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Below is the complete Brandon ambulance ordinance that was repealed in December 2004, reportedly because of concerns about response times. Since then, Brandon has been under the jurisdiction of the county ambulance ordinance. Brandon City Council has written a new city ordinance, which Brandon residents will vote on in April. The proposed ordinance is posted elsewhere in this blog. Please, take some time to compare the old ordinance and the new one, and if you have any questions, ask your City Council representative.

AMBULANCE
agreement, 14-10-2
conflicting ordinances repealed, 14-10-6
ordinance, 14-10-1
penalty, 14-10-5
qualifications of personnell, 14-10-4
recommendation by fire department, 14-10-2

CHAPTER 6-7
AMBULANCE SERVICE

6-7-1 LICENSE REQUIRED
No person shall operate a surface ambulance service transporting patients from within the City, nor advertise or offer such service to the public, unless the operator of such service shall have first obtained a surface ambulance license from the City.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-2 ANNUAL APPLICATION REQUIRED
Surface ambulance services licenses are issued for a one-year period. The same requirements for renewal apply as for initial licensure.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-3 NOTIFICATION OF CHANGE IN LEGAL STATUS
The holder of a surface ambulance license shall notify the City when any substantial change is made in the legal status of the organization, shareholders or officers of the organization; and shall notify the City within ten days if any information contained in the application changes or becomes inaccurate.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-4 DISPLAY OF LICENSE
The holder of a surface ambulance license shall display a copy of the service license on the premises of the business at all times.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-5 QUALITY ASSURANCE REQUIRED
The City shall enter into a contractual agreement with an agency for the purpose of quality assurance in regard to all aspects of surface ambulance services, including, but not limited to, licensing requirements, vehicle and equipment inspection, personnel certification, suspension and removal, and compliance with the ordinances, rules, regulations, and policies of the City of Brandon and compliance with the rules, regulations and policies of the quality assurance agency.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-6 REQUIREMENTS FOR LICENSED SURFACE AMBULANCES

1. Vehicle specifications: Vehicles utilized as surface ambulances must meet all state requirements as well as comply with the requirements of the City of Brandon.

2. Availability: All surface ambulance services licensed within the City will be available for service 24 hours a day, seven days per week. Call answering, staffing and vehicle availability must be maintained to meet this requirement.

3. Response and Level of Service: Requests for surface ambulance service shall be responded to within 90 seconds of notification of the request, on at least 90 percent of the calls for service, with a maximum call received time-to-time en route of 3 (three) minutes, as evidenced by having a fully staffed and stocked ambulance en route within that time frame, unless the request is for a scheduled transfer for which alternate requirements are specified by the calling party. The 90-second requirement for an ambulance en route may be waived by the City in unusual circumstances, to be considered an individual basis.

4. Staffing Requirements: Acceptable staffing includes at least one EMT-paramedic, certified by the City as a senior paramedic and at least one EMT-B, EMT-1or EMT-P certified by the City, as specified in the City’s Certification Policy. Both the senior paramedic and the EMT-B, -1, or-P staff member shall be present in each surface ambulance unit on each call in which a patient is treated within, or transported from, the City of Brandon, including transports which are scheduled by advance appointment.

5. Equipment/Medications: All surface ambulance units must carry the minimum equipment and medications specified on the Advanced Life Support Equipment/Medication list as specified by the City of Brandon.

6. Indirect Medical Control: All surface ambulance services must have a Medical Director to provide indirect medical control. The Medical Director must have a South Dakota medical license, a D.B.A. Certificate, and staff privileges, in good standing, at least one acute-care hospital in Sioux Falls, SD.

7. Direct Medical Control: All surface ambulance services must have procedures in place to receive direct (on-line) medical control by physician(s), licensed in South Dakota, and staff privileges, in good standing, with at least one acute-care hospital in Sioux Falls, SD, 24 hours a day 7 days per week. This may be provided by a fully executed agreement with at least one Sioux Falls acute-care hospital for on-line medical control, or alternative arrangements may be made for the provision of 24 hours a day 7 days per week availability of online medical control, subject to review and recommendation by the quality assurance agency employed by the City of Brandon, and subject to the approval of the City of Brandon.

8. Insurance Requirements: Any licensed surface ambulance service must maintain a certificate or policy of insurance issued by a responsible insurer, covering the vehicles to be operated and the personnel to be employed by the service. A current certificate or policy of insurance must be on file with the City at all times during the period during which the service holds a surface ambulance service license. The liability insurance~shall provide the following coverage:

General liability of comprehensive form shall provide minimum limits of:
Property damage $500,000 per incident
Personal injury, for one person $500,000 per incident
Personal injury, for one accident $1,000,000 per incident
Umbrella policy $1,000,000 per incident

Employee professional liability insurance shall provide minimum limits of $1,000,000 per incident.

9. Business: Licensed surface ambulance services must pay all taxes, assessments, utilities, rates and other expenses when due and without delinquency, and shall not permit any liens to be imposed by reason of any delinquency.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-7 COMPLIANCE WITH REGULATIONS AND CERTIFICATION REQUIRED

Application for a City of Brandon surface ambulance license is considered to be agreement with and acceptance of all record-keeping requirements, rules, regulations, and policies set forth in this ordinance and subsequently adopted by the City of Brandon, whether that adoption is made by ordinance, resolution or motion. Failure to comply with all requirements, rules, regulations and policies, including this ordinance, administrative and operational policies, patient care guidelines, reporting requirements, and compliance with quality assurance standards which are from time-to-time approved by the City of Brandon, is a violation of this ordinance subject to fine and/or imprisonment (see Brandon Municipal Code Section 1-10-1), and also subjects the licensee to suspension and possible revocation of the license to operate surface ambulance services in the City of Brandon. Certification of the service and its personnel are required prior to licensure.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-8 LICENSE APPLICATION

Each prospective licensee for a surface ambulance service license in the City shall make application, in writing, to the City of Brandon. Such application shall be verified by the person making the application and shall contain the following information:

(a) The full name and address of the applicant; and if a partnership, the name and address of each partner; and if a corporation, the names and addresses of the officers and the board of directors thereof; and the name and address of the general manager of the applicant’s surface ambulance service.
(b The address of the principal place of business of the applicant.

(c) A resume of the experience of the applicant in the operation of a surface ambulance service.

(d) A detailed statement of the type of surface ambulance service which the applicant proposes to operate in the City.

(e) A certified copy of the ambulance service license of the applicant which has been issued by the state of South Dakota.

(f) A detailed listing of vehicles to be utilized as surface ambulances, documenting compliance with the standards set forth in this ordinance.

(g) A written plan for staffing levels to provide surface ambulance service 24 hours a day 7 days per week meeting the response and level of service requirements set forth in this ordinance.

(h) A list of employees expected to be employed by the applicant, along with their training, credentials, and experience, all of which shall document adequate staffing to meet the standards set forth in this ordinance. All employees shall be certified by the entity designated by the City of Brandon for quality assurance review prior to approval of an application for new license, and after licensure, all new employees shall be certified by the quality assurance entity prior to commencement of any work which involves patient contact.

(i) Copies of inspections, completed by the City’s quality assurance entity, which document that all surface ambulance units are equipped with adequate equipment and medications to meet the standards set forth in this ordinance and in the requirements, rules, regulations, and policies approved by the City of Brandon.

(j) Verification of availability of Indirect Medical Control, as evidenced by a copy of a fully executed contract, letter of employment or agreement for employment, by and between the proposed licensee and a Medical Director, which shall include certification that the Medical Director has staff privileges, in good standing, with at least one acute-care hospital in Sioux Falls, SD, and shall include a copy of the Medical Director’s South Dakota medical license and a copy of the Medical Director’s D.E.A. Certificate.

(k) Verification of availability of Direct Medical Control, to include either a fully executed agreement with at least one Sioux Falls acute-care hospital for on-line medical control, or in the alternative, other arrangements for the provision of 24 hours a day 7 days per week availability of on-line medical control, which arrangements meet the approval of the City of Brandon.

(l) A plan to comply with the sanitary and safety standards set forth in this ordinance, including vehicle and equipment inspections as specified.

(m) Verification of satisfactory safety inspection of each vehicle to be utilized as a surface ambulance, completed by a an ASE (National Institute for Automotive Service Excellence) certified mechanic.

(n) Insurance verification, as set forth in this ordinance, including a list of vehicles insured, if not blanket coverage.

(a) The fee for licensure shall be established by Resolution of the City and payment shall accompany the application.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-9 SANITARY AND SAFETY STANDARDS

Licensees shall comply with the following standards for sanitation and safety, in addition to such other standards as are included in the policies and regulations of the City of Brandon:

1. The interior of the ambulance and the equipment on the ambulance shall be clean, sanitary and maintained in good working order at all times.

2. Exterior surfaces of the ambulance shall be cleaned routinely.

3. Oxygen masks, cannulas, humidity containers, suction catheters, tubing, or any airway designed to be inserted in a patient’s nose or mouth shall be single service, and must be properly stored and handled. Equipment and supplies identified by the manufacturer as single use or disposable shall not be reused and shall be properly disposed of in appropriate bio-medical waste containers.

4. Immediately after an ambulance has been utilized to transport a patient, the patient compartment and any non-disposable equipment used must be thoroughly cleaned and disinfected prior to reuse, according to standard infection control practices.

5. Freshly laundered linens or disposable linens shall be used on cots and pillows. Clean linen shall be used for each patient.

6. Smoking and eating is prohibited in licensed ambulances. Consuming beverages is prohibited in licensed ambulances except as part of patient care.

7. Body substance isolation procedures, universal precautions and personal protective equipment shall be used by personnel participating in patient care activities.

8. All members of the ambulance service shall be trained concerning infection control policies and procedures and records of such training shall be maintained as part of the continuing education records of the service.

9. All ambulance services shall have written policies concerning infection control which shall include at a minimum: pre-exposure precautions; post-exposure procedures; and procedures for decontamination and/or disposal of all equipment and supplies.

10. Vehicles, medical devices, radio communication devices, and rescue equipment must be maintained in accordance with manufacturer’s specifications and shall be in operational condition at all times. Emergency vehicle warning lights and audible warning devices must function in the manner in which they were designed. Each ambulance vehicle shall be checked monthly to determine that it is in proper working order and a notation on the maintenance records shall be made of the monthly review.

Maintenance records shall contain the date, the name of the person performing each routine vehicle check, change, addition, service, repair, and responses to complaints of vehicle operators. Maintenance records shall record all mechanical checks and repairs of each vehicle. A vehicle safety inspection shall be carried out prior to licensure and quarterly thereafter, by a an ASE (National Institute for Automotive Service Excellence) certified mechanic. Written copies of the results of each safety inspection shall be provided to the City of Brandon.

11. Maintenance records must be maintained for all medical equipment, to include defibrillators, glucometers, infusion pumps, and any other electronic equipment Maintenance records shall contain the date, the name of the person performing each routine equipment check, changes, additions, service, repair, and response to complaints of equipment operators. Maintenance records shall record all mechanical checks and repairs of each piece of equipment. Written copies of all maintenance records for equipment shall be provided to the City of Brandon on at least a monthly basis, commencing with the first day of the first month following licensure.

12. Each defibrillator shall be checked at least monthly to determine that it is in proper working order and a notation made in the maintenance records shall be made of the check. Each defibrillator shall be checked at least semi-annually to determine that it is correctly calibrated in accordance with manufacturer’s recommendations and shall be re-calibrated if necessary and a notation made in the maintenance records.

13. Surface ambulance services must make provisions to keep IV fluids warm per physician protocol and must check to determine that fluids are maintained at proper temperature and check monthly to determine that fluids are the correct temperature and have current expiration dates.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-10 RECORD KEEPING
A patient care record will be completed for each call to which the surface ambulance service responds, even if there is not patient, and for each patient assessed or treated by the surface ambulance service, including responses to routine transfers. This patient care record must meet the standards of the state of South Dakota and the City of Brandon. For all patients transported, a copy of the patient care report must be left with the patient when the patient arrives at the destination. A copy of all patient care records must be provided to the City of Brandon or its designee, on at least a weekly basis but more often if requested, for purposes of quality assurance.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-11 RECORD RETENTION

Written or transcribed service records as required by these regulations shall be kept by the surface ambulance service for a minimum of five (5) years and shall be available for inspection by the City or its designee upon request.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-12 CONFIDENTIALITY

Confidentiality of both patient and employee records shall be maintained by the ambulance service, by the City, and by the individual, agency, or review boards designated by the City as its entity for quality assurance review.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-13 CRIMINAL PROSECUTION

Violation of this ordinance may result in the prosecution of the owner(s), partner(s), corporate officer(s) general manager(s) and/or employees of the service, for violation of the provisions of this ordinance and/or its supporting requirements, regulations, rules and policies.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-14 SUSPENSION AND REVOCATION OF LICENSE

Violation of this ordinance and the supporting requirements, regulations, rules and policies may result in suspension of the license of the surface ambulance service, and may also result in the suspension and withdrawal of certification of the medical personnel of the service.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-15 PROCEDURES FOR SUSPENSION AND REVOCATION OF LICENSE OF SERVICE; NOTICE, HEARING AND APPEAL

2. In the event that a violation or violations by the service of this ordinance and/or its supporting requirements, rules, regulations and policies is deemed by the City of Brandon or its designated quality assurance agency to warrant immediate action to protect the health, safety, or welfare of the citizens of Brandon, the Incident Investigation and Management Policy of the City shall be followed. Any appeals from the decisions of the quality assurance agency shall be made to the City of Brandon, and the following procedures shall be followed:

a. Upon receipt of a recommendation of suspension or revocation from the quality assurance agency, the City of Brandon shall personally serve written notice upon the service, said notice to state the reasons that the license of the service to operate as a surface ambulance service in the City of Brandon, is immediately suspended pending further review. The service must respond to the City within 24 hours of receipt of notification of the suspension, and such response shall include a corrective action plan. A quorum of the City Council shall conduct a hearing for the purpose of reviewing the alleged violation(s) and the corrective action plan, such hearing to be held within three working days of receipt by the City of said corrective action plan, unless the licensee requests an extension of time, which extension shall not exceed ten days unless agreed by the service and the City.

b. Written notice of the hearing on the proposed revocation of license due to alleged violations of the ordinance, requirements, rules, regulations, or policies shall be received by the licensee at least 24 hours prior the hearing. The written notice of hearing shall comply with the provisions of SDCL 1-26-17(1992 Revision, as may hereafter be amended) regarding contents of notice in contested cases.

c. At such hearing, opportunity shall be afforded all parties to respond and present evidence on issues of fact and argument relevant to the issues. A party to the proceeding may appear in person, or by counsel, or both, may be present during the giving of all evidence, may have a reasonable opportunity to inspect all documentary evidence, may examine and cross-examine witnesses, may present evidence in support of his interest, and may have subpoenas issued to compel attendance of witnesses and production of evidence on his behalf. All witnesses shall be sworn and a verbatim record of all proceedings shall be made by the City

d. Informal disposition may be made if agreed by the service and the City.

e. The formal record of the hearing shall include all pleadings, notices, motions, and written rulings, if any; and all evidence received and considered; and a statement of the issues raised by the City which are refuted by the licensee; and proposed findings of fact, in writing, and objections thereto, also in writing; and the written decision of the City; and copies of all data or evidence submitted to the City for consideration.

f. The City Council’s review of the allegations and the corrective action plan of the service may include, but is not limited to: (1) the alleged violation(s); (2) the severity of the consequence of the violation(s) to the patient; (3) the potential severity of consequences of similar future violations to other patients; (4) the response of the service; (5) the proposed corrective action plan of the service; (6) the response of the City’s quality assurance review entity; (7) the response of the City’s Fire Department First Responder unit or its representatives; (8) the opinion of the Medical Director of the service; (9) the opinion of other medical doctors involved in the care of the patient whose care resulted in the violation(s) as alleged; and (10) any other information the Council deems pertinent and helpful. Based upon the information received by the Council at the hearing, and giving due consideration to the health, welfare, and safety of the citizens of the City of Brandon, the City shall either accept or reject said corrective action plan. Acceptance may include terms and conditions as the City of Brandon deems appropriate. Rejection of the corrective action plan shall constitute immediate revocation of the surface ambulance license of the service.

g. Transcripts of the proceedings shall be provided upon request and upon payment of the costs thereof. The party requesting the transcript shall pay the cost of the original and one copy thereof, and any other parties shall each pay for their own copy of the transcript.

h. A person or entity which has exhausted the remedies available pursuant to this Ordinance and who is aggrieved by a final decision of the City is entitled to judicial review in the Circuit Court, Second Judicial Circuit, Minnehaha County, South Dakota. Failure of the City to render a final decision within thirty days of the close of the hearing entitles the party aggrieved to appeal from the record then existing as if a decision had been made adversely to such party. All appeals taken hereunder shall proceed pursuant to the provisions of SDCL 1-26-30.4 through SDCL 1-26-40.

Legislative History:
Ordinance No. 286, 11/6/00

6-7-16 PROCEDURES FOR SUSPENSION AND REVOCATION OF CERTIFICATION OF PERSONNEL; NOTICE, HEARING AND APPEAL

In the event that an individual employee of the service shall have violated any provisions of this ordinance or its supporting requirements, rules, policies and regulations, then the Incident Investigation and Management Policies adopted by the City of Brandon shall be followed by the City’s quality assurance agency, which shall provide such services as are necessary to the City of Brandon, including but not limited to: incident investigation on, training, re-certification and/or suspension of the employee. An appeal by the employee from the decisions of the City’s quality assurance agency shall be made to the City of Brandon following the procedures outlined in Section 6-7-15 herein.

Legislative History:
Ordinance No. 286, 11/6/00