HomeMy WebLinkAbout9887-08 Amend Chapter 9, Article 3. Addressing Ambulance/Medical user fees and dedicated fundORDINANCE No. saa~
Passed by the Common Council of the Ciry of South Bend, Indiana
December 8,
Attest:
Attest:
Ciry Clerk
President of Common Council
Presented by me to the Mayor of the City of South Bend, Indiana
December 9,
20 08
2008
~ Ciry Clerk
Approved and signed by me December 10 , Z0 0 8
~`~`..~ e Mayer
Bill No. ~ 7^ _ -08
Ordinance No. mil, ~ B1 ~ ~g
AN ORDINANCE OF THE COMMON COUNCIL OF THE CITY OF SOUTH BEND,
INDIANA, AMENDING CHAPTER 9, ARTICLE 3 OF THE SOUTH BEND MUNICIPAL
CODE ADDRESSING AMBULANCE/MEDICAL USER FEES AND DEDICATED FUND
STATEMENT OF PURPOSE AND INTENT
Since 1981, the City of South Bend, Indiana, has had regulations codified into the South
Bend Municipal Code which address ambulance and medical user fees. The current ambulance and
medical user fees took effect on August 1, 2002.
The South Bend Fire Administration has conducted a survey of these fees and charges and
believes that adjustments are warranted in light of increased costs to the city for medical training
and certifications, as well as in light of the increased costs for needed medical supplies. The
proposed fee adjustments also follow Medicare billing guidelines.
This ordinance is believed to be in the best interests of the South Bend Fire Department, and
the City of South Bend, Indiana, to help maintain the best possible public safety services in this
area.
u1/~ ~e ~ ~~~ ~ ~'~~~ ~~~~of the City of South Bend, Indiana, as follows:
Section I. Chapter 9, Article 53 of the South Bend Municipal Code is amended to read in its entirety
as follows:
ARTICLE 3. AMBULANCE/MEDICAL USER FEE AND DEDICATED FUND
Sec. 9-16. Ambulance/Medical User Fees.
(a) The following user fee schedule shall be charged for all ambulance/medical services provided
by the City through its paramedic branch of the Fire Department:
Resident Non-
Resident
(1) Basic Life Support (BLS Non-Emergency) $281.05 $374.74
(2) Basic Life Support (BLS Emergency) $449.69 $599.58
(3) Advanced Life Support (ALS Non-Emergency) $337.26 $449.68
(4) Advanced Life Support (ALS-1 Emergency) $534.00 $712.00
(5) Advanced Life Support (ALS-2 Emergency) $772.91 $1,030.54
(6) Mileage, Basic (Within City Limits) (Per patient miles, $ 9.63
minimum one (1) mile)
(7) Mileage, Rural (Per patient miles, minimum one (1) mile) $ 12.84
(8) Non-Transport ALS Medical Call $100.00 $150.00
(b) The above fees shall be charged per patient run occurrence; however, when
ambulance/medical services are provided for a patient using a private ambulance, the mileage fee
shall not be charged; and further provided that when more than two (2) members of an immediate
family residing at the same address are transported per incident, the basic fee, mileage fee, and
emergency fee shall only be billed for two (2) persons.
(c) Non-resident is defined as a person whose primary residence at the time of the service
is outside the corporate boundaries of the City of South Bend, Indiana.
(d) Basic Life Support (BLS) means transportation by ground ambulance vehicle and
medically necessary supplies and services, plus the provision of BLS ambulance services. The
ambulance must be staffed by an individual who is qualified in accordance with state and local laws
as an emergency medical technician-basic (EMT-Basic).t
(e) Advanced Life Support, Level 1 (ALS1) means transportation by ground ambulance
vehicles, medically necessary supplies and services and either an ALS assessment by ALS
personnel or the provision of at least one ALS intervention.
(f) Advance Life Support, Level 2 (ALS2) means either transportation by ground
ambulance vehicle, medically necessary supplies and services, and the administration of at least
three (3) medications by intravenous pus bolus or by continuous infusion excluding crystalloid,
hypotonic, isotonic, and hypertonic solutions (Dextrose, Normal Saline, Ringer's Lactate); or
transportation, medically necessary supplies and services, and the provision of at least one (1) of the
following ALS procedures:
(1) Manual defibrillation/cardioversion
(2) Endotracheal intubation
(3) Central venous line
(4) Cardiac pacing
(5) Chest decompression
(6) Surgical airway
(7) Intraosseous line
(g) Non-Transport Medical Calls means a response to a medical emergency call by
ambulance vehicle and the administration of ALS skills upon or medication given to a patient who
then refuses transport to the hospital.
