Tracy Municipal Code Ch. 3.32 Ambulance Services

For the purposes of this chapter, unless otherwise apparent from the context, certain words and phrases used in this chapter are defined as follows:

(a) "Ambulance" shall mean a vehicle specially constructed, modified, or equipped and used for the purpose of transporting sick, injured, convalescent, infirm, or otherwise incapacitated persons. "Ambulance" shall not include the non-emergency transportation of persons confined to wheelchairs.

(b) "Ambulance service" shall mean the activity, business, or service, for hire, profit, or otherwise, of 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 County.

(c) "Ambulance provider" shall mean a person, firm, partnership, corporation, or other organization which furnishes or offers to furnish ambulance service within a zone.

(d) "Ambulance driver" shall mean a person who is properly licensed by the State as an ambulance driver and who is minimally certified as an Emergency Medical Technician I - Ambulance (EMT-I A).

(e) "Ambulance attendant" shall mean a person who is minimally certified as an Emergency Medical Technician I — Ambulance (EMT-I A) whose primary duty is to care for sick, injured, or disabled persons while they are being transported in an ambulance.

(f) "Ambulance station" shall mean the premises (including living quarters) located within an ambulance zone from which the ambulance provider renders service to such zone.

(g) "Emergency response zones" shall mean the areas shown on the map entitled "Emergency Response Zones of San Joaquin County", on file in the office of the Sheriff and the Clerk of the Board, and as it may be changed from time to time by the County Board of Supervisors.

(h) "Emergency response area list" shall mean that list of permittees for each emergency response area who possess an emergency ambulance service permit.

(i) "Emergency call" shall mean a request for an ambulance to transport or assist persons in apparent sudden need of medical attention 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) "Non-emergency call" shall mean an ambulance call for a purpose other than an emergency.

(k) "Emergency service" shall mean the service performed in response to an emergency call. "Emergency service" shall also include the transportation of a patient, regardless of a presumption of the death of the patient, or the transportation of a body for the purpose of making an anatomical gift, as provided in Section 12811 of the Vehicle Code of the State and the Uniform Anatomical Gift Act of the Health and Safety Code.

(l) "Private call" shall mean any call which is received by the ambulance provided directly from a private party for services.

(m) "Dry run" shall mean any ambulance response made as a result of an emergency call whereupon, after responding to such call, it is found no ambulance is needed.

(n) "Permit Officer" shall mean the Director of Health Care Services or his designee.

(o) "Ambulance operator's permit" shall mean written authorization by the County to provide ambulance service within the County.

(p) "Emergency ambulance service permit" shall mean written authorization by the County to provide emergency ambulance service within the County specified ambulance response zones.

(q) "Emergency Medical Technician Paramedic" (EMT-P) shall mean an individual trained and certified in advanced life support care in accordance with the provisions contained in Division 2.5 of the Health and Safety Code of the State and such additional requirements as the San Joaquin County EMS agency may adopt.

(r) "Emergency Medical Technician I Ambulance" (EMT-I A) shall mean an individual trained and certified in basic life support care in accordance with the provisions of Divisions 9 et seq. of Title 22 of the California Administrative Code.

(Prior code § 3-8.01)

No person shall engage in the business of operating an ambulance on the streets of the City without first obtaining a permit from the County upon forms prescribed by the Permit Officer. No permit shall be granted until the County declares by resolution that the public convenience and necessity require the proposed service and that the same will promote the convenience, safety, and welfare of the general public. All business license taxes shall be paid as provided in Title 6 of this Code.

(Prior code § 3-8.02)

Applications for the permits required by this chapter shall contain the following data:

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

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

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

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

(e) A description of each ambulance, including the make, model, year of manufacture, and vehicle identification number; the current State license number; the length of time the vehicle has been in use; and the color scheme, insignia, name monogram, and other distinguishing characteristics of the vehicle;

(f) 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 his equipment in a clean and sanitary condition;

(g) A description of the company's program for the maintenance of the vehicles and a description of the number and type, frequency, and private line codes of the vehicles' radios;

(h) A list, amended as required during the year for any personnel changes, giving the name and a description of the training for each ambulance attendant and driver and a copy of each certificate or license issued by the State or County establishing the qualifications of such personnel in the ambulance;

(i) A description of the company's training and orientation programs for attendants, dispatchers, and drivers;

(j) A statement of the legal history of the applicant, including criminal and civil convictions;

(k) Each applicant who desires an emergency ambulance service permit, in addition to the information required in this section, shall show the ability to provide emergency ambulance service twenty-four (24) hours per day, seven (7) days per week, year round;

(l) All service charges and the rate structure of the company;

(m) Whether the service will include advanced life support service and, if so:

(1) The number of advanced life support units to be deployed on each shift; and

(2) The provisions, if any, for the continuing education of the advanced life support personnel;

(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 to privately owned ambulance companies (in accordance with Section 2501 of the Vehicle Code of the State) shall be submitted;

(o) Evidence of insurance coverage as required by this chapter; and

(p) The applicant may be required to submit such other information as the Permit Officer deems necessary for the determination of compliance with this chapter.

