HomeMy WebLinkAboutORD FOR INTRODUCTION 12-02-85 ..... ORDINANCES FOR INTRODUCTION
NO. 1
DATE: December 2, 1985
TO:
FROM:
S U BJ ECT:
HONORABLE I~YOR AMD CITY COUNCIL
COMMUNITY DEVELOPMENT DEPARTMENT
URGENCY ADOPTION OF ORDINANCE NO. 953 AND FIRST READING OF
ORDINANCE NO. 955 FOR ADOPTION OF NEH MODEL AMBULANCE ORDINANCE
RECOI~ENDED ACTION:
MoO.
M.O.
M.O.
M.O.
M.O.
M.O.
That Ordinance No. 953 have first reading by title only.
That Ordinance No. 953 be introduced.
That Ordinance No. 953 have second reading by title only.
That Ordinance No. 953 be passed and adopted as an urgency ordinance.
That the First Amendment to the agreement to provide licensing and
regulation of ambulance service and convalescent transport be signed for
submittal to the Orange County Board of Supervisors.
That Ordinance No. 955 have its first reading by title only.
That Ordinance No. 955 be introduced.
SUN4ARY:
As a result of recent antitrust court actions (Community Communications Co. vs.
City of Boulder 1982, wherein a government entity's ability to franchise was
proved illegal), the Board of Supervisors directed the County Emergency Medical
Services (EMS) staff to draft a new Ambulance Ordinance with the following
policy guidelines:
Deregulation of non-emergency ambulance services.
Setting a maximum rate for emergency transport service.
Development of an objective commpetitive mechanism whereby contracts for
emergency response areas may be awarded.
Prior to final adoption by the Board of Supervisors, the draft Ordinance was
extensively reviewed throughout the community. The result of this process is a
viable and functional Ordinance approved by the Board of Supervisors effective
January 1, 1986.
ANALYSIS AND CONCLUSIONS:
The objectives for the new model ordinance were to: deregulate the ambulance
services, streamline licensing procedures and provide optimum and standardized
care with a minimum of cost. Should the city adopt this new ordinance, all
licensing procedures and service regulation will be provided by the County EMS.
~/'~City Council
December 2, 1985
page two
The COunty Fire Department handles all proposal procedures and evaluates each
service provider. At this time, the Fire Department is preparing a
recommendation for review and approval prior to January 1, 1986.
This new ordinance must be in effect and an ambulance provider approved by
January 1, 1986. At this time, it is necessary to adopt this as an urgency
ordinance. The first reading and introduction of this as a regular ordinance is
also necessary to avoid any lapse in service once the urgency ordinance expires.
Assistant Planner
LP:do
attach:
City agreement authorizing County to provide licensing services
Ordinance No. 953
Ordinance No. 955
Community Development Department
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FIRST AMENDMENT
TO AGREEMENT
TO PROVIDE LICENSING AND REGULATION OF
AMBULANCE AND CONVALESCENT TRANSPORT SERVICE
THIS FIRST AMENDMENT is made to that certain Agreement dated
August 5, 1980, hereinafter referred to as the "Agreement," by and
)etween the COUNTY OF ORANGE, a political subdivision of the State
of California, and the CITY OF TUSTIN.
1. All references in the Agreement to the "Health Officer"
are hereby changed to refer to the "Health Care Agency."
2. Any reference in the Agreement to convalescent transport
services, or the licensing thereof, is hereby deleted.
IN WITNESS WHEREOF, the parties have executed' this First
Amendment to the Agreement.
DATED:
SIGNED AND CERTIFIED THAT A
COPY OF THIS DOCUMENT HAS BEEN
DELIVERED TO THE CHAIRMAN OF
THE BOARD
COUNTY OF ORANGE
By-
Chairman of the Board of
Supervisors
LINDA D. ROBERTS
Clerk of the Board of
Supervisors
DATE:
TFN :wi :D: 11/20/85: (527A)
CITY OF TUSTIN
By:
Title:
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ORDINANCE NO. 953
AN URGENCY ORDINANCE OF THE CITY COUNCIL OF THE CITY OF TUSTIN,
CALIFORNIA, REPEALING PART 2, SECTIONS 3421 THROUGH 3429.6,
CHAPTER 4, ARTICLE 3 OF THE TUSTIN MUNICIPAL CODE AND
ESTABLISHING N~ REQUIREMENTS FOR THE OPERATION OF
AMBULANCES IN THE INCORPORATED AREAS OF THE COUNTY OF ORANGE
The City Council of the City of Tustin, California, does
hereby ordain as follows:
I. The City Council finds and determines as follows:
A. Due to recent litigation, it has been determined that the
deregulation of ambulance services is now mandatory. Such
deregulation now requires that the City of Tustin adopt an
ordinance establishing new requirements for the operation
of ambulance s.
The Orange County Emergency Medical Services Department
must receive a newly adopted ambulance ordinance and signed
contract for ambulance services by January 1, 1986 in order
to insure that the City of Tustin will receive continued
ambulance services.
Ce
There is a current and immediate threat to the public
health, safety and welfare such that if an ambulance
ordinance is not immediately passed, the City of Tustin
will be without ambulance services to protect its populace.
II. The City Council of the City of Tustin, California, does
hereby further ordain as follows:
Part 2, Sections 3421 through 3429.6, Chapter 4, Article 3
of the Tustin City Code is hereby repealed in its entirety and
replaced by the following:
Part 2 AMBULANCES
3421. INTENT AND PURPOSE.
It is the intent of this Part to establish general operating
procedures and standards for medical transportation services
operating within the incorporated areas of the City in both
emergency and other situations, to provide a fair and impartial
means of allowing responsible private operators to provide such
services in the public interest and to provide a means for the
designation of emergency response areas.
