San Joaquin County Municipal Code Ch. 5 Ambulance Permit Requirements

(1) Each Ambulance permittee, except for permits granted under Section 4-7302, at its sole cost and expense, shall obtain, maintain, and comply with all County insurance coverage(s) and requirements. Such insurance coverage shall be acceptable to County Counsel and Risk Management Offices and shall be primary coverage as respects County. Any insurance or self-insurance maintained by County shall be in excess of Contractor's insurance coverage and shall not contribute to it.

(a) Worker's Compensation in the minimum statutorily required coverage amounts.

(b) Automobile Liability Insurance for each of the permittee's vehicles used in the performance of its permit, including owned, non-owned (e.g. owned by the permittee's employees), leased or hired vehicles.

(c) Comprehensive or Commercial General Liability Insurance coverage, including coverage for: (a) bodily injury, (b) personal injury, (c) broad form property damage, (d) contractual liability, and (e) cross- liability.

(d) Professional Liability Insurance.

(2) The Board of Supervisors shall set the minimum limits for the required insurance coverage. These shall take effect ninety (90) days after adoption by the Board of Supervisors.

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

An ambulance provider shall provide the Permit Officer with information in reference to any pending action or unpaid judgments or liens against the provider, and the notice of the transactions or acts giving rise to the judgments or liens. The ambulance provider shall notify the Permit Officer in writing of the actions within one (1) week of the notification from the levying agency. The reported information will be reviewed by the Permit Officer who will make a determination regarding the effect this information will have on the agency's ability to provide continuous service in accordance with this Division.

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

(1) The Board of Supervisors shall set the amount of a performance security for non- competitively granted exclusive operating permits. The amount of a performance security for a competitively granted exclusive permit may shall be established as part of the competitive process and incorporated into the exclusive operating area contract. The amounts shall be that required to ensure continuous availability of emergency ambulance service in the event of a major breach by the permitee.

(2) The permittee, prior to beginning service, shall provide a performance bond or other security method to the Permit Officer in the amount set in a form acceptable to the Permit Officer. Acceptable methods may include a cash on deposit, cash bond, insurance bond, irrevocable letter of credit, and/or lien on vehicles and equipment.

(3) The performance security shall be structured so that in the event of a major breach by the permittee, the security is immediately transferred to San Joaquin County, with any challenge or appeal to follow.

(4) For the purpose of this section, a major breach is defined as discontinuation of service without sufficient notice as required by Section 4-7307(9)(b), any event that results in revocation of any ambulance permit as described in Section 4-7601, or any event defined as a major breach in an exclusive operating area contract.

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

The permittee, unless holding a permit to provide non-emergency service only, shall be approved by the San Joaquin County EMS Agency as an advanced life support provider prior to beginning service.

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

Permittees shall engage or perform dispatch services on a twenty-four (24) hour a day basis and shall train dispatchers in accordance with a curriculum approved by the Permit Officer to radio operation and protocols and to the emergency response zones served before the dispatcher begins dispatching emergency calls. Dispatch services shall comply with the EMS Agency dispatch policies and procedures.

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

(1) All emergency ambulances in regular service shall be staffed and equipped at the advanced life support level (ALS). This requirement may be modified or waived by the Permit Officer.

(2) Any response to an emergency request for ambulance service that is responded to by a unit not staffed and equipped at the ALS level shall be reported immediately to the EMS Agency.

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

No ambulance service shall cause or allow its ambulances to respond to a location without first receiving a specific request from a San Joaquin County EMS Agency approved dispatch center.

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

(1) No person or organization shall announce, advertise, offer, or in any way claim that it provides emergency ambulance service unless it possesses a current, valid, emergency ambulance service permit.

(2) No person or organization shall announce, advertise, offer, or in any way claim that it provides advanced life support services unless it has been approved as an advanced life support provider by the San Joaquin County EMS Agency.

(3) No permittee under this Division shall announce, advertise, offer, or in any way publicize any seven digit phone number for use in emergencies. Any use of a seven- digit number for non-emergency ambulance service shall include the phrase "FOR EMERGENCIES, CALL 9-1-1" in capital letters that are at least as big as the letters used for the seven-digit telephone number.

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

(1) The allowable rates that the holder of a competitively granted exclusive permit may charge for providing emergency service shall be established as part of the competitive process and incorporated into the exclusive operating area contract.

(2) The Board of Supervisors may set by resolution the emergency rates that all other ground ambulance permittees may charge for providing emergency service.

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

(1) The permittee shall, at least annually, submit its system status management plan to the Permit Officer for approval. The plan shall identify:

(a) Ambulance station locations;

(b) Posting locations;

(c) Policies and procedures regarding posting or otherwise placing ambulances at locations other than ambulance stations;

(d) The number of ambulances normally available for emergency response by time of day and day of week, with any seasonal variations.

Any changes to the plan shall be submitted to the Permit Officer for approval prior to implementation.

(2) A permittee shall move ambulances to post locations as directed by an approved San Joaquin County EMS Agency dispatch center in order to maximize countywide ambulance availability.

(3) Nothing in this section should be interpreted as precluding a permittee from moving ambulances into different locations on a temporary basis in response to unanticipated circumstances. These shall be reported to the Permit Officer on the next business day.

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