2021-116-Ordinance Recorded 3/25/2021Recorded in Deschutes County CJ2021-116
Nancy Blankenship, County Clerk
Commissioners' Journal 03/25/2021 1:21:03 PM
I_E NSEL o` 6 cOG2� II I I I III I IIIIII I I II I II II II I I III
2021-116
For Recording Stamp Only
BEFORE THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON
An Ordinance Amending Chapter 8.30, Ambulance
Service Area, of the Deschutes County Code and * ORDINANCE NO. 2021-003
Amending Appendix A to Chapter 8.30 _ the
Ambulance Service Area Plan for Deschutes County.
WHEREAS, the Deschutes County Ambulance Service Area ("ASA") Advisory Committee is comprised
of representatives from each ambulance service provider franchise in each ASA identified in the Plan, as well as a
representative from the Deschutes County Health Department, Deschutes 9-1-1, the Deschutes County Emergency
Manager, and a citizen member and physician advisor; and
WHEREAS, the Committee appointed a subcommittee of members to review and draft amendments to
Chapter 8.30 ASA of the Deschutes County Code ("DCC"), including Appendix A to Chapter 8.30 (the ASA
Plan); and
WHEREAS, the subcommittee approved these amendments to allow franchisees to use subcontractors
with prior approval from the Deschutes County Board of County Commissioners ("Board"), and also to update,
edit, and clean up the language of DCC Chapter 8.30 and the ASA Plan; and
WHEREAS, Deschutes County Legal Counsel has reviewed and approved these changes pursuant to
DCC 1.01.012; and
WHEREAS, the Board considered these amendments at duly noticed public hearings on March 3, 2021
and on March 10, 2021 and concluded that the public and ASA operations will benefit from the amendments,
now, therefore,
THE BOARD OF COUNTY COMMISSIONERS OF DESCHUTES COUNTY, OREGON, ORDAINS
as follows:
Section 1. AMENDMENT. DCC 8.30 is amended to read as described in Exhibit "A," attached hereto
and by this reference incorporated herein, with new language underlined and language to be deleted in
sn.
Section 2. AMENDMENT. Appendix A to DCC 8.30, The Ambulance Service Plan for Deschutes
County, is hereby adopted to read as described with new language underlined and language to be deleted in
st --ikethFeugh in Exhibit `B," attached hereto and by this reference incorporated herein.
PAGE 1 OF 2 - ORDINANCE NO. 2021-003
Dated this of e(•1 C 20 4)
ATTEST: tm
149�
Recording Secretary
BOARD OF COUNTY COMMISSIONERS
OF DESCHUTES COUNTY, OREGON
— OppbS e-d —
ANTHONY DeBONE, Chair
PHIL CHANG, Vice C it
Date of 1st Reading: / l) day of AJ G 202t
�-D a-k "Ax4�
PATI ADAIR, Commissioner
Date of 2°a Reading:
day of aA 20 .
Record of Adoption Vote
Commissioner
Yes No Abstained Excused
Patti Adair
A
Anthony DeBone
X
Phil Chang
Effective date: �2 day of 2024
ATTEST
4co c a----
Re g Secret
PAGE 2 OF 2 - ORDINANCE NO.2021-003
Chapter 8.30. DESCHUTES COUNTY AMBULANCE SERVICE AREAS
8.30.010. Title.
8.30.020. Purpose.
8.30.030. Definitions.
8.30.035. Ambulance Service Area (A&A) 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. Subcontracting of Services by Franchisees
8.30.0-70075. Enforcement.
8.30.07-5080. Interruption of Service -Prevention.
8.30.080085. Appeals, Abatement and Penalties.
8.30.085090 Franchise Duties.
8.30.090095. Exemptions.
8.30.100 Appendix A - Ambulance Service Area Plan for Deschutes County, Oregon
8.30.010. Title.
This title shall be known as the "Deschutes County Ambulance Service Areas."
(Ord. 2021-003 §1, 2021; Ord. 98-064 §1, 1998)
8.30.020. Purpose.
A. The purpose of DCC 8.30 is to establish ambulance services areas, assign emergency ambulance service
providers, recognize non -emergency and inter -facility ambulance providers, create an ambulance service
area fASAladvisory committee, provide penalties for violations of its provisions and prescribe effective
dates.
B. For the efficient and effective provision of emergency, non -emergency, and inter -facility ambulance
services in accordance with the Ambulance Service Area ("� Plan(ASA Plan), which is found in
Appendix A to this Chapter, the ambulance service areas shown on the map known as Appendix #1 of
the ASA Plan is -are hereby adopted as the ambulance service areas ASA for Deschutes County. The
Board, after notice to the affected ASA prev-iderfranchisee within each ASA 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.
(Ord. 2021-003 § 1, 2021; Ord. 98-064 § 1, 1998)
8.30.030. Definitions.
Unless otherwise apparent from the context, certain words and phrases used in DCC 8.30 are defined as set
forth in the "rnbulanee SerAee "fea SA Plan for Deschutes County, Oregon, Appendix A to this Chapter.
(Ord. 2021-003 § 1. 2021; Ord. 2003-023 § 1, 2003; Ord. 98-064 § 1, 1998)
8.30.035. Ambulance Service Area (ASA)-Advisory Committee -Established.
A. A committee to be known as the Ambulance Service Area Advisory Committee (Ccommittee) is hereby
established.
Chapter 8.30 1 (95/201803/2021)
1. The eenimit ee Committee shall consist of not less than twelve and no more than fourteen members
from the following:
a. Emergency department physician.
b. Deschutes County Health Department representative.
c "..,w.,'. nee s ider representative A rRepresentatives from the franchisees in each
€anshise4of the ASAs within Deschutes County.
d. Deschutes County Emergency Manager
e. 9-1-1 center representative.
f. Citizen member.
2. The Board shall designate a County staff member as the ASA Administrator. The Administrator and
other employees of the County appointed by staff as the Board as it deems appropriate shall be ex-
officio members of the eenirnWe Committee.
B. Members of the Committee shall be appointed by and serve at the pleasure of the Board. The Board may
appoint additional persons to the eemmittee-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
conffnitteeCommittee.
C. Except for the ASA Administrator and any other County staff, appointments to the Committee shall be
for staggered eients
shall tee- or —two-year terms. Members shall serve until their successors are appointednd qualified.
Vacancies shall be filled by the Board for the balance of the unexpired term. Per -sons Members of the
Committee may be appointed to successive terms.
D. The eonimit4ee Committee shall elect a chairperson. The ee i#ee-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 eeittee Committee may call a special meeting with five days' notice to other members of the
eemmitt-e- Committee. However, members may waive such notice.
E. A quorum constitutes one-half of the eor:-mittee Committee members plus one for the transaction of
business. _A majority vote of those present and voting is required to pass motions concerning actions to
be taken by the Committee.
F. In addition to mother duties prescribed bS -within DCC 8.30, the eein:iaee-Committee shall:
1. Review and make recommendations to the Administrator regarding the requirements for establishing
franchises to provide ambulance services within the County.
2_Review and make recommendations to the Administrator regarding the ce'eeriteria for
determining selecting a franchisee to provide ambulance services within the County.
-23. Regularly provide information to the Board from pre -hospital care consumers, providers and the
medical community concerning the activities and performance of franchisees.
-34. Periodically review the ASA Plan and make recommendations to the Board in with --regard to:
a. Standards established in the plan -Plan and improvements to such standards, of or the addition of
new standards as required by OAR 333-260-0000 through 333-260-0070;
b. Coordination between emergency medical service resources;
c. Dispatch procedures and compliance; and
d. Effectiveness and efficiency of the ASA boundaries.
45. Implement the quality assurance program outlined in the ASA Plan to insure ensure compliance with
the ASA Plan.
56. Perform 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
eer.«nifteeCommittee member having a direct or indirect financial pecuniary interest in any matter before
the coniff ftee Committee for consideration shall withdraw from participation in any action by the
Chapter 8.30 2 (05/2201803/2021)
eem e Committee in said matter. Nothing in DCC 8.30.035 shall limit the ability of any person to
provide testimony before the eenmitteeCommittee.
