Chapter 5.52 — AMBULANCES

(a)

Administrative Authority: The City Manager of the City of San Marcos or his/her designated representative.

(b)

Ambulance: As used in this chapter, "Ambulance" means any vehicle designed, equipped and used for the emergency and non- emergency transport of the sick or injured persons. Ambulance does not include vehicles "for hire" such as: a gurney van transport, a wheelchair van, or vehicles specifically used to transport the disabled or convalescent from one facility to another.

(c)

Ambulance Attendant: "Ambulance Attendant" means a person who is minimally certified as an Emergency Medical Technician I - Ambulance (EMT-IA) whose primary duty is to care for the sick, injured or disabled persons.

(d)

Ambulance Driver: "Ambulance Driver" means a person properly licensed by the State of California as an ambulance driver and who is minimally certified as an Emergency Medical Technician I - Ambulance (EMT-IA).

(e)

Ambulance Provider: "Ambulance Provider" means a person, firm, partnership, corporation, municipality, government agency or other organization which furnishes or offers to furnish ambulance service to the public, its employees, visitors and/or residents of the City of San Marcos; "Ambulance Provider" includes all organizations that provide or operate an ambulance on their private property whether or not required to do so by local, State or federal law and/or regulation.

(f)

Ambulance Provider's Permit: "Ambulance Provider's Permit means written authorization by the City of San Marcos to provide emergency or non-emergency Ambulance Service within the City of San Marcos.

(g)

Ambulance Service: "Ambulance Service" means the activity, business or service, for hire, profit, or otherwise, of being prepared for, responding to requests for and/or transporting one or more persons by ambulance on or in any of the streets, roads, highways, alleys, or any public way or place in the City of San Marcos.

(h)

Code I, II, or III Calls:

(1)

Code I—Any non-emergency transportation of patients without the use of red light and siren.

(2)

Code II—An emergency where time is critical, requiring immediate response by the Ambulance Provider, without the use of red light and siren.

(3)

Code III—An emergency where time is critical, requiring immediate response with the use of red light and siren.

(i)

Emergency Call: "Emergency Call" means a request for an ambulance to transport or assist persons in apparent sudden need of medical attention; or, an ambulance transport that is initially classified as a Non-emergency call that becomes an Emergency call due to a change in the patient's medical condition; or, in a medical emergency, as determined by a physician to transport blood or any therapeutic device, accessory to such device, or tissue or organ for transplant.

(j)

Emergency Medical Technician I Ambulance (EMT-IA): "EMT-IA" means an individual trained and certified in basic life support care in accordance with the provisions contained in Title 22, California Code of Regulations, Division 9, Chapter 2 et seq.

(k)

Emergency Medical Technician-Paramedic (EMT-P): "EMT-P" means an individual trained and certified in advanced life support care in accordance with the provision contained in Title 22, California Code of Regulations, Division 9, Chapter 4 et seq. and accredited by the Medical Director of the San Diego County Division of Emergency Medical Services.

(l)

Emergency Service: "Emergency Service" means the service performed in response to an Emergency Call. Emergency Service also includes transportation of a patient, regardless of a presumption of death of the patient, or transportation of a body for the purpose of making an anatomical gift, as provided in Section 12811 of the California Vehicle Code, and the California Uniform Anatomical Gift Act.

(m)

Non-emergency Call: "Non-emergency Call" means an ambulance call for a purpose other than an emergency.

(n)

Private Call: "Private Call" means any call for services that is received by an Ambulance Provider directly from a private party.

(o)

Special Event: "Special Event is any situation where a previously announced event, including, but not limited to, concerts, sporting events or contest, and other events that place a grouping or gathering of people in one general locale sufficient in number, or subject to activity that creates the need to have one or more ambulances prepositioned at the event.

(a)

This ordinance shall not apply to vehicles operated as ambulances and to persons engaged in providing service where ambulance services are rendered at the request of any City of San Marcos communications center or at the request of any City of San Marcos law enforcement or fire protection agency during any "state of war emergency", "state of emergency", or "local emergency" as defined in California Government Code Section 8558 or during any period (not over 30 days, but renewable every 30 days) when the City Council or the City Manager or his/her designee has determined that adequate emergency ambulance service will not be available from existing permittees.

