Chapter 7
AMBULANCE SERVICE¹

Art. I. Charges, §§ 7-1, 7-2

Art. II. Emergency Medical Services System, §§ 7-3 – 7-12

ARTICLE I. CHARGES

Sec. 7-1. Ambulance charges.

Ambulance service fees are hereby fixed as follows:

(1) Base resident charge: Three hundred eighty-three dollars and fifty-nine cents ($383.59) for patients who are residents of Nez Perce County, Idaho.

(2) Base nonresident charge: Four hundred fifty-nine dollars and eleven cents ($459.11) for patients who are not residents of Nez Perce County, Idaho.

(3) Local nonemergency interfacility, home and medical flight connection charge: Two hundred twenty-two dollars and ninety-six cents ($222.96).

(4) a. Out-of-area transfer for patients who are residents of Nez Perce County, Idaho: Four hundred thirty-eight dollars and forty cents ($438.40);

b. Out-of-area transfer for patients who are not residents of Nez Perce County, Idaho: Five hundred seventeen dollars and fifty-five cents ($517.55);

c. Second attendant on out-of-area transfer: One hundred eighty-eight dollars and one cent ($188.01).

(5) Multiple patients charge:

a. Each stretcher patient bill separately: Two hundred thirteen dollars and nine cents ($213.09);

b. Sit-up patient (if stretcher not available): One hundred nine dollars and fifty-nine cents ($109.59).

(6) Mileage fee: Nine dollars and eighty-eight cents ($9.88) per patient per mile.

(7) Medical convenience or standby time: Eighty-seven dollars and ten cents ($87.10) per hour or part thereof.

(8) Oxygen: Thirty-four dollars and eighty-three cents ($34.83).

(9) Advanced life support service: One hundred eighty-two dollars and sixty-six cents ($182.66).

(10) Extrication charge: One hundred sixteen dollars and fourteen cents ($116.14).

(11) All medication and supplies used by the city in the administration of emergency medical services shall be replenished from the receiving hospital stores and billed directly to the patient by the hospital. In the event hospital stores cannot replenish the medications and supplies used, the city shall bill the patient the actual costs of the medications and supplies plus ten (10) percent.

(12) Interest: Interest may be charged on the unpaid balance of all ambulance accounts thirty (30) days after the date of the first statement sent to the patient after third-party payor payments are received at the rate of one and one-half (1-1/2) percent per month.

(13) Infection control charge: Three dollars and forty-two cents ($3.42) per transport call.

(14) a. Out-of-area transports not originating or terminating within the Lewiston ambulance service area for patients who are residents of Nez Perce County, Idaho: Five hundred forty-seven dollars and ninety-nine cents ($547.99);

b. Out-of-area transports not originating or terminating within the Lewiston ambulance service area for patients who are not residents of Nez Perce County, Idaho: Six hundred thirty-nine dollars and thirty-three cents ($639.33). (Code 1960, § 2-4.2; Ord. No. 3267, § 1, 4-14-75; Ord. No. 3343, § 1, 1-17-77; Ord. No. 3461, § 1, 9-25-78; Ord. No. 3670, § 1, 9-27-82; Ord. No. 3702, § 1, 7-25-83; Ord. No. 3887, § 1, 10-5-87; Ord. No. 3978, § 1, 9-10-90; Ord. No. 4021, § 1, 1-13-92; Ord. No. 4077, § 1, 8-30-93; Ord. No. 4106, § 1, 8-1-94; Ord. No. 4131, § 1, 6-5-95; Ord. No. 4199, § 1, 9-8-97; Ord. No. 4244, § 1, 8-23-99; Ord. No. 4275, § 1, 10-16-00; Ord. No. 4311, § 1, 8-26-02; Ord. No. 4341, § 1, 9-22-03; Ord. No. 4369, § 1, 8-23-04; Ord. No. 4417, § 1, 8-22-05; Ord. No. 4482, § 1, 8-27-07)

Sec. 7-2. Reserved.

