Chapter 2.34
EMERGENCY MEDICAL AND AMBULANCE SERVICE

Sections:

2.34.010    Definitions.

2.34.020    Establishment of emergency medical and ambulance service and utility.

2.34.030    Service to be provided by fire department or by interlocal agreement.

2.34.040    Emergency medical and ambulance service fund.

2.34.050    Emergency medical and ambulance service rates.

2.34.060    Billing for ambulance service.

2.34.080    Compliance with Medicare and Medicaid requirements.

2.34.090    Penalty for violations.

2.34.100    Utility authorization.

2.34.110    Utility rate setting.

2.34.120    User classifications.

2.34.130    Collection of fees.

2.34.140    Utility fee exemptions.

2.34.150    Periodic utility fee review.

2.34.160    Payment.

2.34.170    Billing for ambulance transports.

2.34.180    Allocation of billing revenue.

2.34.190    General fund contribution.

2.34.200    Severability.

2.34.010 Definitions.

A. “Ambulance” means a ground vehicle designed and used to transport the ill and injured and to provide personnel, facilities, and equipment to treat patients before and during transportation.

B. “Availability costs” means those costs attributable to the basic infrastructure needed to respond to a single call for service within the utility’s response criteria, including costs for dispatch, labor, training of personnel, equipment, patient care supplies, and maintenance of equipment.

C. “Demand costs” means those costs attributable to the burden placed on the ambulance service by individual calls for ambulance service, including costs related to frequency of calls, distances from hospitals, and other factors identified in a cost-of-service study conducted to assess burdens imposed on the utility.

D. “Occupant” means a person who is employed by a Soap Lake business at a Soap Lake business location or is a tenant of a Soap Lake property or business.

E. “Patient” means an individual who is sick, injured, wounded, or otherwise incapacitated or helpless.

F. “Person” means any individual, firm, partnership, association, corporation, company, group of individuals acting together for a common purpose, or organization of any kind, including a government agency.

G. “Place of business” means a business located and operating within the city and paying a service fee under this chapter.

H. “Resident” means a person who utilizes a dwelling unit inside the city as a fixed abode, and is not a guest, visitor, or other temporary inhabitant. A student who is regularly enrolled in an educational institution outside the city but who would normally and regularly be a city resident but for attendance at such educational institution shall be deemed to reside within the city.

I. “Utility” means the city of Soap Lake, Washington, ambulance service utility, including without limitation all equipment, employees, agents, supplies, overhead and other associated costs incurred to deliver all regulatory and ambulance services. (Ord. 1086 § 1, 2008).

2.34.020 Establishment of emergency medical and ambulance service and utility.

Consistent with the authority granted by state law, including RCW 35.21.766 and 35.27.370(15), as now enacted or hereafter amended, an ambulance public utility is established by the city. There is established an emergency medical and ambulance service by the city of Soap Lake to be operated by the city or by interlocal agreement according to a license issued by the state of Washington. (Ord. 1086 § 1, 2008).

2.34.030 Service to be provided by fire department or by interlocal agreement.

So long as the city provides emergency medical and ground ambulance service within the corporate limits of the city now, or as the city’s limits are expanded, the Soap Lake fire department will be the sole provider of emergency medical and ground ambulance services originating within the city limits except as provided for in this chapter. The city may provide those emergency medical and ground ambulance services through an interlocal agreement. It shall be unlawful for any person, firm, or corporation to operate or cause to be operated within the city limits an ambulance or ambulance service except as provided for in this chapter. An ambulance or ambulance service operating within the corporate limits of the city, other than the ambulances provided by the city, will operate only through mutual aid, interlocal agreement, or contract with the city, executed between the parties. (Ord. 1086 § 1, 2008).

2.34.040 Emergency medical and ambulance service fund.

There is established and created a special fund to be known as the emergency medical and ambulance service fund. Any and all revenues received for emergency medical and ambulance services shall be credited to the emergency medical and ambulance service fund. All expenditures for the regulation, operation, and maintenance of the city’s emergency medical and ambulance service shall be paid out of the emergency medical and ambulance service fund. Capital needs related to construction, major renovation or major repair of the physical plant shall be separately accounted for as required by RCW 35.21.766(3), as now enacted or hereafter amended. (Ord. 1086 § 1, 2008).

2.34.050 Emergency medical and ambulance service rates.

The rates for emergency medical and ambulance services shall be set by city council resolution. Rates shall be set at a level to cover the actual costs incurred by the city in providing the emergency medical and ambulance service and may be amended from time to time by the city council by resolution. Additional service fees for professional services, medical supplies, and other items expended in the transfer or transport of the patient shall be charged at rates determined by the city council. (Ord. 1086 § 1, 2008).

2.34.060 Billing for ambulance service.

Each person who utilizes the emergency medical and ambulance service shall be billed by the city at the rate set by resolution. The mayor shall establish a procedure to bill and collect rates for the emergency medical and ambulance service. Under the procedure, the city may elect to bill the patient directly or bill the patient’s insurance company and, if the patient’s insurance does not cover all the costs of ambulance service, bill the remaining balance to the patient directly. The city may contract with a billing service to bill and collect the rates for the emergency medical and ambulance service. This process may be performed by the agency providing the service under an interlocal agreement. (Ord. 1086 § 1, 2008).

