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Memo
1 I
From: Thomas Kuhn, Community Health Manager, Health Services
I Sent: Tuesday, October 09, 2012
To: Erik Kropp
Cc: Scott Johnson
Subject: October 31,2012 BOCC Work Session Agenda Request
I would like to request to be placed on the agenda for the October 31,2012, 1:30pm to 4:00pm BOCC
Work Session Agenda. The purpose of our request is to ask the Commissioners to approve and adopt
language changes to Ambulance Service Area (ASA) Plan and Ordinance Chapter 8.30.
Participants for the agenda item include: Doug Kelly, EMS Chief, Redmond Fire & Rescue and ASA
Committee Chair; Tim Moor, Fire Chief, Redmond Fire & Rescue; and myself.
I I have forwarded our documentation we asking the board to approve. Please let me know if you have
additional questions. I am not sure how long this may take, but I imagine it could be completed in under
an hour. The following is some background on the work that is being done with the ASA and Ordinance
Chapter 8.30:
Background:
Deschutes County Emergency Medical Services, through the Ambulance Service Area (ASA) Committee,
has updated language and titles recently adopted by the Oregon Medical Board and Oregon Health
Authority that are contained within the current ASA Plan and Ordinance. The ASA Committee has also
approved changes in the regulation of non-emergency ambulance transports found within the ASA Plan
and Ordinance.
The proposed language for the Board to consider helps stabilize funding/staffing levels for Deschutes
County Fire Departments and allows each franchise to regulate non-emergency ambulance transports
within their jurisdiction. This Policy change is recommended to the Board for adoption to help ensure
the availability of our resources to better respond to call the volume. Although this policy change does
not have a direct affect on emergency 911 responses, a lack of action may impact our emergency
medical services ability to respond to calls.
Chapter 8.30. AMBULANCE SERVICE AREA
8.30.010. Title.
8.30.020. Purpose.
8.30.030. Definitions.
8.30.035. Ambulance Service Area (ASA) Advisory Committee-Established.
8.30.040. Administration.
8.30.045. Service Providers Regulated.
8.30.050. Franchise-Application.
8.30.055. Franchise-Review of Application.
8.30.060. Franchise-Terms and Renewals.
8.30.065. Franchise-Discontinuance of Service; Transfer.
8.30.070. Enforcement.
8.30.075. Interruption of Service-Prevention.
8.30.080. Appeals, Abatement and Penalties.
8.30.085 Franchise Duties.
8.30.090. 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 Area.
(Ord. 98-064 §l, 1998)
8.30.020. Purpose.
A. The purpose ofDCC 8.30 is to establish ambulance services areas, assign emergency ambulance service
providers, create an ambulance service area advisory committee, provide penalties and prescribe
effective dates.
B. For the efficient and effective provision of emergency ambulance services in accordance with the
Ambulance Service Area (ASA) Plan, the ambulance service areas shown on the map known as
Appendix #1 of the ASA Plan is hereby adopted as the ASA for Deschutes County. The Board, after
notice to the affected ASA provider and by the adoption of an order, may adjust the boundaries of an
ASA from time to time as necessary to provide efficient and effective emergency ambulance services.
(Ord. 98-064 §I, 1998)
8.30.030. Definitions.
Unless otherwise apparent from the context, certain words and phrases used in DCC 8.30 are defmed as set
forth in the Ambulance Service Area Plan for Deschutes County, Oregon, Appendix A to this Chapter.
(Ord. 2003-023 §1, 2003; Ord. 98-064 §I, 1998)
8.30.035. Ambulance Service Area (ASA) Advisory Committee-Established.
A. A committee to be known as the Ambulance Service Area Advisory Committee (committee) is hereby
established.
1. The committee shall consist of.w not less than twelve and no more than fourteen members from
the followinl! : one meml3er from eaea of tee fullowiag:
a. Emergency department physician.
b. Deschutes County Health Department representative .
Chapter 8.30 (06/2003)
c. Ambulance service provider representative from each ASA .
d. Sheriffs Offiee feflfeseBtath~. Deschutes County Emergency Manager
e. 9-1-1 center representative.
f. BMT Hosie .
g. EMT mtermeaiate.