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3421.5. DEFINITIONS.
For purposes of this Part, the following terms are defined:
(a) Advanced life su_gp.p~ ~ and ~ 1_~ ~
service mean the same as defined in the California Health and
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Safety Code.
(b) ~ means a motor vehicle, helicopter, or similar
vehicle, specifically constructed, modified, equipped, or arranged
and operated for the purpose of transporting patients requiring
immediate or ongoing medical services excluding the transportation
of such persons to or from locations not providing services as
defined in this Part.
(c) ~ ~ means the activity, business or
service, for hire, profit, or otherwise, of transporting one or
more persons by ambulance; provided, however, ambulance service
shall not include the transportation by ambulance by an employer of
his or her own employees in an ambulance owned and operated by the
employer solely for this purpose.
(d) A/~ ~ 9~ means any person who
operates or owns an ambulance service.
(e) Attendant means a trained, qualified individual who,
regardless of whether he or she also serves as driver, is responsi-
ble for the care of patients.
(f) County means the County of Orange, State of California.
~ means the City of Tustin, County of Orange, State of
Cal if or ni a.
(g) D_~ means the Emergency Medical Services Agency
of the County of Orange or the Health Care Agency of the County of
Orange, or as otherwise designated by the Board of Supervisors.
(h) ~ means an individual employed by an ambulance
service operator responsible for sending an ambulance to provide
ambulance service to a patient.
(i) Driver means an attendant who drives or pilots an
ambulance.
(j) ~Le_r_gg/kg~t means a sudden, unforeseen event giving rise
to a need for ambulance service with basic or advanced life support
se rv i ce s.
(k) ~ ~ area means a geographical location
specified by the Fire Chief within which emergency service may be
provided under a license.
(1) ~ ~ means ambulance service performed in
response to an emergency.
(m) Fire Chief means the Director of Fire Services for the
City of Tustin.
(n) Health Care ~gency means the Orange County Health Care
Agency or other agency designated by the Board of Supervisors of
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Orange County to perform the Health Care Agency's functions under
this Part.
(o) ~ means an ambulance service operator which has
been granted a license under this Part to provide ambulance ser-
vice.
(p) Medical ~ means services provided by health care
professionals licensed pursuant to the California Business and
Professions Code or as specified by regulations adopted pursuant to
this Part.
(q) ~_~ means the same as defined in the California
Heal th and Safety Code.
(r) ~ means a wounded, injured, sick, invalid, or
otherwise incapacitated person.
(s) Person means any individual, firm, corporation, partner-
ship, association, or other group or combination acting as a unit.
(t) ~ means a medical doctor or osteopath holding
the appropriate license or certificate to practice as such with the
State of California pursuant to the Business and Professions Code.
(u) Public ~ aqency means any public law enforcement
agency, fire protection agency, or forest ranger operating in the
Co unty.
3422. LICENSE REQUIRED.
(a) It shall be unlawful for any person to be an ambulance
service operator, or to act in such a capacity either directly or
indirectly, without possession of a license issued pursuant to this
Part.
A license may specify the specific geographical area within
the City in which it is valid; provided, however, with respect to
emergency response areas, reference to the emergency response area
by a specific number or similar identification shall be sufficient
description of geographic limitation. A license shall be valid for
not more than one calendar year or the expiration of the calendar
year in which it was issued, whichever is shorter.
(b) The provisions of this Part shall not apply to:
(1) Ambulances operated at the request of a public safety
~:agency during any "state of war emergency," "state of emergency" or
"local emergency," as defined in the Government Code.
' (2) Ambulance service transporting a patient from a location
26 ~ outside of Orange County regardless of destination.
(3) Ambulance service transporting a patient by a fixed-wing
28 airplane.
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3422.5 TRANSFER AND TERM OF LICENSE.
NO license issued pursuant to this Part can be transferred
by operation of law or otherwise. The following shall be
considered transfers for purposes of this section:
(a) Any change in the business structure of a licensee,
including, but not limited to, changes from or to:
(1) A sole proprietorship;
(2) A partnership, including any change in the partners; and
(3) A corporation, including any change in the shareholders,
whether by operation of law or otherwise.
(b) Bankruptcy, an assignment for the benefit of creditors,
or the appointment of a receiver.
(c) A sale or transfer of over ten (10) percent of the
assets of a licensee.
A licensee may apply to the Health Care Agency for an
amendment to the terms of the license, which request shall be
processed in the same manner as an original application. Not-
withstanding anything in this section to the contrary, licenses may
be suspended, revoked, or terminated prior to the expiration date,
pursuant to the provisions of this Part.
3423 . APPLICATIONS.
(a) Each application for a license shall be accompanied by
an application fee, if any, set by the Board of Supervisors, and be
made upon forms prescribed by the Health Care Agency.