(b)

This ordinance shall not apply to vehicles operated as ambulances and to persons engaged in the transport of patients where the transport is initiated outside the San Marcos City limits for transport into the City.

(c)

Agencies of the United States Government operating ambulances are exempted from all portions of this ordinance.

(d)

Government agencies operating ambulances 24 hours per day staffed with full-time paid employees shall be exempted from the application process identified in Sections 5.52.030 through 5.52.080.

No person (either as owner, agent or otherwise) shall furnish, operate, conduct, maintain or otherwise engage in, or offer or profess to engage in Ambulance Service within the boundaries of the City of San Marcos, unless the person holds a currently valid Ambulance Provider's Permit.

Each applicant who desires an Ambulance Provider's Permit for the City of San Marcos shall file with the City Clerk an Ambulance Provider's application form accompanied by a sworn statement setting out the following:

(a)

The names and addresses of the applicant, registered owner(s), partner(s), officer(s), director(s) and all shareholders who hold or control ten percent or more of the stock of the applicant;

(b)

The applicant's training and experience in the transportation and care of patients;

(c)

The name(s) under which the applicant has engaged, does, or proposes to engage in Ambulance Service;

(d)

A description of each ambulance including: the make, model, year of manufacture, vehicle identification number; current State license number; the current odometer reading of the vehicle (including miles that have "turned over" on the odometer); and the color scheme, insignia, name monogram and other distinguishing characteristics of the vehicle;

(e)

A statement that the applicant owns or has under his control, in good mechanical condition, required equipment to consistently provide quality Ambulance Service, and that the applicant owns or has access to suitable facilities for maintaining its equipment in a clean and sanitary condition;

(f)

A description of the applicant's program for maintenance of the vehicles;

(g)

A description of the number and type, frequency and private line codes of the vehicles' radios, and telephone numbers of the vehicles' cellular telephones;

(h)

A description of the locations and housing facilities from which Ambulance Services will be offered, noting the hours of operation and the number of ambulances staffed at each location and available for dispatch to the City of San Marcos;

(i)

A list of all ambulance drivers and attendants which identifies each persons' EMT certification number and issuing county, CPR certification, California Driver's License, and Ambulance Driver's Certificate, with expiration date of each;

(j)

A description of the applicant's training and orientation programs for Ambulance Attendants, dispatchers, and Ambulance Drivers;

(k)

A statement of the legal history of the applicant, registered owner(s), partner(s), officer(s), director(s) and controlling shareholder, including criminal convictions and civil judgment and that the County Sheriff's Department, acting as the City's law enforcement agency, has approved the applicant;

(l)

Certification that the applicant possesses and shall 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 $1,000,000.00 per occurrence, and professional liability, with a limit of not less than $1,000,000.00 per claim. Such insurance shall be primary to and not contributing with any other insurance covering or maintained by the City. The general liability and auto insurance policies shall name the City of San Marcos as an additional insured. Such insurance shall be provided by insurer(s) satisfactory to the City of San Marcos. Evidence of such insurance shall be attached to the application and shall provide that the Administrative Authority is to be given written notice at least 30 days in advance of any modification or termination of any such insurance. The insurance must meet the approval of the City Attorney;

(m)

Acknowledgement that the applicant shall not be granted any Ambulance Provider's Permit unless the applicant obtains and files with the Administrative Authority, 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 Clerk of the City of San Marcos;

(n)

An affirmation that the applicant possesses and maintains currently valid California Highway Patrol Inspection Reports for each vehicle listed in the application, and a copy of the license issued by the Commissioner of the California Highway Patrol (in accordance with Section 2501 of the California Vehicle Code);

(o)

Verification that the permit fees specified by Section 5.52.050 of this chapter have been deposited with the City Clerk;

(p)

The applicant may be required to submit such other information as the Administrative Authority deems necessary for the determination of compliance with this ordinance.

(a)

Upon filing an application for an ambulance operator permit as provided by Section 5.52.040, the applicant shall deposit with the City Clerk the amount of the permit fee provided to be paid in subsection (b), which shall be held by the City Clerk until the City Council shall have authorized the granting of the permit.