B. EMT Paramedie .
i. Citizen member.
2. The Board shall designate a County staff member as the ASA Administrator. The Administrator
and other County staff as the Board deems appropriate shall be ex-officio members of the
committee.
B. Members shall be appointed by and serve at the pleasure of the Board. The Board may appoint
additional persons to the committee to serve as ex-officio members or advisors. The Board may approve
designation of alternates to serve in the absence of persons appointed to the committee.
C. Except for the ASA Administrator and any other County staff, appointments shall be for staggered
terms on the initial committee for a term not to exceed three years. Subsequent appointments shall be
for two-year terms. Members shall serve until their successors are appointed and qualified. Vacancies
shall be filled by the Board for the balance of the unexpired term. Persons may be appointed to
successive terms.
D. The committee shall elect a chairperson. The committee shall meet at such times it deems necessary or
as called by the Administrator or the Board. The chairperson or any two members of the committee may
call a special meeting with five days notice to other members of the committee. However, members
may waive such notice.
E. Five eemmit:tee memeers eeBstitute a A quorum constitutes one-balf of the committee members
plus one for the transaction of business. A majority vote of those present and voting is required to pass
motions.
F. In addition to other duties prescribed by DCC 8.30, the committee shall:
1. Review and make recommendations to the Administrator regarding the selection criteria for
determining a franchise to provide ambulance service.
2. Regularly provide information to the Board from pre-hospital care consumers, providers and the
medical community.
3. Periodically review the ASA Plan and make recommendations to the Board in regard to:
a. Standards established in the plan and improvements of or new standards as required by OAR
333-260-0 ~0 througb 333-260-0070 ;
b. Coordination between emergency medical service resources;
c. Dispatch procedures and compliance; and
d. Effectiveness and efficiency of the ASA boundaries.
4. Implement the quality assurance program outlined in the ASA Plan to insure compliance with the
ASAPlan.
5. 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
committee member having a direct or indirect fmancial pecuniary interest in any matter before the
committee for consideration shall withdraw from participation in any action by the committee in said
matter. Nothing in DCC 8.30.035 shall limit the ability of any person to provide testimony before the
committee.
((Ord. 2003-023 §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 committee, shall be
responsible for the administration of the ASA Plan. In order to carry out the duties imposed by the ASA
Chapter 8.30 2 (0612003)
Plan, the Administrator, or persons authorized by the Administrator, are authorized to enter on the premises
of any person regulated by the ASA Plan at reasonable times and in a reasonable manner to detennine
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. 98-064 § 1, 1998)
8.30.045. Service Providers Regulated.
A. Effective May 14, 1997, no person shall provide emergency ambulance services within Deschutes
County unless such person is franchised in accordance with DCC 8.30. The franchisee mav
subcontract non-emergency or inter-facility ambulance transpOrts as defmed in the ASA Plan.
B. If there is more than one application made for an ASA, the provider that meets the application
requirements of DCC 8.30.050 and that was providing service on the effective date of this Ordinance
shall be franchised to provide emergency ambulance service for the ASA.
(Ord. 98-064 §1, 1998)
8.30.050. Franchise-Application.
A. Any person desiring to provide ambulance service within Deschutes County shall submit an application
to be assigned an ASA within 30 days of the effective date of this ordinance. 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 insure compliance
with DCC 8.30 or to make a more informed decision.
C. The applicant shall provide the following information:
1. The name and address of the person or agency applying .
2. The ASA the person desires to serve, the location(s) from which ambulance services will be
provided, and the level of service to be provided.
3. A statement as to whether or not the 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 Division Authority .
5. A statement that all equipment and supplies in each ambulance conforms to Health Di'f'H;iofl
Authority standards.
6. A list of personnel to be used in providing emergency ambulance service and their current
Emergency Medical TeehBieian Services Provider level and eertifieate license number, or other
appropriate certification.