Editor’s note – Ord. No. 4131, § 2, adopted June 5, 1995, repealed § 7-2, designating charges for fireboat service. Said section was derived from Ord. No. 3757, § 2, adopted April 1, 1985, as amended by Ord. No. 3778, § 1, adopted May 20, 1985, Ord. No. 3860, § 1, adopted May 4, 1987, and Ord. No. 4021, § 2, adopted January 13, 1992.

ARTICLE II. EMERGENCY MEDICAL SERVICES SYSTEM

Sec. 7-3. Purpose.

This article is enacted for the purpose of establishing a basic framework to direct the provision of emergency and nonemergency ambulance services within the city of Lewiston. It is the intent of the city council to define the structure of the city’s commitment to emergency medical care to the citizens of the city of Lewiston, to determine working relationships between different care providers and to develop the most cost effective and highest quality patient care solutions to emergency and nonemergency ambulance medical care within the city. (Ord. 4138, § 1, 8-21-95)

Sec. 7-4. Authority.

This article is enacted pursuant to the authority granted by Article 12, Section 2 of the Idaho Constitution and Idaho Code, Sections 50-301, 50-302 and 50-304. (Ord. 4138, § 1, 8-21-95)

Sec. 7-5. Definitions.

As used in this article, the following terms shall be defined as follows:

Advisory board: The Lewiston emergency medical service advisory board appointed by the Lewiston city council pursuant to the provisions of this article.

Ambulance services: Ambulance service providers holding a current emergency medical service certificate of compliance and/or a current nonemergency transfer service certificate of compliance.

City council: The city council of the city of Lewiston.

Dispatch: The system of communication which provides public access to emergency and nonemergency ambulance services and which activates and coordinates the responses of emergency and nonemergency ambulance service providers.

Emergency medical services: Out-of-hospital, emergency health care delivered by an emergency ambulance service utilized in responding to a perceived individual need for immediate care in order to prevent loss of life or aggravation of physiological or psychological illness or injury. Expressly excluded from this definition are the operation of medical offices by licensed physicians and the operation of hospitals and air ambulance emergency and nonemergency transport services.

Medical emergency: Any event or series of events which prompts an individual to believe that immediate health care needs cannot be met by the individual him/herself or his/her family.

Nonemergency transport services: The nonemergency transport service by ambulance of a patient to and/or between home, hospital, care facility, medical office or rehabilitation facility under medical supervision.

Paramedic program: The provision of state of Idaho licensed and certified paramedic services.

Provider: Any individual, firm, partnership, association, public agency or corporation which offers or supplies out-of-hospital medical care or health related transportation services to the public within the city of Lewiston. (Ord. 4138, § 1, 8-21-95)

Sec. 7-6. Advisory board.

(a) There is hereby established a Lewiston emergency medical services advisory board (EMSAB) which shall serve to advise the city council in matters affecting the provision of emergency and nonemergency ambulance services within the city and to review applications for a certificate of public convenience and necessity and make recommendations to the city council on the same. The EMSAB shall annually review the overall performance of emergency and nonemergency ambulance service providers, ensure the highest quality of patient care, suggest methods to improve service delivery and minimize costs, provide recommendations to the city council in the development of rules and policies governing providers, hear and investigate complaints against ambulance service providers and to perform such other emergency medical services related tasks as the city council shall designate.

(b) The EMSAB shall be comprised of seven (7) members, all residents of the city of Lewiston. EMSAB members shall be appointed to four (4) year terms as provided in section 2-181 of this code; however, initial appointments shall be made with four (4) members receiving four (4) year terms and three (3) members receiving two (2) year terms. Members shall serve at the pleasure of the city council. One member shall represent the Lewiston fire department. One member shall represent each medical transport service provider operating in the city. One member shall represent St. Joseph Regional Medical Center. One member shall represent the private health care sector. One member shall represent the extended care facility industry. The remaining members shall be from the general public and unaffiliated with the medical care industry. The EMSAB shall meet at least once a year and as necessary throughout the year. Staff support to the EMSAB shall be provided by the emergency medical service division chief from the Lewiston fire department. Business of the EMSAB shall be governed by sections 2-183 through 2-186 of this code. (Ord. 4138, § 1, 8-21-95)

Sec. 7-7. Authority of personnel at emergency care sites.