(b) Each applicant shall submit the following:
(1) The names and addresses of the applicant(s) and the
owner(s) of the ambulance(s) and the business and any interest
therein;
(2) The applicant's training and experience in the
transportation and care of patients;
(3) The names under which the applicant has engaged, does,
or proposes to engage in ambulance service;
(4) A description of each ambulance including the make,
model, year of manufacture, vehicle identification number, 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, a description of the
company's program for maintenance of the vehicle, and a description
of the vehicle's radio(s);
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(5) Proof that the applicant has obtained all licenses and
~ermits required by State of local law or regulation for the type
of ambulance service proposed, excluding only a license to provide
the service for which application is made;
(6) The names and qualifications of each attendant, driver,
or dispatcher employed, or to be employed, in providing ambulance
se rv i ce;
(7) Proof that the applicant possesses and maintains cur-
rentlY valid California Highway Patrol inspection reports for each
vehicle listed in the application;
(8) A description of the company's training and orientation
programs for attendants, drivers and dispatchers;
(9) Evidence of such financial responsibility and insurance
coverage as may be required by the Health Care Agency pursuant to
regulations adopted in accordance with this Part;
(10) Identification of the geographical area to be served by
the applicant, if required by the department;
(11) As to new applications or transfers as specified in
Section 3422.5, a fingerprint receipt for each principal of the
applicant, issued by the Orange County Sheriff-Coroner indicating
each principal of the applicant has undergone a complete criminal
history check, followed by a report from the Orange County Sheriff-
Coroner showing no conviction of crimes which would be violations
of the provisions of Section 3424(d) (2) , (3) , (4) , (5) , (6) or (7) .
(12) A list of all substations or offices where equi~uent
and personnel are, or will be based, including hours of operation;
~nd
(13) A description of whether the service proposed by the
applicant will include basic life support services or advanced life
support service, and if so:
(i) The number of basic life support service or
advanced life support service units to be deployed on each shift;
(ii) The emergency response area(s) to receive basic
life support service or advanced life support service; and
(iii) The provisions, if any, for continuing education
of attendants.
(14) Such other information as the Health Care Agency may
require in regulations adopted pursuant to this Part.
(c) Renewal applications shall be submitted in the same form
and require the same materials, as original applications except the
requirement of Section 3423 (a) (11).
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3423.5 · INVESTIGATIONS.
Upon receipt of a completed application and the required
fee, if any, the Health Care Agency shall make, or cause to be
made, such investigation as the Health Care Agency deems necessary
to determine if:
(a) The applicant is a responsible and proper person to
conduct, operate or engage in the provision of ambulance services;
(b) The applicant meets the requirements of this Part and of
other applicable laws, ordinances or regulations.
3.424. ISSUANCE OR DENIAL OF LICENSE.
(a) The Health Care Agency shall issue a license to an
applicant if the Health Care Agency, after completing any investi-
gation required pursuant to this Part, determines all requirements
of this Part have been met and the license fee, if any, set by the
Board of Supervisors, has been paid.
(b) In the event of denial, the applicant shall be informed
in writing of the reasons therefor.
(c) The licensee shall obtain and keep in force during the
term of a license, comprehensive automobile liability insurance and
professional liability insurance issued by a company authorized to
do business in the State of California, acceptable to the Health
Care Agency, insuring the owner against loss by reason of injury or
damage that may result to persons or property from negligent opera-
tion or defective construction of such ambulance, or from violation
of this Part or any other law of the State of California, or the
United States. Said comprehensive automobile liability policy
shall be in the sum of not less than $500,000 for combined single
limit, bodily injury and property damage. Said professional
liability insurance shall be in the sum of not less than $1,000,000
per person and $1,000,000 annual aggregate. Workers' compensation
insurance shall be carried covering all employees of the license
holder. Before the Health Care Agency shall issue a license,
copies of the policies, or certificates evidencing such policies,
shall be filed with the Health Care Agency. All policies shall
contain a provision requiring a thirty (30) day notice to be given
to the Department prior to cancellation, modification, or reduction
in limits. The amount of comprehensive automobile liability
insurance shall be subject to review and adjustment by the Health
Care Agency pursuant to regulations adopted under this Part. In
the use of helicopters the equivalent insurance requirements shall
apply.
(d) Grounds for denial of a license application shall be:
(1) Failure to meet the requirements of any provisions of
this Part;
(2) Violation by any principal of an applicant of Penal Code
Section 290;
(3) Habitual or excessive use of narcotics or dangerous
drugs ;.
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(4) Conviction during the preceding seven (7) years of any
Ii crime relating to the use, sale, possession or transportation of
narcotics, addictives or dangerous drugs;
(5) Habitual or excessive use of intoxicating beverages;
(6) Conviction during the preceding seven (7) years of any
crime punishable as a felony in the State of California;
(.7) Conviction of any crime involving moral turpitude,
including fraud or intentional dishonesty for personal gain.
(e) In determining the effect of any criminal acts on the
issuance or denial of a license, the Health Care Agency shall
consider whether the criminal acts are related to the activities of
an ambulance service and shall evaluate the rehabilitation of the
persons involved. The Health Care Agency shall not consider crimes
of which the applicant is, or was, accused but not convicted.
3424.5. LICENSE SUSPENSION OR REVOCATION.
(a) The Health Care Agency may suspend or revoke license for
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failure by the licensee to comply, and maintain compliance with, or
1511for violation of, any applicable provisions, standards or require-
ments of State law or regulation, of this Part, or of any regula-
tions promulgated hereunder. Suspension of a license is not a
16 condition precedent to revocation of a license.
17 (b) Before suspension or revocation, the Health Care Agency
shall give written notice to the licensee. Said notice shall:
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(1) Specify the reasons for which the action is to be taken;
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(2) Set a hearing for not more than fifteen (15) days nor
20 less than seven (7) days after the date of the notice;
21 (3) Specify the date, time and place of the hearing; and
22 (4) Be served on the licensee either by delivery to its
principal place of business or to its designated agent for service
23 of such notices, if any.
24i[ (c) If the licensee, subsequent to service of a suspension
25ilor revocation notice under this Section, remedies some or all of
i~the conditions to which the notice refers, the Health Care Agency
~may rescind a suspension or revocation at any time.
