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BULLET St. Louis City Revised Code Chapter 8.14 Ambulances

St. Louis City Revised Code (annotated) has been converted to electronic format by the staff of the St. Louis Public Library. This electronic version has been done for the interest and convenience of the user. These are unofficial versions and should be used as unofficial copies.

Official printed copies of St. Louis City Revised Code may be obtained from the Register's Office at the St. Louis City Hall.



Chapter 8.14
Ambulances

Sections:

8.14.010 Definitions.
8.14.020 Licenses--Required.
8.14.030 Ambulance license--Application.
8.14.040 Ambulance license--Change of ownership.
8.14.050 Ambulance license--Transfer.
8.14.060 Ambulance license--Defacing.
8.14.070 General standards.
8.14.080 Inspections.
8.14.090 Disaster and emergency aid.
8.14.100 Liability insurance.
8.14.110 Duties of director.
8.14.120 Equipment.
8.14.130 Attendants and drivers--License--Application--Fee.
8.14.140 Attendants and drivers--Applicant investigation--License nontransferable.
8.14.150 Licenses--Renewal.
8.14.160 Licenses--Revocation.
8.14.170 Records.
8.14.180 Obedience to traffic laws.
8.14.190 Penalty for violation.
8.14.200 Appeals.

V.A.M.S.:

190.100 et seq. 304.022 Ambulances

67.300 et seq. Ambulance services

City Counselor Ops.: 9896, 10036, 10286

8.14.010 Definitions.

Unless otherwise specified, the following terms have the herein prescribed meanings:

A. "Ambulance" means any 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 dual purpose police patrol cars and funeral coaches or hearses which otherwise comply with the provisions of this chapter. For the purpose of this chapter, the word ambulance shall be understood not to apply to vehicles used for the transportation of persons who are, or may be sick and who are being transported to and from their homes for normally scheduled medical and clinic appointments.

B. "Attendant" means an individual responsible for the operation of an ambulance and the care of the patients whether or not the attendant also serves as driver.

C. "Attendant-driver" means a person who is qualified as an attendant and a driver.

D. "Director" means the Director of the Department of Health and Hospitals of the City.

E. "Driver" means an individual who drives an ambulance.

F. "Patient" means any individual who is acutely ill, injured, wounded, or otherwise incapacitated or helpless and is in urgent need of medical attention and/or hospitalization. For the purposes of this chapter, the word patient shall not be understood to apply to persons who are, or may be sick or injured and who are being transported for normally scheduled nonemergent medical or clinic appointments.

G. "Person" means any individual, firm, partnership, association, corporation, company, group of individuals acting together for a common purpose or organization of any kind.
(Ord. 55272 1, 1969: 1960 C. 667.010.)

8.14.020 Licenses--Required.

No person, either as owner, agent or otherwise, shall furnish, and operate, conduct, maintain, advertise, or otherwise be engaged in or profess to 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 he holds a currently valid license for an ambulance, issued pursuant to this chapter. An ambulance operated by an agency of the United States shall not be required to be licensed hereunder.

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

Provided, however, that no such licenses shall be required for an ambulance, or for the driver, attendant or attendant-driver of an ambulance, which:

A. Is rendering assistance in the case of a major catastrophe or emergency with which the licensed ambulances of the City are insufficient or unable to cope; or

B. Is operated from a location or headquarters outside of the City in order to transport patients who are picked up outside of the City to locations within the City.
(Ord. 55272 2, 1969: 1960 C. 667.020.)

City Counselor Ops.: 10286

McQuillin:

26.158 Motor vehicle licensing

8.14.030 Ambulance license--Application.

Applications for ambulance licenses shall be made upon such forms as may be prepared or prescribed by the Director and shall contain:

A. The name and address of the applicant and of the owner of the ambulance;

B. The trade or other fictitious 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, 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;

E. A photograph of each ambulance;

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

G. Such other information as the Director shall deem reasonably necessary to a fair determination of compliance with this chapter.
(Ord. 60735 2 (part), 1988; Ord. 55272 3, 1969: 1960 C. 667.030.)

