1997-16997-Ordinance No. 97-040 Recorded 5/19/199797-16997 of 61:-2532
BEFORE THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON
23
An Ordinance Adopting Chapter 8.30,
Ambulance Service Areas, of the Deschutes
County Code, and Declaring an Emergency.
ORDINANCE NO. 97-040
WHEREAS, ORS 682.205 requires Deschutes County to develop and adopt a plan for the
coordination of emergency ambulance services and to establish Ambulance Service Areas, consistent
with the plan, to provide efficient and effective emergency ambulance services; and
WHEREAS. ORS 221.485, 221.495, 478.260(3) and 682.025 through 682.355 require Deschutes
County to develop and adopt a plan for emergency ambulance services that recognizes the authority of
incorporated cities and rural fire protection districts to operate and regulate emergency ambulance
services within their own territories subject to the Ambulance Service Area Plan; and
WHEREAS, provision of effective and efficient ambulances services within incorporated cities
and rural fire protection districts must be accomplished primarily on a cooperative basis, and
WHEREAS, an Ambulance Service Area Plan was adopted by the Deschutes County Board of
County Commissioners on May 7, 1997; now, therefore,
THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON,
ORDAINS as follows:
Section 1. Adoption. Ordinance 97-040, the Ambulance Service Areas Ordinance of Deschutes
County is hereby adopted as set forth in Exhibit A and is codified as Code Chapter 8.30, Ambulance
Service Areas, is hereby adopted as set forth in Exhibit B, with both exhibits being attached hereto and by
this reference incorporated herein.
Section 2. Severability. The provisions of this ordinance are severable. If any section, sentence,
clause or phrase of this ordinance is adjudged to be invalid by a court of competent jurisdiction, that
decision shall not affect the validity of the remaining portions of this ordinance.
Section 3. Codification County Legal Counsel shall have the authority to format the provisions
contained herein in a manner that will integrate them into the County Code consistent with the Deschutes
County Form and Style Manual for Board Documents. Such codification shall include the authority to
make such changes, to make changes in numbering systems and to make such numbering changes
consistent with interrelated code sections. In addition, as part of codificationof these ordinances, County
Legal Counsel may insert appropriate legislative history reference. Any legislative history references
included herein are not adopted as part of the substance of this ordinance, but are included for
administrative convenience and as a reference. They may be changed to correct errors and to conform to
proper style without action of the Board of County Commissioners.
Section 4. Emergency. This ordinance being necessary for the immediate preservation of the
public peace, health and safety, an emergency is declared to exist, and this ordinance takes eff� ,,�t$ - ,
PAGE I - ORDINANCENO.97-040 (5-14-97)
1. CLQ i E AY
M!
��'"Z 191997
passage.
DATED this 14`" day of May, 1997.
ATT T:
Recording Secretary
PAGE 2 - ORDINANCE NO. 97-040 (5-14-97)
Q1s1=253,
BOARD OF COUNTY COMMISSIONERS OF
DASCHUTES-C-DUNTY40REGON
GEN,
RqBERT I . NIPPER, Cdfi'i issioner
t DAL. SWEARINGEN, Commissioner
EXHIBIT "A"
BEFORE THE BOARD OF COUNTY COMMISSIONERS FOR DESCHUTES COUNTY, OREGON
An Ordinance Establishing an
Ambulance Service Area; Assigning
Emergency Ambulance Service
Providers; Creating an Ambulance
Service Area Advisory Committee;
Providing Penalties; Prescribing
Effective Dates; and Declaring
an Emergency.
ORDINANCE NO 97-040
THE DESCHUTES COUNTY BOARD OF COMMISSIONERS, FOR DESC1 UTES COUNTY
OREGON, ORDAINS AS FOLLOWS:
SECTION 1 TITLE
This Ordinance shall be known as the Deschutes County Ambulance Service Ordinance, and may be so cited
and pled.
SECTION 2 AUTHORITY
This Ordinance is enacted pursuant to ORS 682.205, 682.275 and ORS 203.035, and other applicable law.
SECTION 3 POLICY AND PURPOSE
The Deschutes County Board of Commissioners finds:
That ORS 682.205 requires Deschutes County to develop and adopt a plan for the county relating to
the need for a coordination of emergency ambulance services and to establish Ambulance Service
Areas (ASAs) consistent with the plan to provide efficient and effective emergency ambulance
services.
2. That this Ordinance, which establishes an ASA, methods for selecting an emergency ambulance
provider for an ASA, and the Ambulance Service Area Advisory Committee, together with the
document known as the Deschutes County Ambulance Service Area Plan (ASA Plan), and
incorporated herein by this reference, make up the complete plan for emergency ambulance services
for Deschutes County.
3. That the provisions of ORS 221.485 and 221.495, 478.260(3), and 682.025 through 682.355 requires
Deschutes County to develop and adopt a plan for emergency ambulance services that recognizes the
authority of cities and rural fire protection districts to operate and regulate emergency ambulance
I - ORDINANCE NO. 97-040 (ADOPTED 5-14-97)
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services within their own territories subject to the ASA Plan. That the provision of effective and
efficient emergency ambulance services pursuant to the Deschutes County ASA Plan within cities and
rural fire protection districts must be accomplished primarily on a cooperative basis. Deschutes
County will employ formal sanctions and litigation to enforce the provisions of the Deschutes County
ASA Plan when voluntary compliance cannot be obtained.
SECTION 4 DEFINITIONS
The words and phrases in this Ordinance shall have the meaning provided in ORS Chapter 682 and OAR
Chapter 333, Divisions 250, 255, 260, and 265, unless specifically defined herein to have a different meaning.