27'!proof (d) At the hearing, the Health Care Agency has the burden of
and may present evidence as to why such action should be
28 taken and to answer the evidence7 presented by the licensee.
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(e) The Health Care Agency may reduce the period of time for
hearing under a suspension or revocation notice to no less than
twenty-four (24) hours when the Health Care Agency makes written
preliminary findings that such action is necessary to protect the
public health, safety and welfare. When, as a result of such an
emergency proceeding, a license is suspended or revoked, the
licensee may request an additional hearing at which the licensee
will have the burden of establishing renewed compliance justifying
reinstatement of the license. Such additional hearing will be
commenced within five (5) days of the licensee's request. The
request for, and the scheduling of, an additional hearing shall not
stay operation of the suspension or revocation order.
(f) Hearings conducted pursuant to this section shall be
conducted before a hearing officer designated by the Department.
At the conclusion of said hearing, the hearing officer shall
expeditiously prepare a written summary of the evidence and
proposed findings and conclusions for consideration by the Health
Care Agency Director.
(g) The Health Care Agency Director shall issue a written
decision within thirty (30) days after conclusion of the hearing.
3425. APPEAL TO BOARD OF SUPERVISORS.
In the event of denial, suspension, or revocation of a
license, the applicant or licensee shall have the right to request
a hearing before the Board of Supervisors, which hearing shall be
requested and conducted in the manner specified in Section 5-2-19
of the Codified Ordinances of Orange County.
3425.5. NOTIFICATION.
The licensee shall notify the Health Care Agency within
twenty-four (24) hours after any change in ownership or management
of the licensee, or any interruption of service of more than
twenty-four (24) hours duration, or any substantial change in
staffing or equipment. For purposes of this section, the term
"substantial change" shall be as defined by regulation adopted
pursuant to this Part.
3426. PERSONNEL STANDARDS.
(a) A licensee shall only employ personnel performing tasks
described in this Part who comply with the requirements of this
se ct i on.
(b) Attendants shall be at least eighteen (18) years of age
and trained and competent in the proper use of all equipment, and
shall hold current "EMT lA" certification in compliance with all
State laws, rules and regulations. Additionally, each attendant
shall hold a license from the Health Care Agency indicating
compliance with this section. Applications for such licenses shall
be in a form required by the Health Care Agency and shall be
accompanied by the fee, if any, established therefor. All appli-
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cants for licenses as an attendant shall be subject to the same
criminal history review as required for principals of ambulance
companies pursuant to this Part no less than once every four years.
Certificates may be denied, suspended, or revoked in the same form
and fashion as that specified for ambulance service licensees in
this Part. Licenses shall be valid for two years from the date of
issuance or certification as an Emergency Medical Technician-lA,
whichever is less. Renewal of a license shall be in the same
fashion as issuance of a new license.
(c) Each licensee shall have at least one dispatcher.
Emergency ambulance service licensees shall have a dispatcher on a
twenty-four (24) hour-per-day basis and shall adequately train the
dispatcher to radio operation and protocols and to the emergency
response area(s) served before said dispatcher begins dispatching
emergency calls. For purposes of this Section, "adequate" training
of a dispatcher shall be that which meets State standards, if any,
or County requirements.
(d) Ambulance drivers shall, in addition to the requirements
of this Part for attendants, maintain an appropriate license issued
by the California Department of Motor vehicles and, if applicable,
the Federal Aviation Administration.
3426.2. RATES.
No licensee shall charge more than those rates approved by
the Board of Supervisors for emergency ambulance services.
3426.5. USAGE OF AMBULANCE SERVICE LICENSEES.
(a) The City shall contract with licensees on a competitive
basis for provision of ambulance service in response to emergencies
in each emergency response area. Said contracts shall provide for
one primary contractor per emergency response area, with such other
back-up service by other emergency ambulance service providers as
deemed necessary by the City. In awarding these contracts, the
City shall consider the comparative value of competing proposals in
the same fashion as would be the case were the City evaluating
proposals from prospective service providers for other City
activities, including consideration of:
(1) The quality of service to be provided;
(2) The level of service to be provided;
(3) The rates charged for services to be provided; and
(4) The cost, if any, to the City.
(b) The Fire Chief shall administer the contracts for
ambulance service awarded by the City Council under this section.
The Fire Chief shall also prepare and keep current emergency
response area lists specifying contract providers for each area.
The Fire Chief shall include on the list for each emergency
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response area the provider which has entered into an ambulance
service agreement with the City as the primary contractor as well
as the emergency ambulance service provider (s) who will provide
back-up emergency ambulance service for that area.
(c) In the event no proposals acceptable to the City under
the provisions of this section are received from one or more
emergency response areas, the City shall designate one or more
licensees in that emergency response area to provide emergency
ambulance services. From the date of such designation until a
regular emergency ambulance service shall be an express condition
of the license and unreasonable or unjustified refusal of such
calls shall be a violation of this Part.
(d) No person shall provide ambulance, service in response
to, or as a result of, an emergency, unless that person is a
licensee specified in each instance by a physician or public safety
agency. A licensee thus specified by a physician need not be a
contractor selected pursuant to this Section. Any ambulance
service operator receiving a request for emergency ambulance ser-
vice from other than a public safety agency shall immediately, by
telephone, notify a public safety agency designated by regulation
of the request.
No licensee responding to an emergency shall transport a
patient unless:
or
(1) A paramedic is present.at the location of the patient;
(2) A physician is present at the location of the patient
and directs transportation in the absence of a paramedic; or
(3) A safety qualified employee of the Orange County Fire
Department, or an appropriate employee of a public safety agency
designated by regulation directs transportation in the absence of a
paramedic.