(Ord. 2021-003 §1, 2021; Ord. 2013-005 §1, 2013 Ord. 2003-023 §2, 2003; Ord. 98-064 §1, 1998)
8.30.040. Administration.
The Administrator, under the supervision of the Board and with the assistance of the eemmiaeeCommittee,
shall be responsible for the administration of the ASA Plan and ensure compliance with DCC 8.30._ In order
to carry out the duties imposed by the ASA Plan and DCC 8.30, the Administrator, or persons authorized by
the Administrator, are authorized to enter on the premises of any person regulated by the ASA Plan and DCC
8.30 at reasonable times and in a reasonable manner to determine compliance. The Administrator shall also
have access to records pertaining to ambulance service operations of any person regulated by the ASA Plan.
These records shall be made and provided as requested by the Administrator.
(Ord. 2021-003 & 1, 2021; Ord. 98-064 § 1, 1998)
8.30.045. Service Providers Regulated.
A , bve May 14, 1997, n No person or entijy shall provide emergency ambulance services within
Deschutes County unless such person or enti is franchised in accordance with DCC 8.30 or is an
ambulance service provider that has been authorized by the Board to contract with, and has in fact
contracted with, a franchisee to provide such services pursuant to DCC 8.30.070. Each franchisee retains
the first right of refusal for non -emergency and inter -facility ambulance transports originating within their
ASA boundaries.
as defined i the ASA Plan
B. If there is more than one application made for a franchise within an ASA, the provider that meets the
application requirements of DCC 8.30.050 and that was providing ambulance services en the-effeztive
date of this Ordin *e pursuant to DCC 8.30 shall be franchised to provide emergency ambulance services
for the ASA.
(Ord. 2021-003 § 1, 2021; Ord. 2013-005 § 1, 2013; Ord. 98-064 § 1, 1998)
8.30.050. Franchise -Application.
A. Any person or entijy desiring to provide ambulance service within Deschutes County shall submit an
application to be assigned a franchise within an ASA w thin : n days of the efr five date fthis ofdi,,. nce
The application shall be submitted to the Administrator.
B. Applications for franchises shall be on forms provided by the Board. In addition to information required
by the forms, the Board may require additional information it deems necessary to insur-e ensure
compliance with DCC 8.30, including the ASA Plan, or to make a more informed decision.
C. The applicant shall provide the following information:
1. The name and address of the person or- geney applyir, 1pp icant.
2. The ASA the person or entijy 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 applicant 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 Oregon Health Authority.
5. A statement that all equipment and supplies in each ambulance conforms to Health Authority
standards.
6. A list of personnel to be used in providing emergency ambulance service and their current Emergency
Medical Services Provider level and license number, or other appropriate certification.
Chapter 8.30 3 (05/201803/2021)
7. Proof of financial ability to operate, including an operating budget for public bodies or financial
statement for private entities, references, and a statement 4--demonstrating the provision 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.
8. Proof of public liability insurance in the amount of not less than the limits of liability provided under
the Oregon Tort Claims Act, ORS 30.260 to 30.300. Public'agencies may in lieu of insurance establish
a program of self-insurance in accordance with State law.
9. A statement of experience in providing emergency ambulance service of a comparable quality and
quantity to insure ensure compliance with DCC 8.30, regulations promoted thereunder, any franchise
issued, and the ASA Plan.
10. Statement of ability to comply with the rules and regulations of the ASA Plan and applicable County
ordinances, in the form of a narrative summary.
11. A description of any prepaid ambulance plan, including number of years of operation, funding and
term.
12. Any other materials or information 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 also 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. 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 reasonable costs
of Deschutes County in administering the ASA Plan and ensuring compliance with DCC 8.30.
E. Franchise applications shall be reviewed by the ASA ^ mmitteeCommittee, who will make a
recommendation efas to the assignment of franchises within theeach ASAs to the Board. The assignment
of franchise within an ASA shall be made by an order of the Board.
(Ord. 2021-003 §1, 2021; Ord. 2013-005 §1, 2013; Ord. 98-064 §1, 1998)
8.30.055. Franchise -Review of Application.
A. Applications shall be reviewed by the eemnaitteeCommittee, who shall make such an 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 f= pr-eviding emergency= mbulanee ..e_ , iee to an
A&N-the franchisee within any 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 eemmittee-Committee shall make its
recommendation to the Board to grant, deny, modify, or attach appropriate conditions to the application.
The senunittee Committee shall transmit its recommendation within 60 days after the application.
D. Upon receipt of the 's Committee's recommendation, the Board:
1. Shall publish notice of its intent to hold a public hearing on the application and the Committee's
recommendations at least 10 days, but not later than 30 days following publication of such notice.
2. May require additional investigation by the eemmittee Committee if it finds that there is insufficient
information on which to base its action.
3. Shall, upon the basis of the application, the eeTCommittee's recommendation, such other
information as is permitted by DCC 8.30, 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.
Chapter 8.30 4 (055/201803/2021)
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 DCC 8.30.055 and enter an emergency order if it
finds there is an immediate and serious danger to the public, or it findser a health hazard or public
nuisance would be created by a delay.
conditions, and the franchise find-S hellshe, iS unable to pFevide a paAieular- sen,iee, the Board may
PeFfflit the fm-nehise, to Suh-PORMtraet Such SovVieVe, to -aneffier- per -son if the P-AN-w-d- finds that the quality
«F ..tie as it deems neeessai�,.
(Ord. 2021-003 § 1, 2021; Ord. 98-064 § 1, 1998)
8.30.060. Franchise -Terms and Renewals.
A. ,
2000.
A&T-h r-�a-fter, and- unlesia-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 a continuing ten (10) years beginning on
July 1 and ending June 30 ten years later.
GB. _Unless grounds exist for refusal to renew a franchise under provisions for suspension or revocation
as set forth within DCC 8.30, or unless tea franchise is to be awarded to a new person or entity, ep,
uly ' st of eaeh year, the franchises will be automatically renewed on July 1' of each year for a term
of one (1) year, unless the Board notifies the --a franchisee at least 60 days in advance of July 1st; of its
intent not to renew the franchise. Upon notice from the Board of intent not to renew, the term of the
current franchise will be no more than frve}-two 2 ears from the date of notice of intent not to
renew.
DC.Not more than 180 days and not less than 120 days prior to the expiration of the franchise, any person or
entity desiring to take over the -a franchise shall submit an application to the Administrator.
€D.Review of all applications for -to- take over ef-a franchise shall be conducted in accordance with the
provisions of DCC 8.30.
(Ord. 2021-003 § 1, 2021; Ord. 2018-004: Ord. 2003-023 §3, 2003; Ord. 98-064 § 1, 1998)
8.30.065. Franchise -Discontinuance of Service;Transfer.
A. If a franchisee discontinues service before the expiration date of his�herits franchise, the Board shall set a
time by which applications must be submitted for a new franchise in the ASA.
B. The eem it ee—Committee shall develop an interim plan for coverage of the ASA, using existing
franchisees and/or other available resources until the A SA franchise can be reassigned.
C. The Board shall issue a temporary certificate, valid for a stated period not to exceed six 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 month period. ,
D. A franchisee may transfer its 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 DCC 8.30.
(Ord. 2021-003 § 1, 2021; Ord. 98-064 § 1, 1998)
8.30.070. Sub -contracting of Services by Franchisees.
A. A franchisee wishing to contract with another ambulance service provider to provide emergency
ambulance services within the boundaries of its ASA must first obtain approval from the Board to do so.
Before such approval will be provided by the Board:
Chapter 8.30 5 - (05/201903/2021)
1. Contracts assigning the provision of emergency ambulance services from a franchisee to a
subcontracted ambulance service provider shall be in writing. The franchisee will provide the
proposed contract with a proposed subcontracted ambulance service provider and M supporting
materials to the Board for its review and approval, and
2. The proposed subcontracted ambulance service provider must be vetted and approved by the
Board to provide emergency ambulance services using the application process outlined in DCC
8.30.050 - Franchise -Application.
