Ambulance Service Ordinance w/Amendments 7/6/99HARNETT
COUNTY NC
Book
1448
Pages
0724 -0735
PILED
12 PAGEISI
11/01/2000
11:13 AM
KIMBERLY S.
HARGROVE
Register Of Deeds
AMBULANCE SERVICE ORDINANCE
101
HARNETT COUNTY, NORTH CAROLINA
Originally Adopted May 4, 1992
with Amendments through July 6, 1999
TABLE OF CONTENTS
Section 1.0 Definitions ....................... ............................... 3
Section 2.0 Violations ........................ ............................... 4
Section 3.0 Enforcement ...................... ............................... 5
Section 4.0 Franchise - Required ............... ............................... 6
Section5.0 Fee .............. .............................................. 7
Section 6.0 Same - Application ................ ............................... 7
Section 7.0 Same - Granting ................... ............................... 8
Section 8.0 Same - Term ....................... ..............................8
Section 9.0 Standards for Ambulance Franchise ... ............................... 9
Section 10.0 Standards for Drivers and Attendants ............................... 10
Section 11.0 Standards for Vehicles and Equipment .............................. 10
Section 12.0 Standards for Communications ..... ............................... 10
Section 13.0 Insurance ........................ .............................10
Section 14.0 Records ......................... .............................11
Section 15.0 Rates and Charges ............... ............................... 11
Section 16.0 Inspection of Records Authorized ... ............................... 11
2
AMBULANCE AND SERVICES ORDINANCE
Section 1.0 Definitions
Unless the context otherwise requires, the following definitions shall apply in the interpretation
and enforcement of this Ordinance:
A. Ambulance: The term "Ambulance" shall mean any publicly or privately owned vehicle
that is specially designed, constructed or modified and equipped, and is intended to be
used for and is maintained or operated for the transportation upon the streets and
highways in this state of persons who are sick, injured, wounded or otherwise
incapacitated or helpless.
B. Ambulance Attendant: The term "Ambulance Attendant" shall mean the individual who
is responsible for the operation of an ambulance and rendering assistance to the
emergency medical technician during the transportation of a patient. The ambulance
attendant shall at least be certified as an ambulance attendant by the state.
C. Ambulance Service: The term "Ambulance Service" shall mean a publicly or privately
owned enterprise that is engaged in the transportation of patients to emergency and/or
non - emergency medical facilities.
D. Approved: The term "Approved" shall mean approved by the state medical care
commission pursuant to the latter's rules andregulations promulgated under G. S. § 143B-
165.
E. Back -up Ambulance Service: The term "Back -up Ambulance Service" shall mean the
system of personnel and equipment meeting the same criteria as ambulance service, but
not normally dispatched at first call response.
F. Board: The term "Board" shall mean the Hamett ,County.Board of Commissioners.
G. Coun • The term "County" shall mean the Board of Commissioners or a designated
representative.
H. Dispatcher: The term "Dispatcher" shall mean a person who is available at all times to
receive requests for emergency services, to dispatch emergency services, and to advise
the City Police, County Sheriff and Emergency Medical Facilities of any existing or
threatened emergencies.
I. Emergency The term "Emergency" and "Emergency Transportation Service" shall mean
the operation of an ambulance in order to provide medical care and transportation of a
patient who is in need of immediate medical treatment in order to prevent loss of life or
further aggravation of physiological or psychological illness or injury.
J. Emergency Medical Technician (EMT): The term "Emergency Medical Technician"
shall mean an individual who has completed the minimum eighty one (8 1) hour program
for emergency medical technician certification, and is so certified by the state.
K. First Responder: The term "First Responder" shall mean the first dispatched medical or
rescue aid to arrive at the scene and provide emergency medical assistance to stabilize
the patient while waiting for further medical aid and/or transport.
L. Franchise: The term "Franchise" shall mean a permit issued by the County to a person
for the operation of an ambulance service.
M. Franchisee: The term "Franchisee" shall designate the holder of a permit issued by the
County for the operation of an ambulance service.
N. License: The term "License" shall mean any driver's license or permit to operate a motor
vehicle issued under or granted by the laws of the state.