Unless otherwise directed by a physician present at the location of
the patient, a licensee shall transport a patient pursuant to
regulations adopted under Section 3427.
3427. RULES AND REGULATIONS.
(a) As to all sections of this Part except Section 3426.5,
the Health Care Agency shall make such rules and regulations and as
may be necessary to implement this Part. Prior to adoption,
proposed rules and regulations shall be submitted to the Orange
County Emergency Medical Care Committee for comment.
(b) As to Section 3426.5, the Fire Chief shall make such
rules and regulations and as may be necessary to implement this
Part. Prior to adoption, the Fire Chief's rules and regulations
shall be submitted to the Orange County Emergency Medical Care
Committee for comment.
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(c) The Health Care Agency or the Fire Chief or their
designee(s) may inspect the records, facilities, transportation
units, equipment and method of operations of each licensee whenever
necessary and, by the Health Care Agency, at least annually.
3427.5. COMPLAINTS.
The City, the Department, any user, subscriber, public
safety agency or consumer who believes, or has reason to believe,
that he or another party has been required to pay an excessive
charge for services, received inadequate services or services pro-
vided were not in compliance with the provision of this Part, may
file a written complaint with the Department setting forth such
allegations. The Department shall notify the ambulance service
operator of such complaint. The ambulance service operator shall
file a written response within fifteen (15) calendar days after
receipt of notification.
3 42 8. VARIANCE.
As to all but Section 3426.5, the Health Care Agency may
grant variances from the terms of this Part if he finds such action
is necessary to protect the public health, safety or welfare. As
to Section 3426.5, the Fire Chief may grant variances from the
terms of this Part if he finds such action is necessary to protect
the public health, safety or welfare. As to the Health Care
Agency, such variances may include the issuance of a temporary
license. No variance shall exceed one hundred and eighty (180)
days in duration.
3 42 9. VIOL AT ION.
Violation of any provision of this Part by an ambulance
service operator shall be a misdemeanor."
PASSED AND .ADOPTED as an Urgency Ordinance at a regular
meeting of the City Council of the City of Tustin, California held
this day of , 1985.
ATTEST:
FRANK H. GREINKE,
May o r
MARY WYNN,
City Clerk
(53 9.WL)
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~q ORDINANC~ OF THE CTT¥ CC)Db]CIT. OF THE CTT~ OF TUSTTN,
2 CALIFORNIA, REPEALING PART 2, SECTIONS 3421 THROUGH 3429.6,
CHAPTER 4 ARTICLE 3 OF THE TUSTIN ~JNICIPAL CODE AND
3 ESTABLISHING N~; REQUIREMENTS FOR THE OPERATION OF
AMBULANCES IN THE INCORPORATED AREAS OF THE COUNTY OF ORANGE
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§ The City Council of the City of Tustin, California, does
hereby ordain as follows:
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Part 2, Sections 3421 through 3429.6, Chapter 4, Article 3
? of the Tustin City Code is hereby repealed in its entirety and
replaced by the following:
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Part 2 AMBULANCES
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3421. INTENT AND PURPOSE.
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it is the intent of this Part to establish general operating
11 procedures and standards for medical transportation services
operating within the incorporated areas of the City in both
12 emergency and other situations, to provide a fair and impartial
means of allowing responsible private operators to provide such
15 services in the public interest and to provide a means for the
designation of emergency response areas.
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3421.5 . DEFINITIONS.
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For purposes of this Part,' the following terms are defined:
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(a) Advanced life F~ service and basic life ~
17 service mean the same as defined in the California Health and
Safety Code.
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(b) ~ means a motor vehicle, helicopter, or similar
1911vehicle, specifically constructed, modified, equipped, or arranged
Iland operated for the purpose of transpOrting patients requiring
P-Ollimmediate or ongoing medical services exCluding the transportation
~of such persons to or from locations not providing services as
211 defined in this Part. .
22 (c) ~ Service means the activity, business or
service, for hire, profit, or otherwise, of transporting one or
more persons by ambulance; provided, however, ambulance service
shall not include the transportation by ambulance by an employer of
his or her own employees in an ambulance owned and operated by the
employer solely for this purpose.
(d) A b~ service ~ means any person who
operates or owns an ambulance service.
(e) Attendant means a trained, qualified individual who,
regardless of whether he or she also serves as driver, is responsi-
ble for the care of patients.
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(f) County means the County of Orange, State of California.
City means the City of Tustin, County of Orange, State of
3 California.
4 (g) ~ means the Emergency Medical Services Agency
of the County of Orange or the Health Care Agency of the County of
5 Orange, or as otherwise designated by the Board of Supervisors.
6 (h) D~ means an individual employed by an ambulance
service operator responsible for sending an ambulance to provide
? ambulance service to a patient.
8 (i) Driver means an attendant who drives or pilots an
ambulance.
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(j) F~kgT~t~lg~ means a sudden, unforeseen event giving rise
10 to a need for ambulance service with basic or advanced life support
se rv i ce s.
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(k) ~ ~ area means a geographical location
12 specified by the Fire Chief within which emergency service may be
provided under a license.
(1) ~ service means ambulance service performed in
14 response to an emergency.
15 (m) Fire Chief means the Director of Fire Services for the
City of Tustin.
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(n) Health Care Agency means the Orange County Health Care
17 Agency or other agency designated by the Board of Supervisors of
Orange County to perform the Health Care Agency's functions under
18 this Part.
