Chapter 4.18 AMBULANCE SERVICES

Adequate emergency medical services, including ambulance services, are indispensable to the health, safety and well-being of the Rancho Cordova community.

Because of the geographic nature of the city, the proximity of hospitals and other health care centers, the inability of ambulance services to recover charges for emergency responses to low income persons and responses to false alerts and other calls which do not result in the provision of a service, and other factors, a fragmented delivery system with unlimited competition in the delivery of such services, whether by public or private entities, will not guarantee either adequate response to all areas of the city and to all income segments of the population or affordable and cost-effective services.

Pursuant to the provisions of the Emergency Medical Services Act (Section 1797 et seq. of the Health and Safety Code), Section 13862(e) of the Health and Safety Code, and the city’s emergency medical services plan, the purposes of this chapter are to establish a regulatory system by licensing and otherwise, to administer and control the provision of emergency ambulance services, including emergency ambulance services, and to impose affirmative service obligations to be performed by licensees, guaranteeing the adequacy and efficiency of emergency ambulance services to the city. [Ord. 38-2007 § 1 (Exh. 1(A)); Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 0924 § 1, 1993; SCC 0923 § 1, 1993; SCC 578 § 8 (part), 1983].

4.18.005 Director.

The county director of the department of health and human services is charged with the responsibility of administering the regulations imposed by this chapter and exercising the authority conferred thereby. Such authority shall include the power and duty to issue special business licenses authorizing ambulance services, promulgate and enforce administrative regulations, enter into contracts, designate advance life support transportation providers and otherwise perform the duties and exercise the authorities conferred herein.

To these ends, the county director of the department of health and human services shall be vested with the same powers and authorities in relation to ambulance services and the issuance and administration of special business licenses therefor as are vested in the chief of police under RCMC 4.02.070, 4.02.085, 4.02.100 and 4.02.105; and RCMC 4.10.000 through 4.10.155. Any reference to the chief of police in said sections shall be deemed to be a reference to the director in relation to ambulance services.

Whenever the term “director” is used in this chapter, the term shall mean the county director of the department of health and human services. [Ord. 38-2007 § 1 (Exh. 1(A)); Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 1204 § 13, 2001; SCC 0924 § 1, 1993; SCC 0869 § 14, 1992; SCC 578 § 8 (part), 1983].

4.18.010 Definitions.

As used in this chapter, the terms defined by RCMC 4.18.015 through 4.18.040 shall be ascribed the meanings indicated therein. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.015 Definitions – Ambulance.

“Ambulance” means any privately or publicly owned or leased vehicle specifically constructed, modified, equipped or arranged and used for the purpose of transporting sick or injured persons and which responds or may respond to medical emergency calls in this city. [Ord. 38-2007 § 1 (Exh. 1(A)); Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 0924 § 1, 1993; SCC 0923 § 1, 1993; SCC 578 § 8 (part), 1983].

4.18.020 Definitions – Ambulance service.

“Ambulance service” means the activity, business or service conducted by any person, for hire, profit or otherwise, of transporting in medical situations one or more patients by ambulance on or in any of the streets, roads, highways, alleys or any public way or place in the city. [Ord. 38-2007 § 1 (Exh. 1(A)); Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 0924, § 1, 1993; SCC 0923 § 1, 1993; SCC 578 § 8 (part), 1983].

4.18.025 Definitions – Attendant.

“Attendant” means a trained, qualified individual who, regardless of whether such individual also serves as driver, is responsible for the care of ambulance patients and who has met all license and other requirements established under applicable state laws and regulations. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.026 Definitions – Person.

“Person” shall mean a sole proprietorship, partnership, corporation, unincorporated association, cooperative, joint venture or other individual entity carrying on an enterprise, business or service for which a permit or license must first be procured, and shall include any officer, employee, agent or other representative by or through whom the enterprise, business or service is operated or conducted, and charitable, philanthropic and other nonprofit entities and enterprises as well as those which are for profit.

“Person” shall also include a public agency, including but not limited to a city, fire protection district, or community services district and any officer, employee or agent thereof while acting in the capacity as such, except as otherwise provided by the Emergency Medical Systems Act. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 0924 § 1, 1993; SCC 0923 § 2, 1993].

