Chapter 9 — OPERATIONAL STANDARDS AND REQUIREMENTS

EMERGENCY MEDICAL SERVICES AIRCRAFT TRANSPORTATION SERVICES

To establish minimum standards for the integration of emergency medical services (EMS) aircraft and personnel into the County of San Diego prehospital patient transport system as a specialized resource for the transport and care of emergency medical patients. EMS aircraft must be authorized by the County of San Diego EMS Office in order to provide prehospital patient transport within San Diego County.

(Added 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)

(a) Standard A-1: EMS aircraft operations shall be an integrated component of the regional Emergency Medical Services Plan with provisions for timely response, communications, access to appropriate care, quality improvement and evaluation, and disaster preparedness.

(1) The County of San Diego EMS Office shall:

a. Maintain an inventory of the number and type of authorized EMS aircraft, the patient capacity of authorized EMS

aircraft, the level of patient care provided by EMS aircraft personnel, and receiving facilities with landing sites approved by the State Department of Transportation, Aeronautics Division.

b. Establish policies and procedures to assure compliance with Federal, State and local statutes.

c. Establish policies and procedures that:

1. Apply to air ambulance service providers and medical flight crews for medical control.

2. Apply to EMS aircraft operations in the County of San Diego for record keeping, quality assurance, and

continuous quality improvement.

(b) Standard A-2: Air ambulances shall be appropriately equipped and staffed to safely respond, meet the needs of the patient and to transport him/her to an appropriate receiving facility equipped and staffed to care for the patient.

(c) Standard A-3: At least one permitted air ambulance provider shall be available to provide primary response rotorcraft services to medical incident scenes 7 days a week, 24 hours a day.

(1) Unless specifically exempted by the ordinance, all air ambulance operators offering services to, from or between

hospitals located in San Diego County shall obtain an Ambulance Operators Permit issued by the County of San Diego EMS Office.

(2) Air Ambulance Providers shall:

a. Respond to all medically appropriate requests without financial screening (weather and aircraft airworthiness

excluded).

b. Respond to scenes (Primary Response Air Ambulance) when an authorized requesting agency determines the

need for air ambulance transport meets the County of San Diego, EMS policies.

c. Have a written agreement with the County of San Diego EMS Office specifying operational and aircraft capabilities,

which meet or exceed requirements of applicable EMS aircraft classifications.

d. Obtain and maintain accreditation by the Commission on Accreditation of Medical Transport Systems (CAMTS).

1. Air ambulance providers requesting initial licensure that are ineligible to apply for CAMTS accreditation based

upon stated CAMTS requirements, must provide documentation to demonstrate equivalence with CAMTS standards, and within four months must have completed an onsite CAMTS consultation.

2. Documentation must be provided after completion of the onsite CAMTS consultation demonstrating a conditional

CAMTS accreditation. Air ambulance providers must apply for full CAMTS accreditation within one year.

3. A provisional license will be granted for no longer than two years at which time they must provide documentation

that the service is fully CAMTS accredited.

(3) Primary Response Air Ambulance: The designation as a Primary Response Air Ambulance for purposes of the EMS system of the County of San Diego confers upon the service operator the recognition that it has the commitment, personnel and resources necessary to provide optimum medical care for the patient.

a. An air ambulance provider which is designated or permitted as a primary response air ambulance shall meet or

exceed the requirements set out in California Code of Regulations, Title 22, Division 9, Chapter 8, Section 100302 and 100306.

b. In addition, primary response air ambulance providers shall:

1. Meet or exceed all state, federal licenses and permits necessary to provide air ambulance services.

2. Maintain valid ambulance operator and equipment permits issued by the County of San Diego EMS Office .

3. Maintain adequate resources located in San Diego County to provide services on a continuous basis 24 hours a

day, 7 days a week.

4. Maintain minimum staffing of two (2) attendants certified or licensed in advanced life support, one of which is a

Registered Nurse (RN), for each responding flight crew.

5. Operate at all times under medical direction and control of a designated base hospital and a licensed physician

and surgeon with relevant experience in the provision of emergency medical care.

6. Comply with the County of San Diego EMS Office quality improvement process to include representative

participation on the Prehospital Audit Committee.