19 ('o) ~ means an ambulance service operator which has
Ilbeen granted a license under this Part to provide ambulance ser-
~ vice' (p) Medial ~ means services provided by health care
professionals licensed pursuant to the California Business and
22 Professions Code or as specified by regulations adopted pursuant to
this Part.
(q) ~ means the same as defined in the California
Heal th and Safety Code.
(r) Patient means a wounded, injured, sick, invalid, or
otherwise incapacitated person.
(s) Person means any individual, firm, corporation, partner-
ship, association, or other group or combination acting as a unit.
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(t) ~ means a medical doctor or osteopath holding
the appropriate license or certificate to practice as such with the
State of California pursuant to the Business and Professions Code.
(u) Public ~ agency means any public law enforcement
agency, fire protection agency, or forest ranger operating in the
County.
3422. LICENSE REQUIRED.
(a) It shall be unlawful for any person to be an ambulance
service operator, or to act in such a capacity either directly or
indirectly, without possession of a license issued pursuant to this
Part.
A license may specify the specific geographical area within
the City in which it is valid; provided, however, with respect to
emergency response areas, reference to the emergency response area
by a specific number or similar identification shall be sufficient
description of geographic limitation. A license shall be valid for
not more than one calendar year or the expiration of the calendar
iyear in which it was issued, whichever is shorter.
(b) The provisions of this Part shall not apply to:
(1) Ambulances operated at the request of a public safety
agency during any "state of war emergency," "state of emergency" or
"local emergency," as defined in the Government Code.
(2) Ambulance service transporting a patient from a location
outside of Orange County .regardless of destination.
(3) Ambulance service transporting a patient by a fixed-wing
ai rpl ane.
3422.5 TRANSFER AND TERM OF LICENSE.
No license issued pursuant to this Part can be transferred
by operation of law or otherwise. The following shall be
considered transfers for purposes of this section:
(a) Any change in the business structure of a licensee,
including, but not limited to, changes from or to:
(1) A sole proprietorship;
(2) A partnership, including any change in the partners; and
(3) A corporation, including any change in the shareholders,
whether by operation of law or otherwise.
(b) Bankruptcy, an assignment for the benefit of creditors,
or the appointment of a receiver.
(c) A sale or transfer of over ten (10) percent of the
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assets of a licensee.
A licensee may apply to the Health Care Agency for an
amendment to the terms of the license, which request shall be
processed in the same manner as an original application. Not-
withstanding anything in this section to the contrary, licenses may
be suspended, revoked, or terminated prior to the expiration date,
pursuant to the provisions of this Part.
3423 . APPLICATIONS.
(a) Each application for a license shall be accompanied by
an application fee, if any, set by the Board of Supervisors, and be
made upon forms prescribed by the Health Care Agency.
(b) Each applicant shall submit the following:
(1) The names and addresses of the applicant(s) and the
owner(s) of the ambulance(s) and the business and any interest
therein;
(2) The applicant's training and experience in the
transportation and care of patients;
(3) The names under which the applicant has engaged, does,
or proposes to engage in ambulance service;
(4) A description of each ambulance including the make,
model, year of manufacture, vehicle identification number, 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, a description of the
company's program for maintenance of the vehicle, and a description
of the vehicle's radio(s);
(5) Proof that the applicant has obtained all licenses and
permits required by State of local law or regulation for the type
of ambul'ance service proposed, excluding only a license to provide
the service for which application is made;
(6) The names and qualifications of each attendant, driver,
or dispatcher employed, or to be employed, in providing ambulance
se rv i ce;
(7) Proof that the applicant possesses and maintains cur-
rently valid California Highway Patrol inspection reports for each
vehicle listed in the application;
(8) A description of the company's training and orientation
programs for attendants, drivers and dispatchers;
(9) Evidence of such financial responsibility and insurance
coverage as may be required by the Health Care Agency pursuant to
regulations adopted in accordance with this Part;
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(10) Identification of the geographical area to be served by
the applicant, if required by the department;
(11) As to new applications or transfers as specified in
Section 3422.5, a fingerprint receipt for each principal of the
applicant, issued by the Orange County Sheriff-Coroner indicating
each principal of the applicant has undergone a complete criminal
history check, followed by a report from the Orange County Sheriff-
Coroner showing no conviction of crimes which would be violations
of the provisions of Section 3424(d) (2) , (3) , (4) , (5) , (6) or (7) .
(12) A list of all substations or offices where equivalent
and personnel are, or will be based, including hours of operation;
and
(13) A description of whether the service proposed by the
applicant will include basic life support services or advanced life
support service, and if so:
(i) The number of basic life support service or
advanced life support service units to be deployed on each shift;
(ii) The emergency response area(s) to receive basic
life support service or advanced life support service; and
(iii) The provisions, if any, for continuing education
of attendants.
(14) Such other information as the Health Care Agency may
require in regulations adopted pursuant to this Part.
(c) Renewal applications shall be submitted in the same form
and require the same materials, as original applications except the
requirement of Section 3423 (a)(11).
3423.5 . INVESTIGATIONS.
Upon receipt of a completed application and the required
fee, if any, the Health Care Agency shall make, or cause to be
made, such investigation as the Health Care Agency deems necessary
to determine if:
(a) The applicant is a responsible and proper person to
conduct, operate or engage in the provision of ambulance services;
(b) The applicant meets the requirements of this Part and of
other applicable laws, ordinances or regulations.
3424. ISSUANCE OR DENIAL OF LICENSE.
(a) The Health Care Agency shall issue a license to an
applicant if the Health Care Agency, after completing any investi-
gation required pursuant to this Part, determines all requirements
of this Part have been met and the license fee, if any, set by the
Board of Supervisors, has been paid.
