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2003-955-Ordinance No. 2003-023 Recorded 6/19/2003w - REV-I�EW�ED LEGAL, COUNSEL CODE INVIEW COMMITTEE DESCHUTES BLANKENSHIP, COUNTY CLERK CJ 1003'955 NANCY COMMISSIONERS' JOURNAL 11111111111111111111 0611912003 03;55;47 PM IIIIIIIII IIII 2003-000935 BEFORE T14E BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON An Ordinance Amending Title 8.30 Adding New Definitions, Providing Five Year Franchise Terms * ORDINANCE NO. 2003-023 and Revising the Ambulance Service Area Plan for Deschutes County and Declaring an Emergency THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON, ORDAINS as follows: Section 1. AMENDMENT. DCC 8.30.030, Definitions, is amended to read as set forth in EXHIBIT "A," attached hereto and by this reference incorporated herein, with new language underlined and language to be deleted in stfik ug. Section 2. AMENDMENT. DCC 8.30.035, Ambulance Service Area (ASA) Advisory Committee - Established, is amended to read as set forth in EXHIBIT "B," attached hereto and by this reference incorporated herein, with new language underlined and language to be deleted in stfi�. Section 3. AMENDMENT. DCC 8.30.060, Franchise -Terms and renewals, is amended to read as set forth in EXHIBIT "C," attached hereto and by this reference incorporated herein, with new language underlined and language to be deleted in stfik. Section 4. AMENDMENT. Appendix A, Ambulance Service Area Plan, is amended to read as set forth in EXHIBIT "D," attached hereto and by this reference incorporated herein, with new language underlined and language to be deleted in stfi�= Appendix A is numbered DCC 8.30.100. Section 5. 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 effect on its passage. DATED this 18'h day of June, 2003. ATTEST: (/ tj L Recording Secretary PAGE 1 OF 2 - ORDINANCE NO. 2003-023 (06/18/03) BOARD OF UNTY COMMISSIONERS OF DES TES COUNTY, OREGON R. LUK , Chair �-- TOM DEWOLF, Commissioner MI A L M. DALY, C missioner 1 Date of I" Reading: Date of 2nd Reading: /0 --day of , 2003. �0 "day of 003. Record of Adoption Vote Commissioner Yes No Abstained Excused Dennis R. Luke Tom DeWolf Michael M. Daly 1/ Effective date:'&--d—ay of , 2003. PAGE 2 OF 2 - ORDINANCE NO. 2003-023 (06/18/03) 8.30.030. Definitions. FoF thepaj-poses of PGG, 9.30, iii lnless otherwise apparent from the context, certain words and phrases used in DCC 8.30 are defined as set forth in the Ambulance Service Area Plan for Deschutes County, Oregon-..(—S e--Appendix A: to this Chapter) (Ord. 200' -023 § 1, 2003: Ord. 98-064 § 1, 1998) EXHIBIT "A" TO ORDINANCE 2003-023 (06/18/03) L 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 10 members; one member from each of the following: a. Emergency department physician. b Ambulanee se4-viee medieal difeeten eb. Deschutes County Health Department. dc. Ambulance service provider. eel. Sheriff's Office representative. fe. 9-1-1 center representative. gf. EMT -Basic. lag. EMT -Intermediate. ih. EMT -Paramedic. }i. ti"r ablie at lafg@Citizen member. 2. The Board shall designate a County staff member as the ASA Administrator. 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 approve designation of alternates to serve in the absence of persons appointed to the committee. C. Except for the ASA Administrator and any 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 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 EXHIBIT "B" TO ORDINANCE 2003-023 (06/18/03) members of the committee. However, 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 DCC 8.30, 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 in regard to: a. Standards established in the plan and improvements of or new standards as required by OAR 333-260-0050; b. Coordination between emergency medical service resources; c. Dispatch procedures and compliance; and d. 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. Perfonn such other duties as directed by the Board. G. Committee members shall avoid acting in any manner where a conflict of interest may arise. Any committee member having a direct or indirect financial pecuniary interest in any matter before the committee for consideration shall withdraw from participation in any action by the committee in said matter. Nothing in DCC 8.30.035 shall limit the ability of any person to provide testimony before the committee. (Ord. 2003-023 5,2, 2003: Ord. 98-064 § 1, 1998) 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, the term of an emergency ambulance service franchise shall be t-hl-ee :i e ears beginning on July 1 and ending June 30-Afee-.five years later. C. Unless grounds exist for refusal to renew a franchise under provisions for suspension or revocation as set forth in DCC 8.30, 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 180 days and not less than 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 provided for in DCC 8.30. (Ord. 2003-023: 0, 2003: Ord. 98-064 §1, 1998) EXHIBIT "C" TO ORDINANCE 2003-023 (06/18/03) DCC 8.30.1.00 - APPENDIX A We AMBULANCE SERVICE AREA PLAN FOR DESCHUTES COUNTY, OREGON Page 1 of 29 — EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) Table of Contents I. Certification By Governing Body of Deschutes County ASA Plan ........................................................................Page 4 II. Overview of Deschutes County................................................................................Page 5 III. Definitions................................................................................................................Page 6 IV. Boundaries 1. Ambulance Service Area Narrative and Description............................Page 910 2. Maps........................................................................................................Page 124 3. Alternatives to Reduce Response Times.................................................Page 134 V. Systems Elements 1. Notification/Response Times..................................................................Page 145 2. Level of Care...........................................................................................Page 145 3. Personnel.................................................................................................Page 145 4. Medical Supervision...............................................................................Page 136 5. Patient Care Equipment...........................................................................Page 136 6. Vehicles...................................................................................................Page 1-56 7. Training...................................................................................................Page 136 8. Quality Assurance................................................................................... Page 167 8.1 Structure....................................................................................Page 167 8.2 Process...................................................................................... Page 167 8.3 Problem Resolution...................................................................Page 1�78 8.4 Sanctions for Non -Compliant Personnel or Providers..............Page 1-78 8.5 Penalties.................................................................................... Page 1,99 8.6 Nuisance....................................................................................Page 189 9 NonemergencT� ransports Page 19 VI. Coordination 1. Authority for Ambulance Service Area Assignment ............................Page =1-920 2. Entity That Will Administer The ASA Plan ........................................ Page 4-920 3. Complaint Review Process...................................................................Page 2021 4. Mutual Aid Agreements........................................................................Page 2021 5. Disaster Response................................................................................. Page 2021. 5.1 County Resources Other Than Ambulances .............................Page 24-2 5.2 Out of County Resources.......................................................... Page 24-2 5.3 Mass Casualty Incident Plan .....................................................Page 2T2 6. Coordination........................................................................................... Page 223 7. EMS Responder Guidelines....................................................................Page 223 8. Personnel and Equipment Resources...................................................... Page 2a4 9. Emergency Communications and Systems Access Page 2 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 4- 9.1 Telephone Access.....................................................................Page 2:�4 9.2 Dispatch Procedures............................................................. Page 2-34 9.3 Radio System............................................................................Page 245 10. Emergency Medical Services Dispatcher Training...............................Page 2-56 VII. Provider Selection 1. Initial Assignment of Existing Ambulance Service Providers................Page 267 2. Reassignment of an ASA........................................................................ Page 267 3. Application Process for Applying for an ASA ......................................Page 2€-7 4. Notification of Vacating an ASA............................................................Page 267 5. Maintenance of Level of Service............................................................Page 267 VIII. County Ordinances and Rules.................................................................................Page 2-78 IX. Appendices 1. ASA Map...........................................................................................................#1 2. Fire District Boundaries Maps...........................................................................#2 3. Incorporated City Maps......................................................................................#3 4. Copy of Mutual Aid Agreement (Example).......................................................#4 5. Copy of Deschutes County Ambulance Service Area Ordinance ......................#5 Page 3 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 4 I. CERTIFICATION OF DESCHUTES COUNTY AMBULANCE SERVICE AREA PLAN The undersigned certify pursuant to Oregon Administrative Rule 333-260-0030 (2)(a)(b)(c) that: Each subject or item contained in the Deschutes County Ambulance Service Plan has been addressed and considered in the adoption of the plan by this body. 2. In this governing body's judgment, the ambulance service areas established in the plan provide for the efficient and effective provision of ambulance services. 3. To the extent they are applicable, the County has complied with ORS 682.205(2)(3) and 682.335 and existing local ordinances and rules. DATED this day of ' 998 June 200 3) AL rANW! Tev"m 62 a -Wal Me! MAW, OMAN -- ! •. _ •. ��'�€�=----—R�fih'RT-1✓-Pd�tgP1�-Cet��i-ssi� _ ............___,..__...--- BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUN Y, OREGON DEN -NIS R. LUKE, Chair Page 4 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) TOM DEWOLF. Commissioner ATTEST: Recording Secretary MICHAEL M. DALY Commissioner Page 5 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) II. OVERVIEW OF DESCHUTES COUNTY Deschutes County is located in the geographic center of the state. The County covers approximately 3200 square miles, extending east about 105 miles from the crest of the Cascade Mountains to the Harney County line, and spreading 53 miles from north to south beginning at the Jefferson County line and terminating at it southern border along Klamath and Lake Counties. Population of the county as of T,.,,.., y 199 July 1, 2002 was 401 126,500. The City of Bend, with a population of= -1-3 44157,750, and the City of Redmond with 4-,-9W16.110, are the county's largest cities. Both are located on Highway 97 which runs north and south through the county. Other population areas are located along Highway 20 between Black Butte Ranch and Bend. Lumber, tourism, and small business provide the basis of the county's economy. Deschutes County has many natural barriers, such as mountains, lakes, rivers, wilderness, and large roadless areas, which were considered when assigning the ambulance service areas. Boundaries for the most part had been established several years ago by the prehospital care providers and have proven effective. Deschutes County is divided into eight separate ambulance service areas. The ambulance service providers offer basic, intermediate and advanced life support emergency medical care and transportation. The eight ambulance service providers that serve Deschutes County, their boundaries and other general information are described in this ASA Plan. A current set of maps are on file in the Deschutes County Office of Emergency Services. These maps depict current boundaries for ambulance service areas, fire districts, response times and the location of the PSAP. Page 6 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) III. DEFINITIONS 1. "Address and consider" has the meaning given these terms by ORS 682.205(2)(3). 2. "Ambulance" has the meaning given that term by ORS 682.025. 3. "Ambulance Service" has the meaning given that term by ORS 682.325. 4. "Ambulance Service Area (ASA)" means a geographic area which is served by one ambulance service provider, and may include all or a portion of a county, or all or portions of two or more contiguous counties. 5. "Ambulance Service Plan" means a written document, which outlines a process for establishing a county emergency medical services system. A plan addresses the need for and coordination of ambulance services by establishing ambulance service areas for the entire county and by meeting the other requirements of these rules. Approval of a plan will not depend upon whether it maintains an existing system of providers or changes the system. For example, a plan may substitute franchising for an open -market system. 6. "ASA Advisory Committee (Committee)" means a committee formed to review standards, make recommendations to or set new standards for the Board of County Commissioners for all matters regarding EMS and review and make recommendations regarding soundness of the ASA. 7. "ASA Administrator" is the person designated by the Board of Commissioners to administer the ASA ordinance and plan. 8. "Communication System" means two-way radio communications between ambulances, dispatchers, hospitals and other agencies as needed. A two -channel multi -frequency capacity is minimally required. 9. "Deschutes County Board of Commissioners (Board)" means the elected officials that has jurisdiction over the Deschutes County ASA Plan. 10. "Division" means the Oregon Health Division, Department of Human Resources. 11. "Effective Provision of Ambulance Services" means ambulance services provided in compliance with the county ambulance service plan provisions for boundaries, coordination and system elements. 12. 