Ordinance No. 750ORDINANCE NO. 750
AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF
CYPRESS CALIFORNIA REPEALING ORDINANCE 637 AND
ESTABLISHING NEW REQUIREMENTS FOR THE OPERATION OF
AMBULANCES IN THE CITY OF CYPRESS
The City Council of the City of Cypress, California, does
ordain as follows:
SECTION 1. Chapter 2A of the Code of the City of Cypress
is hereby repealed in its entirety and replaced by the
following:
Sec. 2A -1. 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 of Cypress 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 emergency response areas.
Sec. 2A -2. Definitions.
For purposes of this chapter, the following terms are
defined:
(a) Advanced life support service and basic life support
service 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 service 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 a 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 a driver, is
responsible for the care of patients.
(f) City means the City of Cypress, State of California.
(g) County means the County of Orange, State of 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 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 a sudden, unforeseen event giving rise
to a need for ambulance service with basic or advanced life
support services.
(1) Emergency response area means a geopgraphical location
specified by the Fire Chief within which emergency service may
be provided under a license.
(m) Emergency service means ambulance service performed in
response to an emergency.
(n) Fire Chief means the Director of Fire Services for the
County of Orange.
(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) License 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.
(u) Physician means a medical doctor or osteopath holding
the appropriate license or certificate to practice as such with
the State of California pursuant to the Business and
Professions Code.
(v) Public safety agency means any public law enforcement,
fire protection agency, or forest ranger operating in the
County.
2A -3. 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, 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 emergency response areas, reference to the emergency
response area by a specific number of 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 Division 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 Orange County regardless of destination.
(3) Ambulance service transporting a patient by a
fixed -wing airplane.
Sec. 2A -4. 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 license,
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.
(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. 2A -5. Applications.
(a) Each application for a license shall be accompanied by
an application fee, if any, set by the Board of Supervisors of
the County, 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, or proposes to engage in ambulance service;
(4) A description of each ambulance including 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 vehicle, 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 company's training and
orientation programs for attendants, drivers and dispatchers;
(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 2A -4, 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 Chapter
2A- 7(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:
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(i) The number of basic life support service or
advanced life support service units to be deployed on each
shift;
(ii) The emergency response area(s) to receive
basic life support service or advanced life support
service; and
(iii) 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 2A- 5(a)(11).
Sec. 2A -6. 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 inthe provision of abulance services;
(b) The application meets the requirements of this chapter
and of other applicable laws, ordinances or regulations.
Sec. 2A -7. 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 Board of Supervisors, has been paid.
(b) In the event of denial, the applicant shall be
informed in writing of the reasons therefor.
(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:
(1) Failure to meet the requirements of any
provisions of this chapter;
(2) Violation by any principal of an applicant of
Penal Code Section 290;
(3) Habitual or excessive use of narcotics or
dangerous drugs;
(4) Conviction during the preceding seven (7) years
of any crime relating to the use, sale, possession or
transportation of narcotics, addictives or dangerous drugs;
(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;
(7) Conviction of any crime involving moral
turpitude, including 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 persons involved. The Health Officer
shall not consider crimes of which the applicant is, or was,
accused but not convicted.
Sec. 2A -8. License Suspension or Revocation.
(a) The Health Officer may suspend or revoke license for
failure by the licensee to comply, and maintain compliance
with, or for violation of, any applicable provisions, standards
or requirements of State law or regulation, of this chapter, or
of any regulations promulgated hereunder. Suspension of a
license is not a condition precedent to revocation of a license.
(b) Before suspension or revocation, the Health Officer
shall give written notice to the licensee. Said notice shall:
(1) Specify the reasons for which the 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 a 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 proceeding, 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.
(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 conclusion of the
hearing.
Sec. 2A -9. Appeal to 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 City Council, which hearing shall
be requested and conducted in the manner specified in Section
5 -2 -19 of the Codified Ordinances of Orange County.
Sec. 2A -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. 2A -11. Personnel Standards.
(a) A licensee shall only employ personnel performing
tasks described in this chapter who comply with the
Requirements of this section.
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(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 "EMT 1A" 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 therefor. 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 years. Certificates
may be denied, suspended, or revoked in the same form and
fashion as that specified for ambulance service licensees in
this chapter. Licenses shall be valid for two 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 fashion as issuance of a new license.
(c) Each licensee shall have at least one 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 protocals and to
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 chpater for attendants, maintain an
appropriate license issued by the California Department of
Motor Vehicles and, if applicable, the Federal Aviation
Administration.
Sec. 2A -12. Rates.
No licensee shall charge more than those rates approved by
the Board of Supervisors for emergency ambulance services.
Sec. 2A -13. Usage of Ambulance Service Licensees.
(a) The County shall contract with licensees on a
competitive basis for provision of ambulance service in
response to emergencies in each emergency response area. Said
contracts shall provide for one primary contractor per
emergency response area, with such other back -up service by
other emergency ambulance service providers as deemed necessary
by the County. In awarding these contracts, the County shall
consider the comparative value of competing proposals in the
same fashion as would be the case where the County evaluating
proposals from prospective service providers for other County
activities, including consideration of:
(1) The quality of service to be provided;
(2) The level of service to be provided;
(3) The rates charged for services to be provided; and
(4) The cost, if any, to the County.
