Ordinance Number 892ORDINANCE NO. 892
AN ORDINANCE OF THE CITY OF SAN JUAN CAPISTRANO,
CALIFORNIA, REPEALING TITLE 5, CHAPTER 16 OF THE MUNICIPAL
CODE AND ESTABLISHING NEW GENERAL OPERATING
PROCEDURES AND STANDARDS FOR AMBULANCE
TRANSPORTATION SERVICES WITHIN THE CITY
WHEREAS, Title 5, Chapter 16 of the City of San Juan Capistrano Municipal
Code regulates Ambulance Transportation Services; and
WHEREAS, the City last amended in its entirety Title 5, Chapter 16 of the
Municipal Code in 1985 and designated sections in 1998; and
WHEREAS, the Orange County Fire Authority General Counsel has reviewed the
member cities ordinances and found them to be out of date with numerous
inconsistencies; and
WHEREAS, the Orange County Fire Authority General Counsel recommends
that each member city update its current ordinance in its entirety with a City Model
Ambulance Ordinance as provided by Orange County Fire Authority; and
WHEREAS, this update will provide consistent, system wide language among
the member cities, as well as governing the authority for the setting of the Advanced
Life Support (ALS) rate, administration of competitive process, and award of ambulance
contracts.
THE CITY COUNCIL OF THE CITY OF SAN JUAN CAPISTRANO,
CALIFORNIA, DOES HEREBY ORDAIN AS FOLLOWS:
SECTION 1. Chapter 16 of Title 5 of the Codified Ordinances of the City
of San Juan Capistrano, as adopted by the City is hereby amended in its entirety as
follows:
Sections:
5-16.01.
5-16.02.
5-16.03.
5.16.04.
5.16.05.
5.16.06.
5.16.07.
Title 5. Public Welfare
Chapter 16. Ambulance Service
Intent and purpose.
Definitions.
License required.
Transfer and term of license.
Applications.
Investigations.
Issuance or denial of license.
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5.16.08.
License suspension or revocation.
5.16.09.
Appeal to Orange County Board of Supervisors.
5.16.10.
Notification.
5.16.11.
Personnel standards.
5.16.12.
Rates.
5.16.13.
Selection of ambulance service licensees for
exclusive operating areas.
5.16.140.
Rules and regulations.
5.16.150.
Complaints.
5.16.160.
Variance.
5.16.170.
Violation — penalty.
Sec. 5.16.01. Intent and Purpose.
It is the intent of this chapter to establish general operating procedures and
standards for medical transportation services operating within 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 exclusive operating areas. This chapter is
modeled after Division 9, Article I of Title 4 of the Codified Ordinances of the County of
Orange (County Model Ambulance Ordinance No. 3517; OCC §4-9-1).
Sec. 5.16.02. Definitions.
For purposes of this chapter, the following terms are defined:
a. Advanced life support service ("ALS") and basic life support service
('BLS") mean the same as defined in the California Health and Safety Code.
b. Ambulance 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 chapter.
C. Ambulance 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. Ambulance service operator 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 responsible for the care of patients.
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f. County means the County of Orange, State of California.
g. City means the City of San Juan Capistrano, California.
h. Department 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 Orange County Board of Supervisors.
i. Dispatcher means an individual employed by an ambulance service
operator responsible for sending an ambulance to provide ambulance service to a
patient.
j. Driver means an attendant who drives or pilots an ambulance.
k. Emergency means sudden, unforeseen event giving rise to a need for
ambulance service with basic or advanced life support services and is a condition in
which an individual has a need for immediate medical attention, or where the potential
for such need is perceived by emergency medical personnel or a public safety agency.
I. Exclusive Operating Area f" EOA" j means the same as defined in Section
1797.85 of the Health and Safety Code, and which is established pursuant to Section
1797.224 of the Health and Safety Code.
M. Emergency service means ambulance service performed in response to
an emergency.
n. Fire Chief means the Fire Chief of the Orange County Fire Authority.
o. Health Officer means the Orange County Health Officer or other official
designated by the Board of Supervisors of Orange County to perform the Health
Officer's functions under this chapter.