8.14.040 Ambulance license--Change of ownership.

Any change of ownership of a 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 as upon original licensing.
(Ord. 55272 4(b), 1969: 1960 C. 667.040 (b).)

8.14.050 Ambulance license--Transfer.

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. No ambulance license may be sold, assigned or otherwise transferred without the approval of the Director and a finding of conformance with all the requirements of this chapter as upon original licensing.
(Ord. 55272 4 (c), 1969: 1960 C. 667.040 (c).)

8.14.060 Ambulance license--Defacing.

No official entry made upon a license may be defaced, removed or obliterated.
(Ord. 55272 4 (e), 1969: 1960 C. 667.040 (e).)

8.14.070 General standards.

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 equipment conforming with the standards, requirements and regulations provided for in this chapter, which equipment shall be in proper and good condition for such use;

C. Currently comply with all applicable laws and local ordinances relating to health, sanitation and safety;

D. Be equipped with such lights, sirens and special markings to designate it as an ambulance as may be prescribed in reasonable regulations promulgated by the Director.
(Ord. 55272 4 (a), 1969: 1960 C. 667.040 (a).)

8.14.080 Inspections.

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 Director or his designated representative during usual hours of operation.
(Ord. 55272 4 (d), 1969: 1960 C. 667.040 (d).)

See 8.14.110

8.14.090 Disaster and emergency aid.

The Director, in conjunction with the Board of Health is authorized to cooperate with City or other area governmental agencies in areawide programs for disaster and emergency aid, and the regulations developed under Section 8.14.070, which provide for such cooperation including provision for the transmission of patients to consenting hospitals with adequate emergency room facilities as determined by the Director.
(Ord. 55272 4 (f), 1969: 1960 C. 667.040 (f).)

8.14.100 Liability insurance.

No ambulance license shall be issued under this chapter, nor shall the 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, for each and every ambulance operated by or for the applicant or licensee, providing for the payment of damages, in such amounts and for such coverages as required by the Missouri Motor Vehicle Safety Responsibility Law, Chapter 303, RSMo. 1959, as amended, and as amended hereafter.

The insurance policies shall be submitted to the Director for approval prior to the issuance of each ambulance license. Satisfactory evidence that insurance is at all times in force and effect shall be furnished to the Director, in such form as he may specify, by all licensees required to provide such insurance under the provisions of this chapter.

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.

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 written notice to the Director and to the assured before any cancellation or termination thereof earlier than its expiration date and the cancellation or other termination of any policy shall automatically revoke and terminate the licenses issued for the ambulance covered by the policy, unless another insurance policy complying with the provisions of this section shall be provided and be in effect at the time of the cancellation or termination.
(Ord. 55272 5, 1969: 1960 C. 667.050.)

8.14.110 Duties of director.

The Director shall, upon receipt of an application for an ambulance license as provided for herein, cause such investigation as he deems necessary to be made of the applicant and of his proposed operations.

The License Collector of the City shall issue a license hereunder for a specified ambulance, to be valid for a period of one year unless earlier suspended, revoked or terminated, when such issuance is certified by the Director after the Director finds:

A. That the public convenience and necessity require the proposed ambulance service;

B. That each ambulance, its required equipment and the premises designated in the application conform to regulations promulgated by the Director as provided in this section;

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

D. That only duly licensed drivers, attendants, and attendant-drivers are employed in such capacities;

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

Prior to the issuance of any ambulance license, the Director shall cause to be inspected the vehicles, equipment and premises designated in each application, to determine compliance with the standards prescribed in Section 8.14.070 and in Section 8.14.120, and with the regulations in such sections; provided, however, that under the terms of this chapter the Director shall have no responsibility, and shall exercise no authority, in connection with laws and ordinances of general applicability which deal with motor vehicle inspection.

Subsequent to issuance of an ambulance license, the Director shall cause to be inspected each licensed vehicle and its equipment and premises, whenever he deems inspection to be necessary, but in any event, no less frequently than twice each year. The periodic inspection required hereunder shall be in addition to any other safety or motor vehicle inspection required to be made for ambulances or other motor vehicles, or other inspections required to be made under general law or ordinances, and shall not excuse compliance with any 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 general law or ordinance.

A copy of each initial, semi-annual or other ambulance, equipment and premises inspection report by the Director under the provisions of this section shall be promptly transmitted to the applicant or licensee to whom it refers.

The Director is authorized to establish for City owned and operated ambulance a fee schedule based on cost of operation and is further authorized to bill and collect such fees in the same manner as is provided for other collections of the Division of Hospitals.
(Ord. 55272 6, 1969: 1960 C. 667.060.)

8.14.120 Equipment.

Required equipment in each ambulance shall include, at all times when the ambulance is in use as such, equipment adequate in the judgment of the Director for dressing wounds, splinting fractures, controlling hemorrhage, and providing oxygen.

The Director, in conjunction with the Board of Health, is authorized and directed to promulgate regulations after public notice and to implement standards as to equipment and operation of ambulances. In determining regulations, the Director shall take into consideration recommendations for equipment and operation adopted by the American College of Surgeons or its duly authorized committee on trauma. Ambulance licensees and operators shall comply with regulations as may be promulgated by the Director with the endorsement of the Board of Health.
(Ord. 55272 7, 1969: 1960 C. 667.070.)

8.14.130 Attendants and drivers--License--Application--Fee.

Applications for drivers, attendants and attendant-drivers licenses hereunder shall be made upon forms as may be prepared or prescribed by the Director and shall contain:

A. The applicant's full name, current residence, places of prior residence, and length of time he has resided in the City.

B. The applicant's age, marital status, height, color of eyes and hair;

C. Whether he has ever been convicted of a felony or misdemeanor, and if so, when and where and for what cause;

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

E. Affidavits of good character from two reputable citizens of the United States and residents of the City who have personally known the applicant;

F. Two recent photographs of the applicant, of a size designated by the Director, one of which shall be attached to the license;

G. Other information as the Director shall by regulation adopt, deemed reasonably necessary to a fair determination of compliance with this chapter.
(Ord. 60735 2 (part), 1988; Ord. 55272 8, 1969: 1960 C. 667.080.)

8.14.140 Attendants and drivers--Applicant investigation--License nontransferable.

A. The Director shall, within a reasonable time after receipt of an application as provided for herein, cause investigation as is necessary to be made of the applicant for a driver's, attendant's or attendant-driver's license, to determine the accuracy of the statements made in the application.

B. The Director shall issue a license to a driver, attendant or attendant-driver, valid for a period of three years, unless earlier suspended, revoked or terminated, when he finds that the applicant:

1. Is not addicted to the use of intoxicating liquors or narcotics, and is morally fit for the position;

2. Is able to speak, read and write the English language;

3. Has been found by a duly licensed physician, upon examination, attested to on a form provided by the Director, to be of sound physique, possessing eyesight corrected to at least 20/40 in the worst eye, and free of physical defects or diseases which might impair the ability to drive or attend an ambulance; and

4. For each applicant for attendant or attendant-drivers license, the applicant has a currently valid certificate evidencing successful completion of a course of training equivalent to the advanced course in first-aid currently given by the American Red Cross; provided, however, this requirement may be temporarily waived by the Director if the applicant is currently participating in an equivalent course approved by the Director.

Provided, however, that no one shall be licensed as a driver or attendant-driver unless he holds a currently valid chauffeur's permit from the State.

C. A license as driver, attendant or attendant-driver issued hereunder shall not be assignable or transferable.

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

E. Is competent to use, apply and direct the use and application of all first-aid equipment required to be carried upon a licensed ambulance.
(Ord. 55272 9, 1969: 1960 C. 667.090.)

8.14.150 Licenses--Renewal.

Renewal of any license hereunder, upon expiration for any reason or after revocation, shall require conformance with all of the requirements of this chapter as upon original licensing.
(Ord. 55272 10, 1969: 1960 C. 677.100.)

8.14.160 Licenses--Revocation.

The Director may, and is authorized to, suspend or revoke a license issued hereunder for failure of a licensee to comply and to maintain compliance with, or for his violation of, any applicable provisions, standards or requirements of this chapter, or of regulations promulgated hereunder or of any other applicable laws or ordinances or regulations promulgated thereunder, but only after warning and such reasonable time for compliance as may be set of the Director. Within thirty days after a suspension, the licensee shall be afforded a hearing, after reasonable notice. The Director shall, within fifteen days after conclusion of such hearing, issue a written decision (which shall include written findings) as to the suspension of the license. The written decision shall be promptly transmitted to the licensee to whom it refers.

The initial, semi-annual or other ambulance, equipment and premises inspection reports of the Director provided for in this chapter shall be prima facie evidence of compliance or noncompliance with, or violation of, the provisions, standards and requirements provided in this chapter, and of the regulations promulgated in this chapter, for the licensing of ambulances.

Upon suspension, revocation or termination of an ambulance license hereunder, the ambulance shall cease operation and no person shall permit the ambulance to continue operations. Upon suspension, revocation or termination of a driver's, attendant's or attendant-driver's license hereunder, the 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.
(Ord. 55272 11, 1969: 1960 C. 667.110.)

8.14.170 Records.

Each licensee of an ambulance shall maintain accurate records upon forms as prescribed by, and containing information as may be required by the Director concerning the transportation of each patient within the City or from one place within the City to another place within or beyond its limits. The records shall be available for inspection by the Director at any reasonable time, and copies thereof shall be filed by the licensee within twenty-four hours on request by the Director.

The provisions of this section shall apply with equal force in case the patient shall die before being transported in the 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.
(Ord. 55272 12, 1969: 1960 C. 667.120.)

8.14.180 Obedience to traffic laws.

A. The driver of an ambulance, when responding to an emergency call or while transporting a patient, may exercise the privileges set forth in this section; but subject to the conditions herein stated, and only when the driver has reasonable grounds to believe that an emergency in fact exists requiring the exercise of such privileges.

B. Subject to the provisions of subsection A hereof the driver of an ambulance may:

1. Park or stand, irrespective of the otherwise applicable provisions of law, ordinance or regulation;

2. Proceed past a red or stop signal or stop sign, but only after slowing down as may be necessary for safe operation;

3. Exceed the maximum speed limits permitted by law, ordinance or regulation, so long as he does not endanger life or property; and

4. Disregard laws, ordinances or regulations governing direction or movement or turning in specified directions.

C. The exemptions granted herein shall apply only when the ambulance is making use of audible and visual signals meeting the requirements of law, ordinance and regulation.

D. The foregoing provisions of this section shall not relieve the driver of an ambulance from the duty to drive with due regard for the safety of all persons; nor shall the provisions protect the driver from the consequences of his reckless disregard for the safety of others.
(Ord. 55272 13, 1969: 1960 C. 667.130.)

McQuillin:

24.639 Vehicles excepted from speed regulations

24.614 Exception to requirement of obedience to traffic signals

30.161 Applicability of law of the road to ambulances

53.86 Nonliability of municipality for negligence in operation of ambulance

8.14.190 Penalty for violation.

Any person violating, or failing to comply with, any provision of this chapter shall be deemed guilty of a misdemeanor; and upon conviction thereof, shall be fined an amount not exceeding five hundred dollars; or be imprisoned for a period not exceeding thirty days; or be both so fined and imprisoned for each offense.

Each day that any violation of, or failure to comply with, this chapter is committed or permitted to continue shall constitute a separate and distinct offense under this section and shall be punishable as such.
(Ord. 55272 14, 1969: 1960 C. 667.140.)

8.14.200 Appeals.

Any person aggrieved by any action of the Director may appeal such action to the Board of Public Service of the City within seven days of such decision by filing a written appeal to the Board of Public Service. The Board of Public Service shall hear the appeal and thereafter render its decision affirming, reversing or modifying or reversing the action of the Director, and to such end shall possess all the powers on appeal granted the Director in this chapter. The decision shall be subject to the procedures and review provided by the Administrative Review Act of the state.
(Ord. 55272 17, 1969: 1960 C. 667.150.)

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