Sonoma County Municipal Code § 28-1 Title

The ordinance codified in this chapter shall be known as the "Emergency and Pre-Hospital Medical Services System Ordinance of Sonoma County."

(Ord. No. 6294, § I, 11-12-2019)

This chapter is to provide for the public health, safety and welfare in the use of ambulance and other pre-hospital emergency care resources by providing for the establishment of effective standards for the operation, equipment and personnel of ground ambulance and air ambulance services. It is intended to be consistent with and in furtherance of the public purposes expressed by the legislature in the Emergency Medical Services Act and other enactments. It is intended to improve the availability, quality and to promote the sustainability of emergency medical services provided to the residents of and visitors to Sonoma County. It is intended to recognize the value of the diversity of agencies engaged in the provision of EMS within Sonoma County as well as the diverse needs of the rural and urban communities they serve. It is intended to ensure the coordination of the provision of health care within the out-of-hospital environment in Sonoma County is done in partnership with public safety agencies, public and private ambulance services, hospitals and health care systems as well as allied community partners. It is intended to recognize resources and needs within Sonoma County communities vary from rural to urban settings and to consider the EMS system as a whole in planning and coordination efforts. It is intended to recognize that some EMS services are provided by agencies with additional public safety responsibilities and to ensure consideration where appropriate is given to multi-disciplinary agencies' needs in providing services to their communities. It is intended to apply to basic life support, limited advanced life support services, advanced life support services, paramedic and emergency medical technician services, and all ambulance services, to the extent permitted by law. This chapter is not intended to regulate the provision of wheelchair vans, gurney cars or similar dedicated non-ambulance vehicles. This chapter applies to vehicles or aircraft requiring an emergency vehicle license from the California Highway Patrol, or an air carrier operating certificate from the Federal Aviation Administration. This chapter shall be liberally construed for the accomplishment of these purposes.

(Ord. No. 6294, § I, 11-12-2019)

Unless otherwise specified, for the purposes of this Chapter words and terms are defined as follows:

(1) "Advanced life support" or "ALS"; see "class of service."

(2) "Ambulance" means any privately or publicly owned vehicle especially designed, constructed, modified, equipped, arranged, maintained, and operated for the sole purpose of transporting sick, injured, infirm, convalescent or otherwise incapacitated persons, and expectant mothers.

(3) "Ambulance dispatch center" means any entity that dispatches ambulances in response to requests for service through any means of communication.

(4) "Ambulance service provider" means any person or entity who, for monetary, public service, or other consideration, transports, in one (1) or more air or ground ambulances providing any class of service, one (1) or more persons needing medical attention or services from any location in the county.

(5) "Ambulance service provider permit" means a permit issued by the LEMSA in accordance with LEMSA policy authorizing the holder to act as an ambulance service provider within the county.

(6) "Basic life support" or "BLS"; see "class of service."

(7) "Board" means the board of supervisors, county of Sonoma.

(8) "CCR" means California Code of Regulations

(9) "Class of service" means the level or levels of complexity of field emergency medical services that may be provided by the EMS provider agency and/or certified and/or licensed persons. These are:

(i) Public safety first aid as defined in CCR Title 22, section 100009 provided by peace officers, firefighters and public safety lifeguards not certified at a higher level.

(ii) Emergency medical responder (EMR) ls described as a standard for training promulgated by the National Registry of Emergency Medical Technicians. If the state of California creates an EMR certification standard with substantially similar training and requiring competency under that standard, the meaning of the EMR shall be as defined in HSC and/or California Code of Regulations.

(iii) Basic life support (BLS) as defined in Health and Safety Code section 1797.60 provided at the EMT scope of practice level, as defined in Health and Safety Code section 1797.80.

(iv) Advanced life support (ALS) level care as defined in Health and Safety Code section 1797.56 provided by a paramedic as defined in Health and Safety Code section 1797.84.

(v) "Critical care transport" or "CCT" level care during transport which exceeds the paramedic scope of practice, requiring a higher level of health care licensure.

(10) "County" means the county of Sonoma, state of California.

(11) "Department" means county of Sonoma, department of health services.

(12) "Dispatch steering committee" means a committee established by the legal entity having responsibility for EMS dispatch services. The role of the committee is to establish general and medical dispatch policies with input from the affected agencies.

(13) "Emergency call" means a request for medical care or ambulance transportation to an acute care hospital from a location other than an acute care hospital.

(14) "Emergency medical care council (EMCC)" means the Emergency Medical Care Committee of Sonoma County appointed by the Sonoma County Board of Supervisors pursuant to California Health and Safety Code section 1797.272.