B. A franchisee may contract with another ambulance service provider to provide non -emergency or inter -
facility ambulance transports so long as the quality, effectiveness, and scope of such services are at all
times maintained by the subcontracted ambulance service provider. Contracts assigning the provision of
non -emergency and inter -facility ambulance transports to a subcontracted ambulance service provider
shall be in writing_
C. Franchisees mgy contract for emergency ambulance services or non -emergency or inter -facility
ambulance transports with a private, non -governmental entity or person as otherwise provided herein.
Franchisees may contract with a private, non -governmental entity or person for a term of up to two years.
Franchisees must request authorization from the Board to renew such contracts at least forty-five (45)
days prior to the expiration of the term of any such contract. Renewal requests may be authorized by the
Board so long as the requirements placed on subcontracted ambulance service providers in paragraphs
(A) and (B) above, as applicable, are maintained, and so long as an acceptable record of service is
demonstrated to the Board.
D. Any ambulance service provider approved to contract with a franchisee to provide emergency ambulance
services or non -emergency or inter -facility ambulance transports as provided herein shall not have the
status of franchisee, but will rather be an approved subcontractor of the franchisee within the boundaries
of the franchisee's ASA.
E. Any ambulance service provider contracting with a franchisee to provide emergency ambulance services
or non -emergency or inter -facility ambulance transports as provided herein must comply with all
applicable requirements found in DCC 8.30.090(A) through (D) in the performance of such services.
(Ord. 2021-003 § 1, 2021,)
8.30.0750. Enforcement.
A. Subject to the policies and remedies stated in DCC 8.30, and penalties provided elsewhere in DCC 8.30,
the Administrator shall, upon reasonable cause, make initiate an investigation to determine if there is
sufficient reason and cause to suspend, modify, revoke, or refuse to renew a franchise as provided in DCC
8.30.070075.
B. If in the judgment of the eeFpAnttee-Committee or Board, there is sufficient evidence to constitute a
violation of applicable local, state or federal law, or if the franchise has materially misrepresented facts
or information given in the application for the franchise, the Board shall notify the franchisee in writing,
by certified mail, 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-committe� Committee.
C. Ten 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 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 on the matter. 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 10 days
prior to such hearing. The burden of proof at the hearing shall be upon the Administrator to show by
Chapter 8.30 6 (05/201803/2021)
substantial evidence in the record as a whole that the franchisee failed to comply with DCC 8.30, the ASA
Plan, state statute, or administrative rule.
D. 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.
E. 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.
(Ord. 2021-003 1, 2021; Ord. 98-064 § 1, 1998)
8.30.0-7-5080. Interruption of Service -Prevention.
Whenever the Board finds that the failure of service would adversely impact the health, welfare or safety of
the residents of this County, the Board shall, after reasonable notice, but not less than 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.
(Ord. 2021-003 §1, 2021; Ord. 98-064 §1, 1998)
8.30.080085. Appeals, Abatements and Penalties.
A. All the decisions of the Board under DCC 8.30 shall be reviewable by the Circuit Court of the State of
Oregon for the County of Deschutes, enly-solely by way of writ of review.
B. The provision of emergency ambulance service by any person in violation of DCC 8.30, or regulations
promulgated thereunder, is a nuisance and the court may, in addition to other remedies provided by law
or by DCC 8.30, 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 DCC 8.30 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 $500.00 for a
non -continuing offense, i.e., an offense not spanning two or more consecutive calendar days. In the case
of a continuing offense, i.e., an offense which spans two or more consecutive calendar days, violations of
the provisions is punishable by a fine of not more than $500.00 per day up to a maximum of $1,000.00 as
provided by law.
(Ord. 2021-003 §1, 2021; Ord. 98-064 §1, 1998)
8.30.085090. Franchisee Duties.
The Franchisee:
A. Shall conduct its operation in compliance with all applicable state and federal laws, rules and regulations,
the terms of this Ordinanee .DCC 8.30 and the Deschutes County ASA Plan;
B. Shall not fail or refuse to respond to an emergency call for service when an ambulance is available for
service;
C. It is expected that billing and invoicing for services performed by franchisees will be performed
according to applicable state, federal, or local law.
ED: Shall not respond to a medical emergency located outside its assigned ASA except:
1. When a request for specific emergency ambulance service is made by the person calling for the
ambulance and the call does not dictate an emergency service response;
Chapter 8.30 7 (05/22M03/2021)
2. 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;
3. When the response is for supplemental assistance or mutual aid.
DE. Shall not voluntarily discontinue service to. its assigned ASA until it has:
1. Given 60 days written notice to the Administrator, or
2. Obtained written approval of the Board.
€F. DCC 8.30.0908-5(EA)_(4shall not apply to:
1. Change, restriction or termination of service when required by any public agency, public body or
court having jurisdiction; or
2. Transfer of franchises pursuant to DCC 8.30.
(Ord. 2021-003 § 1, 2021; Ord. 98-064 § 1, 1998),
8.30.090095. Exemptions.
A. Nothing in DCC 8.30 prohibits a 911 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.
B. DCC 8.30 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 not covered by the Deschutes County ASA Plan 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.
(Ord. 2021-003 § 1, 2021; Ord. 98-064 § 1, 1998)
Chapter 8.30 8 (05l201803/2021)
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1ES
AMBULANCE SERVICE AREA PLAN
FOR
DESCHUTES COUNTY, OREGON
Table of Contents
Chapter 8.30 APPENDIX A (3,L29�83/2021)
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 Narratives and Description........................................................ Page 9
2. Maps.................::...............................................................................................................
Page 15
3. Alternatives to Reduce Response Times...........................................................................
Page 15
V. Systems Elements
1. Notification/Response Times............................................................................................
Page 16
2. Level of Care.....................................................................................................................
Page 16
3. Personnel...........................................................................................................................
Page 17
4. Medical Supervision..........................................................................................................Page
17
5. Patient Care Equipment..............................................................................:......................
Page 17
6. Vehicles.............................................................................................................................
Page 17
7. Training.............................................................................................................................
Page 17
8. Quality Assurance.............................................................................................................
Page 18
8.1 Structure..........................................................................................................................
Page 18
8.2 Process.............................................................................................................................Page
18
8.3 Problem Resolution.........................................................................................................
Page 19
8.4 Sanctions for Non -Compliant Personnel or Providers ....................................................Page
19
8.5 Penalties...........................................................................................................................
Page 20
8.6 Nuisance..........................................................................................................................
Page 20
9. Nonemergency Transports................................................................................................
Page 20
VI. Coordination
1. Authority for Ambulance Service Area Assignment.........................................................
Page 21
2. Entity That Will Administer The ASA Plan.....................................................................
Page 21
3. Complaint Review Process................................................................................................Page
21
4. Mutual Aid Agreements....................................................................................................
Page 21
5. Disaster Response..............................................................................................................Page
22
5.1 County Resources Other Than Ambulances....................................................................Page
22
5.2 Out of County Resources .................................. :...............................................................
Page 22
5.3 Mass Casualty Incident Plan...........................................................................................
Page 22
6. Coordination......................................................................................................................
Page 23
7. EMS Responder Guidelines..............................................................................................
Page 23
8. Personnel and Equipment Resources.................................................................................Page
23
9. Emergency Communications and Systems Access
9.1 Telephone Access............................................................................................................Page
23
9.2 Dispatch Procedures........................................................................................................Page
24
9.3 Radio System...................................................................................................................Page
24
10. Emergency Medical Services Dispatcher Training.........................................................
Page 25
VII. Provider Selection
Chapter 8.30 APPENDIX A (5/201-83/2021)
J
L
1. Reassignment of an ASA................................................................................................... Page 25
2. Application Process for Applying for an ASA..................................................................Page 25
3. Notification of Vacating an ASA...............:...................................................................... Page 25
4. Maintenance of Level of Service'..................................................................................... Page 26
VIII. Franchise Agreement.................................................................................................Page 26
IX. County Ordinances and Rules..................................................................................Page 26
Chapter 8.30 APPENDIX A (83/2021)
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:
1. Each subject or item contained in the Deschutes County Ambulance Service Plan has been
addressed and considered in the adoption of the plan lan by this body.