O. Non - emergency Transportation Service: The term "Non- emergency Transportation
Service" shall mean the operation of an ambulance for any purpose other than an
emergency.
P. Operator: The term "Operator" shall mean a person in actual physician control of-an
ambulance which is in motion or which has the engine running.
Q. Owner: The term "Owner" shall mean any person or entity who owns and operates an
ambulance service.
R. Patient: The term "Patient" shall mean an individual who is sick, injured, wounded or
otherwise incapacitated or helpless.
S. Person: The term "Person" shall mean any individual, firm, partnership, association,
corporation, company, group of individuals acting. together for a common purpose or
organization of any kind, including any governmental agency other than the United
States.
T. Rescue: The term "Rescue" shall mean situations where the victim cannot escape an area
through the normal exit or under his own power.
Section 2.0 Violations
A. It shall be a misdemeanor for any person to obtain or receive ambulance service without
intending at the time of obtaining or receiving such services to pay, if financially able,
the necessary charges. A determination that the recipient of such services has failed to
pay for the services rendered for a period of ninety (90) days after request for payment,
11
and that the recipient is financially+ able to do so, shall raise a presumption that the
recipient of the services did not intend to pay for the services at the time they were
obtained or received.
B. Violation of this article or the terms of any franchise granted hereunder shall be a
misdemeanor as provided by G. S. §14-4. Each such violation also shall subject the
offender to a civil penalty in the amount of one hundred dollars ($100.00) for each
separate breach of the franchise or violation of this article. This civil penalty must be
paid within ten (10) days after the hearing on the citation has been held as provided in
Section 2- 7- 38(b). If not so paid, such penalty may be recovered by the County as
provided by G. S. §153A-123(c). If the civil penalty is not paid within the ten (10) days
as provided for above, the County may suspend or revoke the franchise.
Section 3.0 Enforcement
The Harnett County Office of Emergency Medical Services shall be the enforcing agency for the
regulations contained in this article. Such office will:
A. Receive all franchise proposals. from potential providers.
B. Study each proposal for conformance to this article.
C. Recommend to the Board of Commissioners the award of the franchise(s) to the
applicants submitting.the best proposal(s).
D. Inspect the premises, vehicles, equipment and personnel of franchisees to assure
compliance to this article and perform any other inspections that may be required.
E. Recommend the temporary or permanent suspension of a franchise in the event of
noncompliance with the franchise terms of this article; recommend the imposition of
misdemeanor or civil penalties as provided therein.
F. Ensure by cooperative agreementmith other ambulance services the continued service
in a district where an ambulance service franchise has been suspended.
G. Receive monthly reports from ambulance services and. consolidate the same into a
quarterly summary for review by the Board.
H. Receive complaints from the public, other enforcing agencies and ambulance services
regarding franchise infractions; review the complaint with the council; obtain corrective
action with the approval of the Board.
I. Recommend improvements to the County which will ensure better medical
transportation.
W
M1�
Maintain all records required by this article and other applicable County regulations.
K. Perform such of the above functions as may be required by any municipality within the
County.
Section 4.0 Franchise - Required
A. No person, either as owner, agent or otherwise, shall furnish, operate, conduct, maintain,
advertise or otherwise be engaged in or profess to be engaged in the business or service
of emergency and/or non - emergency transportation of patients within the County unless
the person holds a valid permit for each ambulance used in such business or service
issued by the office of emergency medical services of the state department of human
resources and has been granted a franchise for the operation of such business or service
by the County pursuant to this article. All ambulance and rescue units currently
operating will have six (6) months to comply with this Ordinance and apply for a
franchise. If existing Ambulance and Rescue Units fail to comply they will be required
to cease operation.
B. No person shall drive, attend or permit a vehicle to be operated for ambulance purposes
within the County unless he holds a currently valid certificate as an ambulance attendant
or emergency medical technician issued by the state.