Other specific definitions include:
a. "Administrator" means a person designated by order of the Board to administer this Ordinance and
the duly authorized deputy or assistant of such person.
b. "Ambulance Service Area (ASA)" means a geographical area which is served by one ambulance
service provider, and may include all or a portion of a county, or all or portions of one or more
contiguous counties.
C. "Ambulance Service Area Advisory Committee (Committee)" means the committee that will advise
the Board as it pertains to the ASA Plan.
d. "Board" means the Deschutes County Board of Commissioners for Deschutes County, Oregon.
e. "Franchise" means a franchise to provide emergency ambulance service issued by the Board pursuant
to this Ordinance.
f. 'Persons" means and includes individuals, corporations, associations, firms, partnerships, joint stock
companies, cities, rural fire protection districts, county service districts and special service districts
formed and existing pursuant to Oregon Revised Statute.
SECTION 5 EXEMPTIONS
This Ordinance shall not apply to:
1. ambulance services and ambulances owned or operated under the control of the United States
Government;
2. vehicles and aircraft being used to render temporary assistance in the case of a major catastrophe or
emergency with which the ambulance services of the surrounding locality are unable to cope, or when
directed to be used to render temporary assistance by an official at the scene of an accident;
3. vehicles operated solely on private property or within the confines of institutional grounds, whether or
not the incidental crossing of any public street, road or highway through the property or grounds is
involved; and
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4. ambulances or vehicles transporting patients from outside the county to a health care facility within
the county, or which are passing through without a destination in the county.
SECTION 6 ADMINISTRATION
The administrator, under the supervision of the Board and with the assistance of the Committee, shall be
responsible for the administration of this Ordinance. In order to carry out the duties imposed by this
Ordinance, the administrator, or persons authorized by the administrator, are hereby authorized to enter on the
premises of any person regulated by this Ordinance at reasonable times and in a reasonable manner to
determine compliance with this Ordinance and regulations promulgated pursuant thereto. The administrator
shall also have access to records pertaining to ambulance service operations of any person regulated by this
Ordinance. These records shall be made available within five (5) working days to the administrator at the
person's place of business, or copies made and provided as requested by the administrator.
SECTION 7 AMBULANCE SERVICE AREAS
For the efficient and effective provision of emergency ambulance services in accordance with the ASA Plan,
and the ASA map are incorporated herein by this reference, are hereby adopted as the ASA for Deschutes
County. The Board, after notice to the affected ASA provider(s) and by the adoption of an order, may adjust
the boundaries of an ASA from time to time as necessary to provide efficient and effective emergency
ambulance services.
SECTION 8 AMBULANCE SERVICE PROVIDERS REGULATED
Effective May 14, 1997, no person shall provide emergency ambulance services in Deschutes County,
Oregon, unless such person is franchised in accordance with the applicable provisions of this
Ordinance.
SECTION 9 APPLICATION FOR AMBULANCE SERVICE FRANCHISE
1. Any person desiring to provide ambulance service within Deschutes County shall submit an
application to be assigned an ASA within thirty (30) days of the effective date of this ordinance. The
application shall be submitted to the Health Officer.
2. Applications for franchises shall be on forms provided by the Board. In addition to information
required on the forms, the Board may require additional information it deems necessary to insure
compliance with this Ordinance.
3. The applicant shall provide the following information:
a. The name and address of the person or agency applying.
b. The ASA the person desires to serve, the location(s) from which ambulance services will be
provided, and the level of service to be provided.
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C. A statement as to whether or not the person will subcontract for any service to be provided. If
some service will be provided by subcontract, a copy of that subcontract shall be provided.
d. A list of vehicles to be used in providing emergency ambulance services including year, make
and model, and verification that each vehicle is licensed as a basic and/or advance life support
ambulance by the State Health Division.
e. A statement that all equipment and supplies in each ambulance conforms to State Health
Division standards.
f. A list of personnel to be used in providing emergency ambulance service and their current
Emergency Medical Technician level and certificate number, or other appropriate certification.
g. Proof of financial ability to operate, including an operating budget for public bodies or
financial statement for private entities, references and/or statement of past ambulance service.
Private companies must include a profit and loss statement in addition to the above materials.
Other appropriate financial information, such as income, tax returns, or reports by
governmental authorities shall also be submitted upon request. Public bodies must provide
information regarding the sources and amounts of funding for emergency ambulance services.
h. Proof of public liability insurance shall be equal to or exceed the limits established under the
Oregon Tort Claims Act (30.260-30.285) as amended from time to time by the Oregon
Legislature. Proof of public liability insurance in the amount of not less than $100,000
because of bodily injury to or death of one person in any one accident; subject to that limit for
one person, $300,000 because of bodily injury to or death of two or more persons in any one
accident; $50,000 because of injury to or destruction of the property of others in any one
accident; and $500,000 because of injury arising from the negligent provision of pre -hospital
care to any individual. Public applicants may be self-insured. All non-public persons shall
name Deschutes County as an additional named insured and shall give the administrator at
least 30 days written notice of any changes in insurance provider or cancellation of an
insurance policy.
i. A statement of experience in providing emergency ambulance service of a comparable quality
and quantity to insure compliance with this Ordinance, regulations promulgated thereunder,
any franchise issued, and the ASA Plan.
j. Proof of ability to comply with the terms and conditions of the ASA Plan and applicable
county ordinances, in the form of a narrative summary.
k. A description of any prepaid ambulance service plan, including number of members, number
of years of operation, funding and term.
1. Information, in the form of run logs, medical records, medical director correspondence, audit
reports, training records, policy and procedure manuals and equipment records and inventories,
and any other records or materials requested.