' ALS 1, ALS2 and BLS defmitions track the language codified in Title 42 of the Code of Federal Regulations, Chapter
IV, §414.605 entitled "Fee Schedule for Ambulance Services".
Ordinance Addressing Ambulance/Medical Services Fees
Page 3
(h) Mileage, Rural, shall apply to vehicle runs made to areas in zones or zip codes
designated as rural by Medicare and the U.S. Department of Health and Human Services in its
Medicare regulations.
(i) The above fees shall take effect on January 1, 2009.
Sec. 9-17 Dedication of Ambulance/Medical User Fees Revenues to the E.M.S. Capital
Improvement Fund, Fund # 288; Quarterly Transfers
The revenues generated by the rates set forth in Sec. 9-16 shall be dedicated to defraying the
expenses of the E.M.S. operating budget, a part of the General Fund of the City of South Bend and
for capital purchases and leases of E.M.S. equipment, firefighting equipment and fire station
repairs. All moneys collected will be deposited in the E.M.S. Capital Improvement Fund, Fund #
288. Quarterly transfers in the amount of sixty-two thousand five hundred dollars ($62,500.00) will
be made from the E.M.S. Capital Improvement Fund on or about the last day of each quarter of the
calendar year. Annual transfers shall not be less than two hundred fifty thousand dollars
($250,000.00).
Sec. 9-18. Annual Review of User Fees by Common Council Following September 1St Report
From the South Bend Fire Department.
(a) The South Bend Fire Department shall prepare a report and file the same with the
Office of the City Clerk on or before September 1St of each year. Said report shall summarize
ambulance/medical service runs as of August 15tt' of that year by identifying the number and type of
each run; amount billed; amount collected; amount in collection; number of lawsuits filed; and
recommendations with regard to fee amounts. Any fee recommended fee adjustments shall include
reasons for the requested adjustments.
(b) The Common Council shall review the report filed annually by the South Bend Fire
Department. The Council's Personnel and Finance Committee and/or the Council's Health and
Public Safety Committee shall make a formal recommendation to the Common Council following a
public hearing. Data contained in the annual report and testimony provided at the committee's
hearing shall be used in determining fair and equitable user fees.
Section II. This ordinance shall be in full force and eff r its passage by the
Common Council, approval by the Mayor, legal publ' , _ , ~
Counci1.I0lember Tho~ias LaFountain
Perso el and Finance Committee Chairperson
Member of the Common Council
Ordinance Addressing Ambulance/Medical Services Fees
Page 4
r -~~%~
tt ~~
Council Member Karen L. White
Health & Public Safety Committee Chairperson
Me r of the C on Council
ember Ann ello
Health & Public Safety Committee Vice-Chair
Member of the Common Council
Vo rde, City Clerk
~~ by me to Stephen J. Luecke, the Mayor of the City of South Bend, Indiana, on the
day of / 2008, at ~ ~UC~ o'clock ~. m.
U, ~~„ i
~~~ ~ ~ by me on the ~~day of ~,C.Gt~ flii 7~at d: ~~ o'clock
~.m.
Steph J. Lu c
Mayor
City of South Bend, Indiana
1st Rl~ADiNG ~~-Z~~~~
PUCCIC NEARING ~ L ~ ~'flg
3rd READING (Z--g"-O~
NOT APPROVED
F,Ei•EE:[ED ~ d
NOV 1 9 ~~~
J4HFF VQQ"CE
cITY c~er;x, ~o. Saida, !y.
~-
TO THE COMMON COUNCIL OF THE CITY OF SOUTH BEND:
Your Committee of the Whole, to whom was referred:
BILL NO.
72-08 A BILL OF THE COMMON COUNCIL OF THE CITY OF SOUTH BEND,
INDIANA, AMENDING CHAPTER 9, ARTICLE 3 OF THE SOUTH BEND
MUNICIPAL CODEADDRESSINGAMBULANCE/MEDICAL USE FEES
AND DEDICATED FUND
Respectfully report that they have examined the matter and that in their opinion, this bill is
being recommended to the full Council with a favorable recommendation.
