Loading...
HomeMy Public PortalAboutCHAP 80 EMS-RFD fee schedules.pdf TITLE VIII MEDICAL EMERGENCY RESPONSES CHAPTER 80: RICHMOND FIRE DEPARTMENT RESPONSES TO EMERGENCY MEDICAL CALLS SECTION GENERAL PROVISIONS80.01 Purpose 80.02 Authority 80.03 Applicability 80.04 Definitions 80.05 Responsibility for Administration 80.06 Compatibility with Other Chapter Requirements 80.07 Emergency Ambulance Response Fees 80.08 Replacement Cost Fees 80.09 Incidental Fees 80.10 Billing Procedures 80.11 Disposition of Funds 80.12 Annual Review of Fees and Procedures 80.13 Effective Date 80.01 PURPOSEThe Common Council of the City of Richmond, after careful investigation and consideration, finds that certain fees and cost recovery procedures must be utilized to assist the City of Richmond, through its Fire Department, to recover the cost of expenses for supplies and cover the cost of services incurred by the Richmond Fire Department when the department responds to or provides emergency medical ambulance services that contribute to and are necessary to the public health, safety, and welfare of the people of the City of Richmond. 80.02 AUTHORITYThis Chapter is adopted under the authority granted by Indiana Code 16-31-5 and all acts supplemental and amendatory thereto. This authority provides that a municipality that maintains emergency medical services may establish and provide for the collection of reasonable fees for any emergency ambulance services the municipality provides. 80.03 APPLICABILITYThis Chapter shall apply to all persons or organizations who receive services from emergency ambulance responders of the City of Richmond Fire Department. 80.04 DEFINITIONS For the purposes of this Chapter the following definitions shall apply. Any term in this Chapter not defined below shall take on its common or dictionary meaning. (a) Advanced Life Support (“ALS”) is defined as care that is given: (1) at the scene of: (A) an accident; (B) an act of terrorism, if the governor has declared a disaster emergency in response to the act of terrorism; or (C) an illness; (2) during transport; or (3) at a hospital; by a paramedic or an emergency medical technician-intermediate during an emergency ambulance response by the Richmond Fire Department and that is more advanced than the care usually provided by an emergency medical technician or an emergency medical technician-basic advanced. The term may include any of the following: (1) Defibrillation. (2) Endotracheal intubation. (3) Parenteral injections of appropriate medications (4) Electrocardiogram interpretation. (b) Ambulance is defined as a conveyance on: (1) land; (2) water; or (3) air; that is used or is intended to be used for the purpose of responding to emergency life-threatening situations and providing emergency transportation service. (c) Basic Life Support (“BLS”) is defined as the following: (1) Assessment of emergency patients. (2) Administration of oxygen. (3) Use of mechanical breathing devices. (4) Application of anti-shock trousers. (5) Performance of cardiopulmonary resuscitation. (6) Application of dressings and bandage materials. (7) Application of splinting and immobilization devices. (8) Use of lifting and moving devices to ensure safe transport. (9) Administration by an emergency medical technician or emergency medical technician-basic advanced of epinephrine through an auto-injector. (10) For an emergency medical technician-basic advanced, the following: (A) Electrocardiogram interpretation. (B) Manual external defibrillation. (C) Intravenous fluid therapy. (11) Other procedures authorized by the Indiana emergency medical services commission, including procedures contained in the revised national emergency medical technician basic training curriculum guide. Except as provided by: subsection (a)(9) and the training and certification standards established under IC 16-31-2-9(3); subsection (a)(10)(C); and the training standards established under IC 16-31-2-9(4); the term does not include invasive medical care techniques or advanced life support. (d) Emergency Medical Technician (“EMT”) is defined as follows: (1) An individual who is certified under Indiana Code 16-31 to provide basic life support at the scene of an accident, illness, or during transport; or (2) An individual who is certified under Indiana Code 16-31 who can perform at least one (1) of but not all the procedures of a paramedic and who: (1) has completed a prescribed course in advanced life support; (2) has been certified by the Indiana emergency medical services commission; (3) is associated with a single supervising hospital; and (4) is affiliated with a provider organization. (e) Expendable Material is defined as an item that is regularly used during the course of a response, including, but not limited to, latex gloves, hypodermic syringes, dispensed medications, bandages, hazardous spill absorption materials, agents used in cleanup operations, or any other item that must be replaced due to the rendering of services and/or response to an event by the Richmond Fire Department. (f) First Responder is defined as an individual who is: (1) certified under IC 16-31 and who meets the Indiana emergency medical services commission's standards for first responder certification; and (2) the first individual to respond to an incident requiring emergency medical services. (g) Hazardous Material Spill is defined as unexpected, unintentional, or unapproved discharge or other loss of oil or other substances that contain hazardous or otherwise objectionable substances that damage or threaten to damage the public health, safety, and welfare, which, for the purposes of this Chapter only, are the result of a motor vehicle accident to which the Richmond Fire Department is a responder. (h) Incidental cost is defined as a subordinate and indirect cost that is incurred during the course of the response. (i) Level I Motor Vehicle Response Service