San Joaquin County Municipal Code Ch. 3 Permits

(1) The EMS Agency shall establish emergency ambulance zones in the development of an EMS plan. Emergency ambulance zones shall be classified as either exclusive (competitive), exclusive (non-competitive), or non-exclusive.

(2) Exclusive (competitive) zones are those in which a permit will be granted to a single provider through a competitive process, in accordance with Section 1797.224, California Health and Safety Code.

(3) Exclusive (non-competitive) zones are those in which a permit will be granted to a single provider without a competitive process, in accordance with Section 1797.224, California Health and Safety Code.

(4) Non-exclusive emergency ambulance zones are those in which permits will be granted to any qualified ambulance provider.

(Ord. No. 4563, 8-18-2020)

(1) 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 ambulance service unless the person holds (and is entitled to hold) a currently valid ambulance operator's permit.

(2) 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 air ambulance service unless the person holds (and is entitled to hold) a currently valid ambulance operator's permit. This includes air ambulance services that are based outside of San Joaquin County that provide emergency response within San Joaquin County.

(3) No permit is required for the delivery into San Joaquin County of persons picked up outside the County boundaries. No permit is required for specialized teams comprised of members that include a physician that are authorized or permitted by another emergency medical services agency and that pick up patients in San Joaquin County for transportation to an acute care hospital based outside of the County or for circumstances specified in San Joaquin County EMS Agency policies and procedures.

(Ord. No. 4563, 8-18-2020)

(1) The permit process for ambulance providers seeking a permit to operate within exclusive (competitive) zones shall be incorporated into the competitive process, as described in subsection (2).

(2) A competitive process meeting the requirements of Section 1797.224, California Health and Safety Code shall be used to grant an exclusive operating permit to a single provider within any exclusive (competitive) zone. The County shall use a written request for proposals that shall identify the minimum and desired criteria that will be used to select the ambulance service. It shall include, but not be limited to, all applicable requirements established by this division.

(3) A contract shall be negotiated with the ambulance provider selected under the competitive process. It shall bind the ambulance provider to the requirements established by this division, any greater requirements established through the competitive process, and the policies and procedures of the San Joaquin County EMS Agency.

(Ord. No. 4563, 8-18-2020)

(1) Application to existing ambulance services: Any ambulance service permitted in San Joaquin County on the effective date of the ordinance codified in this Division and operating in a zone that has been designated as exclusive (non-competitive) may apply for a non-competitively granted exclusive operating permit. Only one exclusive operating permit may be granted within any zone.

(2) The permit process for ambulance providers seeking a permit to operate within exclusive (non-competitive) zones shall be conducted as described in Section 4-7307. In addition, the applicant shall provide sufficient information to show that it qualifies for an exclusive operating permit without a competitive process pursuant to Section 1797.224, California Health and Safety Code.

(3) Upon receipt of an application for the issuance of a non-competitively granted exclusive operating permit, the Ambulance Permit Officer shall determine whether the applicant service does meet the requirement of Section 1797.224, California Health and Safety Code and shall recommend issuance or denial of the requested permit.

The Board of Supervisors may:

(a) Grant the issuance of the permit; or

(b) Deny the issuance of the permit and redesignate the zone in question as an exclusive (competitive) zone or a non-exclusive zone. If the Board redesignates the zone as an exclusive (competitive) zone, the EMS Agency shall conduct a competitive process to select an ambulance provider for that zone.

(4) A contract shall be negotiated with the ambulance provider granted a non-competitively granted exclusive operating permit. It shall bind the ambulance provider to the requirements established by this division and regulations promulgated thereunder and the policies and procedures of the San Joaquin County EMS Agency. If the County is unable to successfully negotiate a contract with the provider, the Board shall redesignate the zone as an exclusive (competitive) zone and the EMS Agency shall conduct a competitive process to select an ambulance provider for that zone.

(Ord. No. 4563, 8-18-2020)

The permit process for ambulance providers seeking an emergency service permit to operate within non-exclusive zones shall be conducted as described in Section 4-7307.

