Chapter 5.90
AMBULANCES
Sections:
5.90.030 License required – Application – Fee.
5.90.040 Standards for license.
5.90.060 Ambulances and equipment.
5.90.070 Performance standards – Compliance – Records.
5.90.075 Reciprocal recognition of ambulance personnel licenses and ambulance vehicle inspections.
5.90.080 Emergency notification.
5.90.120 Penalty for violation.
5.90.010 Definitions.
For the purposes of this chapter, the following definitions shall apply:
A. “Ambulance” means a ground vehicle designed and used to transport the ill and injured and to provide personnel, facilities and equipment to treat patients before and during transportation where it is not anticipated that emergency medical care will be required during transportation.
B. “Medic Unit (MICU)” means an ambulance vehicle operated by the city which routinely carries personnel certified at the level of paramedic and routinely engages in the provision of pre-hospital advanced life support patient care.
C. “Interfacility critical care” means providing advanced life support medical care to patients being transported between hospitals.
D. “Emergency medical care” or “emergency” means a sudden and/or unexpected medical problem which requires the immediate assistance of an agency trained in and designated to provide pre-hospital medical care.
E. “Nonemergency medical care” means a medical condition which is not sudden and/or unexpected, therefore not requiring immediate assistance and results in a scheduled response. Pre-hospital initiation of drug therapy (with the exception of oxygen) or field intravenous fluid lines would not be expected for nonemergency patients.
F. “Post-hospital interfacility critical care transports” refers to patients transported from one hospital to another hospital for specialized critical care and shall also be considered included within “nonemergency medical care.”
G. “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.
H. “Mutual aid” refers to situations in which a licensed nonemergency ambulance service is required, as determined by the fire department, to make ambulances and personnel available for emergency response under the city’s direction.
I. “Secretary” means the Secretary of the Washington State Department of Health, Emergency Medical Services Division.
J. “Fire department” or “city” means the city department providing response to fire and emergency medical alarms in the city, and/or another public entity providing such service in the city pursuant to city contract or franchise. (Ord. 2940 § 1, 2007; Ord. 2228 § 2, 1991; Ord. 2199 § 1, 1990).
5.90.020 Applicability.
A. All emergency medical service is and shall be provided in the city by its fire department. The provisions of this chapter shall apply to nonemergency ambulance services based within the city and also to those whose vehicles enter the city on a regular basis (75 percent or more of the service’s or unit’s patient transport volume originates within the city) to pick up patients.
B. Nothing herein shall prohibit the fire department from operating nonemergency ambulance services. (Ord. 2228 § 3, 1991; Ord. 2199 § 1, 1990).
5.90.030 License required – Application – Fee.
A. It shall be unlawful for any person, firm or corporation to operate or cause to be operated (as described in PTMC 5.90.020(A)) within the city limits an ambulance or ambulance service without first being issued a license therefor by the city.
B. It shall be unlawful for any person, firm or corporation to violate any of the provisions of this chapter.
C. It shall be unlawful for any person, firm or corporation (other than the city fire department) to operate or cause to be operated (as described in PTMC 5.90.020(A)) emergency ambulance services within the city limits, except as provided in PTMC 5.90.100.
D. Such license may be obtained by applying therefor at the office of the city treasurer on forms provided.
E. The fee for such license shall be $100.00 per ambulance, and it shall be renewable annually, and $25.00 for each EMT (may be assessed on the individual EMT). The fee shall be payable in January of each year for the ensuing year, and there shall be no proration for new applications during the year.
F. To the extent not inconsistent with other provisions of this chapter, the provisions of Chapter 5.04 PTMC, dealing with general issuance of city licenses, shall also be applicable to this chapter and are hereby incorporated. (Ord. 2199 § 1, 1990).