2.34.080 Compliance with Medicare and Medicaid requirements.

This chapter and the charges for the emergency medical and ambulance service hereunder shall be construed and implemented in a manner consistent with the applicable Medicare and Medicaid requirements. (Ord. 1086 § 1, 2008).

2.34.090 Penalty for violations.

Any person who violates any provision of this chapter shall be deemed to have committed a civil infraction and shall be subject to a penalty of $5,000. (Ord. 1086 § 1, 2008).

2.34.100 Utility authorization.

The ambulance service utility shall have the authority, through the mayor or designee, to collect and spend the revenue authorized in this chapter in the amounts sufficient to regulate, operate and maintain the ambulance service. (Ord. 1086 § 1, 2008).

2.34.110 Utility rate setting.

A monthly utility fee for the operation of the ambulance service utility shall be established from time to time by resolution of the council. This rate setting will be in accordance with RCW 35.21.766. The amount of the fee shall be based upon the costs of the ambulance service utility as established by the cost-of-service study referenced in RCW 35.21.766(3). The costs remaining after applying transport fees and the general fund contribution will be divided among the ambulance service utility user classifications. These fees will be based upon the demand costs and availability costs.

A. The rate attributed to availability costs shall be uniformly applied across all user classifications.

B. The rate attributed to demand costs shall be applied to each utility user classification based on the classification’s burden on the utility.

C. Fees shall not exceed the revenue requirements to cover the costs of the ambulance service utility, as authorized by the council by adoption of an annual budget and subsequent amendments. (Ord. 1086 § 1, 2008).

2.34.120 User classifications.

The monthly service fee shall be assessed on each of the following user classifications:

A. Occupied residences.

B. Hospitals.

C. Skilled nursing facilities.

D. Assisted living facilities.

E. Commercial occupancies.

F. Public facilities. (Ord. 1086 § 1, 2008).

2.34.130 Collection of fees.

The utility fee shall be collected on a monthly basis from each user. The occupant of each unit within the user classifications shall be responsible for payment of the service fee to the extent that occupant is billed separately for the utility. The owner of the unit within each user category will be responsible for payment of the utility fee to the extent that the individual occupants are not separately billed for the utility. Multifamily residential units or other multi-unit properties that are billed for other utilities through a single utility connection shall be charged a utility fee for each active or occupied unit. No utility fee will be charged to any vacant building or unoccupied unit or parcel. (Ord. 1086 § 1, 2008).

2.34.140 Utility fee exemptions.

Any change in occupancy or use of a parcel, or any other change in circumstance that eliminates application of an exemption from the utility fee, shall immediately make the affected property subject to the applicable utility fee. The utility fee shall become due and payable as of the date of the change in use or circumstance and it will continue until the parcel again meets the exemption requirements.

A. Monthly rates shall not be prorated.

B. Any customer seeking an exemption from payment of the utility fee must file a written petition with the city clerk.

C. The combined rates charged shall reflect an exemption for persons who are Medicaid eligible and who reside in a nursing facility, boarding home, adult family home, or receive in-home services.

D. The combined rates charged may reflect an exemption or reduction for designated classes consistent with Article VIII, Section 7 of the State Constitution, and the amounts of any such exemption or reduction shall be a general expense to the ambulance service utility. These expenses will be designated as an availability cost, to be spread uniformly across the user classifications. (Ord. 1086 § 1, 2008).

2.34.150 Periodic utility fee review.

The mayor or designee will periodically review the ambulance service utility’s revenues, expenses, indebtedness and fees. Based upon this review, the mayor or designee will recommend appropriate utility fee changes to the council. (Ord. 1086 § 1, 2008).

2.34.160 Payment.

The utility fee shall be collected in the same manner and upon the same billing as is issued for the collection of water and sewer charges as provided in SLMC 13.14.120 and 13.18.080. (Ord. 1086 § 1, 2008).

2.34.170 Billing for ambulance transports.

A. Each person who is transported by the ambulance service utility shall be billed by the city at the rates established by the council. Each person transported will be exempt from out-of-pocket expenses associated with the ambulance transport; provided, that the patient is a city resident or is transported from a location that pays the utility fee, the patient supplies the city with all necessary information and documentation of records and insurance information, and the patient assigns to the city the patient’s right to receive payment from all applicable payers.

B. Patients who do not meet these criteria will be responsible for all applicable fees for the services provided by the ambulance service utility. (Ord. 1086 § 1, 2008).

2.34.180 Allocation of billing revenue.

All revenue received from direct billing will be allocated to demand costs. Excess revenue will then be applied to availability costs. (Ord. 1086 § 1, 2008).

2.34.190 General fund contribution.

The general fund contribution to the ambulance service utility will be not less than 70 percent of the general fund revenue expended to the ambulance service utility during the fiscal year that included May 6, 2004. (Ord. 1086 § 1, 2008).

2.34.200 Severability.

If any provision of this chapter or its application to any person or circumstance is held invalid, the remainder of this chapter or the application of the provision to other persons or circumstances is not affected and to this end the provisions of this chapter are declared to be severable. (Ord. 1086 § 1, 2008).