(Ord. No. 4563, 8-18-2020)

(1) The permit process for ambulance providers seeking a permit to provide air ambulance service only shall be conducted as described in Section 4-7307.

(2) In addition to the information shown in Section 4-7307, the application shall provide:

(a) Proof of any required FAA permit.

(b) Proof that the applicant possesses and maintains Department of Transportation permission for use of the landing site where the aircraft is based and submits a copy of the permit or letter of permission.

(Ord. No. 4563, 8-18-2020)

The permit process for ambulance providers seeking a permit to provide non-emergency service only shall be conducted as described in Section 4-7307.

(Ord. No. 4563, 8-18-2020)

(1) Application: Each application for an ambulance operator's emergency and non- emergency permit shall be made upon forms prescribed by the Permit Officer.

(2) Required Data: Each applicant who desires an ambulance operator's permit shall submit the following:

(a) The names and addresses of the applicant, registered owner, partner, officer, director and controlling shareholder(s);

(b) The name under which the applicant has engaged, does, or proposes to engage in ambulance service;

(c) A financial statement for the previous fiscal year, prepared by a certified public accountant;

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

(e) A description of the company's program for maintenance of the vehicles;

(f) A description of the locations from which ambulance services will be offered, noting the hours of operation;

(g) Statement of the legal history of the applicant, including criminal and civil convictions;

(h) Evidence of insurance coverage under Section 4-7500;

(i) Any other information the Permit Officer deems necessary for determination of compliance with this division.

(3) In addition, except for applicants for a permit to provide non-emergency service only, each applicant shall show:

(a) The ability of the applicant to provide emergency ambulance service within established response times for each emergency response area applied for, twenty-four (24) hours per day, seven (7) days per week, year round;

(b) All service charges and rates to be charged, showing compliance with any maximum charges established by the County; and

(c) The number of emergency ambulances to be deployed on each shift.

(4) Investigation: Upon receipt of a completed application and the required fee, the Permit Officer shall make or cause to be made such investigation to determine if:

(a) The applicant meets the requirements of this division and of other applicable laws, ordinances, and regulations; and

(b) That the applicant's vehicles, equipment, and appurtenances, including radios are in good working order, the applicant has received a license issued by the Commissioner of the California Highway Patrol, in accordance with Section 2501, California Vehicle Code.

(5) Issuance: Within ninety (90) days of receipt of a complete application, the Permit Officer shall determine:

(a) Whether the applicant meets all requirements of this Division; and

(b) Whether the applicant is able to provide the requested service; and

(c) Whether the applicant has knowingly made a false statement of fact in such application; and

(d) Whether the applicant has knowingly failed to disclose facts pertinent to the application; and

(e) Whether the applicant was previously a holder of a Permit issued under this chapter which has been revoked or not renewed based on the provisions of this division; and

(f) Whether the applicant proposes to provide service in a zone that has been designated as an either exclusive (competitive) or exclusive (non-competitive) zone.

(6) Approval or Denial: If it is determined that the applicant does not meet all requirements within this Division, then the Permit Officer shall deny the application and notify the applicant in writing within ninety (90) days of the receipt of the application. Otherwise, the Permit Officer shall approve the application.

(7) Appeal from Denial of Issuance: Except when an application is denied because the applicant proposes to provide service in a zone that has been designated as either an exclusive (competitive) or exclusive (non-competitive) zone, whenever the Permit Officer 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 Permit Officer and a hearing will be scheduled within thirty (30) days of the applicant's written request for a hearing and conducted pursuant to Section 4-7603. When the Permit Officer issues an emergency ambulance service permit, the existing service within the response zone may file an appeal with the Permit Officer. A hearing on the request shall be scheduled within thirty (30) days of the written request for an appeal and conducted pursuant to Section 4-7603.

(8) Decisions—Finality: The decision of the Hearing Officer rendered pursuant to this chapter shall be final, unless appealed to the Director of Health Care Services within Sixty (60) days after such decision is rendered in writing, and notice of the same is given to the applicant by certified mail.