5.90.040 Standards for license.
All applicants shall be appropriately certified by the Secretary, and be in good standing, pursuant to Chapter 18.73 RCW and regulations adopted from time to time thereunder. Upon receiving an application and the fee, the clerk/treasurer 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:
A. The applicant is properly certified by the state;
B. The applicant’s facilities, ambulances and equipment meet state standards;
C. Employees of the applicant are certified and in good standing;
D. A record check of the applicant and employees by the chief of police shows no criminal convictions for crimes having a direct adverse relationship to custody of incapacitated persons, custody of narcotic or controlled substances, or safe driving of emergency vehicles; and
E. The applicant is otherwise capable of performing ambulance services. (Ord. 2199 § 1, 1990).
5.90.050 Ambulance personnel.
No ambulance shall be operated as such without at least two persons, each of whom shall be an EMT, or licensed or certified by the state as having at least an equivalent or higher level of training. Additionally, the driver must hold a valid Washington State driver’s license. (Ord. 2199 § 1, 1990).
5.90.060 Ambulances and equipment.
A. Ambulances shall be maintained and inspected pursuant to requirements from time to time adopted by the Secretary. All licensees shall provide the fire department with copies of reports of inspection submitted to the Secretary pursuant to RCW 18.73.145.
B. Ambulances shall receive semiannual mechanical and medical inspections (each January and June). Inspections shall be carried out by a designee of the fire chief. The licensee shall pay an inspection fee of $50.00, but in no case less than the cost of performing said inspection, for each semiannual inspection required under this chapter. Each licensee shall further pay an inspection fee of $25.00, but in no case less than the cost of performing said inspection, for each inspection prompted by a complaint; provided, however, that no complaint-prompted inspection fee shall be paid where the chief of the fire department has determined the complaint to be unwarranted and without substantial merit. All inspection fees shall be due and payable within 10 days of the date of the inspection.
C. In case of any lack of compliance with any of the requirements of this chapter, or any deficiencies, such licensee shall promptly remedy same or be subject to notice of suspension or revocation.
D. All ambulances and equipment storage and cleaning areas are subject to random inspection by the fire department, at reasonable times, 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. Licensees shall take immediate action to eliminate any unsanitary condition when becoming aware of it and shall immediately correct any situation about which the fire chief or the Secretary has delivered written notice.
F. Ambulances shall not be used without the minimum equipment prescribed by the Secretary and the city fire department. In the event any variance from requirements is granted by the state, a licensee must apply for and obtain a similar such variance from the city fire department. (Ord. 2199 § 1, 1990).
5.90.070 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 and pursuant to local medical protocols established from time to time by the Jefferson County medical program director.
B. Each ambulance service licensed under this chapter shall, immediately upon the issuance of a license, file with the city clerk/treasurer its schedule of rates to be charged for its services for the duration of the calendar year in which the license is issued. Thereafter, each ambulance service licensed under this chapter shall annually file with the city clerk/treasurer its schedule of rates to be charged for its services. The annual rate schedule shall be filed on or before the first of December of the year preceding the year for which the schedule is to be in effect.
C. All rate schedules filed pursuant to this section shall be a matter of public record and open to public inspection in the office of the city clerk during normal business hours. Each licensee shall strictly adhere to its schedule throughout the calendar year for which that schedule has been filed; provided, that a licensee may charge and collect rates in accordance with a revised rate schedule by filing the revised schedule with the city clerk not less than one full calendar month prior to the effective date of the revised schedule.
D. It is unlawful for anyone driving or operating an ambulance to charge, demand, collect or receive any greater or less rate or fare than those then currently filed with the city clerk. It is unlawful for any ambulance operator to give directly or indirectly, or cause to be given, any rebates, commissions, reserve rebates or any reduced rates or cash discounts to any person or persons or groups of any nature, except as listed on its then current schedule of rates on file with the city clerk.
E. A Washington State medical incident report (MIR) shall be logged by ambulance crews for each pre-hospital patient transported 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 medical program director on a weekly basis, or more often if requested for good cause. The MPD will review these transports to ensure appropriateness of commercial ambulance utilization. The MPD will provide the city with demographic information as requested by the city.