2. In this governing body's judgment, the ambulance service areas established in the planRlan
provide for the efficient and effective provision of ambulance services.
3. To the extent they are applicable, the County has complied with ORS 682.062 and 682.066
and existing local ordinances and rules.
DATED this 231h-lday of jam 2021-13.
BOARD OF COUNTY COMMISSIONERS
OF DESCHUTES COUNTY, OREGON
^Alan=Unge:Anthony DeBone, Chair
Tammy BanPhil Chan, Vice Chair
ATTEST:
Recording Secretary Anthony De ,o Patti Adair, Commissioner
Chapter 8.30 APPENDIX A (3,20183/2021)
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 its southern border along Klamath and Lake Counties.
Population of the county as of 2024-0 was 157,733197,692. The City of Bend, with a population of
9100,430, and the City of Redmond with 24-,24530, 667, are the county's largest cities. Both
are located on Highway 97, which runs north and south through the county. Other population areas
are the City of Sisters, located along Highway 20 between Black Butte Ranch and Bend with a
population of ''M2, 443, and the City of La Pine in the Southern portion of the county with a
population of'�2, 443. Health care industry, tourism, and small business provide the basis of
the county's economy.
Chapter 8.30 APPENDIX A (3l90�83/2021)
III. DEFINITIONS
1. "Address and consider" has the meaning given these terms by ORS 682.062.
2. Advanced Emergency Medical Technician (AEMT or Advanced EMT)" means a person
who is licensed by the Division as an Advanced Emergency Medical Technician. OAR 333-265-
0000,(1).
3. "Ambulance: has the meaning given that term by ORS 682.025(1).
4. "Ambulance Service" has the meaning given that term by ORS 682.025(2).
5. "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.
6. "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.
7. "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.
8. "ASA Administrator" is the person designated by the Board of Commissioners to
administer the ASA ordinance and plan lan.
9. "Elausex--Priority Dispatch" is a system used by the PSAP to prioritize calls from least
severe to most severe. Omega, alpha,
Char -lie, ilea., and Eehe eall .. always esensid,ered emergeney e is 10. "Communication System" means a system of two-way radio communications between
ambulances, dispatchers, hospitals and other agencies as needed. A two -channel multi -frequency
capacity is minimally required.
11. "Deschutes County Board of Commissioners (Board)" means the elected governing body
that has jurisdiction over the Deschutes County ASA Plan.
12. "Division" means the Oregon Health Authority, Emergency Medical Services and Trauma
Program.
13. "Effective Provision of Ambulance Services" means ambulance services provided in
compliance with the County Ambulance Service Plan provisions or boundaries, coordination and
system elements.
14. "Efficient Provision of Ambulance Services" means effective ambulance services
provided in compliance with the County Ambulance Service Plan provisions for provider selection.
Chapter 8.30 APPENDIX A (5,L20183/2021)
15. "Emergency" ,means those medical or trauma conditions that manifest themselves by
symptoms of sufficient severity that a prudent layperson possessing an average knowledge of health
and medicine would reasonably expect that failure to receive immediate medical care would place
the health of a person, or the fetus in the case of a pregnant woman, in serious jeopardy. An
emergency condition also includes any condition specifically dealt with in the emergency medical
dispatch system adopted by Deschutes County 911.
16. `Emergency Ambulance" means that ambulance provider designated by the Board as the
sole ambulance provider for an assigned ASA.
17. "Emergency Ambulance Provider" means that ambulance provider designated by the
county as an emergency ambulance provider for an ASA.
45—.18. "Emergency care" means the performance of acts or procedures under emergency
conditions in the observation, care and counsel of persons who are ill or injured or who have
disabilities; in the administration of care or medications as prescribed by a licensed physician,
insofar as any of these acts is based upon knowledge and application of the principles of biological,
physical and social science as required by a completed course utilizing an approved curriculum in
pre -hospital emergency care. However, "emergency care" does not include acts of medical
diagnosis or prescription of therapeutic or corrective measures. ORS 682.025(3).
4-6—.19. "Emergency Medical Responder (EMR)" means a person licensed by the Division as
defined in OAR 333-265-0000(14).
4-7—.20. "Emergency Medical Services (EMS) Agency" means any person, partnership, corporation,
governmental agency or unit, sole proprietorship or other entity that utilizes Emergency Medical
Services Providers to provide pre -hospital emergency or non -emergency care. An emergency
medical services agency may be either an ambulance service or a non -transporting service. OAR
333-265-0000(15).
4-8-21. "Emergency Medical Services Provider (EMS Provider)" means a person who has received
formal training in pre -hospital and emergency care and is state -licensed to attend to any ill, injured
or disabled person. Police officers, fire fighters, funeral home employees and other personnel
serving in a dual capacity, one of which meets the definition of "emergency medical services
provider" are "emergency medicals service providers" within the meaning of ORS Chapter 682.
OAR 333-265-0000(16).
4-9L-.-22."Emergency Medical Technician (EMT)" means a person licensed by the Division and&
defined in OAR 333-265-0000(17, 18).
20-. 23.—"Emergency Medical Technician -Intermediate (EMT -Intermediate)" means a person
licensed by the Division and defined in OAR 333-265-0000(19).
24-24. "Paramedic' means a person licensed by the Division and defined in OAR 333-265-
0000(20, 27).
25. "Inter -Facility Ambulance" is one who is licensed by the State of Oregon and provides
transportation services between hospitals or transfers to and from a hospital to a residential care
facility, assisted living facility, adult foster care home, convalescent care facility, non -urgent
medical clinic. rehabilitation center, or private residence.
Chapter 8.30 APPENDIX A (5QQ1 3/2021)
22 26. "Franchise" means the authorization granted by the Board to provide exclusive emergency
ambulance services in a specific geographic region within Deschutes County.
24 27. "Health Officer" means the Deschutes County Health Officer.
2-5-. 28. "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 682.010to 682.991 and OAR 333-250-0000 through 333-250-0100 and 333-255-0000
through 333-255-0092.
29. "Non -Emergency" means those medical or trauma conditions that are not specifically dealt
with in the emergency medical dispatch system adopted by the County. Unless specified by rule,
those conditions that fall within the emergency medical dispatch system shall immediately be
transferred to the emergency ambulance providers designated by Deschutes Coupthrough the
911 system.
30. "Non -Emergency Ambulance" Non -emergency ambulance provider is one who is licensed as
an ambulance by the State of Oregon and provides transportation services for those conditions that
are defined as non -emergency.
2-6-. 31. "Nonemergency care" means. the performance of acts or procedures on a patient who
is not expected to die, become permanently disabled or suffer permanent harm within the next 24
hours, including but not limited to observation, care and counsel of a patient and the administration
of medications prescribed by a physician licensed under ORS chapter 677, insofar as any of those
acts are based upon knowledge and application of the principles of biological, physical and social
science and are performed in accordance with scope of practice rules adopted by the Oregon
Medical Board in the course of providing pre -hospital care. See ORS 682.025(8).
32. "Non -Emergency Transportation Service" means a person who holds a valid license to
provide non -emergency ambulance transportation.
27-. 33. "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.
2 . 34. "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 leaser, entitled to the possession of an ambulance
vehicle or operation of an ambulance service under a security agreement or a lease for a term of 10
or more successive days.
29, 35. "Patient" means an ill, injured, or disabled person who may be transported in an ambulance.
-A—.36. Provider Selection Process" means the process established by the county for selecting an
ambulance service provider or providers.
3-1. 37. "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.
Chapter 8.30 APPENDIX A (3,L201 83/2021)
3-2-.-38. "Quick Response Team (QRT)" means an agency that provides initial response and basic
life support care without transportation capabilities by licensed emergency medical service
providers.
33-39. "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.
3.4- 40. -"Stable Patient" is a patient with the following criteria:
1. Has vital signs in a normal range that are not changing 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.
2. Does not, and is not expected to, require cardiac monitoring or ALS procedures.
3. Has a patent natural airway and is not in respiratory distress.
4. Has no unstabilized injuries that will be aggravated by motion in transport.
5. Is not experiencing acute changes in level of consciousness.
3-5-41. "Supervising Physician" has the meaning of a supervising physician as provided in ORS
682.025(14).
