HomeMy WebLinkAboutBill 30-16 Amending South Bend Municipal code to address ambulance/medical service fees1222 S. MICHIGAN STREET
SOUTH BEND, INDIANA 466o1 -2821
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CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
SOUTH BEND FIRE DEPARTM
STEPHEN F COX
FIRE CHIEF
Common Council President Tim Scott
County -City Building
South Bend, IN 46601
President Scott,
RHONE 574! 235-9255
FAX 574/235-9305
Filed in Clerk 's al.! .
-...
JUN U s 20116
K/AREETvAH FOW! E
CITY CLERK SOUTH BEND, IN
June 6, 2016
I am respectfully requesting the South Bend Common Council consider my recommendation to increase
the Ambulance User Fees charged by the South Bend Fire Department. As required by The South Bend
Municipal Code, Chapter 9, Article 3, Section 19 -18, I have provided the required 2016 Annual Review
of User Fees with the recommendation for an increase that reflects the increase in reimbursement amounts
allowed by Medicare. These amounts are current to this year. As I have stated in the past, Medicare
typically adjusts this reimbursement allowance at least annually, which usually includes an increase in the
rate of reimbursement. If adjustments are not made to our user fees, we are unable to take advantage of
Medicare's reimbursement increases. This ordinance also includes a provision for self- effectuating annual
fee increases based on Medicare or similar federal or state annual rate adjustments. I recommend adoption
of this self - effectuating provision because Medicare and similar rates provide a reliable, pre- approved
standard for reasonableness and relationship of cost to service.
I appreciate your consideration on this matter. I look forward to presenting the ordinance to Council at
your Committee and regular meetings.
Sincerely,
i
ep n F. x
Fire hief
JAMES LUCCKI TODD L. SKWARCAN ANDREW J. MYER JOHN CORTHIER F'EDERICO RODRIGUEZ, JR
ASST. CHIEF OPERATIONS ASST. CHIEF SERVICES ASST. CHIEF EMS ASST. CHIEF TRAINING FIRE. MARSHAL.
ORDINANCE NO.
AN ORDINANCE OF THE COMMON COUNCIL OF THE CITY OF SOUTH BEND,
INDIANA, AMENDING SECTIONS OF CHAPTER 9, ARTICLE 3, OF THE SOUTH
BEND MUNICIPAL CODE TO ADDRESS AMBULANCEIMEDICAL SERVICE FEES
STATEMENT OF PURPOSE AND INTENT
Since 1981, the City of South Bend, Indiana has codified the regulation of ambulance and
medical user fees into the South Bend Municipal Code. South Bend's current ambulance and
medical user fees took effect on August 1, 2015 (Ordinance No. 10368 -15).
The South Bend Fire Administration has regularly reported to the Common Council its
ambulance service activity pursuant to Chapter 9, Section 9 -18 of the South Bend Municipal
Code, and has provided its recommendation regarding adjustment of user fees. The Fire Chief's
most recent report was submitted to the South Bend Common Council on May 31, 2016.
Based on its survey of these fees and charges, and due to increased costs to the City for
personnel training and necessary medical supplies, it is recommended that ambulance and
medical user fees be adjusted consistent with the 2016 Medicare Fee Schedule. To fully recover
the costs and expenses of the Fire Department paramedic branch in providing ambulance and
emergency medical services, a modest adjustment is required of the current rates.
It is further recommended by the Fire Administration that hereafter the South Bend Fire
Chief be authorized to adjust these user fees once annually and automatically by the same
percentage rate as any adjustments made to the Medicare Fee Schedule rates, with notice to the
City Clerk after which such new rates will take effect. These changes are reasonable,
appropriate, and in the best interests of the City of South Bend.
NOW, THEREFORE, BE IT ORDAINED by the Common Council of the City of
South Bend, Indiana, as follows:
Section I. Chapter 9, Article 3, Section 9 -16 of the South Bend Municipal Code shall be
amended to read in its entirety as follows:
Sec. 9 -16. Ambulance /medical user fee -- Established.
(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:
(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 (EMT)'.
(e) Advanced Life Support, Level 1 (ALS 1): 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.
1 ALS 1, ALS2 and BLS definitions track the language codified in Title 42 of the Code of Federal Regulations,
Chapter IV, §414.605 entitled "Fee Schedule for Ambulance Services ".
Resident
Non-
Resident
Non - Resident
Resident
(1) Basic Life Support (BLS
$320.34
$426.05
$322.19
$ 428.51
Nonemergency)
(2) Basic Life Support—(BLS
515.49
685.60
Emergency)
512.55
681.69
(3) Advanced Life Support –(ALS
c i�
386.63
514.21
Non Emergency)
384.41
(4) Advanced Life Support --
5,
612.15
814.16
Emergency (ALS -1 Emergency)r
809
(5) Advanced Life Support – (ALS -2
4
886.01
1,178.39
Emergency
'
(6) Mileage, Basic (Within City
Limits) (per patient miles, minimum
12.66
12.66
12.66
12.66
one (1) mile)
(7) Mileage, Rural (per patient miles,
19.16
19.16
19.16
19.16
minimum one (1) mile)
(8) Non - Transport Medical Calls
150.00
200.00
150.00
200.00
(9) Specialized Care (AO 434)
1,041.11
1�7
1,047.09
1,392.63
(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 (EMT)'.
(e) Advanced Life Support, Level 1 (ALS 1): 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.
1 ALS 1, ALS2 and BLS definitions track the language codified in Title 42 of the Code of Federal Regulations,
Chapter IV, §414.605 entitled "Fee Schedule for Ambulance Services ".
(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:
(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.
(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 August 1,_2015 2016.
(j) Hereafter, and in the event Medicare or other federal or State health care regulations require or
allow an adjustment to ambulance/ medical user fees, the South Bend Fire Chief is authorized to
and may amend once annually the user fees set out in subpart (a) of this Section by the same
percentage as the Medicare Fee Schedule rates for such services have been adjusted. This
adjustment shall be effective on the calendar date immediately following the date on which
written notice of said fee rate adjustment is filed in the office of the City Clerk. At the time such
notice is filed, a copy of the new rates shall be made available in paper form for public viewing in
the South Bend Central Fire Station, and such new rates shall also be published promptly on the
City's web site.
Section II. This ordinance shall be in full force and effect from and after its passage by the
Common Council and approval by the Mayor.
Member of the Common Council
Attest:
City Clerk
Presented by me to the Mayor of the City of South Bend, Indiana on the day of
, 2016, at o'clock M.
Approved and signed by me on the
at o'clock, m.
1 * READMG
PUBLIC HEARING
3 rd READING
NOT APPROWD
REFERRED
PASSED
City Clerk
day of
2
Mayor, City of South Bend, Indiana
Fled in Clerk's Office
E N 0 8 2016
KAREEMAH FOWLER
C E CLERK, SOUTH BEND, IN