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The following words and phrases when used in this Article 14 have the meanings set forth herein:
“Ambulance” means a vehicle specially constructed, modified, equipped, or arranged to accommodate a gurney and operated commercially for the purpose of medical transportation of sick, injured, convalescent, infirm, or otherwise incapacitated persons.
“Ambulance Service Provider” means a person who furnishes or offers to furnish emergency medical services using an ambulance.
“Certificate of Operation” means a document issued by the Director to a person who qualifies to operate an ambulance in the City.
“Certificate of Participation” means a document that the Director issues to a Receiving Hospital or STEMI Center to authorize the facility to receive patients through Ambulance Service Providers.
“City” means the City and County of San Francisco.
“Color scheme” means a particular design, consisting of appliances, colors, figures, and letters, or any combination thereof, assigned to a particular person for application to the ambulance or ambulances, or to routine medical transport vehicle or vehicles authorized to be operated by such person, for purposes of identification and distinction.
“Department,” unless otherwise indicated, means the Department of Public Health of the City.
“Director” means the Director of the Department, or the Medical Director of the EMS Agency, if required by State law, or the Director’s designated agents or representatives.
“EMS Agency” means the City’s Emergency Medical Services Agency, which is designated as the local EMS Agency under California Health and Safety Code Section 1797.200.
“Facility” means any place or building that is organized, maintained, and operated for the diagnosis, care, prevention, and treatment of human illness, physical or mental, including convalescence and rehabilitation and including care during and after pregnancy, or for any one or more of these purposes, for one or more persons, to which the persons are admitted for a 24-hour stay or longer.
“Hospital” means an acute care facility licensed under California Health and Safety Code, Chapter 2 (commencing with Section 1250) of Division 2, with a permit for basic emergency service or an out-of-state acute care hospital which substantially meets the State requirements as determined by the local EMS agency that is using the hospital in the emergency medical services system, and is licensed in the State.
“Operator” means a person to whom a Certificate of Operation and permit or permits have been issued to operate an ambulance.
“Pediatric Center” means a facility designated by the EMS Agency to receive ambulances and treat critical care pediatric patients.
“Permit” means a permit issued by the Director for an ambulance conforming to the requirements of this Article that is owned or controlled by a person holding or qualifying for a Certificate of Operation pursuant to this Article.
“Person” means and includes an individual, a proprietorship, firm, partnership, joint venture, syndicate, business trust, company, corporation, association, committee, governmental agency, or any other legal entity.
“Receiving Hospital” means a licensed general acute care hospital certified by the EMS Agency to receive patients through Ambulance Service Providers.
“Regulation” means any rules, regulations, policies, procedures, or protocols promulgated by the Director, the State, or under Federal law regarding emergency medical services.
“STEMI” means ST segment elevation myocardial infarction, a type of heart attack, or myocardial infarction, that is caused by a prolonged period of blocked blood supply, which affects a large area of the heart muscle, and causes changes on an electrocardiogram and in the blood levels of key chemical markers.
“STEMI Center” means a facility designated by the EMS Agency to receive ambulances and treat patients with STEMI.
“Stroke Center” means a facility designated by the EMS Agency to receive ambulances and treat stroke patients.
“Trauma Center” means a facility designated by the EMS Agency to receive ambulances and treat trauma patients.
(a) No person shall operate an ambulance or routine medical transport vehicle service upon the streets of City until, after application, the Director has issued a Certificate of Operation therefor.
(b) A Certificate issued pursuant to this Article shall set forth the commercial or public uses permitted and shall be valid until suspended or revoked. Said Certificate shall not be transferable, and shall be deemed revoked upon sale, transfer or assignment of the commercial use for which the Certificate was issued.
(c) A Certificate may be suspended or revoked for violations of this Article after a hearing by the Director. Upon suspension or revocation the offices for which the Certificate was issued shall be posted with the order of the Director. The Director shall remove a suspension upon determination that violations have been remedied and compliance with this Article thereby exists.