(b)

If the City Council determines that the public convenience and necessity warrant the granting of a permit, it shall authorize such permit and the City Clerk shall issue to the applicant such permit, provided the applicant has paid the appropriate business license fee as required by Chapter 5.04, Uniform Licensing Procedures.

(c)

The application for each Ambulance Provider's Permit shall be made upon forms prescribed by the City of San Marcos. The permit or a legible copy thereof shall be carried in the ambulance at all times.

Within 30 days of receipt of a completed application, the Administrative Authority shall make a determination regarding the issuance of the applied for permit.

The Administrative Authority may order the denial of an application for a permit or a renewal thereof if it is determined that:

(a)

The applicant does not meet all the requirements within this ordinance;

(b)

The applicant, or any partner, officer, director, representative or agent thereof has knowingly made a false, misleading or fraudulent statement of a material fact in the application or in any reports or other documents required to be filed with the Administrative Authority pursuant to this ordinance;

(c)

The applicant is not the real owner or operator of the ambulance service;

(d)

The applicant was previously the holder of a permit issued under this ordinance, which permit has been suspended or revoked and the terms and conditions of the suspension or revocation have not been fulfilled;

(e)

The applicant has acted in the capacity of a permitted person or firm under this ordinance without having a valid permit therefore;

(f)

The applicant has entered a plea of guilty to, or been found guilty of, or has been convicted of a felony or a crime involving moral turpitude, including an offense relating to the use of, sale, possession or transportation of narcotics, habit forming drugs or any other

controlled substances, and the time for appeal, irrespective of an order granting probation following such conviction suspending the imposition of sentence, or of a subsequent order under the provisions of Section 1203.4 of the Penal Code allowing such person to withdraw his plea or verdict of guilty, or dismissing the accusation of information; or

(g)

The applicant has violated any provision of this ordinance or any provisions of any other ordinance or law relating to ambulance services.

The Administrative Authority shall notify the applicant in writing of the denial within 30 days of the receipt of the application. Such notice shall be either sent by mail to the applicant's last address provided in the application or be personally delivered, and shall set forth the reasons for such denial of application. The applicant shall also be entitled to the appeal provisions of Section 5.52.170.

Each applicant and Permit owner shall report to the Administrative Authority any change in the data required in Section 5.52.040 within 30 days of the effective date of the change, except that any changes in the data required in 5.52.040(i) need only be reported annually as required by Section 5.52.100 hereof.

Permits issued under this ordinance shall be valid for a period of one year unless earlier suspended, revoked, terminated. Permits may be renewed for successive one-year periods pursuant to the terms of Section 5.52.100 hereof.

Applicants for renewal of an Ambulance Provider's Permit under this ordinance shall annually file with the Administrative Authority an application in writing, on a form furnished by the Administrative Authority, which shall include any changes in the information required in Section 5.52.040 hereof from the current application on file. The application for renewal shall be filed with the Administrative Authority at least 30 days prior to the expiration date of the current permit, and be accompanied by a renewal fee (Business License). Renewal of an Ambulance Provider's Permit shall require conformance with all requirements of this ordinance as upon issuance of an initial permit. Nothing in this ordinance shall be construed as requiring the automatic renewal of a Permit upon its expiration and the burden of proof respecting compliance with all the requirements of this ordinance and of entitlement to a Permit shall be with the applicant for renewal.

The Administrative Authority may authorize a temporary permit to an ambulance provider based outside the City that has received a permit from the County and is properly licensed by the California Highway Patrol up to 30 event days for special events. Temporary Permittees shall meet all requirements of this ordinance.

The Administrative Authority shall have the right to revoke or suspend an Ambulance Provider permit upon any of the following grounds:

(a)

A permit was procured by a false or fraudulent statement of a material fact when such fact, if it had been disclosed, would have constituted a just cause to deny issuance of a permit.

(b)

The permittee fails to keep in force and effect the policy of insurance required by this ordinance.

(c)

The permittee charges rates in excess of those established by the City Council.

(d)

The ambulance service is not furnished on the full hourly schedule set forth in the application for permit.

(e)

The permittee violates or causes or permits to be violated any of the provisions of this chapter, or any other ordinance or law pertaining to the regulation of ambulance services.

(f)

Facts are determined to exist which would provide just cause to deny issuance of a permit in the event the permittee were an original applicant for a permit or renewal thereof.

