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All EMS entities operating in the County shall be authorized by the LEMSA in accordance with the requirements of this chapter and any federal or state law or regulation governing EMS.
Authorization shall consist of provider authorization and, if indicated for the type of EMS entity, an ambulance provider permit.
Provider authorizations shall be issued in accordance with LEMSA provider authorization policy.
Ambulance service provider permits shall be issued in accordance with LEMSA ambulance service permit policy. (§ 1, Ord. 1515, eff. December 19, 2019)
(a) Any entity (either as an owner, agent or otherwise) who wishes to furnish, operate, conduct, maintain, or otherwise engage in, or offer, or profess to engage in providing ambulance service in the County shall have a valid ambulance service provider permit in accordance with the LEMSA system plan and EMS policies, procedures, and guidelines.
(b) Permit requirements shall apply to providers of air and ground ambulances, including BLS, ALS, IFT and CCT vehicles with the following exceptions:
(1) No permit is required of an ambulance service provider engaged in the transport of patients where the transport is initiated outside county boundaries for transport into the County.
(2) No permit is required of an ambulance service provider responding to a request from the EMS administrator or designee to calls arising from a declared multi-casualty incident (MCI) or declared disaster.
(3) No permit is required for specialized teams including, but not limited to: neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) teams that are permitted by another EMS agency and that pick up patients within the County for transportation to an acute care, tertiary, or quaternary care hospital located outside of the County, unless also responding to other services within the 9-1-1 system or inter-facility calls.
(c) Non-transport ALS. Any person, either as owner, agency, or otherwise, or any agency, who wishes to furnish, operate, conduct, maintain, or otherwise engage in, offer, or profess to engage in, or offer ALS non-transport services within the County, shall have a current valid non-transport ALS provider contract in accordance with the LEMSA's EMS system plan and EMS protocols, policies, and guidelines.
(d) An application for an initial ambulance Certificate of Operation shall be accompanied by payment of an application fee and an ambulance inspection fee. These fees are established by resolution of the Board of Supervisors, are listed in the Yolo County EMS Agency Fee Schedule and shall not exceed the reasonable cost of administering and enforcing this chapter. If the fees are not paid within thirty (30) days of permit issuance, the provider's permit will be considered suspended and the provider shall not provide the related service(s) within the County until the fees are paid in full. If the fees are not paid within ninety (90) days, the permit will be considered expired and a new application must be submitted to the LEMSA. Failed ambulance inspections will require a new inspection fee prior to the re-inspection of that ambulance. Exceptions to this section may be granted by the LEMSA. (§ 1, Ord. 1515, eff. December 19, 2019)
(a) Any EMS entity providing ambulance service, BLS, ALS, CCT or other EMS services requiring LEMSA authorization in the County, shall secure an ambulance service permit from the LEMSA specifying terms and conditions for the provision of EMS including, but not limited to, class of service to be provided, LEMSA approval for optional scope of practice, participation in LEMSA data and quality improvement activities and applicable performance standards as defined in LEMSA policies, procedures and guidelines.
(b) Provider authorizations shall not apply to cities or fire districts providing prehospital emergency medical services subject to and in accordance with Health and Safety Code section 1797.201. Such agencies providing services under section 1797.201 shall nonetheless be subject to LEMSA medical control and applicable performance standards as defined in LEMSA policies, procedures and guidelines. Compliance of City and Fire District prehospital emergency service providers with LEMSA medical control and applicable performance standards pursuant to LEMSA policies, procedures and guidelines shall not evidence or constitute an "agreement" with such City and Fire Districts for purposes of section 1797.201, and nothing in this chapter may be so construed. Nothing in this chapter is intended to affect or may be construed to affect in any way the rights and obligations of City and Fire District prehospital emergency service providers pursuant to section 1797.201. Nothing in this chapter is intended to affect or may be construed to affect the eligibility of City and Fire District prehospital emergency service providers to enter exclusive operating agreements under Health and Safety Code section 1797.224.
(c) Permit application.
(1) Applicants for an ambulance service permit or non-transporting ALS provider permit shall complete the LEMSA application process, which includes:
A. A LEMSA ambulance service provider permit application.
B. Provide a detailed description of company logo, color scheme used to designate the ambulance and attach a photo image.
C. A list of each ambulance including the following: make, model, year, mileage, VIN and license plate number.
D. Description of the company's program for vehicle maintenance.
E. Description of the company's vehicle radio/communication capabilities.
F. Copies of California Highway Patrol (CHP) inspection reports for each vehicle.
G. Portfolio of the company's experience and training in the transportation and care of patients.
H. List of employee's name and certification level with issued and expiration dates (EMT, paramedic, registered nurse, etc.).
I. Description of the company's training and orientation program for EMS personnel.
J. Applicants shall submit their planned work schedule for employees, including scheduled breaks and related staffing levels,
K. ePCR system description which is NEMSIS compliant.
L. A letter stating the willingness to share data with the LEMSA and participate in the Clinical Quality Improvement (CQI) process.
M. Current copy of the company's business license(s) and/or permits required by state law and regulations,
N. Recent financial statement (revenue, expenditures, balance sheet) stating total assets and liabilities.
O. Providing all transport and mileage billing rates.
P. Current insurance face sheet for: general liability for vehicle operation, comprehensive medical liability, workers compensation.
1. For general and comprehensive medical liability, the County shall be named as a co-insured. A valid certificate to self-insure from State of California Director of Industrial Relations is acceptable for workers compensation insurance. (§ 1, Ord. 1515, eff. December 19, 2019)
(a) Upon receipt of a completed application, the LEMSA shall conduct an inspection of the permit requester, including the applicant, any partner, officer, director, company and its ownership, to determine if there are any concerns related to the health, safety and welfare of the public. The inspection includes each vehicle, and its equipment and premises. A vehicle inspection fee is required per vehicle and the fee is approved by the board of supervisors. This required inspection shall be in addition to any other safety or motor vehicle inspections required or made under state, federal or local law.
(b) After the LEMSA has completed its inspection, it may issue the permit to be valid for a period of up to one year. The permit sticker must be placed on the window of the rear driver window of each permitted vehicle.
(c) Failed ambulance inspections will require a new inspection fee prior to the re-inspection of that ambulance. (§ 1, Ord. 1515, eff. December 19, 2019)
(a) Permits shall be renewed annually by the LEMSA upon application of the permittee if the LEMSA determines the permit holder has within the operating period of the expiring permit, acted in conformity with this chapter and the protocols and polices of the LEMSA.
(b) Applicants for permit renewal must be made at least thirty (30) days prior to the expiration date of the existing permit. The renewal fee must be included with the application for renewal. (§ 1, Ord. 1515, eff. December 19, 2019)
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