HomeMy WebLinkAbout2008 DC ASA PlanDCC 8.30.100 – APPENDIX A
AMBULANCE SERVICE AREA PLAN
FOR
DESCHUTES COUNTY, OREGON
05/08 1
Table of Contents
I. Certification By Governing Body of
Deschutes County ASA Plan....................................................................................Page 4
II. Overview of Deschutes County.............................................................................................Page 5
III. Definitions ............................................................................................................................Page 6
IV. Boundaries
1. Ambulance Service Area 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 16
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 22
5. Disaster Response.................................................................................................Page 22
5.1 County Resources Other Than Ambulances..........................................Page 22
5.2 Out of County Resources ......................................................................Page 23
5.3 Mass Casualty Incident Plan.................................................................Page 23
6. Coordination.........................................................................................................Page 23
7. EMS Responder Guidelines .................................................................................Page 23
8. Personnel and Equipment Resources....................................................................Page 24
9. Emergency Communications and Systems Access
9.1 Telephone Access..................................................................................Page 24
9.2 Dispatch Procedures..............................................................................Page 24
9.3 Radio System.........................................................................................Page 25
10. Emergency Medical Services Dispatcher Training............................................Page 25
VII. Provider Selection
1. Reassignment of an ASA .....................................................................................Page 26
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2. Application Process for Applying for an ASA.....................................................Page 26
3. Notification of Vacating an ASA.........................................................................Page 26
4. Maintenance of Level of Service..........................................................................Page 26
VIII Franchise Agreement………………………………………………. Page 26
IX County Ordinances and Rules...............................................................................Page 26
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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 by this body.
2. In this governing body's judgment, the ambulance service areas established in the plan
provide for the efficient and effective provision of ambulance services.
3. To the extent they are applicable, the County has complied with ORS 682.205(2)(3) and
682.335 and existing local ordinances and rules.
DATED this 28th day of May 2008.
BOARD OF COUNTY COMMISSIONERS
OF DESCHUTES COUNTY, OREGON
____________________________________________
DENNIS R. LUKE, Chair
_____________________________________________
TAMMY (BANEY) MELTON, Vice Chair
ATTEST:
______________________________
Recording Secretary
____________________________________________
MICHAEL M. DALY, Commissioner
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II. OVERVIEW OF DESCHUTES COUNTY
Deschutes County is located in the geographic center of the state. The County covers
approximately 3200 square miles, extending east about 105 miles from the crest of the Cascade
Mountains to the Harney County line, and spreading 53 miles from north to south beginning at
the Jefferson County line and terminating at it southern border along Klamath and Lake Counties.
Population of the county as of July 1, 2006 was 152,615. The City of Bend, with a population of
77,780, and the City of Redmond with 23,500, 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
1,750, and the City of La Pine in the Southern portion of the county with a population of 1,585.
Health care industry, tourism, and small business provide the basis of the county's economy.
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III. DEFINITIONS
1. “Address and consider” has the meaning given these terms by ORS 682.205(2)(3).
2. “Ambulance: has the meaning given that term by ORS 682.025.
3. “Ambulance Service” has the meaning given that term by ORS 682.325.
4. “Ambulance Service Area (ASA)” means a geographic area which is served by one
ambulance service provider, and may include all or a portion of a county, or all or
portions of two or more contiguous counties.
5. “Ambulance Service Plan” means a written document, which outlines a process for
establishing a county emergency medical services system. A plan addresses the need for
and coordination of ambulance services by establishing ambulance service areas for the
entire county and by meeting the other requirements of these rules. Approval of a plan
will not depend upon whether it maintains an existing system of providers or changes the
system. For example, a plan may substitute franchising for an open-market system.
6. “ASA Advisory Committee (Committee)” means a committee formed to review
standards, make recommendations to or set new standards for the Board of County
Commissioners for all matters regarding EMS and review and make recommendations
regarding soundness of the ASA.
7. “ASA Administrator” is the person designated by the Board of Commissioners to
administer the ASA ordinance and plan.
8. “Clausen Priority Dispatch” is a system used by the PSAP to prioritize calls from least
severe to most severe. Omega, alpha, and bravo calls are usually considered non-
emergency calls. Charlie, Delta and Echo calls are always considered emergency calls.
9. “Communication System” means two-way radio communications between ambulances,
dispatchers, hospitals and other agencies as needed. A two-channel multi-frequency
capacity is minimally required.