M. In the case of an application to transfer or take over an already assigned franchise:
(1) A detailed summary of how the proposed change will improve emergency ambulance
4 - ORDINANCE NO. 97-040 (ADOPTED 5-14-97)
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response time, and the quality and level of services to the ASA. It shall include an
assessment of how the proposed change will impact the existing first response system.
(2) Evidence that the call volume in the ASA is sufficient to financially or otherwise
justify the change in service.
(3) Information, in the form of run logs, medical records, medical director
correspondence, audit reports, training records, policy and procedure manuals and
equipment records and inventories, and any other records or materials requested.
4. "The Board may from time to time, by order, adopt fees to defray the actual reasonable costs incurred
by Deschutes County in processing applications, and adopt annual franchise fees to defray the
reasonable costs of Deschutes County in administering this Ordinance.
5. The applications shall be reviewed by the Committee and shall recommend the assignment of the
ASAs to the Board. The assignment of an ASA shall be made by an Order of the Board.
SECTION 10 EXISTING AMBULANCE SERVICE PROVIDERS
Unless there has been more than one application made for an ASA, the persons who meet the application
requirements of Section 9 and who were providing service on the effective date of this Ordinance shall be
franchised to provide emergency ambulance service for the ASA they were serving on the effective date of this
Ordinance.
SECTION I 1 REVIEW OF APPLICATION FOR FRANCHISE
Applications (other than those providers/persons who are qualified under Section 10 above) shall be
reviewed by the Committee, who shall make such investigation as it deems appropriate, and who may
request assistance of other persons as necessary.
2. The administrator shall notify the holder of a franchise for providing emergency ambulance service to
an ASA of any applications by another person to take over that franchise.
3. Unless the time is extended by the Board for good cause, the Committee shall make its
recommendation to the Board to grant, deny, modify or attach appropriate conditions to the
application. The Committee shall transmit its recommendation within sixty (60) days after the
application and any required supplemental information has been received.
SECTION 12 BOARD ACTION ON APPLICATION FOR FRANCHISE
Upon receipt of the Committee's recommendation, the Board:
1. Shall publish notice of its intent to hold a public hearing on the application and recommendations at
least ten (10) days, but not later than thirty (3 0) days following publication of notice.
2. May require additional investigation by the Committee if it finds that there is insufficient information
on which to base its action.
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Shall, upon the basis of the application, the Committee's recommendation, such other information as
is permitted by this Ordinance, and such information as is presented to the Board at the public hearing
make an order granting, denying or modifying the application or attaching conditions thereto.
Shall not make an order adverse to the applicant or to the holder of, or applicant for, another franchise
effective less than 30 days after the date of such order and shall notify such persons in writing of the
order. The Board may suspend operation of this subsection and enter an emergency order if it finds
that there is an immediate and serious danger to the public or that a health hazard or public nuisance
would be created by a delay.
After the Board makes an order granting an emergency ambulance service franchise, with or without
conditions, and the franchisee finds it is unable to provide a particular service, the Board may permit
the franchisee to subcontract such service to another person if the Board finds that the quality and
extent of the service would not be jeopardized. The Board may require the filing of such information
as it deems necessary.
SECTION 13 FRANCHISE TERMS AND RENEWALS
The initial ambulance service franchise in an ASA shall be valid from the date of issuance until June
30, 2000.
2. Thereafter, unless the Board finds that a longer or shorter term is required in the public interest, the
term of an emergency ambulance service franchise shall be three (3) years, beginning on July 1 of a
year and ending June 30 three (3) years later.
Unless grounds exist for refusal to renew a franchise under provisions for suspension or revocation as
set forth in Section 16, or unless the franchise is to be given to a new person, franchises shall be
renewable. Application for renewal shall be made on forms provided by the Board.
Not more than one hundred eighty (180) days and not less than one hundred twenty (120) days prior
to the expiration of the franchise, a franchisee wanting to renew the franchise and any person desiring
to take over the franchise shall submit an application to the administrator.
Review of all applications for renewal or take over of a franchise shall be conducted in the same
manner as for an application pursuant to Sections 9, 11 and 12 of this Ordinance.
SECTION 14 EARLY DISCONTINUANCE OF SERVICE BY FRANCHISEE
If a franchisee discontinues service before the expiration of his/her franchise, the Board shall set a
time by which applications must be submitted for a new franchise in the ASA.
2. The Committee shall develop an interim plan for coverage of the ASA, using existing franchisees
and/or other available resources until the ASA can be reassigned.
The Board shall issue a temporary certificate, valid for a stated period not to exceed six (6) months,
entitling a person to provide emergency ambulance service in all or part of the ASA. The Board may
6 - ORDINANCE NO. 97-040 (ADOPTED 5-14-97)
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renew a temporary certificate for one additional six (6) month period.
SECTION 15 TRANSFER OF FRANCHISES
A franchisee may transfer the franchise to another person only upon written notice to and approval by the
Board. Review of an application for transfer of a franchise shall be conducted in the same manner as for an
application pursuant to Sections 9, 11, and 12 of this Ordinance.
SECTION 16 ENFORCEMENT OF FRANCHISE PROVISIONS
Subject to the policies stated in Section 3, and in addition to the remedy provided in Section 17, and
penalties provided elsewhere in this Ordinance, statue or rule the administrator shall, upon reasonable
cause, make an investigation to determine if there is sufficient reason and cause to suspend, modify,
revoke or refuse to renew a franchise as provided in this Subsection.