7. Submit prehospital reports as per the County of San Diego EMS Office policies.

8. Establish and maintain radio/ telephone communication capability, 24 hours a day, 7 days a week, capable of

maintaining constant communication with the aircraft and local public safety dispatch entities.

9. Maintain all equipment, and adhere to all standards set forth in the County of San Diego policies, protocols and

procedures and prescribed in the EMS Plan.

10. Maintain at a minimum one (1) similarly configured back up aircraft, which is available within a maximum of

twenty-four (24) hours to maintain service continuity 7 days per week, 24 hours per day.

(4) Interfacility Air Ambulance. The designation as an Interfacility Air Ambulance for purposes of the EMS system of the

County of San Diego confers upon the service operator the recognition that it has the commitment, personnel and resources necessary to provide optimum medical care for the patient.

a. An air ambulance provider which is designated or permitted as an Interfacility air ambulance shall meet or exceed

the requirements set out in California Code of Regulations, Title 22, Division 9, Chapter 8, Section 100302 and 100306.

b. In addition, Interfacility air ambulance providers shall:

1. Meet or exceed all state, federal licenses and permits necessary to provide air ambulance services.

2. Maintain valid ambulance operator and equipment permits issued by the County of San Diego EMS Office .

3. Enter into a MOA with the County of San Diego EMS Office for purposes of ALS Air Ambulance services, which meet or exceed provider performance and aircraft specifications.

   4. Maintain adequate resources located in San Diego County to provide services on a continuous basis 24 hours a

day, 7 days a week.

5. Maintain minimum staffing of one Registered Nurse and one Emergency Medical Technician Paramedic (EMT-P)

for each responding flight crew.

6. Operate at all times under medical direction and control of a designated base hospital and a licensed physician

and surgeon with relevant experience in the provision of emergency medical cares.

7. Comply with the EMS Office Quality Assurance/ Quality Improvement (QA/QI) process to include representative

participation on applicable audit committee.

8. Submit prehospital patient reports as per the County of San Diego EMS Office Policies.

9. Establish and maintain radio/telephone communication capability, 24 hours a day, 7 days a week, capable of

maintaining constant communication with the aircraft and local public safety dispatch entities.

10. Maintain all equipment, and adhere to all standards set forth in County of San Diego's policies, protocols and

procedures and prescribed in the EMS Plan.

(5) Rescue Aircraft:

a. Must have an entry that allows loading and unloading without excessive maneuvering of the patient.

b. Must be configured in such a way that the air medical personnel have access to the patient in order to begin and

maintain both basic and advanced (if an ALS personnel is on board) life support during flight.

c. Must be equipped with a stretcher sturdy and rigid enough that it can support cardiopulmonary resuscitation.

d. The stretchers shall be large enough to carry the 95th percentile adult patient in the U.S., full length in the supine

position. (The 95th percentile adult male in the U.S. is 6 ft. and 212 lbs.)

e. Must have the necessary radios that are capable of communicating with emergency ground units, the air medical

communications center, all hospitals in San Diego County, and all law enforcement agencies in the County.

f. Must be equipped with medical supplies and equipment for the various types of missions to which it will respond, as

need indicates. These supplies must include, but not be limited to:

1. Airway management equipment, including oxygen and suction equipment

2. Bandages and dressings

3. Stethoscope

4. Blood pressure kit

5. Cervical collars

6. Assorted splints

g. Must be climate controlled to prevent temperature extremes that would adversely affect patient care.

h. Must have interior lighting to ensure adequate observation of the patient.

i. Shall be configured to ensure that the pilot and controls are protected from inadvertent contact by the patient or air

medical care providers.

j. All patients must be properly restrained to ensure the safety of the patients as well as the air medical personnel

located in the patient care area.

k. The aircraft must be equipped with appropriate survival equipment and supplies.

(d) Standard A-4: Primary response air ambulance services shall be made available to sick and injured persons in the county whenever it is safe, appropriate and necessary to optimize the care of the patient. The pilot in command shall have the full authority to abort or decline response to any request for service when mechanical, geographic, or flight condition might endanger the crew or others.

(1) No person or organization shall provide or hold himself or herself out as providing prehospital Air Ambulance or Air

Rescue services unless that person or organization has aircraft which have been classified by the County of San Diego EMS Office with the exception of State or Federal aircraft.

