Chapter 5.11
AMBULANCES*

Sections:

5.11.010    Purpose.

5.11.020    Definitions.

5.11.030    Administration of licensing.

5.11.040    Conditions of a business license.

5.11.050    Response criteria.

5.11.060    Business license required for each ambulance company.

5.11.070    Application for business license – Issuance.

5.11.080    License renewal.

5.11.090    Licenses not transferable.

5.11.100    Denial, revocation or suspension of business license.

5.11.110    Insurance and identification.

5.11.120    State license and standards and requirements.

5.11.130    Ambulance attendants.

5.11.140    Verification.

5.11.150    Rates to be filed.

5.11.160    Community events.

5.11.170    Violations – Penalties – Misdemeanor.

5.11.180    Additional enforcement.

*Editor’s note – Ord. No. 3214, § 2, adopted Mar. 7, 1995, repealed former ch. 5.11, §§ 5.11.010 – 5.11.190, which pertained to adult entertainment. Subsequently, Ordinance No. 3341, § 1, April 2, 1997, added a new chapter 5.11.

5.11.010 Purpose.

The city council declared it to be in the public interest and for the protection of the health, safety and welfare of the residents of the city and its environs to provide for the highest level of emergency medical services reasonably practicable. The city council finds it to be in the public interest to provide for the inspection, regulation and control of emergency medical services to achieve high standards and thereby to eliminate inadequate, improper and harmful practices that may endanger the health and safety of the people. The city council also designates the chief of the fire department as the city’s representative with respect to matters of emergency medical services and the coordination of health care issues to collate with the fire department provision of emergency medical services, health care services and transport. Such issues include but are not limited to the fire department responsibilities to be the city’s prime provider of emergency medical services, along with related health care and transportation issues which must be coordinated to deliver our overall quality of emergency medical services (Advanced Life Support, Basic Life Support and relationships with related health care providers).

(Ord. No. 3341, § 1, 4-2-97)

5.11.020 Definitions.

As used in this chapter, the following words and phrases shall have the following meaning unless the context clearly requires otherwise:

Ambulance means any privately or publicly owned vehicle that is especially designed, constructed, equipped, maintained and licensed by Washington state for the transportation of patients who are sick, injured or otherwise incapacitated.

Aid unit means any publicly owned vehicle that is especially designed, constructed, equipped, maintained, used and licensed by the state of Washington to primarily deliver emergency medical personnel and equipment to an emergency scene. An aid unit has limited means to transport patients who are sick, injured or otherwise incapacitated. This specifically relates to Kent fire department engine/aid apparatus.

Ambulance attendant means any trained or otherwise qualified individual responsible for the operation of an ambulance and the care of the patients, whether or not the medical attendant also serves as a driver, who is the holder of a valid certificate issued under this chapter.

Ambulance company means any person corporation or other legal entity who operates an ambulance for hire.

Business license or license means a license to operate an ambulance company within the city.

Business license clerk means such city employees or agents as the mayor shall designate to issue and administer business licenses under this chapter, or any designee thereof.

City means city of Kent.

City clerk means the city clerk of the city of Kent designated as the official keeper of records.

Fire department or department means the fire department of the city.

Fire official means the fire chief or the fire chief’s designee to perform the duties provided for in this chapter.

Patient means an individual who is sick, injured, wounded or otherwise incapacitated or helpless.

Licensee means a person in whose name a license to operate an ambulance company within the city has been issued as well as the individual listed as an applicant on the application for a license.

Person means any individual, firm, joint venture, co-partnership association, social club, fraternal organization, corporation, estate, trust, business trust, receiver, or any other group or combination acting as a unit.

(Ord. No. 3341, § 1, 4-2-97)

5.11.030 Administration of licensing.

The business license clerk, subject to a review and recommendation from the fire official, is responsible for issuing, denying, revoking, renewing, suspending, and canceling business licenses to operate aid ambulance company within the city. The fire official is responsible for ascertaining whether a proposed application complies with all the requirements enumerated herein and all other applicable codes and regulations now in effect or as amended or enacted subsequent to the effective date of this chapter. The fire official shall make all necessary investigations and inspections for enforcement of this chapter.

(Ord. No. 3341, § 1, 4-2-97)

5.11.040 Conditions of a business license.

The fire official is responsible for ascertaining whether a proposed application complies with all the requirements enumerated herein and all other applicable codes and regulations now in effect or as amended or enacted subsequent to the effective date of this chapter. The fire official shall make all necessary investigations and inspections for enforcement of this chapter. As a condition of issuance of a business license, the operator of each ambulance company consents to the following:

1. The fire official shall be permitted to make regular inspections of any ambulance company operating under a business license issued, at all reasonable hours, with or without advance notice, upon the presentation of appropriate credentials to an authorized representative of the company, and shall make such reports relative to conditions existing at such times and in such manner as the fire official may direct.

2. The fire official is given authority to determine whether and to what extent an ambulance rotation list, fire department units, sole contract/franchise approach or a mix of the above will be utilized to transport patients from an emergency medical scene. The fire official is authorized to establish procedures, guidelines and contracts for implementing the above mentioned approaches for emergency medical service transport.

3. The fire official shall be the final authority to determine if an ambulance company should be added to or removed from the fire department rotation list.

4. It is recognized that the fire department currently transports patients where it serves the interest of the public. The fire official shall determine the distribution of transportation responsibilities as it relates to calls within the scope of the fire department’s responsibilities.

5. Further, the fire department is authorized to provide transport, preventative and cooperative medical services to serve the interests and needs of our citizens. It is recognized that this may be done in conjunction with other health care providers in order to manage the risk to our citizens and to control the rate of growth in the demand for EMS services.

6. It is understood that a significant expansion of services shall be reviewed by city administration and any significant additional program costs are subject to council approval.

7. In the future, if it is determined that it would best serve the interests of the city to provide ALS services in lieu of the county, the fire department shall be designated as the provider and/or coordinator of ALS services. Such a program change would be subject to review and approval of the mayor and city council.

(Ord. No. 3341, § 1, 4-2-97)

5.11.050 Response criteria.

A. The city shall be the first response provider of emergency medical services (EMS). Ambulance companies receiving a direct request for EMS services shall notify the fire department’s 9-1-1 communications center immediately so that a fire department first response can be initiated. The only exception to this requirement shall be for the transport of stable patients from one (1) medical facility to another and routine medical transports and exams.

B. The 9-1-1 system must be activated for all pre-hospital EMS primary examinations and unstable patient care.

C. The department shall establish ambulance response criteria and make such criteria known to each ambulance company at the time of application and renewal of business license. Application for a business license does not automatically qualify an ambulance company to be on the rotation list for the fire department for ambulance services.

D. Each ambulance company shall submit a response report quarterly or on demand of the fire official outlining compliance with the response criteria.

(Ord. No. 3341, § 1, 4-2-97)

5.11.060 Business license required for each ambulance company.

Every person who operates an ambulance company within the city shall be required to obtain a business license from the business license clerk. An ambulance company operates within the city if it is:

A. Stationed within the corporate limits of the city; or

B. Dispatched from within or without the corporate limits of the city and repeatedly or customarily makes trips for hire within the city to pick up injured or sick fares; or

C. Making any trips into the city for hire to pick up injured or sick fares after occasional or repeated advertising, within the city, for such service.

The business license shall be renewed on an annual basis. The business license clerk shall not issue such business license unless the applicant has fulfilled all requirements of this chapter and any applicable provisions of the state law relating to personnel, equipment and operations including but not limited to Chapter 18.73 RCW and Chapter 246-976 WAC as now or hereafter amended. Provided, that the provisions of this chapter shall not apply to any ambulance which shall pass through the city in the delivery of fares picked up at points beyond the corporate limits of the city.

(Ord. No. 3341, § 1, 4-2-97)

5.11.070 Application for business license – Issuance.

A. Application for a business license to operate an ambulance company shall be made upon forms provided by the city and shall contain:

1. Name, home address and telephone number of the applicant;

2. Business name under which the ambulance company will be operated within the city, and business address and telephone number;

3. The number of ambulances to be initially placed in service within the city;

4. The number of licensed ambulance attendants initially to be employed;

5. A roster of ambulances to be used in the city with proof that each ambulance is currently licensed as an ambulance by the state of Washington;

6. A roster of certified ambulance attendants with proof that each attendant is currently certified as an emergency medical technician (EMT) by the state of Washington (including certification expiration date);

7. Proof that ambulances and personnel are verified trauma providers as provided in Chapter 246-976 WAC;

8. Certificate of insurance as required by the city; and

9. The schedule of rates.

B. Prior to the issuance of a business license, the application and all pertinent records shall be reviewed by the fire official to ensure compliance with the license requirements under this chapter, as well as, any rules or regulations referenced herein or issued hereunder. Upon written approval of the application by the fire chief or the chief’s designee and the payment of fees, the business license clerk shall issue an ambulance operator’s business license. All equipment proposed for use shall be subjected to random inspection by the designated fire official, who shall determine whether said records and equipment conform to all the requirements of this chapter.