is defined as services that are rendered in response to a motor vehicle accident where the services shall consist of one or more of the following: (1) the establishment of a safe environment at the scene of the accident; (2) any further investigation that may be required; or (3) Basic Life Support or medical care to a patient who then refuses or does not require transportation to a hospital. Services provided that exceed standard Level I services shall cause the response to be categorized at a higher Level. (j) Level II Motor Vehicle Response Service is defined as services that are rendered in response to a motor vehicle accident where the services shall consist of one or more of the following: (1) Basic Life Support or Advanced Life Support where the individual requires transportation to a hospital; (2) the cleanup of spills; (3) protection from downed power lines; or (4) extinguishment of vehicle fires. Level II may also include any services normally provided in Level I. (k) Level III Motor Vehicle Response Service is defined as services that are rendered in response to a motor vehicle accident where the services shall consist of extrication of entrapped individuals. Level III may also include any services normally provided in Level I or II. (l) Level IV Motor Vehicle Response Service is defined as services that are rendered in response to a motor vehicle accident where the services shall consist of preparation of individuals who require air flight to trauma hospitals, and the establishment of a helicopter landing site. Level IV may also include any services normally provided in Level I, II, or III. (m) Non-resident is defined as a person whose primary residence at the time of the service or response is outside the corporate boundaries of the City of Richmond, Indiana. (n) Non-transport patient is defined as a patient with a minor medical condition who does not require transportation to a hospital or who, because of the non-severity of his or her medical condition, refuses transportation to a hospital. The final determination of the severity or non-severity of the medical condition is within the discretion of the treating officer. (o) Paramedic for purposes of this Chapter is defined as an individual who is: (1) affiliated with a certified paramedic organization; (2) employed by a sponsoring hospital approved by the commission; or (3) employed by a supervising hospital with a contract for inservice education with a sponsoring hospital approved by the commission; and who has completed a prescribed course in advanced life support and has been certified by the Indiana emergency medical services commission. (p) Patient run occurrence is defined as a response to a medical emergency call by a Fire Department ambulance or emergency response vehicle and the administration of basic or advanced life support skills upon, or medication given, to a patient. (q) Replacement cost is defined as the direct cost to pay to replace any item of expendable material plus any shipping fees to replace that item. (r) Resident is defined as a person whose primary residence at the time of the service or response is within the corporate boundaries of the City of Richmond. (s) Response or respond is defined as the deployment or mobilization of the Richmond Fire Department emergency ambulance to emergency medical calls, motor vehicle accident calls, hazardous material spill calls, or any calls of an emergency nature directed to the Richmond Fire Department, to the scene of the accident, illness, event, or occurrence. (t) Responsible Party is defined as: (1) the person being treated, attended to, or rescued during a response by the Richmond Fire Department emergency ambulance and personnel; (2) the liable insurance company of the person who was treated, attended to, or rescued during a response by the Richmond Fire Department emergency ambulance and personnel; (3) the individual directly or indirectly responsible for a person being treated, attended, or rescued during a response by the Richmond Fire Department emergency ambulance and personnel; (4) The owner and/or the liable insurance company of the owner of the motor vehicle for which hazardous material spills or debris around the vehicle are cleaned up, fires are extinguished, or the site of the accident around the vehicle is secured during a response by the Richmond Fire Department emergency ambulance and personnel; (5) The legal representative of a deceased party or the legal guardian of an incapacitated or minor party, which deceased party, incapacitated party, or minor party was treated, attended to, or rescued during a response by the Richmond Fire Department emergency ambulance and personnel; or (6) The person or entity responsible for conducting the special event for which the Fire Department provides medical standby safety services. (u) Service is defined as any necessary action conducted by the Richmond Fire Department during an emergency ambulance medical response including, but not limited to, medical treatment, medical services, basic life support, advanced life support, dispensing of medication, patient handling, cleanup of hazardous substances, evacuation, securing premises, extrication, extinguishment, transportation, equipment operation and utilization, and any and all other services required to assure public health and safety from known hazards which resulted from the accident, illness, event, or occurrence to which the EMT was called to respond to. (v) Special event is defined as any special community event, whether public or private, in the City of Richmond in which the Richmond Fire Department ambulance and personnel are on medical standby for the safety of guests, patrons, invitees, staff, or other attendees of the event, in order to render care for any medical emergencies or incidents that may occur during the during the course of the event. (w) Special handling is defined as the administration of either physical or medical care upon an individual where: (1) an unruly patient requires restraints; (2) more than one unit is required to handle the patient; or (3) more than one unit is needed for transportation assistance of the patient. (x) Supervised Waiting Time is defined as a time delay in transferring the patient from the care of the Richmond Fire Department emergency ambulance and personnel to a private transporting authority. (y) Transport patient is defined as a patient who, because of the severity of his or her medical condition, requires transportation to a hospital. The final determination of the severity or non-severity of the medical condition is within the discretion of the treating officer. 