HomeMy WebLinkAboutAgenda - 04-20-1993 - VI-C 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
Action Agenda
Item No VZ C
ACTION AGENDA ITEM ABSTRACT
Meeting Date: April 20, 1993
SUBJECT: Updated Emergency Service Franchise Ordinance
DEPARTMENT Emergency Management PUBLIC HEARING YES X NO
ATTACHMENT(S) INFORMATION CONTACT
Updated Ordinance Nick Waters, ext 3030
Existing Ordinance TELEPHONE NUMBER
Hillsborough 732-8181
Chapel Hill 968-4501
Mebane 227-2031
Durham 688-7331
PURPOSE: To hold a public hearing on, and consider adoption of, an
updated ordinance regulating emergency medical, first responder, and
rescue service and granting of franchises in Orange County.
BACKGROUND: At the March 23 meeting, the Board of Commissioners
established April 20, 1993 as the date for a public hearing on an
updated ordinance regulating emergency medical, first responder, and
rescue service and the granting of franchises for these services. The
County Attorney has observed all statutory requirements for notice of
the public hearing. In accordance with NCGS 153A-250 (a) , the Board may
adopt the ordinance after the public hearing if it finds it necessary
to do so to assure the provision of adequate and continuing ambulance
service, first responder service, and rescue service which preserves,
protects, and promotes the public health, safety, and welfare. However,
the Board need not adopt the ordinance at the April 20 meeting if it
prefers to consider adoption at a subsequent meeting of the Board.
The new ordinance would update and modernize the ambulance and EMS
regulations of Orange County and the franchising process, and would
repeal and replace an existing ordinance in effect since March 1 , 1981.
The new ordinance addresses additional services, improved technology,
and more rigorous professional certification levels that have evolved
since the original ordinance was adopted. For example, the new
ordinance recognizes certification levels now encompassed in the
General Statutes that were not recognized in the adoption of the
original ordinance: EMT-I (Intermediate) , EMT-D(Defibrillation) , EMT-
AI (Advanced Intermediate) , and EMT-P(Paramedic) . For the protection of
citizens, emergency service providers need to be held to some standard
of care. The new ordinance contains an enforcement section which
provides for quality assurance. It establishes standards for
driver/attendant certification, vehicles/equipment, communications,
and establishes a system of required record keeping.
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A draft version of the ordinance was reviewed by the Emergency Medical
Services Advisory Council, and has incorporated comments received from
the volunteer rescue squads and fire departments which would provide
services under the provisions of the new ordinance. Staff have also
incorporated the changes recommended by the County Attorney into the
proposed ordinance.
Prior to the public hearing, staff will present a brief explanation of
the significant enhancements of the proposed ordinance, relative to the
existing ordinance.
RECOMMENDATION: The Manager recommends that the Board conduct the
public hearing and consider adopting the ordinance.
Revised 04/06/93 3
AN ORDINANCE REGULATING EMERGENCY MEDICAL., FIRST RESPONDER, AND
RESCUE SERVICE AND GRANTING OF FRANCHISES AND CONTRACTS
TO THE OPERATORS IN THE COUNTY OF ORANGE
An ordinance governing the granting of franchises for
emergency services and other prehospital emergency medical
services . The County of Orange Board of Commissioners does
ordain the following:
SECTION I . DEFINITIONS
Unless the context otherwise requires, the following definitions
shall apply in the interpretation and enforcement of this
ordinance:
1 . 1 AMBULANCE
The term "ambulance" means any privately or publicly
owned motor vehicle, aircraft, or vessel that is
specially designed, constructed, or modified and
equipped and is intended to be used for and is
maintained or operated for the transportation on the
streets or highways , waterways or airways of this
State of persons who are sick, injured, wounded, or
otherwise incapacitated or helpless .
1 . 2 EMERGENCY MEDICAL TECHNICIAN (EMT)
The term "emergency medical technician" means an
individual who has completed a training program in
emergency medical care at least equal to the National
Standard Training Program for Emergency Medical
technicians as defined by the United States Department
of Transportation and has been certified as an emergency
medical technician by the State of North Carolina Office
of Emergency Medical Service .
1 . 3 AMBULANCE PROVIDER
The term "ambulance provider" means an individual, firm,
corporation or association who engages or professes to
engage in the business or service of transporting
patients in an ambulance.
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1 .4 APPROVED 4
The term "approved" shall mean approved by the North
Carolina Medical Care Commission pursuant to the
latter' s rules and regulations promulgated under
N. C. General Statutes 143E-165 .
1 . 5 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.
1. 6 COUNCIL
The term "council " shall mean the Orange County
Emergency Medical Services Advisory Council .
1 . 7 COUNTY
The term "county" shall mean the Orange County and its
Board of Commissioners or their designated
representative.
1. 8 TELECOMMUNICATOR
The term "telecommunicator" shall mean a person who is
available at all times to receive requests for emergency
services, to dispatch emergency services , and to advise
local law enforcement agencies, fire departments ,
rescue squads , and emergency medical services and
facilities of any existing or threatened emergency.
1.. 9 EMERGENCY
The terms "emergency" and emergency "transportation
service" 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 or physiological or
psychological illness or injury.
1. 10 FIRST RESPONDER
The term "first responder" shall mean an organization
with personnel 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 .
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1 . 11 FRANCHISE
The term "franchise" shall mean a permit issued by the
County to a person for the operation of an ambulance
service, rescue squad or first responder unit .
1 . 12 FRANCHISEE
The term "franchisee " shall mean any person having been
issued a franchise by the County for the operation of an
ambulance service, rescue squad or first responder unit.
1 . 13 LICENSE
The term "license" shall mean any driver's license or
permit to operate a motor vehicle issued under or
granted by the laws of the State of North Carolina.
1. 14 CONTRACT
The term "contract" shall mean the instrument by which
both parties agree to the terms of operation of the
service to be provided.
1 . 15 CONVALESCENT TRANSPORTATION SERVICES
The term "convalescent transportation service" shall
mean the operation of an ambulance for any purpose other
than transporting emergency or emergent patients .
1. 16 OPERATOR
The term "operator" shall mean a person in actual
physical control of an ambulance or rescue service
vehicle which is in motion or which has the engine
running.
1. 17 OWNER
The term "owner" shall mean any person or entity who
owns an ambulance or provides a service covered by this
ordinance.
1. 18 PATIENT •
The term "patient" means 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.
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1 . 19 PERSON
The term "person" shall mean any individual, firm,
partnership, association, corporation, company, group of
individuals acting together for a common purpose, or
organization of any kind, including any governmental
agency other than the United States .
1 . 20 RESCUE
The term "rescue" shall mean situations where the victim
cannot escape an area through the normal exit or under
his own power.
1 . 21 SERVICE
The term "service" shall mean the same as owner.
1 . 22 VICTIM
The term "victim" shall mean any patient or potential
patient that is entrapped, entangled, pinned, fallen,
suspended, or otherwise in need to rescue services .
SECTION II . FRANCHISE REQUIRED
2 . 1 No person either as owner, agent or otherwise, shall
furnish, operate, conduct, maintain, advertise, or
otherwise be engaged in or profess to be engaged in the
business or service of emergency, emergent and/or
convalescent transportation of patients within the
County of Orange unless the person holds a valid permit
for each ambulance used in such business or service
issued by the North Carolina Department of Human
Resources, Office of Emergency Medical Services , and has
been granted a franchise for the operation of such
business or service by the County pursuant to this
Ordinance.
2 . 2 No person shall drive an ambulance, attend a patient in
one, or permit one to be operated when transporting a
patient within the County of Orange unless he or she
holds a currently valid North Carolina Operator' s
License and a currently valid certificate as an EMT
(Emergency Medical Technician) , EMT-D (Emergency Medical
Technician-Defibrillator) , EMT-I (Emergency Medical
Technician-Intermediate) , EMT-AI (Emergency Medical
Technician-Advanced Intermediate) or EMT-P (Emergency
Medical Technician-Paramedic issued by the North
Carolina Department of Human Resources, Office of
Emergency Medical Services .
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2.3 No person either as owner, agent or otherwise, shall
furnish, operate, conduct, maintain, advertise, or
otherwise be engaged in or profess to be engaged in the
business or service of providing rescue 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 No franchise shall be required for:
(a) Any entity operated from a location or headquarters
outside of the County of Orange in order to
( 1) transport patients who are picked up beyond the
limits of the County of Orange to facilities located
within the County of Orange, or (2 ) 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.
(b) Ambulances owned and operated by an agency of the
County, the State of North Carolina, or the United
States.
SECTION III. APPLICATION FOR AMBULANCE FRANCHISE
3. 1 Application for a franchise to operate ambulances,
emergency or convalescent, in the County of Orange shall
be made by the ambulance provider upon such forms as may
be prepared or prescribed by the County and shall
contain:
(a) The name and address of the ambulance provider and
of the owner of the ambulance(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 transportation and care of
patients.
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(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 vehicles
will be dispatched. A financial statement of the
applicant as the same pertains to the operations
in the County of Orange, said financial statement
to be in such form and 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) Any information the County shall deem reasonably
necessary for a fair determination of the
capability of the applicant to provide ambulance
services in the County of Orange in accordance
with the requirements of state laws and the
provisions of this regulation.
SECTION IV. APPLICATION FOR MEDICAL FIRST RESPONDERS
4 . 1 Application for a franchise to operate as medical first
responders in the County of Orange shall be made by the
provider upon such forms as may be prepared or
prescribed by the County and shall contain:
(a) The name and address of the provider and of 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 .
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(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 vehicles will be dispatched.
A financial statement of the applicant as the same
pertains to the operations in the County of Orange,
said financial statement to be in such form and 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 fist 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 description of the applicant's capability to
provide coverage 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) Any information the County shall deem reasonably
necessary for a fair determination of the capability
of the applicant to provide medical first responder
services in the County of Orange in accordance with
the requirements of state laws and the provisions of
this regulation.
SECTION V. APPLICATION FOR RESCUE SERVICES
5 . 1 Application for a franchise to provide rescue services
in the County of Orange shall be made by the provider
upon such forms as may be prepared or prescribed by the
County and shall 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 techniques of victims .
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(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 vehicles will be dispatched.
A financial statement of the applicant as the same
pertains to the operations in the County of
Orange, said financial statement to be in such form
and 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) Any information the County shall deem reasonably
necessary for a fair 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 regulation.
SECTION VI . GRANTING OF FRANCHISE
6 . 1 Prior to accepting applications for the operation of any
service, the Board of Commissioners may designate
specific service areas as franchise districts . Said
districts will be established using criteria that
includes geographic size, road access, the location of
existing medical transportation services , population,
and response time. The County shall have the authority
to redistrict or rearrange existing districts at any
time at their discretion.
6 . 2 An applicant may apply for a franchise to operate an
ambulance service, emergency or convalescent, rescue
service, or Medical First Responder Unit or any two or
all three. If more than one ( 1) service is to be
provided, an application 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 necessary
to be made of the applicant and his proposed operations .
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6 .4 A franchise may be granted if the County finds that:
(a) The applicant meets county/state standards and
standards outlined in the franchise ordinance.
(b) The proposed service will fit within the existing
service so as not to adversely affect the level of
service or operations of other franchisees to render
service.
(c) A need exists for the rendered service in order to
improve the level of service available to residents
of the County helping to assure the provision 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.
SECTION VII . TERM OF FRANCHISE
7 . 1 The County may issue a franchise hereunder to an
ambulance provider, to be valid for a term of five (5)
years. The franchise holder can surrender a franchise
granted pursuant to this Ordinance with 60 days notice
to the County, and the County may revoke the franchise
as provided in Section XIV 1.E. After a notice of
service termination is given, the provider may reapply
for a franchise if continued service is desired.
7 .2 Upon suspension, revocation, or termination of a
franchise granted hereunder, such franchised ambulance
service, rescue squad or first responder unit
immediately shall cease operations. Upon suspension,
revocation, or termination of a driver' s license or an
attendant' s certificate i.e. , First Responder, Rescue,
Emergency Medical Technician, EMT-D, EMT-I, EMT-AI, or
EMT-P certificate, such persons shall cease to drive an
ambulance or provide medical care, First Responder and
Rescue Service or attend an ambulance. The franchisees
shall not or permit such an individual to drive an
ambulance or provide medical care in conjunction with
the ambulance service, provide rescue service or first
responder service.
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 of more than 10 percent of the
right of control of franchisee is acquired by a person
or group of persons acting in concert, none of whom own
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or control 10 percent or 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.
7 . 5 Any change of ownership of a franchised service without
the approval of the County shall terminate the franchise
and shall require a new application and a new franchise
and conformance with all the requirements of this
Ordinance as upon original franchising.
7 , w Any change in the level of service offered of a
franchised ambulance service, rescue squad or first
responder unit without the approval of the County shall
terminate the franchise and shall require a new
application and a new franchise and conformance with all
the requirements of this Ordinance as upon original
franchising.
7 . 7 No franchise may be sold, assigned, mortgaged, or
otherwise transferred without the approval of the
County; and a finding of conformance with all
requirements of this Ordinance as upon original
franchising. Each franchised ambulance, rescue, 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 The franchise certificate shall be posted in a readily
visible location at the base of operations for the
franchised service.
7 . 9 A franchise certificate may not be defaced, removed, or
obliterated.
SECTION VIII . STANDARDS FOR DRIVERS AND ATTENDANTS
8 . 1 Standards for drivers and attendants as developed by the
North Carolina Medical Care Commission 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 Board of
Medical Examiners for Advanced Life Support Technicians
shall be applied and the same are incorporated herein by
reference.
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SECTION IX . STANDARDS FOR VEHICLES AND EQUIPMENT
9 . 1 Vehicle and equipment standards as developed by the
North Carolina Medical Care Commission pursuant to
Article 7 , Chapter 131E-157 , and Article 56 , Chapter
143 , of the General Statutes of North Carolina, and
shall be applied and the same are incorporated herein by
reference .
SECTION X . STANDARDS FOR COMMUNICATIONS
10 . 1 Each ambulance vehicle shall be equipped with an
operational two-way radio capable of establishing good
quality voice communications from within the geographic
confines of the County to each hospital ( s ) emergency
department in the County in which the service is based.
Each ambulance vehicle shall be equipped with two-way
radio communications capabilities for communications
with all hospital emergency departments to which
transportation of patients is made on a regular or
routine basis anywhere within the state . Each ambulance
or 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. This section
shall not apply to privately owned vehicles of the
members .
10 . 2 Each 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 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 communications
center in the County of Orange .
10 . 4 Each service shall be dispatched from the County
Dispatch Center or an acceptable and approved
alternative .
SECTION XI . INSURANCE
11 . 1 No franchise shall be issued under this Ordinance, nor
shall such franchise be 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 North
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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 accidents resulting from any
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 or his agency; and,
(b) In the minimum sum of $1, 000 , 000 for the loss of or
damage to the property of another, including
personal property, under like circumstances , in sums
as may be required by the State or as approved by
the County of Orange .
SECTION XII . RECORDS
Each franchisee shall maintain the following records :
(a) Record 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 .
(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 information.
(d) Driver and Attendant Checklist and Inspection Report
Shall list contents and description of operations
for each vehicle, signed by the individual verifying
vehicle operations and equipment .
SECTION XIII . RATES AND CHARGES
13 . 1 Each franchisee shall submit a schedule of rates to the
County for approval and shall not charge more nor less
than the approved rates without specific approval by the
County.
13 . 2 No service shall attempt to collect rates on emergency
calls until the patient has reached the point of
destination, has received medical attention and is in a
condition deemed by the physician fit to consult with
the service, but such service may attempt to collect
rates with family or guardian of the patient once the
patient is in the process of receiving medical
attention.
13 . 3 On convalescent calls , attempts to collect payment may
be made before the ambulance begins its trip .
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SECTION XIV. ENFORCEMENT
14 . 1 The Orange County Office of Emergency Management shall
be the enforcing agency for the regulations contained in
this Ordinance. Such office will:
(a) Receive all franchise proposals from potential
providers.
(b) Study each proposal for conformance to this
Ordinance.
(c) Recommend to the Board of Commissioners the
approval/disapproval of the franchise(s) to the
applicants submitting the best proposal(s) .
(d) Inspect the premises, vehicles, equipment, and
personnel of franchisees to assure compliance to
this Ordinance and perform any other inspections
that 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.
( f) Insure by cooperative agreement with other services
the continued service in a district where a service
franchise has been suspended.
(g) Receive complaints from the public, other enforcing
agencies, and services regarding franchise
infractions.
(h) Recommend improvements to the County which will
insure better rescue service and medical care and
transportation.
(i) Maintain all records required by this Ordinance and
other applicable County regulations.
SECTION XV. 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.
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SECTION XVI . COUNTY EMERGENCY MEDICAL SERVICES ADVISORY COUNCIL
16 . 1 The Council shall have the responsibility and duty of
advising the Emergency Management Director on matters
relating to the enforcement of this Ordinance as
specified in Section XIV above and shall provide
information and advice to the Board of County
Commissioners 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.
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16 . 2 Representatives from the franchised providers may attend
any meetings when the Council considers matters relating
to the granting of franchises and/or reviewing
complaints from the public and investigations regarding
franchised services .
SECTION XVII . EFFECTIVE DATE; REPEALER; GRANDFATHER PROVISIONS
17 . 1 This Ordinance shall take effect on the day of
, 1993 . AN ORDINANCE REGULATING THE OPERATION
OF AMBULANCE SERVICES AND THE ADMINISTRATION OF
EMERGENCY MEDICAL ASSISTANCE IN ORANGE COUNTY, NORTH
CAROLINA effective March 1, 1981, is hereby repealed
effective , 1993 . Any
person, firm, or corporation providing ambulance
service, rescue service or first responder service
pursuant to a valid franchise issued by Orange County
under the repealed March 1, 1981 Ordinance shall be
entitled to continue that service as provided 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.
Chairman, Orange County Board of
Commissioners
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eiF MaraL1 I) ITN
AN ORDINANCE REGULATING THE OPERATION OF AMBULANCE SERVICES
AND THE ADMINISTRATION OF EMERGENCY MEDICAL ASSISTANCE
IN ORANGE COUNTY, NORTH CAROLINA
WHEREAS, the private operation of ambulances for
the transportation of persons injured, infirm, and invalid is.
a business vested with great public interest; and
WHEREAS, it is essential and necessary for the
. public good and welfare and for the preservation of the
health and safety of the citizens of Orange County, that a
prompt, adequate, and efficient ambulance service should be
available to the citizens of Orange County; and
WHEREAS, the Orange County Board of Commissioner; ,
has found and hereby declares a public necessity for the
regulation of the private operation of ambulances in Orange
County; and
WHEREAS, the administration of emergency medical
assistance to injured persons is a matter of great public
interest and concern; and
WHEREAS, it is essential and necessary for the
public safety and welfare of the citizens of Orange County,
North Carolina that such persons as regularly respond to
requests for emergency aid and assistance and regularly
administer medical aid to injured persons in emergency
medical situations be properly trained and instructed in
. their tasks; and
WHEREAS , the Orange County Board of Commissioners
has found and hereby declares a public necessity for the
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regulation of the administration of emergency medical
assistance in Orange County;
NOW THEREFORE, be it ordained by the Orange Count
• Y g Y.
North Carolina Board of Commissioners as follows:
Section 1. Definitions.
The following words and phrases , when used in this
article, shall have the following prescribed meanings, except
when the context clearly indicates a different meaning: ; '.
a. Ambulance - any privately or publicaly-owned
motor vehicle or aircraft that is specifically designed or
constructed and equipped and is intended to be used for and
is maintained or operated for the transportation of patients,
including funeral coaches or hearses, which otherwise comply
under the provisions of this ordinance, except any such motor
vehicle or aircraft owned by or operated under the direct
control of the United States.
b. Ambulance Attendant - a person certified as an
. ambulance attendant by the office of emergency medical
services, North Carolina Medical Care Commission in
accordance with rules and regulations adopted by the North
Carolina Medical Care Commission.
c. Certificate - a permit issued by the Orange
County Board of Commissioners granting the right, privilege
and duty to regularly respond to requests for emergency aid
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and assistance and the right, privilege and duty to
regularly administer medical aid and assistance to patients
in emergency medical situations.
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d. Emergency Medical Technician - A person
certified as an emergency medical technician by the office of
emergency medical services, North Carolina Medical Care
Commission in accordance with rules and regulations adopted
by the North Carolina Medical Care Commission.
e. Franchise - a permit issued by the Orange
County Board of Commissioners granting the right, privilege,
and duty to operate an ambulance or ambulances.
f. Board -. the Board of Commissioners of Orange
County.
g. Patient - an individual who is sick, injured,
wounded, or otherwise incapacitated or helpless. This
includes any person being transported to medical attention or
from medical attention in an ambulance.
h. Person - 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.
Section 2. Franchise Required.
A. No person, either as ownerr agent or otherwise
shall furnish, operate, conduct, maintain, advertise or
otherwise engage in or profess to be engaged in the business
or service of the transportation of patients upon the public
ways of Orange County without first having applied for and
obtained a franchise from the Orange County Board of
Commissioners authorizing such operation. An ambulance
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operated by an agency of the United States shall not he
required to be licensed hereunder. l
B. No ambulance shall be operated for ambulance
purposes and no individual shall drive, attend or permit an
ambulance to be operated for such purposes on the public ways
of Orange County unless it is occupied by at. least one
emergency medical technician who shall be responsible for the
medical aspects of the mission prior to arrival at the
hospital and assuming no other person of higher certification
or license is available, and one ambulance attendant who shall
be responsible for the operation of the vehicle and
rendering assistance to the emergency medical technician
during the duration of the mission.
C. Provided, however, that no such requirement
shall be required for an ambulance which is rendering
assistance to a licensed ambulance in the case of a major
catastrophe or emergency in which the licensed ambulances of
Orange County are insufficient or unable to cope or is
operated from a location or headquarters outside of Orange
County in order to transport patients who are picked up
beyond the limits of Orange County to locations within Orange
County. But no such outside ambulance shall be used to pick
up patients within Orange County for transportation to
locations within Orange County unless the requirements of
subsection B of this section are met.
Section 3. Application for a franchise.
All persons applying to the Board for a franchise
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for the operation of one or more ambulances shall file with
the Board a written application setting forth the following:
a. The name and address of applicant and of the
owner of the ambulance;
b. The trade or other ficitious name, if any,
under which the applicant does business and proposes to do
business;
c. The training and experience of the applicant in
the transportation and care of patients;
d. A description of each ambulance including the
make, model, and year of manufacture, motor and chassis
number, current state or federal aviation agency lcense
number, the length of time the ambulance has been in use and
the color scheme, insignia, name, monogram or other
distinguishing characteristics to be used to designate .
applicant 's ambulance;
e. A financial statement of the applicant
indicating the net worth of the owner of applicant over and
above all debts, judgments, claims and demands whatsoever;
f. Whether. there are any unsatisfied judgments of
record against such owner and, if so, the title of all
actions and the amount of judgments unsatisfied;
' g. Court record, if any, of applicant . Provided
if applicant is a corporation, partnership, association Cr
other organization, the court record of any of the officers,
. directors and supervising employees thereof, including .
general manager or director ;
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h. Whether there are any liens, mortgages or
other encumbrances on such ambulances and, if so, the amount -
and character thereof;
i. And, such other information as the Board may,
in its discretion, require.
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Section 4 . Granting a franchise.
Upon receipt of an application for a franchise , the
Board shall fix the time and place for hearing the applicant.
No franchise shall issue unless the Board shall find, after
the hearing, that the public convenience and necessity
require the proposed ambulance service. Determining whether
the public convenience and necessity require the operation of
an ambulance or ambulances for which application for a
franchise is made, the Board shall consider and investigate
the statements made in the application, the adequacy of
existing ambulance service, the financial responsibility,
experience and character of the applicant, the public need
for additional service, the ability of existing holders of
franchises to provide anv necessary additional service and
any other factors pertinent to such determination. If the
Board finds that the public convenience and necessity require
the proposed ambulance service, the Board shall grant a
franchise upon the terms and conditions prescribed by this
ordinance.
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Section 5. Term of franchise.
The franchise granted shall be for such term. and
under such conditions as the Board may deem necessary and
shall cover such area of Orange County as the Board shall
deem necessary, provided that any franchise granted may be
suspended or revoked by the Board after a hearing held upon .
thirty (30) days notice to any franchise holder. No
franchise granted may be sold, assigned, or transferred nor
in any way vest in any person other than the applicant to
whom the franchise is granted.
Section 6. State regulations.
All ambulances operated by holders of franchises
granted hereunder shall he subject to all applicable laws and
regulations of the State of North Carolina.
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Section 7. County regulations.
A. Every ambulance operated under a franchise
granted hereunder shall be occupied as prescribed in Section
2B of this ordinance.
B. Every ambulance franchised hereunder shall
carry public liability insurance against injury to persons
and property damage in an amount not less than [$100,000 in
respect to any one person, [300,009 in respect to any one
accident, and [ $50,00)0 in respect to property damage.
Section S. Operation of Ambulances. . •
The operator of an ambulance franchised hereunder
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shall operate said ambulance in a careful manner and shall
comply with all statutory speed limits, right of way
regulations, and all other highway- safety laws enacted by the
State of North Carolina and all municipal ordinances of •
cities and towns in which such ambulance is being operated,
whether such vehicles are being operated on official
business, an amergencyl or otherwise.
Section 9. Certificate Required. •
A. No person, either as agent , employee or
otherwise, shall regularly respond to requests• for emergency
aid and assistance within Orange County and render aid and
assistance to patients in emergency situations within Orange
County without first having applied for and received a -
certificate from the Orange County Board of Commissioners
authorizing such activity.
Section 10. Application for Certificate.
All persons applying to the Board for a certificate
to regularly respond to requests for emergency medical aid
and assistance shall file with the Board a written
application setting forth the following:
• a. The name and address of the applicant and of
the owner of any vehicle to be used in responding to the
requests for emergency aid and assistance;
b. The trade name, organizational title or other
adopted name, if any, under which the applicant operates; -
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c. In the case of any group or association of
individuals, a list or roster of the members or affiliates of
the organization, their individual addresses, the emergency
medical training and experiences of each member, special__
medical skills or capabilities of each member, continuing
medical education and training programs of the organization, . .
communication capabilities and requirements of the
organization's communication system, medical equipment and
supplies available for use by the organization and all .
sources of income to the organization; .
d. Such other information as the Board, in its
discretion, may •require.
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Section 11. Granting a Certificate.
1 Upon receipt of an application for a certificate,
the Board shall fix the time and place for hearing the
applicant. No certificate shall issue unless the Board shall
find, after the hearing, that the public convenience and
necessity require that such certificate issue. Determining
whether the public convenience and necessity require the
issuance of such certificate, the Board shall consider and.
investigate the statements• made in the application, the
adequacy of existing emergency medical services, the
experience and training of the applicants , the public need .
for such service and any other factors pertient to such a
determination. If the Board finds that the public
1 .. convenience and necessity require the issuance of such -
certificate, the Board shall grant a certificate upon the
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terms and conditions set forth in this ordinance .
Section 12. Terms of the Certificate.
The certificate granted shall be for such term and .
under such conditions as the Board may deem necessary and
shall cover such area of Orange County as the Board shall
deem necessary, provided that any franchise granted may be
suspended or revoked by the Board after a hearing held upon
thirty (30) days notice to the certificate holder. '''No• •
certificate may be sold, assigned or transferred nor in any
way vest in any other person than the applicant to whom the
certificate issues.
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Section 13. Violators. •
Violation of any provision of this ordinance is a
misdemeanor punishable as provided in N.C. Gen. Stat. 514-4.
This ordinance may also be enforced by injunction or other
appropriate remedy as provided by law.
Section 14. Separability.
If any section, subsection, sentence, clause,
phrase or portion of this ordinance is for any reason held
invalid or unconstitutional by any court of competent
jurisdiction, such portion shall be deemed a separate,
distinct and independent provision and such holding shall not
affect the validity of the remaining portions thereof.
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Section 15. Ordinances Repealed.
All ordinances and parts of ordinances in conflict
with the provisions of this ordinance are hereby repealed.
Section 16. Effective. Date.
This ordinance shall become effective on _
March I, 1981
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