P. Licensee means an ambulance service operator which has been granted
a license under this chapter to provide ambulance service.
q. Medical services 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 chapter.
r. Paramedic means the same as defined in the California Health and Safety
Code.
S. Patient means a wounded, injured, sick, invalid, or otherwise incapacitated
person.
t. Person means any individual, firm, corporation, partnership, association,
or other group or combination acting as a unit.
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U. Physician means a medical doctor or osteopath holding the appropriate
license or certificate to practice as such within the State of California pursuant to the
Business and Professions Code.
V. Public safety agency means any public law enforcement agency, fire
protection agency, or forest ranger operating in the County.
Sec. 5-16.03. 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, within the City without possession of
a license issued pursuant to this chapter. A license may specify the specific
geographical area within the City in which it is valid; provided, however, with respect to
EOA's, reference to the EOA 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 chapter 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
the City regardless of destination.
3. Ambulance service transporting a patient by a fixed -wing airplane.
Sec. 5-16.04. Transfer and term of license.
No license issued pursuant to this chapter 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.
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C. A sale or transfer of over ten (10) percent of the assets of a licensee.
A licensee may apply to the Health Officer for an amendment to the terms of the
license, which request shall be processed in the same manner as an original
application. Notwithstanding 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 chapter.
Sec. 5-16.05. Applications.
A. Each application for a license shall be accompanied by an application fee,
if any, set by the Orange County Board of Supervisors, and be made upon forms
prescribed by the Health Officer.
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 engage,
- and 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 vehicles, 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 or 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
service;
7. Proof that the applicant possesses and maintains currently valid
California Highway Patrol inspection reports for each vehicle listed
in the application;
8. A description of the applicant company's training and orientation
programs for attendants, drivers, and dispatchers;
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9. Evidence of such financial responsibility and insurance coverage as
may be required by the Health Officer pursuant to regulations
adopted in accordance with this chapter;
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 5-16.04
of this chapter, 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 5-16.07(D)(2), (3), (4), (5), (6) or (7);
12. A list of all substations or offices where equipment 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:
a. The number of basic life support service or advanced life
support service units to be deployed on each shift;
b. The emergency response area(s) to receive basic life
support service or advanced life support service; and
C. The provisions, if any, for continuing education of attendants.
14. Such other information as the Health Officer may require in
regulations adopted pursuant to this chapter.
C. Renewal applications shall be submitted in the same form and require the
same materials as original applications, except the requirement of Section 5-
16.05(B)(11).
Sec. 5-16.06. Investigations.
Upon receipt of a completed application and the required fee, if any, the Health
Officer shall make, or cause to be made, such investigation as the Health Officer 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 chapter and of other
applicable laws, ordinances, or regulations.
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Sec. 5.16.07. Issuance or denial of license.
A. The Health Officer shall issue a license to an applicant if the Health
Officer, after completing any investigation required pursuant to this chapter, determines
all requirements of this chapter have been met and the license fee, if any, set by the
Orange County Board of Supervisors, has been paid.
B. In the event of denial, the applicant shall be informed by the Health Officer
in writing of the reasons therefore.
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 Officer, insuring the owner against loss by reason of injury or damage that may
result to persons or property from negligent operation or defective construction of such
ambulance, or from violation of this chapter 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 Officer shall
issue a license, copies of the policies, or certificates evidencing such policies, shall be
filed with the Health Officer. 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 Officer pursuant to regulations adopted under
this chapter. In the use of helicopters, the equivalent insurance requirements shall
apply.
D. Grounds for denial of a license application shall be:
Failure to meet the requirements of any provision of this chapter;
2. Violation by any principal of an applicant of Penal Code Section
290;
3. Use of narcotics or other controlled substances;
4. Conviction during the preceding seven (7) years of any crime
relating to the use, sale, possession, or transportation of narcotics,
or other controlled substances;
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;
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7. Conviction of any crime involving moral turpitude, including, but not
limited to, 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 Officer shall consider whether the criminal acts are related to the
activities of an ambulance service and shall evaluate the rehabilitation of the person(s)
involved. The Health Officer shall not consider crimes of which the applicant is, or was,
accused but not convicted.