'Efficient Provision of Ambulance Services" means effective ambulance services provided in compliance with the county ambulance service plan provisions for provider selection. Page 7 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) l 13. "Emergency" means any non -hospital occurrence or situation involving illness, injury or disability requiring immediate medical or psychiatric services, wherein delay in the provision of such services is likely to aggravate the condition and endanger personal health or safety. 14. "Emergency Medical Service (EMS)" means those pre -hospital functions and services whose purpose is to prepare for and respond to medical emergencies, including rescue and ambulance services, patient care, communications and evaluation. 15. "Emergency Medical Technician -Basic (EMT -Basic)" means a person certified by the Division as defined in OAR 333-265-0000(8). 16. "Emergency Medical Technician -Intermediate (EMT -Intermediate)" means a person certified by the Division as defined in OAR 333-265-0000(9). 17. "Emergency Medical Technician -Paramedic (EMT -Paramedic)" means a person certified by the Division as defined in OAR 333-265-0000(10). 18. "First Responder" means a person certified by the Division as defined in ORS 682.025(11)(a)(b). 19. "Franchise" is the authorization granted to provide emergency ambulance service in a specific geographic region. 20. "Frontier" is the areas of the County that are not urban, suburban, or rural, but includes those areas designated wilderness areas by the Federal Government. 2-0:21. "'Health Officer" means the Deschutes County Health Officer. 24-.22. "License" means those documents issued by the Division to the owner of an ambulance service and ambulance, when the service and ambulance are found to be in compliance with ORS 682.015 to 682.991 and OAR 333-250-0000 through 333-250-0100 and 333- 255-0000 through 333-255-0090. I 2-1.23. "Notification Time" means the length of time between the initial receipt of the request for emergency medical service by either a provider or a PSAP, and the notification of all responding emergency medical service personnel. 24. "Owner" means the person having all the incidents of ownership in an ambulance service or an ambulance vehicle or where the incidents of ownership are in different persons, the person, other than a security interest holder or lessor, entitled to the possession of an ambulance vehicle or operation of an ambulance service under a security agreement or a lease for a tern of 10 or more successive days. Page 8 of 28 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) X25. "Patient" means an ill, injured, or disabled person who may be transported in an ambulance. 2-5--.26. "Physician Advisor" has the meaning of a supervising physician as provided in ORS 682.235. 24:27. "Provider" means any public, private or volunteer entity providing EMS. 2-7-.28. "Provider Selection Process" means the process established by the county for selecting an ambulance service provider or providers. 2:29. "Public Service Answering Point (PSAP)" means a 24 hour communications facility established as an answering location for 9-1-1 calls originating within a given service area. 24730. "Quick Response Team (QRT)" means an agency that provides initial response and basic life support care without transportation capabilities by certified First Responders. X31. "Response Time" means the length of time between the notification of each provider and the arrival of each provider's emergency medical service unit(s) at the incident scene. 32 "Rural" is an incorporated community of 2,000 to 10,000 population density which is not urban or suburban and the area within a radius of 30 miles of that community's center, which is not urban. or suburban. 33. "Stable Patient" is a patient with the following criteria: 1 Has vital signs in a normal range that are not changin-" significantly or expected to do so. a. Pulse 50-120. b. Systolic blood pressure 90-190. c. Respirations between. 10 to 29 breaths per minute. ? Does not and is not expected to require cardiac monitoring, or ACLS procedures. 3. Has a patent natural airway and is not in respiratory distress. 4 Has no unstabili zed ipjgries that will be aCwravated by motion in transport. 5. Isnot experiencing acute changes in level of consciousness. 4 "Suburban" is an area which is not urban and which is contiguous to an urban coumnunity It includes the area within a 10 -mile radius of that community's center. It also includes areas beyond the 10 -mile radius which have a population density of 1.,000 or more per square mile. �?35. "System Response Time" means the elapsed time from when the PSAP receives the call until the arrival of the appropriate provider unit(s) on the scene. Page 9 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 36 "Urban" is an incorporated community of 10,000 or more population density. Page 10 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) IV. BOUNDARIES 1. Ambulance Service Area Narrative and Description. Deschutes County consists of eight ASAs. The eight ASAs are: (1) Bend; (2) Black Butte Ranch; (3) Burns; (4) Crooked River Ranch; (5) LaPine; (6) Redmond; (7) Sisters; and (8) Sunriver. The boundaries of each of the eight ambulance service areas are as follows: ASA #1 - Bend Size of ASA: Approximately 750 square miles. However, most of the ASA is comprised of either the Deschutes National Forest or B.L.M. lands. BEGINNING at the intersection of the south line of section 16, T17S, RBE, W.M., with the westerly line of Deschutes County; thence easterly upon section lines approximately 10.4 miles to the SE corner of section 18, T17S, R10E; thence northerly upon the section line to the NL-- corner of said section 18; thence easterly upon section lines to the SE corner of section 9, T17S, R1OE; thence northerly upon section lines to the NW comer of section 3, T17S, R10E; thence easterly upon section lines to the SE corner of section 36, T16S, R10E; thence northerly upon section lines to the NW corner of section 19, T16S, RI 1E; thence easterly upon section lines to the SE corner of section 17, T16S, RI IE; thence northerly upon the section line to the NE corner of said section 17; thence easterly upon the section line to the NE corner of section 16, T16S, RI 1E; thence northerly upon section lines approximately 1.5 miles to the intersection with the south line of section 34, T15S, RI IE; thence westerly upon said section line approximately 1/2 mile to the SW corner of said section 34; thence northerly upon the section line to the NW corner of said section 34; thence southeasterly approximately 2.9 miles to the SW corner of section 1, T16S, RI 1E; thence northerly upon the section line to the NW corner of said section l; thence easterly upon section lines approximately 2.25 miles to the NE corner of the W 1/2 W 1/2 of section 5, T16S, R12E; thence southerly to the SE corner of the W 1/2 W 1/2 of said section 5; thence easterly upon Newcomb Road to the SE corner of section 4, T16S, R12E; thence easterly upon the south line of section 3, T16S, R12E, to the intersection with the centerline of the Deschutes River; thence southerly along the centerline of the Deschutes River to the intersection with the south line of section 9, T16S, R12E; thence easterly upon said section line to the NE corner of the W 1/2 of section 16, T16S, R12E; thence southerly to the SE corner of the NW 1/4 of said section 16; thence westerly to the SW corner of the E 1/2 NW 1/4 of said section 16, thence southerly to the SE corner of the W 1/2 W 1/2 of said section 16; thence easterly upon section lines to the NW corner of section 19, T16S, RUE; thence southerly approximately I mile to the SW corner