Chapter 18.06
AMBULANCE SERVICES
Sections:
18.06.030 LICENSE REQUIRED - APPLICATION.
18.06.050 AMBULANCES AND EQUIPMENT.
18.06.060 PERFORMANCE STANDARDS - COMPLIANCE - RECORDS.
18.06.070 EMERGENCY NOTIFICATION.
18.06.080 RESPONSE TO 911 INITIATED AID CALLS.
18.06.100 RATES - FILING REQUIRED.
18.06.110 DENIAL OR REVOCATION OF LICENSE.
18.06.120 VIOLATION - PENALTY.
18.06.010 DEFINITIONS.
For the purposes of this chapter, the following definitions shall apply:
(a) "Advanced life support (ALS)" means those services requiring medical treatment by a certified paramedic.
(b) "Aid call" means any 911 initiated call, request or dispatch for emergency medical treatment.
(c) "Ambulance" means any privately or publicly owned ground transportation vehicle that is especially designed, constructed, equipped, maintained or used for the transportation of patients who are sick, injured or otherwise incapacitated, which is operated as part of an ambulance service.
(d) "Ambulance service" means any person, as defined in this section, who operates an ambulance for hire which is either stationed within or outside the City limits or dispatched from within or outside the City limits to pick up injured or sick fares within the City or which makes trips to the City, from points outside its City limits, for the purpose of transporting sick or injured fares from points within the City; provided, however, that the provisions of this chapter shall not apply to any ambulance which shall pass through the City in the delivery of fares picked up at points beyond the limits of the City.
(e) "Basic life support (BLS)" means those medical services which can be performed by one who is a certified emergency medical technician.
(f) "Cencom (911)" means the Central Communication Emergency Dispatch Center.
(g) "Communication system" means two-way radio communications equipment necessary for communication between ambulances, dispatchers, hospitals and other agencies as needed, including those with a four (4) band multifrequency capability.
(h) "Department" means City of Bremerton Fire Department.
(i) "Emergency" means a situation or patient condition (1) in which either of the administration of a drug (except oxygen) or initiation of an intravenous line is performed; or (2) in which a person requesting ambulance assistance requires immediate response by medically trained personnel; or (3) which an EMT would assess, in the interest of good patient care, to require the assistance of at least a paramedic certified pursuant to Chapter 18.71 RCW and regulations promulgated thereunder.
(j) "Emergency medical technician (EMT)" means a person who is certified as such by the Secretary, pursuant to Chapter 18.73 RCW and regulations promulgated thereunder.
(k) "Mutual aid" refers to situations in which a licensed nonemergency BLS ambulance service is required, as determined by the Department, to make ambulances and personnel available for emergency response under the City’s direction.
(l) "Patient" means an individual who is sick, injured, wounded or otherwise incapacitated or helpless.
(m) "Person" means any individual, firm, partnership, association, corporation, company, or group of individuals acting together for a common purpose or organization of any kind, including any governmental agency other than the United States.
(n) "Secretary" means the Secretary of the Department of Health of the State of Washington. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.010)
18.06.020 APPLICABILITY.
(a) The provisions of this chapter shall apply to nonemergency BLS ambulance services operating within the City of Bremerton limits.
(b) Ambulance services providing ALS and BLS interfacility transports shall follow the guidelines established under Chapter 18.71 RCW, Kitsap County EMS Council and Kitsap County Medical Program Director. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.020)
18.06.030 LICENSE REQUIRED - APPLICATION.
(a) No person, firm, or corporation shall operate or cause to be operated an ambulance or ambulance service within the City without first obtaining a Washington State verification and license in addition to a City business license. No person, firm, or corporation, other than the Department, shall operate or cause to be operated emergency ALS ambulance service within the City limits, except as provided in BMC 18.06.090.
(b) An application for a business license to operate an ambulance or ambulance service shall contain the following information:
(1) A description of each ambulance, including the make, model, year of manufacture, motor chassis and VIN number, together with current state license number, the length of time the ambulance has been in use and the color scheme, insignia, name, monogram or other distinguishing characteristics to be used to designate applicant’s ambulance.
(2) The location and description of the place or places from which the ambulance service is intended to operate and the number of licensed EMTs to be initially employed.
(3) In the event that the applicant is granted a license, the applicant shall be required to immediately update its application when there is a change in any of the items listed on the application. The failure of the license holder to update its application upon a change in any of the required items will result in a violation of this chapter.
