Ordinance Number 388ORDINANCE NO. 388
REGULATING AMBULANCE SERVICES
AN ORDINANCE OF THE CITY OF SAN JUAN CAPISTRANO,
CALIFORNIA, REGULATING THE OPERATION OF AMBULANCES
AND CONVALESCENT TRANSPORT VEHICLES
THE CITY COUNCIL OF THE CITY OF SAN JUAN CAPISTRANO, CALIFORNIA,
DOES HEREBY ORDAIN AS FOLLOWS:
Intent and Purpose.
It is the intent of this Ordinance to prescribe the
basic regulations for the operation of ambulances and convalescent
transport vehicles in the City of San Juan Capistrano in emergency
and non -emergency situations for the care and transportation of
persons needing such services. It is the purpose of the City
Council in enacting this Ordinance to provide a fair and impartial
means of selecting responsible private operators to engage in
ambulance and convalescent care and transportation in the public
interest and to prevent the deleterious effects of unregulated
competition in such service.
nt finifinnc.
The following terms, as used in this Ordinance shall,
unless the context clearly indicates otherwise, have the respective
meanings herein set forth.
(a) Ambulance means a motor vehicle specifically
constructed, modified, equipped, or arranged and
operated for the purpose of transporting patients
requiring emergency service.
(b) Convalescent Transport Vehicle means a motor
vehicle specially constructed or modified, equipped
or arranged and operated for the purpose of
transporting patients not requiring emergency
service.
(c) Ambulance Service means any private person who
operates one or more ambulances. Ambulance service
shall not include a person who maintains ambulances
for the use of his own employees.
(d) Convalescent Transport Service means any private
person who operates one or more convalescent
transport vehicles.
(e) Ambulance Service Operator means any'person who
operates an ambulance service.
(f) Ambulance Attendant means a qualified person
acting as an attendant on an ambulance responding
to a call and who occupies the patient compartment
while transporting any patient in apparent need of
medical attention.
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(g) Business means any trade, business, occupation,
practice or profession.
(h) City means the City of San Juan Capistrano, State
of California.
(i) Department means the Public Health and Medical
Services of the Human Services Agency - County of
Orange.
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(j) Driver means any qualified person who operates an
ambulance while responding to a call and while
transporting any patient.
(k) Emergency means a request for the immediate dispatch
of an ambulance to transport or provide other
assistance for a person apparently having a sudden
unforeseen need of immediate emergency medical
attention.
(1) Emergency Service means the service performed in
response to an emergency call.
(m) Patient means a wounded, injured, sick, invalid,
convalescent, or otherwise incapacitated person.
(n) Person means any individual, firm, corporation,
partnership, association, or other group or combination
acting as a unit.
(o) Licensee means any ambulance service or convalescent
transport service which has been regularly granted
a license to engage in the ambulance service or
convalescent transport service.
(p) Public Safety Agency means any public law enforcement,
fire protection agency, lifeguard, or forest
ranger operating in Orange County.
(q) Health Officer means the Orange County Health
Officer.
SECTION 1. Need and Necessity_
(a) Required.
It shall be unlawful for any person either as
owner, agent or otherwise, to operate, conduct,
advertise, or otherwise engage in or profess to be
engaged in the business of ambulance service or
convalescent transport service upon the streets,
or any public way or place in the City, without
possession of a license issued pursuant to this
Ordinance. A licensed ambulance service may
provide convalescent transport service without the
necessity of an additional license. No license
may be transferred by operation of law or otherwise:
(b) Exceptions. The provisions of this Section shall
not apply to:
(1) Vehicles operated as ambulances or convalescent
transport vehicles at the request of local
authorities during any "state of war emergency,"
"state of emergency," or "local emergency," as.
defined in the Government Code.
(2) Ambulances or convalescent transport vehicles
transporting a patient from a location outside
the incorporated territory of City regardless
of destination.
SECTION 2. Specification of Emergency Response Areas.