4.18.030 Definitions – Driver.

“Driver” means an individual who drives an ambulance and who has met all license and other requirements established under applicable state law and regulations. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.035 Definitions – Emergency.

“Emergency” means a situation in which there is a perceived physiological or psychological need for immediate medical care, based on an injury or other unforeseen acute physical or mental disorder which apparently threatens life or function. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.040 Definitions – Patient.

“Patient” means a person who is in need of medical emergency ambulance services. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.045 Emergency response zones.

The director is hereby authorized to divide the city into service areas for the provision of emergency ambulance services, each service area to be known as an emergency response zone. The zones shall be described on a map which is maintained in the office of the director, and is available for public inspection during regular office hours. Notwithstanding any provision to the contrary, those emergency response zones established by the director in advance of the date of enactment of this chapter shall remain in full force and effect until hereafter amended or revised.

Subject to preemptory amendment by the city council at any time following a public hearing, notice of which is given in the manner prescribed by RCMC 4.02.090, the director shall be authorized from time to time to amend, revise, create, abolish or otherwise alter the boundaries of emergency response zones.

The notice of the annual public hearing relating to rates required by RCMC 4.18.130 shall inform the public of its right to inspect the then-current emergency response zone map, and invite public comment thereon during that hearing. At the conclusion of that public hearing, the director, in addition to the determinations required by RCMC 4.18.130 relating to rates, shall make a determination respecting affirmance or modification of the emergency response zones in the same manner and in accordance with the same procedure as is applicable to rate determinations; provided, that findings of fact and conclusions shall not be required. The director’s determination shall be appealable to the city council in the same manner and in accordance with the same procedures as are applicable to rate determinations under RCMC 4.18.135.

Emergency response zones shall be defined in a manner which best promotes the provision of emergency ambulance services, and in formulating such zones, such factors as the following shall be considered: the geographical area to be served in relation to the public street system, the distribution of population, the proximity of hospitals and other health care centers, minimally necessary response times, and the economics of ambulance services. [Ord. 38-2007 § 1 (Exh. 1(A)); Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 0924 § 1, 1993; SCC 0923 § 1, 1993; SCC 578 § 8 (part), 1983].

4.18.050 Special business license required.

Except as provided by RCMC 4.18.055, no person shall operate or conduct a business which responds to a location within the city for the purpose of providing an emergency ambulance service to an individual at that location, unless under and by authority of a valid, unexpired and unrevoked special business license authorizing emergency ambulance services issued pursuant to the provisions of Chapter 4.10 RCMC and this chapter.

Unless dispatched by the county communications center, no person possessing a special business license authorizing ambulance services shall respond to a location within the city but outside the emergency response zone for which the license is issued for the purpose of providing an emergency ambulance service at the location to which response is made.

No person performing advanced life support services (as defined in Section 1797.52 of the California Health and Safety Code) shall provide ambulance services without a special business license authorizing ambulance services and without being designated as an advanced life support transportation provider by the city’s EMS agency.

Any city or fire district having the right to operate an ambulance service pursuant to the provisions of Section 1797.201 of the California Health and Safety Code shall be granted a special business license authorizing ambulance services upon application, receipt by the department of medical systems of all information required to confirm that such applicant has the right to operate an ambulance service under Section 1797.201 of the California Health and Safety Code, and determination by the department that the applicant is so entitled. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 0924 § 1, 1993; SCC 0923 § 1, 1993; SCC 578 § 8 (part), 1983].

4.18.055 Exceptions.

A special business license shall not be required, and neither the provisions of Chapter 4.10 RCMC nor those of this chapter shall be applicable to:

A. Vehicles operated as ambulances and persons engaged in the ambulance service where ambulance services are rendered at the request of the county communications center or at the request of any public protection agency during and as a result of any state or local emergency, local disaster or local peril proclaimed by a public official pursuant to law;

B. The transportation of an individual in need of emergency medical care at the direction of any peace officer, firefighter or physician licensed to practice medicine in this state, when no ambulance of a licensed ambulance service is available and such transportation is required immediately for the preservation of life;

C. Ambulances transporting patients through the city from locations outside the city to locations outside the city, or from outside the city to a location within the city; or

D. Nonemergency ambulance services provided within the city. [Revised during 2008 codification; Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.060 Authority of licenses – Term – Amendment.

A special business license for the provision of emergency ambulance services shall authorize the holder thereof to provide emergency ambulance services within the emergency response zone or zones identified in the license which the provider holds.

Notwithstanding the provisions of RCMC 4.02.080, the term of special business licenses issued pursuant to the provisions of this chapter shall commence on July 1st and end on June 30th each year, unless earlier suspended or revoked. An initial license shall expire on the June 30th next following the date of issuance, and the fee prescribed pursuant to the provisions of RCMC 4.02.060 shall be prorated based upon the number of months within the initial term.

The amendment of an emergency response zone by revision of the boundaries thereof or otherwise by the director or city council pursuant to RCMC 4.18.045 shall become effective as to any licensee affected thereby 60 days following the date of service of written notice thereof upon the licensee, and the service requirements of the license shall be deemed to be amended accordingly. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.065 Number of licenses per zone.

The director shall authorize emergency ambulance services within each emergency response zone by such number of holders of special business licenses as he or she, in his or her discretion, determine will best promote the public interest. The public interest shall be deemed best promoted by the apportionment of services in a manner which assures the most comprehensive, reliable and expeditious emergency ambulance service in all areas, at the lowest cost to the consumer, and with the least amount of city subsidy necessary to underwrite the uncompensated costs thereof. In determining what best promotes the public interest, the director shall consider such factors as the economics of ambulance services; the benefits, if any, of rate competition; the socioeconomic composition of the population served; the geographic population distribution within each emergency response zone; the geographical characteristics of such zone in relation to the available traffic circulation systems; the ambulance service capacity possessed by providers; the capital investment required to provide emergency ambulance services; and the practical difficulties, if any, of enforcing uneconomical service mandates. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.070 Application.

Notwithstanding the provisions of RCMC 4.10.025, the application for a special business license to provide ambulance services shall be filed in the office of the director.

In addition to the matters prescribed by RCMC 4.10.030, an application shall contain the following:

A. All names under which the applicant has engaged, does, or proposes to engage in ambulance services;

B. A description of each ambulance, including the make, model, year of manufacture, motor and chassis numbers, and current state license numbers;

C. Assurance that the applicant has obtained all licenses and permits required by the state laws or regulations for ambulances and ambulance operators;

D. The station location from which the ambulance will operate;

E. Evidence of such financial responsibility or insurance coverage as may be required by the director in regulations issued by him;

F. Designation of which emergency response zone or zones the applicant proposes to serve with emergency ambulance services; and

G. With respect to new applicants only, all facts which the applicant desires to present for the purpose of showing that the issuance of the license to provide emergency ambulance services within the zone or zones proposed would best promote the public interest. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.075 Issuance.

A. Prior to action upon an application, the application shall be referred for written recommendation to any advisory body which has been designated by the city council to act thereon.

B. The director shall issue a special business license to provide emergency ambulance services unless:

1. One or more of the findings prescribed by RCMC 4.10.040 are made; or

2. The director finds in writing that the applicant is not capable of conducting or operating the ambulance service in a manner which is safe and otherwise satisfies minimum medical standards relating to the transportation or medical care of patients; or

3. The director finds in writing as to a particular zone for which application is made that provision of the emergency ambulance service would not best promote the public interest.

C. That definition of “best promote the public interest” contained in RCMC 4.18.065 shall apply to the determination by the director under this section, and those factors prescribed by said section shall be considered.

D. The refusal of the director to approve a proposal to provide emergency ambulance services within a particular emergency response zone shall be evidenced by a written notice containing the finding which is served upon the applicant; and shall be deemed to constitute a form of denial of the application which authorizes an appeal under RCMC 4.10.115, even if the license is issued authorizing service in another zone. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.080 Change of information.

