HomeMy WebLinkAboutORD-2009-186 - Regulating Emergency Medical, First Responder and Rescue Service & Granting of Franchise & Contracts to the Operatiors in the County of Orangeo~~ - acx~ - ~ ~~ ~a- 7~~a ~
~~
AN ORDINANCE REGULATING AMBULANCE, EMERGENCY MEDICAL, FIItST ~~~° ~`YE
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, f11e_ County of Orange _Board _of_ Commissioners _dq_;::::- Deleted: r
ordain the following: ~ Deleted: `~
~ECTION.L DEFIlVITIONS__
Deleted: E
Formatted• Underline
Unless the context otherwise requires, the following definitions shall apply to the interpretation •' ~,; Underline
and enforcement of this Ordinance: .
1.1 ~Inbulance. The term "ambulance" means any_-privately_ or_publicly -owned motor-----° Formatted: Bullets and Numbering
- - - -------------------------------------------------------- --------- -
vehicle, aircraft, or vessel that is specifically designed, constructed, or modified and ',, "' • Delved: 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 '• Fortnathed: ~~. Not Bold
who are sick, injured, wounded, or otherwise incapacitated or helpless.
_ -- Deleted:.
1.2 Ambulance Provider. 1fie term "ambulance provider" means an individual, firm,-------- Fortnat6ed: Indent: LeR: 0",
corporation, or association who engages or professes to engage in the business or services Hanging: 0.5", Tabs: Not at o.25"
of transporting patients in an ambulance.
------- Formatted: Indent: Lett: 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 Tatter's rules and regulations promulgated under
N.C.G.S. 143B-165.
1.4 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 >R+hich both parties agree tom------ 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-------- Formatted: 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
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order to prevent loss of life or further aggravation of physiological or psychological
illness or injury.
1.9 Emergency Aanagement 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 all agencies, personnel, equipment, and
facilities) organized to respond to medical emergencies and integrated with other health
care providers and nerivorks including public health, community health monitoring
activities, and special. needs populations.
1..10 Emergency Medical Dispatcher or Telecommunicator. The term "emergency medical;----- Formatted: mdenu Left: o•,
"
dispatcher" of "telecommunicator" shall mean an emergency telecommunicator who has ~ Hanghrtg: 0,5', Tabs: Not at 0.25
completed educational requirements and been credentialed by the Department of Health ~~ ~~~~ and Numbering
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-------- Formatted: Boilers and Numbering
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. 143-514, and the Orange County Medical. Director in order to
prevent loss of life or further aggravation of physiological or psychological illness or
injury.
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-------- Formatted: Burets and Numbering
Review Committee means a panel composed of EMS program representatives
responsible for analyzing patient care data and outcome measures to evaluate the ongoing
quality of patient care, system performance, 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 Emergency Services
Director in consultation with the County Medical Director.
1.15 Emergency Medical Technician (EMT). The term- "emergency medical technician"~-=----
means an,~ndividual w_ho 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, j-as 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
Deleted: ~
Finageo~y Medico! Technician (EM7).
The tens "emergency medial
tedwcian" tneaas an
Deleted: et least equal to the National
Standard Training Program for
Emergency Medical Teclmiaans as
de£med hY the United Stares llepartment
of Transportation and
Page 2 of 18
5
.- Formatted: Bugels and Numbering
1.16. Emergency Medical Technician -Intermediate. The term "emergency medical'- Formatted: Indent: t.eft: o•,
"
leted a training program in ;
has com
l
h
id
i
di
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p
w
o
v
ua
n
means an
technician -intermediate
~
l care aS the intermediate level that has been approved for legal ;
di Fornta~~ Bullets and Numbering
ca
emergency me
' "
recognition by the North Carolina Department of Health and Human Services, in ',
' ,
Formatted: Indent: test: o
"
•
'
has been certified
i
i
C
l C
i , Tabs: Not at 0.25
Hanging: 0.5
omm
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on,
are
ca
accordance with rules promulgated by the Med
th Carolina Office of Emergency Medical
t
f N
th
S
b
di Forntat~d: Bullets and Numbering
or
ta
e o
e
ate
y
as an EMT -Interme
the County Medical Director to perform services at the EMT- ~'
roved b
d
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i Matted: Bullets and Numbering
y
cES, an
app
erv
Intermediate level in the Orange County EMS system. ~ ~
Ambulance Provides. The tam
~ "ambulance provides" means an
1.17. ~"'
Emergency Medical Technician -Paramedic. The term "emergency medical technician -~ inaiviaaal, ~, corpcxation. ~*
t
f
l
paramedic" means an individual who has completed a training program in emergency esses
o
ro engages or pro
association w
engage m the business or services of
medical care at the paramedic level that has been approved for legal recognition by the ;: ~spo~s patiats in an ambnianu-1
North Carolina De artment of Health and Human Services, in accordance with rules ''
P
~ 1
Approved. The tam "approved" span
promulgated by the Medical Care Commission, has been certified as anEMT-Paramedic r,~ moved by the xorth Carolina
by the State of North Carolina Office of Emer enc Medical Services and a roved b
g Y ~ PP Y ' ; MedtcalCareComrmsstonptasuantto
the lattes's riles and regulations
the County Medical Director to perform services as anEMT-Paramedic in the Orange pranulgatedunderN.C.G.s.143B-165.
County EMS system.. ' ti Secondary Ambulance Provides. The
+' terra "cecondary ambulance providd'
I.18. Emer enc Services Director. The term shall mean the erson deli ated b the Oran ' ~
g y P ~ Y ~'~ ; shall 1°~ ~6 ~~' of personnel and
eyuipmart meeting the same aitaia as a
County Board of Commissioners to manage the overall Emergency Management System primaryamtwlanceproviaes,butnot
~~~ ~ ~ ~
in Orange County. ; j
9
1.19 lrst Res onder_ The term first res onder'_shall mean an organization_with personnel-'
-~~----------p - -~ -------------- -----
p ~~`;,'e~Cow~tyEmagencyMeaieal
- - - -----------
-----------
trained in emergency medical care that is dispatched to the scene of a medical emergency serv;ces AdvisoryCmmor7.9
for the primary purpose of providing emergency medical assistance to a patient until the ~;y. ~e tesm wry. =hero mean
ambulance and additional medical aid arrives. otaage county ernes its Board of
Camm_=ones= or their designated
represmtatives.l
1.20 franchise. The term "franchise" shall mean a permit issued by the County_ to a person for,, t
,
- - - - - ---------------------------- - - - -
the operation of am ambulance service, rescue squad or first responder unit. Telecommunicator. The tam
.~,,,,;~. sl,an mesa a person
vvhi is avanable u sU times to receive
1.21 Franchisee. The term "franchisee" shall mean any person having been issued a franchise. ~~'•. ~OCS"fOf°11E1geOCY~"`'rO
dispatch emergenry services, ad to advise
by the County for the operation of an ambulance service, rescue squad or first responder ': ~, local law wfarcem~t agencies, fire
ilrllt. an~m edical sesvices and I
'
'
~ Formatted: Bullets and Numbering
'
I.22. ~,,
~,,
~.icense__ The term_"license" shall mean_any_ driver's license or permit to operate a motorh;
li
f
h ~~: t
na.
e State of North Caro
t
vehlcle issued under or granted by the laws o
tted: Indent: Left: 0"
F
'•,
' ,
orma
Hanging: 0.5'
'
1.23. ~. •,
Medical Responder. "Medical Responder" shall mean an individual who has completed,
~' Formatted: Bullets and Numbering
•,
an educational program. in emergency medical care and first aid approved and
~'
Format3ed: Bullets and Numbering
credentialed by the Departmant of Health and Human Services as a medical .responder
EMS
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i
O Dew`'
.
oun
y
range
n
and the Orange County Medical Director to operate °
,
Formatted: Indent: Left: 0
1.24.
Medical Director. "Medical Director" shall mean the physician appointed, either directly; ,
~ Hanging: 0.5", No bullets or
numbering
' '•
or by written delegation, by the County anal have the responsibilities as provide by l0A ~; tndern: Left: o•,
0403 and l0A NCAC 13P .0404. The County may, in addition, appoint an ~.
NCAC 13P Hanging: 0.5", Tabs: Not at 0.33•
. Formatted: Bullets and Numbering
Page 3 of 18
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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 anal editioas.
----- Formatted: No bullets or
1.25. Ton-Emergency_ Trans ortation _Services. The term "non-emergency trans _ rtation~~- ' ""'"""'~
--- - ------ - ---------------------- - - - ----po -- ----- Drletad: q
--~ - -
service" shall mean the operation of an ambulance for any purpose other than ';, ~~ .~ rem, _~~^ sbau
transporting emergency or emergent patients. ~ ~~ ~~~ bs' "'~'~' h°a'
pasties agree to the rums of operation of
', the service to be proviskdq
1.26 Operation Protocols. "Operation Protocols" shall mean the administrative policies ands. ~'•,'•, q
procedures of EM.S that provides guidance for the day-to-day operations of the system. ~';~' FortnatEed: Indent" Left: o^,
Hanging: 0.S
1.27 ~Jperator. _The term_ "operator" shall _mean a -person- in_ actual physical control of_ any, :, '•,
'
' Fotmatbcd: Bullets and Numbering
~,,
ambulance or rescue service vehicle which is in motion or which has the engine running , Formatted: Indent; Left: o^,
~ Hanging: 0.5^, Outline numbered +
~ ~•
person or_entity__who owns an ambulance or-,, ~, ~;
shall man any
1.28 Owner. The term "owner" Level: 2 + Numbering Style: 1, 2, 3,
,•, + Start at^ 26 + Alignment: Left +
_
_
provides aservice covered by this Ordinance. Aligned an 0" + Tab after: 0.29• +
Indent at: 0.29^, Tabs: 0.5", Lid
,~~'
'
;
1.29 patient. The term "patient" shall_ mean an-individual who is sick, in~ured,.wounded,_ or-; Formatted: No bullets or
otherwise incapacitated or helpless such that the need for some medical assistance might ^., '~;; ~;';
~ numbering
be anticipated while being transported to or from a medical facility. Deleted: q
Formatted: Bullets and Numbering
;, •,•.
1.30 ~erson.___The term_ "person" shall_ mean_ anx individual,_ firm, _partnershipj_ association,-., '•;;, ~; ~~~: Bullets and Numbering
corporation, company, group of individuals acting together for a common purpose, or ;•. ;,,; Deleted: q
organization of any kind, including any governmental agency other than the Umted ~'•;
States. Forrttaited: Bullets and Numbering
Deleted: q
1.31 Practical Examination. "Practical Examination means a test where an applicant forte. ~'• Fortnattede Bulets and Numbering
credentiating as an emergency medical technician, or medical responder, emergency ~ ~ De~d:1
medical technician -intermediate, or emergency medical- technician -paramedic ~ Formatted: Bullets and Numbering
demonstrates the ability to perform specified eiergency medical care skills.
1.32 escue. The teen "rescue" shall mean a removal of individuals facin _ external, non :;:-----
---------•-~------------------------------------------g -
--- Formatted: Bullets and Numbering
-
-------------------------------------
medical, and non-patient related peril to areas of relative safety. -' ~~~ i
Deleted: situations whose the victim
1.33 Rescue Squad or Rescue Unit. The term "rescue squad" or "rescue unit" shall mean a~~, ~~ ~~ ~ ~Wer
~
group of individuals who are not necessarily trained in emergency medical services, fire FO1n' Bullets and Numbering
fighting, or law enforcement, but who expose themselves to an external, non-medical,
and non-patient related peril to effect the removal of individuals facing the same type of
peril to areas of relative safety.
l .34 Secondary Ambulance Provider. The teen "secondary ambulance provider" shall mean-------- ~~++~ 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.
« .~ ~---•-•
1.35 ernce. The term service shall mean the same as owner.
------------------------------------•---------------------------------------------------•------------------------------------- Formatted: Bullets and Numbering
- Deleted: q
Page 4 of 18
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1.36 Treatment Protocols. "Treatment Protocols" shall mean a document approved by thew------ r-orn+atted: sunets and Numbering
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.
1.37 ~Victim_ The term "victim" shall mean any patient or potential,patient that_is_entrapped,-•,_;;-- Dew:
- --------- ----------- ----- - - --- ---- -
entang[ed pinned, fallen, suspended, or otherwise in need of rescue services. -' Formatted: Buuehs and Numbering
Deleted: q
SECTION~I.__FRANCHISE_REQiJIRED------------------------------------- ----- Deleted:n
2.1 No person either as owner, agent or otherwise, shall furnish, operate, conduct, maintain,•~;----- Formatted: indent: ~ fY,
advertise, or otherwise be engaged in or profess to be engaged in the business or service ~ Hanging: o.s~
of emergency medical service, emergency, emergent and/or non-emergency ~~ Bullets and Numbering
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 ofklealth_and_Human_Services, Office --- Delebed:x~enlteso,uces
of Emergency Medical Service,r_and_has been granted a franchise for the operation of_---_.- Deteted:s
------- - - --------- -
such business or services by the County pursuant to this Ordinance.
apatient in_one, orpennit one to be operated;-----
2.2 ,~To person shall drive an ambulance, attend
----------- formatted: Bullets and Numbering
_
--- -
when transporting a patient within the County of Orange unless he or she holds a - -- Deleted: q
currently valid North Carolina Operator's License, aFurrentlyvalid_certificate as an EMT-__----- Deleted: na
(Emergency Medical Technician), AMT-I (Emergency _ Medical _Technician-__ -~ •-'--
• ~~; ~y
-'-
]ntermediate), AMT-P _ Emergency--Medical Technician -_ Paramedic) _ or__M.edical
- - - - ------ - - - ~
Deleted: F.MT-D (Emergenry Medical
Responder issued by the North Carolina Department of Health and Human Services, and '• reclmioian-Desbriuata;
has been approved by the Orange County Medical Director to provide such service in •' Deed;
OrangeCountyt----------------------------------------------------------------------•--------------------------------•--- Deleted:Resoarces,officeof
Emergwry Medical Services.
operate,_conduct, maintain,------
2.3 ,~To person either as owner, agent or otherwise, shall furnish, formatted: gullets ark Numbering
_
advertise, or otherwise be engaged in or profess to be engaged in the business or service -- D~~; 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 ~lo_franchise shall be required for_ ~•----- formatted: golfers and Numbering
-' Deleted: q
a. Any entity operated from a location or headquarter outside of the County of•------- Formatted: Tale: Not at 1.25"
Orange in order to transport patients who aze 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
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b. Ambulances owned and operated by an agency of the County, the State of North-------- Fon,+atted: Tabs: Not at l.zs"
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 the«,------ Formatted:BuuetsandNumbering
County of Orange shall be made by the ambulance provider upon such forms as may be ~`~ -- ti'eleted:,
prepared or prescribed by the County and shall include, but are not limited to, the .;' t-eleted;
following----------------- --------------_-__-- ~ Formatted:Indent: Left: 0",
Hanging: OS
a. The name and address of the ambulance provider and of the owner of the^-- ~' ~eletad: ~~
ambulances(s). ~' Formatted: Tabs: Not at 1.25"
b. The trade or other fictitious names, if any, under which the applicant does-------- Fon»atted: 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 the-------- Formatted: Tabs: Not at 1.25`
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 1.25"
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 furnish credentialed--:;---- Formatted: Tabs: Not at 1.25^
personnel and a current roster of all credelltialed personnel with a list of their ~- Formatted: Bullets and Numbering
credentials.
h. A copy of the applicant's written operational protocols for the management of ------ Formatted: Bullets.aM Numbering
equipment, supplies and medications.
i. Any information the County shall deem reasonably necessary for a fair-------- Formatted: aui~ and Numbering
determination of the capability of the applicant to provide ambulance services in
Page 6 of 18
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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~_______________-.---- Detet~a: s
4.1 Application for 'a franchise to operate as medical or first responders in the County of«;----- Formatted: Indent" Leff 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 followin Forn+a~~ Bu~letsand 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 applicant will furnish credentialed--•----- r-orn+atted: Burets and Numbering
personnel and a current roster of all 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 Numlxring
equipment, supplies and medications.
h. A description of the; applicants' capability to. provide coverage .for the district--~--"'- Fo:matted: Boilers 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
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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;----- Ponmatted: invent: Lein o.5',
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 are riot be limited tgthe following------ --- ----_ ~ ~~~ Bullets and Numbering
-' Deleted: c~rain
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 fiom 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-------- r-o~matted: t3ullels and Numbering
credentialed personnel and a current roster of all member 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: Bullets and Numbering
management of equipment, supplies and medications.
Page 8 of 18
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i. A written statement showing that applicant meets the eligibility-------- Formatted: Burets 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.
j. 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 Boazd of«;----- Formatted: Indent: i.eft: O.s',
Commissioner may designate specific service azeas as franchise districts. Said ~ Hanging: o.s•
districts will be established using Friteria that_ include _ ~eo~ra_phic _ size, road ~+~~ Bullets and Numbering
access, the location of existing medical transportation services, population, and •- ~~~•~'"O~"~
response time. The County shall have the authority to redistrict or rearrange
existing districts ay any time at their discretion.
6.2 ~n__applicant _may apply for__a _ franchise to oPerate_ an__ambulance_ service,--__---- Formatted: Burets and Numbering
emergency or convalescent, rescue service, or lv~dical or First I~sponder,Unit or •''- Deleted: i
any two or all three. If more than one (1) service is to be provided, an applicant ~?: ''-- Deleted: a:
must be filed for each service. Dented: t
Deleted: r
6.3 ,Upon_recei t of an_a lication_for a franchise, the Coun shall schedule atime--, ~',
Deleted: u
- - - p - - -- pP-- -- - ----------------------------------~'--------------------------------- .
and place for hearing the applicant. Within 30 days after hearing, the County '•,
shall cause such investigation as it may deem necessary to be made of the F°r'rr~° Buuets and Numbering
applicant and his proposed operations. ~ ~
6.4 ~ fi•anchise may be granted if the County finds that: ~------ Formatted: Bullets and Numbering
--------------
'- Deleted:l
a. The applicant meets both county and State standards in addition to the ~'• Formatted: IndenC. Left: o.s"
rstandazds outlined in the franchise ordinance; and. ____________________~ -'-- Deleted; ~
----°--------- Deleted: and
b. The 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; an~_ .---'" 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 TERMIlVATION OF FRANCHISE ...-- Deleted: ~IAThe >iandu~ has mxaved
-- ---------------------------------------------------------------------------------------•------------•-----------------------•------ two(z)readingsbyB,eCo~mty.9
4
7.1. The County may issue a franchise hereunder to an ambulance provider, to be valid-----__-
Formatted: Indent: Left: 0.5",
for up to a term of five (5) years. Hanging: o.s
Formatted: Bullets and Numbe
7.2 The franchise holder can swrender the franchise with 60 days notice to the ~--- -• ~,n,a~; Indent: Left: 0.5",
COUnty. Hanging: 0.5"
7.3 The County may revoke th.e franchise as provided in Section XIV l.E: After a__ __ _-_..-- Deleted:.
•----
notice of service terntiliation 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, or an~~;----- Formatted: Indent: test: 0.5",
ambulance permit, or franchise granted hereunder, such franchised ambulance ~ Hanging: 0.5'
service, rescue squad or medical or first responder unit immediately shall cease ~~ 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 th.e State or Orange County ofd--------
driver's license or an attendant's credentials (i.e., first responder, rescue, '•,
emergency medical technician,kMT-I,~.MT-P_or m_ edical responder credentials), ~'~
such persons shall cease to drive an ambulance or provide medical caze, medical ';~ ~'.,
or first responder services or attend an ambulancev_ _ _ _ _ _ ______________ ______ __ __ ",, ~•.,
7.5 The franchise shall not permit an individual to drive an ambulance 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 required where ownership or control off, ''~'~,
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, singulazly or collectively, at the date of '
the franchise. By its acceptance of the franchise, the franchisee specificalty
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.