Derek D. Dieter
Chairperson, Committee of the Whole
4 SpU Tg 8~~
\` ~\~11i1~~~l~j~ d
,~ ~ ~! ~ City of South Bend
~: \ PFJ;C6 ~% ~
~ ~, -, a
"''~~ ~ Common Council
y 1865 s 441 County-City Building .227 W. Jefferson Blvd
South Bend, Indiana 46601-1830
Timothy A. Rouse
President
Oliver J. Davis
Vice-President
November 19, 2008
Derek D. Dieter The South Bend Common Council
Chairperson, Committee 4~' Floor County-City Building
of the Whole South Bend, Indiana 46601
(574) 235-9321
Fax (574) 235-9173
TDD (574) 235-5567
http://www southbendin.gov
Derek D. Dieter Re: Ambulance/Medical User Fee Ordinance
First District
Dear Council Members:
Henry Davis, Jr.
Second District
During this year's labor negotiations between the City of South Bend and
Thomas LaFountain representatives of the South Bend Firefighter's Association Local No. 362 of the
Third .District International Association of Firefighters AFL-CIO, there was agreement to work
together in order to assure that the best possible fire safety services are provided by
Ann Puzzello the South Bend Fire Department to the citizens of our community. In addition to
Fourth District facing the financial challenges, there was agreement to work toward developing
David Varner
Fifth District • Improved departmental efficiencies
• Enhanced accountability
Oliver J. Davis • Developing a better costJbenefit analysis of public safety services
Sixth District
As a result of these discussions, we are filing the attached ordinance which would
Al "Buddy' Kirsits make user fee adjustments for the many medical services provided by the South
At Large Bend Fire Department. This ordinance has had the input of Fire Chief Howard
Timothy A. Rouse Buchanon, II, Assistant Chief Mark Nowicki and Assistant Chief Stephen Cox.
Assistant Chief Cox conducted extensive background work on this project and will
At Large be filing a memorandum in support of this ordinance. Input from Local No. 362 was
Karen L. White also sought, as we worked in collaboration with all parties.
At Large
The current fees charged were established in 2002, and are used to offset expenses
Kathleen Cekanski-Farrand incurred by the South Bend Fire Department in delivering such medical services.
Council Attorney The proposed use fee schedule follows Medicare billing guidelines and are
recommended to be modified as follows:
Type of Medical Services Resident Non-Resident
(1) Basic Life Support (BLS Non-Emergency) X99 $281.05 ~~ $374.74
Resident
(2) Basic Life Support (BLS Emergency) X388 $449.69 ~-$599.58
(3) Advanced Life Support (AL5 Non-Emergency) ~3-A8 $337.26
X7-5-$449.68
(4) Advanced Life Support (ALS-1 Emergency) X489 $534.00 Q^$712.00
(5) Advanced Life Support (ALS-2 Emergency) ~-$772.91 SSA- $1,030.54
(6) Mileage, Basic (Within City Limits) (Per patient miles,
minimum one (1) mile) $~47- $ 9.63
(7) Mileage, Rural (Per patient miles, minimum one (1) mile) -$ 12.84
(8)Non-Transport ALS Medical Call ~-5-$100.00 Q'~$150.00
Terminology in the ordinance has also been updated to correspond with the federal guidelines
which are codified in the Code of Federal Regulations. Revisions have also been made to have
greater transparency of the process of annually reviewing the reports which summarize the number
and type of ambulance and medical service runs; amount billed; amount collected; amount in
collection; number of lawsuits filed; and recommendations for fee adjustments along with
justification for such requested adjustments. This annual report would be required to be filed with
the Office of the City Clerk on or before September 1St of each year. The report would then be
given a public hearing through a joint committee meeting of the Personnel and Finance Committee
and the Health and Public Safety Committee thereafter.
We believe that this ordinance is needed in order to continue to provide top-quality ambulance and
medical services through the South Bend Fire Department in acost-efficient manner. We ask that.
the ordinance be referred to a joint committee meeting of the Personnel and Finance Committee and
the Health and Public Safety Committee, so that you may receive additional information from Fire
Chief Howard Buchanon, II, Assistant Chief Mark Nowicki, Assistant Chief Stephen Cox,
representative of South Bend Firefighter's Association Local No. 362, and concerned citizens. We
urge each of t i public safety measure. Thank you.
Sincer
ct a omas LaFountain
Per el and Finance Committee Chairperson
ouncil MembeG r Kare~~ FIIC:~ X11 ~~~`-'iC'~ ~~~1Ce
He & Public afety Comm' a Chairperson
LuUQ~
ci~ b An el o Nov ~
Healt & Public Safe ommittee Vice-Chair
JOYN ~'SG.1'~ F'1D,1*1.
CI't~ CLERK,