Authority to direct activities of providers present at the care site of a medical emergency shall reside in the ranking paramedic from the Lewiston fire department. This section is intended to apply only to medical services and does not affect authority of law enforcement, fire suppression or other nonmedical service activities by legally responsible responding public agencies. In the event personnel of a nonemergency ambulance service encounters a patient in need of emergency medical services, the personnel are obligated to immediately notify the Lewiston fire department to arrange for an emergency ambulance rendezvous in order to ensure paramedic service and adequate staffing are available to the person in need of emergency medical services. (Ord. 4138, § 1, 8-21-95)

Sec. 7-8. Policies, procedures and standards.

For the protection of the health, safety and welfare of the citizens of the city of Lewiston, the city council, with the assistance of the EMSAB, shall develop and implement policies, procedures and standards for the provision of emergency and nonemergency ambulance services within the city, including dispatch policies. Any emergency medical service provider or nonemergency transfer service who acts contrary to adopted policies, procedures and standards may, after proper notice and opportunity for hearing, have its certificate of compliance revoked. (Ord. 4138, § 1, 8-21-95)

Sec. 7-9. Certificate of compliance.

No person, firm, partnership, corporation or public agency shall provide emergency or nonemergency ambulance services with a point of origin and destination within the city of Lewiston without obtaining a certificate of compliance from the EMSAB. Certificates of compliance shall be issued on an annual, calendar year basis, for no charge, to all emergency medical service providers who submit and maintain documentation which complies with the following standards:

(1) Current Idaho ambulance licenses issued to the provider and a copy of the current Idaho application listing all vehicles in its service which will serve as ambulances.

(2) A list of the names of all paramedic, advance EMT-A, EMT-A and EMT staff members working for the provider, along with copies of each’s current certification and driver’s license. Such certification reports shall be updated continually within the course of the year as personnel changes dictate.

(3) Copies of a certificate of insurance indicating that the provider has in force general liability insurance and motor vehicle liability insurance, with a face amount of at least $500,000. Said insurance must remain in full force throughout the course of the calendar year.

(4) A certificate, executed by the provider’s chief executive, indicating the provider will comply with the provisions of this article and any applicable policies, procedures and standards adopted by the city council. (Ord. 4138, § 1, 8-21-95)

Sec. 7-10. Certificate of public convenience and necessity.

No certificate of compliance shall be issued to a new provider unless the city council finds that the provider’s proposed service is required by the public convenience and necessity and that the applicant is fit, willing and able to provide service that conforms to the policies, procedures and standards set by this article. (Ord. 4138, § 1, 8-21-95)

Sec. 7-11. Unlawful acts and penalties.

(a) It shall be unlawful for any person or provider of emergency or nonemergency ambulance services to commit any act that would obstruct the orderly delivery of emergency or nonemergency ambulance services by any certificated provider.

(b) It shall be unlawful for any person to provide emergency or nonemergency ambulance services within the city without a current certificate of compliance.

(c) It shall be unlawful for any person or provider to violate or fail to comply with any provision of this article or the policies, procedure and standards adopted pursuant hereto.

(d) Any person or provider who violates any provision of this section shall be guilty of a criminal misdemeanor and subject to the penalties provided for in section 1-7 of this code. Each day the violation continues shall constitute a separate violation. (Ord. 4138, § 1, 8-21-95)

Sec. 7-12. Emergency waiver.

In the event of a major disaster or major incident requiring the response and use of mutual aid resources from outside the city, the city manager may temporarily waive the requirement to possess a certificate of compliance to provide emergency and nonemergency ambulance services. (Ord. 4138, § 1, 8-21-95)

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Footnotes

1. State law reference – Provisions relating to ambulance service generally, Idaho Code, Chapter 39 of Title 31.