All ambulance service licenses shall specify the City
territory, if any, within which the licensee may provide emergency
ambulance service and no ambulance service operator shall provide
emergency ambulance service for ambulance calls originating
within the City but outside the territorial limits fixed in the
license.
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(a) Exceptions. A licensee may provide emergency
service for ambulance calls originating outside
the territorial limits fixed in the license issued
to him:
(1) Upon request by any City public safety agency
when such public safety agency has made
reasonable attempts to utilize an ambulance
service within the emergency response area.
(2) Upon request of any person for emergency
ambulance service when an ambulance is not
immediately available in the emergency response
area from which the request originates.
(3) Upon request of another license holder who
does not have an ambulance immediately available
in the emergency response area from which a
request originates.
(4) To provide return ambulance service to a
person who originally used licensee's services
for ambulance transportaion to a destination
outside of his service area.
(5) To provide ambulance service pursuant to a
written contract between the licensee and a
facility licensed pursuant to Division 2,
Chapter 2, Health and Safety Code, or licensed
physician, provided that the Health Officer
has received, prior to the provision of such
service, a copy of such contract.
(6) TO PROVIDE STANDBY AMBULANCE ON A CONTRACT BASIS
FOR SPECIAL EVENTS.
SECTION 3. Application.
(a) Procedure and Information Required. Applicants
for ambulance and/or convalescent transport
service license shall file with the Department an
application in writing, on a form to be furnished
by the Department, which shall give the following
information:
(1) Name and description of applicant.
(2) Business address and residence address of
record of the applicant.
(3) Trade or firm name, or DBA as recorded.
(4) I£ a corporation, a joint venture of a general
or limited partnership, the names of all
partners and officers, their permanent addresses
and their percentage of participation in the
business.
45) (i) A statement of facts showing the experience
of the applicant in the operation of an
ambulance service or convalescent transport
service and demonstrating that the
applicant is qualified to render efficient
ambulance service or convalescent transport
service.
(ii) A photocopy of the license issued by the
Commissioner of the California Highway
Patrol to privately owned ambulance
companies (in accordance with Section
2501, California Vehdcle Code) shall be
appended to the application.
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(6) The geographical boundary of the territory
requested for emergency responses.
(7) A statement that the applicant owns or has
under his control, in good mechanical
condition, required equipment to adequately
conduct an ambulance service or convalescent
transport service in the territory for which he
is applying, and that the applicant owns or has
access to suitable facilities for maintaining
his equipment in a clean and sanitary condition.
(8) A list, amended as required during the year for
any changed, substituted, loaned or leased
vehicles, giving a complete description of each
ambulance vehicle or convalescent transport
vehicle operated by the applicant, including
the patient capacity thereof, and a copy of the
most recent Ambulance Inspection Report AND
CURRENT EMERGENCY VEHICLE PERMIT issued by the
California Highway Patrol for each ambulance.
(9) An affirmation that each ambulance or convalescent
transport vehicle and its appurtenances conform
to all applicable provisions of this Ordinance
and applicable provisions of City and State
laws and regulations.
(10) A statement that the applicant employs sufficient
personnel adequately trained to deliver ambulance
services of good quality, according to personnel
provisions of the Ordinance, at all times in
the applicant's proposed service area.
(11) A list, amended as required during the year for
any personnel changes, giving the name and a
description of the training for each ambulance
service or convalescent transport service
employee, and a copy of each certificate or
license issued by the State and/or County
establishing qualifications for such personnel
in ambulance or convalescent transport
operations.
(12) A statement that shows to the satisfaction of
the Department that the issuance of a license
is in the public interest and there is a need
for a license to be issued in that there is a
requirement for ambulance service or convalescent
transport service which can be legally served
by the applicant.
(13) AN AFFIRMATION THAT ALL AMBULANCES BASED IN
SAN JUAN CAPISTRANO WILL BE LICENSED UNDER
THIS ORDINANCE.
(14) Such other facts or information as the Department
may require.