(2) Operation of State or Federal aircraft in San Diego County

a. A request from a designated dispatch center shall be deemed as authorization of aircraft operated by the California

Highway Patrol, Department of Forestry, National Guard or the Federal Government.

(e) Standard A-5: All personnel involved in the provision of EMS aircraft services shall be licensed, certified, equipped and trained to levels required to safely and consistently respond and provide care in the flight environment.

(f) Standard A-6: Air ambulances designated or permitted as primary response rotorcraft shall be considered to be the air response asset of choice for incident scene operations. Rescue rotorcraft may be used to supplant or extend the availability of air medical transportation.

(1) General Aircraft Standards: Designated EMS aircraft operators shall adhere to appropriate Federal Aviation

Regulations (FAR) including but not limited to Parts 135, 91, 61, 43 and Advisory Circular 135-14A as it pertains to flight operations, maintenance inspections, pilot flight and duty time. The aircraft operator will also hold "Air Ambulance Operations Specifications".

Interface Air Ambulances With Rescue Aircraft

a. Nothing in the Ordinance should be considered to limit the operation of a rescue aircraft in responding to medical

emergencies.

b. Rescue aircraft will notify the air ambulance communication center(s) when requested for medical services or

responses via radio or appropriate ground relay.

c. ALS/BLS Rescue aircraft medical personnel may, based on the needs of the patient, prevailing weather or

availability of a primary response air ambulance:

1. Rescue/extricate/treat the patient and transport

2. Rescue/extricate/treat patient and await an air or ground ambulance

d. ALS Rescue aircraft medical personnel, upon making the decision to transport, shall notify their base hospital,

which shall notify or facilitate communication with the appropriate receiving hospital.

e. BLS Rescue aircraft medical personnel, upon making the decision to transport, shall notify the communication

center, which shall notify or facilitate communication with the appropriate receiving hospital.

f. Auxiliary Rescue aircraft medical personnel may rescue/extricate/treat the patient and await or rendezvous with an air or ground ambulance, but shall not transport the patient to a receiving hospital.

(Added 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)

All personnel involved in the provision of EMS aircraft services in San Diego County shall be licensed, certified, equipped and trained to levels required to safely and consistently respond and provide care in the flight environment.

(a) EMS aircraft Medical Flight Crew shall have relevant training and experience in the care of the patient and meet the qualifications of the role within which they are functioning.

(1) Primary Response air ambulances shall maintain minimum staffing of at least two (2) attendants licensed in

advanced life support for each responding flight crew, one of which is a Registered Nurse (RN).

(Added 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)

Every applicant for an Air Ambulance providers permit shall obtain and maintain in full force liability insurance including but not limited to comprehensive aircraft liability, each with a combined single limit of not less than $10,000,000 per occurrence and professional liability with a limit of not less than $1,000,000 per claim. Primary response air ambulance applicants shall obtain and maintain in full force liability insurance including but not limited to comprehensive aircraft liability, each with a combined single limit of not less than $5,000,000 per occurrence and professional liability of not less than $5,000,000 per claim.

(Added 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)

The County EMS Office shall not grant any Ambulance/Transport 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.

(Added 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)

(a) Primary Response Air Ambulance Providers shall be available to provide primary response air ambulance services to medical incident scenes seven (7) days a week, 24 hours per day. Notwithstanding the above, the pilot in command shall have full authority to abort or decline response to any request for service when mechanical, geographic, or flight conditions might endanger the crew or others.

(b) Rescue Aircraft shall only transport patients in coordination and conjunction with primary response air ambulance agencies. This type of craft is to be available primarily for rescue purposes.

(c) Each air 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.

(1) Nothing in this ordinance shall be considered to abridge or supplant the primary jurisdiction of the United States

Coast Guard over air medical and other rescue operations at sea or within the Port of San Diego. During activation of an San Diego County Emergency Operations Plan Mass-Casualty Incident (MCI) Operations Annex D event or declared states of emergency the following shall apply:

a. Directly request the assistance of the Coast Guard for any appropriate mission including inland river rescue. The

air medical communication center shall maintain a mechanism for promptly contacting the Command Duty Officer Coast Guard Air Station, San Diego for such requests.

b. Based on the best information available, any incident scene commander or local emergency management official

may request the assistance of local or regional military air medical assets. * Such request will be routed through the air medical communication center with Commander Naval Air Pacific (COMNAVAIRPAC), Naval Air Station North Island being the primary point of contact for all requests. The air medical communication center shall maintain a mechanism for promptly contacting the command duty officer, COMNAVAIRPAC.