-36—.42."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.
43. "Unstable Patient" is any patient who cannot be stabilized who is deteriorating or likely to
deteriorate. A medical, provider contacting 911 for emergency transport may make the determination
whether or not patient is stable or unstable and requires emergency transport. These patients require
emergency transport.
IV. BOUNDARIES
1. Ambulance Service Area Narratives 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) La Pine; (6) Redmond; (7) Sisters; and (8) Sunriver. The
boundaries of each of the eight ambulance service areas are as follows:
All Townships and Ranges listed are based upon the Willamette Meridian.
ASA #1— Bend
Size of ASA: Approximately 1450 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, R8E, with the westerly
line of Deschutes County; thence east upon the section lines approximately 6.3 miles to the NW
corner of Section 22, T17S, R9E; thence south upon the section line to the SW corner of the N'/z
of said Section 22; thence east 3.0 miles to the SE corner of the N'/z of Section 24, T17S, R9E;
thence north upon the section line to the NE corner of said Section 24; thence east upon the
section line to the SE corner of Section 18, T17S, R10E; thence north upon the section line to the
NE corner of said Section 18; thence east upon the section lines 2.0 miles to the SE corner of
Chapter 8.30 APPENDIX A (3{201 g3/2021)
Section 9, T17S, RI OE; thence north upon the section lines 2.0 miles to the NW corner of Section
3, T17S, R10E; thence east upon the section lines 3.0 miles to the SE corner of Section 36, T16S,
R10E; thence north upon the section line to the NE corner of said Section 36; thence east upon
the section line to the SW corner of the SE'/4 of Section 10, T16S, RI IE; thence east upon the
southern boundary of Deschutes County Tax Lot 1611000008100 approximately 0.2 miles where
said tax lot boundary turns in a northeastern direction; thence northeasterly upon said tax lot
boundary line to the intersection of said tax lot boundary with the eastern boundary of Deschutes
County Tax Lot 1611000001419; thence northeasterly upon the eastern boundary line of said tax
lot to the intersection of said tax lot with Deschutes County Tax Lot 1611000001418; thence
northeasterly upon the eastern boundary of said tax lot to the intersection of Deschutes County
Tax Lot 1611000001401; thence northerly upon the eastern boundary of said tax lot to the
intersection with the western boundary of Deschutes County Tax Lot 1611000007900; thence
south upon the western boundary of said tax lotto the SW corner of the SW '/4 of the NW '/4 of
Section 29, T16S, RI IE; thence.east to the SE corner of the SW '/4 of the NW '/4 of said Section
29; thence north to the NE corner of the NW '/4 of the NW '/4 of said Section 29; thence east upon
the section line to the SE corner of the SW '/4 of Section 20, T16S, R11E; thence north to the NE
corner of the SW '/4 of said Section 20; thence east to the SE corner of the NE'/4 of said Section
20; thence north upon the section line to the NE corner of said Section 20; thence east upon the
section line to the SE corner of the SW '/4 of Section 16, T16S, RI IE; thence north to the NE
corner of the SE'/4 of the SW '/4 of said Section 16; thence west to the NW corner of the SE'/4 of
the SW '/4 of said Section 16; thence north to the NE corner of the SW '/4 of the NW '/4 of said
Section 16; thence west to the SW corner of the NW '/4 of the NW '/4 of said Section 16; thence
north upon the section line to the NW corner of said Section 16; thence east upon the section line
to the NE corner of said Section 16; thence north upon the section line to the intersection with the
southernmost right-of-way line of US Highway 20; thence perpendicularly across US Highway
20 in a northeastern direction to the intersection with the southern boundary line of Deschutes
County Tax Lot 1611100000300; thence southeasterly along the southern boundary of said tax lot
to the SE corner of said tax lot; thence north to the NE corner of the NW '/4 of the NW '/4 of
Section 10, T16S, RI IE; thence east upon the section lines to the SW corner of Section 1, T16S,
RI IE; thence north upon the section line to the NW corner of said Section 1; thence easterly upon
section lines approximately 2.25 miles to the NE corner of the W '/2 of the W '/2 of section 5,
T16S, R12E; thence southerly to the SE corner of the W '/2 of the W '/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 '/2 of section 16, T16S, R12E; thence southerly to the SE corner of the NW '/4 of said section
16; thence westerly to the SW corner of the E'/z of the NW '/4 of said section 16; thence
southerly to the SE corner of the W '/2 of the W '/z of said section 16; thence easterly upon
section lines to the NE corner of section 24, T16S, ROE; also being a point on the Deschutes
County/Crook County boundary line; thence continuing southerly and easterly upon the
Deschutes County/Crook County line to the NE corner of section 1, T22S, R21E also being a
point on the Deschutes County/Lake County boundary line; thence westerly upon the Deschutes
County/Lake County boundary to Forest Highway 23; thence northerly upon Forest Highway 23
to the township line between T21 S and T22S, R16E; thence westerly upon the south lines of
Township 21 S, to Forest Road 9710; thence northerly upon Forest Road 9710 to the intersection
of Forest Road 9710 and Forest Road 9714; thence northeast on Forest Road 9714 to the
intersection of Forest Road 9714 and Forest Road 9711-840 at the south base of Luna Butte;
thence north on Forest Road 9711-840 approximately 1 mile to the northwest base of Luna Butte
where Forest Road 9711-840 becomes Forest Road 9711- 800; thence northerly on Forest Road
9711-800 to the intersection of Forest Road 9711-800 and Forest Road 9711; thence westerly on
Chapter 8.30 APPENDIX A (83/2021)
Forest Road 9711 to the intersection of Forest Road 9711 and Forest Road 9711-200; thence
northerly on Forest Road 9711-200 approximately 1.75 miles where Forest Road 9711-200
becomes Forest Road 9701-600; thence continue northerly on Forest Road 9701-600 to the
intersection of Forest Road 9701-600 and Forest Road 9701; thence south on Forest Road 9701 to
the intersection of Forest Road 9701 and Forest Road 9701-150; thence west on Forest Road
9701-150 to the intersection of Forest Road 9701-150 and Highway 97 at the south entrance to
the ODOT Weigh Station; thence west across Highway 97 approximately 50 feet to the
intersection of Highway 97 and an unnamed forest road; thence north on the unnamed forest road
approximately 1/10th of a mile where the unnamed forest road becomes Forest Road 9700-060;
thence continue north on Forest Road 9700-060 to the point where Forest Road 9700-060 dead -
ends into the railroad tracks on the section line shared by Section 1,T19S, R11E and Section 36,
T18S, R11E; thence southwesterly along the railroad tracks to the section line shared by Section
10 and Section 11, T19S, RI IE; thence north to the NE corner of Section 11, 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 the centerline of State Highway 372 (a.k.a. Cascade Lakes Highway);
thence westerly upon said centerline 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, RBE; thence northerly
approximately 3.5 miles to the NE corner of the SE 1/4 of section 22, T18S, RBE; thence westerly
to the Deschutes County/Lane County boundary line; thence northerly upon the Deschutes
County/Lane County Boundary line to the Point of Beginning.
ASA #2 - Black Butte Ranch
Size of ASA: Approximately 13 square miles.
BEGINNING at the NW corner of Section 5, T14S, R9E at the Deschutes/Jefferson County
boundary line; thence south upon the section lines to the SW corner of Section 20, T14S, R9E;
thence east upon the section lines to the SW corner of Section 23, T14S, R9E; thence north upon
the section line to the NW corner of Deschutes County Tax Lot 1409000002102; thence east upon
said tax lot's northern boundary to the NE corner of said tax lot; thence southeasterly upon said tax
lot's boundary to its intersection with the east section line of Section 23, T14S, R9E (approximately
221' north of the SE corner of said section); thence north upon the section lines to the point where
the easterly boundary of Section 14, T14S, R9E intersects the southerly right-of-way (ROW) line
of US Highway 20; thence southeasterly along said ROW line to the point perpendicular to the
westerly intersection of the US Highway 20 and Indian Ford Road ROW lines (located in T14S,
R9E, Section 13); thence northeasterly across US Highway 20 to said ROW line intersection;
thence northwesterly upon the northerly ROW line of US Highway 20 to the intersection of said
ROW line with the easterly ROW line of Camp Sherman Road; thence southwesterly across US
Highway 20 to the point where US Highway 20 ROW line intersects the easterly ROW line of
George McAllister Road; thence northwesterly upon the US Highway 20 ROW line to the point of
intersection with the north boundary line of Section 5, T14S, R9E at the Deschutes/Jefferson
County boundary; thence west along the north line of said section to the Point of Beginning;
excluding the physical intersections of US Highway 20 with Camp Sherman Road and Indian Ford
Road.