(d) All applications for a Certificate shall be filed upon forms provided by the Department. Said application shall be verified under oath and shall furnish the following information:
(1) The name, business and residence address and status of the applicant.
(2) The financial status of the applicant, including the amounts of all unpaid judgments against the applicant and the nature of the transaction or acts giving rise to said judgments.
(3) The experience of the applicant in the transportation and care of sick or injured persons.
(4) Any facts which the applicant believes tend to warrant the issuance of a Certificate.
(5) The actual or projected number of ambulances and/or routine medical transport vehicles, the model, make and year, condition and stretcher patient capacity of each ambulance or routine medical transport vehicle proposed to be operated by the applicant and a description and address of offices which are to serve as the base of operations.
(6) The color scheme to be used to designate the ambulance or ambulances and/or routine medical transport vehicle or vehicles of the applicant.
(7) Such further information as the Director may reasonably require.
(a) No ambulance or routine medical transport vehicle owned or controlled by any person to whom a Certificate has been issued shall be operated upon the streets of City until, after application, the Director has issued a permit therefor. Prior to the issuance of a permit, the Director shall thoroughly examine and inspect the ambulance or routine medical transport vehicle for compliance with the requirements of this Article. An ambulance under valid permit may provide routine medical transport service without the necessity of an additional permit.
(b) Ambulances shall be equipped in accordance with:
(1) The requirements of the California Highway Patrol, and any revisions thereto; and
(2) The standardized drug and equipment list, and any revisions thereto, adopted by the Director, who shall consider the recommendations of the San Francisco Emergency Medical Care Committee.
(c) Routine medical transport vehicles shall be equipped in accordance with:
(1) The standard vehicle safety and equipment requirements of the California Highway Patrol for ambulances and any revisions thereto.
(2) Standard patient carrying fixtures and restraints necessary for the comfort and safety of patients.
(d) Any permit issued hereunder shall be valid for a period of one year from the date when issued and shall be renewed annually upon determination by the Director that the ambulance or routine medical transport vehicle for which the permit applies conforms to all requirements set forth in this Article. Such requirements shall include the provision that all equipment be maintained in a fresh, clean and sanitary condition at all times.
(a) All persons operating an ambulance or ambulances in City on the effective date of this ordinance shall be exempted from the requirements of Sections 902(a), 902(d) and 905 for a Certificate of Operation for a period of one year from the effective date of this ordinance. A Certificate shall be issued by the Director to any person who qualifies for exemption pursuant to this Section upon condition that compliance with all other sections of this Article otherwise exists.
(b) Any person operating an ambulance or ambulances in City on the effective date of this ordinance pursuant to a permit issued by the Director by authority of law existing immediately prior to that date shall be exempted from the requirements of Sections 903 and 905 for a period of one year, from the effective date of this ordinance, during which existing permits will continue to be valid unless suspended, revoked or terminated. Upon expiration of the permit, an operator shall otherwise comply with all provisions of this Article.
(c) Any person operating an ambulance or ambulances, or routine medical transport vehicle or vehicles in City on or after the effective date of this ordinance which does not involve the transporting of persons from a place of origin to a place of destination, both of which are solely within City, shall be exempted from the requirements of this Article.
(a) Pursuant to the provisions of this Article relating to Certificates of Operation and permits, the Director shall not renew a Certificate of Operation or a permit or issue a new Certificate of Operation or a new permit for an ambulance or routine medical transport vehicle service until he has caused such investigation as he deems necessary to be made of the applicant and of his proposed operations.
(b) The Director shall issue hereunder a Certificate of Operation or a permit for a specified ambulance or routine medical transport vehicle service, said Certificate of Operation or permit for a specified ambulance or routine transport vehicle to be valid for one year unless earlier suspended, revoked or terminated, when he finds:
(1) That each such ambulance or routine medical transport vehicle, its required equipment and the premises designated in the application, complies with the requirements of this Article.
