Chapter 5.14 AMBULANCE, AID VEHICLES AND NONEMERGENCY TRANSPORT VEHICLES

The ordinance codified in this chapter is enacted to regulate the care and/or transport of disable, dill, or injured persons, in or with ambulances, first aid vehicles or nonemergency transport vehicles, and is an exercise of the city’s policy power. This chapter shall be so construed so as to effect that end and is for the protection of the public health, safety and welfare. It is enacted to supplement and to exceed the standards for ambulance, first aid vehicles and non-emergency transport vehicles and emergency medical services as set forth in RCW Chapters 18.71, RCW 18.73, RCW 70.168, RCW 18.130, to the extent possible under RCW 18.73.020 and WAC Chapter 246-976. (Ord. 94-26 § 1(part), 1994).

5.14.020 Definitions.

For the purposes of this chapter, the following definitions shall apply:

“Aid vehicle” means a vehicle primarily designed and used to carry first aid equipment and individuals trained in first aid or emergency medical procedure.

“Aid vehicle operator” means any person, firm or organization engaging in the treatment or transportation of ill or injured persons, or who, by advertising, representation or otherwise, holds himself out as engaging in such activity.

“ALS” means Advanced Life Support as defined by the ability to provide procedures listed as ALS procedures in Walla Walla County Patient Care Guidelines.

“Ambulance” means an emergency vehicle designed and used to transport the ill and injured and to provide facilities and equipment to treat patients before and during transportation.

“Ambulance operator” means any person, firm or organization engaging in the transporting of ill or injured persons, or who, by advertising, representation or otherwise, holds himself out as engaging in such activity.

“BLS” means Basic Life Support as defined by the ability to provide procedures listed as BLS procedures in Walla Walla County Patient Care Guidelines or by the applicable provisions of the Revised Code of Washington or Washington Administrative Code, whichever is broader in scope.

“City” means the city of Walla Walla.

“Communication system” means two-way radio communications between ambulances, dispatchers, hospitals and other agencies as needed.

“Emergency medical care” or “emergency medical services” means such medical treatment and care which may be rendered to persons injured, sick or incapacitated at the scene of such injury, sickness or incapacitation or in the ambulance.

“Emergency medical technician” means a person who has successfully completed a prescribed course of instruction and has been issued a current card identifying him as an emergency medical technician by the Secretary of the Department of Health.

“EMS dispatcher” means a person who is trained and qualified to provide basic life support instructions via telephone in accordance with Walla Walla County Patient Care Guidelines and established protocols.

“Medical attendant” means any trained or otherwise qualified individual responsible for the operation of an ambulance and the care of the patients, whether or not the medical attendant also serves as a driver.

“Nonemergency transport vehicle” means a for-hire vehicle for the transportation of the convalescent, handicapped or debilitated persons where emergency medical care will not be required during transportation and which is not required to meet DOH requirements for a licensed ambulance.

“Nonemergency transport vehicle operator” means any person, firm or organization engaging in the for-hire transportation of the convalescent, handicapped, or debilitated person using a nonemergency transport vehicle.

“Operating an ambulance” or “operating a first aid vehicle” or “operating a nonemergency transport vehicle” means the operation of an ambulance, first aid vehicle or nonemergency transport vehicle which:

1. Is stationed within the city; or

2. Is dispatched from within or without the corporate limits of the city and repeatedly or customarily makes trips for hire within the city to pick up patients for fares and fees; or

3. Makes any trips into the city for that purpose after occasional or repeated advertising within the city, or such service; provided, that the provisions of this chapter shall not apply to any ambulance which shall pass through the city in the delivery of patients picked up at points beyond the corporate limits of the city.

“Patient” means an individual who is sick, injured, wounded or otherwise incapacitated or helpless.

“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.

“Secretary” means the Secretary of the Department of Health of Washington State. (Ord. 94-26 § 1(part), 1994).

5.14.030 Exemptions.

The provisions of this chapter shall not apply to ambulances, first aid cars, or non-emergency transport vehicles based outside the jurisdiction of the city and which operationally enter the city only to deliver a patient on a run originating outside the city. (Ord. 94-26 § 1(part), 1994).