Sec. 5-16.08. License suspension or revocation.
A. The Health Officer may suspend or revoke a license for failure by the
licensee to comply with, and maintain compliance with, or for violation of, any applicable
provision, standard, or requirement of state law or regulation or this chapter, or of any
regulations promulgated hereunder. Suspension of a license is not a condition
precedent to revocation of a license.
B. Before issuing a suspension or revocation, the Health Officer shall give
written notice to the licensee. Said notice shall:
1. Specify the reason(s) for which the proposed 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 Officer may rescind the suspension or revocation at any time.
D. At the hearing, the Health Officer 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 Officer 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
Officer 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
proceedings, 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.
8 06-15-2004
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 receiving the Hearing Officer's findings and conclusions.
Sec. 5-16.09. Appeal to Orange County 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 Orange County_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.
Sec. 5-16.10. Notification.
The licensee shall notify the Health Officer 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 chapter.
Sec. 5-16.11. Personnel Standards.
A. A licensee shall only employ personnel performing tasks described in this
chapter who comply with the requirements of this section.
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 Emergency Medical
Technician -1A ("EMT -1A"), or State educational equivalent, certification in compliance
with all State laws, rules, and regulations. Additionally, each attendant shall hold a
license from the Health Officer indicating compliance with this section. Applications for
such licenses shall be in a form required by the Health Officer and shall be
accompanied by the fee, if any, established therefore. All applicants for licenses as an
attendant shall be subject to the same criminal history review as required for principals
of ambulance companies pursuant to this chapter no less than once every four (4)
years. Certificates may be denied, suspended, or revoked in the same form and
manner as that specified for ambulance service licensees in this chapter. Licenses
shall be valid for two (2) years from the date of issuance or certification as an
Emergency Medical Technician -1A, whichever is less. Renewal of a license shall be in
the same manner as issuance of a new license.
C. Each licensee shall have at least one (1) 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
9 06-15-2004
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 chapter for
attendants, maintain an appropriate license issued by the California Department of
Motor Vehicles and, if applicable, the Federal Aviation Administration.
Sec. 5-16.12. Rates.
No licensee shall charge more than the maximum BLS rates approved by the
Orange County Board of Supervisors. No licensee shall charge more than the maximum
ALS rates approved by the Orange County Board of Supervisors or the Orange County
Fire Authority.
Sec. 5-16.13. Selection of ambulance service licensees for exclusive
operating areas.
A. The Orange County Fire Authority shall administer the competitive
process, on behalf of the local EMS agency, for the award of EOA contracts within the
City. The Orange County Fire Authority shall select and shall enter into contracts with
licensees for the provision of ambulance service in response to emergencies in each
EOA, unless the City has provided written notification to the Orange County Fire
Authority of its intention to retain licensee selection and contracting authority for itself.
Such contracts shall provide for one primary contractor per EOA, with such other back-
up service by other emergency ambulance service providers as deemed necessary by
the Fire Chief. In awarding these contracts, the Orange County Fire Authority, or City if
it elects to retain licensee selection and contracting authority, shall consider the
comparative value of competing proposals in the same fashion as would be the case
were the County evaluating proposals from prospective service providers for other
governmental activities, including consideration of:
The quality of service to be provided;
The level of service to be provided;
The rates charged for services to be provided; and
4. The cost, if any, to the awarding agency
B. The Fire Chief shall administer the contracts for ambulance service
awarded by the Orange County Fire Authority, or by the City if applicable, under this
Section. The Fire chief shall also prepare and keep current EOA lists specifying contract
providers for each EOA. The Fire Chief shall include on the list for each EOA the
provider which has entered into an ambulance service agreement with the Orange _
County Fire Authority, or the City if applicable, as the primary contractor as well as the
emergency ambulance service provider(s) who will provide back-up emergency
ambulance service for that area.
10 06-15-2004
C. In the event no proposals acceptable to the Orange County Fire Authority,
or to the City if it elects to retain licensee selection and contracting authority under the
provisions of this section, are received for one or more EOA's, the Orange County Fire
Authority, or the City if applicable, shall designate one or more licensees to provide
emergency ambulance services for the EOA. From the date of such designation until a
regular emergency ambulance service agreement is signed for the affected area(s),
provision of 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 chapter.
