Victorville Municipal Code Ch. 3.64 Ambulance Service

Unless otherwise stated, words and terms are defined as follows:

"Advanced life support (ALS) or limited advanced life support (LALS) ambulance" means an ambulance which has additional equipment and supplies as specified by the local EMS agency.

"Ambulance" means any privately or publicly owned vehicle specially designed, constructed, modified, equipped, arranged, maintained and operated for the sole purpose of transporting persons requiring emergency medical treatment or transportation, including those who are sick, injured, wounded or pregnant. Any vehicle designated as an ambulance shall further be equipped so as to meet or exceed the definition of ambulance as found in California Code of Regulations, Title 13, Chapter 5, Article 1, Sections 1100.2 and 1103.2, Ambulance Equipment.

"Ambulance attendant" means a qualified person acting as an attendant on an ambulance which is transporting a patient and who occupies the patient compartment.

"Ambulance service" means any private or public corporation, partnership, association, individual or agency which operates one or more ambulances or other medical transportation means.

"Ambulance service operator" means the manager, director or officer who directs an ambulance service.

"Basic life support (BLS) ambulance" means an ambulance which has equipment and supplies as specified in Title 13, California Administrative Code.

"City council" means the City Council of the city of Victorville.

"City manager" means the city manager of the city of Victorville or his authorized representative, including any officer or employee of the city.

"Driver" means a qualified person who operates an ambulance, as specified by Section 3.64.140 of this chapter.

"Emergency medical technician-I (EMT-I)" means a person trained and certified in all aspects of basic life support according to standards prescribed by Division 2.5 of the Health and Safety Code.

"Emergency medical technician-paramedic (EMT-P)," "paramedic" or "mobile intensive care paramedic" means a person specially trained and certified to provide advance life support according to standards prescribed by Division 2.5 of the Health and Safety Code.

"Level of service" means the complexity of field emergency medical services that may be provided by franchisee and will be specified as basic life support provided by emergency medical technician I (EMT-I) personnel conforming to California Health and Safety Code Section 1797.170. Full advance life support provided by California licensed physician or by paramedics certified by the medical director of the local emergency medical services agency under California Health and Safety Code, Section 1797.172.

"Medical emergency" means an unforeseen and non-pre-arranged occurrences demanding an immediate need for pre-hospital treatment and transportation.

"Mobile intensive care nurse (MICN)" means a nurse who has been certified by the medical director of the local EMS agency as qualified in the issuance of emergency instructions to EMT-Ps.

(Ord. 1843 § 1, 1997; Ord. 1736 § 2, 1995; Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

It is unlawful for any person, either as owner, agency or otherwise, to operate, conduct, advertise or otherwise engage in or profess to be engaged in the business or service of the transportation of medical emergency patients upon the streets or any public way or place in the city, except in conformance with a valid franchise to do so issued by the city, with the following exceptions:

(1) The licensing and franchise requirements shall not apply to vehicles operated as ambulances at the request of local authorities during any emergency as defined in the California Emergency Services Act (Chapter 7 of Division 1 of Title 2 of the Government Code);

(2) Ambulances based in adjoining or neighboring cities, unincorporated areas, counties or states which are operating under appropriate regulatory agencies within the adjacent or neighboring cities, unincorporated areas, counties or states.

(Ord. 1843 § 2 (part), 1997; Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

The granting of franchises under the terms of this chapter will be by resolution following a public hearing before the City Council.

(1) The City Council may order the issuance of one or more franchise(s) to provide ambulance service within the jurisdiction of the city upon a finding that the public health, safety, welfare, convenience and necessity require the availability of such ambulance services and that the applicant meets all requirements of this chapter.

(2) The City Council may order the denial of a franchise on the grounds of infeasibility. Whenever a new application is filed under the provisions of this chapter for a franchise to provide ambulance service within the city limits when services already exist, the City Council may determine, after due investigation by the city manager that, as a matter of fact, there does not exist in the city sufficient potential need for ambulance service to justify the granting of an additional, separate and distinct, franchise for use within the city limits. Predicated on this, the City Council may deny the application as being economically and financially unsound and not in the public interest and welfare.

(3) The granting of a franchise is conditioned upon the grantee's filing with the City Clerk of the city within ten days, a written acceptance thereof agreeing to comply with the terms and conditions of this chapter.

