§ 45-58. Ambulance requirements.

(a)

Operations, standards and procedures, equipment and response times.

(1)

In order to be placed into service, each ambulance must be currently approved by the California Highway Patrol and the LEMSA, pursuant to the EMRO.

(2)

Each ambulance must be maintained in a safe operating condition, including all engine parts, body parts, and all other operating parts, and equipment used in and on the unit.

(3)

Each ambulance must have affixed on each side and the rear thereof the unit designation assigned by the operator and name of the service. The lettering for such identification shall be at least four (4) inches in height. The assigned unit designation shall also be affixed to the ambulance top and shall be at least twenty-four (24) inches in height.

(4)

Every ambulance operated in Butte County shall be in a clean and sanitary condition subject to the sanitary standards as are prescribed by the LEMSA.

(b)

Communication equipment. Each ambulance shall be equipped with at least the following communication equipment:

(1)

Standardized UHF/Mobile radio providing at least ten (10) channels with fixed unit located in the patient compartment of the vehicle.

(2)

VHF 16 Channel (minimum) radio with Butte County recommended frequencies.

(3)

At least one (1) portable UHF radio.

Additional communications equipment requirements may be established by the LEMSA.

(4)

All radio communication equipment shall be narrow band capable as required by the FCC.

(c)

Required personnel.

(1)

The service must maintain sufficient staff to ensure twenty-four (24) hour dispatch capability.

(2)

No service will allow either ambulance Attendants or Drivers to work more than forty-eight (48) hours consecutively. If a service allows its Attendants or Drivers to work forty-eight (48) hours consecutively it is prohibited by this chapter to do so more than one (1) time per consecutive fourteen (14) day period. During any shift longer than twenty-four (24) hours, Drivers and Attendants shall perform only pre-hospital care and shall have no other duties.

(3)

In addition to any other requirements contained herein, no service may utilize a Driver to operate a unit unless:

a.

He or she is familiar with the EOA or other geographic area of the Provider's service area;

b.

He or she has adequate knowledge of all the hospitals within the EOA or other geographic area of the Provider's service area;

c.

He or she can operate a two (2) way radio; and

d.

He or she can drive an ambulance under emergency conditions.

(4)

Each service must provide written notice to the LEMSA of any change in personnel or ambulances, within ten (10) days after such change, unless an alternate plan has been approved by the LEMSA.

(5)

Services may utilize only those Drivers and Attendants who are appropriately licensed, certified and accredited.

(6)

When in operation every ambulance must be staffed, at a minimum, by two (2) persons, one (1) of whom is an Attendant and the other a Driver.

(7)

Services must ensure to the best of their ability that their attendants are free of physical defects or diseases which may either endanger their patients or impair their ability to attend to patients.

(d)

Insurance requirements.

(1)

Each ambulance service Provider shall obtain and keep in force during the term of its Provider Agreement insurance coverage issued by a company authorized to do business in the State of California and of the type and coverage amount specified in Section 45-42.

(2)

Each ambulance placed into operation by the Provider shall be included within the scope of the required insurance coverage and limits.

(e)

Vehicle Equipment.

(1)

All ambulances must have equipment as specified in the LEMSA policy referencing Vehicle Equipment List.

(2)

All medical equipment and supplies on ambulances must be stored pursuant to LEMSA approved medical control policies.

(f)

Requirements for interior configuration, design and dimension of ambulances. Each ambulance must:

(1)

Contain at least three hundred (300) cubic feet of space.

(2)

Have additional shelf and other storage space sufficient for controlled substances including locked storage in accordance with Section 45-59.1.

(3)

Have proper storage of other medical equipment and supplies to prevent patient injury in transit and to meet approved procedures for management of patients.

(4)

Have systems which will control temperature adequately to maintain the integrity of the medical supplies and drugs as well as the health and safety of the patients and Attendants.

(g)

Maintenance program. Each ambulance, at a minimum, shall be maintained in accordance with a maintenance and replacement plan approved by the LEMSA.

(h)

Required equipment reserve. Each Provider is to maintain a minimum backup reserve to adequately meet response time standards. These ambulances must normally be based in Butte County and readily available for immediate use. The ambulances would be used for high volume periods, standbys, and backup for transfers and maintenance.

(i)

Response time criteria. Each ambulance service Provider shall meet or exceed the response time criteria established for all areas as determined by LEMSA policy.

(j)

Dispatching. Each 911 ambulance service Provider in Butte County shall be required to adhere to the following dispatching requirements:

(1)

Any requirement set forth by the LEMSA in any competitive procurement process documents for the provision of ambulance services which includes ambulance dispatch.

(2)

Twenty-four (24) hour EMD.

(3)

Have radio equipment sufficient to permit communication:

a.

With all ambulances operated by the service; and

b.

Permitting communication with the service's local and county public service answering points.

(4)

Phone system with multi outside line capability.

(5)

Back-up power system with an automatic start or immediate access to an alternative dispatching source.

(6)

Complying with all CHP guidelines.

(k)

Call Service. Non-911 ground ambulance service Provider are not required to provide dispatching services as set forth in sub-section (j) above. However, such Providers shall be required to provide a call-answering service twenty-four (24) hours per day, seven (7) days per week.

(l)

Station Requirements. Every station and substation used by an ambulance service must meet the following requirements:

(1)

Compliance with applicable building, fire, zoning and land use codes and regulations;

(2)

Adequate sanitary storage space for equipment and materials to be used in the operation of the service;

(3)

Communication capability with a central dispatch facility having both a primary and secondary communication system;

(4)

Properly located to permit any ambulance operating therefrom rapid and safe egress to a main thoroughfare;

(5)

Adequate off-street parking space for all units operating therefrom;

(6)

Attended by EMD personnel on a twenty-four (24) hour basis, unless the service participates in a central dispatch facility approved by the LEMSA and provides EMD and pre-arrival instructions;

(7)

At least one (1) additional clean uniform for each on duty staff member;

(8)

Maintained in a clean and sanitary condition and have suitable sleeping quarters, and an on-site restroom facility;

(9)

Maintain clean, sanitary and safe food preparation and storage facilities.

(m)

Every station and substation shall be inspected prior to the issuance of any Provider Agreement and, thereafter, shall be inspected at least once yearly by the LEMSA or its designee(s) for the purpose of determining whether or not the station or substation is in compliance with the EMRO and any other health department regulations.

(Ord. No. 4057, § 1, 5-21-13)