(a)

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 I- Ambulance (EMT-IA) or EMT-Paramedic ( EMT-P); or be licensed as a physician or registered nurse in the State of California, and shall demonstrate compliance with all applicable County of San Diego and State laws and regulations.

(b)

Each person providing ambulance 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 certification level and comply with the requirements of this ordinance.

(c)

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

(d)

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

(e)

If for any reason an ambulance provider ceases to provide ambulance service on a continuous 24 hours per day basis, any advertisement of emergency services which have been discontinued shall be promptly terminated and said provider shall furnish immediate notification of such discontinuance to the Administrative Authority. Special event permittees shall be exempt from the requirement of 24 hours per day provision of service.

(f)

Ambulance Providers shall cooperate with the Administrative Authority, or his/her designee, in any investigations of possible violations of this ordinance 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.

(g)

The Administrative Authority shall formulate as necessary and reasonable, policies/procedures/protocols covering Ambulance Service operations, equipment, personnel, and standards of response and dispatch for the effective and reasonable administration of this ordinance.

(h)

In the event that more than one Ambulance Provider is issued an Ambulance Operator Permit, the Providers may be required by the Administrative Authority to enter into a separate "Basic Life Support Performance Agreement" to be placed on a "rotational list" of available Providers.

(i)

Ambulance providers on a rotational list shall:

(1)

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 9-1-1 emergency operator;

(2)

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;

(3)

Disclose to any person requesting service that an ambulance is not available for an emergency call;

(4)

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;

(5)

Record all telephone and radio calls for ambulance.

(j)

Ambulance Providers on a rotational list shall be prohibited from engaging in the following activities:

(1)

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;

(2)

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

(3)

Performing ambulance services unless possessing a current, valid Ambulance Provider's Permit;

(4)

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

(5)

Announcing, advertising, or offering ambulance service or advanced life support services without being authorized by the City of San Marcos to provide such service;

(6)

Causing or allowing any ambulance to respond to a location without first receiving a specific request for ambulance service at that location.

The inspection of ambulances is delegated by the City to the California Highway Patrol and the City will accept the list of requirements for ambulances and certificates of inspection issued by the Highway Patrol. The permittee shall provide copies of the these certificates to the City's Administrative Authority after each inspection and issuance by the Highway Patrol.

The City Council shall be, and it is hereby authorized and empowered to establish and keep on file with the City Clerk a maximum rate schedule which may be charged by ambulance providers issued a permit under this chapter. Such rates shall be established by resolution and may be changed from time to time. Permitted Ambulance Providers shall make available upon request the rates for services as provided in this chapter.

Any appeal shall be filed and conducted as prescribed in this section:

(a)

Within 15 calendar days after the date of any denial, suspension, revocation or other notice by the Administrative Authority, an aggrieved party may appeal such action by filing with the City Clerk of the City of San Marcos, a written appeal briefly setting forth the reasons why such denial, suspension, revocation or other decision is not proper.

(b)

Within 30 days after the date of receipt of said appeal the City Clerk shall schedule a hearing before the City Council. At least one week prior to the date of the hearing on the appeal, the Clerk shall notify the appellant and the Administrative Authority of the date and place of the hearing. The City Council is authorized to conduct the hearing on the appeal. At such hearing the Administrative Authority and the appellant may present evidence relevant to the denial, suspension, revocation, or other decision of the Administrative Authority. The City Council shall receive evidence and shall rule on the admissibility of evidence and on questions of law. The formal rules of evidence applicable in a court of law shall not apply to such hearing.

(c)

At the conclusion of the hearing, the City Council may uphold the denial, suspension, revocation, or other decision of the Administrative Authority, or the City Council may allow that which has been denied, reinstate that which has been suspended or revoked, or modify or reverse any other Administrative Authority's decision which is the subject of the appeal. The City Clerk shall within ten days of said hearing forward the decision of the City Council to the appellant, and other interested parties. The decision of the City Council is final.

Any person guilty of violating this ordinance shall be deemed guilty of a misdemeanor and shall be punishable in accordance with Section 1.12.010.

(Ord. No. 93-955, 9-14-93; Amend. of 2-5-2025(1))