(4) The City Council declares that public convenience, necessity and welfare requires a minimum of three ALS transporting ambulances to be maintained by each franchisee; such ambulances will be operated from locations within the city. These three ALS transporting ambulances will be operated exclusively within the city and be dispatched exclusively by the Desert Communications Center. Exception to the exclusive operation within the city will be automatic aid agreements with County Service Area 38, otherwise known as Spring Valley Lake, Mountain View Acres, Baldy Mesa and Oak Hills.

(5) Before any franchise is issued under the provisions of this chapter, the City Council shall require the applicant, as a condition of the issuance of the franchise, to post with the city manager a cash bond in the sum of two thousand five hundred dollars or a surety bond payable to the city in the same amount furnished by a corporation authorized to do business in the State of California. The bond shall be conditioned upon the full and faithful performance by the franchisee of his or her obligation under the applicable provision of this chapter and shall be kept in full force and effect by the franchisee throughout the life of the franchise and all renewals thereof. The City Council, upon recommendation of the city manager, from time to time may, by resolution, establish such additional or lower bond requirement for individual franchise holders as may be deemed necessary in the event it is determined the foregoing bond requirements constitute insufficient or more than sufficient protection to the city, as the case may be. The bond requirement may be waived by the City Council if public need and necessity require it.

(6) The franchisee shall obtain and keep in force during the term of the franchise, public liability and bodily injury insurance issued by a company authorized to do business in the State of California, insuring the owner of such ambulance and also naming the city as an additional insured against loss by reason of injury or damage that may result to persons or property from negligent operation or defective maintenance of such ambulance, or from violation of this chapter or San Bernardino County Emergency Medical Agency protocols or of any other law of the state or the United States. The policy shall be in the sum of not less than two million dollars for personal injury to or death of any one person in any single accident; and the limits of each such vehicle shall not be less than five hundred thousand dollars for damages to or destruction of property in any one accident. Worker's compensation insurance shall be carried covering all employees of the franchise holder. Before the city manager shall issue a franchise, copies of the policies or certificates evidencing such policies shall be filed with the City Clerk. All policies shall contain a provision requiring a thirty-day notice to be given to the city prior to cancellation, modification or reduction in limits. The amounts of public liability insurance for bodily injury and property damage shall be subject to review and adjustment at the city's option.

(Ord. 1843 § 2 (part), 1997; Ord. 1736 §§ 1, 3, 1995; Ord. 1638 § 1, 1993; Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Franchise fees shall be established by council resolution on an annual basis. Franchise fees shall become due on July 1st of each year. The annual fee may be prorated on a quarterly basis. Franchise fees may be waived by the City Council if public need and necessity require it.

(Ord. 1736 § 4, 1995: Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Prerequisites to the issuance of a franchise or renewal of a franchise for an applicant shall including the filing with the city an application in writing on a form to be furnished by the city which shall provide the following minimum information:

(1) Name and description of applicant;

(2) Business address and residence address of record of the applicant;

(3) Trade or firm name, or DBA as recorded;

(4) If a corporation, a joint venture or a partnership or limited partnership, the names of all partners, both general and limited, or the names of corporate officers, their permanent addresses and their percentage of ownership of the business;

(5) A statement of facts showing the experience of the applicant in the operation of an ambulance service and that the applicant is qualified to render efficient twenty-four-hour ambulance service. A photocopy of the license issued by the Commissioner of the California Highway Patrol to privately owned ambulances shall be provided to the city prior to the start of ambulance operations;

(6) The level or levels of service which the applicant proposes to provide;

(7) A statement that the applicant owns, or has under his or her control, all equipment required to adequately conduct an ambulance service in the territory or service area for which he is permitted, which meets the requirements established by the California Vehicle Code and the local EMS authority, and that the applicant owns, or has access to, suitable and safe facilities for maintaining his ambulance service in a clean, sanitary and mechanically sound condition;

(8) For any renewal applications which have been amended as required during the year for any changed, substituted, loaned or leased vehicles, a list giving a complete description of each ambulance vehicle operated by the applicant, including the patient capacity thereof, and a copy of the most recent ambulance inspection report issued by the California Highway Patrol for each vehicle;

(9) For initial and renewal applications, an affirmation that each permitted ambulance and its appurtenances conform to all applicable provisions of this chapter, the California Vehicle Code, the California Administrative Code and any other applicable state laws and directives;

(10) A statement that the applicant employs sufficient personnel adequately certified and available to deliver ambulance services of good quality at all times as set forth in this chapter;

(11) A statement signed by the applicant that as a condition of the city's issuance of a franchise, applicant agrees to appear and defend all actions against the city arising out of the exercise of said franchise, and shall indemnify, defend and hold the city, its officers, employees and agents harmless of and from all claims, demands, actions or causes of actions of every kind and description directly or indirectly, arising out of, or in any way connected with exercise of this permit.