(2) Interface/Utilization with Non-medical Civilian or Public Safety Aircraft: Based on the best information available, any

incident scene commander or local emergency management official may utilize non-medical civilian aircraft for the purpose of transporting the sick and injured. This should occur only after all alternative resources have been exhausted. Incident scene commanders shall make their best effort to configure and staff the aircraft appropriately based on conditions at scene and resources available. Non-medical aircraft pilots shall be provided with the air medical communication frequency. The air medical communication centers will assist said aircraft in accessing and notifying an appropriate receiving hospital.

(d) Air Medical Dispatch must be coordinated through a designated dispatch center so as to ensure the safety of all participants and patients in the EMS and Air Medical Systems. Should there be more than one permitted primary response rotorcraft agency in San Diego County there shall be a centralized dispatch agency designated by the County of San Diego.

(Added 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)

(a) Each air medical services provider shall establish at least one base of operations within the geographic borders of San Diego County. All such locations shall comply with all applicable zoning, building, and occupational health and safety regulations.

(b) Each base of operations shall be adequate to house the aircraft crew required for the aircraft based at that location. Cooking facilities, rest rooms, showers, and beds sufficient for all personnel on duty are required for all bases. Alternate temporary posting locations shall be adequate to protect the crew and include toilet and rest facilities as determined by the Permit Officer.

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

(Added 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)

Air Medical Services 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.

(Added 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)

The Permit Officer shall make necessary and reasonable policies/procedures/protocols covering air medical services operations, equipment, personnel, and standards of dispatch for the effective and reasonable administration of this Division.

(Added 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)

Air medical services providers shall:

(a) Dispatch an aircraft 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;

(b) Disclose to any person requesting service those instances when an aircraft is not available for an emergency call;

(c) 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; and

(d) Record all telephone and radio calls for air medical services.

(Added 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)

Air medical services 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 aircraft in any manner contrary to the provisions of this Division or contrary to any applicable statute, rule or regulation;

(c) Performing air medical services unless possessing a current, valid Air Ambulance Provider's Permit or a current, valid Critical Care Transport Provider's Permit, respectively;

(d) Announcing, advertising, or offering:

(1) Air medical services without possessing a current, valid Air 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 Air Ambulance Provider's Permit.

(e) Causing or allowing aircraft to respond to a location without first receiving a specific request for air medical services at that location.

(Added 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)

(a) Air ambulances shall meet the following requirements:

(1) Aircraft shall have sufficient patient cabin area to accommodate transportation of two patients, not stacked, on

stretchers. Both patients must be accessible to care providers for ACLS interventions.

(2) Aircraft shall have an entry that allows loading and unloading without excessive maneuvering of the patient, and

does not compromise functioning of monitoring systems, intravenous lines, or manual and mechanical ventilation.

(3) Aircraft must be configured in such a way that air medical personnel have access to any patient in order to begin

and maintain both basic and advanced life support during flight.

(4) The stretchers shall be sturdy and rigid enough that it can support cardiopulmonary resuscitation. If a backboard or

equivalent device is required to achieve this, such a device shall be readily available.

a. The stretcher and the means of securing it for flight must be consistent with FAR(s).

b. The stretchers shall be large enough to carry the 95th percentile adult patient in the U.S., full length in the supine

position. (The 95th percentile adult male in the U.S. is 6 ft. and 212 lbs.)

c. The head of the stretcher is capable of being elevated at least 30 degrees for patient care and comfort.

(5) The aircraft must have heat and air conditioning capability to prevent temperature extremes that would adversely

affect patient care.

(6) The aircraft should have an electric inverter with a minimum power output of 750 volt/amps, with two outlets, to

convert DC current to AC current for operation of specialized equipment, such as transport isolette and balloon pumps.

(7) The aircraft must be equipped with medical supplies and equipment for the various types of missions to which it will

respond, as need indicates, and as required by local and regional authorities and the program medical director. These supplies must include, but need not be limited to:

a. Airway management equipment including oxygen, mechanical suction, intubation equipment and ventilator support

equipment.

b. Cardiac monitor/defibrillators for two patients.

c. Advanced cardiac life support drugs and therapeutic modalities; or equivalent specific to type of mission.

d. Other electronic devices deemed necessary to deliver specific patient care (i.e., pulse oximeter, IV pumps, ETC02

detector/monitor, external pacemaker, and Doppler).