(Prior code § 3-8.03)

(a) Upon the receipt of a completed application and the required fee, the Permit Officer shall make, or cause to be made, such investigation to determine that the radio in each vehicle is installed, is in good working order, and is integrated with the existing medical communications system.

(b) The City Manager may direct the Chief of Police to cause a separate investigation to be made, and file a report, within thirty (30) days after the date of the filing of the application. The Chief of Police may require the applicant or any person named within the application to be fingerprinted and photographed.

(Prior code § 3-8.04)

Upon the filing of a fully-completed application for a permit to engage in the business of the operation of an ambulance and the receipt of the report of the Permit Officer and/or Chief of Police, the City Manager may present the application to the Council which shall fix a time for a public hearing thereon for the purpose of determining whether the public convenience and necessity require the proposed service. No permit shall be granted until the Council, after an investigation and hearing, shall declare by resolution that the public convenience and necessity require the proposed service and that the same will promote the convenience, safety, and welfare of the general public.

(Prior code § 3-8.05)

(a) Liability insurance required. The permittee shall obtain and keep in force during the term of the permit comprehensive automobile liability insurance and professional liability insurance, issued by a company authorized to do business in the State, insuring the owner against loss by reason of injury or damage which may result to persons or property from the negligent operation or defective construction of such ambulance or from violations of this chapter or any other law of the State or the United States. Such comprehensive automobile liability policy shall be in the sum of not less than Five Hundred Thousand and no/100ths ($500,000.00) Dollars for combined single limit bodily injury and property damage. Such professional liability insurance shall be in the sum of not less than One Million and no/100ths ($1,000,000.00) Dollars combined single limit bodily injury and property damage.

(b) Additional insured. The permittee shall maintain an insurance policy which contains an endorsement naming the County and the cities which have adopted this chapter and in which the permittee provides service as an additional insured for general liability.

(c) Hold harmless. The provider shall indemnify, defend, and hold harmless the County, and the affected cities, and its officers, agents, and employees from all claims, demands, or liability arising out of or encountered in connection with this chapter or performance under it, whether such claims, demands, or liability are caused by the provider or the provider's agent or employees, excepting only such injury or harm as may be caused by the County's fault or negligence. Such indemnification shall extend to claims, demands, or liability for injuries occurring after performance under the permit required by this chapter as well as during the performance of such permit.

(d) Workman's Compensation Insurance. All employees of the permittee shall be covered by a Workman's Compensation Insurance policy.

(e) Notices of cancellation. Insurance policies shall contain a provision requiring a thirty (30) day notice to be given to the Permit Officer prior to cancellation, modification, or reduction in limits.

(f) Evidence of insurance. Before a permit is issued and during the term of the permit, a certificate of insurance indicating compliance with all insurance requirements shall be filed with the Permit Officer.

(g) Modifications to insurance requirements. The Permit Officer, in concurrence with the City, may grant a waiver from the professional liability insurance requirements of One Million and no/100ths ($1,000,000.00) Dollars to Five Hundred Thousand and no/100ths ($500,000.00) Dollars for a period not to exceed sixty (60) days.

(Prior code § 3-8.06)

Written notice of the hearing required by Section 3.32.050 of this chapter shall be given to all persons to whom permits for the operation of ambulances have been theretofore issued. Due notice of the time and place of the public hearing before the Council shall also be given to the general public by causing a notice of such hearing to be published in a newspaper of general circulation in the City at least ten (10) days before the hearing.

(Prior code § 3-8.07)

No permit for the operation of an ambulance may be sold, assigned, mortgaged, or otherwise transferred without the consent of the Council. An application for the transfer of any license for an ambulance shall be subject to the same terms, conditions, and requirements as the application for an original license.

(Prior code § 3-8.08)

The owner of any ambulance operating in the City shall file with the City and County a true and correct schedule of the rates to be charged for the transportation of passengers in all vehicles operated by such owner. Such rates shall not be changed or modified in any manner without complying with the resolution setting ambulance rates adopted by the County Board of Supervisors. Additionally, the Council may approve the rates ambulance providers may charge for providing services under this chapter.