If in the judgment of the Committee or Board, there is sufficient evidence to constitute a violation of
applicable local, state or federal law, this Ordinance, ORS Chapter 823 or the Rules promulgated
thereunder, the ASA Plan, or if the franchisee has materially misrepresented facts or information
given in the application for the franchise, the Board shall notify the franchisee in writing, by certified
mail, return receipt requested, or by personal service, as is provided by law for the service of a
summons, of the violation and what steps he must take to cure the violation. The Board shall send a
copy of the notice to the Committee.
Ten (10) days following the receipt of notice of violation, the Board may enter its order of revocation,
modification, suspension or non -renewal, and may thereby revoke, modify, suspend, or not renew the
franchise, unless prior thereto the franchisee shall file with the Board his request for a hearing on the
Board's notice of violation. If said request is timely filed, or if the Board so moves on its own,
revocation, modification, suspension, or non -renewal will be stayed until the Board can, at its earliest
convenience, hold a public hearing thereon. Notice of said hearing shall be given to the franchisee by
mail and to all others by publication in a newspaper of general circulation in the county or the ASA at
least ten (10) days prior to such hearing. The burden of proof at the hearing held hereunder shall be
upon the administrator to show by substantial evidence in the record as a whole that the franchisee
failed to comply with this Ordinance, ASA Plan, State statute or Administrative rule.
Substantial evidence in the record exists to support a finding of fact or order when the record, viewed
as a whole, would permit a reasonable person to make that finding or order.
2. In lieu of the suspension or revocation of the franchise, the Board may order that the violation be
corrected and make the suspension or revocation contingent upon compliance with the order within
the period of time stated therein. Notice of the Board action shall be provided by mail to the
franchisee. The notice shall specify the violation, the action necessary to correct the violation, and the
date by which the action must be taken. The franchisee shall notify the Board of the corrective action
taken. If the franchisee fails to take corrective action within the time required, the Board shall notify
the franchisee by certified mail, return receipt requested, or by personal service that the franchise is
suspended or revoked upon service of the notice.
3. Should the franchisee fail to comply with the Board's order, then the Board may take any steps
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authorized by law to enforce its order.
SECTION 17 PREVENTING INTERRUPTION OF SERVICE
Whenever the Board finds that the failure of service or threatened failure of service would adversely impact the
health, safety or welfare of the residents of this county, the Board shall, after reasonable notice, but not less
than twenty-four (24) hours notice to the franchisee, hold a public hearing. Upon appropriate findings after the
hearing, the Board shall have the right to authorize another franchisee or other person to provide services.
SECTION 18 APPEALS, ABATEMENT AND PENALTIES
All the decisions of the Board under this Ordinance shall be reviewable by the Circuit Court of the
State of Oregon for the County of Deschutes, only by way of writ of review.
The provision of emergency ambulance service by any person in violation of this Ordinance, or
regulations promulgated thereunder, is a nuisance and the Court may, in addition to other remedies
provided by law or by this Ordinance, institute injunctive abatement or other appropriate legal
proceedings to temporarily or permanently enjoin or abate such emergency ambulance service.
Any person who violates any of the provisions of this Ordinance is guilty of a violation. Failure from
day to day to comply with the terms of these provisions shall be a separate offense for each day.
Failure to comply with any provision shall be a separate offense for each such provision.
4. Violations of these provisions are punishable, upon conviction, by a fine of not more than five
hundred ($500) dollars for a non -continuing offense, i.e., an offense not spanning two (2) or more
consecutive calendar days. In the case of a continuing offense, i.e., an offense which spans two (2) or
more consecutive calendar days, violation of the provisions is punishable by a tine of not more than
five hundred ($500) dollars per day up to a maximum of one thousand ($1,000) dollars as provided by
law.
SECTION 19 DUTIES OF AMBULANCE SERVICE FRANCHISEE
The Franchisee:
Shall conduct its operation in compliance with all applicable state and federal laws, rules and
regulations, the terms of this Ordinance and the Deschutes County ASA Plan;
2. Shall not fail or refuse to respond to an emergency call for service when an ambulance is available for
service;
I Shall not respond to a medical emergency located outside its assigned ASA except:
When a request for specific emergency ambulance service is made by the person calling for the
ambulance and the call dose not dictate an emergency response;
b. When the franchisee assigned to the ASA is unavailable to respond and the franchisee is
requested by another franchisee or 9-1-1 dispatch to respond; or
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:f
5
0161-2542
C. When the response is for supplemental assistance or mutual aid.
Shall not voluntarily discontinue service to his/her assigned ASA until he/she has:
a. Given sixty (60) days written notice to the administrator, or
b. Obtained written approval of the Board.
Subsection 4 of this Section shall not apply to:
a. Change, restriction or termination of service when required by any public agency, public body
or court having jurisdiction; or
b. Transfer of franchises pursuant to Section 15 of this Ordinance
SECTION 20 AMBULANCE SERVICE AREA (ASA) ADVISORY COMMITTEE
I . There is hereby created an Ambulance Service Area (ASA) Advisory Committee.
a. The Committee shall consist of ten members:
(1) Emergency department physician - 1;
(2) Ambulance service medical director - l;
(2) Deschutes County Health Department - 1;
(3) Ambulance service provider - 1;
(4) Law enforcement representative - l;
(5) 9-1-1 center representative - 1;
(6) Medical facility administrator - 1;
(7) EMT -Basic - 1;
(8) EMT -Intermediate - 1;
(9) EMT -Paramedic - 1; and
(10) Public member - 1
b. The administrator and other Deschutes County staff as the Board deems appropriate shall be
ex -officio members of the Committee.
2. Members shall be appointed by and serve at the pleasure of the Board. The Board may appoint
additional persons to the Committee to serve as ex -officio members or advisors. The Board may
appoint or approve designation of alternates to serve in the absence of persons appointed to the
Committee.