(b) Renewal of license. Applicants for renewal of an
ambulance service license under this Ordinance shall
file with the Department an application in writing,
on a form to be furnished by the Department, which
shall include the information required in Subsections
1, 2, 3, 4, 5 (i), 6, 7, 8, 9, 10, 11, 12, 13, 14,
above.
(c) Convalescent Transport Services. Applicants for
original or renewal license of a convalescent transport
service license under this Ordinance shall file with
the Department an application in writing, on a form
to be furnished by the Department which shall include
the information required in Subsections 1, 2, 3, 4,
5 (i), 6, 7, 8, 9, 10, 11, 12, 13, 14, above.
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SECTION 4. Investigation and Public Hearing by
Health Officer.
Upon the receipt of a completed application for ambulance
service or convalescent transport service, together with the
application fee established by Resolution of the Board of Supervisors,
the Health Officer shall conduct an investigation and hold a
public hearing to determine if the public health, safety, welfare,
convenience and necessity require the granting of a license and
to further determine if the applicant meets all the requirements
of this Ordinance. In making such determination the Health
Officer shall consider, among other things, the demand for
ambulance service and the adequacy of existing service. At least
15 days' written notice of said hearing shall be given by registered
mail to the applicant, to all persons holding ambulance service
licenses and to the City Manager. Notice shall be given to the
general public by posting in the Orange County Hall of Administration
and City Hall at least 15 days prior to said hearing.
SECTION 5. Issuance or Denial of License.
Following the above hearing, the Health Officer may order
the issuance of a license to conduct an ambulance service or
convalescent transport service if he finds:
(a) OPTIONS.
(1) That the public health, safety, welfare,
convenience and necessity requires such ambulance
services, including any requested emergency
response areas.
(2) THAT THE APPLICANT HAS SUCCESSFULLY PROVEN
NEED AND NECESSITY TO THE CITY COUNCIL.
(b) The applicant is financially responsible and otherwise
able to provide the requested service.
(c) The applicant and any officers of applicant are of
good moral character and are likely to provide
ambulance services in a satisfactory manner. In
making said determination the Health Officer shall
consider whether any such person:
(1) Has previously provided satisfactory ambulance
services;
(2) Has committed any act which, if committed by
any licensee, would be grounds for the revocation
of a license issued pursuant to this Ordinance;
(3) Has committed any act involving dishonesty,
fraud or deceit with the intent to injure
another or benefit himself or another;
(4) Has previously violated the terms of this
Ordinance;
1(5) Has been convicted of a felony or a crime
involving moral turpitude;
(6) Has knowingly made a false statement of fact in
such application.
(d) In determining the effect of the above acts or
convictions, the Health Officer shall consider
whether they are related to the activities of an
ambulance service or convalescent transport service
and shall evaluate the rehabilition of such person.
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(e) In the event of denial, the applicant shall be
informed in writing of the reasons therefor.
SECTION 6. Liability Insurance.
The licensee shall obtain and keep in force during the
term of said license, comprehensive automobile liability insurance
and professional liability insurance issued by a company authorized
to do business in the State of California, insuring the owner
against loss by reason of injury or damage that ,nay result to
persons or property from negligent operation or defective
construction of such ambulance, or convalescent transport vehicle,
or from violation of this Ordinance 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 Five Hundred,
Thousand Dollars ($500,000) for combined single limit, bodily
injury and property damage. Said professional liability insurance
shall be in the sum of not less than One Million Dollars
($1,000,000) per person and One Million Dollars ($1,000,000) annual
aggregate. Workers' Compensation Insurance shall be carried
covering all employees of the license holder. Before the Health
Officer shall issue a license, copies of the policies, or certificates
evidencing such policies shall be filed with the Department. 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 City annually at the City's option.
SECTION 7. Renewal of License.
Licenses may be renewed annually by the Health Officer
upon application of the licensee, if the Health Officer determines
that public health, welfare, need and necessity still exist for the
license holder and the license holder has, during the period of the
expiring license, operated in conformity with the provisions of
this Ordinance and the rules and regulations of the Department, and
that he is capable of continuing operation in conformity with the
rules and regulations of the Department.
