133.01  Definitions	133.09  Standards for Drivers, Attendants and
133.02  License Required	Attendant-Drivers Permits
133.03  Application for Ambulance License	133.10  Renewal of Ambulance License
133.04  Standards for Ambulance License	133.11  Revocation
133.05  Liability Insurance	133.12  Reports
133.06  Procedures for License Application	133.13  Inspection Reports
133.07  Standards for Ambulance Equipment	133.14  Determination of Adequacy of Equipment
133.08  Application for Driver, Attendant and	and Service
Attendant-Driver Permits

133.01    DEFINITIONS.  The following terms are defined for use in this chapter.

1.                  “Ambulance” means any privately or publicly owned motor vehicle that is specially 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 with the provisions of this chapter.  This definition and the terms of this chapter do not apply to any ambulance owned and operated by the City.

2.                  “Attendant” means a trained and/or qualified individual responsible for the operation of an ambulance and the care of the patients whether or not the attendant also serves as driver.

3.                  “Attendant-driver” means an individual who is qualified as an attendant and a driver.

4.                  “Driver” means an individual who drives an ambulance.

5.                  “Health Officer” means the County Health Officer.

6.                  “Patient” means an individual who is sick, injured, wounded or otherwise incapacitated or helpless.

133.02    LICENSE REQUIRED. 

1.                  No person, either as owner, agent or otherwise, shall furnish, operate, conduct, maintain, advertise or otherwise be engaged in the business or service of the transportation of patients upon the streets, alleys or any public way or place of the City unless such person holds a currently valid license for an ambulance issued pursuant to this chapter.  An ambulance operated by an agency of the United States or State of Iowa is not required to be licensed hereunder.

2.                  No ambulance shall be operated, and no individual shall drive, attend or permit it to be operated on the streets, alleys, or any public way or place in the City unless it is under the immediate supervision and direction of a person who is holding a currently valid permit as an attendant-driver or attendant.

3.                  Provided, however, no such license shall be required for an ambulance, or permits for the attendant or attendant-driver of an ambulance which is rendering assistance to the public in the case of a major catastrophe or emergency for or with which the licensed ambulances of the City are insufficient or unable to cope.

4.                  Each license shall be valid for a period of two years unless earlier suspended, revoked or terminated.

5.                  The provisions of this section relating to licensing shall apply only with respect to situations wherein the ambulance is picking up and transporting persons within the City and shall not be applicable to situations wherein the ambulance is solely delivering the person within the City limits or traversing through the City by traveling upon the public streets.

133.03    APPLICATION FOR AMBULANCE LICENSE.  Applications for ambulance licenses hereunder shall be made upon such forms as may be prescribed by the Fire Chief.  Applicants shall file with the Clerk a sworn application in writing which shall give the following information:

1.                  The name and address of the applicant and the owner of the ambulance.

2.                  The trade or other name, if any, under which the applicant does business and proposes to do business.

3.                  The training and experience of the applicant in the transportation and care of patients.

4.                  A description of each ambulance, including the make, model, year of manufacture, motor and chassis number; current State license 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.

5.                  The location and descriptions of the place or places from which it is intended to operate.

6.                  Such other information as the Fire Chief or Clerk shall deem reasonably necessary to a fair determination of compliance with this chapter.

7.                  An accompanying license fee of $10.00 per ambulance.

133.04    STANDARDS FOR AMBULANCE LICENSE. 

1.                  Each ambulance shall, at all times when in use as such:

A.                 Conform with the standards, requirements and regulations provided for in this chapter for the transportation of patients, from the standpoint of health, sanitation and safety, and the nature of the premises in which it is maintained.

B.                 Contain the following equipment and maintenance:

(1)        The vehicle shall be equipped as specified in Federal specifications No. KKK-A-1822 or shall be a vehicle specifically manufactured for use as an ambulance during or subsequent to the calendar year 1975. 

(2)        Mouth gags, either commercial or made of tongue blades taped together and padded.

(3)        Universal dressings, approximately 10 inches by 36 inches, compactly folded and packaged in a convenient size.

(4)        Sterile gauze pads, 4 inches by 4 inches.

(5)        Soft-roller, self-adhering bandages, 6 inches by 5 yards.

(6)        Roll of aluminum foil, 18 inches by 25 feet, sterilized and wrapped.

(7)        Two rolls of plain adhesive tape, 3 inches wide.

(8)        Two sterile burn sheets.

(9)        Sterile saline solution.

(10)      Hinged half-ring lower extremity traction splint.

(11)      Assortment of padded board splints.

(12)      Short and long spineboards with accessories.

(13)      Triangular bandages.

(14)      Sterile obstetrical kit.

(15)      Poison kit.

(16)      Blood pressure manometer, cuff and stethoscope.

(17)      Compartmentalized pneumatic trousers with inflation equipment.

(18)      All ambulances shall be equipped with a 2-way radio to provide contact with hospitals and the ambulance company shall have its own base station.

C.                 Every ambulance shall be maintained in a clean and sanitary condition.

D.                 Bed linens must be changed as soon as practicable after discharge of patient.  Ambulance shall be cleaned as soon as practicable after discharge of patient.

E.                  Every ambulance shall be inspected not less than once each year by the Fire Chief or representative of the Fire Chief and each inspection shall include brakes, lights, tires and such other mechanical and safety equipment as the Fire Chief deems necessary for public safety.  No ambulance which is found defective after such inspection shall be placed in service until such defect has been corrected, and approved by the Fire Chief.  The annual inspection fee shall be $25.00.  The periodic inspection required hereunder shall be in addition to any other safety or motor vehicle inspections required to be made for ambulances or other motor vehicles, or other inspections required to be made, under other laws or ordinances, and shall not excuse compliance with any other requirement of law or ordinance to display any official certificate of motor vehicle inspection and approval nor excuse compliance with the requirements of any other applicable laws or ordinances.

F.                  Each ambulance company operating and licensed in the City shall have and maintain not less than two ambulances with sufficient personnel to operate same on a 24 hour basis.

G.                 Any change of ownership of licensed ambulance shall terminate the license and shall require a new application and a new license and conformance with all the requirements of this chapter by the new owner as upon original licensing.

H.                 Application for transfer of any ambulance license to another or substitute vehicle shall require conformance with all the requirements of this chapter as upon original licensing for the new vehicle.

I.                    No official entry made upon a license may be defaced, removed or obliterated.

2.                  Each licensed ambulance, 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 Fire Chief during usual business hours of operation.

3.                  Any ambulance while being used to transport the sick or injured in the City shall have a driver and attendant.

133.05    LIABILITY INSURANCE.

1.                  No ambulance license shall be issued under this chapter, nor shall such license be valid after issuance, nor shall any ambulance be operated in the City, unless there is at all times in force and effect insurance coverage, issued by an insurance company licensed to do business in the State of Iowa, for each and every ambulance owned and/or operated by or for the applicant or licensee, and also naming the City of Marion as an additional insured.  The minimum limits of liability of the insurance policy will be as follows:

A.                 To cover the assured’s legal liability for personal injury or death resulting therefrom, for each ambulance, for any recovery by one person as a result of any one accident or cause, $100,000; and for all persons receiving personal injury as a result of any one accident or other cause, $300,000.

B.                 To cover the assured’s legal liability for damage to or destruction of any property as a result of any one accident or other cause, $50, 000.

2.                  A certificate of such insurance shall be submitted to the Clerk for approval prior to the issuance of each ambulance license.

3.                  Every insurance policy required hereunder shall contain a provision for a continuing liability thereunder to the full amount thereof, notwithstanding any recovery thereon, that the liability of the insurer shall not be affected by the insolvency or the bankruptcy of the assured, and that until the policy is revoked, the insurance company will not be relieved from liability on account of nonpayment of premium, failure to renew license at the end of the year, or any act or omission of the named assured.

4.                  Every insurance policy required hereunder shall extend for the period to be covered by the license applied for and the insurer shall be obliged to give not less than thirty (30) days’ written notice to the City and to the assured before any cancellation or termination of the policy earlier than its expiration date and the cancellation or other termination of any such policy shall automatically revoke and terminate the licenses issued for the ambulances covered by such policy, unless another insurance policy complying with the provisions of this section shall be provided and be in effect at the time of such cancellation or termination.

133.06    PROCEDURES FOR LICENSE APPLICATION. 

1.                  The Fire Chief in conjunction with the Police Chief shall within twenty (20) days after receipt of an application for an ambulance license as provided for herein, cause such investigation as the Fire Chief deems necessary to be made of the applicant and of the applicant’s proposed operations and the vehicles, equipment, and premises designated in the application.  Upon completion thereof, the Chiefs shall submit their report and recommendation to the Clerk.

2.                  Upon receipt of the aforementioned report and recommendation from the Chiefs, the Clerk will then review the same and issue a license for a specified ambulance, to be valid for a period of two years unless earlier suspended, revoked or terminated, if the Clerk finds the following conditions have been met:

A.                 The public convenience and necessity require the proposed ambulance service.

B.                 Each such ambulance, its required equipment and the premises designated in the application comply with the standards prescribed in this chapter and with the regulations promulgated under this chapter.

C.                 The applicant is a responsible and proper person or organization to conduct or work in the proposed business.

D.                 Only drivers, attendants and attendant-drivers are employed in such capacities, holding valid permits as hereinafter provided.

E.                  All the requirements of this chapter and all other applicable laws and ordinances have been met.

133.07    STANDARDS FOR AMBULANCE EQUIPMENT.  The Fire Chief or Clerk may promulgate standards for ambulance equipment under this chapter.  Each licensee of an ambulance shall comply with such regulations as may be promulgated under the provisions of this section and shall maintain in each ambulance, at all times when it is in use as such, all equipment as may be prescribed hereunder.

133.08    APPLICATION FOR DRIVER, ATTENDANT AND ATTENDANT-
DRIVER PERMITS.  Applications for driver, attendant and attendant-driver permits hereunder shall be made upon such forms as may be prescribed by the Fire Chief.  Applicants shall file with the Clerk a sworn application in writing which shall give the following information:

1.                  The applicant’s full name, current residence, and places of residence for two years previous to moving to his or her present address.

2.                  The applicant’s age, marital status, height, color of eyes and hair.

3.                  Whether said applicant has ever been convicted of a felony or misdemeanor, and if so, when and where and for what cause.

4.                  The applicant’s training and experience in the transportation and care of patients, and whether he or she has previously held a permit or license as a driver, chauffeur, attendant or attendant-driver, and if so, when and where, and whether his or her permit or license has ever been revoked or suspended in any jurisdiction and for what cause.

5.                  Affidavits of good character from two reputable citizens who have personally known such applicant and observed his or her conduct during two years next preceding the date of the application.

6.                  Such other information as the Fire Chief or the Clerk shall deem reasonably necessary to a fair determination of compliance with this chapter.

7.                  An accompanying permit fee of five dollars ($5.00).

133.09    STANDARDS FOR DRIVERS, ATTENDANTS AND ATTENDANT-
DRIVERS PERMITS. 

1.                  The Fire Chief in conjunction with the Police Chief shall, within a reasonable time after receipt of an application as provided for herein, cause such investigation as they deem necessary to be made of the applicant for a driver, attendant or attendant-driver permit.

2.                  The Clerk shall issue a permit to a driver, attendant or attendant-driver hereunder, valid for a period of two years, unless earlier suspended, revoked or terminated, when the Clerk finds that:

A.                 The applicant is not addicted to the use of intoxicating liquors or narcotics, and is morally fit for the position;

B.                 The applicant is able to speak, read and write the English language;

C.                 The applicant is free of physical defects or diseases which might impair the ability to drive or attend an ambulance;

All ambulance attendants shall be certified as emergency medical technicians-ambulance by the State of Iowa or by the National Registry of Emergency Medical Technicians.

3.                  No one shall be given a permit as a driver or attendant-driver unless such person holds a currently valid Iowa driver’s license.

4.                  A permit as driver, attendant, or attendant-driver issued hereunder shall not be assignable or transferable.

5.                  No official entry made upon a permit may be defaced, removed or obliterated.

The same procedure as above provided shall be followed for renewals.

133.10    RENEWAL OF AMBULANCE LICENSE.  Renewal of any ambulance license hereunder, upon expiration for any reason or after revocation, shall require conformance with all the requirements of this chapter as upon original licensing.

133.11    REVOCATION.  Any violation of this chapter or of regulations promulgated hereunder shall be sufficient grounds for revoking any license or permit issued pursuant to this chapter.  Upon suspension, revocation or termination of an ambulance license hereunder, operations as such shall cease with such ambulance and no person shall permit further operation with such ambulance as such.  Upon suspension, revocation or termination of a driver, attendant or attendant-driver permit hereunder, such driver, attendant or attendant- driver shall cease to drive or attend an ambulance and no person shall employ or permit such individual to drive or attend an ambulance.

133.12    REPORTS. 

1.                  Each licensee of an ambulance hereunder shall maintain accurate records, upon such forms as may be prescribed, and containing such information as may be required by the Fire Chief concerning the transportation of each patient within the City, or from one place in the City to another place within or beyond its limits.  Such records pertaining to injury on public property shall be available for inspection by the Fire Chief at any reasonable time.

2.                  The provisions of subsection 1 of this section shall apply with equal force in case the patient dies before being so transported in such ambulance or dies while being transported therein or at any time prior to the acceptance of the patient into the responsibility of the hospital or medical or other authority if the patient is still under the care or responsibility of the ambulance licensee.

133.13    INSPECTION REPORTS.  A copy of each initial, semiannual or other ambulance, equipment and premises inspection report by the Police or Fire Chief under the provisions of this chapter shall be promptly transmitted to the applicant or licensee to whom it refers.

133.14    DETERMINATION OF ADEQUACY OF EQUIPMENT AND SERVICE.  Whenever the Fire Chief deems that the equipment provided in an ambulance is substantially the equivalent or superior to that required by this chapter, the Fire Chief shall accept the same in lieu of any specific requirement of this chapter.  The Clerk, in determining whether or not to grant an application for license under this chapter, may set public hearing thereon and following public hearing shall determine whether the conditions set forth in Section 133.06 of this chapter have been met.  All reports submitted to the Clerk shall be deemed to be public records.