3. Except for the ASA administrator and other Deschutes County staff, appointments shall be for
staggered terms on the initial Committee for a term not to exceed three (3) years. Subsequent
appointments shall be for two (2) year terms. Members shall serve until their successors are
appointed and qualified. Vacancies shall be filled by the Board for the balance of the unexpired term.
Persons may be appointed to successive terms.
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4. The Committee shall elect a chairperson. The Committee shall meet at such times as it deems
necessary or as called by the Administrator or the Board. The chairperson or any two members of the
Committee may call a special meeting with five (5) days notice to other members of the Committee;
provided however, that members may way such notice.
5. Five (5) members constitute a quorum for the transaction of business. A majority vote of those
present and voting is required to pass motions.
6. In addition to other duties prescribed by this Ordnance the Committee shall:
a. Review and make recommendations to the administrator regarding the selection criteria for
determining a franchise to provide ambulance service.
b. Regularly provide information to the Board from prehospital care consumers, providers and the
medical community.
C. Periodically review the ASA Plan and make recommendations to the Board including, but not
limited to:
(1) Review the standards established in the Plan and make recommendations regarding
improvement of or new standards as required by OAR 333-260-0050;
(2) Monitor the coordination between emergency medical service resources;
(3) Review dispatch procedures and compliance; and
(4) Review the effectiveness and efficiency of the ASA boundaries.
d. Implement the quality assurance program outlined in the ASA Plan to insure compliance with
the ASA Plan.
e. Perform such other duties as directed by the Board.
7. Committee members shall avoid acting in any matters where a conflict of interest may arise. Any
Committee member having a direct or indirect financial or pecuniary interest in any matter before the
Committee for consideration shall withdraw from participation in any action by the Committee is said
matter. Nothing is this Section shall limit the ability of any person to provide testimony to the
Committee.
SECTION 21 REGULATIONS OF AMBULANCE SERVICE
Upon its own motion or upon a recommendation of the Committee, the Board may adopt ordinances,
resolutions or orders regulating emergency ambulance service or implementing this Ordinance. Such
regulations shall not conflict with ORS 823 and rules promulgated pursuant thereto.
SECTION 22 INITIAL RESPONDER
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Nothing in these provisions prohibits a 9-1-1 agency, responsible for the dispatching of emergency services,
from dispatching an initial responder to the scene of a medical emergency in addition to dispatching an
emergency ambulance service provider.
SECTION 23 EMERGENCY CLAUSE
Any judgment or declaration by any court of competent jurisdiction that any portion of this Ordinance
is unconstitutional or invalid shall not invalidate any other portion of this Ordinance.
Upon recommendation of the Committee or upon its own motion, the Board may from time to time
amend the provisions of this Ordinance. Amendments shall be made only after a public hearing
before the Board with such advance notice of the hearing as deemed appropriate by the Board or as
generally provided by ordinance, regulation or order of the Board.
3. in order to provide efficient and effective emergency ambulance service in Deschutes County and
thereby preserve the health, safety and welfare of the residents and inhabitants of the county, an
emergency is declared to exist and the terns and provisions of this Ordinance shall become effective
upon enactment of this Ordinance.
SECTION 24 REPEAL OF PRIOR ORDINANCE
Any prior Deschutes County Ordinance relating to or entitled Deschutes Ambulance Service Area Plan is
repealed.
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EXHIBIT "B"
Chapter 8.30. AMBULANCE SERVICE
AREA
8.30.010.
Title.
8.30.020.
Purpose.
8.30.030.
Definitions.
8.30.035.
Ambulance service area (ASA)
advisory committee -established.
8.30.040.
Administration.
8.30.045.
Service providers regulated.
8.30.050.
Franchise -application.
8.30.055.
Franchise -review of application.
8.30.060.
Franchise -terms and renewals.
8.30.065.
Franchise -discontinuance of
service; transfer.
8.30.070.
Enforcement.
8.30.075.
Interruption of service -prevention.
8.30.080.
Appeals, abatement and penalties.
8.30.085.
Franchisee duties.
8.30.090.
Exemptions.
8.30.010. Title.
This title shall be known as the Deschutes
County Ambulance Service Ordinance. (Ord.
97-040 § 1, 1997)
8.30.020. Purpose.
A. The purpose of this chapter is to
establish ambulance service areas, assign
emergency ambulance service providers, create
an ambulance service area advisory committee,
provide penalties and prescribe effective dates.
B. For the efficient and effective
provision of emergency ambulance services in
accordance with the ASA Plan, the ASA shown
on the map attached hereto as Appendix #1, and
incorporated herein by this reference, are hereby
adopted as the ASA for Deschutes County. The
Board, after notice to the affected ASA provider
and by the adoption of an order, may adjust the
boundaries of an ASA from time to time as
necessary to provide efficient and effective
0.61--2545
emergency ambulance services. (Ord. 97-040
§ 1, 1997)
8.30.030. Definitions.
For the purposes of this chapter, unless
otherwise apparent from the context, certain
words and phrases used in this chapter are
defined as set forth in the Ambulance Service
Area Plan for Deschutes County, Oregon,
attached as Appendix 8. (Ord. 97-040 § 1,
1997)
8.30.035. Ambulance Service Area (ASA)
Advisory Committee -Established.
A. A committee to be known as the
Ambulance Service Area Advisory Committee
(committee) is hereby established.
1. The committee shall consist of ten
members, one member from each of the
following:
a. Emergency department physician,
and
b. Ambulance service medical
director, and
C. Deschutes County Health
Department, and
d. Ambulance service provider, and
e. Law enforcement representative,
and
f. 9-1-1 center representative, and
g. EMT -Basic, and
h. EMT -Intermediate, and
i. EMT -Paramedic, and
j. Public at large.
