HomeMy Public PortalAbout075-2008 - RFD - Authorizing the recovery of costORDINANCE NO. 75-2008
AN ORDINANCE AUTHORIZING THE RECOVERY
OF COSTS FOR EMERGENCY MEDICAL SERVICES PROVIDED BY THE RICHMOND
FIRE DEPARTMENT; ESTABLISHING FEE SCHEDULES; AND APPROVING
APPROPRIATIONS OF FEE PAYMENTS
WHEREAS, The Richmond Fire Department is a responder that provides emergency ambulance
services, medical treatment, emergency medical services, to individuals involved in
incidents that include, but are not limited to, motor vehicle accidents, medical
emergencies, illnesses, or other hazardous situations in Richmond, Indiana and
surrounding communities; and
WHEREAS, The Richmond Fire Department provides additional services when there is a need to
stand by with individuals waiting for transportation provided by a private emergency
transport company and a need to provide additional support for patient handling due to
extenuating circumstances; and
WHEREAS, The Richmond Fire Department in response to motor vehicle accidents provides
additional services that include, but are not limited to, cleaning of hazardous material
spills and debris, extrication of entrapped individuals, extinguishments of fires, and other
safety or hazardous situations which may occur at the scene of a motor vehicle accident;
and
WHEREAS, The Fire Department provides safety services for special events throughout the
community it serves and these regularly scheduled special events often require the Fire
Department ambulance and personnel to be on standby to render care for any medical
emergencies or incidents that may occur during the course of the event; and
WHEREAS, It is in the interest of public health, safety, and welfare that the above services be
provided; and
WHEREAS, To allow the City of Richmond, under the authority granted by Indiana Code 16-31-5, to
recoup the costs of services provided and the cost of supplies expended during an
emergency medical response, a fee schedule needs to be established; and
WHEREAS, The establishment of fees is in the best interest of the City of Richmond and its residents.
NOW, THEREFORE, BE IT ORDAINED BY THE COMMON COUNCIL OF THE CITY OF
RICHMOND, INDIANA THAT THE FOLLOWING TITLE AND CHAPTERS SHALL BE
ADDED TO THE RICHMOND CITY CODE:
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SECTION
80.01 PURPOSE
TITLE VIII
MEDICAL EMERGENCY RESPONSES
CHAPTER 80:
RICHMOND FIRE DEPARTMENT RESPONSES
TO EMERGENCY MEDICAL CALLS
GENERAL PROVISIONS
Purpose
Authority
Applicability
Definitions
Responsibility for Administration
Compatibility with Other Chapter Requirements
Emergency Ambulance Response Fees
Replacement Cost Fees
Incidental Fees
Billing Procedures
Disposition of Funds
Annual Review of Fees and Procedures
Effective Date
The 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 AUTHORITY
This 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 APPLICABILITY
This Chapter shall apply to all persons or organizations who receive services from emergency
ambulance responders of the City of Richmond Fire Department.
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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.
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(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.
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(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.
(1) 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.
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(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
(5) The person or entity responsible for conducting the special event for which the
Fire Department provides medical standby safety services.
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(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
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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/Resbonse 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 1/4 hour
$125.00
$175.00
Patient Supervised Waiting Time — ea. addt'l 1/4 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***
$4,800.00
$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.
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***Richmond residents shall not be charged for extraction rescue services as the result of a motor
vehicle accident. However, fees consistent with the 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.
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80.13 EFFECTIVE DATE
This ordinance shall be in full force and take effect upon its passage.
Passed this 16th day of _March , 2009.
S/S Bruce Wissel
Bruce Wissel, President
Common Council of
The City of Richmond
ATTEST: _S/S Karen Chasteen , City Clerk
(Karen Chasteen)
Presented by me to the Mayor of the City of Richmond, Indiana, this _17th _ day of
March , 2009, at 9:00 a.m.
S/S Karen Chasteen , City Clerk
(Karen Chasteen)
Signed and Approved by me, Sarah L. Hutton, Mayor of the City of Richmond, Indiana, this _17th
day of March , 2009, at 9:05 a.m.
S/S Sarah L. Hutton , Mayor
(Sarah L. Hutton)
ATTEST: S/S Karen Chasteen , City Clerk
(Karen Chasteen)
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