CHAPTER 430

An Act to amend the Code of Virginia by adding in Title 82 a new chapter
numbered 16.1, consisting of sections numbered $2-810.1 through
82-810.8, to provide for the regulation of ambulances and the issu-
ance of permits to operate same and for the certification of emergency
medical care attendants by the State Board of Health; to create the
Advisory Committee on Emergency Services to assist the Board; to
provide penalties for violations; and to authorize local regulation of
and provision of ambulance services.

[H 163]

Approved April 2, 1968
Be it enacted by the General Assembly of Virginia:
1. That the Code of Virginia be amended by adding in Title 32 a new
chapter numbered 16.1, consisting of sections numbered 32-310.1 through
32-310.8, as follows:
Chapter 16.1

§ 32-310.1. (a) On and after January one, nineteen hundred sixty-
nine, no person, firm, corporation or association, either as owner, agent,
or otherwise, shall hereafter furnish, operate, conduct, maintain, adver-
tise, or otherwise engage in or profess to be engaged in the business or
service of transporting patients upon the streets or highways in Virginia
unless he holds a currently valid permit for each ambulance used in such
business or service, issued by authority of the State Board of Health.

(b) As used in this chapter, “ambulance” shall mean any privately
or publicly owned vehicle that is specially designed, constructed, or modi-
fied 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.

(c) 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 proce-
dures established by the Board. Prior to issuing an origina] or renewal
permit for an ambulance, it shall be determined 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 chapter and in the regulations
of the Board. Permits issued for ambulances shall be valid for a period
specified by the Board, not to exceed two years.

(d) The Board may authorize the issuance of temporary permits for
vehicles not meeting required standards valid for a period not to exceed
sixty days when the public interest will be served thereby.

(e) 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 at all reasonable times to such
inspection as the Board may require.

(f) The issuance of a permit hereunder shall not be construed so as
to authorize any person, firm, corporation, or association to provide ambu-
lance services or to operate any ambulances without a franchise or permit
in any county or municipality which has enacted an ordinance pursuant to
§ 32-310.8 making it unlawful to do so.

§ 32-310.2. For the purpose of assisting the State Board of Health
in developing standards for use in the administration of this chapter, there
is hereby created the Advisory Committee on Emergency Services. Such
Committee shall be composed of nine members appointed by the Governor
so as to give representation to the League of Virginia Counties, Virginia
Municipal League, Medical Society of Virginia, Virginia Hospital Associa-
tion, Virginia Funeral Directors Association, Virginia Association of Res-
cue Squads, Inc., the American Red Cross and Virginia State Fireman’s
Association through appointments made from lists of nominees submitted
by such organizations and so as to represent commercial ambulance serv-
ices. Initially, four members shall be appointed for terms of two years
and five for terms of four years, and thereafter appointments shall be
made for terms of four years in a manner to preserve insofar as possible
the representation of the aforesaid organizations.

The Committee shall choose its own chairman and shall meet at the
call of the chairman or the State Health Commissioner.

§ $32-310.3. (a) The Board shall adopt regulations specifying sani-
tation 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 supplies
and equipment specified by the Minimal Equipment List for Ambulances
as adopted by the Committee on Trauma of the American College of
Surgeons and in effect on the effective date of this chapter; provided, how-
ever, the State Board of Health, with the approval of the Advisory Com-
mittee on Emergency Services, 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

erence.

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

_ § 82-310.4. (a) On and after January one, nineteen hundred sixty-
nine, every ambulance, except those specifically excluded from the opera-
tion of this chapter, when operated on an emergency mission in this State
shall be occupied by at least one person who possesses a valid Emergency
Medical Care Attendant’s Certificate issued by authority of 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 as an emergency
medical care attendant.

(b) The Board shall adopt regulations setting forth the qualifications
required for certification of such attendants. Such regulations shall be
eee when approved by the Advisory Committee on Emergency

ervices.

(c) Persons desiring certification as emergency medical care attend-
ants shall apply to the Board using forms prescribed by the Board. Upon
receipt of such application the Board shall cause the applicant to be
examined and if it is determined that the applicant meets the requirements
of its regulations duly adopted pursuant to this chapter, it shall issue a
certificate to the applicant. Emergency medical care attendants’ certifi-
cates so issued shall be valid for a period not to exceed two years and may
be renewed after reexamination if the holder meets the requirements set
forth in the regulations of the Board. Any certificate so issued may be
suspended at any time it is determined that the holder no longer meets
the qualifications prescribed for such attendants.