5.14.040 License – Required.

Anyone who on the effective date of the ordinance codified in this chapter is the licensed operator of an ambulance, first aid vehicle, or nonemergency transport vehicle service in the city or who desires to begin to engage in the operation of an ambulance, aid vehicle, or nonemergency transport vehicle business in the city shall apply to the city clerk for a license. The application shall be on a form provided by the city clerk’s office. Such forms shall be properly completed by the applicant and shall be then returned to the city clerk’s office together with the proof of insurance and proof that he or she has secured any and all licenses and verifications required by the state of Washington. Further, the licensee shall be verified and the need for the ambulance or aid service must have been established in the South Central EMS and Trauma Care Council’s Trauma Plan as accepted and approved by the Department of Health as required by RCW 70.168. Licenses shall be personal to the individuals or entities to which issued, and such licenses shall not be transferable. (Ord. 94-26 § 1(part), 1994).

5.14.050 License – Application – Investigation.

A. The city clerk shall transmit the license application to the fire department, and the fire department shall inspect the vehicles proposed by applicant to be used in the proposed business and shall investigate to ascertain whether the applicant and his equipment meet the requirements of this chapter and of RCW Chapters 18.71, 18.73, 18.130 and 70.168. Within twenty-one days of receipt by the fire department of such application, the fire chief or his designee shall report to the city clerk on proper forms prepared by the city clerk or fire department as to whether the applicant and his equipment meet the requirements of state statutes and regulations of this chapter. The application upon its receipt shall be referred by the city clerk to the police chief or his or her designee who shall report to the city clerk as to whether the applicant or any officer thereof in the case of a corporation has been convicted of a felony or of a misdemeanor involving theft or fraud within the past five years.

B. Vehicles proposed by applicant for license must be licensed as either “ALS” or “BLS” vehicles. Once licensed as “ALS” vehicles, the licensee must be able to provide all “ALS” services as provided for in the Walla Walla Patient Care Guidelines from the “ALS” vehicle.

C. Vehicles not licensed as “ALS” may not be advertised or in any way portrayed as an “ALS” or paramedic unit. The licensee may not advertise or portray the company as providing paramedic or “ALS” services unless the company provides at least one “ALS” unit based and maintained in the city, and licensed by the city.

D. There shall be a fee of fifty dollars for the fire department inspection of each vehicle to be used in the city, and further, there shall be a fee of fifty dollars for the police department background investigation of the applicant. Said fees shall be payable in advance, at the time the applicant returns the application to the city clerk with all of the other documents required by this chapter. (Ord. 94-26 § 1(part), 1994).

5.14.060 License – Insurance required.

A. Insurance required by this chapter of all applicants and filed with the application shall include an insurance policy or policies issued to the license applicant by an insurance company authorized to do business in the state providing coverage for all ambulances to be used by the licensee in the city and to provide liability insurance for the benefit of any person killed or suffering bodily injury as a result of any accident or occurrence involving the ambulance. The minimum coverage shall be one million dollars for any one person killed or injured in any one accident or occurrence and two million dollars for all persons killed or injured in any one accident or occurrence. Such policy shall also provide a minimum coverage of one hundred thousand dollars for damages arising out of injury to or destruction of property in any one accident or occurrence.

B. Each such policy must contain a provision that it cannot be cancelled by the insurer for any reason unless he has given the city clerk notice of at least thirty days of such cancellation and such insurance shall remain in effect during such thirty days.

C. All insurance policies filed by a licensee or applicant shall be forwarded by the city clerk to the city attorney and no license shall be issued or renewed unless the city attorney has approved the insurance policy as to form and amount.

D. Every insurance policy is required to contain a provision that it will remain in full force and effect, notwithstanding any recovery thereon and that the liability of the insurer will not be affected by insolvency or bankruptcy of the insured and that until or unless the policy is cancelled as provided in this section that liability of the insurer will not be affected by any failure of the insured to pay premiums. Such policy shall include coverage for the ambulance, first aid vehicle or nonemergency transport vehicle wherever used in the city, even if used in violation of this chapter and shall name the city as an additional insured.

E. Evidence of insurance policies for the full term of the license shall be submitted to the city clerk at the time of application for license. Such evidence shall be a certificate from the licensee’s insurance company that the insurance exists, shall name the city as an additional insured and provide specifically that the insurance will not be cancelled without written notice having been delivered to the city clerk not less than thirty days prior to the effective date of cancellation. In the event of a cancellation of a licensee’s insurance policy required to be carried hereunder, and the licensee does not obtain a replacement insurance policy and supply proof of the same to the city clerk before the effective date of cancellation of prior insurance, then the licensee’s license shall be deemed revoked without further notice from the city clerk. The licensee further agrees to execute a hold harmless agreement in favor of the city regarding the licensee’s operations. (Ord. 94-26 § 1(part), 1994).

5.14.070 License – Nontransferable.

Licenses issued under this chapter shall be personal to the one to whom issued and cannot be transferred to any other person nor can any vehicle be used by any licensee which is not licensed to the licensee except as may be provided in mutual aid agreements with the city dealing with public emergencies. All vehicles and equipment used by any licensee and any and all records pertaining to the conduct of its business shall be available at any time for inspection by city fire, police or finance personnel. (Ord. 94-26 § 1(part), 1994).

5.14.080 License – Personnel requirements.

The following shall be the minimum personnel requirements to be provided by all ambulance, first aid vehicles and nonemergency transport vehicle licensees:

A. On each run there shall be at least two employees of the licensee who are currently certified as emergency medical technicians by the state (one of these may be the driver).

B. There shall be employed by each licensee enough so certified E.M.T.’s to operate at least one of the licensee’s vehicles on a twenty-four-hour, seven-day a week basis, and at least this number of persons must be on duty at all times.

C. There shall be on-duty twenty-four hours a day, seven days a week, at least one person at the licensee’s communications center. At least one person on duty shall be trained as an emergency medical dispatcher.

D. There shall be at least one person in the management of the licensee on duty, or available twenty-four hours a day, seven days a week.

E. Each licensee shall have a written agreement with the Walla Walla County E.M.S. medical program director or his designee to provide medical expertise, opinions and run review, as required, and such agreement shall be on file with the city clerk. (Ord. 94-26 § 1(part), 1994).

5.14.090 Licensee – Personnel registration.

A. Each applicant for license shall submit to the city clerk with his or her application, a list showing all proposed personnel and such list shall be kept current at all times. Such list shall include name, age, current address, addresses for the past two years, a record of all traffic offenses of which he or she has been found guilty of or pleaded guilty to within the past five years, and convictions of any felony or misdemeanor relating to any sex offense, relating to violence against a person or involving theft. A photocopy of each person’s Washington State E.M.S. certification shall also be included in the list.

B. Qualification for ambulance, first aid vehicle, or nonemergency transport vehicle personnel:

1. Age: all personnel working these units shall be at least twenty-one years of age;

2. Drivers license: all personnel working these units shall possess a valid Washington driver’s license;

3. Criminal traffic record: no personnel working these units shall have been convicted of any major criminal driving offense including, but not limited to, the following:

a. Driving while intoxicated,

b. Physical control of motor vehicle while intoxicated,

c. Reckless driving,

d. Hit and run attended or unattended,

e. Negligent driving;

4. Civil traffic record: any person who has committed three or more traffic infractions within the last five years may be disqualified if the police chief finds that such a record demonstrates a substantial disregard for public safety;

5. Felony record: any person shall be disqualified if he or she has been convicted of a felony within the last ten years, if such felony directly relates to the position of driver or attendant, such as theft, assault or eluding a police officer, sex offense, violent offense, or abuse;

6. E.V.A.P. training: no person shall operate an ambulance, first-aid vehicle or nonemergency transport vehicle without having first completed the emergency vehicle accident prevention course offered by Washington State Fire Service Training or other course approved by the fire chief or his designee.

C. The police department shall provide information on any new employee within three days. (Ord. 94-26 § 1(part), 1994).

5.14.100 Licensee – Personnel training provisions required.

A. All licensees shall have a written policy statement available for inspection showing that the licensee is providing ongoing training to all personnel, to include on-the-job training, classroom training, and advanced training. At any time the city may require that proof be made that all personnel have received such training, which is to include updating on new techniques.