Chapter 8.30 APPENDIX A (3/20183/2021)
ASA #3 — Burns
ALL of T22S, R22E 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 - LaPine
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.
BEGINNING at the intersection of the north line of section 2, T21 S, R6E; thence easterly upon
the section lines to the NW corner of section 1, T21 S, R7E; 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 section1 to
the NE corner of said section 1; thence easterly approximately 11.5 miles upon the section lines
to the intersection with the center line of Forest Highway 42, (a.k.a. South Century Drive); thence
northeasterly upon said Highway 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 of the SW 1/4 of said section
1; thence northerly to the NW corner of the SE1/4 of the 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 center line of Forest Highway 40, (a.k.a. Spring River Road);
thence easterly and northerly upon said Forest Highway to the intersection with the railroad tracks
in section 5, T20S, R11E; thence southerly upon said tracks to the north line of section 8, T20S,
R11E; 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 of Forest Road 9710; thence
southerly and easterly upon said Forest Road to the south line of section 35, T21 S, ROE; thence
easterly upon the section lines to the intersection of Forest Road 23; thence southerly upon said
Forest Road to the Deschutes County/Lake County boundary line; thence westerly upon the
Deschutes County/Lake County boundary line to the Deschutes County/Lake County/Klamath
County intersection; thence westerly upon the Deschutes County/Klamath County boundary line
to the Deschutes County/Klamath County/Lane County intersection; thence northerly and easterly
along the Deschutes County/Lane County boundary line to the point of beginning.
Chapter 8.30 APPENDIX A (3,129153/2021)
ASA #6 - Redmond
Size of ASA: Approximately 192 square miles.
BEGINNING at the common corner of Deschutes, Jefferson and Crook Counties; thence
southerly upon the Deschutes County/Crook County boundary line to the NE corner of section
24, T16S, ROE; thence westerly upon section lines to the SE corner of the W '/z of the W 1/2 of
section 16, T16S, R12E; thence northerly to the NE corner of the W 1/2 of the SW 1/4 of the said
section 16; thence easterly to the center 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 downstream 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 '/2 of the W 1/2 of section 5, T16S, R12E; thence northerly to the NE corner of the W '/2 of
the W 1/2 of the said section 5; thence westerly upon section lines to the SW corner of section
36, T15S, R11E; thence north to the NW corner of section 25, T15S, RI IE; thence west to the
SW corner of section 22, T15S, R1 IE; thence north approximately 10 miles upon section lines to
the Deschutes County/Jefferson County boundary line; thence easterly upon the Deschutes
County/Jefferson County boundary 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 397 square miles. However, a large portion of the ASA is comprised
of Deschutes National Forest lands that are uninhabited.
BEGINNING at the intersection of the south line of Section 16, T17S, R8E, with the westerly
line of Deschutes County; thence east upon the section lines approximately 6.3 miles to the NW
corner of Section 22, T17S, R9E; thence south upon the section line to the SW corner of the N'/z
of said Section 22; thence east 3.0 miles to the SE corner of the N'/z of Section 24, T17S, R9E;
thence north upon the section line to the NE corner of said Section 24; thence east upon the
section line to the SE corner of Section 18, T17S, R10E; thence north upon the section line to the
NE corner of said Section 18; thence east upon the section lines 2.0 miles to the SE corner of
Section 9, T17S, R10E; thence north upon the section lines 2.0 miles to the NW corner of Section
3, T17S, R10E; thence east upon the section lines 3.0 miles to the SE corner of Section 36, T16S,
RI OE; thence north upon the section line to the NE corner of said Section 36; thence east upon
the section line to the SW corner of the SE'/4 of Section 10, T16S, R11E; thence east upon the
southern boundary of Deschutes County Tax Lot 1611000008100 approximately 0.2 miles where
said tax lot boundary turns in a northeastern direction; thence northeasterly upon said tax lot
boundary line to the intersection of said tax lot boundary with the eastern boundary of Deschutes
County Tax Lot 1611000001419; thence northeasterly upon the eastern boundary line of said tax
lot to the intersection of said tax lot with Deschutes County Tax Lot 1611000001418; thence
northeasterly upon the eastern boundary of said tax lot to the intersection of Deschutes County
Tax Lot 1611000001401; thence northerly upon the eastern boundary of said tax lot to the
intersection with the western boundary of Deschutes County Tax Lot 1611000007900; thence
south upon the western boundary of said tax lot to the SW corner of the SW '/4 of the NW '/4 of
Section 29, T16S, R11E; thence east to the SE corner of the SW '/4 of the NW '/4 of said Section
29; thence north to the NE corner of the NW '/4 of the NW '/4 of said Section 29; thence east upon
the section line to the SE corner of the SW'/4 of Section 20, T16S, R11E; thence north to the NE
corner of the SW '/4 of said Section 20; thence east to the SE corner of the NE '/4 of said Section
Chapter 8.30 APPENDIX A (3,120I83/2021)
20; thence north upon the section line to the NE corner of said Section 20; thence east upon the
section line to the SE corner of the SW '/4 of Section 16, T16S, R11E; thence north to the NE
corner of the SE '/4 of the SW '/4 of said Section 16; thence west to the NW corner of the SEA of
the SW '/4 of said Section 16; thence north to the SE corner of the NW '/4 of the NW '/4 of said
Section 16; thence west to the SW corner of the NW '/4 of the NW '/4 of said Section 16; thence
north upon the section line to the NW corner of said Section 16; thence east upon the section line
to the NE corner of said Section 16; thence north upon the section line to the intersection with the
southernmost right-of-way line of US Highway 20; thence perpendicularly across US Highway
20 in a northeastern direction to the intersection with the southern boundary line of Deschutes
County Tax Lot 1611100000300; thence southeasterly along the southern boundary of said tax lot
to the SE corner of said tax lot; thence north to the NE corner of the NW '/4 of the NW '/4 of
Section 10, T16S, R11E; thence east upon the section lines to the SW corner of Section 1, T16S,
Rl IE; thence north upon the section line to the NW corner of said Section 1; thence west upon
the section line to the SW corner of Section 36, T15S, RI IE; thence north to the NW corner of
Section 25, T15S, R11E; thence west to the SW corner of Section 22, T15S, RI IE; thence north
upon the section lines approximately 3.75 miles to the SW corner of the NW '/4 of the NW '/4 of
Section 3, T15S, RI IE; thence east to the SE corner of the NW '/4 of the NW '/4 of said Section 3;
thence north to the NE corner of the SW'/4 of the SW'/4 of Section 34, T14S, RI 1E; thence east
to the SE corner of the NE'/4 of the SW '/4 of said Section 34; thence north to the NE corner of
the NE '/4 of the SW '/4 of said Section 34; thence west to the NW corner of the NW '/4 of the SW
'/4 of said Section 34; thence north upon the western section line of said Section 34 to the
intersection with McKenzie Canyon Road; thence northeasterly along McKenzie Canyon Road to
the intersection with the northern section line of said Section 34; thence east upon the section
lines to the SW corner of the SE'/4 of Section 26, T14S, RI IE; thence north to the NW corner of
the SE'/4 of said Section 26; thence east to the NE corner of the SE'/4 of said Section 26; thence
north upon the section lines to the NE corner of the SE'/4 of the SE'/4 of Section 23, T14S, RI IE;
thence west to the NW corner of the SW '/4 of the SE'/4 of said Section 23; thence north 2.25
miles to the NE corner of the SW'/4 of Section 11, T14S, R11E; thence west to the NW corner of
the SW'/4 of said Section 11; thence north upon the section lines to the NW corner of Section 2,
T14S, RI IE at the Deschutes County/Jefferson County boundary line; thence west upon the
Deschutes County/Jefferson County boundary line to the intersection of the Deschutes
County/Jefferson County/Linn County Line intersection; thence southerly upon the Deschutes
County/Linn County line to the Deschutes County/Linn County/Lane County intersection; thence
southerly upon the Deschutes County/Lane County line to the Point of Beginning; excluding all
of Black Butte Ranch ASA #2.