(9) Term:

(a) Permits shall be continued upon payment of the annual renewal fee unless earlier suspended, revoked or terminated for cause or unless the Board of Supervisors changes the designation of the zone to exclusive (competitive);

(b) Notice of intent to discontinue service: A permittee providing emergency ambulance service may discontinue such services, in one or more zones, only after providing one-hundred and eighty (180) days notice in writing of intent to discontinue services to the Permit Officer. The permitee may discontinue service in less than one hundred and eighty (180) days after written agreement of the Permit Officer;

(c) Discontinuation of service without required notice shall be considered a major breach of the permit. In the event of a major breach, the Permit Officer shall take the steps necessary to execute the performance bond specified in Section 4-7502 and to continue emergency ambulance service.

(10) Existing Ambulance Service: Within sixty (60) days of the effective date of the ordinance codified in this Division, the ambulance companies that have been continuously providing ambulance services for a minimum of one hundred eighty (180) days prior to the effective date of the ordinance codified in this Division, may apply for and obtain an ambulance operator's permit. The existing ambulance service may submit changes only, in writing, to the last application on file with the EMS Agency to comply with this section. The Permit Officer shall issue or deny a permit to each existing company within sixty (60) days of receipt of an application for such a permit, based on their ability to meet the requirements as set forth in this Division. The fee for the initial license for existing companies shall be the fee set for new applicants. The fee for applications filed under this section may be prorated if the term of the permit renewal is less than one year.

(11) Change of Data: An applicant or permittee shall report to the Permit Officer any change in the data required in Section 4-7307 or in any regulation adopted pursuant to this division within ten (10) days of the effective date of the change.

(12) Transfer of Permit: No permit shall be transferred to another person except upon prior approval of the Permit Officer. Application for transfer of any ambulance operator's permit shall be subject to the same terms, conditions, and requirements as if the application were for an original permit.

(Ord. No. 4563, 8-18-2020)

(1) Except for ambulance services granted a competitive exclusive operating permit, applicants for renewal of an ambulance operator's permit or emergency ambulance service permit under this division shall annually file with the Permit Officer an application in writing, on a form furnished by the Permit Officer, which shall include information required in Section 4-7307. The application for renewal shall be accompanied by a renewal fee.

(2) Renewal of an ambulance operator's permit shall require conformance with all requirements of this division as upon issuance of an initial permit. Nothing in this division shall be construed as requiring the granting of a permit upon expiration of a previous permit, and the burden of proof respecting compliance with all the requirements for a period and of entitlement of a permit shall remain at all times with the applicant for renewal.

(3) In addition, an application for renewal of an ambulance operator's permit within exclusive (non-competitive) zones shall provide sufficient information to show that the permittee continues to qualify for an exclusive operating permit without a competitive process pursuant to Section 1797.224, California Health and Safety Code.

(4) An ambulance provider shall annually submit, within ninety (90) days of the close of each business year, a financial statement of its business activities, prepared by a certified public accountant. Renewal of a permit is contingent upon submission of a financial statement within the proper time frames.

(Ord. No. 4563, 8-18-2020)

(1) No permit is required to furnish, operate, conduct, maintain, or otherwise engage in or advertise litter van services in San Joaquin County.

(2) A litter van provider in San Joaquin County shall maintain equipment, personnel, and conduct operations in compliance with standards for reimbursement for nonemergency medical transportation services for eligible Medi-Cal beneficiaries pursuant to California Welfare and Institutions Code, Division 9, Part 3, Chapter 7 and California Code of Regulations, Title 22, Division 3, Chapter 3, Article 3, (22 CCR §§ 51200 and 51231.1).

(3) No litter van provider shall furnish, operate, conduct, maintain, or otherwise engage in or advertise, offer, or profess to engage in ambulance service in San Joaquin County unless they hold a currently valid ambulance operator's permit.

(4) No litter van provider shall transport to an emergency department of an acute care hospital or utilize any ingress, egress, or parking specified for ambulances or emergency vehicles within the County.

(Ord. No. 4563, 8-18-2020)