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ARTICLE 14: AMBULANCES AND ROUTINE
MEDICAL TRANSPORT VEHICLESSec. 901. Definitions.
Sec. 902. Certificate of Operation Required.
Sec. 903. Permit Required.
Sec. 904. Exemptions.
Sec. 905. Findings to be Made by Director.
Sec. 905.1. Permits to be Issued to Authorized Ambulance Services Only.
Sec. 906. Liability Insurance for Routine Medical Transport Vehicles.
Sec. 907. Liability Insurance for Ambulance Operators.
Sec. 908. Dispatcher and Office Requirements.
Sec. 910. Color Scheme– Adoption– Application.
Sec. 911. Operation Requirements.
Sec. 912. Driver Requirements.
Sec. 913. Attendant Requirements.
Sec. 914. Proof of Compliance.
Sec. 915. Penalty.
SEC. 901. DEFINITIONS.
The following words and phrases when used in this Article have the meanings set forth herein:
(a) City means the City and County of San Francisco.
(b) 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.
(c) Director means the Director of Health Care Services, or his designated agents or representatives, of City.
(d) Person means and includes an individual, a proprietorship, firm, partnership, joint venture, syndicate, business trust, company, corporation, association, committee, or any other legal entity.
(e) Ambulance means a vehicle specially constructed, modified, equipped, or arranged to accommodate a stretcher and operated commercially for the purpose of urgent transportation of sick, injured, convalescent, infirm, or otherwise incapacitated persons. As used herein, urgent transportation means transporting by ambulance of a person (1) requiring immediate measures to prevent loss of life or worsening of a traumatic injury or illness, or (2) having sudden need of medical attention.
(f) Routine medical transport vehicle means a vehicle specifically constructed, modified, equipped, or arranged to accommodate a stretcher and operated commercially for the purpose of transporting sick, injured, convalescent, infirm, or otherwise incapacitated persons not requiring urgent transportation.
(g) Department, unless otherwise indicated, means the Department of Public Health of the City and County of San Francisco.
(h) Certificate means a Certificate of Operation which shall be issued by the Director to a person who qualifies to operate an ambulance or routine medical transport vehicle service in the City and County of San Francisco.
(i) Permit means a permit which shall be issued by the Director for an ambulance or routine medical transport vehicle conforming to the requirements of this Article which is owned or controlled by a person holding or qualifying for a Certificate pursuant to this article.
(j) Operator means a person to whom a Certificate of Operation and permit or permits have been issued for purposes of operating an ambulance or routine medical transport vehicle service.
SEC. 902. CERTIFICATE OF OPERATION REQUIRED.
(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.
SEC. 903. PERMIT REQUIRED.
(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.
SEC. 904. EXEMPTIONS.
(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.
SEC. 905. FINDINGS TO BE MADE BY DIRECTOR.
(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.
SEC. 905.1 PERMITS TO BE ISSUED TO AUTHORIZED AMBULANCE SERVICES ONLY.
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)
SEC. 906. LIABILITY INSURANCE FOR ROUTINE MEDICAL TRANSPORT VEHICLES.
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)
SEC. 907. LIABILITY INSURANCE FOR AMBULANCE OPERATORS.
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)
SEC. 908. DISPATCHER AND OFFICE REQUIREMENTS.
(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.
SEC. 910. COLOR SCHEME– ADOPTION– APPLICATION.
(a) The operator of every ambulance or routine medical transport vehicle service shall adopt a color scheme and, after approval thereof by the Director, shall apply such color scheme to each ambulance or routine medical transport vehicle authorized by a permit. The Director shall not approve or allow adoption or application of any color scheme which imitates or conflicts with any other color scheme, authorized by this Article, in such manner as is misleading and would tend to deceive the public.
No sign, letter, color, appliance or thing of decorative or distinguishing nature shall be attached or applied to any ambulance or routine medical transport vehicle other than such as have been approved by the Director in the color scheme authorized for each such ambulance.
(b) Notwithstanding Section 910(a) and in lieu thereof, an operator may adopt a color scheme consistent with specifications recommended by the National Highway Traffic Safety Administration of the United States Department of Transportation, as contained in Federal Specification Number KKK-A-1822, published January 2, 1974. At such time as the color scheme recommended in Specification Number KKK-A-1822 becomes mandatory for ambulances operated in the State of California, the requirements of Section 910(a) shall become inoperative.
SEC. 911. OPERATION REQUIREMENTS.
(a) All operations shall be required to comply with such reasonable rules and regulations regarding ambulance or routine medical transport vehicle equipment and maintenance, equipment safety, and sanitary conditions as the Director shall prescribe.
(b) Each operator shall provide a security area not on the public streets of City for purposes of maintaining all ambulances when not in service.
(c) In addition to the requirements of this Article, an operator shall comply with all State and Federal requirements pertaining to the operation of an ambulance or routine medical transport vehicle service.
(d) Every ambulance or routine medical transport vehicle and office from which it is operated shall be inspected by the Director once annually or more often as shall be determined by the Director, to insure compliance with equipment, equipment safety, sanitary, and other rules and regulations relating to ambulance service operations.
(e) Each ambulance or routine medical transport vehicle providing service shall be manned and operated at all times by a qualified driver and attendant.
(f) Each operator, driver, and attendant shall be required to prohibit and constrain the smoking of tobacco products within the confines of any ambulance or routine medical transport vehicle while engaged in the transport of a patient passenger.
(g) Each operator shall provide annually to the Director an equipment inventory, proof of state licensure, and such other information as the Director may reasonably require relating to ambulance or routine medical transport vehicle service operations.
SEC. 912. DRIVER REQUIREMENTS.
A person employed as an ambulance or routine medical transport vehicle driver shall possess a current valid ambulance driver's license issued by the Department of Motor Vehicles.
Effective six months from the date of enactment of this ordinance, all persons employed as an ambulance driver shall have successfully completed an EMT-1A course accredited by the State of California Department of Health.
SEC. 913. ATTENDANT REQUIREMENTS.
On the effective date of this ordinance, persons employed as ambulance attendants shall have successfully completed an EMT-1A course accredited by the State Department of Health; and persons employed as routine medical transport vehicle attendants shall have successfully completed a course of training equivalent to the advanced course in first aid given by the American Red Cross.
Effective 18 months from the date of enactment of this ordinance, all persons employed as ambulance attendants must qualify as mobile intensive care paramedics certified by the Director; and persons employed as routine medical transport vehicle attendants shall have successfully completed an EMT-1A course accredited by the State Department of Health.
SEC. 914. PROOF OF COMPLIANCE.
(a) An operator shall, within 48 hours after employing a driver or attendant, submit written proof to the Department and local California Highway Patrol office that the driver or attendant complies with the requirements of Section 912 and 913.
(b) Termination of employment of any driver or attendant shall require written notification by an operator to the Department and local California Highway Patrol office within 48 hours.
(c) The Director shall maintain records of data required to be submitted by this Article.
SEC. 915. PENALTY.
Any person violating any of the provisions of this Article shall be guilty of a misdemeanor and upon conviction thereof shall be punishable by a fine not in excess of $500 or by imprisonment in the County Jail for a period not to exceed six months, or by both such fine and imprisonment.