703.13 PRIVATE AMBULANCE PERFORMANCE STANDARDS.
   No later than the 15th day of December, each private ambulance which applies for its initial license with the City of Stow shall submit proof of compliance with the following standards:
   (a)   Organization.
      (1)   A written organizational structure (chart) should be required to assure that the organization is managed effectively and efficiently, and so that line of responsibility and authority can be clearly delineated.
         A.   Include reporting authority involving outside entities, such as medical direction and/or medical control, and reporting authority involving any local or state regulating entity such as Stow Fire Department, or Public Safety Services Commission.
      (2)   Written job description for all positions should be maintained.
      (3)   Written policies regarding specific delineation of responsibility and authority within the organization.
      (4)   One principle administrative officer (i.e., President, chief operating officer) who is responsible for the day to day operation of the service.
      (5)   Written management policies, directives, protocols and procedures which refer to operations of the organization.
   (b)   Communications.
      (1)   Written dispatch procedures must exist.
      (2)   Computer-aided dispatch system which electronically "time stamps" appropriate time records (i.e., time received, time dispatched, time on scene)
      (3)   Shall provide a training program for dispatch personnel assuring that such personnel can ascertain the appropriate level of response priority, and provide the appropriate medical prearrival instructions to the caller.
      (4)   Have in place a back-up power source as may be necessary for the continued operation of the dispatch center in the event of power failure. Such systems shall be tested periodically to insure that it is still working.
      (5)   All telephone conversations involving dispatch personnel and all radio communication shall be tape recorded.
      (6)   Current FCC licenses must be maintained and displayed for all radio equipment and frequencies utilized by the service.
   (c)   Clinical Standards.
      (1)   Standards of care shall be developed and periodically updated in conjunction with the Medical Director.
      (2)   The company shall have a written agreement with a physician board certified by the American Board of Emergency Medicine to act as the Medical Director/Advisor.
      (3)   Shall appoint an individual to review field report forms, manage continuing education programs and perform quality assurance functions. This individual will also serve on the EMS Operating Committee.
      (4)   Continuing education efforts shall meet or exceed state requirements for recertification.
      (5)   Response time requirements.
         A.   In district responses should be ninety percent (90%): fifteen minutes.
         B.   Out of district responses should be eighty percent (80%): fifteen minutes.
         C.   No responses over twenty minutes.
         D.   No red lights or siren will be used for Code 2 response.
      (6)   Each Code 2 response must have one paramedic on the responding vehicle.
      (7)   All "primary responses" by a private company must be in an advanced life support capable vehicle.
      (8)   The private ambulance companies will use the standardized format of the Stow Fire EMS report.
      (9)   The company must develop and implement a written policy regarding infectious disease control procedures.
      (10)   Demonstrate compliance with preventative maintenance program for all vehicles and medical equipment.
   (d)   Record Keeping Procedures.
      (1)   Written reports shall document all significant actions it takes.
         A.   A record shall be created to document each request for service, including calls cancelled prior to arrival and incidents which result in no patient being transported.
         B.   A record shall be created to document all findings and treatment given, if any, whenever contact is made with a patient or one presumed to be a patient regardless of whether or not the patient is ultimately treated or transported.
         C.   Documentation shall be created for any unusual or otherwise significant events as reported by ambulance personnel or others.
         D.   Documentation shall be created to track the maintenance on all ambulance vehicles including preventive maintenance, unscheduled down-time and any accidents.
      (2)   Service shall maintain written manuals of policies and procedures. This manual shall include, at a minimum, the following information:
         A.   Employment policies.
         B.   Safety and vehicle operations.
         C.   Billing and collection.
         D.   Communications.
         E.   Ambulance operations.
         F.   Standards of clinical care.
         G.   Vehicle and equipment maintenance.
      (3)   Demonstrate that it uses a defined process of goal setting, budgeting and follow-through in its planning process.
      (4)   Written policies and procedures to address safety, accident reduction and loss control.
         A.   Shall have records of all accidents, their investigations and ultimate outcome.
         B.   Shall have a formal accident review process for which records are maintained.
      (5)   Shall demonstrate a commitment to management development and training programs.
   (e)   Financial Management.
      (1)   Develop and utilize a written budget.
      (2)   Maintain accurate financial records to describe its current and historic financial condition. Such records are to be kept in accordance with generally accepted accounting principles.
      (3)   Written billing and collection policies that are in keeping with consumer protection and nondiscrimination laws.
   (f)   Personnel.
      (1)   Ensure that all patient care employees are appropriately certified and/or licensed. The service shall maintain current and historical documents (or copies) including, as appropriate:
         A.   EMT-A, advanced EMT-A, and paramedic license.
         B.   Driver's license.
         C.   Driving record abstract.
      (2)   Provide compensation and benefits for employees appropriate to their job description.
      (3)   Should maintain a written procedure by which the employee can report alleged unfair policies or practices.
      (4)   Disciplinary consequences and the events that will precipitate them must be clearly delineated.
      (5)   Should provide a formal orientation for each employee to familiarize them with the company's policies and procedures that affect the individual job classification.
      (6)   Should have a written personal appearance standard for all employees. There shall be written standards delineating how employees should interact with the public, clients and each other.
      (7)   Should provide formal driver training.
      (8)   Pre-employment drug and alcohol screening.
   (g)   Interagency Relations.
      (1)   Play a role in the regional disaster plan and response.
      (2)   In addition to the standard licensing application, an inventory and list of all serial numbers of cardiac monitor/defibrillators must be attached.
         (Ord. 2001-94. Passed 6-28-01.)