(8) All medical equipment must be maintained according to the manufacturer's recommendations, be functional at all

altitudes and must not interfere with the avionics.

(9) A standardized written inventory for controlled drug administration shall be maintained pursuant to the County of

San Diego EMS Air Medical Policies.

a. Drugs and equipment shall be maintained consistent with the County of San Diego EMS Policies and Protocols.

b. Additional drugs and treatments may be authorized by an agency medical director for use and/or administration by

a registered nurse.

(10) Aircraft shall be a light or medium weight multiengine helicopter capable of routinely responding to unimproved landing sites under visual flight rule (VFR) conditions.

(11) Aircraft shall have a minimum operating range of 300 statute miles plus reserve without refueling.

(12) Aircraft shall be able to lift and hover out of ground effect (HOGE) with the following loading under the following

conditions:

a. Loading: All required medical and safety equipment, 3-person flight crew, at mean male weight, one at mean

female weight (total 500 pounds), 2 patients in the 95th percentile adult weight (total 424 pounds). Fuel sufficient to complete a non-stop flight of 120 statute miles plus reserve.

b. Conditions: Mean sea level at temperature of 115 degrees Fahrenheit as well as 3000 feet elevation at 88 degrees

Fahrenheit.

(13) Aircraft shall be "hot load" capable.

(14) Aircraft shall be equipped for inadvertent Instrument Flight Rule (IFR) operation.

(17) Primary response air ambulances must meet the following requirements:

a. Must have separate communication equipment to ensure air medical personnel to ground exchange of information

pertinent to the mission between individuals, EMS and law enforcement agencies, and health care facilities, including at a minimum medical control and air traffic control.

b. A similar configured backup rotorcraft of the same capability as the primary aircraft shall be maintained, ready and

promptly available to replace the primary response rotorcraft in the event of mechanical failure. The aircraft must be equipped with appropriate survival equipment.

(b) EMS aircraft that are designated or permitted as rescue aircraft providers shall meet the following requirements:

(1) Aircraft shall have an entry that allows loading and unloading without excessive maneuvering of the patient and, for

ALS rescue aircraft, does not compromise functioning of monitoring systems, intravenous lines, or other ALS treatments.

(2) Aircraft must be configured in such a way that air medical personnel have access to any patient in order to begin

and maintain basic and advanced life support (ALS rescue aircraft) during flight.

(3) Must have an entry that allows loading and unloading without excessive maneuvering of the patient.

(4) Must be configured in such a way that the air medical personnel have access to the patient in order to begin and

maintain both basic and advanced (if a paramedic is on board) life support during flight.

(5) Must be equipped with a stretcher sturdy and rigid enough that it can support cardiopulmonary resuscitation.

(6) The stretchers shall be large enough to carry the 95th percentile adult patient in the U.S., full length in the supine

position. (The 95th percentile adult male in the U.S. is 6 ft. and 212 lbs.)

(7) Must have the necessary radios that are capable of communicating with emergency ground units, the air medical

communications center, all hospitals in the County, and all law enforcement agencies in the County.

(8) Must be equipped with medical supplies and equipment for the various types of missions to which it will respond, as need indicates. These supplies must include, but not be limited to:

a. airway management equipment, including oxygen and suction equipment

b. bandages and dressings

c. stethoscope

d. blood pressure kit

e. cervical collars

f. assorted splints

(9) All medical equipment must be maintained according to the manufacturer's recommendations, be functional at all

altitudes, and must not interfere with the aircraft's avionics.

(10) The aircraft must be equipped with appropriate survival equipment and supplies.

(Added 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)

The air medical services provider shall allow the Permit Officer or his/her designee to inspect, on an announced or unannounced basis, all aircraft used to provide air medical services. The inspections should be held, whenever possible, during normal business hours provided, however, that the inspection of an aircraft would be stopped should the aircraft 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 aircraft is properly configured, maintained and equipped for the provision of air medical service.

(b) the description of the aircraft required by this ordinance is accurate.

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

(Added 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)