7.5 ~lliy change _of ownershi_p _of_ a_ franchised service without the approval of_the~-
County shall terminate the franchise and shall require a new application and a
Formatted: Indent: Left: 0.5",
Hanging: 0.5', Outline numbered +
Level: Z + Numbering Style: 1, Z, 3,
... + Start at: 4 + Aiignmer~ Left +
Aligned at: 0.5' + Tab after. 0.75"
+ Indent at: 0.75', Tabs: Not at
0.75'
Deleted: a
Deleted: EMI'-D,
Deleted: EMr-AI, or
Deleted: free
Formatted: Inderrt: Left: 0.5"
Formatted: Inder>C Left: 0.5",
Hanging: 0.5', Outline numbered +
Level: 2 + Numbering Style: 1, Z, 3,
... + Start at: 4 + Alignment: Left +
Aligned at: 0.5" + Tab after: 0.75"
+ Indent at: 0.75", Tabs: N~ at
0.75"
Formatted: Indent: Left: 0.5",
Hanging: 0.5"
Formatted: Bullets and Numbering
Deleted: q
Formatted: Bullets and Numbering
Deleted: q
Formatted: Bullets and Numbering
Deleted:l
Page 10 of 18
13
new franchise and conformance with all the requirements of this Ordinance as
upon original franchising.
7.6 level of service offered of a franchised ambulance service,--------
~rr~ change in the Formatted: Bullets and Numbering
_
rescue squad or first responder unit without the prior approval of the County shall -- Deleted: q
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.
7.7 Flo franchise may be_sold, assigned,_mort~aged,_or otherwise transferred without~•:-_•-- Delebed:q
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 fi-arrchise certificate shall beposted in a readily visible location at the base of-------- Formaibed: Bullets and Numbering
operations for the franchised service. Deleted: t
7.9 ~ franchise certificate ma}~ not be defaced, removed or obliterated. ___ ~•• ----
_ - D~e~~4
~- Formatted: Bullets and Numbering
SECTION VIII. STANDARDS FORFERSONNEL _________________.--
-- -------------------------------------------°-------°-- Deleted:AMBULANCEDRIVERS
AND ATTENDANTS
8.1 Ambulance drivers and attendants shall comply with the ~arrdards for ambulance-~;-----
----- wrmatted: Indent; tetr. o.s',
- - -----
.drivers and attendants as developed by the North Carolina Medical Care '~, Hanging: 0.4, Right 0'
Commissions as requirements for certification of emergency medical technicians
~ Formatted: Bullets and Numbering
pursuant to Article 7, Chapter 131E-158, and Article 56, Chapter 143 of the Deleted: s
General Statutes of North Carolina, and rules and regulations promulgated by the
North Carolina Medical Care Commission and Fiorth Carolina Medical Board -,.--- Deleted: Board of Medical Examiners
--------------------------------------- "
which~re incorporated herein by reference. for Advanced Life SuppoRTeclmicians
. -. - Deleted: sLaB tx applied ~ dw same
8.2 All personnel of Emergency Medical Service providers shall be approved by the•~, ~- Formatted: Indent: Left: O.S,
"
County Emergency Medical Services Director prior to providing medical care in ~ Hanging: 0.5
Orange County. Each submission for approval shall be accompanied by the ~atted: Justified, Indent: Left:
• 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 All 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
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°---- Foramatted: Indent: Left o.5',
Hanging: 0.5"
Medical Care Commission pursuant to Article 7, Chapter 131E-157, and Article •, ~_ Bullets and Nutrtbering
56, Chapter 143, of the General Statutes of North Carolina, shall be applied and
the same are incorporated by reference.
92 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.
Formatted: Indent: Left: O.S,
SECTION X. STANDARDS FOR COMMUNICATIONS .' Hanging: 0.5'
.' __- Formatted: Bullets and Numbering
10.1 Each ambulance vehicle shall be equipped with an operational two-way radio asp-"'"~
provided by l0A NCAC 13P.0207 through l0A NCAC 13P.0213 This section ~,.--"~
shall not apply to privately owned vehicles of the members.
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 •i',
Federal Communication Commission's Rules and Regulations.
10.3 ~ach_base_ of operations must have at least one open telephone line:__Telephone•,, ~'•~
numbers must be registered with each law enforcement agency and the '•:,, ~';i•
Emergency Services Communications Center in the County of Orange_________________~ ~',,; ~'~;
~~
. ~,
]A.4 each franchiseshall be dispatched from the Emergency Service Communication_ :;';''.
, ,.
Centeir_ or_ an__ac_ceptable_and approved_alternative__as__lonp,__as they _are_ to '~,'•,~,'•;•
compliance with the terms of this Ordinance and their franchise agreement as ';,':•,•'~
determined by the Emergency Services Director.
SECTION XI. INSURANCE
11.1 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
Deleted: capable of estabnshing good
quality -voice communications from
within the geographic rnn5nes of the
Cowry to for each hospital(s) emergency
deparhne~ m the Cowry in whirb the
service is based. Each ambulanx vehicle
Shan be equipped with two-way radio
communications cspsbdities fa
communicazions with all hospital(s)
emergency depar>meao to which
trwsportation of patients is made on a
regular or routine basin anywhere within
the ante. Each ambulan« a rescue
vehicle shall be egtupped with ao
operational two-way radio capable of
establishing com<nunicatirms from within
the geographic confines of the Cowry to
the dispatching agency within the
County.
Formatted: Bullets and Numbering
Deleted: 1
Formatted: Bullets and Numbering
Dtdebad: ~
Deleted: c
Deleted: c
Ordered: 4
Deleted: servicc
Deleted: County Dispatch Ceara or an
acceptable and
Formatted: Indent: Lett 0.5",
Hanging: 0.5'
Formatted: Bullets and Numbering
Page 12 of 18
15
North Carolina 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 Left 1",
accidents resulting from an cause for which the owner of said vehicle Hanging: o.s", Tabs: Not at 2.63°
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 1",
property of another, including personal property, under like circumstances, Hanging: o.s•, Tabs: Not at 2.63'
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: Inderrt: Leff: 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 Formatted: 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 -' °~~°
t---- ----------------------------------------------------------------------------- - ------
b. Tri° 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
information ----- Deleted:
c. Personne)~ Checklist and Inspection Report - Shall list contents ands------ Formatted: Bullets and Numbering
description of operation for each vehicle, signed by the individual verifying -- t)eieted: Driva and attmdmt
vehicle operations and equipmentt_____________________________________________________________------ t)eteted:.
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 bey------ Formatted: 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: iz pt
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,
1~T.C. Gen. Stat. 143-518 and a!1 other state and federal law.
122 Each franchise shalt submit a written monthly report to the Emergency Services -------- Formatted: Left, indent. Left: o.s,
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 and 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-------- Formatted: Bullets and Numbering
shall not charge more nor less than the approved by the County rates without
specific approva4---• -----•----------------------------------------------- Deleted: by meco>mty
I32 ~To service shall attempt_to collect rates on emergency calls until_the~atient has-:,_;;-- ~~: 1
--- - - - - - ---------------- ----------------------
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_ reguires_ transportation. to a non-~------ Formatted: Bullets and Numbering
emergency facility, attempts to collect payment may be made before the - '- Deleted:l
ambulance begins its trip. ~~: ~
,iSECTION XIV. ENFORCEMENT ,'" , Formatted: tnaent. l~ o.s,
----------•-----------------------------------°-----•-------------------------•-•-----------------------------------------------~' •" Hanging: 0.5"
.- Formatted: Bullets and Numbering
,' -.
14.1 The Orange County~merg~ency Services Director~shall-be the enforcing authorit~+~ '''--•__ DeJeted:offioes°f
--- -
for the regulations contained in this Ordinancet_ Such Director will: `~ --
- ~ Deleted: Ma°egemmt
a. Receive all franchise applicatior><from potential_providers____ ________ _ _ •-_ _ Dew` Be°`y
Deleted:
b. Review each_proposal_ for conformances to this Ordinance; ,ponduct an '•, Dew' °~a
investigation of the appl'icant's proposal__ unde,i consideration b~__ the 1~:; , ~~~ P~~
County. Deleted: se~ay -_
Deleted: ene
c. Recommend to the Board of Commissioners the approval/disapproval of .,' p~~; t ~
the franchise(s):--- - ----_--- ~ Deleted: ra
----------------------------------------------•--------------------- -
. Deleted::) to the appL'cmt(s)
- submietina the beat °ro°ossl(s
Page 14 of 18
17
d. Inspect the premises, vehicles, equipment, and personnel of franchiseegto _------ Dde~d:
assure compliance to this Ordinance and perform any other inspection that -- -• Deleted: ~
may be required.
e. Recommend to the Boazd 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------- r-onmatbed: 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 credentialed 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. insure by cooperative agreement with-other services_the co_ n_tinu_ ed_s_er_vice_ __-.--- Deleted: q
in a district where a service franchise has been suspended.
h. Receive complaints from the public, other enforcing agencies, ands------ 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. - - Meted: s~;~ ana
j. Maintain all records required by this Ordinance and other applicable State-------- Formatted: Bullets and Numbering
and County regulations.
SECTION XV. ~7SPECTIONS -_--- Deleted: MISCELLANEOUS
15.1 The County may upon reasonable notice inspect a franchisee's records, premises,«;;--
and equipment at any time in order to insure compliance with this Ordinance and
any franchise granted hereunder.
SECTION XVI. ORANGE COUNTY EMERGENCY MEDICAL SERVICE ~'~
- Formatted: Indent Left: 0.5',
Hanging: 0.5'
Formatted: Bullets and Numbering
Formatted: Indent Left: 0",
Hanging: 1.5'
Deleted: ADVLSORY C
Deleted: uNCIL
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: wcd
Formatted: Indent Left: 0.75"
ADVISORY,COMMITTEF{--------------------------------------------------------------==----
16.1 The Orange County Emergency Medical Services Advisory Committeetshall 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:
.,
Page 15 of 18
18
a. Review enforcement of this Ordinance and make recommendation to theme------ Formatted: Numbered + Level: 1 +
Emergency Service-Director on matters relatin to the enforcement of this Numbering style: a, b, c, ... + start
- - - -------------------•---~ - -------•------•---------- --, at l+AlignmentLeft+Alignedat
Ordinance. 0.75 + Tab after: 1" + Indent at:
The Emergency Service Director, or his designee, shall provide the
franchise written notice of the stay and the reasons for the stay either
concurrently with issuance of the stay or if oral suspension within 5
days of notice. Notice shall be provided either orally with a certified
letter to follow or by certified mail.
b. Provide information and advise to the Emergency Services Director regazding~;~•.,~'•, oe~:M~ean~r
such standards of care, policies, procedures, and actions which will maintain and '~ •. Deleted: a
improve the quality of emergency medical services for the residents of Orange ~,' Formatted: Indent: Lett: 0.75
County, including pre-hospital care provided by volunteer rescue./EMS Squads, ~' ~; Numbered + Level: 1 +
county EMS services and privately owned ambulance services. Numbering style: a, b, c, ... + start
at: 1 + Alignmert Left + Aligned at:
0.75" t Tab after: 1" + Indent at:
c. Plan, develop and implement emergency medical care in coordination with the~•.. 1"
regional and statewide system.. ~' Formatted: Bullets and Numbering
16.2 The~oal_of the_Advisory_Committee shalt be to asswe the provisions of a high:.;;--
- - - --•-- - - - ----°°-------•--
level of quality caze and service to persons in need of emergency medical
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.