10. “Deschutes County Board of Commissioners (Board)” means the elected officials that
has jurisdiction over the Deschutes County ASA Plan.
11. “Division” means the Oregon Health Division, Department of Human Resources.
12. “Effective Provision of Ambulance Services” means ambulance services provided in
compliance with the County Ambulance Service Plan provisions or boundaries,
coordination and system elements.
13. “Efficient Provision of Ambulance Services” means effective ambulance services
provided in compliance with the County Ambulance Service Plan provisions for provider
selection.
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14. “Emergency” means any non-hospital occurrence or situation involving illness, injury or
disability requiring immediate medical or psychiatric services, wherein delay in the
provision of such services is likely to aggravate the condition and endanger personal
health or safety.
15. “Emergency Medical Service (EMS)” means those pre-hospital functions and services
whose purpose is to prepare for and respond to medical emergencies, including rescue
and ambulance services, patient care, communications and evaluation.
16. “Emergency Medical Technician-Basic (EMT-Basic)” means a person certified by the
Division as defined in OAR 333-265-0000(8).
17. “Emergency Medical Technician-Intermediate (EMT-Intermediate)” means a person
certified by the Division as defined in OAR 333-265-0000(9).
18. “Emergency Medical Technician-Paramedic (EMT-Paramedic)” means a person certified
by the Division as defined in OAR 333-265-0000(10).
19. “First Responder” means a person certified by the Division as defined in ORS
682.025(11)(a)(b).
20. “Franchise” is the authorization granted to provide emergency ambulance service in a
specific geographic region.
21. "Health Officer" means the Deschutes County Health Officer.
22. "License" means those documents issued by the Division to the owner of an ambulance
service and ambulance, when the service and ambulance are found to be in compliance
with ORS 682.015 to 682.991 and OAR 333-250-0000 through 333-250-0100 and 333-
255-0000 through 333-255-0090.
23. "Notification Time" means the length of time between the initial receipt of the request for
emergency medical service by either a provider or a PSAP, and the notification of all
responding emergency medical service personnel.
24. "Owner" means the person having all the incidents of ownership in an ambulance service
or an ambulance vehicle or where the incidents of ownership are in different persons, the
person, other than a security interest holder or 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.
25. "Patient" means an ill, injured, or disabled person who may be transported in an
ambulance.
26. "Physician Advisor" has the meaning of a supervising physician as provided in ORS
682.235.
27. "Provider" means any public, private or volunteer entity providing EMS.
28. "Provider Selection Process" means the process established by the county for selecting an
ambulance service provider or providers.
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29. "Public Service Answering Point (PSAP)" means a 24 hour communications facility
established as an answering location for 9-1-1 calls originating within a given service
area.
30. "Quick Response Team (QRT)" means an agency that provides initial response and basic
life support care without transportation capabilities by certified First Responders.
31. "Response Time" means the length of time between the notification of each provider and
the arrival of each provider's emergency medical service unit(s) at the incident scene.
32. “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 ACLS
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.
33. "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.
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 easterly upon section lines approximately 10.4 miles to the SE
corner of section 18, T17S, R10E; thence northerly upon the section line to the NE corner of said
section 18; thence easterly upon section lines to the SE corner of section 9, T17S, R10E; thence
northerly upon section lines to the NW corner of section 3, T17S, R10E; thence easterly upon
section lines to the SE corner of section 36, T16S, R10E; thence northerly one mile to the NW
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corner of section 31, T16S, R1lE; thence easterly on the section line 0.5 miles to the southwestern
boundary of Deschutes County Tax Lot 1611000008100; thence east along the said Tax Lot
southern boundary approximately 0.2 miles where the said tax boundary turns in a northeastern
direction; thence following the said tax boundary line to the intersection of the said tax lot