The applicant and permittee shall report to the director any change in the data required in RCMC 4.18.070 within 10 days of the effective date of the change, except that any change in the data required by RCMC 4.10.030(C) or (D) and RCMC 4.18.070(D) shall be reported immediately. No change or addition of ambulance station location may be made without the prior written consent of the director. [Revised during 2008 codification; Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.085 Investigations.

At his initiative, and at the request or direction of the city council, the director shall conduct such investigations respecting the efficiency, adequacy and quality of the delivery of emergency ambulance services as the director, in his or her sole discretion, or city council, in its sole discretion, determines necessary or appropriate for protection of the public welfare.

The director may prepare and issue such written reports concerning the results of any investigations conducted as he or she deems appropriate, and shall prepare and issue such reports as may be directed by the city council. Any such reports shall omit the names and any other personally identifiable information concerning persons who have received emergency ambulance services, and shall also omit any data respecting the salaries or other compensation of the personnel of an ambulance service, the earnings from business operations and other financial data of an ambulance service, and any other information or data which the director deems that the public interest requires be confidentially maintained. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.090 Inspections.

Each ambulance, its equipment and the premises designated in the application, and all records relating to maintenance and operation of an ambulance service, shall be open to inspection during regular working hours by the director or his or her designated representative.

The refusal by a licensee or an officer, employee or agent thereof to permit inspection by the director or designated representative pursuant to the authority conferred by this section shall constitute grounds for suspension or revocation of the special business license. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.094 Service fees for administering, regulating, and monitoring licensed ambulance providers.

Each holder of a special business license pursuant to this chapter shall pay to the city fees in such amounts as are annually prescribed by resolution adopted by the city council. Revenue from such fees shall not exceed the costs incurred by the various departments of city government in administering, regulating and monitoring the provisions of this chapter.

Holders of such licenses may be required to pay a monthly or annual fee, and the amount of such fee may be differentiated based upon the number of ambulances utilized by the licensee, the number of patient transports performed by the licensee on an annual or monthly basis, or other factors designed to reasonably apportion the cost of administration, regulation and monitoring. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 0910 § 1, 1993].

4.18.095 Public inspection of records.

It is understood that all records maintained by the director are subject to inspection by members of the general public under those terms, conditions and limitations prescribed by Section 6250 et seq. of the Government Code. A licensed ambulance service may file with the director a written request that the director deny inspection or copying to members of the general public of specifically enumerated types of information contained in its application for the special business license or application for renewal thereof, or collected or received by the director or his or her designated representative pursuant to investigations or inspections authorized by RCMC 4.18.085 or 4.18.090. The written request shall: (A) identify in specific detail the information to be denied inspection; (B) offer to compensate the city for such administrative costs as may be incurred in the alteration of records or supervision of inspection in such a manner as to deny inspection of the materials specified and permit inspection of other material; (C) shall offer to defend the city and any officer, employee or agent thereof against any lawsuit commenced for the purpose of obtaining a court order authorizing inspection, identifying the name and business address of the attorney who would provide the defense at the sole cost and expense of the licensee; and (D) shall promise that all costs, fees or damages, including attorneys’ fees, incurred by the city in refusing inspection would be paid directly by the licensee at its sole cost and expense.

With respect to any specifically identified data or information the disclosure of which is requested by a licensee to be denied, which the director finds would not be relevant as evidence in any proceeding relating to the issuance, renewal, suspension or revocation of a special business license under the provisions of Chapter 4.10 RCMC and this chapter, the director shall deny to a member of the general public the opportunity to inspect or copy a record containing the information from and after the date of receipt of the request filed in the manner and form prescribed above and deposit of any reimbursement required to cover the cost of implementing the denial of inspection.

In any proceeding commenced for the purpose of enforcing a right to inspect data or information covered by a request by a licensee, the director may elect that defense of the city, the director or the city’s other officers, employees or agents be conducted and performed by the city attorney. In such event, the licensee shall pay to the city the cost of all services rendered by the city attorney according to the standard hourly rate which the city attorney charges for the rendition of legal services, in addition to all costs, fees and damages which the licensee may be required to pay directly to the party or parties who have prosecuted the litigation.