1"
Formatted: Font 12 pt
r-orrnatted: Inder:t: Left: 0.5,
Hanging: 0.5, Outline numbered +
Level: 2 + Numbering Style: 1, 2, 3,
... + Start at: 1 + Alignment Left +
Aligned at D.5 + Tab after. 0.75
+ Indent at: 0.75, Tabs: Not at
0.75
Formatted: Inder;t: Left: 0.5
Formatted: Bullets and Numbering
16.2 ,representatives from the franchised providers_may attend any meetings when_the•-_:---- Formatted: Bullets and Numbering
- --------------- --- - - -
Coinmittee considers _ matters -relating - to the--grantang _ of _ franchises -and/or _ -'-- Deleted: 1
reviewing complaints from the public and investigations regarding franchise -• De~eted:c~
services.
16.3 The Emergency Medical Services Advisory Committee shall hear appeals of
of franchises. In case of stay of a franchise as provided in Section XIV (f):
a.
Formatted: Indent: Left: 0.5,
Hanging: 0.5, Tabs: Not at 0.29"
Formatted: Bullets and Numbering
Formatted: Numbered + Level: 3 +
Numbering Style: a, b, 4 ... + Start
at 1 + Alignment Right + Aligned
at 1.63" + Tab after. 1.75 +
Indent at 1.75"
r- ----- 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 Attom.ey who will forward ~•=--•-- Formatted: Lett
the appeal to Emergency Services Medical Committee. -- Formatted: Bullets and Numbering
Page 16 of 18
19
d. The franchisee may either appeal by letter or request a hearing before~--•--- r-onnateed: Bullets and Numbering
the Emergency Services Medical Committee.
e. The Hearing shall be scheduled within 2 days of receipt of notice of-------- Formattea: Bullets and Numbering
appeal and shall be commenced within 10 days.
f. The Emergency Services Medical Committee shall provide awritten-------- rormattea: Bullets and Numbering
response to the franchise within l.0 days of the hearing. The
Committee shall remove the stay, provide a recommendation for
corrective action and set a time for completion or forward a
recommendation to the Board of County Commissioners for
suspension or termination of the &~anchise agreement.
g. The Board of County Commissioners shall review the-------- Formatted: Numbered + Level: 3 +
recommendation and make a decision based on the information Numbering Style: a, b, 4 ... + Slart
contained in the recommendation from the County Emergency at: 1 + Alignment: Rlght + Aligned
at: 1.63'+Tabafter. 1.75'+
Medical Services Committee. Indern at: 1.75"
rSECTION XVH. EMERGENCY SERVICES PEER REVIEW COiVII1'IITTEE -.--- Formatted: Font. Bold
1.7.1 In accordance with G.S. 131 E-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
performance, and medical direction within the EMS system.
---•-- Formatted: Indent: Left: 0.5'
17.2 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.
17.3 Review of medical records by the Emergency Service Peer Review Committee ism------- Formatted: Bullets and Numbering
confidential acid protected under G.S. 1.43-518. 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. 13 I E-95.
N XVIIl. EFFE
_________ __ _ CTIVE DATE; REPEALER; GRANDFATHER PROVISIONS ~ De1~`1
~--------------------- -•----------°----------------•-------------------------------~' Formatted: Inder~ Left: 0.5",
Hanging: 0.5"
18.1 This Ordinance shall be amended as of _ day of December, 2009. "=-- -- Formatted: gullets and Numbe
18.2 This Ordinance too effect on the 2 da _ of_ April, _ 1993 An Ordinance _. -" °~~` ~"
------------------------°-~----y . - - x--------------....-•--------=-- Deleted:
Regulation the Operation of Ambulance Services and the Administration of ''•
Emergency M~dical_Assistance in Orange County, North Carolina effective May __ - ~~' -~ I9
--- - - -- ---
-- -- ----------- - - - - - - - - - --------------------
1, 1981, is hereby repealed effective, April 20, -1993x -Any _person, firm, or --- ~~~~ m
corporation providing ambulance service, rescue service or first responder service'` Deleted:
• Deleted:
Page 17 of 18
20
pursuant to a valid franchise issued by Orange County under the repealed Mazch
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 Ordiriance shall be effective on December, 2009________________________•- ~~~ 1
Valerie P. Foushee, Chair
Orange County Board of Commissioners __ ______ _________________ ueae~ac
-------- Formatted: Inder~ Left: 0'
ATTEST: DATE:
Donna Baker, Clerk to the
Orange County Board of Commissioners
Page 18 of 18
r
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 Cazolina. Medical
Caze 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 caze, 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.
21
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: December 7, 2009
Action Agenda
Item No. ~- - Yl
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
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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:
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• 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.
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n. An Amendment to the EMS Franchise Aareement entitled "An Ordinance Reaulatina
Emeraencv Medical, First Responder and Rescue Service and Grantina of Franchise
and Contracts to the Operators in the County of Oranae"
This item was removed and placed at the end of the consent agenda for separate
consideration.
o. Chance in BOCC Regular Meeting Schedule for 2010
The Board amended its regular meeting calendar for 2010 by adding a Board of Health joint
dinner meeting with the Board of County Commissioners for Thursday, March 4, 2010 at 5:30
p.m. (prior to the 7:00 p.m. Budget Work Session) at Southern Human Services Center, 2501
homestead Road in Chapel Hill, North Carolina.
~ Classification and Title Chance for Budget Director to Deputy Financial Services
Director and Temporary Employment Aareement
The Board approved the title change and classification of Budget Director, grade 31 to Deputy
Financial Services Director, grade 27; and approved the terms of temporary employment
agreement for Michael Talbert to provide functional responsibilities as the Interim Deputy
Financial services Director.
VOTE ON CONSENT AGENDA: UNANIMOUS
ITEMS REMOVED FROM CONSENT AGENDA:
k. Fiscal Year 2009-10 Budaet Amendment #5
The Board considered approving budget, grant and capital project ordinance
amendments for fiscal year 2009-10.
This item was deferred to December 75, 2009.
n. An Amendment to the EMS Franchise Aareement entitled "An Ordinance
Reaulatina Emeraencv Medical, First Responder and Rescue Service and Grantina of
Franchise and Contracts to the Operators in the County of Orange"
The Board considered 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," and authorizing the Chair to sign.
PUBLIC COMMENT
Jeremy Browner represents Orange County Rescue Squad, Inc. and he read a letter in
opposition to the EMS Franchise Agreement entitled, "An Ordinance Regulating Emergency
Medical, Fist Responder, and Rescue Service and Granting of Franchise and Contracts to the
Operators in the County of Orange." He said that the Orange County Rescue Squad disagrees
with the current makeup as drafted and wishes that it was instead chaired by an Orange
County Commissioner, and that it have a representative from the Orange County Chief's
Council, have a representative from the Orange EMS that is active on the line; and include the
Orange County Health Director. OCRS does not believe that the EM Director should have a
vote on the committee.
In addition, the Orange County Rescue Squad feels that there are certain due process
requirements that should be added to the process, which will include:
- An evidentiary hearing in which parties offer evidence
- The cross-examination of adverse witnesses
- The right to inspect documents
- The giving of sworn testimony
- The right to have written findings of fact supported by competent, substantial, and
material evidence
In addition, there is no understanding on what vote will constitute the opinion of the
committee that will be reported to the County Commissioners. He asked that the County
Commissioners amend the draft to indicate whether it is the simple majority or not.
Finally, in response to 16.3-g, in which the EMS Committee would report to the County
Commissioners, the Orange County Rescue Squad asks that the ability to respond directly to
the County Commissioners be allowed.
Commissioner Gordon asked if this was time-sensitive for tonight and John Roberts
said that he would recommend addressing this at the first meeting in January.
A motion was made by Commissioner Gordon, seconded by Commissioner Yuhasz to
approve referring this to the County Attorney's office for further review to come back with a
recommendation as soon as preferable.
VOTE: UNANIMOUS
5. Public Hearings
a. Zoning Ordinance Text Amendment Relating to Outdoor Lighting
The Board received the Planning Board recommendation on astaff-initiated Zoning
Ordinance Text Amendment to Section 6.31 Outdoor Lighting Standards of the Zoning
Ordinance and considered a decision on adoption.
Planner Michael Harvey introduced this item and went over the attachments. This item
was presented at the August 24, 2009 Quarterly Public Hearing. Staff is proposing to tighten
up the plan submittal requirements to require more information from non-residential
developers. The current ordinance is not specific enough. Language has been added to
address Commissioner Yuhasz's concern relating to the review of single-family duplex
residential development, stipulating that they are not required or mandated to submit formal
lighting plans or light data sheets as contained within the attachment. The staff has begun the
process of trying to differentiate between non-residential developments within urbanizing and
rural portions of the County.
The Planning Board recommended several modifications to the definition sections. It
was staff's determination that if those items were not advertised specifically, they could not
incorporate them into this amendment packet. The Planning Board agreed to allow staff to
incorporate those proposed changes into the revised sections for the UDO. There are also
amendments to the ordinance for lighting in rural areas of the County and firm deadlines for
when lights have to be turned off.
The recommendation by the Planning Board is to adopt the ordinance amendment as
contained in Attachment 1.
Commissioner Gordon noted that the I~lanning Board made many good suggestions.
She asked if these would be addressed later. Michael Harvey said that these comments would
be coming back.
Commissioner Jacobs made reference to 6.31.9 on page 14, the third line, and said
that the word "while" does not need to be there.
Commissioner Jacobs said that he has repeatedly brought up the bank on NC 86
entering Hillsborough on the east side and it has lights that glare in the face of everyone that