(c) Upon receiving an application and the fee, the City shall forward the application to the Fire Chief for review and approval. No license shall be issued unless the Fire Chief is satisfied, pursuant to policies duly adopted, that (1) the applicant is properly certified by the State; (2) the applicant’s facilities, ambulances, and equipment meet State and local standards; (3) employees of applicant are EMT certified and in good standing; (4) a record check of the applicant and its employees shows no criminal convictions within five (5) years prior to the date of application of federal, state or local laws involving the custody of incapacitated persons, the custody of narcotic or controlled substances, or the use of motor vehicles; (5) the applicant has fulfilled all the requirements of the laws of the state, including, but not limited to, Chapter 18.73 RCW and Chapter 248-17 WAC, as those chapters currently exist or are hereafter amended, pertaining to emergency medical care and transportation services and ambulance rules and regulations; (6) the applicant has met all the requirements of this chapter; (7) all personnel employed by the applicant are state certified and have regular emergency vehicle driving training. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.030)
18.06.040 INSURANCE.
(a) Each ambulance service shall obtain from a reputable insurance company and, at all times, maintain in full force the following insurance:
(1) Comprehensive general liability insurance written on an occurrence basis with limits no less than one million dollars ($1,000,000) combined single limit per occurrence and one million dollars ($1,000,000) general aggregate for personal injury, bodily injury and property damage;
(2) Automobile liability insurance with limits no less than one million dollars ($1,000,000) combined single limit per accident for bodily injury and property damage; and
(3) Professional liability insurance with limits no less than one million dollars ($1,000,000) limit per occurrence/claim.
(b) Applicant shall provide an insurance certificate to this effect, naming the City of Bremerton as an additional insured on the comprehensive general liability and automobile liability policies prior to the issuance of a business license. Such policies shall also provide for not less than thirty (30) days’ written notice to the City Clerk of intended cancellation of coverage. The cancellation and/or termination of any such policy shall automatically revoke and terminate any business license issued for the ambulance service, unless a substitute insurance policy complying with the provisions of this section shall be provided and be in effect at or prior to the time of such cancellation or termination. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.040)
18.06.050 AMBULANCES AND EQUIPMENT.
(a) Ambulances shall be maintained and inspected pursuant to requirements from time to time adopted by the Secretary. All ambulance services shall provide the Department with copies of reports of inspection submitted to the Secretary pursuant to RCW 18.73.145.
(b) Inspection by the City. In addition to any other inspection required by state law, the Department shall have the right to inspect the records, equipment, and accessories of all ambulance services up to twice annually at the discretion of the Department. Additionally, the Department shall conduct individual inspections of an ambulance service within three (3) days of the receipt of any complaint about the ambulance service. Notwithstanding the above required inspections or any other provision of this chapter, the Department may, at all reasonable times, inspect the records, equipment and accessories of any ambulance service.
(c) The ambulance service shall pay an inspection fee for each inspection required under this chapter and further shall pay an inspection fee as set forth in Chapter 3.01 BMC for each inspection prompted by complaint; provided, however, that no complaint-prompted inspection fee shall be paid where the Chief of the Department has determined the complaint to be unwarranted and without substantial merit.
All inspection fees shall be prepaid to the City Treasurer. Proof of payment must be provided before inspections commence. Any deficiencies identified during inspection shall be remedied within thirty (30) days or the ambulance service business license shall be subject to revocation.
(d) All ambulances and equipment storage and cleaning areas shall be subject to inspection by the Department, during operating hours, to ensure that they are maintained in a clean and functional state. Disinfection or chemical sterilization of reusable equipment must meet guidelines established by the National Center for Disease Control.
(e) Each ambulance service shall take immediate action to eliminate any unsanitary condition upon becoming aware of such and shall immediately correct any unsafe situation as directed by the Fire Chief or the Secretary by written notice.
(f) Ambulances shall not be used without the minimum equipment prescribed by the Secretary. In the event a variance from said requirements is granted by the State, the licensee must notify the Department of the variance granted. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.080)
18.06.060 PERFORMANCE STANDARDS - COMPLIANCE - RECORDS.
(a) All services performed hereunder shall be in accordance with the standards and principles of the course of instruction given EMTs or paramedics, as the case may be, by the State, and pursuant to local medical protocols established from time to time by the Kitsap County Medical Program Director.
