(A) Application of provisions. This section applies to participants in the ambulance service system and those bound by the provisions of this subchapter.
(B) Who must hold certificate. No person shall be employed or volunteer as an ambulance driver, EMT, EMT-B, EMT-BA, AEMT, EMT-I or paramedic on an ambulance regulated by this chapter unless they hold a certification issued by the Health Officer.
(C) Criteria for certification.
(1) The Health Officer shall set requirements to obtain a certificate as an ambulance driver, EMT, EMT-B, EMT-BA, AEMT, EMT-I or Paramedic; and
(2) All ambulance drivers, EMT, EMT-B, EMT-BA, AEMT, EMT-I or paramedics must maintain state certification.
(D) Application for certification. Applications for certification as an ambulance driver, EMT, EMT-B, EMT-BA, AEMT, EMT-I or paramedic shall be made on forms prepared or approved by the Health Officer. Each application may require a non-refundable application fee.
(E) Criteria for permits.
(1) The Health Officer shall set the requirements to obtain a permit for any ambulance providers regulated by this chapter and including special use providers; and
(2) Provider permits shall be of four types:
(a) Volunteer ambulance provider;
(b) Volunteer reserve ambulance provider;
(c) Emergency medical ambulance service provider; or
(d) Special ambulance provider.
(F) Application for vehicle permits. Applicants for vehicle permits shall be made on forms prepared and approved by the Health Officer. Each application may require a non-refundable application fee.
(G) Ambulance service permit liability insurance standards.
(1) No ambulance service provider permit shall be issued under this subchapter, nor shall such permit be valid for issuance, nor shall any provider vehicle be operated in the area unless the ASP has valid insurance coverage and has submitted a certificate of insurance demonstrating that the applicant has auto, general and medical liability insurance.
(2) The certificate must show the policy includes as additional insured's Clark County Government and the Clark County Health Department and all agents thereof (County Health Officer, Health Department Administrator, Administrator, County Office of Emergency Communications, etc.) and the policy:
(a) Is in effect with an insurer that is authorized to write insurance in Indiana and the insurer is rated A or better by Best;
(b) Provides a combined single limit of at least $1,000,000 for the injury or death of any number of persons in any one occurrence;
(c) Provides medical liability insurance to provide for limitation of each claim of not less than $1,000,000; and
(d) Has a $1,000,000 umbrella policy providing additional coverage to all underlying liability policies;
(e) If and insurance policy required under this section:
1. Is canceled during the policy's term;
2. Lapses for any reason;
3. Has the policy's coverage fall below the required amount;
4. The person or organization to whom the certification was issued shall immediately notify the Health Officer and must also immediately replace the policy with another policy that complies with this section.
(f) If the insurance policy for an emergency medical services provider vehicle that is required to be insured under this section is canceled, lapses for any reason, or has the policy coverage fall below the required amount, the use of the emergency medical services vehicle:
(1) Must immediately cease; and
(2) Shall not resume until approval to resume its use has been obtained in writing from the Health Officer.
(H) Permit required.
(1) No person or organization shall operate an ambulance service rendering pre-hospital care or transportation to ambulance patients unless that person or organization has obtained and currently holds a provider permit as determined in this section.
(2) No organization shall operate an ambulance for the provisions of emergency or non-emergency ambulance service to ambulance patients, except as authorized hereunder by the Health Officer.
(I) Term of certifications and permits: renewal.
(1) All permits and certification issued pursuant to this subchapter shall be valid for a period of two years from the date of issuance, except as herein expressly provided.
(2) It shall be the responsibility of a permit or certificate holder to apply for a new permit or certificate no later than 30 days prior to the expiration of the current permit or certificate.
(3) The County Health Officer may, at his or her discretion, require renewal applicants to demonstrate knowledge and skills then currently required of a first time applicant.
(J) Revocation or suspension of permits and certification; compliance.
(1) The Health Officer shall in his or her own capacity or by a designee named by the Health Officer enforce all provisions of this subchapter. Upon determining that a violation has occurred that does not meet the requirements for revocation or suspension below the Health Officer, or his or her designee shall issue a written letter to the party requiring compliance within 15 days. If the violation is not timely resolved by the date requested the Health Officer may issue a cease and desist order and assess a fine payable to the Safety Fund for each day of violation. (See § 31.99).
(2) The Health Officer is authorized to recommend to the Board of Health revocation or suspension of any permit or certification issued pursuant to the provisions of this section if the ambulance driver, EMT, EMT-B, EMT-BA, AEMT, EMT-I, paramedic, VRAP, special use provider, emergency medical service provider or non-emergency medical service provider who:
(a) Fails to maintain the qualifications or otherwise constitutes a danger to the safety and health of patients; or
(b) Fails to cure violations that are subject to the provisions of division (J)(1) above.
(3) Prior to revocation or suspension of a certificate, a medical audit shall be conducted by the Health Officer or his or her designee. The report shall be forwarded to the Board of Health. The Board of Health shall notify the affected person of audit results and offer to hold an administrative hearing for him or her. The Board of Health then determines if revocation, suspension, or any other disciplinary action is warranted.
(4) If the Health Officer determines that the risk of harm to the public is substantial, the certification may be suspended without first providing a hearing. However, a hearing before the Board of Health shall be scheduled to convene within ten working days of the suspension or disciplinary action to consider revocation of the certification or disciplinary action. The Health Officer may require a physical and mental examination be conducted prior to the hearing.
(5) The Health Officer, or an authorized representative, may issue a citation to any person or organization which may be found to be in violation of this ordinance. The citation will specify the nature of the violation of this subchapter. The person(s) or organization receiving a citation shall be required to appear, at a time designated, in any circuit or superior court in the county for a hearing upon such citation. The court shall conduct a hearing upon the alleged violation of this subchapter. The attorney for the Board of Commissioners, or any attorney appointed by it, is authorized to civilly prosecute said citation in the name of the County Health Department in such hearing. If the court finds, at the conclusion of all the evidence, by a preponderance of evidence, that this subchapter has been violated, the court shall impose the sanctions and penalties described below.
(6) Any person or organization convicted of a violation of this subchapter shall be punished by a fine of not less than $25 and not more than $2,500 for each such violation. (See I.C. 36-1-3-8(10)) Each day, or part of a day, that each violation occurs shall constitute a distinct and separate offense punishable by said fine. Each fine hereunder shall be in addition to, and not in substitution of, any other penalties which may be set forth under any chapter, section, or provision of this subchapter and nothing contained herein shall be construed as preventing the enforcement of the ordinance by injunction or any other equitable or legal relief as provided by I.C. 36-1-6 et seq., I.C. 16-1-4-13 or any other applicable law.
(K) Additional certification and permit requirements.
(1) All books and records of any provider shall be available to the County Health Officer or his or her designee within limits of patient confidentially restrictions.
(2) All providers under the terms of this section shall report to the Health Officer and provide the following information:
(a) On a monthly basis the number of calls received by the provider per month and the average response time for each call and in addition thereto the type of transport emergency or nonemergency; and
(b) All permitted providers shall file an annual audited financial statement. They shall also file an annual report specifically showing the number of calls, the type of transport (emergency or non-emergency), average response times and any other information as required or requested by the Health Officer.
(Ord. 9-2008, passed 12-8-2008; Ord. 2-2014, passed 1-30-2014) Penalty, see § 31.99