(b) The Fire Chief shall administer the contracts for
ambulance service awarded by the Board of Supervisors under
this section. The Fire Chief shall also prepare and keep
current emergency response area lists specifying contract
providers for each area. The Fire Chief shall include on the
list for each emergency response area the provider which has
entered into an ambulance service agreement with the County as
the primary contractor as well as the emergency ambulance
service provider(s) who will provide back -up emergency
ambulance service for that area.
(c) In the event no proposals acceptable to the County
under the provisions of this section are received for one or
more emergency response areas, the County shall designate one
or more licensees in that emergency response area to provide
emergency ambulance services. 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 resonding 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 Department, or an appropriate employee of a public safety
agency designated by regulation directs transportation in the
absense 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 2A -14.
Sec. 2A -14. Rules and Regulations.
(a) As to all sections of this chapter except Section
2A -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 2A -13, the Fire Chief shall make such
rules and regulations and as may be necessary to implement this
chapter. Prior to adoption, the Fire Chief's 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
designee(s) may inspect the records, facilities, transportation
units, equipment and method of operations of each licensee
whenever necessary and, by the Health Officer, at least
annually.
Sec. 2A -15. Complaints.
The Department, any user, subscriber, public safety agency
or consumer who believes, or has reason to believe, that he or
another party has been required to pay an excessive charge for
services, received inadequate services or services provided
were not in compliance with the provision of this chapter, may
file a written complaint with the Department setting forth such
allegations. The Department 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 notification.
Sec. 2A -16. Variance.
As to all but Section 4 -9 -13, the Health Officer may grant
variances from the terms of this chapter if he finds such
action is necessary to protect the public health, safety or
welfare. As to Section 4 -9 -13, the Fire Chief may grant
variances from the terms of this chapter if he 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 variance shall exceed
one hundred and eighty (180) days in duration.
Sec. 2A -17. Violation.
Violation of any provision of this chapter by an ambulance
service operator shall be a misdemeanor.
SECTION 2. This ordinance is adopted as an urgency measure
to avert damage to the public health, safety and welfare by
assuring a coordinated program for the delivery of ambulance
services.
SECTION 3. Severability. If any section, subsection,
subdivision, sentence, clause, phrase, or portion of this
ordinance, or the application thereof to any person or place,
is for any reason held to be invalid or unconstitutional by the
decision of any Court of competent jurisdiction, such decision
shall not affect the validity of the remaining portions of this
ordinance or its application to other persons or places. The
city council hereby declares that it would have adopted this
ordinance, and each section, subsection, subdivision, sentence,
clause, phrase or portion thereof, irrespective of the fact
that only one or more sections, subsections, subdivisions,
sentences, clauses, phrases, or portions or the application
thereof to any person or place, be declared invalid or
unconstitutional.
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SECTION 4. The City Clerk is hereby authorized and
directed to certify as to the passage of this ordinance and to
give notice by causing copies of this ordinance to be posted in
three (3) public places throughout the City.
INTRODUCED AND ADOPTED at a regular meeting of the City
Council of the City of Cypress held on the 23rd day of
September 1985.
In the event that it is hereafter judicially determined
that this ordinance may not be enacted as an urgency measure,
this ordinance shall be determined to have received its first
reading at a regular meeting of the City Council of said City
held on the 23rd day of September , 1985, and finally
adopted and ordered posted at a regular meeting of said Council
held on the 15th day of October , 1985.
ATTEST:
CITY RKC THE C Y OF CYPRESS
MAYOR OF HE CITY OF CYPRESS
STATE OF CALIFORNIA )
SS.
COUNTY OF ORANGE
I, DARRELL ESSEX, City Clerk of the City of Cypress, DO
HEREBY CERTIFY that the foregoing Ordinance was duly adopted at
a regular meeting of said City Council held on the 23rd day of
September 1985 by the following roll call vote.
AYES: 5
NOES: 0
ABSENT: 0
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COUNCIL MEMBERS: Coronado, Lacayo, Mullen, Partin,
and Kanel
COUNCIL MEMBERS: None
COUNCIL MEMBERS: one
CITY CL RF:` •F THE. ITY OF CYPRESS
STATE OF CALIFORNIA )
COUNTY OF ORANGE ) SS
I, DARRELL ESSEX, City Clerk of the City of Cypress,
DO HEREBY CERTIFY that the foregoing Ordinance was duly
adopted at a regular meeting of the said City Council held
on the 15th day of October 1985; by the following roll call
vote:
AYES: 4 COUNCIL MEMBERS: Coronado, Lacayo, Partin and
NOES: 0 COUNCIL MEMBERS: None Kanel
ABSENT: 1 COUNCIL MEMBERS: Mullen
Y OF CYPRESS