(b) Records of 911 initiated calls shall be logged by ambulance crews and shall include the appearance and status of and treatment administered to injured, sick, or incapacitated persons treated or transported. Copies of such records shall be mailed or otherwise delivered to the Kitsap County EMS Office on a monthly basis, or more often if requested for good cause. Subject to the requirements of the State Public Disclosure Act, such records shall be confidential and shall be released only to proper officials of the City or Kitsap County EMS Office. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.090)
18.06.070 EMERGENCY NOTIFICATION.
In the event a call for emergency medical assistance is received by an ambulance service or a representative thereof, the caller shall be directed to call Cencom (911) and the ambulance service representative shall also call Cencom (911). (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.100)
18.06.080 RESPONSE TO 911 INITIATED AID CALLS.
(a) At each aid call to which a Department ambulance responds, the Department officer in charge shall determine whether the patient is in need of advanced life support (ALS) or basic life support (BLS) services. If the officer decides that the patient is in need of advanced life support services, the patient shall be transported to a hospital in a Department ambulance if available; provided, however, if the patient’s medical interests would be best served by transporting the patient by private ambulance, the officer in charge may arrange for the patient to be transported in that manner.
(b) No effort shall be made by an ambulance service to assume the custody of a patient before release of custody has been made by the Department officer in charge.
(c) It is unlawful for an ambulance service, in responding by vehicle to any call requested by the Department, to use emergency lighting or siren, unless (1) responding to emergencies or transporting a patient in accordance with the mutual aid provisions of this chapter or (2) directed to do so by Department.
(d) In the event there is more than one ambulance service operating in the City which seeks to participate in the 911 aid calls, a representative and/or representatives from each ambulance service shall meet and devise a rotation schedule that shall be submitted to the Department upon request. Said schedule shall: (1) provide for only one (1) company to respond to 911 initiated aid calls during any given month; (2) include a twelve (12) month rotation; (3) be amended only upon thirty (30) day notification to the City Clerk; and (4) provide for substitution by other ambulance service companies in the rotation under circumstances where an ambulance service has no ambulances available to provide service during its rotation. In the event a schedule is not submitted, the Department shall prepare a rotation schedule that shall control the assignment of 911 aid calls to ambulance services licensed under this chapter.
(e) Each ambulance service shall keep available an adequate supply of ambulances, personnel and equipment which will enable it to respond to a 911 call for assistance within ten (10) minutes of the time of the request ninety percent (90%) of the time, and within fifteen (15) minutes the remainder of the time. Response times shall be measured from the time of request for service is made from Cencom until the ambulance service arrives at the scene. The ambulance service may be requested by the Department to submit monthly reports at the conclusion of its rotation stating response times for all emergency calls served during its rotation.
(f) In the event that the ambulance service has no ambulances available for emergency calls during its rotation, the ambulance service shall immediately advise the Department and Cencom of such conditions, and shall further advise that the ambulance service is unavailable to respond to any emergency until further notification. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.110)
18.06.090 MUTUAL AID.
(a) Each ambulance service shall cooperate with any request by the Department for mutual aid assistance within Kitsap County.
(b) Each ambulance service shall equip its vehicles with radios capable of receiving and transmitting on City and County Fire Department frequencies, which frequencies shall be used by licensees only in the event of a request for service or a mutual aid situation described herein. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.120)
18.06.100 RATES - FILING REQUIRED.
Each ambulance service at the request of the Department shall file with the Department its current schedule of rates to be charged for services. Such schedule or rates shall be a matter of public record open to public inspection in the Fire Department’s office during normal City business hours and such schedule must be adhered to by the licensee throughout the period for which the license is issued. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.130)
18.06.110 DENIAL OR REVOCATION OF LICENSE.
Any application for a business license and any business license issued pursuant to Chapter 5.02 BMC may be denied or revoked for a violation of the provisions of this chapter pursuant to the procedures set forth in Chapter 5.02 BMC relating to the denial and revocation of general business licenses. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003)
18.06.120 VIOLATION - PENALTY.
(a) Any violation of any provision of this chapter constitutes a civil violation under Chapter 1.04 BMC for which a monetary penalty may be assessed and enforcement may be required as provided therein.
(b) In addition to or as an alternative to any other penalty provided in this chapter or by law, any person who violates any provision of this chapter shall be guilty of a misdemeanor pursuant to BMC 1.12.020(2). Each day, or a portion thereof, during which a violation occurs shall constitute a separate violation. (Ord. 5102 §1 (in part), 2010: Ord. 4848 §1 (in part), 2003; Ord. 4367 (in part), 1992. Formerly 5.50.140)