C. No franchise shall be required for:
Any entity rendering assistance to a franchised ambulance service in the
case of a major catastrophe or emergency with which the services
franchised by the County are insufficient or unable to cope; or
2. Any entity operated from a location or headquarters outside the County
in order to transport patients who are picked up beyond the limits of the
County, but no such entity shall be used to pick up patients within the
County fortransporting to locations within the County or other locations
unless it is rendering assistance as referred to in (1) above; or
Any entity that picks up patients within the County for transporting to locations
outside the County over fifty (50) miles from the County boundary line; or
4. Law enforcement personnel; or
5. A non - profit corporation organized under the laws of the State of North Carolina
which provides emergency ambulance and rescue service pursuant to or as the
result of a valid contract with the County of Harnett; or
6. In those situations where the patient or his designee should make a written
request for non - emergency transport by a non - franchised entity to the County
0
EMS Director and said transport is approved by both the EMS Director and the
County Manager. The approval or non - approval of this request will be at the sole
discretion of the EMS Director and the County Manager whose decision shall be
based on the particular needs of the patient and the County's ability to provide
service under the circumstances of each particular case.
Section 5.0 Fee
The fee for applying for a franchise shall be in the amount designated by the Harnett County
Board of Commissioners.
Section 6.0 Same - Application
Application for a franchise to operate ambulances in the County shall be made upon such forms
as may be prepared or prescribed by the County and shall contain:
A. The name and address of the applicant and of the owner of the ambulance.
B. The trade or other fictitious names, if any, under which the applicant does business,
along with a certified copy of an assumed name certificate stating such name or articles
of incorporation stating such name.
C. A resume of the training and experience of the applicant in the transportation and care
of patients.
D. A description and copy of state certification for each ambulance owned and operated by
the applicant.
E. The location and description of the place or places from which it is intended to operate.
F. Audited financial statement of the applicant as the same pertains to the operations in the
County, such financial statement to be in such form and in such detail as maybe required
by.the County.
G. A description of the applicant's capability to provide twenty four (24) hour coverage,
seven (7) days per week for the district covered by the franchise applied for, and an
accurate estimate of the minimum and maximum times for a response to calls within
such district.
H. Any information the County shall deem reasonably necessary for a fair determination of
the capability of the applicant to provide ambulance service in the County in accordance
with the requirements of state laws and the provisions of this article.
Section 7.0 Same- Grantine
A. Prior to accepting applications from applicants for the operation of an ambulance service,
the County may designate specific service areas as franchise districts, which districts will
be established on criteria that include geographic size, road access, the location of
existing medical transportation services, population and response time. The County shall
have the authority to redistrict or rearrange existing districts at any time at its discretion.
B. An applicant may apply for a franchise to operate either emergency transportation service
or non - emergency transportation service. If both types of service are to be provided,
separate application must be filed for each type.
An applicant may also apply for a limited franchise to operate for a particular purpose.
If such a limited franchise is granted by the County then the franchise shall specify the
conditions of operation and the franchisee shall be limited and adhere to that scope of
operation.
C. Upon receipt of an application for a franchise, the County shall schedule a time and place
for hearing the applicant. Within thirty (30) days after hearing, the County shall cause
such investigation as it may deem necessary to be made of the applicant and his proposed
operations.
D. A franchise may be granted if the County finds that:
The public convenience and necessity require the proposed ambulance
service.
2. Each such ambulance of the applicant, has required equipment and the
premises designated in the application have been certified by the County
and state.
3. Only . duly: licensed .ambulance, attendants and emergency, medical
technicians are employed in such capacities.
Section 8.0 Same -Term
A. The County may issue a franchise hereunder to an owner of an ambulance service, to be
valid for a term to be determined by the County. Subsequent termination of any awarded
franchise shall be pursuant to the provisions of the applicable franchise
ordinance /agreement. If a franchise is terminated, the ambulance service can apply for
a franchise if continued service rights are desired.
B. If any franchisee shall violate or fail to comply with any provision of this article or a
franchise issued hereunder, the franchisee shall be cited by the County for violation or
failure to comply. The County, after a hearing pursuant to this citation, may impose a
civil penalty of one hundred dollars ($100.00) for each separate breach of the franchise
as provided in section 7.0 or may suspend or revoke the franchise. If upon such hearing
the County shall find that the franchisee has corrected any deficiencies and has brought
his operation into compliance with the provisions of this article, the franchise shall not
be suspended or revoked, but a civil penalty as provided in section 7.0 may be imposed.
C. Upon suspension, revocation or termination of a franchise granted hereunder, such
franchised ambulance service immediately shall cease operation. Upon suspension,
revocation or termination of a driver's license or attendant's certificate or emergency
medical technician certificate, such person shall cease to drive an ambulance or provide
medical care in conjunction with an ambulance service, or attend an ambulance; and no
person shall employ or permit such individual to drive an ambulance or provide medical
care in conjunction with an ambulance service.
Section 9.0 Standards for Ambulance Franchise
A. Each franchised ambulance service shall comply at all times with the requirements of this
article, the franchise granted hereunder, and all applicable state and local laws relating
to health, sanitation, safety, equipment and ambulance design, and all other laws and
ordinances.
B. Prior approval of the County shall be required where ownership or control of more than
ten percent (10) of the right of control of a franchisee is acquired by a person or group
of persons acting in concert, none of whom own or control ten percent (10 %) or more of
such right of control, singularly or collectively, at the date of the franchise. By its
acceptance of the franchise, a franchisee specifically agrees that any such acquisition
occurring without prior approval of the County shall constitute a violation of the
franchise by the franchisee and shall be cause for termination at the option of the County.
C. Any change of ownership of a franchised ambulance service without the approval of the
County shall terminate the franchise and shall require a new application and a new
franchise and conformance with all the requirements of this article as upon original
franchising.
D. No franchise may be sold, assigned, mortgaged or otherwise transferred without the
approval of the County and a finding of conformance with all requirements of this article
as upon original franchising. Each franchised ambulance service, its equipment and the
premises designated in the application and all records relating to its maintenance and
operation as such, shall be open to inspection by the state, the County or their designated
representatives.
E. No official entry made upon a franchise may be defaced, removed or obliterated.
Section 10.0 Standards for Drivers and Attendants
Standards for drivers and attendants as developed by the state medical care commission as
requirements for certification of ambulance attendants and emergency medical technicians
pursuant to G. S. Article 26, Chapter 130 (§130-233), and Article 56, Chapter 143 (§ 143 -507 et
seq), shall be applied; and the same are incorporated herein by reference.
Section 11.0 Standards for Vehicles and Equipment
Vehicle and equipment standards as developed by the state medical care commission pursuant
to G. S. Article 26, Chapter 130 (§ 130 -232), and Article 56, Chapter 143 (§ 143 -507 et seq), shall
be applied; and the same are incorporated herein by reference.
Section 12.0 Standards for Communications
A. Each ambulance must be equipped with a two -way VHF radio licensed by the Federal
Communications Commission which must be in operative condition at all times. The
radios must have two (2) crystals which shall be 155.280 and 155.340 megahertz with
four channel capability.
B. Each ambulance service shall provide the County a copy ofthe Federal Communications
Commission license authorizing the use of the communication equipment owned and
operated by that service.
C. Each base of operations must have at least one (1) open telephone line. Telephone
numbers must be registered with each law enforcement agency and communications
center in the County.
Section 13.0 Insurance
No ambulance franchise shall be issued under this article, nor shall such franchise be valid after
issuance, nor shall any ambulance be operated in the County unless there is at all times in force
and effect either insurance coverage, issued by an insurance company licensed to do business in
this state, or a bond with personal or corporate surety, for each ambulance owned and/or operated
by or for the ambulance service, providing for the payment of damages:
A. In the sum of one million dollars ($1,000,000.00) for injury to or death of individuals in
accidents resulting from any cause for which the owner-of thevehicle would be liable on
account.of- liability. imposed on him by law, regardless of whether the ambulance was
being driven by the owner or his agent; and
B. In the sum of five hundred thousand dollars ($500,000.00) for the loss of or damage to
the property of another, including personal property, under like circumstances, in sums
as may be required by the state or as approved by the County.
10
Section 14.0 Records
A. Completed State Ambulance Call Reports (ACR)
B. Record of dispatch, which shall show time call was received, time ambulance dispatched,
time arrived on scene, time arrived at destination, time in service and time returned to
base.
C. Trip record, which shall state all information required in subsection (A) in addition to
patients address and telephone number, condition of patient, type of medical assistance
administered before reaching hospital, total trip miles, schedule of changes, and name
of attendant and driver. The trip record shall be so designed as to provide the patient
with a copy thereof containing all required information. A copy of the trip record may
serve as a receipt for any charges paid.
D. Daily report log, which shall be maintained for the purpose of identifying all persons
transported in any one day.
E. Daily driver and attendant checklist and inspection report which shall list contents and
description of operations for each vehicle, signed by the individual verifying vehicle
operations and equipment.
F. Data sheet, to be submitted on a monthly basis to the Harnett County Department of
Emergency Medical Services.
Section 15.0 Rates and Charges
A. Each franchisee shall submit a schedule of rates to the County for approval and shall not
charge more nor less than the approved rates without specific approval by the County.
B. No ambulance service shall attempt to collect rates on emergency calls until the patient
has reached the point of destination, has received medical attention and is in a condition
deemed by the physician fit to consult with the ambulance service; but such service may
attempt to.collect rates with.the,family.or guardian.of the patient once the patient is in
the process of receiving medical attention.
C. On non - emergency calls, or calls where a person requires transportation to a non -
emergency facility, attempts to collect payment can be made before the ambulance
begins its trip.
Section 16.0 Inspection of Records Authorized
The County may inspect a franchisee's records, premises and equipment at any time in order to
ensure compliance with this article and any franchise granted hereunder.
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Duly adopted on this the 6th day of July, 1999.
Kay Blanchard, Clerk to the Board
ACKNOWLEDGEMENT
NORTH CAROLINA,
HARNETT COUNTY
HARNETT COUNTY BOARD OF COMMISSIONERS
Dan B. Andrews, Chairman
//++ July 6, 1999
F i &4I0 C4' ?_6 V t M, , IJotary Public of the County and State aforesaid,
certify that Dan B. Andrews personally came before me this day who being by me duly
sworn, deposes and says: that he is the Chairman of the Hamett County Board of
Commissioners and Kay Blanchard is the Clerk of said Board, that the seal affixed to
the foregoing instrument is the official seal of Harnett County, that said instrument was
signed and sealed by him, attested by the said Clerk and the County's seal affixed thereto,
all by authority of the Board of Commissioners of said County, and the said Dan B.
Andrews acknowledged said instrument to be the act and deed of Harnett County.
witness my hand and seal on July 6, 1999„ 1 A i
(/ Notary Public ",} LJ.•'•. - -.
My Commission Expires:
12
NORTH CAROLINA
HARNETTCOUNTY p II ''rr 1
The foregoin e i tcate(s) of Y �I t Z Q P flt �, C 6 t Al }On N t, C dfN
Duly adopted on this the 6th day of July, 1999.
J
9 oT
Kay B1anA wd, Clerk to the Board
ACKNOWLEDGEMENT
NORTH CAROLINA,
HARNETT COUNTY
HARNETT COUNTY BOARD OF COMMISSIONERS
A, P.
Dan B. Andrews, Chairman
July 6, 1999
E I i L0. CA-'h ?. (-0 V i ry jk Notary Public of the County and State aforesaid,
certify that Dan B. Andrews personally came before me this day who being by me duly
sworn, deposes and says: that he is the Chairman of the Harnett County Board of
Commissioners and Kay Blanchard is the Clerk of said Board, that the seal affixed to
the foregoing instrument is the official seal of Harnett County, that said instrument was
signed and sealed by him, attested by the said Clerk and the County's seal affixed thereto,
all by authority of the Board of Commissioners of said County, and the said Dan B.
Andrews acknowledged said instrument to be the act and deed of Harnett County.
witness my hand and seal on July 6, 1999m / 1 A /
My Commission Expires:
It6
Notary Public
`gyp, V6
COD
,&8L\c
NORTH CAROLINA
HARNETT COUNTY
The foreaoinatextificate(s) of G I I 4176 f'h P. a I nq IJ D
Notary Public (Notaries Public) is /are certified to be correct. This instrument was
presente�>ior registratiop and recorded in this office at Book �age % - 735.
This day of ►J D J , 2000 at 1!'. /3 o'clock M. , P.M.
Kimberly S. Hargrove
Register of Deeds
Harnett County By:
Register of Deeds, Asst Ilk uty