE ATTENDANTS.¶

Any ambulance attendant or ambulance driver utilized by a Permittee shall be at least 18 years of age; shall be trained and competent in the proper use of all emergency ambulance equipment; shall hold current certification as an Emergency Medical Technician (EMT) or licensure as a Paramedic in California; or be licensed as a physician or registered nurse in the State of California; and shall demonstrate compliance with all applicable State laws and regulations.

All ambulance attendants and ambulance drivers are required to keep a copy of requisite certification(s) /license(s) in their immediate possession while on duty.

(Added by Ord. No. 8192 (N.S.), effective 2-4-93; amended by Ord. No. 8572 (N.S.), effective 9-14-95; amended by Ord. No. 8787 (N.S.), effective 4-29-97; amended by Ord. No. 9668 (N.S.), effective 8-14-04; amended by Ord. No. 10274 (N.S.), effective 8-29-13; amended by Ord. No. 10927 (N.S.), effective 1-10-25)

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SEC. 610.702. UNIFORM AND APPEARANCE.¶

Each person providing ambulance service or critical care transportation service under this Ordinance shall staff each ambulance with appropriate personnel who shall wear clean uniforms that identify employer or sponsoring agency, have visible identification of name and credential level, and comply with the requirements of this Ordinance.

(Added by Ord. No. 8192 (N.S.), effective 2-4-93; amended by Ord. No. 8787 (N.S.), effective 4-29-97; amended by Ord. No. 9668 (N.S.), effective 8-14-04; amended by Ord. No. 10274 (N.S.), effective 8-29-13; amended by Ord. No. 10927 (N.S.), effective 1-10-25)

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SEC. 610.703. DISPATCHERS.¶

Each person providing ambulance service or critical care transportation service under this Division shall assign at least one person or an agency to be responsible for receiving calls and dispatching ambulances.

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SEC. 610.704. CHP PERMIT.¶

Except for those ambulances operated by a governmental agency, every ambulance shall carry a current and valid California Highway Patrol Inspection Permit authorizing the use of the vehicle as an ambulance.

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SEC. 610.705. INSPECTION.¶

The ambulance provider or critical care transport provider shall allow the Permit Officer or his/her designee to inspect, on an announced or unannounced basis, all ambulances used to provide ambulance service. The inspections should be held, whenever possible, during normal business hours; provided, however, that the inspection of an ambulance will be stopped should the ambulance be needed to respond to an Emergency Call. If, at any time during an inspection, an agency representative, officer, director or agent thereof knowingly makes a false, misleading or fraudulent statement or engages in fraudulent behavior, the Permit Officer may order the suspension or revocation of the ambulance permit as provided for in Section 610.501. The purpose of such inspections may include, but shall not be limited to, determining if:

(a) the ambulance is properly maintained and equipped for the provision of Ambulance Service;

(b) the description of the ambulance, required by Section 610.203(o) is accurate;

(c) the ambulance contains two-way radios; the radios are in good working order and that the radios are compatible with the County's emergency medical communications system;

(d) if the ambulance is used for critical care transport, that the communication system allows the ambulance driver and ambulance attendant to communicate with the medical staff at both the discharging and receiving facilities;

(e) the ambulance will be properly equipped with fully-functioning heat and air conditioning in patient care area and driver compartment;

(f) the permitted agency is providing services at the care level authorized by the permit issued.

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SEC. 610.706. INSURANCE.¶

Every applicant for an ambulance Provider's and/or Critical Care Transport Provider's Permit shall obtain and maintain in full force and effect liability insurance, including, but not limited to, comprehensive auto liability, each with a combined single limit of not less than $3,000,000 per occurrence, and professional liability, with a limit of not less than $3,000,000 per claim.

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SEC. 610.707. WORKERS' COMPENSATION INSURANCE REQUIREMENT.¶

The County EMS Office shall not grant any Ambulance Provider's and/or Critical Care Transport Provider's Permit unless the applicant files with the Permit Officer a policy of Workers' Compensation Insurance or a Certificate of Consent to Self Insure issued by the California State Director of Industrial Relations, applicable to all employees of the applicant. The Permittee shall thereafter maintain in full force and effect such coverage during the term of the Permit. Certificates or copies evidencing such coverage shall be provided to and maintained by the County EMS Office. Workers' compensation and employers' liability insurance shall comply with California Labor Code requirements.