F. Each licensee of an ambulance under this chapter shall maintain complete and accurate records, which records shall include the transportation of each patient within the city, or from one place within the city to another place within the city or beyond its city limits. All records shall be available for inspection by the city clerk or his duly authorized representative at all reasonable times.
G. The provision of subsection F of this section shall likewise apply in cases if a patient dies before being so transported in such ambulance or experiences cardiac or respiratory arrest while being so transported therein or at any time prior to the delivery of the patient to a hospital or medical or other authority if the patient is still under the care and responsibility of the ambulance licensee.
H. Each ambulance operator shall deposit with the city clerk a certificate of insurance evidencing comprehensive general liability, auto liability and malpractice insurance issued by a responsible insurance company to be approved by the city and naming the city as an additional insured. The limits of the policy shall be not less than $1,000,000. The insurance certificate shall be submitted to the city clerk for approval prior to the issuance of each ambulance license. Satisfactory evidence that such insurance is at all times in full force and effect shall be furnished to the city clerk, in such form as the city clerk may specify, by all licensees required to provide such insurance under the terms of this chapter. Every insurance policy required under this section shall extend for and cover all claims arising during the period to be covered by the license applied for, notwithstanding such claim or claims may actually be made thereafter, and the insurer shall be obliged to give not less than 30 days’ written notice to the city clerk and to the insured before any cancellation or termination of the policy earlier than its expiration date. Cancellation or other termination of any such policy shall automatically revoke and terminate any license issued for the ambulances covered by such policy, 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. 2228 § 4, 1991; Ord. 2199 § 1, 1990).
5.90.075 Reciprocal recognition of ambulance personnel licenses and ambulance vehicle inspections.
A. To avoid unnecessary duplication of effort, expense and hardship, this section shall be applied when ambulance vehicles and ambulance personnel are licensed or hold valid ambulance or ambulance personnel licenses from other cities, and apply for a license in the city of Port Townsend. Before the reciprocity provided for in this section is recognized, the conditions set forth in this section must be satisfied.
B. Ambulance service personnel who apply for a Port Townsend ambulance license may be granted reciprocity on the following terms and conditions:
1. The applicant produces a valid license issued to him or her from another city to provide ambulance service;
2. The ambulance licensing requirements of such other city are found by the city of Port Townsend to meet or exceed the licensing requirements of the city of Port Townsend;
3. The applicant is able to verify his or her identification with a photo identification issued by a state or by the federal government, such as a valid driver’s license, valid military identification card, valid passport, or similar identification; and
4. The applicant shall pay to the city of Port Townsend a filing fee of $5.00;
5. In addition, any license issued hereunder as a reciprocal license shall provide for an expiration date no later than the expiration date of the applicant’s original license from the other jurisdiction.
C. Ambulance vehicles which are then currently licensed and have been inspected under another city’s ambulance ordinance or regulations may be granted reciprocity such that an inspection or license of the city of Port Townsend is not required as follows:
1. The operator shall produce a valid license, or other acceptable documentation of approved inspection, issued for the vehicle from another city;
2. The other city’s licensing and inspection requirements are found by the city of Port Townsend to meet or exceed the licensing and inspection requirements of the city of Port Townsend;
3. The applicant is able to verify the vehicle’s identification with the certificate of title issued by the State of Washington Department of Licensing for the vehicle;
4. The applicant shall pay a $5.00 filing fee;
5. In addition, any license issued hereunder as a reciprocal documentation of approved inspection shall provide for an expiration date no later than the expiration date of the applicant’s original license or documentation from the other jurisdiction.
D. In such cases for ambulance service personnel or ambulance vehicles which qualify for reciprocity under this section, a special license shall be issued by the city for such personnel or such vehicle, as the case may be, indicating that the same is a reciprocal license or based upon a reciprocal inspection pursuant to the terms of this section, and which license or inspection shall otherwise comply with the provisions of this chapter. (Ord. 2228 § 5, 1991).