2. The administrator and other county
staff as the board deems appropriate shall be ex -
officio members of the committee.
B. Members shall be appointed by and
serve at the pleasure of the board. The board
may appoint additional persons to the
committee to serve as ex -officio members or
advisors. The board may appoint or approve
designation of alternates to serve in the absence
of persons appointed to the committee.
C. Except for the ASA administrator
and other county staff, appointments shall be for
staggered terms on the initial committee for a
term not to exceed three years. Subsequent
appointments shall be for two-year terms.
Members shall serve until their successors are
appointed and qualified. Vacancies shall be
filled by the board for the balance of the
unexpired term. Persons may be appointed to
successive terms.
D. The committee shall elect a
chairperson. The committee shall meet at such
times as it deems necessary or as called by the
administrator or the board. The chairperson or
any two members of the committee may call a
special meeting with five days notice to other
members of the committee; provided, however,
that members may waive such notice.
E. Five committee members constitute
a quorum for the transaction of business. A
majority vote of those present and voting is
required to pass motions.
F. In addition to other duties
prescribed by this chapter, the committee shall:
1. Review and make recommendations
to the administrator regarding the selection
criteria for determining a franchise to provide
ambulance service.
2. Regularly provide information to
the board from pre -hospital care consumers,
providers and the medical community.
3. Periodically review the ASA Plan
and make recommendations to the board
including, but not limited to:
a. Review the standards established in
the plan and make recommendations regarding
improvement of or new standards as required by
OAR 333-260-0050; and
b. Monitor the coordination between
emergency medical service resources; and
C. Review dispatch procedures and
compliance; and
d. Review the effectiveness and
efficiency of the ASA boundaries.
4. Implement the quality assurance
program outlined in the ASA Plan to insure
compliance with the ASA Plan.
5. Perform such other duties as
directed by the board.
G. Committee members shall avoid
acting in any matters where a conflict of interest
may arise. Any committee member having a
direct or indirect financial or pecuniary interest
02546
161=
in any matter before the committee for
consideration shall withdraw from participation
in any action by the committee in said matter.
Nothing in this section shall limit the ability of
any person to provide testimony before the
committee. (Ord. 97-040 § 1, 1997)
8.30.040. Administration.
The administrator, under the
supervision of the Board and with the assistance
of the Committee, shall be responsible for the
administration of this Ordinance. In order to
carry out the duties imposed by this Ordinance,
the administrator, or persons authorized by the
administrator, are hereby authorized to enter on
the premises of any person regulated by this
Ordinance at reasonable times and in a
reasonable manner to determine compliance
with this Ordinance and regulations
promulgated pursuant thereto. The
administrator shall also have access to records
pertaining to ambulance service operations of
any person regulated by this Ordinance. These
records shall be made available within five (5)
working days to the administrator at the person's
place of business, or copies made and provided
as requested by the administrator.
8.30.045. Service providers regulated.
A. Effective May 14, 1997, no person
shall provide emergency ambulance services
within Deschutes County unless such person is
franchised in accordance with this chapter.
B. Unless there has been more
than one application made for an ASA, the
persons who meet the application requirements
of Section 9 and who were providing service on
the effective date of this Ordinance shall be
franchised to provide emergency ambulance
service for the ASA they were serving on the
effective date of this Ordinance. (Ord. 97-040 §
1, 1997)
8.30.050. Franchise -application.
A. Any person desiring to provide
ambulance service within Deschutes Comity
shall submit an application to be assigned an
ASA within thirty (30) days of the effective date
of this ordinance. The application shall be
submitted to the Health Officer.
B. Applications for franchises shall be
on forms provided by the Board. In addition to
information required on the forms, the Board
may require additional information it deems
necessary to insure compliance with this
Ordinance.
C. The applicant shall provide the
following information:
1. The name and address of the person
or agency applying.
2. The ASA the person desires to
serve, the location(s) from which ambulance
services will be provided, and the level of
service to be provided.
3. A statement as to whether or not the
person will subcontract for any service to be
provided. If some service will be provided by
subcontract, a copy of that subcontract shall be
provided.
4. A list of vehicles to be used in
providing emergency ambulance services
including year, make and model, and
verification that each vehicle is licensed as a
basic and/or advance life support ambulance by
the Health Division.
5. A statement that all equipment and
supplies in each ambulance conforms to Health
Division standards.
6. A list of personnel to be used in
providing emergency ambulance service and
their current Emergency Medical Technician
level and certificate number, or other
appropriate certification.
7. Proof of financial ability to operate,
including an operating budget for public bodies
or financial statement for private entities,
references and/or statement of past ambulance
service. Private companies must include a
profit and loss statement in addition to the
above materials. Other appropriate financial
information, such as income, tax returns, or
reports by governmental authorities shall also be
submitted upon request. Public bodies must
provide information regarding the sources and
amounts of funding for emergency ambulance
services.
0161-2541
8. Proof of public liability insurance in
the amount of not less than $100,000 because
of bodily injury to or death of one person in any
one accident; subject to that limit for one
person, $300,000 because of bodily injury to or
death of two or more persons in any one
accident; $20,000 because of injury to or
destruction of the property of others in any one
accident; and $500,000 because of injury arising
from the negligent provision of pre -hospital care
to any individual. Applicants may be
self-insured.
9. A statement of experience in
providing emergency ambulance service of a
comparable quality and quantity to insure
compliance with this Ordinance, regulations
promulgated thereunder, any franchise issued,
and the ASA Plan.
10. Proof of ability to comply with the
terms and conditions of the ASA Plan and
applicable county ordinances, in the form of a
narrative summary.
11. A description of any prepaid
ambulance service plan, including number of
members, number of years of operation, funding
and term.
12. Information, in the form of run logs,
medical records, medical director
correspondence, audit reports, training records,
policy and procedure manuals and equipment
records and inventories, and any other records
or materials requested.
13. In the case of an application to
transfer or take over an already assigned
franchise:
a. A detailed summary of how the
proposed change will improve emergency
ambulance response time, and the quality and
level of services to the ASA. It shall include an
assessment of how the proposed change will
impact the existing first response system.
b. Evidence that the call volume in the
ASA is sufficient to financially or otherwise
justify the change in service.
C. Information, in the form of run logs,
medical records, medical director
correspondence, audit reports, training records,
policy and procedure manuals and equipment
records and inventories, and any other records
or materials requested.
D. The Board may from time to time,
by order, adopt fees to defray the actual
reasonable costs incurred by Deschutes County
in processing applications, and adopt annual
franchise fees to defray the reasonable costs of
Deschutes County in administering this
Ordinance.
E. The applications shall be reviewed
by the Committee and shall recommend the
assignment of the ASAs to the Board. The
assignment of an ASA shall be made by an
Order of the Board. (Ord. 97-040 § 1, 1997)
8.30.055. Franchise -review of application.
A. Applications shall be reviewed by
the Committee, who shall make such
investigation as it deems appropriate, and who
may request assistance of other persons as
necessary.
B. The administrator shall notify the
holder of a franchise for providing emergency
ambulance service to an ASA of any
applications by another person to take over that
franchise.
C. Unless the time is extended by the
Board for good cause, the Committee shall
make its recommendation to the Board to grant,
deny, modify or attach appropriate conditions to
the application. The Committee shall transmit
its recommendation within sixty (60) days after
the application and any required supplemental
information has been received.
D. Upon receipt of the Committee's
recommendation, the Board:
1. Shall publish notice of its intent to
hold a public hearing on the application and
recommendations at least ten (10) days, but not
later than thirty (30) days following publication
of notice.
2. May require additional investigation
by the Committee if it finds that there is
insufficient information on which to base its
action.
3. Shall, upon the basis of the
application, the Committee's recommendation,
such other information as is permitted by this
Ordinance, and such information as is presented
01.61-2548
to the Board at the public hearing make an order
granting, denying or modifying the application
or attaching conditions thereto.
4. Shall not make an order adverse to
the applicant or to the holder of, or applicant
for, another franchise effective less than 30 days
after the date of such order and shall notify such
persons in writing of the order. The Board may
suspend operation of this subsection and enter
an emergency order if it finds that there is an
immediate and serious danger to the public or
that a health hazard or public nuisance would be
created by a delay.
5. After the Board makes an order
granting an emergency ambulance service
franchise, with or without conditions, and the
franchisee finds he/she is unable to provide a
particular service, the Board may permit the
franchisee to subcontract such service to another
person if the Board finds that the quality and
extent of the service would not be jeopardized.
The Board may require the filing of such
information as it deems necessary.
8.30.060. Franchise -terms and renewals.
A. The initial ambulance service
franchise in an ASA shall be valid from the date
of issuance until June 30, 2000.
B. Thereafter, unless the Board finds
that a longer or shorter term is required in the
public interest, the term of an emergency
ambulance service franchise shall be three (3)
years, beginning on July 1 of a year and ending
June 30 three (3) years later.
C. Unless grounds exist for refusal to
renew a franchise under provisions for
suspension or revocation as set forth in Section
16, or unless the franchise is to be given to a
new person, franchises shall be renewable.
Application for renewal shall be made on forms
provided by the Board.
D. Not more than one hundred eighty
(180) days and not less than one hundred twenty
(120) days prior to the expiration of the
franchise, a franchisee wanting to renew the
franchise and any person desiring to take over
the franchise shall submit an application to the
administrator.
E. Review of all applications for
renewal or take over of a franchise shall be
conducted in the same manner as for an
application pursuant to Sections 9, 11 and 12 of
this Ordinance.
8.30.065. Franchise -discontinuance of
service; transfer.
A. If a franchisee discontinues service
before the expiration of his/her franchise, the
Board shall set a time by which applications
must be submitted for a new franchise in the
ASA.
B. The Committee shall develop an
interim plan for coverage of the ASA, using
existing franchisees and/or other available
resources until the ASA can be reassigned.
C. The Board shall issue a temporary
certificate, valid for a stated period not to
exceed six (6) months, entitling a person to
provide emergency ambulance service in all or
part of the ASA. The Board may renew a
temporary certificate for one additional six (6)
month period.
D. A franchisee may transfer his/her
franchise to another person only upon written
notice to and approval by the Board. Review of
an application for transfer of a franchise shall be
conducted in the same manner as for an
application pursuant to Sections 9, 11, and 12 of
this Ordinance.
8.30.070. Enforcement.
A. Subject to the policies stated in
Section 3, and in addition to the remedy
provided in Section 17, and penalties provided
elsewhere in this Ordinance, the administrator
shall, upon reasonable cause, make an
investigation to determine if there is sufficient
reason and cause to suspend, modify, revoke or
refuse to renew a franchise as provided in this
Subsection.
B. If in the judgment of the Committee
or Board, there is sufficient evidence to
constitute a violation of applicable local, state or
federal law, this Ordinance, ORS Chapter 823 or
the Rules promulgated thereunder, the ASA
Plan, or if the franchisee has materially
misrepresented facts or information given in the
0161-2549
application for the franchise, the Board shall
notify the franchisee in writing, by certified
mail, return receipt requested, or by personal
service, as is provided by law for the service of
a summons, of the violation and what steps he
must take to cure the violation. The Board shall
send a copy of the notice to the Committee.
C. Ten (10) days following the receipt
of notice of violation, the Board may enter its
order of revocation, modification, suspension or
non -renewal, and may thereby revoke, modify,
suspend, or not renew the franchise, unless prior
thereto the franchisee shall file with the Board
his request for a hearing on the Board's notice of
violation. If said request is timely filed, or if the
Board so moves on its own, revocation,
modification, suspension, or non -renewal will
be stayed until the Board can, at its earliest
convenience, hold a public hearing thereon.
Notice of said hearing shall be given to the
franchisee by mail and to all others by
publication in a newspaper of general
circulation in the county or the ASA at least ten
(10) days prior to such hearing. The burden of
proof at the hearing held hereunder shall be
upon the administrator to show by Substantial
Evidence in the record as a whole that the
franchisee failed to comply with this Ordinance,
ASA Plan, State statute or Administrative rule.
[Substantial Evidence in the record exists to
support a finding of fact or order when the
record, viewed as a whole, would pen -nit a
reasonable person to make that finding or
order.]
E. In lieu of the suspension or
revocation of the franchise, the Board may order
that the violation be corrected and make the
suspension or revocation contingent upon
compliance with the order within the period of
time stated therein. Notice of the Board action
shall be provided by mail to the franchisee. The
notice shall specify the violation, the action
necessary to correct the violation, and the date
by which the action must be taken. The
franchisee shall notify the Board of the
corrective action taken. If the franchisee fails to
take corrective action within the time required,
the Board shall notify the franchisee by certified
mail, return receipt requested, or by personal
service that the franchise is suspended or
revoked upon service of the notice.
F. Should the franchisee fail to comply
with the Board's order, then the Board may take
any steps authorized by law to enforce its order.
8.30.075. Interruption of service -prevention.
Whenever the Board finds that the failure
of service or threatened failure of service would
adversely impact the health, safety or welfare of
the residents of this county, the Board shall,
after reasonable notice, but not less than
twenty-four (24) hours notice to the franchisee,
hold a public hearing. Upon appropriate
findings after the hearing, the Board shall have
the right to authorize another franchisee or other
person to provide services.
8.30.080. Appeals, abatement and penalties.
A. All the decisions of the Board under
this Ordinance shall be reviewable by the
Circuit Court of the State of Oregon for the
County of Deschutes, only by way of writ of
review.
B. The provision of emergency
ambulance service by any person in violation of
this Ordinance, or regulations promulgated
thereunder, is a nuisance and the Court may, in
addition to other remedies provided by law or
by this Ordinance, institute injunctive abatement
or other appropriate legal proceedings to
temporarily or permanently enjoin or abate such
emergency ambulance service.
C. Any person who violates any of the
provisions of this Ordinance is guilty of a
violation. Failure from day to day to comply
with the terms of these provisions shall be a
separate offense for each day. Failure to
comply with any provision shall be a separate
offense for each such provision.
D. Violations of these provisions are
punishable, upon conviction, by a fine of not
more than five hundred ($500) dollars for a non -
continuing offense, i.e., an offense not spanning
two (2) or more consecutive calendar days. In
the case of a continuing offense, i.e., an offense
0161-2550
which spans two (2) or more consecutive
calendar days, violation of the provisions is
punishable by a fine of not more than five
hundred ($500) dollars per day up to a
maximum of one thousand ($1,000) dollars as
provided by law.
8.30.085. Franchisee duties.
A. The Franchisee:
1. Shall conduct its operation in
compliance with all applicable state and federal
laws, rules and regulations, the terms of this
Ordinance and the Deschutes County ASA Plan;
2. Shall not fail or refuse to respond to
an emergency call for service when an
ambulance is available for service;
3. Shall not respond to a medical
emergency located outside its assigned ASA
except:
a. When a request for specific
emergency ambulance service is made by the
person calling for the ambulance and the call
dose not dictate an emergency response;
b. When the franchisee assigned to the
ASA is unavailable to respond and the
franchisee is requested by another franchisee or
9-1-1 dispatch to respond; or
C. When the response is for
supplemental assistance or mutual aid.
4. Shall not voluntarily discontinue
service to his/her assigned ASA until he/she
has:
a. Given sixty (60) days written notice
to the administrator, or
b. Obtained written approval of the
Board.
5. Subsection 4 of this Section shall
not apply to:
a. Change, restriction or termination
of service when required by any public agency,
public body or court having jurisdiction; or
b. Transfer of franchises pursuant to
Section 15 of this Ordinance
8.30.90. Exemptions.
A. Noting in this chapter prohibits a
911 agency, responsible for the dispatching of
emergency services, from dispatching an initial
responder to the scene of a medical emergency
0161-2551
in addition to dispatching an emergency
ambulance service provider.
B. This Chapter shall not apply to the
following:
1. ambulance services and ambulances
owned or operated under the control of the
United States Government; and
2. vehicles and aircraft being used to
render temporary assistance in the case of a
major catastrophe or emergency with which the
ambulance services of the surrounding locality
are unable to cope, or when directed to be used
to render temporary assistance by an official at
the scene of an accident; and
3. vehicles operated solely on private
property or within the confines of institutional
grounds, whether or not the incidental crossing
of any public street, road or highway through
the property or grounds is involved; and
4. ambulances or vehicles transporting
patients from outside the county to a health care
facility within the county, or which are passing
through without a destination in the county.