7. Proof of fmancial ability to operate, including an operating budget for public bodies or flllancial
statement for private entities, references, and statement of past ambulance service. Private
companies must include a profit and loss statement in addition to the above materials. Other
appropriate fmancial 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 $100,000.00 because of bodily
injury to or death of one person in anyone accident; subject to that limit for one person,
$300,000.00 because of bodily injury to or death of two or more persons in anyone accident;
$20,000.00 because of injury to or destruction of the property of others in anyone accident; and
$500,000.00 because of injury arising from the negligent provision of pre-hospital care to any
individual. Applicants may be self-insured.
Chapter 8.30 3 (0612003)
9. A statement of experience in providing emergency ambulance service of a comparable quality and
quantity to insure 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 include an assessment of how the
proposed change will impact the existing flrst response system.
b. Evidence that the call volume in the ASA is sufflcient to fmancially 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
ofDeschutes County in administering the ASA Plan.
E. Franchise applications shall be reviewed by the ASA committee, who will make a recommendation of
assignment of the ASAs to the Board. The assignment of an ASA shall be made by an order of the
Board.
(Ord. 98-064 §l, 1998)
8.30.055. Franchise-Review of Application.
A. Applications shall be reviewed by the committee, 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 for providing emergency ambulance service to
an ASA of any applications by another person to take over that franchise.
C. Unless the time is extended by the Board for good cause, the committee shall make its recommendation
to the Board to grant, deny, modifY, or attach appropriate conditions to the application. The committee
shall transmit its recommendation within 60 days after the application.
D. Upon receipt of the committee's recommendation, the Board:
1. Shall publish notice of its intent to hold a public hearing on the application and recommendations at
least 10 days, but not later than 30 days following publication of notice.
2. May require additional investigation by the committee if it fmds that there is insufficient
information on which to base its action.
3. Shall, upon the basis ofthe application, the committee'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.
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 fmds there is an immediate and serious danger to the public or a health hazard
or public nuisance would be created by a delay.
S. After the Board makes an order granting an emergency ambulance service franchise with or without
conditions, and the franchise fmds he/she is unable to provide a particular service, the Board may
permit the franchise to subcontract such service to another person if the Board flnds that the quality
and extent of the service would not be jeopardized. The Board may require the filing of such
information, as it deems necessary.
Chapter 8.30 4 (06/2003)
(Ord. 98-064 §1, 1998)
8.30.060. Franchise-Terms and Renewals.
A. The initial ambulance service franchise in an ASA shall be valid from the date of issuance until June 30,
2000.
B. Thereafter, the term of an emergency ambulance service franchise shall be five years beginning on July
1 and ending June 30 five years later.
C. Unless grounds exist for refusal to renew a franchise under provisions for suspension or revocation as
set forth in DCC 8.30, or unless the franchise is to be given to a new person, franchises shall be
renewable. Application for renewal shall be made on forms provided by the Board.
D. Not more than 180 days and not less than 120 days prior to the expiration of the franchise, a franchisee
wanting to renew the franchise and any person desiring to take over the franchise shall submit an
application to the Administrator.
E. Review of all applications for renewal or take over ofa franchise shall be conducted in the same manner
as provided for in DCC 8.30.
«Ord. 2003-023 §3, 2003; Ord. 98-064 §1, 1998)
8.30.065. Franchise-Discontinuance of Service; Transfer.
A. If a franchise discontinues service before the expiration date of hislher franchise, the Board shall set a
time by which applications must be submitted for a new franchise in the ASA
B. The committee shall develop an interim plan for coverage of the ASA, using existing franchisees and/or
other available resources until the ASA can be reassigned.
C. The Board shall issue a temporary certificate, valid for a stated period not to exceed six 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 franchise 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. 98-064 §1, 1998)
8.30.070. 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 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
8.30.070.
B. If in the judgment of the committee or Board, there is sufficient evidence to constitute a violation of
applicable local, state or federal law, 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 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
Chapter 8.30 5 (0612003)
days prior to such hearing. The burden of proof at the hearing shall be upon the Administrator to show
by 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. 98-064 §1, 1998)
8.30.075. Interruption of Service-Prevention.
Whenever the Board fmds 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. 98-064 §1, 1998)
8.30.080. 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, only 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 fme 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 fme of not more than $500.00 per day up to a maximum of
$1,000.00 as provided by law.
(Ord. 98-064 §l, 1998)
8.30.085. 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 Ordinance 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. 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 6 (0612003)
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.
