Chapter 5.28
AMBULANCE SERVICES
Skip Chapter Digest
Sections:
5.28.010 Purpose of provisions.
5.28.020 Definitions.
5.28.030 Emergency medical committee – Created – Purpose – Appointment.
5.28.040 Ambulance operator’s permit requirement.
5.28.050 Permit limitations.
5.28.060 Application for permit.
5.28.070 Exemptions from permit requirement.
5.28.080 Prohibited activities.
5.28.090 Adoption, amendment or deletion of rules and regulations.
5.28.100 Fees.
5.28.110 Violation – Penalty.
5.28.010 Purpose of provisions.
It is the purpose and intent of the city council of the city to provide for the highest reasonable level of emergency medical care to be available to such persons within the city who may be in need of such care. It is further the intent herein to ensure that such care shall be provided in a timely and professional manner on a continuous basis. (Ord. 90-1 § 1, 1990).
5.28.020 Definitions.
For the purposes of this chapter, the following definitions shall apply:
A. "Advanced life support" is the provision of medical intensive care nurse (M.I.C.N.) or medical intensive care paramedic (M.I.C.P.) field services, as specified in the California Health and Safety Code, applicable rules and regulations of the Sonoma County Department of Public Health Emergency Medical Services Agency, and the provisions of this chapter.
B. "Ambulance" means any vehicle that is constructed, equipped, and regularly provided or offered to be provided for transportation in the recumbent position of persons suffering from any physical or psychological illness, injury, disability, or infirmity of any type.
C. "Dispatch agency" means publicly operated emergency communications centers, including but not limited to those operated by the city of Sonoma, Sonoma County, and the state of California.
D. "Emergency" means any occurrence or situation which takes place outside of an acute care hospital, involving illness, injury, or disability requiring immediate medical or psychiatric services, wherein the delay in the provision of such services is likely to aggravate and/or endanger personal health or safety.
E. "Emergency medical system" is a coordinated, preplanned cooperative effort by the city of Sonoma, county of Sonoma, Sonoma Valley Hospital, the various law enforcement and fire protection agencies having jurisdiction with the Sonoma Valley, and any emergency medical services provider operating within the scope of this chapter, with the expressed and implied goal of providing a coordinated response to any and all requests for emergency medical services within each participating entity’s jurisdiction.
F. "First responder" is any agency or individual dispatched to the scene of a medical emergency with the intent of providing interim care, not including transport, prior to the arrival of an advanced life support ambulance, and/or assisting an advanced life support ambulance crew in the provision of emergency medical care.
G. "Hearing board" means a review body consisting of two Sonoma Valley fire chiefs, not including the city fire chief, and a Sonoma Valley Hospital emergency room physician.
H. "Operator" means "person" as defined herein.
I. "Paramedic" is an individual certified by the county of Sonoma as a mobile intensive care unit paramedic, appropriately trained and duly authorized to act as a provider of advanced life support services as defined in the Health and Safety Code. For the purpose of this chapter, paramedic shall also include those individuals licensed by the state of California, and certified by the county of Sonoma as a mobile intensive care nurse.
J. "Person" means any individual or entity as defined in SMC 1.04.010. For the purpose of this chapter, "person" shall include all individuals, firms, or principals having a financial interest in an ambulance operating as required herein.
K. "Sonoma Valley," for the purposes of this chapter, means the area contiguous with the boundaries of the Sonoma Valley Hospital District, generally including all lands north of San Pablo Bay, west of the Napa/Sonoma County line, east of the Sonoma Mountain ridge line, and south of an east-west boundary crossing State Highway 12 near Adobe Canyon Road, north of Kenwood. (Ord. 90-1 § 2, 1990).
5.28.030 Emergency medical committee – Created – Purpose – Appointment.
An emergency medical committee is hereby created for the purpose of recommending and reviewing rules and regulations set forth by this chapter, for reviewing applications for an ambulance operator’s permit, and for reviewing the activities of a permit holder. The city manager shall appoint the members of the emergency medical committee in accordance with the rules and regulations adopted pursuant to SMC 5.28.090. The Sonoma County emergency medical services coordinator, or their designee, may be appointed as a ex officio member of the committee by the city manager. All committee members except the ex officio member shall be considered voting members. (Ord. 90-1 § 3, 1990).