C. Business license fee. The business license fee schedule for issuance and renewal of business licenses under this chapter shall be that currently charged for general business licenses under Ch. 5.01 KCC until such time as the city council may, by resolution, modify the fee schedule.

(Ord. No. 3341, § 1, 4-2-97)

5.11.080 License renewal.

The business license clerk shall mail the forms for application of business license renewals to business enterprises in the city to the last address provided to the director by the licensee. Failure of the business enterprise to receive any such form shall not excuse the business enterprise from making application for and securing the required license or renewal, or for payment of the license fee when and as due hereunder.

(Ord. No. 3341, § 1, 4-2-97)

5.11.090 Licenses not transferable.

No business license issued under the provisions of this chapter shall be transferable or assignable unless otherwise specifically provided for; except that a license may be transferred when a business changes its structure of ownership, provided, however, that a new license shall be required upon a substantial change of ownership whereby those primarily accountable for the business have changed or upon a substantial change in the type of business operated, whereby the primary business being conducted has significantly changed.

(Ord. No. 3341, § 1, 4-2-97)

5.11.100 Denial, revocation or suspension of business license.

A. Grounds. The issuance of a business license to operate an ambulance company may be denied, or such license may be suspended or revoked by the business license clerk, upon the recommendation of the designated fire official when the public interest will be served thereby, upon any of the following grounds:

1. The license was procured by fraud, false representation, or material omission of fact, or for the violation of or failure to comply with any of the provisions of this chapter by the person holding such license, or any of his servants, agents, or employees, while acting within the scope of their employment; or

2. The licensee violates any applicable city, state, or federal law, or the purpose for which the license was issued is being abused to the detriment of the public, or such license is being used for a purpose different from that for which it was issued; or

3. Overcharging of customer rates set forth in the company’s schedule of rates filed with the city clerk or fraudulent billing; or

4. Failure to maintain ambulances and equipment to the standards set forth in Chapter 246-976 WAC; or

5. Repeated complaints by citizens of poor customer service such as rudeness, misrepresentation, unprofessional behavior, etc.

B. Suspension and revocation. A business license procured by fraud or misrepresentation shall be revoked. Where other violations of this chapter or other applicable ordinances, statutes, or regulations are found, the license shall be suspended for a period of thirty (30) days upon the first such violation, ninety (90) days upon the second violation within a twenty-four (24) month period, and revoked for a third and subsequent violation within a twenty-four (24) month period, not including periods of suspension, except that where the fire official finds that any situation exists in licensee’s operations which constitutes a threat of immediate serious injury or damage to persons or property, the business license clerk may immediately suspend any license issued under this chapter, pending a hearing in accordance with this section. The business license clerk shall issue a notice setting forth the basis for the action and the facts that constitute a threat of immediate serious injury or damage to persons or property.

C. Notice. Except when a business license is immediately suspended as set forth in subparagraph (B) above, the business license clerk shall provide at least ten (10) days’ prior written notice to the licensee of the decision to suspend or revoke the license. Such notice shall inform the licensee of the right to appeal the decision to the hearing examiner and shall state the effective date of such revocation or suspension under grounds for revocation or suspension. An appeal at the denial, suspension or revocation of a business license shall be made within thirty (30) days of notice of such denial, suspension or revocation. Such appeal shall be processed pursuant to the hearing procedures set forth in Ch. 2.32 KCC. The hearing examiner shall set a date for hearing such appeal, to take place within forty-five (45) days of the date of the receipt of the notice of appeal unless such time is extended by mutual consent. At such hearing, the appellant and any other interested persons may appear and be heard, subject to the rules and regulations of the hearing examiner. The decision of the business license clerk shall be stayed during the pendency of any appeal to the hearing examiner and during any appeal unless the license was immediately suspended pursuant to subparagraph (B) above.