of said section 19; thence easterly upon section lines to the SE corner of section 24, T16S, R13E, also being a point on the east line of Deschutes County; thence southerly upon said east line to the southeast corner of section 36, T16S, RUE; thence continuing easterly and southerly upon the Deschutes County line to the NE comer of section 1, T22S, R21E; thence southerly upon the range line to the SE corner of section 36, T22S, R21E; thence westerly upon the line common to Deschutes and Lake Counties to Forest Highway 23; thence northerly upon Forest Highway 23 to the township line between T21 S and T22S, R16E, near Sand Springs; thence westerly upon the south lines of Township 21S, Ranges 16E -13E, to Forest Road 9710; thence northerly upon Forest Road 9710 to the north line of section 19, T19S, R12E; thence westerly upon section lines approximately 3.2 miles to the SW corner of section 15, T19S, RHE; thence northerly approximately 2 miles to the NE corner of section 9 T19S, RI IE; thence westerly approximately 2 miles to the NW corner of section 8 T19S, R11E; thence southerly to the SW corner of said section 8, thence westerly upon section lines approximately 6 miles to the SW corner of section 8, T19S, RIOE; thence Page 11 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) northerly upon section lines approximately 2 miles to Forest Road 4614; thence westerly upon Forest Road 4614 to Forest Road 950; thence northerly upon Forest Road 950 to Forest Highway 46, a.k.a. Cascade Lakes Highway; thence westerly upon said Forest Highway 46 to the east line of section 27, T18S, ME; thence southerly approximately 2.2 miles to the SE corner of section 3, T19S, R9E; thence westerly approximately 6 miles upon section lines to the SE corner of section 3, T19S, ME; thence northerly approximately 3.5 miles to the NE corner of the SE 1/4 of section 22, T18S, ME; thence westerly upon the east -west center lines of sections 22, 21, 20 and 19, T19S, R8E to the line common to Deschutes and Lane Counties; thence northerly upon said common County line to the Point of Beginning. ASA #2 - Black Butte Ranch Size of ASA: Approximately 3 square miles. Boundaries: Entire Black Butte Ranch and a portion of Highway 20 from Indian Ford Road west to the Camp Sherman turnoff. ASA #3 — Burns All of T22S, R22E, W.M., and all of T22S, R23E. ASA #4 - Crooked River Ranch Size of ASA: Approximately one square mile. ALL of those portions of Crooked River Ranch lying within Deschutes County. ASA #5 - La Pine Size of ASA: Approximately 646 square miles. However, most of the ASA is comprised of the Deschutes National Forest or in B.L.M. lands and are uninhabited. All that portion of Deschutes County which lies southerly and westerly of the following described line: BEGINNING at the intersection of the westerly line of Deschutes County with the north line of section 2, T21 S, R6E, W.M.; thence easterly upon the north lines of Township 21 S, in Ranges 6E and 7E to the NW corner of section 1 in said Range 7E; thence southerly upon the west line of said section 1, to the SW corner of said section 1; thence easterly upon the south line of said section 1 to the SE corner of said section 1; thence northerly upon the east line of said section 1 to the NE corner of said section 1; thence easterly approximately 11.5 miles upon the south lines of Township 20S in Ranges 8E and 9E to the intersection with Forest Highway 42, a.k.a. South Century Drive; thence northeasterly upon said Forest Highway 42 to the intersection with the east line of section 27, T20S, R10E; thence northerly upon section lines to the NW corner of the SW 1/4 of section 23, T20S, R10E; thence easterly to the NE corner of said SW 1/4; thence northerly to the NW corner of the NE 1/4 of said section 23; thence easterly to the NE corner of said section 23; thence northerly upon section lines approximately 2 miles to the SW corner of section 1, T20S, R10E; thence easterly upon the south line of said section 1 to the SW corner of the SE 1/4 SW 1/4 of said section l; thence northerly to the NW corner of the SEI/4 SW 1/4 of said section 1; thence easterly to the NE corner of the SE 1/4 SW 1/4 of said section 1; thence northerly to the NW corner of the Page 12 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) SE 1/4 of said section 1; thence easterly to the NE corner of said SE 1/4; thence southerly upon the east line of said section 1 to the SE corner of said section 1, also being a point on Forest Highway 40, a.k.a. Spring River Road; thence easterly and northerly upon said Forest Highway to the intersection with the B.N.R.R. tracks in section 5 of T20S, RI IE; thence southerly upon said tracks to the north line of section 8, T20S, RI IE; thence easterly upon the north line of said section 8 to the NE corner of said section 8; thence southerly upon section lines to the SW corner of section 16, T20S, RI IE; thence easterly upon the south line of said section 16 to the SE corner of said section 16; thence southerly upon section lines approximately 2 miles to the SW corner of section 27, T20S, RI 1E; thence easterly approximately 7.5 miles upon section lines to the intersection of the north line of section 35, T20S, R12E with Forest Road 9710; thence easterly and southerly upon said Forest Road to the south line of section 35, T21S, R13E; thence easterly upon the south lines of Township 215, in Ranges 13E -16E to a point on the south line of section 31, T21S, R16E which intersects Forest Highway 23; thence southerly upon said Forest Highway to the Deschutes County line and terminus of this description. ASA #6 - Redmond Size of ASA: Approximately 223 square miles. Beginning at the common corner of Deschutes, Jefferson and Crook Counties; thence southerly upon the County line common to Deschutes and Crook Counties to the SE comer of section 24, T16S, R13E, W.M.; thence westerly upon section lines to the SW corner of section 19, T16S, R13E; thence northerly approximately 1 mile to the NW comer of said section 19; thence westerly upon section lines to the SE corner of the W 1/2 W 1/2 of section 16, T16S, R12E; thence northerly to the NE corner of the W 1/2 SW 1/4 of said section 16; thence easterly to the SE corner of the NW 1/4 of said section 16; thence northerly to the NE corner of the NW 1/4 of said section 16; thence westerly upon the section line to the intersection with the centerline of the Deschutes River; thence northerly along the centerline of the Deschutes River to the intersection with the south line of section 3, T16S, R12E; thence westerly upon said section line to the SW corner of said section 3; thence westerly upon Newcomb Road to the SE corner of the W 1/2 W 1/2 of section 5, T16S, R12E; thence northerly to the NE corner of the W 1/2 W 1/2 of said section 5; thence westerly upon section lines to the NW corner of section 1, T16S, RI 113; thence southerly upon the section line to the SW corner of said section 1; thence northwesterly approximately 2.9 miles to the SW corner of section 27, T15S, R11E; thence northerly approximately 11 miles upon section lines to the line common to Deschutes and Jefferson Counties; thence easterly upon said common County line to the Point of Beginning; excluding all of those portions of Crooked River Ranch lying within Deschutes County. ASA #7 - Sisters Size of ASA: Approximately 326 square miles. Beginning at the common corner of Deschutes, Linn and Jefferson Counties; thence easterly on the County line common to Deschutes and Jefferson Counties approximately 21.5 miles to the NE corner of section 4, T14S, R11E, W.M.; thence southerly