Sec. 28-1.5. - Geographical scope.
Sec. 28-4. - Administrative authority.
The ordinance codified in this chapter shall be known as the "Emergency and Pre-Hospital Medical Services System Ordinance of Sonoma County."
(Ord. No. 4386 § 1, 1991.)
Sec. 28-1.5. - Geographical scope.
This chapter shall apply to the area subject to the local EMS plan except as may otherwise be limited or modified by court order or state law.
(Ord. No. 4386 § 1, 1991.)
(a)
This chapter is to provide for the public health, safety and welfare in the use of ambulance and other pre-hospital emergency care resources by the establishment of effective standards for the operation, equipment and personnel of ground ambulance and air ambulance services. It is intended to be consistent with and in furtherance of the public purposes expressed by the legislature in the Emergency Medical Services Act and other enactments. It is intended to improve the availability and quality of emergency medical services within the EMS area under the jurisdiction of the Sonoma County EMS agency. It is intended to apply to limited advanced life support services, advanced life support services, paramedic and emergency medical technician services, and all emergency ambulance services, to the extent permitted by law. This chapter does not cover wheelchair vans, gurney cars or similar dedicated non-ambulance vehicles. This chapter applies to vehicles or aircraft requiring an emergency vehicle license from the California Highway Patrol, or an air carrier operating certificate from the Federal Aviation Administration. This chapter shall be liberally construed for the accomplishment of these purposes.
(b)
This chapter is not intended to increase the obligations upon publicly owned and operated fire department or fire district ambulance services beyond the obligations already established and observed between the fire department or fire district ambulance services and the county EMS agency on or before January 1, 1991. While fire department and fire district ambulance services shall not be required to secure permits, the ambulances and their personnel shall be subject to all requirements established within this chapter, the Emergency Medical Services Act, the California Code of Regulations, and the policies, practices and procedures adopted pursuant to this chapter by the Sonoma County EMS agency.
(Ord. 4476 § 3, 1991; Ord. No. 4435 § 2, 1991: Ord. No. 4386 § 1, 1991.)
Unless otherwise specified, for the purposes of this chapter words and terms are defined as follows:
(1)
"Advanced life support (ALS)" means special services designed to provide pre-hospital care as defined in Health and Safety Code 1797.52 including, but not limited to, cardiopulmonary resuscitation, cardiac monitoring, cardiac defibrillation, advanced airway management, intravenous therapy, administration of specified drugs and other medicinal preparations, and other specified techniques and procedures administered by certified personnel under direct supervision of a base hospital. (See also: Limited advance life support)
(2)
"Advanced life support engine company" means any fire apparatus staffed and equipped to meet the minimum level requirements of the local EMS agency to provide nontransport advanced life support care.
(3)
"Ambulance" means any privately or publicly owned vehicle specially designed, constructed, modified or equipped, and used for responding to emergency calls, providing advanced life support services, as defined herein for the purpose of transporting sick, injured, convalescent, infirm or otherwise incapacitated persons.
(4)
"Ambulance personnel" means a qualified person (EMT-P, EMT-I, RN, MD) acting as an attendant responding to an emergency call who occupies the patient compartment while transporting any individual in apparent need of medical attention.
(5)
"Ambulance driver" means a licensed person who operates an ambulance as specified by this chapter.
(6)
"Ambulance service" means a private or public organization providing an ambulance for use in ALS service, emergency service or a situation which has the potential of becoming an emergency.
(7)
"Base hospital" means a hospital which, upon designation by the local EMS agency and with a written contractual agreement with the local EMS agency, is responsible for directing the advanced life support system or limited advanced life support system assigned to it or them by the local EMS agency.
(8)
"Basic life support" has the meaning as defined in Health and Safety Code Section 1797.60. Emergency first aid and cardiopulmonary resuscitation procedures which, as a minimum, include recognizing respiratory and cardiac arrest and starting the proper application of cardiopulmonary resuscitation to maintain life without invasive techniques until the patient may be transported or until advanced life support is available.
(9)
"Board" means the board of supervisors, county of Sonoma.
(10)
"Certificate" means a specific document issued to an individual denoting competence in the named area of pre-hospital emergency medical service.
(11)
"Class of services" means the level or levels of complexity of field emergency medical services that may be provided by permittee and/or certified person and will be specified as:
(i)
First Responder—person dispatched in accordance with local EMS system policies who meets minimum training requirements specified in State EMS First Responder Guidelines.
(ii)
Basic life support (BLS)—provided by EMT-I personnel conforming to regulations established pursuant to California Health and Safety Code, Section 1797 et seq.
(iii)
Limited advanced life support (LALS)—provided by EMT-II personnel certified by the EMS agency medical director.
(iv)
Advanced life support (ALS)—provided by EMT-paramedic personnel certified by the EMS agency medical director.
(12)
"County" means the county of Sonoma, state of California.
(13)
"Code 1 call" means any non-Code 3 or non-Code 2 request for ambulance service which is scheduled or unscheduled (i) where a physician, emergency medical personnel, or public safety agency has determined a need for an ambulance because of a potential for an emergency or (ii) where ALS services are requested or may be required.
(14)
"Code 2 call" means any request for ambulance service in a situation designated as non-life-threatening by dispatch personnel in accordance with county policy, requiring the immediate dispatch of an ambulance without the use of lights and sirens.
(15)
"Code 3 call" means any request for ambulance service in a situation perceived or actually life-threatening, as determined by EMS dispatch personnel, in accordance with county policy, requiring immediate dispatch with the use of lights and sirens.
(16)
"Computer-aided dispatch" or "CAD" means computer-aided dispatch system consisting of associated hardware and software to facilitate call taking, unit selection, resource dispatch and deployment, event time stamping, creation and real time maintenance of incident database and providing management information.
(17)
"Contract compliance committee" means a committee which evaluates ambulance contract compliance and reviews levies of penalties for noncompliance.
(18)
"Emergency" means any apparent sudden or serious illness or injury requiring, or having the potential of requiring, immediate medical or psychiatric attention under circumstances that delay in providing such services may aggravate the medical condition or cause the loss of life; furthermore, any case declared to be an emergency, or having the potential to be declared an emergency, as determined by psychiatric observation under Welfare and Institutions Code Section 5150 due to the potential for an emergency.
(19)
"Emergency call" means a request for an ambulance to transport or assist a person in apparent sudden need of medical attention or to assist a person who has the potential for sudden need of medical attention, or in a medical emergency as determined by a physician, to transport blood, any therapeutic device, accessory to such device or tissue or organ for transplant.
(20)
"Emergency medical care committee (EMCC)" means the emergency medical care committee of Sonoma County appointed by the Sonoma County board of supervisors pursuant to California Health and Safety Code Section 1750, et seq.
(21)
"Emergency medical services" means medical services utilized in responding to a medical emergency.
(22)
"EMS area" means all that geographical area within and governed by the Sonoma County EMS plan except as may otherwise be limited or modified by court order or state law.
(23)
"EMS plan" or "emergency medical services plan" means a plan for the delivery of emergency medical services consistent with state guidelines addressing the components listed in Section 1797.103.
(24)
"EMS dispatch" means the emergency medical services dispatch center operated by the Sonoma County sheriff.
(25)
"Emergency medical services system" means a specially organized arrangement of resources including, but not limited to, First Responders and ambulances which provide the personnel, facilities and equipment for the effective and coordinated delivery of ALS and emergency medical care services.
(26)
"Emergency Medical Technician-I (EMT-I)" means an individual trained in all facets of basic life support conforming to regulations adopted pursuant to California Health and Safety Code, Section 1797, et seq. and who has a valid certification issued pursuant to those regulations.
(27)
"Emergency Medical Technician-I (D)" means an individual who meets all of the requirements of an EMT-I with additional training in defibrillation as approved by the local EMS agency.
(28)
"Emergency Medical Technician-II (EMT-II)" means an EMT-I with additional training in limited advanced life support conforming to regulations adopted pursuant to California Health and Safety Code, Section 1797, et seq. and who has a valid certification issued pursuant to those regulations.
(29)
"Emergency Medical Technician-P (EMT-P)" means an individual who is trained in advanced life support conforming to regulations adopted pursuant to California Health and Safety Code, Section 1797, et seq. and who has a valid certification/accreditation issued pursuant to those regulations.
(30)
"Exclusive operating area" means an EMS area or subarea for which the local EMS agency restricts operations to one or more ambulance service or provider of advanced life support services.
(31)
"Fire EMS subcommittee" means a subcommittee of the Sonoma County Fire Chiefs Association.
(32)
"First Responder" means a person dispatched in accordance with local EMS system policies who meets minimum training requirements specified in state EMS First Responder guidelines.
(33)
"First Responder (D)" means a person who meets all of the requirements of a First Responder and who has completed an additional training program in defibrillation approved by the local EMS agency.
(34)
"Medical control" means the medical management of the emergency medical services system pursuant to the provisions of Chapter 5 (commencing with Section 1798) of the California Health and Safety Code.
(35)
"Mobile intensive care nurse (MICN)" means an authorized registered nurse who has been certified by the local EMS agency in conformation with the recommendations of the California Conference of Local EMS Agency Medical Directors definition of mobile intensive care nurses as qualified in the provision of emergency cardiac and noncardiac care and the issuance of emergency instruction to EMT-IIs and EMT-P field personnel.
(36)
"Patient" means a sick, injured, wounded, invalid, expectant mother, convalescent or otherwise incapacitated person.
(37)
"Permittee" means an organization which has initially been granted a permit by the board of supervisors to operate an ambulance service in the county of Sonoma. After initial approval by the board of supervisors, annual permit renewals may be granted by the local EMS agency.
(38)
"Person" means any individual, firm, corporation, association, or group or combination acting as a unit.
(39)
"PSAP (public safety answering point)" means the primary answering location of an incoming 911 call.
(40)
"Receiving facility" means a general acute-care facility which has been assigned a role in the EMS system by the local EMS agency.
(41)
"Service" means ambulance service.
(42)
"Service area" means area of responsibility to provide pre-hospital care, may include, but not be limited to, permit area, dispatch area or area included in exclusive operating area.
(43)
"Limited advanced life support (LALS)" means the services described in Health and Safety Code Section 1797.92 (limited advanced life support defined) and in Title 22 of CCR, Section 100106 (scope of practice of Emergency Medical Technician - II), or successor statutes and regulations. Such services shall only be performed by a person certified as an Emergency Medical Technician-P (paramedic) who is performing those services in the course of employment by an approved EMT-P service provider.
Incorporated by reference are all definitions of Health and Safety Code 1797.50 et seq.
(Ord. No. 4435 § 2, 1991; Ord. No. 4386 § 1, 1991.)
Sec. 28-4. - Administrative authority.
This chapter shall be administered by the Sonoma County director of public health with medical direction provided by the EMS agency medical director and/or his/her designee. The Sonoma County public health department is designated as the EMS agency for Sonoma County pursuant to the Emergency Medical Services System and Pre-hospital Emergency Care Personnel Act of 1980.
(Ord. No. 4386 § 1, 1991.)