80.05 RESPONSIBILITY FOR ADMINISTRATION The City of Richmond shall administer, implement, and enforce the provisions of this Chapter by and through the Richmond Fire Department. Any powers granted or duties imposed upon the City of Richmond in this Chapter may be delegated in writing by the City of Richmond to persons or entities acting in the beneficial interest of or in the employ of the Richmond Fire Department. 80.06 COMPATIBILITY WITH OTHER CHAPTER REQUIREMENTS This Chapter is not intended to interfere with, abrogate, or annul any other Chapter, rule, regulation, statute, or other provision of the law. The requirements of this Chapter should be considered minimum requirements, and where any provision of this Chapter imposes restrictions different from those imposed by any other Chapter, rule, regulation, or other provision of law, the more restrictive provisions or those provisions that impose higher protective standards for human health or the environment, shall be considered to take precedence. 80.07 EMERGENCY AMBULANCE RESPONSE FEES The fees for emergency ambulance response services are hereby established: Services/Response Resident Fee Non-Resident Fee Non-transport Patient Run Occurrence* $75.00 $125.00 Transport Patient Run Occurrence $200.00 $250.00 Special Handling Fee $100.00 $150.00 Patient Supervised Waiting Time – first ¼ hour $125.00 $175.00 Patient Supervised Waiting Time – ea. addt’l ¼ hour $60.00 $60.00 Basic Life Support $200.00 $250.00 Advanced Life Support $400.00 $450.00 Level I Motor Vehicle Response Service** $435.00 $485.00 Level II Motor Vehicle Response Service $495.00 $545.00 Level III Motor Vehicle Response Service*** $1,800.00 $1,850.00 Level IV Motor Vehicle Response Service $2,100.00 $2,150.00 Mileage to an from each location, per mile $8.00 $8.00 Special Event – initial personnel, per hour $150.00 na Special Event – additional personnel, per hour $50.00 na *When two or more members of an immediate family reside at the same address and the patient run occurrence is rendered at that family’s home, only one fee shall be charged for the patient run occurrence when more than one family member receives non-ALS treatment and no transport occurs. **When the Richmond Fire Department emergency ambulance and personnel responds to a motor vehicle accident to administer emergency medical services, each patient and/or vehicle involved shall be evaluated according to the services that were rendered at the scene and/or during transportation to a medical care facility. Each response will then be assigned the appropriate Level as defined in the definition section of this Chapter and shall be billed accordingly. Responses will be evaluated on a case-by-case basis. ***Richmond residents shall not be charged for extraction rescue services as the result of a motor vehicle accident. However, fees consistent with the remainder remainder of services provided (including but not limited to hazardous material spill control or medical services) shall be charged. 80.08 REPLACEMENT COST FEES Replacement costs shall be charged to replace any item of expendable material plus any shipping fees incurred to replace that item, and those charges will be billed according to the Billing Procedures set forth below. 80.09 INCIDENTAL FEES Fees for any other incidental costs not covered above, which may arise during the course of a response, shall be determined on a case-by-case basis, charged accordingly, and will be billed according to the Billing Procedures set forth below. 80.10 BILLING PROCEDURES The fees set forth in this Chapter shall be charged to and billed to responsible parties within thirty (30) days of the rendering of services. In the event a responsible party or user provides proof of duplicate billing from a private emergency responder company dispatched to the same accident or incident, the portions of the invoice sent by the Richmond Fire Department representing the duplicate services shall be retracted. Charges will be due and payable sixty (60) days after the date services are rendered. Unpaid charges are subject to collection action by the City. Internal standard operating procedures developed upon establishment of fees pursuant to this Chapter shall be reviewed by a member of Common Council prior to implementation and shall be reviewed on an annual basis. 80.11 DISPOSITION OF FUNDS The Richmond Fire Department is responsible for the billing and collection of aforesaid fees. All fees collected (other than fees for hazardous materials billed and collected pursuant to Indiana Code 36-8-12.2) will be allocated to the Special Revenue Fund 205 for the Richmond Fire Department. 80.12 ANNUAL REVIEW OF FEES AND PROCEDURES Fees imposed by this ordinance will be reviewed no less than annually by the Common Council and adjustments made as necessary to assure that charges remain reasonable in relation to the cost of providing the services set out herein. It shall be the obligation of the Richmond Fire Department to provide the Common Council with data sufficient to support the amount of the charges. 80.13 EFFECTIVE DATE This ordinance shall be in full force and take effect upon its passage. (3-16-2009)