5.90.080 Emergency notification.
A. In the event a licensee or its personnel, in responding to a nonemergency call, discovers the existence of an emergency situation, he or she shall immediately notify Jefferson County emergency dispatch center (9-1-1) of that fact and the circumstances and request dispatch of Port Townsend Medic-One. Unless otherwise notified by the dispatcher or a responding medic unit from Port Townsend Medic-One, personnel on the scene shall take measures reasonably necessary to maintain the health and safety of the patient.
B. In the event an emergency call for medical assistance is received by the licensee, the caller shall immediately be directed to call 9-1-1 for emergency medical response by Port Townsend Medic-One. (Ord. 2199 § 1, 1990).
5.90.090 Response to calls.
A. It is unlawful for a licensee in responding to any call to use emergency lighting or siren unless responding to emergencies or transporting a patient in accordance with the mutual aid provisions of this chapter.
B. In the event a licensee is required to respond Code Red per the mutual aid provisions of this chapter, the responding crew shall notify Jefferson County emergency dispatch center (9-1-1) of the same. (Ord. 2199 § 1, 1990).
5.90.100 Mutual aid.
A. A licensee is required to cooperate with any request by the fire department for mutual aid assistance. At such times, the city will have operational control of all equipment and personnel for all purposes and may dispatch ambulances to any point within the city. However, in the event of any suit or claim arising out of activities under this section, the city and licensee shall each be responsible for, and to the extent of, their own respective liability.
B. Licensees shall equip vehicles with city fire department frequencies which, however, shall only be used by licensees in the event of a mutual aid situation described herein. (Ord. 2199 § 1, 1990).
5.90.110 Advisory committee.
A. The mayor shall appoint with the concurrence of the city council an advisory committee composed of seven persons. Such advisory committee shall include the mayor, the director of the emergency room or the administrator of Jefferson General Hospital or his or her designee, one citizen of the city, the chiefs of the fire and police departments, and a representative of at least one ambulance company, if any, licensed under the provisions of this chapter.
B. The terms of the members of the advisory committee shall be as follows:
1. The mayor, police chief and fire chief, their respective terms of office;
2. The hospital representative, four years, provided that the first representative appointed shall be appointed for a period of two years;
3. The citizen of the city, two years; and
4. The representatives of the respective ambulance services, the period of the license granted to the ambulance services under this chapter.
C. The advisory committee shall meet as needed, and at least annually, to review and recommend standards and regulations related to emergency medical services and submit its recommendations in writing at least once a year to the city council for its approval. Such review may include recommendations for new or different equipment and regulations relating to paramedical emergency service and may recommend new or different training procedures and the development of new rules and regulations relating to any operation licensed under this chapter. (Ord. 2199 § 1, 1990).
5.90.120 Penalty for violation.
A. In the event of a violation of any provision of this chapter, the fire department shall promptly notify the licensee thereof and, if the situation warrants it, give said licensee a reasonable opportunity to take corrective action.
B. Any person, corporation or entity who violates any provision of this chapter shall be subject to revocation of license pursuant to the procedure set forth in PTMC 5.04B.230. Any person, corporation or entity violating any provision of this chapter shall be guilty of a misdemeanor and, upon conviction, shall be punished by a fine not exceeding $1,000, or by a jail sentence not exceeding 90 days, or by both such fine and jail sentence. (Ord. 2199 § 1, 1990).
5.90.130 Appeals.
Any person applying for or holding a license under this chapter who believes he or she is aggrieved by an action of any city official in connection with a license may appeal the matter to the city council for resolution by filing a written request for appeal with the city clerk no later than 15 days after the date of action being appealed. The request shall state and describe the action appealed from and grounds therefor. The city council will conduct an investigation and render a decision. (Ord. 2199 § 1, 1990).