(d) The Board may authorize the issuance of 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
ninety days.

§ 32-310.5. For the purpose of assisting the State Board of Health
and the Advisory Committee on Emergency Services in the performance
of their duties under the provisions of this chapter, the State Health
Commissioner shall be deemed the authorized agent of the Board and
Committee for the purposes of this chapter and he may designate within
the State Department of Health such personnel as may be required for
the purposes of this chapter.

§ 32-310.6. The following are exempted from the operation of the
provisions of this chapter: oo.

(a) Privately owned vehicles not ordinarily used in the business of
transporting persons who are sick, injured, wounded, or otherwise in-
capacitated or helpless;
(b) 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;

(c) Ambulances based outside this State, except that any such ambu-
lance receiving a patient within this State for transportation to a location
within this State shall comply with the provisions of this chapter.

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

§ 32-310.7. It shall be the duty of the registered owner of the
vehicle concerned to see that the provisions of this chapter and all regu-
lations adopted hereunder are complied with. Upon the violation of any
regulation adopted under authority of this chapter, 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, shall constitute a misdemeanor
punishable as provided in § 18.1-9; provided, however, that an original
permit for an ambulance required in § 32-10.1 and an original certificate
for personnel as provided for in § 32-310.4 shall be issued by the Board,
without regard to the requirements of these sections, to all ambulances
and personnel of any rescue unit operated by any rescue squad, fire
department, police department or any political subdivision if organized
and engaged in rendering the service contemplated under this act on
July 1, 1968 and if certified by their local medical advisor, or if there
is no medical advisor, by their local governing body that the equipment
is adequate and the member performing the service is properly trained to
carry on the duties required of him.

§ 32-310.8. (a) Upon finding as fact, after notice and public hear-
ing, 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, pro-
tect and promote the public health, safety and general welfare, the gov-
erning bodies of the cities and counties, within their respective jurisdic-
tions, are hereby empowered to:

Enact an ordinance making it unlawful to provide ambulance
services or to operate ambulances without having been granted a fran-
chise or permit to do so;

(2) Grant franchises or permits to ambulance operators, based within
or without the city or county; provided, that any ambulance operator pro-
viding ambulance services in any county or city upon the effective date of
this chapter and who continues to provide such services up to and includ-
ing the effective date of any ordinance adopted pursuant to this section,
and who submits to the governing body of any such city or county evi-
dence satisfactory to it of such continuing service, shall be entitled to a
franchise or permit to serve at least that part of such city or county in
which such service has been continuously provided, and the governing
body of any such city or county shall, upon finding that all other require-
ments of this chapter are met, grant such franchise or permit;

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

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

(5) Fix and change from time to time reasonable charges for fran-
chised or permitted ambulance services;

(6) Set minimum limits of liability insurance coverage for am-
bulances ;
(7) Contract with franchised or permitted 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 local board of public welfare to be public assistance
recipients ;

(8) Establish other necessary regulations not inconsistent with stat-
utes or regulations of the State Board of Health relating to ambulance
service.
(b) In addition to the powers set forth above, the governing body
of any city or county is hereby authorized to provide, or cause to be pro-
vided, ambulance services and such city or county shall have the power
to own, operate and maintain ambulances, to provide and to make rea-
sonable 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.

(c) Any incorporated town may exercise, within its corporate limits
only, all those powers enumerated in subsections (a) and (b) of this
section either upon the request of a town to the board of county super-
visors and upon the adoption by the board of county supervisors of a
resolution permitting such exercise, or after one hundred eighty days
written notice to the board of county supervisors if the county is not
exercising such powers at the end of such one hundred eighty day period.

(d) No county ordinance enacted, or other county action taken, pur-
suant to powers granted herein shall be effective within an incorporated
town which is at the time exercising such powers until one hundred
eighty days after written notice to the governing body of the town.

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

(f) Any ambulance operated by a city, county or town under author-
ity of this section shall be subject to the provisions of §§ 32-310.1 through
eaeua and to the regulations of the State Board of Health adopted

ereunder.