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SEC. 610.708. SERVICE REQUIREMENTS.¶

(a) Each ambulance provider shall provide ambulance service on a continuous 24 hours per day basis, excluding circumstances beyond the control of the provider.

(b) If for any reason an ambulance provider stops having the capability of providing ambulance service on a continuous 24 hours per day basis, any advertisement of emergency services which have not been discontinued will stop and immediate notification will be given to the Permit Officer.

(d) Each ambulance provider will cooperate with the ambulance coordinator during a San Diego County Emergency Operations Plan Mass-Casualty Incident (MCI) Operations Annex D event to provide adequate transporting units for the incident.

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SEC. 610.709. FACILITIES.¶

(a) Each ambulance provider shall establish at least one ambulance station within the geographic borders of San Diego County, and shall occupy this station on a continuing basis. All such locations shall comply with all applicable zoning, building, and occupational health and safety regulations.

(b) Each ambulance station shall be adequate to house the ambulance drivers and ambulance attendants required for the ambulances based at that location. There shall be facilities sufficient for all personnel in accordance with all local, state and federal regulations.

(c) The Permit Officer shall cause to be made an inspection of the facilities, equipment and methods of operation of each permittee.

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SEC. 610.710. INVESTIGATIONS.¶

Ambulance Provider and Critical Care Transport Provider Permittees shall cooperate with the Permit Officer, or his/her designee, in any investigations of possible violations of this Division and shall make all dispatch logs and similar dispatch records, including tape recordings, available for inspection and copying at reasonable times at the permittee's regular place of business. All tape recordings will remain available for a minimum of 90 days from the date the recordings are made.

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SEC. 610.711. POLICIES/PROCEDURES/ PROTOCOLS.¶

The Permit Officer shall make necessary and reasonable policies/procedures/protocols covering ambulance service/critical care transport service operations, equipment, personnel, and standards of dispatch for the effective and reasonable administration of this Division.

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SEC. 610.712. GENERAL REQUIREMENTS.¶

Ambulance providers and critical care transport providers shall:

(a) Refer any Private Call of a life threatening nature or a Private Call requiring Advanced Life Support (ALS) level care where ALS care is timely, appropriate and available, to the 911 emergency operator;

(b) Dispatch an ambulance within a reasonable time in response to an emergency call from a person, unless such person is immediately advised of a delay in responding to a call;

(d) Provide prompt transportation of the patient to the most appropriate medical facility, licensed, equipped, and staffed to meet the needs of the patient in accordance with applicable laws, rules, regulations and policies;

(e) Record all telephone and radio calls for ambulance service and be able to provide call recordings as requested by County of San Diego during inspections or investigations. Records shall be maintained for no less than ten years; and

(f) Report all motor vehicle accidents involving an ambulance, involving bodily harm of staff or patient, or significant damage to the vehicle exceeding $500, to the County of San Diego, EMS Office, within 24 hours of occurrence.

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SEC. 610.713. PROHIBITIONS.¶

Ambulance providers and critical care transport providers are hereby prohibited from engaging in the following activities:

(a) Using a scanner or radio monitoring device for the purposes of responding to a call when not requested to respond to that call by an individual requesting that service or the appropriate public safety dispatch center;

(b) Permitting the operation of an ambulance in any manner contrary to the provisions of this Division or contrary to any applicable statute, rule or regulation;

(c) Performing ambulance services or services of a critical care transport provider unless possessing a current, valid Ambulance Provider's Permit or a current, valid Critical Care Transport Provider's Permit, respectively;

(d) Providing advanced life support services to any person or institution without a contract or subcontract with the County for the provision of such services;

(e) Announcing, advertising, or offering:

(1) Ambulance service without possessing a current, valid, Ambulance Provider's Permit; or

(2) Advanced life support services without being authorized by the County to provide such service; or

(3) Critical care transport services without possessing a current, valid Critical Care Transport Provider's Permit.

(f) Causing or allowing ambulances to respond to a location without first receiving a specific request for ambulance service at that location;

(g) Use of lights and sirens when responding to a non-emergency call;

(h) Operation in County of San Diego as Critical Care Transporter, BLS or ALS provider without proper authorization to do so.

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