D. 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.
E. DCC 8.30.085(A)(4) shall 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 nec 8.30.
(Ord. 98-064 § 1, 1998)
8.30.090. Exemptions.
A. Nothing in nec 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 confmes 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. 98-064 §1, 1998)
Chapter 8.30 7 (0612003)
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 1
AMBULANCE SERVICE AREA PLAN
FOR
DESCHUTES COUNTY, OREGON
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 2
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
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 3
VII. Provider Selection
1. Reassignment of an ASA ..................................................................................... Page 26
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
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 4
I. CERTIFICATION OF DESCHUTES COUNTY AMBULANCE SERVICE AREA
PLAN
The undersigned certify pursuant to Oregon Administrative Rule 333-260-0030 (2)(a)(b)(c) that:
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) 062
and 682.335 066 and existing local ordinances and rules.
DATED this 28XXth day of May XXX 200812.
BOARD OF COUNTY COMMISSIONERS
OF DESCHUTES COUNTY, OREGON
____________________________________________
DENNIS R. LUKE Anthony DeBone, Chair
_____________________________________________
TAMMY (BANEY) MELTON Alan Unger, Vice
Chair
ATTEST:
______________________________
Recording Secretary
____________________________________________
MICHAEL M. DALY Tammy Baney, Commissioner
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 5
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 July 1, 2006 2010 was 152,615 157,733. The City of
Bend, with a population of 77,780 76,639, and the City of Redmond with 23,500 26,215, 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 2,038, and the City of La Pine in the Southern
portion of the county with a population of 1,585 1,653. Health care industry, tourism, and small
business provide the basis of the county's economy.
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 6
III. DEFINITIONS
1. “Address and consider” has the meaning given these terms by ORS 682.205(2)(3)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 682.3025(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.
9. “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.
10. “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.
11. “Deschutes County Board of Commissioners (Board)” means the elected officials
governing body that has jurisdiction over the Deschutes County ASA Plan.
12. “Division” means the Oregon Health Division Authority, Department of Human
Resources 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
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 7
selection.
“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 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 prehospital emergency care.
However, “emergency care” does not include acts of medical diagnosis or
prescription of therapeutic or corrective measures. ORS682.025(3)
16. Emergency Medical Responder (EMR) means a person licensed by the Division as
defined in OAR 333-265-0000(14).
“Emergency Medical Service (EMS)” means those pre-hospital functions and services
whose purpose is to prepare for and respond to medical emergencies, including rescue
and ambulance services, patient care, communications and evaluation.
17. “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 nontransporting service. OAR 333-265-0000(15)
18. “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)
19. “Emergency Medical Technician-Basic (EMT-Basic)” means a person certified licensed
by the Division ands defined in OAR 333-265-0000(8 17, 18).
20. “Emergency Medical Technician-Intermediate (EMT-Intermediate)” means a person
certified licensed by the Division ands defined in OAR 333-265-0000(9 19).
21. “Emergency Medical Technician-Paramedic (EMT-Paramedic)” means a person certified
licensed by the Division ands defined in OAR 333-265-0000(10 20, 27).
“First Responder” means a person certified by the Division as defined in ORS
682.025(11)(a)(b).
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 8
22. “Health care facility” means a hospital, a long term care facility, an ambulatory
surgical center, a freestanding birthing center, or an outpatient renal dialysis center.
“Health care facility” does not mean: an establishment furnishing rediential care or
treatment not meeting federal intermediate care standards, not following a
primarily medical model of treatment, prohibited under the rules of the Department
of Human Services or the Department of Corrections; or an establishment
furnishing primarily domiciliary care. ORS 442.015(10)(a-b)
23. “Franchise” is means the authorization granted by the Board to provide exclusive
emergency ambulance services in a specific geographic region within Deschutes
County.
24. "Health Officer" means the Deschutes County Health Officer.
25. "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 010to 682.991 and OAR 333-250-0000 through 333-250-0070 0100
and 333-255-0000 through 333-255-00902.
26. “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 prehospital care. ORS 682.025(8)
27. "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.
28. "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. "Patient" means an ill, injured, or disabled person who may be transported in an
ambulance.
