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Ordinance No. 6371.2 ORDINANCE NO. 637 AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF CYPRESS ADDING CHAPTER 2A TO THE CODE OF THE CITY OF CYPRESS RELATING TO THE REGULATIONS OF AMBULANCES. THE CITY COUNCIL OF THE CITY OF CYPRESS HEREBY DOES ORDAIN AS FOLLOWS: SECTION 1. Chapter 2A, "Ambulances ", hereby is added to the Code of the City of Cypress to read as follows: CHAPTER 2A AMBULANCES Sec. 2A -1. Intent and Purpose. It is the intent of this Chapter to prescribe the basic regulations for the operation of ambulances and convalescent transport vehicles in the City of Cypress 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 Chapter to provide a fair and impartial means of selecting responsible private operators to engage in ambulance and con- valescent care and transportation in the public interest and to prevent the deleterious effects of unregulated competition in such service. In addition, it is the desire that this Chapter be used by all incorporated cities of this County to the extent feasible, as a model city ordinance,to eliminate or mini- mize duplicating regulations and to assure the smooth and coordinated delivery of such services in Orange County. Sec. 2A -2. Definitions. The following terms, as used in this Chapter 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 trans- porting 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. (g) Business means any trade, business, occupation, practice or pro- fession. (h) City means the City of Cypress, State of California, County of Orange. (i) Department means Public Health and Medical Services of the Human Services Agency - County of Orange. 13 (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 or 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 am- bulance 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. Sec. 2A -3. 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 conva- lescent transport service upon the streets, or any public way or place in the City, without possession of a license issued pursuant to this Chapter. A licensed ambulance service may provide convalescent transport service without the necessity of an additional license. No license may be trans- ferred by operation of law or otherwise: (b) Exceptions. The provisions of this Chapter 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 the City regardless of destination. Sec. 2A -4. 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. (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 ser- vice 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 res- ponse area from which the request originates. - 2 - 14 (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 transportation 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. Sec. 2A -5. Application. (a) Procedure and Information Required. Applicants for ambulance 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) If 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. (5) (i) applicant transport qualified A statement of facts showing the experience of the in the operation of an ambulance service or convalescent service and demonstrating that the applicant is to render efficient ambulance service or convales- cent 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 Vehicle Code) shall be appended to the application. (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 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 Chapter, and applicable provisions of City and State laws and regulations. - 3 - 15 (10) A statement that the applicant employs sufficient per- sonnel 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 train- ing for each ambulance service or convalescent transport service employee, and a copy of each certificate or license issued by the State or County establishing qualifications of such personnel in ambulance or convalescent transport operations. (12) A statement that shows to the satisfaction of the Depart- ment 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) Such other facts or information as the Department may require. (b) Renewal of License. Applicants for renewal of an ambulance service license under this Chapter 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 (ii), 6, 7, 8, 9, 10, 11, 12, 13, above. (c) Convalescent Transport Services. Applicants for original or renewal license of a convalescent transport service license under this Chapter shall file with the Department an application in writing, on a form to be furnished by the Department which shall include the infor- mation required in Subsections 1, 2, 3, 4, 5 (1), 7, 8, 9, 11, 12, 13 above. Sec. 2A -6. 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 Chapter. 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 and to all persons holding ambulance service licenses. Notice shall be given to the general public by posting in the Orange County Hall of Administration at least 15 days prior to said hearing. Sec. 2A -7. 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) That the public health, safety, welfare, convenience and necessity requires such ambulance services, including any requested emergency response areas. (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: - 4 - 16 (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 Chapter; (3) Has commit ted 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 Chapter; (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 rehabilitation of such person. (e) In the event of denial, the applicant shall be informed in writing of the reasons therefor. Sec. 2A -8. Liability Insurance. The licensee shall obtain and keep in force during the term of said license, comprehensive automobile liability insurance and professional lia- bility 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 may result to persons or property from negligent operation or defective construction of such ambulance, or convalescent transport vehicle, 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 Five Hundred Thousand Dollars ($500,000) for combined single limit, bodily injury and property damage. Said pro- fessional 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 compre- hensive automobile liability insurance shall be subject to review and adjust- ment by the City annually at the City's option. Sec. 2A -9. 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 exists for the license holder and the license holder has, during the period of the expiring license, operated in conformity with the provisions of this Chapter 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. Sec. 2A -10. 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 require- ments deemed unnecessary. 5 Sec. 2A -11. Term of License. A license shall remain in effect for a period of one (1) year. Sec. 2A -12. 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 (24) 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 Officer immediately in writing, stating the facts of such change. Sec. 2A -13. 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. Sec. 2A -14. Emergency Service Availability. 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 reasons 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. Sec. 2A -15. 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 ambu- lance 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 com- pliance 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 (2) years. Sec. 2A -16. 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: 18 (a) Violated any section of this Chapter, any applicable regu- lations 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. Sec. 2A -17. Ambulance Rates. No licensee shall charge more 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 City Council. Said rate schedule is incorporated herein by reference, and is on file in the office of the Clerk of the City Council. Said rate schedule shall be adopted by the City Council following a public hearing. (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 accom- pany a patient. Sec. 2A -18. Emergency and Disaster Operation. 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 equip- ment, 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. Sec. 2A -19. 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 Chapter. - 7 - Sec. 2A -20. 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 per - sonnel, and standards of dispatch for the effective and reasonable administration of this Chapter. Prior to adoption, said regulation shall be submitte'd to the Fire Chiefs Association and the Emergency Medical Care Committee for their comments and to the City Council for approval. (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. Sec. 2A -21. 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 State law or State regulation. Sec. 2A -22. Variances. The Health Officer may grant a variance from the terms of this Chapter 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. SECTION 2. 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 any 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. SECTION 3. The City Clerk hereby is authorized and directed to certify as to the passage of this ordinance and to give notice thereof by causing copies of this ordinance to be posted in three public places within the City. FIRST READ at a regular meeting of the City Council of said City held on the 22nd day of January 1979, and finally adopted and ordered posted at a regular meeting of said Council held on the 13th day of February 1979. ATTEST: CITY CLERK OF THE CYTY /' F CYPRESS 8 MAYOR OF 'E CITY OF CYPRESS • 20 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 13th day of February 1979; by the following roll call vote: AYES: 5 COUNCIL MEMBERS: NOES: 0 COUNCIL MEMBERS: ABSENT: 0 COUNCIL MEMBERS: Evans, Lacayo, MacLain, Rowan and Hudson None None CITY CLERK OF THE CIl� OF CYPRESS