boundary with the eastern boundary of Deschutes County Tax Lot 1611000001419; thence along
the eastern boundary of the said tax lot to the intersection of the said tax lot with Deschutes
County Tax Lot1611000001418; thence along the eastern boundary of said tax lot to the
intersection of Deschutes County Tax lot 1611000001401; thence along the eastern boundary of
said tax lot to the intersection of Deschutes County Tax lot 1611000007900; thence south along
the western boundary of said tax lot to the SW corner of the said tax lot; thence east along the
southern boundary of the said tax lot to the SE corner of the said tax lot; thence north to the NW
corner of Deschutes County Tax Lot 1611000005600; thence east to the SE corner Deschutes
County Tax lot 1611200000500; thence north to the NW corner of Deschutes County Tax Lot
1611000005600; thence east to the western section line of Section 21, T16S, R11E; thence north
along said section line to the NW corner of said section; thence east along the section line to the
SE corner of the SW ¼ of Section 16, T16S, R11E; thence north to the NE corner of SE ¼ of the
SW ¼ of said section; thence west to the NW corner of the SE ¼ of the SW ¼ of said section;
thence north to the NE corner of the SW ¼ of the NW ¼ of said section; thence west to the SW
corner of the NW ¼ of the NW ¼ of said section; thence north to the NW corner of said section;
thence east to the NE corner of said section; thence north along the section line to the intersection
with the centerline of US Highway 20; thence along the centerline of Highway 20 in a
southeastern direction to the SE corner of Section 10, T16S, R11E; thence north along the section
line to the NW corner of said section; thence east along the section line to the NE corner of
Section 11, T16S, R11E; thence northerly upon the section line to the NW corner of section 1,
T16S, R11E; thence easterly upon section lines approximately 2.25 miles to the NE corner of the
W ½ of the W ½ of section 5, T16S, R12E; thence southerly to the SE corner of the W ½ of the
W ½ 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 ½ of section 16, T16S, R12E; thence southerly to the SE corner of
the NW ¼ of said section 16; thence westerly to the SW corner of the E ½ of the NW ¼ of said
section 16; thence southerly to the SE corner of the W ½ of the W ½ of said section 16; thence
easterly upon section lines to the NE corner of section 24, T16S, R13E; 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 T21S and T22S, R16E; thence westerly upon the south lines of
Township 21S, 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
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
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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, R11E; thence north to the NE corner of Section 11, T19S, R11E;
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, 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, R8E; thence northerly
approximately 3.5 miles to the NE corner of the SE 1/4 of section 22, T18S, R8E; 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 3 square miles.
Boundaries: Entire Black Butte Ranch and a portion of Highway 20 from Indian Ford Road west
to the Camp Sherman turnoff.
ASA #3 – Burns
All of T22S, R22E 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.
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ASA #5 - La Pine
Size of ASA: Approximately 646 square miles. However, most of the ASA is comprised of the
Deschutes National Forest or in B.L.M. lands and are uninhabited.
BEGINNING at the intersection of the north line of section 2, T21S, R6E; thence easterly upon
the section lines to the NW corner of section 1, T21S, 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, 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, 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, R11E; 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, T21S, R13E; 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.
ASA #6 - Redmond
Size of ASA: Approximately 223 square miles.
Beginning at the common corner of Deschutes, Jefferson and Crook Counties; thence southerly
upon the Deschutes County/Crook County boundary line to the NE corner of section 24, T16S,
R13E; thence westerly upon section lines to the SE corner of the W ½ 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
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to the SW corner of said section 3; thence westerly upon Newcomb Road to the SE corner of the
W ½ of the W 1/2 of section 5, T16S, R12E; thence northerly to the NE corner of the W ½ 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, R11E; thence west to the SW
corner of section 22, T15S, R11E; 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 326 square miles.