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 service 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:
1. A paramedic is present at the location of the patient; or
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 Authority, 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 5-16.14
of this chapter.
Sec. 5-16.14. Rules and Regulations.
A. As to all sections of this chapter except Section 5-16.13, the Health Officer
shall make such rules and regulations and as may be necessary to implement this
chapter. Prior to adoption, proposed rules and regulations shall be submitted to the
Orange County Emergency Medical Care Committee for comment.
B. As to Section 5-16.13 of this chapter, the Fire Chief shall make such rules
and regulations and as may be necessary to implement this chapter. Prior to adoption,
the Fire Chiefs rules and regulations shall be submitted to the Orange County
Emergency Medical Care Committee for comment.
C. The Health Officer or the Fire Chief or their respective designee(s) may
inspect the records, facilities, transportation units, equipment, and method of operating
of each licensee whenever necessary and, by the Health Officer, at least annually.
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Sec. 5-16.15. Complaints.
The Department, the City, any user, subscriber, public safety agency or
consumer who believes, or has reason to believe, that an individual has been required
to pay an excessive charge for services, received inadequate services, or services
provided were not in compliance with the provisions of this chapter, may file a written
complaint with the Department and the Fire Chief setting forth such allegations. The
Department and Fire Chief 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 the notification.
Sec. 5-16.16. Variance.
As to all but Section 5-16.13 of this chapter, the Health Officer may grant
variances from the terms of this chapter if he or she finds such action is necessary to
protect the public health, safety, or welfare. As to Section 5-16.13 of this chapter, the
Fire Chief may grant variances from the terms of this chapter if he or she finds such
action is necessary to protect the public health, safety, or welfare. As to the Health
Officer, such variances may include the issuance of a temporary license. No temporary
license shall exceed one hundred and eighty (180) days in duration.
Sec. 5-16.17. Violations - penalty.
Violation of any provision of this chapter by an ambulance service operator shall
be a misdemeanor.
SECTION 2. If any section, subsection, subdivision, paragraph,
sentence, clause or phrase added by this ordinance, or any part thereof, is for any
reason held to be unconstitutional or invalid or ineffective by any court of competent
jurisdiction, such decision shall not affect the validity or effectiveness of the remaining
portions of this ordinance or any part thereof. The City Council hereby declares that it
would have passed each section, subsection, subdivision, paragraph, sentence, clause
or phrase thereof irrespective of the fact that any or more subsections, subdivision,
paragraphs, sentences, clauses or phrases are unconstitutional, invalid or ineffective.
SECTION 3. This Ordinance shall take effect and be in force thirty
(30) days after its passage.
SECTION 4. The City Clerk shall certify to the adoption of this Ordinance
and cause the same to be posted at the duly designated posting places within the City
and published once within fifteen (15) days after passage and adoption as required by
law; or, in the alternative, the City Clerk may cause to be published a summary of this
Ordinance and a certified copy of the text of this Ordinance shall be posted in the Office
of the City Clerk five (5) days prior to the date of adoption of this Ordinance; and, within
fifteen (15) days after adoption, the City Clerk shall cause to be published the
aforementioned summary and shall post a certified copy of this Ordinance, together with
the vote for and against the same, in the Office of the City Clerk.
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STATE OF CALIFORNIA )
COUNTY OF ORANGE ) ss.
CITY OF SAN JUAN CAPISTRANO )
I, MARGARET R. MONAHAN, appointed City Clerk of the City of San Juan Capistrano, do
hereby certify that the foregoing is a true and correct copy of Ordinance No. 892 which was
regularly introduced and placed upon its first reading at the Regular Meeting of the City Council
on the 1st day of June 2004 and that thereafter, said Ordinance was duly adopted and passed
at the Regular Meeting of the City Council on the 15`" day of June 2004 by the following vote, to
wit:
AYES: COUNCIL MEMBERS: Allevato, Bathgate, Swerdlin, Hart, and Mayor Soto
NOES COUNCIL M MBERS: None
ABSENT: COUNCIL M MBJERS: None
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