SECTION 8. Amendment of License.
Any license holder may apply to the Health Officer for an
amendment to terms of his license_ Such request shall be processed
in the same manner as an original application, provided the Health
Officer may waive those requirements deemed unnecessary.
year.
SECTION 9. Term of License.
A license shall remain in effect for a period of one
SECTION 10. Notification.
In the event of a change in ownership or management of any
kind or nature, any interruption of service of more than twenty-four
(29) hours' duration, or any substantial change in staffing or
equipment of the ambulance service or convalescent transport service,
the license holder shall notify the Health Office and City Council
immediately in writing, stating the facts of such change.
SECTION 11. Appeal to the City Council.
In the event of denial, suspension, revocation of a license,
or attendant or driver certificate, the applicants or licensee or
certificate holder shall have the right to request a hearing before
the City Council. Said hearing shall be requested in writing and
the City shall provide notice 10 days in advance of said hearing.
SECTION 12. Emergency Service Availability.
(a) Each ambulance service operator having an emergency
response area shall provide emergency ambulance
service on a continuous twenty-four (24) hour per -day
basis. If for any reason such ambulance service is
interrupted, the license holder shall immediately
stop any advertisement of emergency services which
have been interrupted and notify the Health Officer
immediately and shall state reasons and justification.
Other affected public safety agencies shall be
notified by the license holder in a timely fashion.
(b) EACH AMBULANCE SERVICE, AT CITY'S OPTION, MAY BE
REQUIRED TO OPERATE AN AMBULANCE FROM WITHIN THE
CITY LIMITS.
SECTION 13. Ambulance Personnel.
(a) Ambulance Driver and Attendant. An ambulance attendant
or driver utilized by a license holder shall be at
least eighteen (18) years of age, shall be trained and
competent in the proper use of all emergency ambulance
equipment, shall hold current certification as an
EMT -1 and shall demonstrate compliance with all
applicable State laws and regulations. An ambulance
driver or ambulance attendant who is a California
licensed physician, Registered Nurse, or a paramedic
currently certified by the Orange County Health
Officer shall be exempt from the emergency medical
training requirements of this Section.
(b) Every ambulance driver and attendant utilized by a
license holder shall hold a certificate from the
Health Officer indicating compliance with the
requirements of this Section.
(c) Applications for such certificate shall be in the
form required by the Health Officer and shall be
accompanied by the fee established by Resolution of
the Board of Supervisors.
(d) Certificates may be denied or revoked by the Health
Officer if he finds, after a hearing, that the
applicant does not comply with the requirements of
this Section.
(e) Certificate shall remain in effect for a period of
two years.
(f) ALL APPLICANTS FOR AMBULANCE DRIVER/ATTENDANT WILL
UNDERGO A COMPLETE CRIMINAL HISTORY RECORD CHECK
PRIOR TO ISSUANCE OF A PERMANENT CERTIFICATE.
SECTION 14. Suspension and Revocation of Licenses
or Certificates.
The Health Officer shall be empowered to suspend a license
or certificate pending a hearing if he determines such action is
necessary to protect the public health, safety or welfare. The
period of such suspension shall not exceed sixty (60) days. The
Health Officer shall also be empowered, after conducting a hearing,
to revoke a license, or certificate. Suspension and revocation shall
be on the grounds that the license or certificate holder, or any
partner, officer or director:
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(a) Violated any Section of this Ordinance, any
applicable regulations promulgated by the
Department or any applicable State laws or
regulations concerning ambulance services.
(b) Has committed any acts which would constitute grounds
for denial of a license or certificate.
The certificate holder or licensee shall be given written
notice of the reasons for the proposed revocation, together with
the time and place of the hearing thereon, which notice shall be
given at least fifteen (15) days prior to the hearing.
SECTION 15. Ambulance Rates.