(Prior code § 3-8.09)

(a) Drivers and attendants. Any ambulance attendant or driver utilized by a permittee shall be at least eighteen (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-I A); and shall demonstrate compliance with all applicable State laws and regulations.

(b) Certificates required. Every ambulance driver and attendant utilized by a permittee shall hold a certificate from the Permit Officer indicating compliance with the requirements of this section. A temporary certificate may be issued pending confirmation of all personnel requirements.

(c) Criminal investigations. All applicants for ambulance driver/ attendant certification shall undergo a complete criminal history record check prior to the issuance of a permanent certificate.

(d) Term. The certificate shall remain in effect for a maximum period of two (2) years.

(Prior code § 3-8.10)

Each person providing ambulance service subject to a permit pursuant to this chapter shall staff each ambulance with appropriate personnel who shall wear clean uniforms, be neat, and comply with the requirements of this chapter.

(Prior code § 3-8.11)

Each person providing ambulance service subject to a permit pursuant to this chapter shall assign at least one person to be responsible for receiving calls and dispatching ambulances.

Persons holding emergency ambulance service permits pursuant to this chapter shall provide such dispatch services on a twenty-four (24) hour per day basis and shall train the dispatcher in accordance with a curriculum developed by the Permit Officer to radio operation and protocol and to the emergency response zones served before such dispatcher begins dispatching emergency calls.

(Prior code § 3-8.12)

(a) Identification. Each person providing ambulance service subject to a permit pursuant to this chapter shall wear while on duty an identification badge issued by the Permit Officer which badge is clearly visible to the public. The badge shall identify the training and certification status of the attendant or driver. The badge shall be turned back to the Permit Officer in the event of changes of information on the badge.

(b) Responses. The on-duty ambulance driver and attendant responding to emergency calls shall be based at the ambulance provider's station within the zone of response on a twenty-four (24) hour basis. Voluntary ambulance services shall be exempt, but personnel shall be available within the zone of response.

(c) Exemptions. An ambulance driver or ambulance attendant who is a State licensed physician, Mobile Intensive Care Nurse, Authorized Registered Nurse, or EMT-P with certification by the EMS Medical Director shall be exempt from the emergency medical training requirements set forth in section 3.32.100 of this chapter.

(Prior code § 3-8.13)

(a) Required. Every emergency ambulance shall carry a valid California Highway Patrol Inspection Report authorizing the use of the vehicle as an ambulance.

(b) Inspections. The ambulance provider shall allow the Permit Officer or his designee to inspect, on a pre-announced or unannounced basis, all ambulances used to provide ambulance service. The inspections should be held, whenever possible, during normal business hours. The purpose of such inspections may include, but shall not be limited to, determining if:

(1) The ambulance is properly maintained and equipped for the provision of ambulance services;

(2) The description of the ambulance required by section 3-8.01 of this chapter is accurate; and

(3) The ambulance contains radios; that the radios are in good working order; and that the radios are compatible with the emergency medical communications system.

(Prior code § 3-8.14)

(a) Each ambulance provider shall establish a separate ambulance station within each zone within which such ambulance provider is authorized to operate. Such ambulance station shall be located to provide the minimum response time, considering the traffic and street patterns, to any location within the zone. All such locations shall be approved by the Permit Officer, shall comply with all applicable zoning and building regulations, and shall be maintained in safe and sanitary conditions.

(b) Each ambulance station shall be adequate to house all drivers and attendants required for such ambulances.

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

(Prior code § 3-8.15)

No ambulance service permittee pursuant to this chapter shall cause or allow its ambulances to respond to a location without first receiving a specific request for such service at such location.

Ambulance service permittees shall cooperate with the Permit Officer, or his designee, in any investigation of possible violations of this section and shall make all dispatch logs and similar dispatch records available for inspection and copying at reasonable times at the permittee's regular place of business.

(Prior code § 3-8.16)

The Permit Officer shall make necessary and reasonable rules and regulations covering ambulance service operations, ambulance transport equipment, ambulance personnel, and standards of dispatch for the effective and reasonable administration of this chapter.

(Prior code § 3-8.17)

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

(b) An ambulance provider shall provide the Permit Officer with information in reference to any pending action or unpaid judgment or lien against the provider and the notice of the transactions or acts giving rise to such judgment or lien. The ambulance provider shall notify the Permit Officer in writing of such actions within one week after the notification from the levying agency. The reported information will be reviewed by the Permit Officer who will make a determination regarding the effect such information will have on the agency's ability to provide continuous service in accordance with subsection (k) of section 3-8.03 of this chapter.

(Prior code § 3-8.18)