D. Final administrative review. Appeal to the hearing examiner shall constitute final administrative review.

E. Appeal to superior court. An appeal of the decision of the hearing examiner must be filed with the superior court within thirty (30) calendar days from the date the hearing examiner’s decision was personally served upon or was mailed to the person to whom the notice of denial, suspension or revocation was directed or is thereafter barred.

(Ord. No. 3341, § 1, 4-2-97)

5.11.110 Insurance and identification.

No ambulance operator’s business license shall be issued, nor shall such license be valid after issuance, nor shall any ambulance be operated in the city, unless the operator maintains a policy or policies of insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of activities associated with the operation of the ambulance company. Such insurance shall name the city as an additional insured. The ambulance company shall also indemnify and hold the city harmless from any causes of action arising from the operation of the ambulance company. The minimum scope and limits of coverage shall be set by the city’s risk manager or other person designated by the mayor. Evidence of such insurance shall accompany the application for license and shall be maintained on a continuous basis through subsequent license renewal periods.

(Ord. No. 3341, § 1, 4-2-97)

5.11.120 State license and standards and requirements.

All ambulances operating in the city must be licensed by the state and must meet the standards and requirements set forth in Chapter 246-976 WAC, as now or hereafter amended. Proof of a state license as a transport ambulance must be provided with any application for a city business license for each transport vehicle.

(Ord. No. 3341, § 1, 4-2-97)

5.11.130 Ambulance attendants.

Each ambulance company shall have, for each ambulance in service, on duty and available for immediate response, two (2) ambulance attendants who are currently certified as emergency medical technicians (EMT), as provided in Chapter 246-976 WAC. A certificate of license shall be carried on the person of each ambulance attendant while on duty.

(Ord. No. 3341, § 1, 4-2-97)

5.11.140 Verification.

Any ambulance company operating in the city must be a verified trauma provider and must meet the requirements for personnel and equipment as required in Chapter 246-976 WAC for trauma providers. The ambulance company must specifically be authorized to act as a trauma provider by the Seattle/King County trauma council or successor.

(Ord. No. 3341, § 1, 4-2-97)

5.11.150 Rates to be filed.

Each ambulance company applying for a business license or renewal of license pursuant to this chapter shall, at the time of filing its application therefor, file with the city clerk its schedule of rates to be charged for services during the license period for which application is made. Such schedule or rates shall be a matter of public record open to public inspection in the city clerk’s office during normal city business hours and such schedule must be adhered to by the licensee throughout the period for which the license is issued.

(Ord. No. 3341, § 1, 4-2-97)

5.11.160 Community events.

When an ambulance company is contracted to provide emergency medical standby (i.e., 10K Fun Runs, etc.) by community event promoters, the following conditions shall apply:

1. The ambulance company shall notify the fire official in writing fourteen (14) days prior to the date of the event, or as soon to the event as reasonably possible, stating the date, time and scope of standby responsibilities.

2. Ambulance companies engaging in standby activities shall notify the fire department’s 9-1-1 communications center immediately on all advanced life support/life threatening or significant basic life support calls as required pursuant to subsection (3). Calls will be considered significant based upon extent of injury/illness or when there are multiple patients (more than three (3)).

3. Ambulance company standby for handling basic life support calls must obtain prior approval and parameters for care set by the fire official.

4. All EMS activity provided by the ambulance company at such events shall be documented and a report forwarded to the fire official within one (1) week subsequent to the completion of the event.

(Ord. No. 3341, § 1, 4-2-97)

5.11.170 Violations – Penalties – Misdemeanor.

In addition to other remedies provided for in this chapter, any person who operates an ambulance company within the city without a business license as required in KCC 5.11.060 above, shall, upon conviction, be punished by a fine of not more than one thousand dollars ($1,000), or by imprisonment for not more than ninety (90) days, or by both such find and imprisonment at each and every day during which any violation is committed, continued or permitted, shall be deemed a separate offense.

(Ord. No. 3341, § 1, 4-2-97)

5.11.180 Additional enforcement.

The remedies found in this chapter are not exclusive. The city may seek any other legal or equitable relief, including but not limited to enjoining any acts or practices which constitute or will constitute a violation of any business license, ordinance, or other regulations herein adopted.

(Ord. No. 3341, § 1, 4-2-97)