5.28.040 Ambulance operator’s permit requirement.
No person shall operate an ambulance within the city limits without a valid ambulance operator’s permit, unless specifically exempted in SMC 5.28.070. An ambulance operator’s permit may be issued by the city to a qualified person, upon approval by the city manager of their application. At a minimum, an application for an ambulance operator’s permit shall contain the following:
A. A set of standard operating procedures designed to assure compliance with applicable state, county, and city laws, regulations, and ordinances;
B. A current fee schedule for all services offered;
C. A registry of emergency service providers employed by the operator. The list shall include each employee’s current certification and licensing status, including levels of certification, types of licensing, and expiration dates;
D. A description of the nature and scope of public education and first responder training programs to be provided throughout the term of the permit;
E. Proof of the issuance of performance bonds in the amount established by the rules and regulations adopted pursuant to SMC 5.28.090;
F. Proof of possession of a city business license issued specifically for the operation of an ambulance enterprise, or a letter from the city clerk stating that a business license is not required;
G. The name, address, and telephone number of each person or entity which may have a financial interest in the ambulance operation.
Within 45 days of the receipt of an application for an ambulance operator’s permit, the emergency medical committee shall review and investigate the application. The committee may designate one or more individuals to inspect and test all vehicles, equipment, crew quarters and ambulance storage and staging sites. Inspection and testing of an ambulance shall not include those activities required by Section 2510(b) of the California Vehicle Code, except to verify that the vehicle in question has successfully completed such an inspection within the past 12 months. Upon completion of the investigation, inspection and testing, the committee shall issue a written recommendation to the city manager. The city manager shall, based upon the recommendation of the committee, approve the application, approve the application with conditions, or reject the application.
Upon approval of an application, the city shall issue an ambulance operator’s permit. Ambulance operator’s permits shall remain in effect until midnight on the thirtieth day of June following permit issuance, unless revoked or suspended prior to that date in accordance with this chapter.
Application for permit renewal shall be made at least 30 days prior to the expiration date of an existing permit. Applications for renewal shall be processed by the city as a new application, except that on-site inspections and testing, and a written report shall not be required of the committee unless requested by the city manager.
The holder of an ambulance operator’s permit shall provide written notice to the city a minimum of 180 days prior to terminating service. (Ord. 90-1 § 4, 1990).
5.28.050 Permit limitations.
A. An ambulance operator’s permit shall be valid during the time period specified on the permit only if all of the following conditions are continuously met:
1. Any changes in the information contained in the permit application package are reported to the city, in writing, within 10 days of the change occurring.
2. Written rate information shall be available to the public during normal business hours.
3. Emergency medical services are provided 24 hours a day, seven days a week in accordance with the rules and regulations set forth by this chapter.
4. Emergency medical services shall be provided to all persons in the service area without regard to race, creed, gender, marital status, or the ability to pay.
5. Emergency medical services shall be continuously offered to all portions of the city.
6. Proof of insurance, of the type and amount required by the city manager, shall be furnished to the city upon issuance of a permit. Such insurance shall be constantly maintained.
B. An ambulance operator’s permit shall not be transferable. (Ord. 90-1 § 5, 1990).
5.28.060 Application for permit.
At any time throughout the term of a permit or at the time of application for renewal of a permit the emergency medical committee may provide a written report regarding the past performance of the ambulance operator. In the event the emergency medical committee recommends denial of an application, upon the request of the applicant, a hearing board shall be convened for the purpose of receiving and reviewing all information submitted by the emergency medical committee and the applicant. Such hearing shall be requested within 10 days, and shall be convened within 30 days of the issuance of a report by the committee. A recommendation from the hearing board shall be forwarded to the city manager within 15 days of the hearing.