The failure of any licensee to comply with the promises contained in a request filed pursuant to this section, or to fulfill any financial obligations imposed by this section, shall constitute grounds for suspension or revocation of the special business license. In addition, the city shall be authorized to recover from the licensee as a debt all amounts, plus interest, which a licensee becomes obligated to pay under this section. [Revised during 2008 codification; Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

Article II. Requirements – Services

4.18.100 Driver and attendant qualifications.

A. Each holder of a special business license under this chapter shall employ only drivers and attendants who have met all license training and other requirements in applicable state laws and regulations, and who have completed such additional training as may be prescribed by the director in regulations adopted by him.

B. The attendant need not comply with the training requirements established under this chapter if he is a physician licensed to practice medicine in this state or a California registered nurse.

C. Where an ambulance contains two or more attendants (in addition to the driver), the director, by regulation, may exempt the additional attendants from some or all training requirements.

D. All drivers and attendants shall be clean and wear neat, clean clothing with some easily visible form of company identification at all times while providing ambulance services. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.105 Minimum staffing.

Each ambulance providing emergency ambulance service within the city shall be staffed by at least two persons, one driver and one attendant. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.110 Contracts.

The director, in the name and in behalf of the city, shall be authorized to enter into annual contracts with each ambulance service to whom a special business license authorizing emergency ambulance services has been issued. Such contracts shall include such terms as are mutually acceptable to the parties relating to the following matters:

A. The delivery of ambulance services to the city through service to city prisons and other institutions, at specified rates which do not exceed those which prevail within the city for comparable service;

B. Terms, conditions and requirements related to the delivery of emergency ambulance services; and

C. The payment of city subsidies for emergency ambulance services, of types and in amounts which are approved in advance by the city council. Such subsidies may relate to the uncompensated costs of providing emergency ambulance services to indigents, the uncompensated costs of responding to emergency ambulance service calls under circumstances in which a patient is not transported, or be based upon other factors relevant to the delivery of emergency ambulance services. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.115 Administrative regulations.

Pursuant to the provisions of RCMC 4.02.085, the director may adopt and enforce such regulations as he determines are necessary for the protection of the public health and safety relating to delivery of emergency ambulance services, including ambulance services, pursuant to the Emergency Medical Services System and the Prehospital Medical Care Personnel Act (Section 1797 et seq. of the California Health and Safety Code) and to effectuate the purposes of this chapter. Such regulations may include, but are not necessarily limited to, the following:

A. The maintenance of specified records by licensed ambulance services relating to the receipt and response to service calls, and other matters, and the right of authorized city representatives to inspect such records;

B. The maintenance of minimum specified equipment and appliances within and on ambulances;

C. Terms, conditions and requirements relating to the delivery of emergency ambulance services;

D. Training requirements for ambulance drivers and attendants;

E. Certification of advanced life support and limited advanced life support providers and personnel, pursuant to Section 1797.178 of the California Health and Safety Code;

F. Designation of advanced life support transport providers and personnel;

G. Training programs for emergency medical services personnel; and

H. Medical control. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 0924 § 1, 1993; SCC 578 § 8 (part), 1983].

4.18.120 Dispatching by county center.

The county communications center shall, in response to calls for emergency ambulance services, call only licensed ambulance services authorized to serve in the emergency response zone in which the emergency exists or ambulance services operated by public agencies, unless the center determines that there are no or inadequate services available from such a designated licensee. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.125 Dispatching by ambulance services.

Upon receiving a call for an emergency ambulance service within an emergency response zone which the licensee is authorized to serve, the licensee shall immediately dispatch an ambulance to the address or place given. The ambulance dispatched shall immediately start a direct run to that address or place and shall complete that run unless directed otherwise by the county communications center. If an ambulance is directed to make a direct run and is thereafter diverted for any reason, the licensee shall immediately notify the county communications center. Upon receiving a call for an ambulance and having no ambulance available to immediately make a direct run to the address or place given, the licensee shall immediately notify the county communications center.