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(b) In the event of denial, the applicant shall be informed
in writing of the reasons therefor.
(c) The licensee shall obtain and keep in force during the
term of a license, comprehensive automobile liability insurance and
professional liability insurance issued by a company authorized to
do business in the State of California, acceptable to the Health
Care Agency, insuring the owner against loss by reason of injury or
damage that may result to persons or property from negligent opera-
tion or defective construction of such ambulance, or from violation
of this Part or any other law of the State of California, or the
United States. Said comprehensive automobile liability policy
shall be in the sum of not less than $500,000 for combined single
limit, bodily injury and property damage. Said professional
liability insurance shall be in the sum of not less than $1,000,000
per person and $1,000,000 annual aggregate. Workers' compensation
insurance shall be carried covering all employees of the license
holder. Before the Health Care Agency shall issue a license,
copies of the policies, or certificates evidencing such policies,
shall be filed with the Health Care Agency. All policies shall
contain a provision requiring a thirty (30) day notice to be given
to the Department prior to cancellation, modification, or reduction
in limits. The amount of comprehensive automobile liability
insurance shall be subject to review and adjustment by the Health
Care Agency pursuant to regulations adopted under this Part. In
the use of helicopters the equivalent insurance requirements shall
apply.
(d) Grounds for denial of a license application shall be:
(1) Failure to meet the requirements of any provisions of
this Part;
(2) Violation by any principal of an applicant of Penal Code
Section 290;
(.3) Habitual or excessive use of narcotics or dangerous
dr ugs;
(4) Conviction during the preceding seven (7) years of any
crime relating to the use, sale, possession or transportation of
narcotics, addictives or dangerous drugs;
(5) Habitual or excessive use of intoxicating beverages;
(6) Conviction during the preceding seven (7) years of any
crime punishable as a felony in the State of California;
(7) Conviction of any crime involving moral turpitude,
including fraud or intentional dishonesty for personal gain.
(e) In determining the effect of any criminal acts on the
issuance or denial of a license, the Health Care Agency shall
consider whether the criminal acts are related to the activities of
an ambulance service and shall evaluate the rehabilitation of the
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persons involved. The ~
Health Care Agency shall not
of which the applicant is, or was, accused but not
consider crimes
convicted.
3424.5. LICENSE SUSPENSION OR REVOCATION.
(a) The Health Care Agency may suspend or revoke license for
failure by the licensee to comply, and maintain compliance with, or
for violation of, any applicable provisions, standards or require-
ments of State law or regulation, of this Part, or of any regula-
tions promulgated hereunder. Suspension of a license is not a
condition precedent to revocation of a license.
(b) Before suspension or revocation, the Health Care Agency
shall give written notice to the licensee. Said notice shall:
(1) Specify the reasons for which the action is to be taken;
(2) Set a hearing for not more than fifteen (15) days nor
less than seven (7) days after the date of the notice;
(3) Specify the date, time and place of the hearing; and
(4) Be served on the licensee either by delivery to its
principal place of business or to its designated agent for service
of such notices, if any.
(c) If the licensee, subsequent to service of a suspension
or revocation notice under this Section, remedies some or all of
the conditions to which the notice refers, the Health Care Agency
may rescind a suspension or revocation at any time.
(d) At the hearing, the Health Care Agency has the burden of
proof and may present evidence as to why such action should be
taken and to answer the evidence presented by the licensee.
(e) The Health Care Agency may reduce the period of time for
hearing under a suspension or revocation notice to no less than
twenty-four (24) hours when the Health Care Agency makes written
preliminary findings that such action is necessary to protect the
public health, safety and welfare. When, as a result of such an
emergency proceeding, a license is suspended or revoked, the
licensee may request an additional hearing at which the licensee
will have the burden of establishing renewed compliance justifying
reinstatement of the license. Such additional hearing will be
commenced within five (5) days of the licensee's request. The
request for, and the scheduling of, an additional hearing shall not
;stay operation of the suspension or revocation order.
(f) Hearings conducted pursuant to this section shall be
conducted before a hearing officer designated by the Department.
At the conclusion of said hearing, the hearing officer shall
expeditiously prepare a written summary of the evidence and
proposed findings and conclusions for consideration by the Health
Care Agency Director.
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(g) The Health Care Agency Director shall issue a written
decision within thirty (30) days after conclusion of the hearing.
3425. APPEAL TO BOARD OF SUPERVISORS.
In the event of denial, suspension, or revocation of a
license, the applicant or licensee shall have the right to request
a hearing before the Board of Supervisors, which hearing shall be
requested and conducted in the manner specified in Section 5-2-19
of the Codified Ordinances of Orange County.
3 425 . 5 . NOT I FI CAT ION .
The licensee shall notify the Health Care Agency. within
twenty-four (24) hours after any change in ownership or management
of the licensee, or any interruption of service of more than
twenty-four (24) hours duration, or any substantial change in
staffing or equipment. For purposes of this section, the term
"substantial change" shall be as defined by regulation adopted
pursuant to this Part.
3426. PERSONNEL STANDARDS.
(a) A licensee shall only employ personnel performing tasks
described in this Part who comply with the requirements of this
se ct i on.
(b) Attendants shall be at least eighteen (18) years of age
and trained and competent in the proper use of all equi~,ent, and
shall hold current "EMT lA" certification in compliance with all
State laws, rules and regulations. Additionally, each attendant
shall hold a license from the Health Care Agency indicating
compliance with this section. Applications for such licenses shall
be in a form required by the Health Care Agency and shall be
accompanied by the fee, if any, established therefor. All appli-
cants for licenses as an attendant shall be subject to the same
criminal history review as required for principals of ambulance
companie's pursuant to this Part no less than once every four years.