upon section lines approximately 12 miles to the SW corner of section 34, T15S, R11E; thence easterly upon the section line approximately 1/2 mile to the NE corner of section 4, T16S, R11E; thence southerly upon section lines to the NE corner of section 16, T16S, RI IE; thence westerly upon the section line to the NE corner of section 17, T16S, RI 1E; thence southerly upon the section line to the SE corner of said section 17; thence westerly upon section lines to the NW corner of section 19, T16S, R11E; thence southerly upon section lines to the SE corner of section 36, T16S, R10E; thence westerly upon section lines to the NW corner of section 3, T17S, R10E; thence Page 13 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) southerly upon section lines to the SE corner of section 9, T17S, R10E; thence westerly upon section lines to the NE corner of section 18, T17S, R10E; thence southerly upon section lines to the SE corner of said section 18; thence westerly upon section lines approximately 10.4 miles to the County line common to Deschutes and Lane Counties at the south section line of section 16, T17S, R8E; thence northerly upon said County line to the Point of Beginning; excluding all of Black Butte Ranch and that portion of U.S. Highway 20 from Indian Ford Road to the Camp Sherman turnoff. ASA #8 - Sunriver Size of ASA: Approximately 150 square miles. BEGINNING at the intersection of Forest Road 9710 with U.S. Highway 97; thence southerly upon Highway 97 to the intersection with the north line of section 24, T19S, RI IE; thence westerly upon section lines to the SW corner of section 15, T19S, Rl1E; thence northerly upon section lines approximately 2 miles to the NE corner of section 9, T19S, RI IE; thence westerly upon the section line to the intersection with the centerline of the Deschutes River; thence upstream along the centerline of the Deschutes River approximately 1.25 miles to the east line of section 8, T19S, RI IE; thence southerly upon said section line to the SE corner of said section 8; thence westerly upon section lines approximately 7 miles to the SW corner of section 8, T19S, R10E; thence northerly upon section lines approximately 2 miles to Forest Road 4614; thence westerly upon Forest Road 4614 to Forest Road 950; thence northerly upon Forest Road 950 to Forest Highway 46, a.k.a. Cascade Lakes Highway; thence westerly upon said Highway 46 to the east line of section 27, T18S, R9E; thence southerly approximately 2.2 miles to the SE corner of section 3, T19S, R9E; thence westerly approximately 6 miles upon section lines to the SE corner of section 3, T19S, R8E; thence northerly approximately 3.5 miles to the NE corner of the SE 1/4 of section 22, T18S, R8E; thence westerly upon the east -west center lines of sections 22, 21, 20, and 19, T19S, R8E to the line common to Deschutes and Lane Counties; thence southerly and westerly upon said county line to the north line of section 2, T21 S, R6E; thence easterly upon the north lines of Township 21 S, in Ranges 6E and 7E to the NW corner of section 1 in said Range 7E; thence southerly upon the west line of said section 1, to the SW corner of said section 1; thence easterly upon the south line of said section 1 to the SE corner of said section 1; thence northerly upon the east line of said section 1 to the NE corner of said section 1; thence easterly approximately 11.5 miles upon the south lines of Township 20S in Ranges 8E and 9E to the intersection with Forest Highway 42, a.k.a. South Century Drive; thence northeasterly upon said Forest Highway 42 to the intersection with the east line of section 27, T20S, R10E; thence northerly upon section lines to the NW corner of the SW 1/4 of section 23, T20S, R10E; thence easterly to the NE corner of said SW 1/4; thence northerly to the NW corner of the NE 1/4 of said section 23; thence easterly to the NE corner of said section 23; thence northerly upon section lines approximately 2 miles to the SW corner of section 1, T20S, R10E; thence easterly upon the south line of said section 1 to the SW comer of the SE 1/4 SW 1/4 of said section l; thence northerly to the NW corner of the SE 1/4 SW 1/4 of said section 1; thence easterly to the NE corner of the SE 1/4 SW 1/4 of said section 1; thence northerly to the NW corner of the SE 1/4 of said section 1; thence easterly to the NE corner of said SE 1/4; thence southerly upon the east line of said section 1 to the SE corner of said section 1, also being a point on Forest Highway 40, a.k.a. Spring River Road; thence easterly and northerly upon said Forest Highway to the intersection with the B.N.R.R. tracks in section 5, T20S, RI IE; thence southerly upon said tracks to the north line of section 8, T20S, R1 lE; thence easterly upon the north line of said section 8 to the NE corner of said section 8; thence southerly upon section lines to the SW corner of section 16, T20S, RI IE; thence easterly upon the south line of said section 16 to the SE corner of said section 16; thence southerly upon section lines approximately 2 miles to the SW corner of section 27, T20S, RI IE; thence easterly approximately 7.5 miles upon section lines to the intersection with Forest Road 9710; thence northwesterly upon said Forest Road 9710 to the Point of Beginning. Page 14 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 2. Maps. 2.1 ASA Map. (See Appendix #1) This map represents the boundaries of each of the ambulance service areas within Deschutes County and the "System Response Time," which includes notification, role out, and provider response times. Actual response time is subject to the variables of access, weather, road and traffic conditions as well as other circumstances that can impact response time. 2.2 Fire District Boundaries (See Appendix #2) 2.3 Incorporated Cities (See Appendix #3) 3. Alternatives To Reduce Response Times. Heavily forested, mountainous terrain and severe winter weather conditions present difficult access and long response time to ground ambulances. In those situations, when an urgent response is indicated, the PSAP may elect to call the nearest appropriate rotary -wing air ambulance or the Deschutes County Search and Rescue. In addition, a tiered response system is used to provide the best available patient care while maximizing the available resources. In some instances, for various reasons, an ambulance service provider from an adjoining county's ASA could respond quicker to an incident. Page 15 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) V. SYSTEM ELEMENTS 1. Notification/Response Times. Notification times for ambulances shall be within two (2) minutes for 90% of the calls. Provider response time shall be as follows for 90% of the calls: Urban - 6 min.; Suburban - 13 min.; Rural - 43 min.; and Frontier - 4 hours and 28 min. System Response Time shall be as follows for 90% of the calls: Urban - 8 min.; Suburban - 15 min.; Rural - 45 min.; and Frontier - 4 hours and 30 min. Monitoring of notification and response times shall be accomplished by the following: 1.1 Information received from the public, dispatch center, prehospital care providers, hospitals, or county EMS administration. 