B. At least once a year the fire chief or his designee shall request a written opinion from the county medical program director as to whether licensee’s personnel are being properly trained and shall investigate any reported deficiencies.

C. Licensees shall keep individual written records of training given/received and these must be available to authorized city employees. (Ord. 94-26 § 1(part), 1994).

5.14.110 Communications – Requirements.

The requirements set forth in Section 5.14.080(C) and Section 5.14.120 through 5.14.140 are the minimum communications requirements to be observed by all ambulance licensees. (Ord. 94-26 § 1(part), 1994).

5.14.120 Communications – Dispatch center.

A. Each licensee shall have a dispatch center open twenty-four hours a day, seven days a week, and telephone numbers shall be publicized and shall be filed with the city clerk, fire department, police department, communications center, and all hospitals in the city.

B. Timing and recording equipment shall record all incoming calls.

C. All radio communications shall be recorded.

D. Recordings shall be made available to the police chief or fire chief upon demand.

E. All recordings shall be made available to the policy chief or fire chief upon demand. (Ord. 94-26 § 1(part), 1994).

5.14.130 Communications – Records.

All licensees shall keep available for inspection by the city a written record of all calls including time received, response, destination, nature of call, facility or place patient was taken to, and time back, and shall be signed by the vehicle’s driver and/or by the dispatcher. (Ord. 94-26 § 1(part), 1994).

5.14.140 Communications – Vehicle equipment.

A. All vehicles shall be equipped with properly operating equipment that allows voice communication at all times with area hospitals, a home base station, all licensed vehicles, and with all other licensees. Minimum radio requirements shall include a VHF radio with at least eight channels, programmed as stipulated by the Walla Walla Emergency Dispatch Center Advisory Committee.

B. All communication systems shall be available for city inspection at all times and each licensee shall develop a testing schedule to meet FCC requirements and must adhere thereto, and such testing schedule must be kept available for city inspection. (Ord. 94-26 § 1(part), 1994).

5.14.150 Equipment requirements – General.

A. All ambulances when in operation shall have the minimum equipment required by regulation of the state for ambulances, aid vehicles, or nonemergency transport vehicles. WAC 246-976-300, 246-976-390 and 246-976-310, which shall be on file in the office of the city clerk, lists equipment which licensees are to have at all times on all vehicles. Such list shall be modified by the city clerk as found necessary upon recommendation of the chief of police or fire chief or as required by changes in state regulations. If at any time either chief finds that a licensee does not have a piece of such equipment which he finds is reasonable necessary for public safety, he shall cause the city clerk to send the licensee notice that he is required to install the same within thirty days and that failure to do so shall constitute grounds for suspension or revocation of its license. All equipment shall be in proper operating condition at all times.

B. Any ambulance licensed as an “ALS” vehicle shall be equipped with all “ALS” equipment/supplies necessary to provide all “ALS” procedures encompassed within the Walla Walla County EMS Pre-Hospital Care Guidelines including all addenda and revisions. (Ord. 94-26 § 1(part), 1994).

5.14.160 Equipment requirements – Medical supplies.

A. In addition to the equipment required in Section 5.14.150, all ambulances, aid vehicles, or nonemergency transport vehicles in operation shall be stocked with the minimum medical equipment and supplies required by regulation of the state of Washington. WAC 246-976-390 lists the medical equipment and supplies which licensees shall maintain on each vehicle in operation. Any equipment or medical supplies necessary to provide patient care as stipulated in the Walla Walla County Patient Care Guidelines must also be stocked on each licensed vehicle.

B. If at any time the fire chief finds that licensee does not have a supply which he finds is reasonably necessary for public safety, he shall require the licensee to secure and install the same within a maximum period of thirty days, or as much sooner as found necessary by the fire or police departments, and failure to do so shall constitute grounds for suspension or revocation of license. (Ord. 94-26 § 1(part), 1994).