(Ord. 1843 § 2 (part), 1997; Ord. 1376 § 5, 1995)

(Ord. No. 2303, § 1, 12-3-2013)

Upon receipt of a completed new application, the city manager shall conduct an investigation to determine if the public health, safety, welfare, convenience and necessity require the granting of a franchise and shall further determine if the applicant meets all requirements of the chapter. Upon completion of his or her investigation, the city manager shall recommend to the City Council that a franchise be granted or denied. No franchise shall be issued by the city manager until the City Council has determined that the public health, safety, welfare, convenience and necessity require the granting of such franchise.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

The franchise shall specify the dates of issuance and of expiration, the number of ambulance units to be used by the franchisee, the level or levels of service to be provided and any special conditions regarding communication, equipment, personnel, rates for special services or waiver of requirements deemed appropriate by the city manager.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Upon request by the franchisee, the city manager may amend the conditions specified in a franchise if he or she finds such changes in substantial compliance with the provisions of this chapter. Such amendment shall not affect the expiration date of the existing franchise, nor shall it authorize a change in ownership from that specified in the original franchise.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Franchises shall be renewed annually by the city manager upon application of the franchise holder, if the franchise holder proposes no substantial change in the content of the franchise, and if the city manager determines that the franchise holder has, during the period of the expiring franchise, operated in conformity with the provisions of this chapter and the rules and regulations of the city and that the franchise holder is capable of continuing operation in conformity with the rules and regulations of this chapter.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

The city manager, after conducting a hearing, shall be empowered to suspend or revoke the franchise to operate an ambulance service issued under the provisions of this chapter, when it has been found after investigation that the franchisee or any partner, officer or director of the franchise:

(1) Violated any section of this chapter, or the emergency medical services plan for the county or any rules or regulations that are promulgated by the county department of public health, the city, or San Bernardino County Emergency Medical Agency which relate to the franchise activities;

(2) Has been convicted of any felony;

(3) Has been convicted of any misdemeanor involving moral turpitude or commits an act involving moral turpitude;

(4) Has been convicted of any offense relating to use, sale, possession or transportation of narcotics or habit-forming drugs;

(5) Has committed any act involving dishonesty, fraud or deceit;

(6) Has misrepresented a material fact in obtaining a franchise, or is no longer adhering to the conditions specified in his or her franchise;

(7) Aids or abets an unlicensed or uncertified person to evade the provision of this chapter.

(Ord. 1843 § 2 (part), 1997; Ord. 1736 § 6, 1995; Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Each ambulance service operator shall provide emergency ambulance service of the level or levels specified in his or her franchise on a continuous twenty-four-hour per day basis, excluding acts of God or labor disputes. If, for any reason, an operator stops providing the prescribed level or levels of ambulance service on a continuous twenty-four-hour per day basis, he or she shall immediately stop any advertisement of emergency services and immediately notify the city manager.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Each ambulance service receiving an emergency ambulance request from a private person shall dispatch an ambulance in compliance with the procedures identified in Title 13, California Administrative Code. If an ambulance is not available for immediate dispatch, the procedures identified in Title 13, California Administrative Code, shall be complied with.

(1) Desert Communication Center shall dispatch all emergency responses occurring within the city limits.

(2) A response time of no greater than ten minutes shall be maintained ninety percent of the time for the first requested ambulance. Requests for consecutive ambulances shall be provided by the next closest available unit.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Ambulances shall be maintained at all times in good mechanical repair and in a clean and sanitary condition.

(1) Minimum Equipment. ALS ambulances shall be equipped with all safety and emergency equipment required for ambulances by the California Vehicle Code and the California Administrative Code and administrative rules of the County Health Officer and ICEMA as the same are now written, or hereafter amended.

(2) ALS Ambulance Equipment. In addition to the regular ambulance equipment and supplies, the ALS ambulances shall also be equipped as required by the California Vehicle Code and the California Administrative Code and administrative rules of the county health officer and ICEMA.

(3) Maintenance of Emergency Equipment and Supplies. Dressings, bandaging, instruments and other medical supplies used for care and treatment of patients shall be protected so they are sterile when ready for use. Provisions shall be made to assure autoclaving or resterilization of emergency equipment when required.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Every person who operates an ambulance within the city while responding to emergency calls shall comply with the requirements of the California Administrative Code for ambulance drivers. The driver of an ambulance shall be trained and competent in the proper use of all emergency equipment required by this chapter. The driver shall also hold a certificate as an EMT-I, EMT-II, or EMT-P.