ASA #8 - Sunriver
Size of ASA: Approximately 350 square miles.
BEGINNING at the intersection of the north line of section 2, T21 S, R6E; thence easterly upon
the section lines to the NW corner of section 1, T21 S, R7E; 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 section lines
to the intersection with the center line of Forest Highway 42, (a.k.a. South Century Drive); thence
northeasterly upon said Highway 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, Rl OE;
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
Chapter 8.30 APPENDIX A (83/2021)
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 of the SW 1/4 of said section
1; thence northerly to the NW corner of the SETA of the 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 center line of Forest Highway 40, (a.k.a. Spring River Road);
thence easterly and northerly upon said Forest Highway to the intersection with the railroad tracks
in section 5, T20S, RI 1 E; thence southerly upon said tracks to the north line of section 8, T20S,
R11E; 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, R11E; 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 of Forest Road 9710; thence
northerly upon Forest Road 9710 to the intersection of Forest Road 9710 and Forest Road 9714;
thence northeast on Forest Road 9714 to the intersection of Forest Road 9714 and Forest Road
9711-840 at the south base of Luna Butte; thence north on Forest Road 9711-840 approximately 1
mile to the northwest base of Luna Butte where Forest Road 9711-840 becomes Forest Road
9711- 800; thence northerly on Forest Road 9711-800 to the intersection of Forest Road 9711-800
and Forest Road 9711; thence westerly on Forest Road 9711 to the intersection of Forest Road
9711 and Forest Road 9711-200; thence northerly on Forest Road 9711-200 approximately 1.75
miles where Forest Road 9711-200 becomes Forest Road 9701-600; thence continue northerly on
Forest Road 9701-600 to the intersection of Forest Road 9701-600 and Forest Road 9701; thence
south on Forest Road 9701 to the intersection of Forest Road 9701 and Forest Road 9701-150;
thence west on Forest Road 9701-150 to the intersection of Forest Road 9701-150 and Highway
97 at the south entrance to the ODOT Weigh Station; thence west across Highway 97
approximately 50 feet to the intersection of Highway 97 and an unnamed forest road; thence
north on the unnamed forest road approximately IAOth of a mile where the unnamed forest road
becomes Forest Road 9700-060; thence continue north on Forest Road 9700-060 to the point
where Forest Road 9700-060 dead - ends into the railroad tracks on the section line shared by
Section 1,T19S, RI IE and Section 36, T18S, RI IE; thence southwesterly along the railroad
tracks to the section line shared by Section 10 and Section 11, T19S, RI IE; thence north to the
NE corner of Section 11, 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, R11E; 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, RI OE; 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 the centerline of State Highway 372
(a.k.a. Cascade Lakes Highway); thence westerly upon said centerline 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, RBE; thence northerly approximately 3.5 miles to the NE corner of the SE 1/4 of section
22, T18S, RBE; thence westerly to the Deschutes County/Lane County boundary line.
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,
Chapter 8.30 APPENDIX A (3/2&g3/2021)
weather, road and traffic conditions as well as other circumstances that can impact response
time.
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 emergency medical services providers may elect to call the nearest appropriate
rotary -wing air ambulance or the Deschutes County Search and Rescue.
Emergency medical services providers 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 more quickly to an incident.
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: Each franchisee will provide at the time of application a map of
their proposed ASA which will indicate response times from each oftheir staffed stations. Response
times will be based upon emergency calls only (Charlie, Delta, Echo) per the Clausen Priority
Dispatch System.
Response time maps should be based on 8 minute, 13 minute and 43 minute response times.
Any franchisee can propose a map that reflects different times as long as it is considered to be
within reason and approved by the Committee.
Monitoring of notification and response times shall be accomplished by the following:
1.1 Information received from the public, dispatch center, pre -hospital 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 licensed EMT or above. The EMT must always be present
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 a qualified driver and one licensed EMT -Intermediate. The EMT -Intermediate
must always be present with the patient in the patient compartment of the ambulance when
intermediate level care is required or rendered.
An ambulance operating in Deschutes County and providing advanced life support level care must
consist of a qualified driver and a licensed Paramedic. The Paramedic must always be present with
Chapter 8.30 APPENDIX A (3,120143/2021)
the patient in the patient compartment of the ambulance when ALS care is required or rendered.
1
If the driver is not a licensed EMT, then a second EMT must be available for patient care both in
the ambulance and on scene.
3. Personnel.
When operating an ambulance in Deschutes County, all personnel must meet the requirements of
ORS 682.010 to 682.991 and OAR 333-255-0070 through 333-255-0073. 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 mean or imply that the ambulance service must provide the same higher level
of care on a regular basis.
4. Medical Supervision.
Each EMS agency utilizing EMTs shall be supervised by a physician licensed under ORS 677,
currently registered and in good standing with the Oregon Medical Board as a Medical Doctor
(MD) or Doctor of Osteopathic Medicine (DO). The physician must also be approved by the
Oregon Medical Board 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 847-35-0020-0025;
4.2 hold at least one meeting a year with the EMTs affiliated with each 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 quarterly at least one case review meeting for all EMTs.
St. Charles Medical Center in Bend and Redmond, Oregon shall be the Medical Resource Hospitals.
5. Patient Care Equipment.
Patient care equipment must meet or exceed the Oregon Health Authority's requirements as
specified in ORS 682.010 to 682.991 and OAR 333-255-0070 through 333-255-0073. The
ambulance service provider shall maintain a list of equipment for their ambulances, which shall be
furnished to the Board upon request.
6. Vehicles.
All ambulances must be either a Type I, II, or III and be licensed by the Oregon Health Authority.
All ambulances must meet or exceed the requirements as set forth in ORS 682.010 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 request.
7. Training.
Chapter 8.30 APPENDIX A (5,1281-93/2021)
Training will be consistent with requirements of the Oregon Health Authority and Department of
Transportation curricula.
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 not less than twelve and no more than fourteen
members:
a. Ambulance service medical director who must be an Emergency
department physician
b. Deschutes County Health Department
C. Ambulance service provider representative from each ASA area
d. Deschutes County Emergency Manager
e. 9-1-1 center representative
f. Public member
Membership and terms of the Committee are outlined in Deschutes County Code 8.30 Ambulance
Service Area. The ASA Administrator shall be -a non -voting member, except in the case of a tie,
in order to break the tie.
The principal function of the committee —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 within Deschutes County with the available resources, has
directed that the ASA Advisory Committee be established.
Quality assurance in Deschutes County shall be accomplished through frequent case
review, peer review, and periodic review by the medical directors and/or Ambulance
services' governing bodies (see respective Provider Profiles for definitions of governing
bodies).
Complaints regarding violation of this ASA Plan, shall be submitted in writing4e4he4kwd
.•.h shall f r-wafa it to the Committee. The Committee shall then review the matter and
make recommendations or changes arising from 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.
Questions or concerns involving pre -hospital care provided shall be directed to the
Chapter 8.30 APPENDIX A (54201-83/2021)
Supervising Physician of the Ambulance service provider. At the Supervising Physician's
discretion the complaint shall be passed to the ASA Committee for further review or
directly to the Professional Standards Division of the Oregon Emergency Medical Services
and Trauma Systems. However, patient care issues that are mandated by the State as
reportable actions shall be reported by the Supervising Physician directly to the
Professional Standards Division of the Oregon Emergency Medical Services and Trauma
Systems.