5.14.170 Vehicle requirements.

A. All vehicles used by the licensee shall have been found by inspection by the fire department to meet all regulations of the state, to be safe for operation and to meet the minimum vehicle requirements set forth in WAC 246-976-280, which shall be on file in the city clerk’s office. Vehicles shall at all times be maintained in such a manner as to meet all applicable standards. Those items granted a variance under state license shall be optional unless and until required by state law or regulations under Chapters 18.27, 18.71 and 18.73 RCW and RCW 43.70.040 and 43.70.168. Such list shall be modified by the city clerk as found necessary by the fire chief or police chief.

B. If at any time either chief finds that a licensee does not have a piece of equipment which he finds is reasonably necessary for public safety, he shall require the licensee to secure and install the same within a maximum period of thirty days or as much sooner as found necessary by the fire or police departments, and failure to do so shall constitute grounds for suspension or revocation of the license. (Ord. 94-26 § 1(part), 1994).

5.14.180 Records – Incident/run report.

Each licensee shall use and correctly complete a Washington State Medical Incident Report form for each patient that his or her service examines, treats and/or transports. Further, each licensee shall keep the original of that report, shall transmit an electronic copy of that report to the Trauma Registry Division of the Department of Health’s Office of EMS and Trauma Care, in a timely manner, as prescribed by the state, and shall transmit the “second reporting agency” copy to the Walla Walla County E.M.S. medical program director or his designee in a timely manner for medical review, and shall transmit the “hospital” copy to the hospital or receiving agency for that patient. (Ord. 94-26 § 1(part), 1994).

5.14.190 Response to calls.

A. Licensees shall be permitted to monitor police, fire and ambulance frequencies for the purpose of being apprised of the scene of an accident or other emergency. No licensee shall respond to any emergency call unless their response is specifically requested by the city dispatch center, the city ambulance senior paramedic, or the fire chief or his designee. Such responses shall be on a noncode basis without the use of emergency lights and siren, unless otherwise specifically directed by the city dispatch center, the city ambulance senior paramedic, or the fire chief or his designee.

B. If and when specifically required to respond under code conditions, the vehicle shall use emergency lights and siren and shall in no case exceed the posted speed limits by more than ten miles per hour.

C. When making specifically requested code responses, the vehicles shall make use of audible and visual signals and shall be operated in such a manner as to meet all of the requirements of law for emergency vehicles.

D. In making nonemergency calls, all ambulances, first aid vehicles, and nonemergency transport vehicles shall obey all traffic and parking ordinances of the city.

E. If a licensee, his/her dispatcher, or his/her personnel receive a call requesting an emergency response (except as required in subsection B of this section), that person shall immediately advise city dispatch center of that request, giving all of the available information of that request. (Ord. 94-26 § 1(part), 1994).

5.14.200 Equal employment plan for hiring personnel.

No licensee shall discriminate unlawfully in employment on grounds of race, color, creed, national origin, sex, marital status, age or the presence of any sensory, mental or physical disability not relating to ability to perform duties of the position, and any violation will be grounds for revocation or suspension of license. In addition, each licensee shall prepare, file with the city clerk, and adhere to, an equal employment plan to prevent unlawful discrimination. (Ord. 94-26 § 1(part), 1994).

5.14.210 Rate schedule – Filing.

A. Upon being licensed to operate a business in the city under this chapter, each licensee shall file with the city clerk the rate schedule to be used to cover all charges it will make for ambulance service. Thereafter, it is unlawful for any license to charge any rate other than as shown on such schedule.

B. No such schedule shall thereafter be changed except as follows: the licensee shall file with the city clerk a new rate schedule; the new schedule shall not go into effect until at least thirty days after such filing; with such rate schedule shall be filed a written explanation as to the reasons said to necessitate the change. The licensee shall also pay all costs of publishing such schedule and justification in the city’s official newspaper. During such thirty-day period the licensee shall attend any city council meeting to which it is invited to further explain such rate change. The licensee shall make available to city staff and city council evidence in the form of ledgers and business records showing its revenues, costs and profit and loss during the preceding year. Such information shall be considered public record. All such rates and changes of rates shall meet the city council’s approval. (Ord. 94-26 § 1(part), 1994).

