(A) Response time. This section shall apply to primary providers and VAPs.
(1) An ambulance shall be on the scene of each life-threatening emergency call within eight minutes on 80% of all calls originating within the service area, and 95% within ten minutes of all calls originating within the service area. For all presumptively designated life-threatening emergencies best efforts will be made to place an FR/EMR unit on the scene within five minutes. The response times shall be recorded by CCEOC.
(2) For each life-threatening emergency response exceeding 12 minutes, the contracted provider shall generate within ten days a summary of the run and the action it has taken to reduce the number of long responses. This report shall be sent to the Health Officer; and
(3) To provide prompt initial care, an FR/EMR program shall be promoted by the Health Officer with assistance of other agencies and parties providing emergency care. This system shall have a goal of on-scene response within five minutes.
(B) Patient and scene management.
(1) The senior paramedic in charge at the scene of an emergency shall have authority for patient management.
(2) Authority for management of the emergency scene, exclusive of medical control over patients, shall rest with public safety officials.
(3) In the event a state licensed physician appears on the scene and desires to assume direction and control of patient care, he or she shall do so by presenting credentials or having his or her licensure verified by CCOEC, with the State Professional Licensing Agency, using information from a valid driver’s license. It is also expected that the physician would accompany the patient to his or her final destination.
(C) Destination determination.
(1) For all life-threatening emergency calls, the patient shall be taken to the nearest appropriate facility for that clinical condition in accordance with approved medical protocols, unless otherwise directed by an emergency room physician.
(2) For all non-life-threatening emergency calls, the patient shall be taken to the destination of the patient’s choice, or in cases where the patient is incompetent or unable to make such a judgment, the patient shall be delivered to the destination requested by the appropriate party acting on behalf of the patient. If no person is available to act for the patient, he or she shall be delivered to the nearest available emergency receiving facility.
(D) Removal of ambulance from service. This section shall apply to primary providers and VRAPs. No emergency medical services ambulance or paramedic non-transport vehicle may be removed from service without first advising the CCOEC and recorded into the permanent record.
(E) Obedience to traffic laws. All ambulance providers and their employees shall comply with all applicable laws of the state relating to operation of an emergency vehicle.
(F) Dispatching: rules and regulations. This section shall apply to primary providers, VAPs and VRAPs.
(1) This subchapter envisions all ambulance services to be provided by a limited number of single providers; however, the county government recognizes the valuable role that VRAPs may play in the system. To that end, the system adopted herein shall include a role for volunteer providers.
(2) (a) No rule relating to VRAP and adopted by the Health Officer shall be inconsistent with anything in this section. All VRAPs subject to regulation in this subchapter shall comply with all communications and dispatching standards and with all rules and regulations as may be adopted pursuant to this subchapter.
(b) The Health Officer will carefully examine and consider historical, suggested and legally required dispatch practices and protocols. Dispatch protocols shall be utilized in operations of this subchapter:
1. To the extent of available funding through the Enhanced Emergency Telephone System Fund or other funds as provided by county government; and
2. As required by statute.
(c) Public Safety Officials, who receive a request for emergency ambulance service, shall immediately transfer the requests to the CCOEC. This transfer should be made in such a manner as to allow the CCOEC dispatcher to talk directly with the caller, so that the most accurate possible assessment of the situation can be made, and so that appropriate direction can be given the caller concerning procedures to be taken prior to arrival of the ambulance or FR/EMR. If there is an ambulance request for emergency service within a non-participating service area, the non-participating township, district, or municipality shall notify the CCOEC that an ambulance has been dispatched.
(d) In all calls originating within a service area, the CCOEC shall dispatch the primary provider in that township or dispatch VRAP. Rules concerning patient transport shall be defined in a mutual aid agreement between both services and approved by the Health Officer.
(G) General standards of operation. The following general terms of operation, procedures and protocol shall apply.
(1) EMT - B ambulances may provide convalescent transport.
(2) Ambulances must be strategically stationed throughout their service area subject to approval by the Health Officer.
(3) An ambulance should be no more than two miles from its station unless it is making a run.
(4) A paramedic non-transport vehicle should not be outside of its service area unless it is making a run.
(5) No station shall be left uncovered for more than two hours. CCOEC shall be notified of station coverage changes that last more than one hour.
(6) Convalescent runs should not significantly interfere with the ability to provide emergency medical transport.
(7) The CCOEC shall provide emergency medical dispatching (pre-arrival instructions) as much as possible.
(8) All emergency medical services protocols for the county will be standardized among the services and must be approved by the Board of Health and Health Officer.
(9) Copies of all reports for or audits sent to the state or federal officials shall be sent to the Health Department within ten days after final action, review by the Board of Health within the limits of patient confidentiality restrictions.
(10) The Health Department shall be able to perform random inspection of records within the limit of patient confidentiality restrictions and also equipment and supplies of the ambulance services related to their operations in the county.
(11) Ambulance personnel will cooperate fully with properly trained and certified FR/EMR.
(12) The primary providers shall have a mutual aid agreement with at least one other primary provider.
(13) The primary providers, in cooperation with the fire departments, police departments and the Health Department, will coordinate protocols for utilization of air ambulances.
(14) The Health Officer shall recommend rules and regulations for VRAP. These rules and regulations may include on-board equipment and communication standards.
(15) The rules and regulations covering VRAPs may require periodic local certification of volunteer crew members.
(16) All provider personnel shall maintain certification by the National Incident Management System appropriate for their position.
(17) CCOEC FR/EMR dispatch protocols, when practical, shall be reviewed and suggested changes offered by the participating agencies before the protocols are adopted.
(18) All emergency medical services medical directors (as defined by the Commission), shall practice within the county or a county contiguous to this county unless otherwise approved by the Health Officer.
(19) All emergency medical services shall utilize a supervising hospital located in the county.
(Ord. 9-2008, passed 12-8-2008; Ord. 2-2014, passed 1-30-2014)