1.2 Types of information received are written or verbal complaints, patient care report forms, radio transmission tapes, notification and response time incident cards, trauma registry forms, etc. 2. Level of Care. An ambulance operating in Deschutes County and providing basic life support level care must consist of a qualified driver and one certified EMT -Basic or above. The EMT must always be with the patient in the patient compartment of the ambulance. An ambulance operating in Deschutes County and providing intermediate life support level care must consist of one certified EMT -Basic and one certified EMT -Intermediate. The EMT - Intermediate must always be with the patient in the patient compartment of the ambulance intermediate level care is required or rendered. An ambulance operating in Deschutes County and providing advanced life support level care must consist of an EMT -Basic and an EMT -Paramedic. The EMT -Paramedic must always be with the patient in the patient compartment of the ambulance when ALS care is required or being rendered. 3. Personnel. When operating an ambulance in Deschutes County, all personnel must meet the requirements of ORS 682.015 to 682.991 and OAR 333-255-0070(1), (4) or (6). The practice of staffing an ambulance on a part-time basis with EMTs certified to a higher level of care than is possible at other times does not construe a requirement that the ambulance provide the same level of care on a regular basis. Page 16 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 4. Medical Supervision. Each EMS agency utilizing EMTs shall be supervised by a physician licensed under ORS 677, actively registered and in good standing with the Board of Medical Examiners as a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO). The physician must also be approved by the Board of Medical Examiners as a medical director. Each EMS agency or ambulance service may have its own medical director. The medical director shall: 4.1 comply with the requirements listed in OAR 847-35-0025; 4.2 hold at least one meeting a year with the EMTs affiliated with the respective ambulance services; 4.3 designate an EMT coordinator who shall conduct case reviews in the physicians absence and send summaries of the reviews and problems identified and proposed problem resolution to the physician; and 4.4 provide or authorize at least one case review meeting for all EMTs quarterly. St. Charles Medical Center in Bend, Oregon and Central Oregon District Hospital in Redmond, Oregon shall be the Medical Resource Hospitals. 5. Patient Care Equipment. Patient care equipment must meet or exceed the Oregon Health Division's requirements as specified in ORS 682.015 to 682.991 and OAR 333-255-0070(2), (3), (5) or (7). The ambulance service provider shall maintain a list of equipment for their ambulances, which shall be furnished to the Board upon their request. 6. Vehicles. All ambulances must be either a Type I, 11, or III and be licensed by the Oregon Health Division. All ambulances must meet or exceed the requirements as set forth in ORS 682.015 to 682.991 and OAR 333-255-0060. An up-to-date list of each provider's ambulances shall be furnished to the Board upon their request. 7. Training. Training will be consistent with requirements of the Oregon State Health Division and Department of Transportation curriculum and shall be received through accredited institutions. Page 17 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 8. Quality Assurance. In order to ensure the delivery of efficient and effective pre -hospital emergency medical care, an EMS Quality Assurance Program is hereby established. 8.1 Structure "Deschutes County Ambulance Service Area Advisory Committee (Committee)", shall be formed by ordinance and be composed of ten members: a. Emergency department physician b. Ambulance service medical director C. Deschutes County Health Department d Ambulance service provider e. Sheriff's Office representation f. 9-1-1 center representative g. EMT -Basic h. EMT -Intermediate i. EMT -Paramedic j. Public member Members of the Committee shall be appointed by the Deschutes County Board of Commissioners for a two year term. The initial committee will have staggered terms, ranging from one to three years. In the event of a tie on decisions of the ASA, the ASA Administrator shall become a voting member in order to break the tie. The principal function of the committee shall be to monitor the EMS system within Deschutes County. 8.2 Process The Board, in order to ensure the delivery of the most efficient and effective prehospital emergency care possible with the available resources, has directed that the ASA Advisory Committee be established. Page 18 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) Quality assurance in Deschutes County shall be accomplished through frequent case review, peer review, and periodic review by the medical directors and/or ambulance governing bodies (see respective Provider Profiles for definitions of governing bodies). Complaints regarding violation of this ASA Plan, or questions involving prehospital care provided, shall be submitted in writing to the Board who shall forward it to the Committee. The Committee shall then review the matter and make recommendations or changes on such complaints or questions to the Board. The Board shall also resolve any problems involving system operations (changing protocols to address recurring problems, etc.). Ongoing input may be provided by consumers, providers or the medical community to any individual on the Board or members of the Committee. This individual, in turn, will present the complaint, concern, idea or suggestion (in writing) to the full Board for consideration. 8.3 Problem Resolution Problems involving protocol deviation by EMTs or dispatchers shall be referred to the respective medical director or dispatch supervisor. Problems involving a non-compliant provider shall be reviewed by the Committee with possible referral to Board if necessary. The Board may seek background data and recommendations from the Committee in such instances. However, any member of the Committee who may have a conflict of interest in the matter shall declare such conflict and refrain from participating in any recommendations made. 8.4 Sanctions for Non -Compliant Personnel or Providers Suspension or revocation assignment. Upon a recommendation by the Committee, or upon its own motion, the Board may suspend or revoke the assignment of an ASA upon a finding that the provider has: a. willfully violated provisions of an ordinance, the Deschutes County ASA Plan or provisions of State or Federal laws and regulations; or b. materially misrepresented facts or information given in the application for assignment of an ASA or as part of the review of the performance of the service furnished by the provider. In lieu of the suspension or revocation of the assignment of an ASA, 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. Notice of the Board's action shall be provided to the holder of the assignment which shall specify the violation, the action necessary to correct the violation and the date by which the action must be taken. If the holder of the assignment fails to take corrective action within the time required, the Board shall notify the holder that the assignment is suspended or revoked upon receipt of the notice. Page 19 of 29 - EXHIBIT "M TO ORDINANCE 2003-023 (06/18/03) A person receiving a notice of the assignment, denial, suspension, revocation or contingent suspension or revocation of an ASA may request a hearing before the Board by filing with the Board a written request for a hearing within fourteen (14) days of the decision, setting forth the reasons for the hearing and the issues proposed to b reviewed. The filing of a hearing request shall stay the action, pending the hearing and final determination of the decision, unless a change is required due to an immediate hazard to the public safety. The Board shall set a time and place for the hearing. Within fourteen (14) days after the conclusion of the hearing, the Board shall affirm, reverse or modify its original decision. 