5.14.220 Rate schedule – Changing unlawful.

It is unlawful for prosecution in municipal court and/or for license suspension or revocation for any licensee to charge any rate or other than that on file with the city clerk. Copies of such current rate schedules shall be kept on file also in the police department and fire department and posted in the licensee’s place of business and in each vehicle. (Ord. 94-26 § 1(part), 1994).

5.14.230 Refusal to answer emergency call prohibited.

No licensee shall refuse or hesitate to respond to any emergency call for ambulance service upon any grounds of possible inability to pay on the part of the person or persons needing ambulance service. All persons needing emergency service shall be served without regard to ability to pay and without regard to race, color, creed, national origin, sex, marital status, age, the presence of any sensory, mental or physical disability, place of residence, financial condition or presence or absence of medical insurance. Any violation of this section shall be grounds for revocation or suspension of license. Nothing in this chapter shall be construed to make for city liability for costs of ambulance services. (Ord. 94-26 § 1(part), 1994).

5.14.240 Policy and procedure for treatment/transport of ill or injured patient(s) – City fire department ambulance at the scene.

In addition to other provisions of this chapter relating to the treatment and/or transportation of ill or injured patients by a licensee hereunder, the following procedures shall be followed in the event of a simultaneous response by the city fire department ambulance and a vehicle licensed hereunder to the scene of an accident or other emergency response.

A. The senior paramedic from the city fire department ambulance shall be in charge of the patient(s), and the personnel from any other licensee’s vehicles shall report to him or her;

B. The senior paramedic shall make the determination as to whether the patient(s) is in such a condition that the patient should be transported to a medical facility by the city’s ambulance;

C. In the event that the condition of the patient is not such that the immediate delivery of the patient by the city ambulance to a medical facility is imperative, then the patient may be transported by a licensee’s vehicle or by privately furnished transportation at the sole discretion of the senior paramedic;

D. The senior paramedic from the city fire department ambulance shall be overall in charge of the patient(s) care and treatment;

E. The senior paramedic shall have the right to rely upon the expressed desire of the patient, or the members of the patient’s family, or the Walla Wall County E.M.S. Patient Care guidelines, as prescribed by the Walla Walla E.M.S. Medical Program Director, as to where the patient shall be transported. (Ord. 94-26 § 1(part), 1994).

5.14.250 Revocation of license.

A. In the event of a violation of any of the provisions of this chapter, a license, granted under this chapter, may be revoked or suspended by the city council following a public hearing. Complaints for termination or suspension of any license issued in this chapter shall be filed with the city clerk and served on the city clerk and served on the licensee not less than thirty days prior to the date set by the city council for the hearing to determine if any license shall be revoked or suspended. The complaint shall specify the facts giving rise to the alleged violation. A copy of the complaint shall be sent with the notice of the hearing to the licensee by certified or registered mail to the address shown on the application and/or license.

B. The city council shall conduct a hearing in accordance with its own rules and may adjourn the hearing from time to time and request such additional information or evidence from the licensee or other sources as it deems necessary to apprise itself of all the facts it deems relevant to the complaint.

C. The decision of the city council shall be final with respect to any revocation or suspension of any license issued under this chapter. Any licensee whose license is suspended or revoked may appeal the decision of the city council by making application for a writ of certiorari to the superior court of Walla Walla County within ten days of the date of final decision by the city council. This shall be an exclusive remedy of any licensee under this chapter. During the pendency of any such appeal, the decision of the city council to suspend or revoke a license shall be stayed until final disposition of the matter by the superior court. (Ord. 94-26 § 1(part), 1994).

5.14.260 Penalties.

Failure to perform any act required by this chapter, or the performance of any act prohibited by this chapter, is designated as an infraction and may not be classified as a criminal offense. Any person, firm or corporation found to have committed an infraction under this chapter shall be assessed a monetary penalty. No penalty assessed of infractions under this chapter may exceed five hundred dollars for each separate infraction. (Ord. 94-26 § 1(part), 1994).

5.14.270 Severability.

If any section, subsection, sentence, clause, phrase or portion of this chapter is for any reason declared or held to be invalid or unconstitutional by any court of competent jurisdiction, such portion shall be deemed a separate and distinct and independent provision and such holding shall not affect the validity of the remaining portions hereof. (Ord. 94-26 § 1(part), 1994).