The city manager may deny a permit application or revoke a permit upon finding that a permit holder has failed to meet the requirements of applicable federal, state, or county laws and regulations, or any of the provisions of this chapter. Any person who has had a permit revoked or denied may reapply after 30 days of the denial or revocation. Any person who has had two permit denials or revocations shall be ineligible for a permit for a period of two years commencing from the second revocation or denial.
Any applicant for an ambulance operator’s permit (AOP) whose application is denied in writing by the city manager may appeal to the city council. Such appeal shall be in writing, designate the name of the appellant, shall describe the nature of the decision being appealed, and shall be signed by the appellant. Such appeal shall be filed with the city clerk within 10 days (Sundays and legal holidays excepted) of the date of mailing or service of notice of denial, revocation, or suspension. The council shall act on the appeal within 45 days of filing. (Ord. 90-1 § 6, 1990).
5.28.070 Exemptions from permit requirement.
The requirement for a permit set forth in SMC 5.28.040 shall not apply to the following activities:
A. Operation of an ambulance owned by or operated under contract to the United States Government, when providing service directly to the United States Government or a contractor to any agency thereof;
B. Operation of an ambulance within the city limits which does not normally serve the city, but has been requested by an authorized dispatch agency to provide assistance during periods when multiple requests for emergency medical service have been received, and the assistance is necessary for the timely provision of emergency medical services;
C. Operation of an ambulance during a declared state of emergency, when such operation is in cooperation with the emergency mitigation efforts being conducted by the city;
D. Any ambulance passing through the city when that ambulance’s point of departure and destination are not within the corporate limits of the city. (Ord. 90-1 § 7, 1990).
5.28.080 Prohibited activities.
The following activities or actions are expressly prohibited:
A. Any failure to disclose or false statement of any material fact in an application for an ambulance operator’s permit;
B. Monitoring or intercepting any other emergency medical provider’s communications for profit or gain;
C. Soliciting information regarding accident or emergency locations by payment of any form of gratuity;
D. Operation of an ambulance service which does not continuously offer at least one suitable equipped and staffed advance life support ambulance for emergency response within the city, as directed by an authorized dispatch agency;
E. Charging for services not performed, billing more than one party for the same service, or billing in excess of the approved rate schedule;
F. Performance of any services by an operator or any employees of the operator, outside of the legally established scope of acceptable practice for any individual’s level of certification;
G. Failure to provide appropriately equipped and staffed advanced life support ambulance(s), available for use within the city, as required by the rules adopted by the city manager pursuant to SMC 5.28.090;
H. Response of an ambulance to an emergency call without proper authorization by the appropriate dispatch agency;
I. Failure to respond to a call for emergency medical service within the response time limitations set forth in the rules and regulations adopted pursuant to SMC 5.28.090;
J. Failure to advise the appropriate dispatch agency of any change in status of a permit holder’s ambulances;
K. Falsification, defacement, or obliteration of any license or certification required by this chapter;
L. Violation of any federal, state, county, or city law, regulation, or ordinance. (Ord. 90-1 § 8, 1990).
5.28.090 Adoption, amendment or deletion of rules and regulations.
The city manager is directed to adopt any rules and regulations as necessary in order to assure the provision of timely and appropriate emergency medical care within the corporate limits of the city. The city manager shall consult the emergency medical committee prior to adopting, amending, or deleting any rule or regulation authorized by this chapter.
Public comment shall be accepted for a minimum of 30 days prior to any changes in the rules and regulations. A minimum of one certified copy of the rules and regulations shall be filed with the city clerk, and shall become effective immediately thereafter. The committee may specifically find that it is in the public’s best interest for changes in the rules and regulations to take effect prior to the 30-day public comment period and shall be in full force and effect immediately upon filing with the city clerk. (Ord. 90-1 § 9, 1990).
5.28.100 Fees.
A fee schedule may be set by resolution of the city council to be due upon application for a new permit, permit renewal, or upon a review of the permit in accordance with this chapter. (Ord. 90-1 § 10, 1990).
5.28.110 Violation – Penalty.
Any violation of this chapter or any rules or regulations adopted pursuant to SMC 5.28.090 is a misdemeanor punishable as provided in this code. (Ord. 90-1 § 12, 1990).