8.5 Penalties Any person who violates any provisions of this ASA Plan or Ordinance is guilty of a violation. Failure from day-to-day to comply with the terms of this ASA Plan or Ordinance shall be a separate offense for each such day. Failure to comply with any provision of the Ordinance shall be a separate offense for each such provision. Violations of the provisions of this ASA Plan or Ordinance are punishable, upon conviction, by a fine of not more than Five Hundred Dollars ($500) per day per violation. 8.6 Nuisance In addition to the penalties provided in this plan, violations of any of the provisions of this plan and ordinance is declared to be a nuisance and may be regarded as such in all actions, suits, or proceedings. 9. Nonemergency Transports. Nonemergency prearranged transports for stable patients may be provided by any licensed ambulance service. Prearranged transports shall not be dispatched through 9-1-1. Definition of "stable patient" is contained in the definitions section of this ASA plan. Page 20 of 29 - EXHIBIT "M TO ORDINANCE 2003-023 (06/18/03) VI. COORDINATION 1. Authority For Ambulance Service Area Assignments. The Board has the authority to assign an ASA within Deschutes County in compliance with ORS 682.015 to 682.991. Applications by new providers and requests for assignment change or revocation will be considered for approval if they will improve efficient service delivery and benefit public health, safety and welfare. Cities have the authority to develop and apply ambulance licensing ordinances within their jurisdictional boundaries, and nothing in this plan is intended to obviate that authority. Future updates to this plan and proposals for assignment changes will be the responsibility of the Board. The Board shall receive all requests for changes; present those requests to the Committee for their review and recommendations. Upon completing their review, the Committee shall present their recommendations to the Board. In addition, the Board has the authority to review service provider's records and initiate an assignment change or service area revocation. For the purpose of this plan, the Board shall recognize the Committee as an advisory group. The Deschutes County ASA Plan was prepared with a great deal of input from all county pre- hospital care providers. The Plan requires that the ambulance services providers maintain service records in order that the County can carry out its ASA Plan responsibilities. 2. Entity That Will Administer the ASA Plan. The Deschutes County ASA Committee is hereby established with the adoption of this plan. The Committee shall serve as the principal entity to administer and accept written proposals for amendments to this ASA Plan. The Committee will be activated at any time a concern is submitted, in writing, to the Board, or when deemed appropriate by seven or more members of the Committee. This Committee, as with any governmental body, will be subject to the Oregon Open Meeting Law (ORS Chapter 192), but may temper its activities, within legal limits, according to the sensitivity of the EMS matter involved. Appeals from the Board, in any case where the Board would otherwise have the final decision at the county level shall be directed to the appropriate state regulatory agency, or a Circuit Court, as appropriate. The Committee shall submit a brief written report of its activities or recommendations periodically to the Board. Existence of this committee will: 2.1 prevent needless attention of state regulatory agencies to problems that can be resolved locally; Page 21 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 2.2 increase local awareness of potential problems that may exist; and 2.3 increase the awareness of ambulance medical directors regarding area concerns and activities. 3. .Complaint Review Process. Complaints regarding violation of this ASA Plan, or questions involving prehospital care provided, shall be submitted in writing to the Board. The Board shall then forward the complaint to the Committee for their review and recommendations or changes on such complaints or questions. The Committee shall also resolve any problems involving system operations (i.e., changing protocols to address recurring problems, etc.). Ongoing input may be provided by consumers, providers or the medical community to any individual on the Committee or members of the Board. This individual, in turn, will present the complaint, concern, idea or suggestion in writing to the full Board for consideration. 4. Mutual Aid Agreements. (See Appendix #4) Each ambulance service provider shall sign a mutual aid agreement with the other providers in the County and with other providers in adjoining counties to respond with needed personnel and equipment in accordance with the agreement. All requests for mutual aid shall be made through the appropriate PSAP. All mutual aid agreements will be reviewed annually and modified as needed by mutual consent of all parties. 5. Disaster Response. The Committee shall coordinate the EMS medical function of disaster planning with any formal disaster management plan developed by the Deschutes County Sheriff or other appropriate county authorities. As an interim goal, until an Emergency Services Plan is implemented, ambulance provider personnel faced with a multiple -casualty incident shall examine the situation in terms of its potential or actual magnitude of disaster, and request any appropriate additional resources that may be available. Page 22 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 5.1 County Resources Other Than Ambulances When resources other than ambulances are required for the provision of emergency medical services during a disaster, a request for additional resources shall be made through the appropriate PSAP to the County Emergency Services Office. The Director of the County Emergency Services Office shall be responsible for locating and coordinating all county EMS resources any time that the MCI Plan is implemented. The Director of the County Emergency Services Office shall work directly with local agencies, departments and governments to coordinate necessary resources during any implementation of the MCI Plan. 5.2 Out of County Resources When resources from outside Deschutes County are required for the provision of emergency medical services during a disaster, a request for those resources shall be made through the appropriate PSAP. 5.3 Mass Casualty Incident (MCI) Management Plan The purpose of the MCI plan is to provide guidance to EMS response personnel in the coordination of response activities relating to mass casualty incidents in Deschutes County. The plan is intended for use when any single incident or combination of incidents depletes the resources of any single provider or providers during the normal course of daily operations or at the request of the Health Officer. The plan shall identify the responsibility of the provider concerning: a. coordination; b. communication C. move up; d. triage; and e. transportation. The Committee will periodically review the medical component MCI plan and make recommended changes to meet the county's need. Following the review and changes, the Director of Emergency Services will be ask to append the changes to the medical Page 23 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) component of the County Emergency Management Plan and the modified MCI plan will be promulgated. 6. Coordination. 6.1 The highest ranking officer of the fire or police agency in whose jurisdiction the incident occurs may be the incident -commander. 