Certificates may be denied, suspended, or revoked in the same form
and fashion as that specified for ambulance service licensees in
this Part. Licenses shall be valid for two years from the date of
issuance or certification as an Emergency Medical Technician-lA,
whichever is less. Renewal of a license shall be in the same
fashion as issuance of a new license.
(c) Each licensee shall have at least one dispatcher.
Emergency ambulance service licensees shall have a dispatcher on a
twenty-four (24) hour-per-day basis and shall adequately train the
dispatcher to radio operation and protocols and to the emergency
response area(s) served before said dispatcher begins dispatching
emergency calls. For purposes of this Section, "adequate" training
of a dispatcher shall be that which meets State standards, if any,
or County requirements.
(d) Ambulance drivers shall, in addition to the requirements
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of this Part for attendants, maintain an appropriate license issued
by the California Department of Motor Vehicles and, if applicable,
the Federal Aviation Administration.
3 426.2. RATES.
No licensee shall charge more than those rates approved by
the Board of Supervisors for emergency ambulance services.
3426.5. USAGE OF AMBULANCE SERVICE LICENSEES.
(a) The City shall contract with licensees on a competitive
basis for provision of ambulance service in response to emergencies
in each emergency response area. Said contracts shall provide for
one primary contractor per emergency response area, with such other
back-up service by other emergency ambulance service providers as
deemed necessary by the City. In awarding these contracts, the
City shall consider the comparative value of competing proposals in
the same fashion as would be the case were the City evaluating
proposals from prospective service providers for other City
activities, including consideration of:
(1) The quality of service to be provided;
(2) The level of service to be provided;
(3) The rates charged for services to be provided; and
(4) The cost, if any, to the City.
(b) The Fire Chief shall administer the contracts for
ambulance service awarded by the City Council under this section.
The Fire Chief shall also prepare and keep current emergency
response area lists specifying contract providers for each area.
The Fire Chief shall include on the list for each emergency
response area the provider which has entered into an ambulance
service agreement with the City as the primary contractor as well
as the emergency ambulance service provider(s) who will provide
back-up emergency ambulance service for that area.
(c) In the event no proposals acceptable to the City under
the provisions of this section are received from one or more
emergency response areas, the City shall designate one or more
licensees in that emergency response area to provide emergency
ambulance services. From the date of such designation until a
regular emergency ambulance service shall be an express condition
of the license and unreasonable or unjustified refusal of such
calls shall be a violation of this Part.
(d) No person shall provide ambulance service in response
to, or as a result of, an emergency, unless that person is a
licensee specified in each instance by a physician or public safety
agency. A licensee thus specified by a physician need not be a
contractor selected pursuant to this Section. Any ambulance
service operator receiving a request for emergency ambulance ser-
vice from other than a public safety agency shall immediately, by
1 telephone, notify a public safety agency designated by regulation
of the request.
No licensee responding to an emergency shall transport a
~ patient unless:
4 (1) A paramedic is present at the location of the patient;
or
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(2) A physician is present at the location of the patient
6 and directs transportation in the absence of a paramedic; or
? (3) A safety qualified employee of the Orange County Fire
Department, or an appropriate employee of a public safety agency
8 designated by regulation directs transportation in the absence of a
paramedic.
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Unless otherwise directed by a physician present at the location of
10 the patient, a licensee shall transport a patient pursuant to
regulations adopted under Section 3427.
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3427. RULES AND REGULATIONS.
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(a) As to all sections of this Part except Section 3426.5,
15 the Health Care Agency shall make such rules and regulations and as
may be necessary to implement this Part. Prior to adoption,
14 proposed rules and regulations shall be submitted to the Orange
County Emergency Medical Care Committee for comment.
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(b) As to Section 3426.5, %he Fire Chief shall make such
16 rules and regulations and as may be necessary to implement this
Part. Prior to adoption, the Fire Chief's rules and regulations
17 shall be submitted to the Orange County Emergency Medical Care
Committee for comment.
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(c) The Health Care Agency or the Fire Chief or their
19 designee'(s) may inspect the records, facilities, transportation
units, equipment and method of operations of each licensee whenever
20 necessary and, by the Health Care Agency, at least annually.
21 3427.5. COMPLAINTS.
22 The City, the Department, any user, subscriber, public
safety agency or consumer who believes, or has reason to believe,
2~ that he or another party has been required to pay an excessive
charge for services, received inadequate services or services pro-
24 vided were not in compliance with the provision of this Part, may
file a written complaint with the Department setting forth such
25 allegations. The Department shall notify the ambulance service
operator of such complaint. The ambulance service operator shall
26 ifile a written response within fifteen (15) calendar days after
~receipt of notification.
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3428. VARIANCE.
As to all but Section 3426.5, the Health Care Agency may
grant variances from the terms of this Part if he finds such action
is necessary to protect the public health, safety or welfare. As
to Section 3426.5,. the Fire Chief may grant variances from the
terms of this Part if he finds such action is necessary to protect
the public health, safety or welfare. As to the Health Care
Agency, such variances may include the issuance of a temporary
license. No variance shall exceed one hundred and eighty (180)
days in duration.
3 42 9. VIOL AT ION.
Violation of any provision of this Part by an ambulance
service operator shall be a misdemeanor."
PASSED AND ADOPTED at a regular meeting of the City Council
of the City of Tustin, California held this day of
, 1985.
ATTEST:
FRANK H. GREINKE,
Mayor
MARY WYNN,
City Clerk
(539.WL)