(15) "Emergency medical services" or "EMS" means medical services performed in response to an emergency call.

(16) "EMS aircraft service" means any aircraft service utilized for the purpose of pre-hospital emergency patient response and transport. EMS Aircraft are classified in accordance with CCR Title 22 section 100300.

(17) "EMS dispatch" means the ambulance dispatch center designated by the LEMSA for the dispatch of EMS responders to emergency calls.

(18) "EMS entity" means a public or private organization of any type providing EMS and/or ambulance services within the county.

(19) "EMS system" means a specifically organized arrangement which provides for the personnel, facilities, and equipment for the effective and coordinated delivery of medical care services under emergency conditions, as described in Health and Safety Code section 1797.78.

(20) "Enforcement officer" means a department of health services employee delegated the administrative function of enforcing the provisions of this chapter by, and under the supervision of, the LEMSA medical director and the department.

(21) "EOA" means exclusive operating area as defined in Health and Safety Code section 1797.85.

(22) "Hearing officer" means an administrative law judge from the office of administrative hearings.

(23) "LEMSA" means the local EMS agency established by the county, designated by the board pursuant to Health and Safety Code section 1797.200.

(24) "LEMSA medical director" means the licensed physician and surgeon designated by the county to provide medical control and assure medical accountability throughout the planning, implementation and evaluation of the EMS system in accordance with Health and Safety Code section 1797.202

(25) "Maddy EMS fund" references funding available through Health and Safety Code section 1797.98 which compensates health care providers for emergency medical services for individuals who do not have health insurance and cannot afford to pay for emergency care and for discretionary EMS purposes.

(26) "Medical control" means the medical management of the emergency medical services system pursuant to the Emergency Medical Services System and Pre-hospital Emergency Care Personnel Act of 1980.

(27) "Paramedic service provider agreement (PSPA)" means an agreement between a provider of ALS services and the LEMSA as required by CCR Title 22 section 100168.

(28) "Permit" means an "ambulance service provider permit."

(29) "Permittee" means an ambulance service provider which has been granted a permit by the LEMSA to engage in a business or service in which ambulances are operated.

(30) "Provider agreement" means any agreement between an EMS Entity and the LEMSA specifying terms and conditions for the provision of EMS including, but not limited to, class of service to be provided, LEMSA approval for optional scope of practice, participation in LEMSA data and quality improvement activities and/or performance standards.

(31) "Qualified elected governing entity (QEGE)" means a city, special district providing ambulance services or the county.

(32) "The Act" means the Emergency Medical Services System and Pre-hospital Emergency Care Personnel Act of 1980.

Incorporated by reference are all definitions of Health and Safety Code 1797.50 et seq.

(Ord. No. 6294, § I, 11-12-2019)

(a) The department is designated as the LEMSA for Sonoma County pursuant to the Act.

(b) LEMSA functions shall be the responsibility of the LEMSA medical director. The medical director may assign administrative functions to staff under the supervision of department and the LEMSA medical director.

(c) The LEMSA shall plan, coordinate and monitor the EMS system in conformity with the Act.

a. The Sonoma County Board of Supervisors authorizes the creation of the emergency medical care council (EMCC) as the county emergency medical care committee in accordance with Health and Safety Code section 1797.272

(d) Not less than every five (5) years the director of the department shall retain an outside expert to complete an EMS system review. The review shall consist of an evaluation of the EMS system to include governance, performance and coordination of EMS system participants, and performance of LEMSA oversight functions.

(1) The review shall include, at minimum,

(i) the completion of the EMS plan, and

(ii) a system-wide stakeholder survey.

(2) The EMS system review shall be presented to the EMCC, LEMSA and Sonoma County Board of Supervisors.

(3) The stakeholder survey shall include provider agency partners including hospitals, fire services, ambulance service providers, communications center, base hospital, law enforcement, EMS training programs and community partners. The survey shall at a minimum, assess the relationship between EMS system participants and the LEMSA. Survey results shall be incorporated into the EMS system review and featured in any presentation of the EMS system review to the entities receiving a submission in accordance with this chapter.

(4) In addition to the EMS plan and stakeholder survey, the EMS system review may include areas of evaluation requested by the EMCC or department director.

(5) The EMCC may request EMS system review on a more frequent schedule than every five (5) years. In no case shall an EMS system review occur more than annually. If an EMS system review is requested outside of the five-year cycle, the outside expert shall complete an EMS plan update in place of an EMS plan submission.

(6) EMS system reviews performed more frequently than every five (5) years shall be at the discretion of the department director or Sonoma County Board of Supervisors.

(Ord. No. 6294, § I, 11-12-2019)