When responding for an emergency ambulance service, the ambulance driver shall comply with all radio communications regulations, as shall be determined by the director pursuant to administrative regulations after consultation with licensed ambulance services. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.130 Rates.

Except with respect to rates which the director determines are set as a result of a freely competitive service delivery system in which multiple ambulance services provide emergency services within the same geographical area under variable rates established without expressed or implied agreement among the providers, all emergency ambulance service rates, including rates for services and supplies incidental thereto, shall be subject to the approval of the director. Such approval shall be given on an annual basis, following a public hearing conducted by the director, notice of which is given in the manner prescribed by RCMC 4.02.090. The rates reviewed shall be those proposed by licensed ambulance services, and the proposal shall be submitted, together with such accompanying material, data and information as may be required, pursuant to administrative regulations enacted under RCMC 4.18.115. The decision of the director shall approve, approve in part, or disapprove proposed rates, and said decision shall be based upon the reasonable costs of providing the service in relation to a reasonable rate of return on investment. A licensed ambulance service desiring to increase approved rates in advance of the annual determination by the director shall make application to do so pursuant to administrative regulations enacted under RCMC 4.18.115, and the director shall act thereon following a special public hearing conducted to receive evidence thereon, notice of which is given in the manner prescribed by RCMC 4.02.090. The director’s decision shall be based upon the same standard as with respect to his or her annual determination.

Each decision by the director made pursuant to the provisions of this section shall be accompanied by written findings of fact and conclusions. The date on which the decision, findings and conclusions will be issued shall be announced prior to the conclusion of the public hearing. A copy of the decision, including the findings and conclusions, shall be served on each licensee affected thereby upon issuance.

Levels of rates and charges proposed by licensees and approvals thereof and other decisions thereon by the director shall not become effective until 15 days following the date announced prior to the conclusion of the public hearing for issuance of the decision, and in the event an appeal is filed pursuant to RCMC 4.18.135, shall not become effective until a final decision thereon by the city council pursuant to said appeal. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.135 Rates – Appeal.

A decision by the director under RCMC 4.18.130 may be appealed to the city council by an affected licensee or any member of the public who may be served by the licensee by filing a written notice of appeal with the clerk of the city council not later than 15 days following the date announced prior to the conclusion of the public hearing by the director for issuance of the decision. Any such appeal shall include a written statement of the reasons therefor and basis upon which the director’s decision is challenged. The city council shall conduct a hearing on the appeal, and in so doing, may review the decision, findings and conclusions of the director solely; said decision, findings and conclusions in accompaniment with the record of the hearing officer’s hearing solely; review such matters and admit supplementary evidence relating to specified issues; or conduct a de novo hearing upon the matter. The determination by the city council shall be final. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.140 Rates – Prohibited charges.

It shall be unlawful for any licensed ambulance service to charge or collect any rate which is regulated pursuant to the provisions of RCMC 4.18.130 and 4.18.135 which has not been approved pursuant to said sections. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 578 § 8 (part), 1983].

4.18.145 Insurance.

It is unlawful for any owner to operate an ambulance or cause or permit the ambulance to be driven or operated, unless there is on file with the clerk of the city council and in full force and effect at all times such ambulance is being operated a policy of 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 from violations of this chapter or of any other law of the state of California or the United States. Such policy shall also provide general public liability, and property damage and professional liability insurance. The property damage and vehicle insurance shall be in the amount of not less than a combined single limit of $1,000,000 for one or more persons injured and property damaged in each occurrence. The public liability insurance shall be in the amount of not less than a combined single limit of $500,000 for one or more persons injured or property damaged in each occurrence. Professional liability insurance shall be in an amount not less than $500,000 per occurrence. The city, and in their capacities as such, its officers, employees and agents, shall be named as additional insureds in said insurance. The policy shall contain a clause prohibiting cancellation or nonrenewal of such insurance, whether for failure to pay a premium or otherwise, without service by the insurer upon the director of health of written notice at least 15 days in advance of the effective date thereof. [Ord. 21-2003 §§ 2, 4; Ord. 20-2003 §§ 2, 4; SCC 663 § 1, 1986; SCC 578 § 8 (part), 1983].