(1) Ambulance Attendant. An ambulance attendant shall hold the required certification as an EMT-P issued by the medical director of the local EMS agency for ALS ambulances.

(2) Attendant Required. Each ambulance being operated within the city, in response to an emergency call, shall be staffed by both a driver and attendant, unless the ambulance service operator has been exempted. The attendant of an ambulance responding to an emergency call shall occupy the patient compartment while transporting any person.

(3) An ambulance driver or ambulance attendant who is a California-licensed physician shall be exempt from the emergency medical training requirement of this section.

(Ord. 1843 § 2 (part), 1997; Ord. 1736 § 7, 1995; Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

No ambulance service shall charge more than the following rates:

(1) One Patient. The schedule of maximum rates that may be charged for ambulance service for one patient shall be as initially set by resolution adopted by the City Council and as adjusted thereafter as provided in this chapter.

(2) Two or More Patients. If the service entails the transport of more than one patient, the total costs of this service will be the base charge plus an amount equal to half the base charge for each additional patient transported. Total charge for the service shall be divided equally between/among the patients. Each additional sit-up patient shall be charged one-quarter the base rate for response to the call.

(3) For group loads from the same origin to the same destination, franchisee shall divide the total mileage rate equally among all the patients.

(4) No charge shall be made for uninjured or well persons who accompany a patient.

(5) All rates are to be computed from the time the ambulance arrives for hire until the ambulance is discharged by the patient or his representative, attending physician or emergency receiving facility.

(6) A schedule of rates, including rates for special services, shall be posted in a conspicuous place within each ambulance.

(7) The schedule of maximum rates shall be adjusted by the city manager on an annual basis on or about April 15th. The adjustment and any change of rates resulting therefrom shall be arrived at by the application of a formula that shall utilize the Ambulance Cost Index (ACI) computed with industry- specific cost component weights and a revenue adjustment that considers variations in the payment mechanism. The formula for such adjustments shall be approved by the City Council as part of regulations for the implementation of this chapter. If there are unusual cost or revenue variances such as those caused by an act of God, labor dispute disruptions or other unusual conditions, a franchisee, or franchisees, may apply to the city manager for an adjustment in addition to any annual adjustment. Such additional adjustment by the city manager shall be computed by application of the formula mentioned above. Any rate referred to herein shall not be effective until such time as it has been approved by the City Council in a public hearing.

(8) Proposed rates for special services, or proposed changes in such rates shall be submitted to the city manager for review. Such rates shall be approved by the city manager before becoming a part of any franchise and before being charged by any franchisee. The city manager shall approve proposed rates for special services, or proposed changes in such rates, if he or she finds that such rates are reasonable in relationship to the cost of providing the special services. Any rate referred to herein shall not be effective until such time as it has been approved by the City Council in a public hearing.

(9) Under no circumstances shall ambulance personnel attempt to collect for the service prior to its being delivered.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

The city manager may authorize a temporary operating franchise to an ambulance service based and properly licensed by the California Highway Patrol outside the city up to thirty days for special activities. Such temporary operating franchise shall conform to the requirements of Section 3.64.070 and shall contain such additional conditions and restrictions that the city manager deems appropriate for the operation.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Any user or subscriber to an ambulance service contending that he has been required to pay an excessive charge for service or that he has received unsatisfactory services may file a written complaint with the City Clerk setting forth such allegations. The city shall notify the ambulance service of such complaint, and the city manager or his designee shall investigate the matter to determine the validity of the complaint. If the complaint is determined to be valid, the city shall take reasonable and proper actions to secure compliance with the conditions of this chapter.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

Any fire department or ambulance personnel contending that medical service rendered is insufficient or unsatisfactory may file a written complaint with his supervisor setting forth such allegations. The fire chief or ambulance company manager shall investigate the matter to determine the validity of the complaint. The city shall take reasonable and proper actions to secure compliance with the conditions of this chapter.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)

The city manager shall make all necessary and reasonable rules and regulations subject to the approval of the City Council, covering ambulance service operation, ambulance equipment, ambulance vehicles, ambulance personnel and rates for the effective and reasonable administration of this chapter. The city manager shall inspect the records, facilities, vehicles, equipment and methods of operation whenever such inspections are deemed necessary.

(Ord. 1373 § 2 (part), 1989)

(Ord. No. 2303, § 1, 12-3-2013)