NORTH CAROLINA GENERAL ASSEMBLY

1967 SESSION

 

 

CHAPTER 343

HOUSE BILL 159

 

 

AN ACT TO ASSURE ADEQUATE AND CONTINUING AMBULANCE SERVICES TO THE CITIZENS OF NORTH CAROLINA.

 

The General Assembly of North Carolina do enact:

 

Section 1.  It is hereby declared as a matter of State policy:

(1)        That, in order to preserve, protect, and promote the public health, safety, and general welfare, adequate and continuing ambulance services should be available to every citizen of North Carolina.

(2)        That uniform minimum standards of adequacy should be prescribed and enforced by and through appropriate State and local agencies in order to assure safe, sanitary, and competent ambulance services.

(3)        That, insofar as it is economically feasible, ambulance services should be provided by private enterprise.

(4)        That, upon the failure of private enterprise to provide adequate and continuing ambulance services in any county, the board of county commissioners of such county should be authorized to provide, or cause to be provided within said county, such services.

Sec. 2.  Section 130-3 of the North Carolina General Statutes is hereby amended as follows: (1) by adding a new subsection to be designated "(a)" and to read as follows:

"(a)       Ambulance includes any privately or publicly owned vehicle that is specially designed, constructed, or modified and equipped and is intended to be used for and is maintained or operated for the transportation upon the streets or highways in this State of persons who are sick, injured, wounded or otherwise incapacitated or helpless. Vehicles designed primarily for rescue operations and which do not ordinarily transport persons upon the streets or highways are excluded."

(2)        by redesignating all present subsections accordingly.

Sec. 3.  Chapter 130 of the North Carolina General Statutes is hereby amended by adding thereto a new Article to be designated "Article 26. Regulation of Ambulance Services" and to read as follows:

"Article 26.

"Regulation of Ambulance Services

"G.S. 130-230.  Permit Required to Operate Ambulance. (a) No person, firm, corporation, or association, either as owner, agent, or otherwise, shall hereafter furnish, operate, conduct, maintain, advertise, or otherwise engage in or profess to be engaged in the business or service of transporting patients upon the streets or highways in North Carolina unless he holds a currently valid permit for each ambulance used in such business or service, issued by the State Board of Health or a duly authorized representative thereof.

"(b)      Before a permit may be issued for a vehicle to be operated as an ambulance, its registered owner must apply to the Board for an ambulance permit. Application shall be made upon forms and according to procedures established by the Board. Prior to issuing an original or renewal permit for an ambulance, the Board shall determine that the vehicle for which the permit is issued meets all requirements as to medical equipment and supplies and sanitation as set forth in this Article and in the regulations of the Board. Permits issued for ambulances shall be valid for a period specified by the Board, not to exceed one year.

"(c)       Duly authorized representatives of the Board may issue temporary permits for vehicles not meeting required standards valid for a period not to exceed 60 days, when it determines the public interest will be served thereby.

"(d)      When a permit has been issued for an ambulance as specified herein, the vehicle for which issued, and records relating to maintenance and operation of such vehicle shall be open to inspection by duly authorized representatives of the Board at all reasonable times.

"(e)       The issuance of a permit hereunder shall not be construed so as to authorize any person, firm, corporation, or association to provide ambulance services or to operate any ambulances without a franchise in any county or municipality which has enacted an ordinance pursuant to G.S. 153-9(58) making it unlawful to do so.

"G.S. 130-231.  Advisory Committee on Ambulance Service Created. For the purpose of assisting the State Board of Health in developing standards for use in the administration of this Article, there is hereby created the Advisory Committee on Ambulance Service. Such Committee shall be composed of nine members, one each designated by the North Carolina Funeral Directors Association, Inc., the Funeral Directors and Morticians Association of North Carolina, Inc., the North Carolina Ambulance Association, Inc., the Medical Society of the State of North Carolina, the North Carolina Hospital Association, the American National Red Cross, the North Carolina State Association of Rescue Squads, Inc., the North Carolina Association of County Commissioners, and the North Carolina League of Municipalities. Each member shall serve at the pleasure of the organization which designated him, and his successor shall be designated in the same manner. The Committee shall choose its own chairman, and shall meet at the call of the chairman or at the call of the State Health Director.

"G.S. 130-232.  State Board of Health to Adopt Standards for Equipment; Inspection of Medical Equipment and Supplies Required for Ambulances. (a) The Board shall adopt regulations specifying sanitation standards for ambulances. Regulations so adopted shall also require that the interior of the ambulance and the equipment within the ambulance be sanitary and maintained in good working order at all times.

"(b)      Every ambulance shall be equipped with the medical equipment and supplies specified by the 'Minimal Equipment List For Ambulances and Dual Purpose Vehicles Serving as Ambulances' as approved by the Committee on Trauma of the American College of Surgeons on January 14, 1961; provided, however, the State Board of Health, with the approval of the Advisory Committee on Ambulance Service, may require additional equipment or supplies to be aboard ambulances or may delete items of medical equipment or supplies from the required Minimal Equipment List adopted herein by reference.

"(c)       The Board shall inspect medical equipment and supplies required of ambulances when it deems such inspection is necessary and maintain a record thereof. Upon a determination, based upon an inspection, that required medical supplies or equipment fail to meet the requirements of this Article or regulations adopted pursuant hereto, the Board shall suspend the permit for the ambulance concerned, until such requirements are met.

"G.S. 130-233.  Certified Ambulance Attendant Required. (a) Every ambulance, except those specifically excluded from the operation of this Article, when operated on an emergency mission in this State shall be occupied by at least one person who possesses a valid Ambulance Attendant's Certificate from the Board. This Section shall not be construed to require a person other than the driver to be aboard if the driver is properly certified by the Board as an ambulance attendant.

"(b)      The Board shall adopt regulations setting forth the qualifications required for certification of ambulance attendants. Such regulations shall be effective when approved by the Advisory Committee on Ambulance Service.

"(c)       Persons desiring certification as ambulance attendants shall apply to the Board using forms prescribed by that agency. Upon receipt of such application the Board shall examine the applicant and if it determines the applicant meets the requirements of its regulations duly adopted pursuant to this Article, it shall issue a certificate to the applicant. Ambulance Attendant's Certificates so issued shall be valid for a period not to exceed two years and may be renewed after re-examination if the holder meets the requirements set forth in the regulations of the Board. The Board is authorized to cancel a certificate so issued at any time it determines that the holder no longer meets the qualifications prescribed for ambulance attendants.

"(d)      Duly authorized representatives of the Board may issue temporary certificates with or without examination when it finds that such will be in the public interest. Temporary certificates shall be valid for a period not exceeding 90 days.

"G.S. 130-234.  Exemptions. (a) The following are exempted from the operation of the provisions of this Article:

"(1)      Privately owned vehicles not ordinarily used in the business of transporting persons who are sick, injured, wounded or otherwise incapacitated or helpless;

"(2)      A vehicle rendering service as an ambulance in case of a major catastrophe or emergency when the ambulances with permits and based in the locality of the catastrophe or emergency are insufficient to render the services required;

"(3)      Ambulances based outside this State, except that any such ambulance receiving a patient within this State for transportation to a location within this State shall comply with the provisions of this Article;

"(4)      Ambulances owned and operated by an agency of the United States Government.

"G.S. 130-235.  Violation Declared Misdemeanor. It shall be the duty of the registered owner of the vehicle concerned to see that the provisions of this Article and all regulations adopted hereunder are complied with. Upon the violation of any regulation adopted under authority of this Article, the State Board of Health shall have power to revoke or suspend the permits of all vehicles owned or operated by the violator. The operation of an ambulance without a valid permit therefor, or the operation thereof after any permit has been suspended or revoked, or the operation thereof without having a certified attendant aboard as required by G.S. 130-233, shall constitute a misdemeanor punishable by a fine or imprisonment or both in the discretion of the court."

Sec. 4.  Paragraph 1 of G.S. 20-10 is hereby amended by adding the following sentence immediately following the period (.) in line 3: "For purposes of this Section, an ambulance when operated for the purpose of transporting persons who are sick, injured, or otherwise incapacitated shall not be treated as a public passenger-carrying vehicle."

Sec. 5.  Section 153-9 of the North Carolina General Statutes is hereby amended by adding the following subsection to be designated as subsection (58) and to read as follows:

"(58)    (a)        Upon finding as fact, after notice and public hearing, that exercise of the powers enumerated below is necessary to assure the provision of adequate and continuing ambulance services and that exercise of the powers enumerated below are necessary to preserve, protect and promote the public health, safety and general walfare, boards of county commissioners within their respective counties are hereby granted powers to:"

"(1)      Enact an ordinance making it unlawful to provide ambulance services or to operate ambulances without having been granted a franchise to do so;

"(2)      Grant franchises to ambulance operators, based within or without the county; "provided, that any ambulance operator providing ambulance services in any county upon the date of ratification of this Act and who continues to provide such services up to and including the effective date of any ordinance adopted pursuant to this subsection, and who submits to the board of commissioners of any such county evidence satisfactory to the board of such continuing service, shall be entitled to a franchise to serve at least that part of said county in which such service has been continuously provided, and the board of commissioners of any such county shall, upon finding that all other requirements of this Act are met, grant such franchise;"

"(3)      Limit the number of ambulances to be operated within the county, and by any operator;

"(4)      Determine and prescribe areas of franchised service within the county;

"(5)      Fix and change from time to time reasonable charges for franchised ambulance services;

"(6)      Set minimum limits of liability insurance coverage for ambulances;

"(7)      Contract with franchised ambulance operators for transportation to be rendered upon call of a county or municipal agency or department and for transportation of bona fide indigents or persons certified by the county welfare authorities to be public assistance recipients;

"(8)      Establish other necessary regulations not inconsistent with statutes or regulations of the State Board of Health relating to ambulance service.

      "In addition to the powers set forth above, the board of commissioners of any county or any portion thereof is hereby authorized to provide, or cause to be provided, ambulance service and shall have the power to own, operate and maintain ambulances, to provide and to make reasonable charges for ambulance services, or to contract with any public or private agency, person, firm, corporation or association, including public and private hospitals, for the rendering of ambulance services.

      "In order to finance the costs of assuring adequate and continuing ambulance services in any manner authorized by this Act, boards of county commissioners are hereby authorized, in addition to the expenditure of nontax funds, to levy annually a special tax at such rate as may be necessary on each one hundred dollars ($100.00) of assessed valuation of taxable property within the county or within any portion of the county affected by lack of ambulance services; such special property tax shall be in addition to any tax allowed by law for such purpose and shall be in addition to the rate allowed by the Constitution for general purposes and may be levied in a special tax district created by the board of county commissioners in any portion of the county affected by lack of ambulance service. Such levy and the expenditure of the proceeds thereof for the purposes authorized herein are hereby declared to be a necessary expense and a special purpose and the special approval of the General Assembly is hereby given for such levy.

      "In the event that a court of competent jurisdiction should decide that such levy and expenditure is not a necessary expense, then and in such event, the boards of county commissioners shall thereupon have the power and authority to call a referendum upon the question of the levy of such tax in the same manner and according to the laws governing general elections for county officers in the respective counties.

"(b)      Any municipality may exercise, within its corporate limits only, all those powers enumerated in paragraph (a) of this subsection either upon the request of a municipality to the board of county commissioners and upon the adoption by the board of county commissioners of a resolution permitting such exercise, or after 180 days written notice to the board of county commissioners if the county is not exercising such powers at the end of such 180 days period.

"(c)       No county ordinance enacted, or other county action taken, pursuant to powers granted herein shall be effective within a municipality which is at the time exercising such powers until 180 days after written notice to the governing body of the municipality.

"(d)      Nothing herein shall be construed so as to authorize any county to regulate in any manner ambulances owned and operated by a municipality, or to authorize any municipality to regulate in any manner ambulances owned and operated by a county.

"(e)       Any ambulance operated by a county or a municipality under authority of this Section shall be subject to the provisions of G.S. 130-230 through 130-234 and to the regulations of the State Board of Health adopted thereunder."

Sec. 6.  Article 36 of Chapter 14 of the North Carolina General Statutes is hereby amended by adding a new Section to be designated "G.S. 14-286.1" and to read as follows:

"G.S. 14-286.1.  Making False Ambulance Request. It shall be unlawful for any person to wilfully summon an ambulance or wilfully report that an ambulance is needed when such person does not have good cause to believe that the services of an ambulance are needed. Every person convicted of wilfully violating this Section shall upon conviction be punished by a fine not to exceed fifty dollars ($50.00) or imprisonment not to exceed 30 days or both such fine and imprisonment."

Sec. 7.  The powers herein granted to counties and municipalities are in addition to and not in substitution of existing powers granted by general laws or local acts.

Sec. 7 1/2.  If any provision of this Act or the application thereof to any person or circumstances is held invalid, such invalidity shall not affect the other provisions or application of this Act which can be given effect without the invalid provision or application, and to this end the provisions of this Act are declared to be severable.

Sec. 8.  Except as provided in Section 7 above, all laws and clauses of laws in conflict with the provisions of this Act are hereby repealed.

Sec. 9.  This Act shall become effective upon its ratification; provided that compliance with regulations and standards of the State Board of Health established pursuant to the authority granted by Section 3 of this Act shall be mandatory only after 90 days following the date of promulgation thereof by the State Board of Health.

In the General Assembly read three times and ratified, this the 9th day of May, 1967.