30. "Physician Advisor" has the meaning of a supervising physician as provided in ORS
682.235.
31. "Provider" means any public, private or volunteer entity providing EMS.
32. "Provider Selection Process" means the process established by the county for selecting an
ambulance service provider or providers.
Formatted: Font: Bold, Underline, Font color:
Red
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 9
33. "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.
34. "Quick Response Team (QRT)" means an agency that provides initial response and basic
life support care without transportation capabilities by certified licensed First Responders
emergency medical service providers.
35. "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.
36. “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.
37. “Supervising Physician” has the meaning of a supervising physician as provided in
ORS 682.025(14).
38. "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) LaPine; (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.
Formatted: Indent: Left: 1.19"
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 10
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 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
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 11
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 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. 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 ½ of said Section 22; thence
east 3.0 miles to the SE corner of the N ½ 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, 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 ¼ 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 ¼ of the NW ¼ of Section 29,
T16S, R11E; thence east to the SE corner of the SW ¼ of the NW ¼ of said Section 29;
thence north to the NE corner of the NW ¼ of the NW ¼ of said Section 29; thence east
upon the section line to the SE corner of the SW ¼ of Section 20, T16S, R11E; thence north
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 12
to the NE corner of the SW ¼ of said Section 20; thence east to the SE corner of the NE ¼ 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 ¼ of Section 16, T16S, R11E;
thence north to the NE corner of the SE ¼ of the SW ¼ of said Section 16; thence west to the
NW corner of the SE ¼ of the SW ¼ of said Section 16; thence north to the NE corner of the
SW ¼ of the NW ¼ of said Section 16; thence west to the SW corner of the NW ¼ of the NW
¼ 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 ¼ of the NW ¼ of Section 10, T16S, R11E; thence
east upon the section lines to the SW corner of Section 1, T16S, R11E; 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 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 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
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 13
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 13 square miles.
Boundaries: Entire Black Butte Ranch and a portion of Highway 20 from Indian Ford Road west
to the Camp Sherman turnoff. 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.
ASA #3 – Burns
All of T22S, R22E and all of T22S, R23E.
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 14
ASA #4 - Crooked River Ranch
Size of ASA: Approximately one square mile.
ALL of those portions of Crooked River Ranch lying within Deschutes County.
ASA #5 - La Pine
Size of ASA: Approximately 646 square miles. However, most of the ASA is comprised of the
Deschutes National Forest or in B.L.M. lands and are uninhabited.
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.
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 15
ASA #6 - Redmond
Size of ASA: Approximately 223 192 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,
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
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. 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 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 32697 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 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
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 16
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
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. 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 ½ of said Section 22; thence east 3.0 miles to the SE corner of the N ½ 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, 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 ¼ 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
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 17
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 ¼ of the
NW ¼ of Section 29, T16S, R11E; thence east to the SE corner of the SW ¼ of the NW ¼ of
said Section 29; thence north to the NE corner of the NW ¼ of the NW ¼ of said Section 29;
thence east upon the section line to the SE corner of the SW ¼ of Section 20, T16S, R11E;
thence north to the NE corner of the SW ¼ of said Section 20; thence east to the SE corner
of the NE ¼ 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 ¼ of Section 16,
T16S, R11E; thence north to the NE corner of the SE ¼ of the SW ¼ of said Section 16;
thence west to the NW corner of the SE ¼ of the SW ¼ of said Section 16; thence north to
the SE corner of the NW ¼ of the NW ¼ of said Section 16; thence west to the SW corner of
the NW ¼ of the NW ¼ 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 ¼ of the NW ¼ of
Section 10, T16S, R11E; thence east upon the section lines to the SW corner of Section 1,
T16S, R11E; 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, 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 upon the section lines approximately 3.75 miles to the SW corner of the
NW ¼ of the NW ¼ of Section 3, T15S, R11E; thence east to the SE corner of the NW ¼ of
the NW ¼ of said Section 3; thence north to the NE corner of the SW ¼ of the SW ¼ of
Section 34, T14S, R11E; thence east to the SE corner of the NE ¼ of the SW ¼ of said
Section 34; thence north to the NE corner of the NE ¼ of the SW ¼ of said Section 34;
thence west to the NW corner of the NW ¼ of the SW ¼ 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 ¼ of Section 26, T14S, R11E; thence north to the NW corner of the SE ¼ of said
Section 26; thence east to the NE corner of the SE ¼ of said Section 26; thence north upon
the section lines to the NE corner of the SE ¼ of the SE ¼ of Section 23, T14S, R11E; thence
west to the NW corner of the SW ¼ of the SE ¼ of said Section 23; thence north 2.25 miles
to the NE corner of the SW ¼ of Section 11, T14S, R11E; thence west to the NW corner of
the SW ¼ of said Section 11; thence north upon the section lines to the NW corner of
Section 2, T14S, R11E 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.