(2) That the applicant is a responsible and proper person to conduct or work in the proposed business.
(3) That only drivers and attendants who comply with the requirements of this Article are employed in such capacities.
(4) That all the requirements of this Article and all other applicable laws and regulations have been met.
Notwithstanding Sections 902 and 905, the Director shall not issue a Certificate of Operation authorizing the operation of ALS services or any ambulance permit to any person not authorized by San Francisco's Emergency Medical Services (EMS) Plan to provide ALS or emergency ambulance services in the City and County of San Francisco, which San Francisco's EMS Plan has established as an exclusive operating area.
(Added by Ord. 132-91, App. 4/5/91)
No certificate or permit shall be issued, nor shall such certificate or permit be valid after issuance, nor shall any routine medical transport vehicle be operated unless there is at all times in full force and effect to provide adequate protection against liability for damages which may be or have been imposed for each negligent operation of each such routine medical transport vehicle, its driver or attendant, a liability insurance policy or policies approved by the Director and issued by an insurance company authorized to do business in the State of California. Satisfactory evidence that the liability insurance required by this section is at all times in full force and effect shall be furnished to the Director by each operator required to provide such insurance. Said evidence of insurance shall be in the form of the Standard Insurance Certificate (Accord Form) and shall contain the statement that the exchange or company issuing said Certificates shall provide the Director with 30 days written notice of cancellation, nonrenewal or reductions of limits of liability coverage.
(Amended by Ord. 258-86, App. 6/30/86)
No Certificate or permit shall be issued, nor shall such certificate or permit be valid after issuance, nor shall any ambulance be operated unless there is at all times in full force and effect to provide adequate protection against liability for damages which may be or have been imposed for each negligent operation of each such ambulance, its driver or attendant, a liability insurance policy or policies approved by the Director and issued by an insurance company authorized to do business in the State of California. Satisfactory evidence that the liability insurance required by this section is at all times in full force and effect shall be furnished to the Director by each operator required to provide such insurance. Said evidence of insurance shall be in the form of the Standard Insurance Certificate (Accord Form) and shall contain the statement that the exchange or company issuing said Certificates shall provide the Director with 30 days written notice of cancellation, nonrenewal or reductions of limits of liability coverage. Operators of ambulance services shall maintain insurance in amounts at least as follows:
(1) Automobile liability insurance in the form of comprehensive automobile liability.
(a) $500,000 on account of bodily injuries or death of one person;
(b) $1,000,000 for any occurrence on account of bodily injuries to or death of more than one person;
(c) $500,000 for any one accident on account of damages to or destruction of property of others.
(2) In lieu of the separate limits stated in (1), the Certificate and permit holder may provide a policy or policies in, at least, the following amount:
(a) $1,000,000 for Combined Single Limit of Liability for each occurrence for bodily injury and/or damage to property of others.
(3) General Liability in the form of Broad Form Comprehensive General Liability Insurance.
(a) $500,000 for any occurrence on account of bodily injuries or death;
(b) $500,000 for any one occurrence on account of damages to or destruction of property of others.
(4) In lieu of the separate limits stated in (3), the Certificate and permit holder may provide a policy or policies in, at least, the following amount:
(a) $500,000 for Combined Single Limit of Liability for each occurrence for bodily injury and/or property damage, which shall include bodily injury to one or more persons and/or damage to property of others.
(5) Professional Liability in the form of Ambulance Attendants Errors and Omissions Liability Insurance.
(a) $500,000 on account of bodily injuries or death of one person;
(b) $500,000 for any occurrence on account of bodily injuries to or death of more than one person.
(Added by Ord. 258-86, App. 6/30/86)
(a) Each operator shall utilize a dispatcher whose sole or primary function shall be to receive and dispatch all calls for ambulance or routine medical transport vehicle service.
(b) Each operator shall maintain an operational and manned office from which an ambulance or ambulances or routine medical transport vehicle or vehicles shall be based on a continuous 24 hour per day basis.
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