No licensee shall charge more OR LESS than the following
rates for ambulance or convalescent transport service:
(a) One patient. The uniform schedule of rates that may
be charged for ambulance service and convalescent
transport service shall be set by Resolution adopted
by the Board of Supervisors of Orange County.
Said rate schedule is incorporated herein by
reference, and is on file in the office of the
Clerk of the Board of Supervisors. Said rate
schedule shall be adopted by the Board of
Supervisors following a public hearing. Notice of
the hearing shall be given to all license holders,
the public and City Council in the same manner as
described in Section 4.
(b) Two or more patients.
(1) Each stretcher or gurney patient carried at
the same time may be charged the full base rate
for response to the call and half the mileage
rate.
(2) Each ambulatory sit-up patient shall be charged
the base rate for response to the call and half
the mileage rate.
(c) No charge shall be made for uninjured or well persons
who accompany a patient.
(d) CHARGES MAY VARY FOR CONTRACT AMBULANCE SERVICES,
PROVIDED THEY MEET WITH THE APPROVAL OF THE
HEALTH OFFICER.
SECTION 16. Emergency and Disaster Operations.
During any "state of war emergency," or "state of
emergency" or "local emergency," as defined by the Government
Code of the State of California, each ambulance service and
convalescent transport service shall provide equipment, facilities,
and personnel as required by the Chief, Medical and Health
Services, whenever the Medical and Health Annex to the County
Emergency Plan is activated.
SECTION 17. User Complaints.
Any user or subscriber to an ambulance service or
convalescent transport service, contending that he has been required
to pay an excessive charge for service or that he has received
inadequate services may file a written complaint with the Department
setting forth such allegations. The Department shall notify the
ambulance service or convalescent transport service of such complaint,
and shall investigate the matter to determine the validity of the
complaint. If the complaint is determined to be valid, the Department
shall take reasonable and proper actions to secure compliance with the
conditions of this Ordinance.
SECTION 18. Regulation and Enforcement.
(a) The Health Officer shall make necessary and reasonable
rules and regulations covering ambulance and
convalescent transport service operation, ambulance
and convalescent transport equipment, ambulance and
convalescent transport vehicles, ambulance and
convalescent personnel and standards of dispatch for
the effective and reasonable administration of this
Ordinance. Prior to adoption, said regulation
shall be submitted to the Emergency Medical Care
Committee, the City Council, and the City Manager
for their comments.
(b) The Health Officer shall inspect the records,
facilities, vehicles, equipment and methods of
operation of each license holder at least annually,
and whenever such inspections are deemed necessary.
SECTION 19. Compliance with State Law and Regulations.
A licensed ambulance service or convalescent transport
service shall, in order to maintain the license, comply with all
applicable provisions of CITY AND STATE LAWS OR REGULATION.
RRCTTnN 20. \/a rianec s.
The HealthOfficermay grant a variance from the terms
of this Ordinance if he finds such action is necessary to protect
the public health, safety, or welfare. Such action may include the
issuance of temporary ambulance or convalescent transport service
licenses. Such variance or temporary license shall remain in effect
for the period indicated by the Health Officer but not to exceed
one hundred eighty (180) days. WHEN SUCH A VARIANCE HAS BEEN
GRANTED, THE CITY MANAGER SHALL BE NOTIFIED.
SECTION 21. Effective Date.
This Ordinance shall take effect and be in force 30 days
after its passage.
SECTION 22. Clerk's Certification.
The City Clerk shall certify to the adoption of this
Ordinance and cause same to be posted in the duly designated
posting places within the City of San Juan Capistrano within 15
days after its passage.
PASSED, APPROVED AND ADOPTED this 18th day of
July 1 1979 , by the following vote, to wit:
AYES: Councilmen Schwartze, Thorpe, Buchheim
and Mayor Friess
NOES: None
ABSENT: Councilman Hausdorfer
KENNETH E. �FRIESS, MAYOR
ATTEST: