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HomeMy WebLinkAboutAgenda - 12-07-2009 - 4nORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: December 7, 2009 Action Agenda Item No. ~- - n SUBJECT: An Amendment to the EMS Franchise Agreement entitled "An Ordinance Regulating Emergency Medical, First Responder and Rescue Service and Granting of Franchise and Contracts to the Operators In the County of Orange" DEPARTMENTS: Emergency Services PUBLIC HEARING: (YIN) No County Attorney ATTACHMENT(S): Proposed Amendments to "An Ordinance Regulating Emergency Medical, First Responder and Rescue Service and Granting of Franchise and Contracts to the Operators In the County of Orange" INFORMATION CONTACT: Frank Montes de Oca, Emergency Services Director, 245-6100 Annette M. Moore, Staff Attorney, 245-2317 PURPOSE: To consider approving amendments to the EMS Franchise Ordinance entitled, "An Ordinance Regulating Ambulance and Emergency Medical, First Responder and Rescue Services and Granting of Franchise and Contracts to the Operators In the County of Orange." BACKGROUND: On April 20, 1993, in accordance with G.S. 153A-250, the Board held a public hearing to consider replacing "An Ordinance Regulating the Operation of Ambulance Services and the Administration of Emergency Medical Assistance in Orange County, North Carolina" (EMS Franchise Ordinance), which had been effective since May 1, 1981, with an updated EMS franchise ordinance governing ambulances and other services. As provided by ~, the statute, the Board found the franchising of ambulance services was necessary to do so to assure the provision of adequate and continuing ambulance service." The then existing EMS franchise ordinance was replaced with the current ordinance entitled, "An Ordinance Regulating Ambulance and Emergency Medical, First Responder and Rescue Services and Granting of Franchise and Contracts to the Operators In the County of Orange," on April 20, 1993. Since 1993, the EMS Franchise Ordinance has not been updated. In the intervening years there have been changes in terminology as well as changes in both the statute and regulations governing these services. These amendments will update and add terminology to the EMS Franchise Ordinance to make it consistent with the existing authority granted to the County by state law and regulations including, but not limited to, the following: 1. North Carolina General Statutes Chapter 131 E, Article 7 z 2. North Carolina General Statutes Chapter 143, Article 56 3. North Carolina General Statutes section 153A-250 4. North Carolina Administrative Code, 10A NCAC 13P .0101 et seq. If the amendments are approved, potential next steps and a tentative timetable is: • Provide application to potential franchisees -January 2010; • Emergency Services will meet with potential franchisees to discuss proposals for franchises; • The Board will hold a public hearing on EMS Franchise Services to determine if a franchise is "necessary to assure the provision of adequate and continuing ambulance service and to preserve, protect, and promote the public health, safety and welfare" - February 2010; • Emergency Services provides recommendations to the Board on applicants' proposals; • Board considers permitting EMS franchises by Ordinance and contract with permitted franchises -February 2010; • Board must approve any franchise permit by Ordinance at two regular meetings - March 2010. FINANCIAL IMPACT: None RECOMMENDATION(S): The Manager recommends that the Board adopt the amendments to "An Ordinance Regulating Ambulance and Emergency Medical, First Responder and Rescue Services and Granting of Franchise and Contracts to the Operators In the County of Orange" effective and authorize the Chair to sign the EMS Franchise Ordinance as amended. The amendments to the EMS Franchise Ordinance will be effective upon signature by the Chair. D f~ l~ - ~CX7~ - I ~~ ~ AN ORDINANCE REGULATING AMBULANCE, EMERGENCY MEDICAL, FIIiST REPSPONDER AND RESCUE SERVICE AND GRANTING OF FRANCHISE AND CONTRACTS TO THE OPERATOR IN THE COUNTY OF ORANGE An ordinance governing the granting of franchises for emergency services and other prehospital emergency medical services, ~Ie County_of Orange_Board__of Commissioners__dc~__;;_=- Deieted:T ordain the following: Deleted: as CF,CTiONI, DEFINITIONS --"-~ °~~` i ' Formatted- Undedine Unless the context otherwise requires, the following definitions shall apply to the interpretation ~' ~r,,,a~ed: underline and enforcement of this Ordinance: 1.1 Ambulance. The term "ambulance" means _ any--privately_ or_Eublicly -owned _ motor-------- Formatted: Bullets and Numbering --- - - - ---------------------------------------------- - vehicle, aircraft, or vessel that is specifically designed, constructed, or modified and '~, -' Delebad:I equipped and is intended to be used for and is maintained or operated for the n transportation on the streets or highways, waterways, or airways of this State of persons '~ ~~: Font: Not Bold who are sick, injured, wounded, or otherwise incapacitated or helpless. -- Deleted:. 1.2 Ambulance Provider. The term "ambulance provider" means an individual, firm,-------- Formatted: Indent: Lett: o", corporation, or association who engages or professes to engage in the business or services Hanging: o.s^, Tabs: Not at o.zs^ of transporting patients in an ambulance. t------- Formatted: Indent: Left: 0.25", No 1.3 Approved. The term "approved" shall mean approved by the North Carolina Medical bullets or numbering Care Commission pursuant to the latter's rules and regulations promulgated under N.C.G.S.143B-165. I.4 Advisory Committee or Committee. The term "Advisory Committee" or "Committee"~------ Formatted: Bullets and Numbering shall mean the Orange County .Emergency Medical Services Committee which is the advisory committee designated by the Board of County Commissioners with respect to emergency medical services in Orange County. 1.5 Contract. The term "contract" shall mean the instrument by which both parties agree to•------- Formatted: Bullets and Numbering the terms of operation of the service to be provided. 1.6 Convalescent Transportation Services. The term "convalescent transportation service"~----- Formatted: Bullets and Numbering shall mean the operation of an ambulance for any purpose other than transporting emergency or emergent patients. 1.7 County. The term "County" shall mean Orange County and its Board of Commissioners------ Fo~att~~ Bullets and Numbering or their designated representative(s). 1.8 Emergency. The term "emergency" or "emergency transportation services" shall mean-------- Formatted: Bullets and Numbering the use of a service, its equipment and personnel to provide medical care, rescue, and/or transportation of a patient who is in need of immediate rescue or medical treatment in Page 1 of 18 4 order to prevent loss of life or further aggravation of physiological or psychological illness or injury. 1.9 Emergency Management System or EMS. Emergency Management System or "EMS"~----- Formatted: Bullets and Numbering shall mean a coordinated arrangement of local resources under the authority of the Emergency Services Director (including atl agencies, personnel, equipment, and facilities) organized to respond to medical emergencies and integrated with other health care providers and networks including public health, community health monitoring activities, and special. needs populations. 1..10 Emergency Medical Dispatcher or Telecommunicator. The term "emergency medical•=;--- dispatcher" of "telecommunicator" shall mean an emergency telecommunicator who has completed educational requirements and been credentialed by the Department of Health and Human Services as an emergency medical dispatcher and who is available to receive requests for emergency services, to dispatch emergency services, and to advise local law enforcement agencies, fire departments, rescue squads, first or medical responder units and emergency medical services and facilities of any existing or threatened emergency. 1.11. Emergency Medical Services. "Emergency Medical Services" means services rendered•- by emergency medical services personnel in responding to improve the health and wellness of the community and to address the individual's need for emergency medical care within the scope of practice as defined by the North Carolina Medical Board, .in accordance with G.S. 1.43-S14, and the Orange County Medical. Director in order to prevent loss of life or further aggravation of physiological or psychological illness or injury. Formatted: Indent: Left: 0", Hanging: 0.5", Tabs: Not at 0.25" Formatted: Bullets and Numbering Formatted: Bullets and Numbering 1.12 Emergency Medical Services Instructor. "Emergency Medical Services Instructor"~------- Formatted: Bullets and Numbering means an individual who has completed educational requirements approved by the Department of .Health and Human. Services and has been. credentialed by that Department as an emergency medical services instructor. 1.13 Emergency Medical Services Peer Review Committee. Emergency Medical Service Peer•- Review Committee means a panel composed of EA•IS prograni representatives responsible for analyzing patient care data and outcome measures to evaluate the ongoing quality of patient care, system perforniance, and medical direction within the EMS system. The committee may include physicians, nurses, EMS personnel, medical facility personnel and county government staff as determined by the Elnergenc}° Services Director in consultation with the County Medical Director. 1.15 Emergency Medical Technician (EMT). The term "emergency medical technician"----~ means an }ndividual who has completed a training_ program _in emergency medical care ... - ---------------- -------- --- - - ---------- that has been approved for legal. recognition by the North Carolina Department of Health and Human Services, in accordance with rules promulgated by the Medical Care Commission, Dias been certified as an EMT by_ the State of North Carolina Office of _. Emergency Medical Services, and approved by the County Medical Director to perform services as an EMT in the Orange County EMS system. Formatted: Bullets and Numbering -- Formatted: Bullets and Numbering - Deleted: ~ Emergency Medical Technician (EMT). The term "emergency medical technician" means an - Deleted: at least equal to the National Standard Training Program for Emergency Medical Technicians as dermed by the United States Department of Transportation and Page 2 of 18 -~ t 1.16. Emergency Medical Technician - Intermediate. The term "emergency medicals~' f technician -intermediate" means an individual who has completed a training program in emergency medical care at the intermediate level that has been approved for legal recognition by the North Carolina Department of Health and Human Services, in ,~,, IJ accordance with rules promulgated by the Medical Care Commission, has been certified 1 as an ENfT -Intermediate by the State of North Carolina Office of Emergency Medical '~ Services, and approved by the County Medical Director to perform services at the EMT- Intermediate level in the Orange County EMS system. ] .17. Emergency Medical Technician -Paramedic. The term "emergency medical technician -~~ paramedic" means an individual who has completed a training program in emergency medical care at the paramedic level that has been approved for legal recognition by the North Carolina Department of Health and Human Services, in accordance with rules promulgated by the Medical Care Commission, has been certified as an EMT-Paramedic i by the State of North Carolina Office of Emergency Medical Services, and approved by the County Medical Director to perform services as anEMT-Paran~edic in the Orange ;' County EMS system.. 1.18. Emergency Services Director. The term shall mean the person designated by the Oranges' ail County Board of Commissioners to manage the overall Emergency Management System. i; in Orange County. 1.19 Irst Res onder_ The term "first res _onder"_ shall mean an organization with personnels' -----------p- - - ------------------------p --------------------- - - trained in emergency medical care that is dispatched to the scene of a medical emergency for the primary purpose of providing emergency medical assistance to a patient until the ambulance and additional medical aid arrives. I.20 ~ranchise._ The term "franchise" shall mean a permit issued by the County_ to_ a person fors,, -- - - - - ------------------------------------------------ ------- the operation of am ambulance service, rescue squad or first responder unit. 1.21. Franchisee. The term "franchisee" shall mean any person having been issued a franchises, '~;~,, by the County for the operation of an ambulance service, rescue squad or first responder ~,. UIllt. 1 ~2. ~,icense__ 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 of North Carolina. 1.23. Medical Responder. "Medical Responder" shall mean an individual who has completed, ~~.. an educational program. in emergency medical care and first aid .approved and ~'~, credentialed by the Department of Health and Human Services as a medical .responder and the Orange County Medical Director to operate in Orange County EMS. 1.24. Medical Director. "Medical Director" shall mean the physician appointed, either directlys=; , or by written delegation, by the County and have the responsibilities as provide by LOA ~' NCAC 13P .0403 and l0A NCAC 13P .0404. The County may, in addition, appoint an Formatted: Bullets and Numbering Formatted: Indent: Left: 0", Hanging: 0.5", Tabs: Not at 0.25" Formatted: Bullets and Numbering Formatted: Indent: Left: 0", Hanging: 0.5", Tabs: Not at 0.25" Formatted: Bullets and Numbering Formatted: Bullets and Numbering Deleted: q Ambulance Provides The term "ambulance provider" means an individual, firm, wrpomtion, or association who engages or professes to engage in the business or services of transporting patients in an ambulance. Approved. The term "approved" shall mean approved by the Notth Carolina Medical Care Commission pursuant to. the letter's rules and regulations promulgated under N,C.G.S. l43B-165.q Secondary Ambulance Provider. The term "secondary ambulance provider" shall mean the system of persomel and equipment mceting the same criteria as a primary ambulance provider, but not normally dispatched on fast call response.y council. The term council" shall mean the Orange County Emergency Medical Services Advisory Couneil.9 4 County. The term "County" shall mean Orange County and its Board of Commissioners or tltev designated representatives.Q 9 Telecommmdcator. The tens "telewmmunicatol' shall mean a person whi is available at all times to receive requests for emergency services, to dispatch emergency services, ad to advise local law enforcement agencies, fire deparmrents, rescue squads, and ~, emergency medical services and .. t ~, Formatted: Bullets and Numbering Deleted: 9 Formatted: Indent: Left: 0", '~, Hanging: 0.5" Formatted: Bullets and Numbering Fornratted: Bullets and Numbering Deleted: ~ ` Formatted: Indent: Left: 0", Hanging: 0.5", No bullets or numbering Formatted: Indent: Left: 0", Hanging: 0.5", Tabs: Not at 0.33" Formatted: Bullets and Numbering Page 3 of 18 6 assistant medical director. The medical director and the assistant medical director shall meet the criteria defined in the "North Carolina College of Emergency Physicians: Standards of Medical Oversight and Data Collection," which is incorporated by reference in accordance with G.S. 150B-21..6, including subsequent amendments and editions. 1.25. Ton-Eme__rgenc_y_ Transportation Services. The term "non-emergency transportation~,_ - - ------ -- ------- --- ------ service" shall mean the operation of an ambulance for any purpose other than `:. transporting emergency or emergent patients. 1.26 Operation Protocols. "Operation Protocols" shall mean the administrative policies ands, procedures of Elvf S that provides guidance for the day-to-day operations of the system. I 1 f Formatted: No bullets or Deleted:y <#>Contract. The term "contract" shall mean the instrument by which both patties agree to the teens of operation of the service to be ptovidedt Formatted: Indent: Left: 0", Hanging: 0.5" __--Y~I. C..IIvIr ~n.l N. ~mtiOriM 1.27 Operator. __The term "operator"_shall mean a_person_In_actual_physlca_ contro o an ,, , -- - ----- - ----- -- --- - - ------ - - ambulance or rescue service vehicle which is in motion or which has the engine running. " 1.28 Owner. The term "owner" shall man any person.or_entity who owns_an ambulance_ or~~, `',,,';, provides a service covered by this Ordinance. 1.29 ~atient__ The term "patient" shall mean an individual who is sick, injured,_wounded, or•_,, `~;;,''~,~' otherwise incapacitated or helpless such that the need for some medical assistance might ~;,,, ~'~;; ~~,;; be anticipated while being transported to or from a medical facility. 1.30 ~erson._ 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. 1.31 Practical Examination. "Practical Examination means a test where an applicant for-. credentialing as an emergency medical technician, or medical. responder, emergency medical technician -intermediate, or emergency medical technician -paramedic demonstrates the ability to perform specified emergency medical care skills. Formatted: Indent: Left: 0", Hanging: 0.5", Outline numbered + Level: 2 + Numbering Style: 1, 2, 3, ... + Start at: 26 + Alignment: Left + Aligned at: 0" + Tab after: 0.29" + Indent at: 0.29", Tabs: 0.5", List tab + Not at 0.29" Formatted: No bullets or numbering Deleted:l Formatted: Bullets and Numbering Formatted: Bullets and Numbering Deleted: ¶ r-ormatted: Bullets and Numbering Deleted:l Formatted: Bullets and Numbering Deleted: ¶ Formatted: Bullets and Numbering 1.32 escue. The term "rescue" shall mean,~he removal of individuals facing_ external, non-t------- ~ Fonrtatted: Bullets and Numbering ~ medical, and non-patient related peril. to areas of relative safety. De~~ 9 Deleted: situations where the victim 1.33 Rescue Squad or Rescue Unit. The term "rescue squad" or "rescue unit" shall mean a~~_ earmot escape an area through the motmal exit or under his own power group of individuals who are not necessarily trained in emergency medical services, fire ~ . ri d N b fighting, or law enforcement, but who expose themselves to an external, non-medical, ~~: Bullets an ng um e and non-patient related peril to effect the removal of individuals facing the same type of peril. to areas of relative safety. 1.34 Secondary Ambulance Provider. The term "secondary ambulance provider" shall mean----~-~ Formatted: Bullets and Numbering the system of personnel and equipment meeting the same criteria as a primary ambulance provider, but not normally dispatched on first call response. 1.3~ ervlce. The term "service" shall mean the same as owner. -------- Forrrtatted: Bullets and Numbering - Deleted: ¶ Page 4 of 18 7 ent Protocols" shall mean a document approved by thet------- t "T l Formatted: Burets and Numbering 1.36 rea m s. Treatment Protoco medical director and the Office of .Emergency Medical. Service specifying the diagnostic procedures; treatment procedures, medication. administration, and patient-care-related policies that shall be completed by emergency service personnel based upon the assessment of the patient. I.37 Victim. The term "victim" shall mean any patient or potential_patient that_is entrap-ped,•-:-;;-~ ~~~~ -' entangled pinned, fallen, suspended, or otherwise in need of rescue services. r-ormattea: Bullets and Numbering Deleted: q -------------------------------------------------------- REQUIRED SECTION~I. FRANCHISE Deleted: ti ----------- ---------- _ 2.1 No person either as owner, agent or otherwise, shall furnish, operate, conduct, maintain,•~;---- - Formatted: Indent: Left: o^, Hanging: o.s^ or otherwise be engaged in or profess to be engaged in the business or service advertise , ency t and/or non-emer Formatted: Bullets and Numbering g of emergency medical service, emergency, emergen transportation of patients within the County of Orange unless the person holds a valid EMS Provider License and a valid permit for each ambulance used in such business or service issued by the North Carolina Department of~-lealth and Human Services, Office ------- -- - ----------------- - Deleted: HmnanResoarces franchise for the operation of ------ been granted a has and of Emergency Medical Service, - Deleted: s _ _ ~_ _ - --------- ----------------------- such business or services by the County pursuant to this Ordinance. 2.2 shall drive an ambulance, attend a patient in_ one, or permit one to be operated-- `----- person ~io - ------------ --------- ----------- ------------------------- - rwrmatted: Bullets and Numbering _ _ - - when transporting a patient within the County of Orange unless he or she holds a -- Deleted: q certificate as an EMT ;--.-- currently valid North Carolina Operator's License, apurrentlyvalid Deleted: na _ (Emergency Medical Technician), AMT-I (Emergency Medical _ Technician __ - _ --'-- -------------- - - - -' ~~; ly '- Intermediate), AMT-P Emergency__ Medical Technician -Paramedic) or Medical ---------------------------- -----------------------------, - ---- - - - - Deleted: EMT-D (Emergency Medical -------------- Responder issued by the North Carolina Department of Health and .Human Services, and '~ ~ Tectnioian-Desbriua[or, ' has been approved by the Orange County Medical Director to provide such service in Deleted: nr Oran e Count --------------------------------------------------------------------- ----------- g yk Deleted:Rewwces,Officeof -------------- Emergency Medical Services. 2.3 person either as owner, agent or otherwise, shall furnish, operate, conduct, maintain,------- ~io ------------------------------ - ---'-- -------------------- - Formatted: Bullets and Numbering _ or otherwise be engaged in or profess to be engaged in the business or service -- advertise Deleted: q , of providing rescue services, medical responder services or first responder services unless they have been granted a franchise for the operation of such business or service by the County pursuant to this Ordinance. 2.4 ~To franchise shall be required for: ~------- ----------------------------------------------------------------------------- - -- Formatxed• Bullets and Numbering -- --------------------------- --- Deleted: q a. Any entity operated from a location or headquarter outside of the County of ------ ~r,,,~d: Tabs: Not at i.zs^ Orange in order to transport patients who are picked up beyond the limits of the County of Orange, to facilities located within the County of Orange, or to pick up patients within the County of Orange for transporting to locations outside the County of Orange; but no such entity shall be used to pick up patients within the County of Orange for transporting to locations within the County of Orange or other locations unless it is rendering assistance to a franchised ambulance service in the case of a major catastrophe or mutual aid. Page 5 of 18 8 Ambulances owned and operated by an agency of the County, the State of North------" r-orn+atted: Tabs: Not at 1.25^ Carolina, or of the United States. ---- Formatted: No underline SECTION III. APPLICATION FOR AMBULANCE FRANCHISE 3.1 Application for a franchise to operate ambulances emergency or convalescent, in theme,------ Formatted: Bullets and Numbering County of Orange shall be made by the ambulance provider upon such forms as may be "" -- oeietea:> prepared or prescribed by the County and shall include, but are not limited to, the ,,' ueieted: following;._--------------------------------------------------------------------------------------------------------- ~ Formatted: Indent: LeR: 0^, Hanging: 0.5" a. The name and address of the ambulance provider and of the owner of the•~-" \~ ~eleted:eorcain ambulances(s). Formatted: Tabs: Not at 1.25" b. The trade or other fictitious names, if any, under which the applicant does-------- Formatted: Tabs: Not at 1.25^ 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-------- Formatted: Tabs: Not at 1.25^ care of patients. d. A full description of the type and level of service to be provided including theme------ Forma~~ Tabs: Not at 1.zs^ location of the place or places from which it is intended to operate, the manner in which the public will be able to obtain assistance and how the vehicle will be dispatched. A financial statement of the applicant as the same pertains to the operations in the County of Orange, said financial statements to be in such forms an in such detail as may be required by the County. e. A list of radio frequencies the applicant is authorized to operate on, and a copy of•------- Formatted: Tabs: Not at 1.zs" the FCC license(s) in the name of the person providing the service. f. A description of the applicant's capability to provide twenty-four hour coverage,-------- Formatted: Tabs: Not at 1.25^ seven 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. g. A copy of the written. plan detailing how the applicant will famish credentialed••_;_--- Formatted: Tabs: Not at 1.zs" personnel and a current roster of all credentialed personnel with a list of their ~' Formatted: Boosts and Numbering credentials. h. A copy of the applicant's written operational protocols for the management of•------- Formatted: Bullets and Numbering equipment, supplies and medications. i. Any information the County shall deem reasonably necessary for a fair-------- Formatted: Bullets and Numbering determination of the capability of the applicant to provide ambulance services in Page 6 of 18 9 the County of Orange in accordance with the requirements of state laws and the provisions of this regulations. SECTION IV. APPLICATION FOR MEDICAL OR FIRST RESPONDEI+k______ _________----- Deleted: s 4.1 Application for a franchise to operate as medical or first responders in the County of~~~----- Formatted: Indent: Left: o°, Orange shall be made by the provider upon such forms as may be prepared or prescribed Hanging: o.s^ by the County and shall include, but not be limited to the fotlowin Formatted: Gullets and Numbering ~---------------- -------------- ------- Deleted: contain a. The name and address of the provider and the owner of the service. 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 treatment and care of patients. d. A full description of the type and level of service to be provided including the location of the place or places from which it is intended to operate, the manner in which the public will be able to obtain assistance and how the vehicle will be dispatched. A financial statement of the applicant as the same pertains to the operations in the County of Orange, said financial statements to be in such forms an in such detail as may be required by the County. A current financial statement provided by a fire department, volunteer or otherwise, operating within the County which has been provided to the County as part of the County budget process shall satisfy this financial statement requirement. e. A list of radio frequencies the applicant is authorized to operate on, and a copy of the FCC license(s) in the name of the person providing the service, unless included as part of a fire department radio system. f. A copy of the written plan detailing how the applicalrt will furnish credentialed-------- Formatted: Bullets and Numbering personnel and a current roster of atl credentialed personnel with a list of their credentials. g. A copy of the applicant's written operational protocols for the management of~------ Formatted: Bullets and Numbering equipment, supplies and medications. h. A description of the applicant's capability to provide coverage for. the- district•------- Formatted: Bullets and Numbering covered by the franchise applied for, and an accurate estimate of the minimum and maximum times for a response to calls within such district. i. Any information the County shall deem reasonably necessary for a fair------ Formatted: Bullets and Numbering determination of the capability of the applicant to provide medical or first Page 7 of 18 10 responder services in the County of Orange in accordance with the requirements of state laws and the provisions of this regulations. SECTION V. APPLICATION FOR RESCUE SERVICES 5.1 Application for a franchise to provide rescue services in the County of Orange- ;--~-~ Formatted: Indent: eft: o.s", Hanging: 0.5" Shall be made by the provider upon such forms as may be prepared or prescribed by the County and shall include, but are not be limited tgthe followin :__ ____________ Formatted: Bullets and Numbering ----~~ - Deleted: contain a. The name and address of the provider and of the owner of the service(s). 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 rescue of victims. d. A full description of the type and level of service to be provided including the location of the place or places from which it is intended to operate, the manner in which the public will be able to obtain assistance and how the vehicle will be dispatched. A financial statement of the applicant as the same pertains to the operations in the County of Orange, said financial statements to be in such forms an in such detail as may be required by the County. e. A list of radio frequencies the applicant is authorized to operate on, and a copy of the FCC license(s) in the name of the person providing the service. f. A description of the applicant's capability to provide twenty-four hour coverage, seven 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. g. A copy of the written plan detailing how the applicant will furnish------- Formatted: Bullets and Numbering credentialed personnel and a current roster of all members of the rescue squad who are eligible for membership in the North Carolina Association of Rescue and Emergency Medical Services, Inc. ("the Association"); number of hours they have attended training and meetings in the last calendar year; and a copy of the roster filed with the Secretary -Treasurer of the Association for the three years preceding the application for franchise. h. A copy of the applicant's written. operational protocols for the-------- Formatted: 6uilets and Numbering management of equipment, supplies and medications. Page 8 of 18 11 A written statement showing that applicant meets the eligibility------- Formatted: Bullets and Numbering requirements established by the North Carolina Association of Rescue and Emergency Medical Services, Inc for the type of level of service being requested. Any information the County shall deem reasonably necessary for afair-------- Formatted: Bullets and Numbering determination of the capability of the applicant to provide rescue services in the County of Orange in accordance with the requirements of state laws and the provisions of this regulations. VI. GRANTING OF FRANCHISE 6.1 Prior to accepting application for the operation of any service, the Board of <;----- Formatted: Indent: Left: o.s•, Commissioner may designate specific service areas as franchise districts. Said ~ Flanging: o.s° districts will be established using Friteria_ that include geographic _ size, road Forn+atted: Bullets and Numbering -------------- --------------- access, the location of existing medical transportation services, population, and -~ ~~~~;~~at''a<in°'"~S response time. The County shall have the authority to redistrict or rearrange existing districts ay any time at their discretion. 6.2 ~1n_ applicant__ma}~__apply_ for__a franchise to operate an__ambulance _service,~----- -„ - ---- -- emergency or convalescent, rescue service, or l~dical or F~rst_1~esponderiJnit or ~- any two or all three. If more than one (1) service is to be provided, an applicant '•: ;~~- must be filed for each service. 6.3 ~Upon_receipt of an_application_for a_franchise, the County shall schedule a time•~, •' and place for hearing the applicant. Within 30 days after hearing, the County '• shall cause such investigation as it may deem necessazy to be made of the applicant and his proposed operations. 6.4 franchise ma be anted_if the Count finds_that: -------- Formatted: Bullets and Numbering ~'------------------y - ~ - -- - ------------y - - - ---------- -- ---------------_ Deleted: ~ a. The applicant meets both county and ~State_ standazds_ in addition_ to__the__ ~'• ~r,,,a~ted; Indent: LeR: o.s° ~Standazds_ outlined in the franchise ordinance; and. ~ ~' - ------------------------------------------------------------------------------ Deleted: i `~ Deleted: and b. T'he proposed service will fit within the existing services so as not to adversely affect the level of service or operations of other franchisees to render service; anc)r_ -~' Dew` c. A need exists for the rendered services in order to improve the level of service available to the residents of the County helping to assure the provisions of adequate and continuing service which preserves, protects, and promotes the public health, safety and welfare and that granting the franchise is a cost effective and reasonable manner of meeting the need. Page 9 of 18 12 (SECTION VII. ____ TERM AND TERMINATION OF FRANCHISE _________ - - --- ---------- - - - - - - - - 7.1 The County may issue a franchise hereunder to an ambulance provider, to be valid-~; ---_. for up to a term of five (5) years. 7.2 The franchise holder can surrender the franchise with 60 days notice to the - - -- County. Deleted: <#>The rrsnchise has received two (2) readings by the County.¶ 9 Formatted: Indent: Left: 0.5", Hanging: 0.5" Formatted: Bullets and Numbering Formatted: Indent: Left: 0.5", Hanging: 0.5" 7.3 The County may revoke the franchise as provided in Section XIV l.E. After a _..--- Deleted:. notice of service ternination is given. the provider Inay reapply for a franchise if continued service is desired. 7.3 Upon suspension, revocation, or termination of an EMS Provider's License, of an-~;-'-'- Formatted: Indent: Left: 0.5", ambulance permit, or franchise granted hereunder, such franchised ambulance Hanging: o.s^ service, rescue squad or medical or first responder unit immediately shall cease ~ Formatted: Bullets and Numbering operations and no care shall be rendered by the personnel associated with the ambulance service, rescue squad or medical or first responder unit. 7.4 Upon suspension, revocation, or termination. by the State or Orange County of~•------- driver's license or an attendant's credentials (i.e., first responder, rescue, '•, emergency medical technician„EMT-1,~MT-P_or medical responder credentials),_ •'•, such persons shall cease to drive an ambulance or provide medical care, medical '~„ ',, or first responder services or attend an ambulanceK______ _________________________________ •~;. •'• 7.5 The franchise shall not permit an individual to drive an anibulance or provide••,'~;~•, ~,,'~ medical. care in conjunction with the ambulance service, provide rescue service, ~'•, or medical or first responder service if the individual's credentials have been • suspended, revoked or terminated by the State or Orange County. 7.3 each franchised service shall comply at all_ times with the requirements of this•.~•• Ordinance, the franchise granted hereunder, and all applicable state and local laws '~;, ~, relating to health, sanitation, safety, equipment, ambulance design and all other ~'•;~, laws and ordinances. „, 7.4 prior approval of the County_ shall_be rec~uired_ where ownership_or_ control_ of~., ~','•, -- - -- - - - - - - - - ------------ - - more than 10 percent of the right of control of the franchise is acquired by a ~;. ~~ person or group of persons acting in convert, none of whom own or control 10 ~'• percent of more of such right of control, singularly or collectively, at the date of the franchise. By its acceptance of the franchise, the 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. Formatted: Indent: Left: 0.5", Hanging: 0.5", Outline numbered + Level: 2 + Numbering Style: 1, 2, 3, ... + Start at: 4 + Alignment: LeR + Aligned at: 0.5" + Tab after: 0.75" + Indent at: 0.75", Tabs: Not at 0.75" Deleted: a Deleted: EMT-D, Deleted: EMT-AI, or Deleted: firs Formatted: Indent: LeR: 0.5" Formatted: Indent: Left: 0.5", Hanging: 0.5", Outline numbered + Level: 2 + Numbering Style: 1, 2, 3, ... + Start at: 4 + Alignment: LeR + Aligned at: 0.5" + Tab after: 0.75" + Indent at: 0.75", Tabs: Not at 0.75" Formatted: Indent: Left: 0.5", Hanging: 0.5" Formatted: Bullets and Numbering Deleted: ~ Formatted: Bullets and Numbering Deleted: y 7.5 Arly__change _of_ ownership _of a_ franchised _service _without the approval__of_ the•-_------ Formatted: Buuets and Numbering County shall terminate the franchise and shall require a new application and a ~ -- Deleted: y Page 10 of 18 13 new franchise and conformance with all the requirements of this Ordinance as upon original franchising. in the level of service offered of a franchised ambulance service,------- 7.6 f~ny change - ----------------------------------------------- ----------------- - - - -- Bullets and Numbering Formatted _ - - --- ~ ~ rescue squad or first responder unit without the prior approval of the County sha Deleted: ~ terminate the franchise and shall require a new application and a new franchise and conformance with all the requirements of this Ordinance as upon original franchising. may be_sold,_ assigned,_mortgaged,_ or otherwise transferred without•~,__.-- 7.7 Rio franchise ~ Delet~a: ~ _ ' the approval of the County; and a finding of conformance with all requirements of Formatted: Bullets and Numbering this Ordinance as upon original franchising. Each franchised ambulance, rescue, or medical or first responder 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. 7.8 ~'he franchise certificate shall beposted in_a readily visible location at the base of-------- -- --------------------------------------- --------- --------------------------------- Formatted: Bullets and Numbering _ operations for the franchised service. ~ ~~0 9 7.9 ~ franchise certificate may not be defaced, removed, or obliterated. ~•• SECTION VIII. STANDARDS FOR j'ERSONNEL____________________.___..____________.__________..- 8.1 Ambulance drivers and attendants shall comply with the s~arldards for ambulance-~;-- drivers and attendants as developed by the North Carolina Medical Care ~~, Commissions as requirements for certification of emergency medical technicians pursuant to Article 7, Chapter 131E-158, and Article 56, Chapter 143 of the General Statutes of North Carolina, and rules and regulations promulgated by the North Carolina Medical Care Commission and ,North Carolina Medical Board _ _.. -------------------------------------------- - which~re incorporated herein by reference. 8.2 All personnel of Emergency Medical Service providers shall be approved by the~•, County Emergency Medical Services Director prior to providing medical care in Orange County. Each submission for approval shall be accompanied by the submission of a driver's license, criminal records history and. letter outlining the applicant's credentials and training. The Department of Emergency Services may designate a form to be used by applicants. 8.3 Each franchise is required to notify the Emergency Services Director, or their designee, when personnel provided for subsection 8.1 leave the service of the franchise. 8.4 A11 emergency service personnel shall adhere to the standards set by state law, regulations and the Orange County Medical Services, Emergency Medical Practice Protocols and any amendments thereto. A practical examination may be D~~d: 4 1 Formatted: Ballets and Numbering Deleted: AMBULANCE DRIVERS AND ATTENDANTS Formatted: Indent: Left: 0.5", Hanging: 0.5", Right: 0" Formatted: Bullets and Numbering Deleted: S Page 11 of 18 14 given on the Orange County Practice Protocols before permission is granted by the Medical Director to practice in Orange County. 8.5 Emergency Medical Practice standards of care shall be reviewed by the Emergency Service Peer Review Committee. STANDARD IX. STANDARDS FOR AMBULANCES AND EQUIPMENT 9.1 Ambulances and equipment standards as developed by the North Carolina ;----- Formatted: Indent: Left: o.s", Medical Care Commission pursuant to Article 7, Chapter 131E-157, and Article Hanging: o.s" 56, Chapter 143, of the General Statutes of North Carolina, shall be applied and Formatted: Bullets and Numbering the same are incorporated by reference. 9.2 All emergency ambulances and rescue squad vehicles franchised solely in Orange County shall contain the words "PROUDLY SERVING WITH ORANGE COUNTY EMERGENCY SERVICES" lettered on both sides and the rear of the vehicle body. SECTION X. STANDARDS FOR COMMUNICATIONS 10.1 Each ambulance vehicle shall be equipped with an operational two-way radio asp-" provided by l0A NCAC 13P.0207 through 10A NCAC 13P.0213 This section .- --------------- shall not apply to privately owned vehicles of the members. Formatted: Indent: Left: 0.5", Hanging: 0.5" Formatted: Bullets and Numbering Deleted: capable of establishing good quality -voice communications from within the geographic confines of the County to for each hospital(s) emergency department in the County in which the semce is based. Each ambulance vehicle shall be equipped with two-way radio communications capabilities for communications with au hospital(s) emergency deparnnents to which transportation of patients is made on a regular or routine basis anywhere widdn the state. Each ambulance a rescue vehicle shall be equipped with an operational two-way radio capable of establishing communications from within the geographic confines of the County to the dispatching agency within the County. Formatted: Bullets and Numbering Deleted: 9 Formatted: Bullets and Numbering Deleted: ~ Deleted: c Deleted: c Deleted: ~ Deleted: service Delettai: County Dispatch Getter or an acceptable and Formatted: Indent: Left: 0.5", Hanging: 0.5" Formatted: Bullets and Numbering 10.2 ~ach_ provider_ shall maintain current authorizations or Federal Communication, Commission licenses for all frequencies and radio transmitters operated by that •,,, provider. Copies of all authorizations and licenses shall be provided to the `,~, Emergency Services Department and on display and available for inspection per '~:~ Federal Communication Commission's Rules and Regulations. 10.3 each base_ of operations must have at least one open telephone line. Telephone••, `~~ -------------------------------- ---------- - - - numbers must be registered with each law enforcement agency and the '~,, •'~,'~,, Emergency Services Communications ~Center_in the County of Orange_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~" 1.0.4 ~ach_ franchises shall be dispatched_from the Emergenc}~_ Service Communication 't•, '• ~,, Cente>:_ or _ an_ acceptable _ and approved _ _alternative as long- _ as_ _ they_ _ are _ _in ~'~, 't,, ~'~, compliance with. the terms of this Ordinance and their franchise agreement as ,•, determined by the Emergency Services Director. SECTION XI. INSURANCE ] 1. t No franchise shall be issued under this Ordinance, nor shall such franchise bey, valid after issuance, nor shall any service vehicles be operated in the county of ~',;~, Orange unless the franchisee has at all times in force and effect either insurance coverage, issued by an insurance company licensed to do business in the State of Page 12 of 18 15 North Cazolina for every vehicle owned and/or operated by or for the service providing for the payment of damages: a. In the minimum sum of $1,000,000 for injury to or death of individuals in•------- Formatted: Indent: Lett: t^, Hanging: 0.5", Tabs: Not at 2.63" accidents resulting from an cause for which the owner of said vehicle would be liable on account of liability imposed on him by law, regardless of whether the vehicle was being driven by the owner of his agency; and b. ]n the minimum sum of $1,000,000 for the loss of or damage to the-------- Formatted: Indent: Left: t^~ Hanging: 0.5", Tabs: Not at 2.63" property of another, including personal property, under like circumstances, in sums as may be required by the State or as approved by the County of Orange. c. The insurance coverage minimum limits required in subsection (a) and (b)--~;--- Formatted: Indent: Left: 1^, of this subsection shall be reviewed annually by the Orange County Hanging: o.s", Tabs: Not at 2.63^ Department of Emergency Services, in Consultation with the County ~~° Bullets and Numbering Attorney and Orange County Risk Manager. Such insurance coverage shall be revised as deemed appropriate and as directed by the Orange County Department of Emergency Services. In directing a change in insurance coverage, the Orange County Emergency Services Department shall consider the risk needs protected by this insurance coverage and the availability in the marketplace of the coverage amounts to be required. SECTION XII. RECORDS 12.1 Each franchise shall maintain the following records: •------- Formatted: Bullets and Numbering a. Records of Dispatch -Shall show time call was received, time dispatched, time arrived on scene, time arrived at destination, time in service, and time returned to base --- Dew`' t------------------------------------------------------------------------------------- b. Trip, Record -Shall state all information required in Section (a) In addition to information on a form approved by the County. The trip record shall be so designed as to provide the patient with a copy thereof containing all required Deleted• information~---------------------------------------- -.-- c. Personnels Checklist and Inspection Report __- Shall _ list__ contents__ and•=;=---- Formatted: Bullets and Numbering description of operation for each vehicle, signed by the individual verifying -- Deleted: oriva ~a nnena~t vehicle operations and equipmentt--_____--____--__-_--__-______________________-________------- Deleted:. d. Any other records required by state law, rules or regulations or deemed by the•------- Formatted: Bullets and Numbering Department of Emergency Service as relevant to the effective and efficient operations of the Emergency Management System. Page 13 of 18 16 e. All of the records identified in subsection a through d above shall be•------ Fortrta~~ Bullets and Numbering maintained for a minimum three (3) year period unless a longer retention period is otherwise required by other retention periods,_ __ __-__-____--________-----~ Formatted: Font: tz pt f. Confidentiality of Patient Records. Each franchise shall maintain------- Formatted: Bullets and Numbering confidentiality of patient records as provided by the Health Insurance Portability and Accountability Act of 1996 (HIPPA), Public Law 104-191, N.C. Gen. Slat. 143-518 and all other state and federal. law. 12.2 Each franchise shall submit a written monthly report to the Emergency Services ~------- Formatted: Left, Indent: Left: 0.5^, Director, or their designee, providing the number of calls and runs during the Hanging: o.s^ month. The report shall contain the number of emergency calls, the number of convalescent calls, the total number of calls alid the total number of patients transported. SECTION XIII. RATES AND CHARGES 13.1 Each franchisee shall submit a schedule of rates to the County for approval and-------t Formatted: Boners and Numbering 1 shall not chazge more nor less than the approved by the County rates without specific approva),,___ - ----" Deleted: by thec°°"ty I3.2 ~To service shall attempt to collect rates on emergency calls_until_thepatient has-~: ----- ~ Deleted: 9 reached the point of destination, has received medical attention and is in a ' Formatted: Bullets and Numbering condition deemed by the physician fit to consult with the service, but such service may attempt to collect rates with family or guardian of the patient once patient is in the process of receiving medical attention. 13.3 On convalescent calls or calls where a_person_requires transportation_to_a_non-~,_ ----- Formatted: Bullets and Numbering emergency facility, attempts to collect payment may be made before the -~ Deleted: ¶ ambulance begins its trip. Deleted:' Formatted: Indent: Left: 0.5", tSECTION XIV.------- ENFORCEMENT --------------------------------- ----------------------------------------~~ ,'" Hanging: os" -- ,' _ Formatted: Bullets and Numbering 14.1 The Orange County,emergency_Services_Director~shall_be the enforcing authority~~_ ------------ ---------------- - __.-_ ~~;oalces°f forthe regulations contained in this Ordinances Such Director will: _ - - -----------~-------------------------~ '~'- - Deleted: Management a. Receive all franchise applicatior>.from potential_providers. ___ __ __ _ ------------- ~~~ genes Deleted: this Ordinance;_ Fonduct_an to for confor mances proposal b. Review each ~~, Deleted: office _ _ _ _ _ investigation of the appl'icant's ~roposal_ _ unde>i _ consideration _ by_ the , ~:, ~~~ rr°posals County. Deleted: study Deleted: and c. Recommend to the Board of Commissioners the approvaUdisapproval of .,' Deleted: preaent the the franchise(~)_ -------------- - ~ Deleted: for ' Deleted: s) to the apph'cant(s) submitting the best proposals Page 14 of 18 17 d. Inspect the premises, vehicles, equipment, and personnel of franchisee~to _ ------ Deleted: assure compliance to this Ordinance and perform any other inspection that - --- Deleted: may be required. e. Recommend to the Board of Commissioners the temporary or permanent suspension of a franchise in the event of noncompliance with the franchise terms of this Ordinance. Recommend the imposition of misdemeanor or civil penalties as provided therein. Immediately stay the operations of a franchise that performs in a manner-------- Formatted: Bullets and Numbering that is unsafe or detrimental to the health, safety and welfare of the residents of Orange County or the State of North Carolina, performs procedures outside the scope of practice for EMS eredentialed personnel or is not in compliance with this Ordinance or their franchise agreement. In case of such stay, the franchise may appeal the suspension as provided in Section XVI. g. ,~nsure_by cooperative agreement with other services_the co_ n_tinu_ e_d_se_ rv_ _ice_ ------ ~e~eted:l in a district where a service franchise has been suspended. h. Receive complaints from the public, other enforcing agencies, and-------- Formatted: Bullets and Numbering services regarding franchise infractions. i. Recommend improvements to the County and implement procedures------ Formatted: Bullets and Numbering which will insure better rescue,~nedical care and ambulance transportation -___--- Deleted: service. -- ------------------------------- Deleted: service and j. Maintain all records required by this Ordinance and other applicable State-------- Formatted: Bullets and Numbering and County regulations. SECTION XV. NSPECTIONS ---_-- Deleted: ivlrscEt,LANEOVs 15.1 The County may upon reasonable notice inspect a franchisee's records, premises,-<:;---- Formatted: Indent: Left: o.s^, Hanging: 0.5" and equipment at any time in order to insure compliance with this Ordinance and Formatted: Bullets and Numbering any franchise granted hereunder. SECTION XVI. ORANGE COUNTY EMERGENCY MEDICAL SERVICE ~~"~ ADVISORY~COMMITTEFi-----_____-_-________-___-•- -• 16.1 T'he Orange County Emergency Medical Services Advisory Committee~shall be a•-----" technical committee to provide guidance and make recommendations to the Board '~, of County Commissioners and Emergency Services Director of Orange County on '~ matters related to emergency medical services such as, but not limited to: , Formatted: Indent: Left: 0", Hanging: 1.5" Deleted: ADVISORY C Deleted: [TNCIL Formatted: Indent: Left: 0.5", Hanging: 0.5", Outline numbered + Level: 2 + Numbering Style: 1, 2, 3, ... + Start at: 1 + Alignment: Left + Aligned at: 0.5" + Tab after: 0.75" + Indent at: 0.75", Tabs: Not at 0.75" Deleted: until Formatted: Indent: Left: 0.75" Page 15 of 18 18 a. Review enforcement of this Ordinance and make recommendation. to the•~--"-"" Fo~a~~ Numbered + Level: 1 + • Numbering Style: a, b, c, ... + Start Emergency Servtce~_D~rector_on___m___a_t_t_e_r__s___r_e_l_a__t_i_n_g_ to_ the_ enforcement_ of_thls_ at:l+Alignment:Left+Alignedat: 0.75" + Tab after: 1" + Indent at: Ordinance. 1" b. Provide infornlation and advise to the Emergency Services Director regarding,; ~. such standards of care, policies, procedures, and actions which will maintain and ' improve the quality of emergency medical services for the residents of Orange County, including pre-hospital care provided by volunteer rescue./EMS Squads, county EMS services and privately owned ambulance services. c. Plan, develop and implement emergency medical care in coordination with the•~ regional and state ride system.. 16.2 The goal of_the Advisory_Committee shall be to assure the provisions_ of a_high~.,.,,-- - ------------------------------------- - ------------- level of quality care and service to persons in need of emergency medics ' services, non- emergency medical services and pre-hospital care in Orange County. 16.3 The County Emergency .Medical Services Committee shall. be comprised of the~~,'~, Emergency Services Director, Emergency Services Medical Director, the Assistant Medical Director, the Emergency Medical. Services Operation Manager ' and the County Health. Director. Deleted: Management Deleted: d Formatted: Indent: Left: 0.75" Formatted: Numbered + Level: 1 + Numbering Style: a, b, c, ... + Start at: 1 + Alignment: Left + Aligned at: 0.75" + Tab after: 1" + Indent at: 1" Formatted: Bullets and Numbering Formatted: Font: 12 pt Formatted: Indent: Left: 0.5", Hanging: 0.5", Outline numbered + Level: 2 + Numbering Style: 1, 2, 3, ... + Start at: 1 + Alignment: Left + Aligned at: 0.5" + Tab after: 0.75" + Indent at: 0.75", Tabs: Not at 0.75" Formatted: Bullets and Numbering 16.2 ~iepresentatives from the franchised providers_may attend_any meetings when theme------- ~~~~ Bullets and Numbering --- - - - ------- -------------------------------- Colmnittee considers matters relating to the__granting _ of_ franchises _ an _ or _ '"- Deleted: q reviewing complaints from the public and investigations regarding franchise ~ -• Deleted: cunnca services. 16.3 The Emergency Medical Services Advisory Committee shall hear appeals of stayF~;----" Formatted: Indent: Left: o.s", Hanging: 0.5", Tabs: Not at 0.29" of franchises. In case of stay of a franchise as provided in Section XIV (f): ` Formatted: Bullets and Numbering a. The Emergency Service Director, or his designee, shall. provide the•------- Formatted: Numbered + Level: 3 + franchise written notice of the sta and the reasons for the sta either Y y Numbering Style: a, b, c, ... + start at: 1 + Alignment: Right + Aligned concurrently with issuance of the stay or if oral suspension within 5 at: 1.63" + Tab after: 1.75^ + rovided either orally with a certified hall be ti ti N f d Indent at: 1.75" p ce s ce. o ays o no letter to follow or by certified mail. t------ - Formatted: Indent: Left: 1.63" b. The Franchisee may appeal the decision to the Emergency Services------ - Formatted: Bullets and Numbering Medical within 10 days of receipt of written notice. If the appeal is not heard within. 10 days the stay will be dissolved pending a hearing on the appeal. c. An appeal shall be served on the County Attorney who will forward t•~----- Formatted: Left the appeal to Emergency Services Medical Committee. ~' Formatted: Butlers and Numbering Page 16 of 18 19 d. The franchisee may either appeal by letter or request a hearing beforet------- Forma~~ Bullets and Numbering the Emergency Services Medical Committee. e. The Hearing shall be scheduled within 2 days of receipt of notice of•------{-r-ormattea: Bullets and Numbering appeal and shall be commenced within 10 days. £ The Emergency Services Medical Committee shall provide a written------- Formatted: Bullets and Numbering response to the franchise within 10 days of the hearing. The Committee shall remove the stay, provide a recommendation for corrective action and set a time for completion or forwazd a recommendation to the Board of County Commissioners for suspension or termination of the franchise agreement. g. The Board of County Commissioners shall review theme------ N bend Style a?~ e ± ~esart+ recommendation and make a decision based on the information at: 1 + Alignment: Right + Aligned contained in the recommendation from. the County Emergency at: 1.63" + Tab after: 1.75" + Medical Services Committee. Indent at: i.~s" Formatted: Font: Bold rSECTION XVIL_____ EMERGENCY_SERVICES PEER REVIEW COMMITTEE__ _ ________-----~ 1.7.1 In accordance with G.S. 131E-155, the Emergency Service Director shall provide------ Formatted: Bullets and Numbering an Emergency Medical Service Peer Review Committee composed of emergency medical service program representatives responsible for analyzing patient care data and outcome measures to evaluate the ongoing quality of patient care, system perfonnance, and medical direction within the EMS system. •- ----- Formatted: Indent: Left: 0.5" 1.7.2 The committee shall include physicians, nurses, EMS personnel, medical facility------- Formatted: Bullets and Numbering personnel and county government staff as determined by the Emergency Services Director in consultation. with the County Medical Director. 1.73 Review of medical records by the Emergency Service Peer Review Committee ism------ Formatted: Bullets and Numbering confidential and protected under G.S. 1.43-5 l8. An Emergency Service .Peer Review Committee, its members, proceedings, records and materials produced, and materials considered shall be afforded the same protection afforded the medical Review Committees, their members, proceedings, records, and materials under G.S. 131E-95. ,tSECTION XVIIl. EFFECTIVE DATE- REPEALER; GRANDFATHER PROVISIONS -'~ Deleted. ~ -- -----------------------------------------------------'----------------------------------------------------------------------= "- Formatted: Indent: Left: 0.5", Hanging: 0.5" 18.1 This Ordinance shall be amended as of _ day of December, 2009. `- -- -- Formatted: Bullets and Numbering t 8.2 This Ordinance too effect on the 20t da of_ April, 1993 An Ordinance -, "~ ~l~' ~" --------------------------~'----y - - c-----------------------<------ oe~eted: Regulation the Operation of Ambulance Services and the Administration of -' Emergency lvJ;pdical Assistance in Orange County,_ North Carolina effective May _ ___ ~~` -- ---------------------------- - ------------------------ ---- 1, 1981, is hereby repealed effective, April _ 20, _ 1993 Any _person, _ firm, or ~~~'° -- ------ ------- - - - - - corporation providing ambulance service, rescue service or first responder service ~'~ -- d~- `` Deleted: Page 17 of 18 20 pursuant to a valid franchise issued by Orange County under the repealed March 1, 1981 Ordinance shall be entitled to continue that service as provide in the franchise and for the term of the franchise. Any such franchise may, however, be suspended, revoked, or terminated as provided in this Ordinance. The amendments to this Ordinance shall be_effective on December, 2009 Valerie P. Foushee, Chair Orange County Board of Commissioners ATTEST: DATE: Donna Baker, Clerk to the Orange County Board of Commissioners Deleted: ¶ cl~, '------- Fprmatted: Indent: LeR: 0" Page 18 of 18 21 Page 3: [1] Deleted helpdesk 11/24/2009 3:54:00 AM Ambulance Provider. The term "ambulance provider" means an individual, firm, corporation, or association who engages or professes to engage in the business or services of transporting patients in an ambulance. Approved. The term "approved" shall mean approved by the North Carolina Medical Care Commission pursuant to the Tatter's rules and regulations promulgated under N.C.G.S. 143B-165. Secondary Ambulance Provider. The term "secondary ambulance provider" shall mean the system of personnel and equipment meeting the same criteria as a primary ambulance provider, but not normally dispatched on first call response. Council. The term council" shall mean the Orange County Emergency Medical Services Advisory Council. County. The term "County" shall mean Orange County and its Board of Commissioners or their designated representatives. Telecommunicator. The term "telecommunicator" shall mean a person whi is available at all times to receive requests for emergency services, to dispatch emergency services, ad to advise local law enforcement agencies, fire departments, rescue squads, and emergency medical services and facilities of any existing or threatened emergency. Emergency. The term "emergency" or "emergency transportation services" shall mean the use of a service, its equipment and personnel to provide medical care, rescue, and/or transportation of a patient who is in need of immediate rescue or medical treatment in order to prevent loss of life or further aggravation of physiological or psychological illness or injury.