BEGINNING at the intersection of the south line of section 16, T17S, R8E, with the westerly
line of Deschutes County; thence easterly upon section lines approximately 10.4 miles to the SE
corner of section 18, T17S, R10E; thence northerly upon the section line to the NE corner of said
section 18; thence easterly upon section lines to the SE corner of section 9, T17S, R10E; thence
northerly upon section lines to the NW corner of section 3, T17S, R10E; thence easterly upon
section lines to the SE corner of section 36, T16S, R10E; thence northerly one mile to the NW
corner of section 31, T16S, R1lE; thence easterly on the section line 0.5 miles to the southwestern
boundary of Deschutes County Tax Lot 1611000008100; thence east along the said Tax Lot
southern boundary approximately 0.2 miles where the said tax boundary turns in a northeastern
direction; thence following the said tax boundary line to the intersection of the said tax lot
boundary with the eastern boundary of Deschutes County Tax Lot 1611000001419; thence along
the eastern boundary of the said tax lot to the intersection of the said tax lot with Deschutes
County Tax Lot1611000001418; thence along the eastern boundary of said tax lot to the
intersection of Deschutes County Tax lot 1611000001401; thence along the eastern boundary of
said tax lot to the intersection of Deschutes County Tax lot 1611000007900; thence south along
the western boundary of said tax lot to the SW corner of the said tax lot; thence east along the
southern boundary of the said tax lot to the SE corner of the said tax lot; thence north to the NW
corner of Deschutes County Tax Lot 1611000005600; thence east to the SE corner Deschutes
County Tax lot 1611200000500; thence north to the NW corner of Deschutes County Tax Lot
1611000005600; thence east to the western section line of Section 21, T16S, R11E; thence north
along said section line to the NW corner of said section; thence east along the section line to the
SE corner of the SW ¼ of Section 16, T16S, R11E; thence north to the NE corner of SE ¼ of the
SW ¼ of said section; thence west to the NW corner of the SE ¼ of the SW ¼ of said section;
thence north to the NE corner of the SW ¼ of the NW ¼ of said section; thence west to the SW
corner of the NW ¼ of the NW ¼ of said section; thence north to the NW corner of said section;
thence east to the NE corner of said section; thence north along the section line to the intersection
with the centerline of US Highway 20; thence along the centerline of Highway 20 in a
southeastern direction to the SE corner of Section 10, T16S, R11E; thence north along the section
line to the NW corner of said section; thence east along the section line to the NE corner of
Section 11, T16S, R11E; thence northerly upon the section line to the NW corner of section 1,
T16S, R11E; thence easterly upon the section lines to the SW corner of Section 36, T15S, R11E; ;
thence north to the NW corner of section 25, T15S, R11E; thence west to the SW corner of
section 22, T15S, R11E; 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 intersection of the Deschutes County/Jefferson County/Linn County
intersection; thence southerly upon the Deschutes County/Linn County line to the Deschutes
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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 and that
portion of U.S. Highway 20 from Indian Ford Road to the Camp Sherman turnoff.
ASA #8 - Sunriver
Size of ASA: Approximately 150 square miles.
BEGINNING at the intersection of the north line of section 2, T21S, R6E; thence easterly upon
the section lines to the NW corner of section 1, T21S, 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, 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, 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, R11E; 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 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, R11E; thence north to the
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NE corner of Section 11, T19S, R11E; 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, 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, R8E; thence northerly approximately 3.5 miles to the NE corner of the SE 1/4 of section
22, T18S, R8E; thence westerly to the Deschutes County/Lane County boundary line;
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2. Maps.
2.1 ASA Map. (See Appendix #1)
This map represents the boundaries of each of the ambulance service areas within
Deschutes County and the "System Response Time," which includes notification, role
out, and provider response times. Actual response time is subject to the variables of
access, weather, road and traffic conditions as well as other circumstances that can
impact response time.
3. Alternatives To Reduce Response Times.
Heavily forested, mountainous terrain and severe winter weather conditions present difficult
access and long response time to ground ambulances. In those situations, when an urgent
response is indicated, the PSAP may elect to call the nearest appropriate rotary-wing air
ambulance or the Deschutes County Search and Rescue.
In addition, a tiered response system is used to provide the best available patient care while
maximizing the available resources. In some instances, for various reasons, an ambulance service
provider from an adjoining county's ASA could respond quicker to an incident.
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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 of their 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, prehospital care providers,
hospitals, or county EMS administration.
1.2 Types of information received are written or verbal complaints, patient care
report forms, radio transmission tapes, notification and response time incident
cards, trauma registry forms, etc.
2. Level of Care.
An ambulance operating in Deschutes County and providing basic life support level care must
consist of a qualified driver and one certified EMT-Basic or above. The EMT must always be
with the patient in the patient compartment of the ambulance.
An ambulance operating in Deschutes County and providing intermediate life support level care
must consist of a qualified driver and one certified EMT-Intermediate. The EMT-Intermediate
must always be with the patient in the patient compartment of the ambulance intermediate level
care is required or rendered.
An ambulance operating in Deschutes County and providing advanced life support level care
must consist of a qualified driver and an EMT-Paramedic. If the driver is not a certified EMT,
then a second EMT, Basic or above, must be available for patient care both in the ambulance and
on scene. The EMT-Paramedic must always be with the patient in the patient compartment of the
ambulance when ALS care is required or being rendered.
3. Personnel.
When operating an ambulance in Deschutes County, all personnel must meet the requirements of
ORS 682.015 to 682.991 and OAR 333-255-0070(1), (4) or (6). The practice of staffing an
ambulance on a part-time basis with EMTs certified to a higher level of care than is possible at
other times does not construe a requirement that the ambulance provide the same level of care on
a regular basis.