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 18
ASA #8 - Sunriver
Size of ASA: Approximately 1350 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
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
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 19
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;
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 20
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 emergency medical services providers 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 Emergency medical services providers 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
more quickerly to an incident.
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 21
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 cCommittee.
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 licensed EMT-Basic 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 certified 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 n 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 present with the patient in the
patient compartment of the ambulance when ALS care is required or being rendered.
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 682.015 010 to 682.991 and OAR 333-255-0070(1), (4) or (6) 333-250-0070 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 construe the
ambulance service must provide the same higher a requirement that the ambulance provide the
same level of care on a regular basis.
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 22
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 Medical Board 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 Medical Board 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 847-35-0020-00255;
4.2 hold at least one meeting a year with the EMTs affiliated with the 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
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 Authority’s
requirements as specified in ORS 682.015 010 to 682.991 and OAR 333-255-0070(2), (3), (5) or
(7) 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 their request.
6. Vehicles.
All ambulances must be either a Type I, II, or III and be licensed by the Oregon Health Division
Authority. All ambulances must meet or exceed the requirements as set forth in ORS 682.015
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 their request.
7. Training.
Training will be consistent with requirements of the Oregon State Health Division Authority and
Department of Transportation curriculum. and shall be received through accredited institutions.
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 23
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 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. Sheriff’s Office representation Deschutes County Emergency Manager
e. 9-1-1 center representative
f. EMT-Basic
g. EMT-Intermediate
h. EMT-Paramedic
i. Public member
Membership and terms of the Committee are outlined in Deschutes County Code
8.30 Ambulance Service Area. 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, tThe ASA
Administrator shall become a non-voting member, except in the case of a tie 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.
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 24
Quality assurance in Deschutes County shall be accomplished through frequent case
review, peer review, and periodic review by the medical directors and/or aAmbulance
services’ 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 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 prehospital care provided shall be directed to the
Supervising Physician Advisor of the Ambulance service provider. If the situation
warrants, At the Supervising Physician discretion the complaint shall be passed to the
ASA cCommittee 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 EMTs emergency medical services providers
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. The Board shall provide
notice to the effected 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.
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 25
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 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 contingent suspension or revocation of an ASA 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 decision 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 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 Class A violations
punishable, upon conviction, by a fine of not more than Five Seven Hundred and twenty
Dollars ($50720) 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 abated as such
in all actions, suits, or proceedings in the manner provided by law.
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.
Each Franchise 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 patient
originating within that territory by another licensed ambulance service agency. Duration of
permission shall last no longer than the term of the franchise. Definition 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
DCC 8.30.100 – APPENDIX A
05/08 (9/2012) 26
agency 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. Duration of permission shall last no longer than the term of the franchise.
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 of
assignment, or and revocation will be considered for approval if they 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 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 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 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
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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 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 Emergency medical services agencies shall sign a mutual aid
agreements with the other emergency medical services agencies 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 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 county
authorities. The Area Trauma Advisory Board (ATAB) Region 7 plan may be utilized in
place of the plan outline below.
As an interim goal, until an Emergency Services Plan is implemented, aAmbulance 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 Manager 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 Manager 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 licensed EMT 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 The senior EMT emergency medical services provider on the first EMS unit to
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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.
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. IEn-route to scene or destination and type or response;
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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
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
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which will enhance their dispatching abilities and skills.
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
Board and or the committee. Only the one franchisee may serve in their an 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;
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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.