6.2 The senior/highest certified EMT at the scene will have overall responsibility for patient care (triage officer); he/she may work closely with the incident commander. 6.3 The on -scene command frequency and staging area will be determined by the incident -commander. Dispatch center will advise responding units as to location of the staging area. 7. EMS Responder Guidelines. 7.1 The senior EMT on the first EMS unit to arrive at the scene shall become the triage officer and may: a. assess nature and severity of the incident; b. advise appropriate PSAP of the situation; C. request appropriate fire and police services, if not already at the scene; d. request initiation of EMS mutual aid if needed; e. alert area hospital(s) of the situation; and f. establish and organize the transportation of all injured or ill patients. 7.2 Additional EMS units arriving at the scene shall: a. check-in with Incident -Commander; b. effect needed rescue, if trained and equipped to do; C. provide emergency medical care and transport patient(s) to the appropriate hospital(s). Page 24 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 8. Personnel and Equipment Resources. All resources are referenced in Deschutes County's and local emergency response plans. 9. Emergency Communications and Systems Access. 9.1 Telephone Access: The Deschutes County Communications (9-1-1) Center is located in Bend and is the Public Safety Answering Point. This center shall receive all emergency service requests in Deschutes County. Persons having access to telephone service will have access to the Deschutes County Communications Center by dialing 9-1-1. Upon receipt of a request, all emergency service providers in Deschutes County, including fire and ambulance, are dispatched by the Deschutes County Communications Center in Bend Oregon. 9.2 Dispatch Procedures: a. The appropriate personnel shall be notified by the dispatcher via radio pagers within two (2) minutes of receipt of a medical call. b. The dispatcher will obtain from the caller, and relay to the first responders the following: 1. Location of the incident; 2. Nature of the incident; and 3. Any specific instructions or information that may be pertinent to the incident. C. EMS personnel shall inform the dispatch center by radio when any of the following occurs: 1. In-service; 2. In -route to scene or destination and type or response; 3. Arrival on scene or destination; 4. Transporting patient(s) to hospital or medical facility, the number of patients, and name of facility; and 5. Arrival at receiving facility. Page 25 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) d. Ambulance personnel shall inform the receiving hospital by radio of the following: 1. Unit identification number; 2. Age and sex of each patient; 3. Condition and chief complaint of the each patient; 4. Vital signs of each patient; 5. Treatment rendered; and 6. Estimated time of arrival 9.3 Radio System: a. The PSAP shall: 1. restrict access to authorized personnel only; 2. meet state fire marshal standards; 3. maintain radio consoles capable of communication directly with all first response agencies dispatched by the PSAP. 4. maintain radio logs which contain all information required by the Federal Communications Commission and Oregon Revised Statutes; 5. be equipped with a back-up power source capable of maintaining all functions of the center. b. The ambulance service provider shall equip and maintain 60 watt or greater, multi -channel radios in each ambulance that allows for the transmission and reception with dispatch, medical resource hospitals, and mutual aid equipment. Providers are dispatched by the Deschutes County 9-1-1 Center by radio pagers. Unless specifically determined by the nature of the call (i.e., non- emergency patient transfer, etc.) the highest level of ambulance staffing available at that time shall be dispatched. Other resources (police, fire) will be dispatched as deemed appropriate. Page 26 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) 10. Emergency Medical Services Dispatcher Training. 10.1 Deschutes County EMS dispatchers must successfully complete an Emergency Medical Dispatch (EMD) training course as approved by the Oregon Emergency Management Division and the Board on Public Safety Standards and Training. 10.2 All EMS dispatchers are encouraged to attend any class, course or program which will enhance their dispatching abilities and skills. Page 27 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) VII. PROVIDER SELECTION 1. Initial Assignment of Existing Ambulance Service Providers. On the date of implementation of this Plan, public notice shall be made that the current in-place provider (who wishes) will be assigned the ASA. The current provider assigned to the area must meet the standards contained in this Plan, specifically those standards outlining efficiency and effectiveness, within six (6) months of the date of implementation of this Plan. In the event that the ASA provider is unable to comply with the standards promulgated for the ASA by this Plan, the provider will notify the Board in writing of its inability to comply and identify which standards are involved. The Board will determine if other qualified providers are available for the ASA who can comply with the standards. If the Board determines no other qualified providers are available it will petition the Division for a variance from the standards so that continuous ambulance service may be maintained, by the existing provider, in the ASA. 2. Reassignment of an ASA. In the event that a reassignment of an ASA is necessary, the committee shall make a written recommendation to the Board. The committee shall develop appropriate criteria, utilizing the selection process described in this plan to be presented to the Board for consideration and/or action by the Board. 3. Application Process for Applying for an ASA. See Deschutes County Code 8.30 regarding application process for applying for an ASA. 4. Notification of Vacating an ASA. In the event that an ASA provider wishes to vacate its ASA, the provider shall provide at least sixty (60) days written notice to the Board. The ASA provider must provide notification in accordance with the provisions of the initial service agreement or contract. 5. Maintenance of Level of Service. In the event that an ASA provider is unable to comply with the standards promulgated for the ASA by this Plan, the provider will notify the Board in writing of its inability to comply and identify which standards are involved. The Board will determine if other qualified providers are available for the ASA who can comply with the standards. If the Board determines no other qualified providers are available, it will apply to the Division for a variance under ORS 682.285 for a variance from the standards so that continuous ambulance service may be maintained by the existing provider. Page 28 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03) t VIII. DESCHUTES COUNTY ORDINANCE The Deschutes County Board of Commissioners shall adopt an ambulance service area ordinance. The ordinance shall include criteria for administering the Deschutes County Ambulance Service Area Plan; limiting ambulance services that may operate in the County; establishing an application process; ambulance franchise terms; enforcement; preventing interruption of service; appeals, abatement and penalties; duties of the franchisee; and establishing membership and duties of the advisory committee. Page 29 of 29 - EXHIBIT "D" TO ORDINANCE 2003-023 (06/18/03)