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4. Medical Supervision.
Each EMS agency utilizing EMTs shall be supervised by a physician licensed under ORS 677,
actively registered and in good standing with the Oregon Board of Medical Examiners as a
Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO). The physician must also be
approved by the Oregon Board of Medical Examiners as a medical director.
Each EMS agency or ambulance service may have its own medical director. The medical director
shall:
4.1 comply with the requirements listed in OAR 847-35-0025;
4.2 hold at least one meeting a year with the EMTs affiliated with the respective
ambulance services;
4.3 designate an EMT coordinator who shall conduct case reviews in the physicians
absence and send summaries of the reviews and problems identified and
proposed problem resolution to the physician; and
4.4 provide or authorize at least one case review meeting for all EMTs quarterly.
St. Charles Medical Center in Bend and Redmond, Oregon shall be the Medical Resource
Hospitals.
5. Patient Care Equipment.
Patient care equipment must meet or exceed the Oregon Health Division's requirements as
specified in ORS 682.015 to 682.991 and OAR 333-255-0070(2), (3), (5) or (7). The ambulance
service provider shall maintain a list of equipment for their ambulances, which shall be furnished
to the Board upon their request.
6. Vehicles.
All ambulances must be either a Type I, II, or III and be licensed by the Oregon Health Division.
All ambulances must meet or exceed the requirements as set forth in ORS 682.015 to 682.991 and
OAR 333-255-0060. An up-to-date list of each provider's ambulances shall be furnished to the
Board upon their request.
7. Training.
Training will be consistent with requirements of the Oregon State Health Division and
Department of Transportation curriculum and shall be received through accredited institutions.
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8. Quality Assurance.
In order to ensure the delivery of efficient and effective pre-hospital emergency medical care, an
EMS Quality Assurance Program is hereby established.
8.1 Structure
"Deschutes County Ambulance Service Area Advisory Committee (Committee)", shall
be formed by ordinance and be composed of ten members:
a. Ambulance service medical director who must be a Emergency
department physician
b. Deschutes County Health Department
c. Ambulance service provider representative from each ASA area
d. Sheriff’s Office representation
e. 9-1-1 center representative
f. EMT-Basic
g. EMT-Intermediate
h. EMT-Paramedic
i. Public member
Members of the Committee shall be appointed by the Deschutes County Board of
Commissioners for a two-year term. The initial committee will have staggered terms,
ranging from one to three years. In the event of a tie on decisions of the ASA, the ASA
Administrator shall become a voting member in order to break the tie.
The principal function of the committee shall be to monitor the EMS system within
Deschutes County.
8.2 Process
The Board, in order to ensure the delivery of the most efficient and effective prehospital
emergency care possible with the available resources, has directed that the ASA Advisory
Committee be established.
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Quality assurance in Deschutes County shall be accomplished through frequent case
review, peer review, and periodic review by the medical directors and/or ambulance
governing bodies (see respective Provider Profiles for definitions of governing bodies).
Complaints regarding violation of this ASA Plan, shall be submitted in writing to the
Board who shall forward it to the Committee. The Committee shall then review the
matter and make recommendations or changes on such complaints or questions to the
Board. The Board shall also resolve any problems involving system operations
(changing protocols to address recurring problems, etc.). Ongoing input may be provided
by consumers, providers or the medical community to any individual on the Board or
members of the Committee. This individual, in turn, will present the complaint, concern,
idea or suggestion (in writing) to the full Board for consideration. Questions or concerns
involving prehospital care provided shall be directed to the Physician Advisor of the
Ambulance provider. If the situation warrants, 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 directly to the
Professional Standars Division of the Oregon Emergency Medical Services and Trauma
Systems.
8.3 Problem Resolution
Problems involving protocol deviation by EMTs or dispatchers shall be referred to the
respective medical director or dispatch supervisor. Problems involving a non-compliant
provider shall be reviewed by the Committee with possible referral to Board if necessary.
The Board may seek background data and recommendations from the Committee in such
instances. However, any member of the Committee who may have a conflict of interest
in the matter shall declare such conflict and refrain from participating in any
recommendations made.
8.4 Sanctions for Non-Compliant Personnel or Providers
Suspension or revocation assignment. Upon a recommendation by the Committee, or
upon its own motion, the Board may suspend or revoke the assignment of an ASA upon a
finding that the provider has:
a. willfully violated provisions of an ordinance, the
Deschutes County ASA Plan or provisions of State or Federal laws and
regulations; or
b. materially misrepresented facts or information given in
the application for assignment of an ASA or as part of the review of the
performance of the service furnished by the provider.
In lieu of the suspension or revocation of the assignment of an ASA, the Board may order
that the violation be corrected and make the suspension or revocation contingent upon
compliance with the order, within the period of time stated. Notice of the Board's action
shall be provided to the holder of the assignment, which shall specify the violation, the
action necessary to correct the violation and the date by which the action must be taken.
If the holder of the assignment fails to take corrective action within the time required, the
Board shall notify the holder that the assignment is suspended or revoked upon receipt of
the notice.
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A person receiving a notice of the assignment, denial, suspension, revocation or
contingent suspension or revocation of an ASA may request a hearing before the Board
by filing with the Board a written request for a hearing within fourteen (14) days of the
decision, setting forth the reasons for the hearing and the issues proposed to b reviewed.
The filing of a hearing request shall stay the action, pending the hearing and final
determination of the decision, unless a change is required due to an immediate hazard to
the public safety. The Board shall set a time and place for the hearing. Within fourteen
(14) days after the conclusion of the hearing, the Board shall affirm, reverse or modify its
original decision.
8.5 Penalties
Any person who violates any provisions of this ASA Plan or Ordinance is guilty of a
violation. Failure from day-to-day to comply with the terms of this ASA Plan or
Ordinance shall be a separate offense for each such day. Failure to comply with any
provision of the Ordinance shall be a separate offense for each such provision.
Violations of the provisions of this ASA Plan or Ordinance are punishable, upon
conviction, by a fine of not more than Five Hundred Dollars ($500) per day per violation.
8.6 Nuisance
In addition to the penalties provided in this plan, violations of any of the provisions of
this plan and ordinance is declared to be a nuisance and may be regarded as such in all
actions, suits, or proceedings.
9. Nonemergency Transports.
Nonemergency prearranged transports for stable patients may be provided by any licensed
ambulance service. Prearranged transports may be arranged through Deschutes County Dispatch.
Definition of “stable patient” is contained in the definitions section of this ASA Plan.
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VI. COORDINATION
1. Authority For Ambulance Service Area Assignments.
The Board has the authority to assign an ASA within Deschutes County in compliance with ORS
682.015 to 682.991. Applications by new providers and requests for assignment change or
revocation will be considered for approval if they will improve efficient service delivery and
benefit public health, safety and welfare. Cities have the authority to develop and apply
ambulance-licensing ordinances within their jurisdictional boundaries, and nothing in this plan is
intended to obviate that authority.
Future updates to this plan and proposals for assignment changes will be the responsibility of the
Board. The Board shall receive all requests for changes, present those requests to the Committee
for their review and recommendations. Upon completing their review, the Committee shall
present their recommendations to the Board. In addition, the Board has the authority to review
service providers records and initiate an assignment change or service area revocation. For the
purpose of this plan, the Board shall recognize the Committee as an advisory group.
The Deschutes County ASA Plan was prepared with a great deal of input from all county pre-
hospital care providers. The Plan requires that the ambulance services providers maintain service
records in order that the County can carry out its ASA Plan responsibilities.
2. Entity That Will Administer the ASA Plan.
The Deschutes County ASA Committee is hereby established with the adoption of this plan. The
Committee shall serve as the principal entity to administer and accept written proposals for
amendments to this ASA Plan. The committee will 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 no less than once per calendar year.
This Committee, as with any governmental body, will be subject to the Oregon Open Meeting
Law (ORS Chapter 192), but may temper its activities, within legal limits, according to the
sensitivity of the EMS matter involved. Appeals from the Board, in any case where the Board
would otherwise have the final decision at the county level shall be directed to the appropriate
state regulatory agency, or a Circuit Court, as appropriate.
The Committee shall submit a brief written report of its activities or recommendations
periodically to the Board.
Existence of this committee will:
2.1 prevent needless attention of state regulatory agencies to problems that can be
resolved locally;
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.
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3. Complaint Review Process.
The complaint procedure can be viewed in section 8.2.
Ongoing input may be provided by consumers, providers or the medical community to any
individual on the Committee or members of the Board. This individual, in turn, will present the
complaint, concern, idea or suggestion in writing to the full Board for consideration.
4. Mutual Aid Agreements. (See Appendix #4)
Each ambulance service provider shall sign a mutual aid agreement with the other providers in
the County and with other providers in adjoining counties to respond with needed personnel and
equipment in accordance with the agreement.
All requests for mutual aid shall be made through the appropriate PSAP.
All mutual aid agreements will be reviewed annually and modified as needed by mutual consent
of all parties.
5. Disaster Response.
The Committee shall coordinate the EMS medical function of disaster planning with any formal
disaster management plan developed by the Deschutes County Sheriff or other appropriate county
authorities.
As an interim goal, until an Emergency Services Plan is implemented, ambulance provider
personnel faced with a multiple-casualty incident shall examine the situation in terms of its
potential or actual magnitude of disaster, and request any appropriate additional resources that
may be available.
5.1 County Resources Other Than Ambulances
When resources other than ambulances are required for the provision of emergency
medical services during a disaster, a request for additional resources shall be made
through the appropriate PSAP to the County Emergency Services Office.
The Director of the County Emergency Services Office shall be responsible for locating
and coordinating all county EMS resources any time that the MCI Plan is implemented.
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The Director of the County Emergency Services Office shall work directly with local
agencies, departments and governments to coordinate necessary resources during any
implementation of the MCI Plan.
5.2 Out of County Resources
When resources from outside Deschutes County are required for the provision of
emergency medical services during a disaster, a request for those resources shall be made
through the appropriate PSAP.
5.3 Mass Casualty Incident (MCI) Management Plan
The purpose of the MCI plan is to provide guidance to EMS response personnel in the
coordination of response activities relating to mass casualty incidents in Deschutes
County.
The plan is intended for use when any single incident or combination of incidents
depletes the resources of any single provider or providers during the normal course of
daily operations or at the request of the Health Officer.
The plan shall identify the responsibility of the provider concerning:
a. coordination;
b. communication;
c. move up;
d. triage; and
e. transportation.
The Committee will periodically review the medical component MCI plan and make
recommended changes to meet the county's need. Following the review and changes, the
Director of Emergency Services will be ask to append the changes to the medical
component of the County Emergency Management Plan and the modified MCI plan 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 certified EMT 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 The senior EMT on the first EMS unit to arrive at the scene shall become the
EMS Branch officer and shall:
05/08 23
a. assess nature and severity of the incident;
b. advise appropriate PSAP of the situation;
c. request appropriate fire and police services, if not already at the scene;
d. request initiation of EMS mutual aid if needed;
e. alert area hospital(s) of the situation; and
f. establish and organize the transportation of all injured or ill patients.
7.2 Additional EMS units arriving at the scene shall:
a. check-in with 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 two
(2) minutes of receipt of a medical call.
b. The dispatcher will obtain from the caller, and relay to the first
responders the following:
1. Location of the incident;
2. Nature of the incident; and
3. Any specific instructions or information that may be pertinent to
the incident.
c. EMS personnel shall inform the dispatch center by radio when any of the
following occurs:
1. In-service;
2. In-route to scene or destination and type or response;
3. Arrival on scene or destination;
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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
multi-channel radios in each ambulance that allows for the transmission
and reception with dispatch, medical resource hospitals, and mutual aid
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.
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VII. PROVIDER SELECTION
1. Reassignment of an ASA.
In the event that a reassignment of an ASA is necessary, the committee shall make a written
recommendation to the Board. The committee shall develop appropriate criteria, utilizing the
selection process described in this plan to be presented to the Board for consideration and/or
action by the Board.
2. Application Process for Applying for an ASA.
See Deschutes County Code 8.30 regarding application process for applying for an ASA.
3. Notification of Vacating an ASA.
In the event that an ASA provider wishes to vacate its ASA, the provider shall provide at least
sixty (60) days written notice to the Board. The ASA provider must provide notification in
accordance with the provisions of the initial service agreement or contract.
4. Maintenance of Level of Service.
In the event that an ASA provider is unable to comply with the standards promulgated for the
ASA by this Plan, the provider will 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 5 year timeframe unless changed by the BOCC and
or the committee. Only the franchisee may serve in their ASA area. Effective 2013 there will be a
nominal application fee of $30 required to help cover basic administrative expenses.
Special Events: The Franchisee may give permission to another ambulance service agency for the
purpose of serving/responding to special events or occasions. Permission shall be granted in
writing and state the duration of the event or occasion.
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 advisory committee.
05/08 26