8.3 Problem Resolution
Problems involving protocol deviation by emergency medical services providers or
dispatehers shall be referred to the respective medical director or dispateh
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. The Board shall provide notice
to the affected provider and allow them the opportunity to issue comments. 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 fixed by the Board.
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.
A person receiving a notice of the assignment, denial of assignment, suspension, or
revocation of assignment or a notice of corrective action the failure of which may result in
suspension or revocation of an assignment may request a hearing before the Board by filing
with the Board a written request for a hearing within fourteen (14) days of the notice,
setting forth the reasons for requesting the hearing and the issues proposed to be reviewed.
The filing of a hearing request shall stay the action, pending the hearing and the Board's
final 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.
Chapter 8.30 APPENDIX A (34291- 3/2021)
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 Class A violations
punishable, upon conviction, by a fine of not more than Seven Hundred and twenty Dollars
($720) per violation.
8.6 Nuisance
In addition to the penalties provided in this planPlan, violations of any of the provisions of
this planPlan and ordinance is declared to be a nuisance and may be abated in the manner
provided by law.
9. Non -emergency Ambulance Transports.
Each Franchisee retains first right of refusal for non -emergency ambulance transports and inter -
facility ambulance transports. Each Franchisee is authorized to permit, by written agreement, non -
emergency and inter -facility ambulance transports of a stable patients originating within that
territory by a-nen-emorge-ney or inter fay «7+bulaneanother licensed ambulance service
providero. another- lieensea anib lance Dufatien-af-permis&ienSuch authorization
shall last no longer than the term of the €ranslri-seFranchise, or until the then current Franchisee
loses its Franchise or otherwise ceases operations. The dDefinition of "stable patient" is contained
in the definitions section of this ASA Plan.
Special Events: A Franchisee may grant permission to another licensed ambulance service agency
provider for the purpose of servicing special events or occasions. Permission shall be set forth in
writing and state the duration of the event or occasion and whether ambulance transport will be
allowed. The dDuration of such permission shall last no longer than the term of the F€ranchise, or
until the then current Franchisee loses its Franchise or otherwise ceases operations.
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, requests for change of assignment, and
revocation will be considered for approval if such action 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 -Plan
is intended to obviate that authority.
Future updates to this plan lan 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
providers records and initiate an assignment change or service area revocation. For the purpose of
this planPlan, the Board shall recognize the Committee as an advisory group.
Chapter 8.30 APPENDIX A (3/201 g3/2021)
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 plenPlan.
The Committee shall serve as the principal entity to administer and accept written proposals for
amendments to this ASA Plan. The een*rto Committee will have a designated administrator and
chairperson.
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.- The Committee shall
meet as needed.
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 periodically submit a brief written report of its activities or recommendations
to the Board.
The e€xistence of this committee Committee will:
2.1 prevent needless attention of state regulatory agencies to problems that can be
resolved locally;
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.
The complaint procedure can be viewed in Article V, section 8.2.
Ongoing inpat--Complaints, concerns, ideas, or suggestions may be provided by consumers,
providers or the medical community to any individual on the Committee or members of the Board.
This individua Members of the Committee or Board, in turn, will present the complaint, concern,
idea or suggestion in writing to the full Board for consideration.
4. Mutual Aid Agreements.
E., eFgeney -Wadi^* services All Franchisees within Deschutes County will participate in agencies
shall--sign-mutual aid agreements with other Franchisees and with the other- emergeney ~ ediG '
the Geunt , a with other providers in adjoining counties to respond with
needed personnel and equipment in accordance with the agreement.
Chapter 8.30 APPENDIX A (83/2021)
All requests for mutual aid shall be made through the appropriate PSAP.
All mutual aid agreements are 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 ceu*ty
County authorities or other local govermnent authorities within the County. The Area Trauma
Advisory Board (ATAB) Region 7 plan may be utilized in place of the plan outlined below.
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.
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 County Emergency Services Manager shall be responsible for locating and
coordinating all county EMS resources any time that the MCI Plan is implemented.
The County Emergency Services Manager 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 -Plan is to provide guidance to EMS response personnel in the
coordination of response activities relating to mass casualty incidents in Deschutes County.
The MCI plan -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 MCI Pplan 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 of the MCI plan -Plan and make
Chapter 8.30 APPENDIX A (5�20183/2021)
recommended changes to meet the e-es-Conn 's need. Following the review and changes, the
Director of Emergency Services will be asked to append the changes to the medical component of
the County Emergency Management Plan and the modified MCI planPlan will be promulgated.
6. Coordination.
6.1 In lieu of a unified command system, the highest-ranking officer of the fire or
police agency in whose jurisdiction the incident occurs shall be the. incident -
commander.
6.2 The senior/highest licensed emergency medical services provider at the scene will
have overall responsibility for patient care as the EMS Branch Officer, he/she shall
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 An appropriately trained EMS The senior emergeney sale* ^ e� provider err
two first EMS ����+ first to arrive at the scene shall become the EMS Branch officer
and shall:
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: check in with the Staging Officer.
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 within an
average of two (2) minutes of receipt of a medical call.
Chapter 8.30 APPENDIX A %5,L201-
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, MDT, or cell
phone -when any of the following occurs:
1. In-service;
2. En -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.
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 all dispatch logs and recordings required by the 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 equipment with
Hiulti ehanne' Fadies communication equipment in each ambulance that
allows for the transmission and reception with dispatch, medical resource
hospitals, and mutual aid resources -equipment.
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.
VII PROVIDER SELECTION
1. Reassignment of an ASA.
Chapter 8.30 APPENDIX A (3,120143/2021)
In the event that.a reassignment of an ASA is necessary, the eommittee-Committee shall make a
written recommendation to the Board. The committee shall develop appropriate criteria, utilizing
the selection process described in this pla* lan to be presented to the Board for consideration and/or
action by the Board.
2. Application Process for Applying for an ASA.
See Deschutes County Code 8.30 regarding the application process for applying for an ASA within
Deschutes Countv.
3. Notification of Vacating an ASA.
In the event that an ASA previde-rFranchisee wishes to vacate its ASAFranchise, the provider shall
provide at least sixty (60) days written notice to the Board. The ASA pre�Franchisee must
provide notification in accordance with the provisions of the initial service agreement or contract.
4. Maintenance of Level of Service.
In the event that an ASA r-ovkluFranchisee is unable to comply with the standards promulgated
for the ASA by this P-lanPlan, the provider will promptly 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.
VIII. Franchise Agreements.
Franchises shall be awarded for a minimum ten (10) year timeframe unless changed by the Board.
Only one franchisee may serve in an ASA area.
Mutual Aid Agreements will not be impacted by this process.
IX. 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 advisoryee Committee.
Chapter 8.30 APPENDIX A (5/20193/2021)
L\X E S COG
*` �a
-c Deschutes County Board of Commissioners
IMSOMWIF
1300 NW Wall St, Bend, OR 97703
(541) 388-6570 - Fax (541) 385-3202 - https://www.deschutes.org/
AGENDA REQUEST & STAFF REPORT
For Board of Commissioners BOCC Wednesday Meeting of March 24, 2021
DATE: March 11, 2021
FROM: Christopher Bell, Legal,
TITLE OF AGENDA ITEM:
SECOND READING: Ordinance No. 2021-003, Text Amendments to DCC 8.30 Ambulance
Service Area and to Deschutes County Ambulance Service Area Plan
BACKGROUND AND POLICY IMPLICATIONS:
The Deschutes County Ambulance Service Area ('ASA') Subcommittee is proposing changes
to Chapter 8.30 of the Deschutes County Code, including Appendix A to Chapter 8.30 (the
ASA Plan) to allow franchisees the latitude to use subcontractors in to provide certain
ambulance services with prior approval from the Board of County Commissioners. The
changes also include grammatical and spelling corrections, and some editing and re-
organizing to update the Code and the ASA Plan and to make them clearer and more easily
understandable. These changes have been reviewed and approved by Legal Counsel and
now come before the BOCC for consideration pursuant to DCC 1.01.012.
FISCAL IMPLICATIONS: None
ATTENDANCE: Chris Bell, Legal; Tom Kuhn, Health