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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. 0 (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. -1- (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. -2- 29"7 (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. -3- (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. _n_ 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. -5- (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: -7- 302 (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: