[Amended 7-9-2014 by Ord. No. 14-09-1466]
The CFDEMS shall respond to emergencies and when called upon
render ambulance and first aid service in accordance with this chapter
and all applicable federal and state statutes, rules and regulations
and in accordance with all bylaws and regulations established by the
CFDEMS subject to the approval or modification postapproval of the
Cresskill governing body, as it may find in the interest of residents.
The Mayor shall appoint a committee, referred to as the "Ambulance
Committee," consisting of the Council Liaison to the CVAES, the Assistant
Council Liaison to the CVAES and the Mayor. The Liaison to the CVAES
shall act as a liaison between the CVAES and the Mayor and Council
and shall perform any duty and exercise any powers given to him or
her by the terms of the chapter as same may be amended.
[Amended 7-9-2014 by Ord. No. 14-09-1466]
The Cresskill Mayor and Council, as it deems appropriate, shall
provide to the CFDEMS such rescue apparatus, equipment and the use
of certain municipal facilities. It shall be the responsibility of
the CFDEMS to maintain this equipment, apparatus and facilities to
the extent directed to do so by the Cresskill Mayor and Council, and
the CFDEMS shall provide periodic reports to the Cresskill Mayor and
Council regarding all apparatus, equipment and facilities. Continued
use of municipal equipment, apparatus and facilities shall be within
the sole discretion of the Cresskill Mayor and Council and shall only
continue for as long as the Cresskill Mayor and Council believe that
said equipment, apparatus and facilities are being used properly and
in accordance with the requirements of this chapter.
[Amended 7-9-2014 by Ord. No. 14-09-1466]
All members must fulfill the membership requirements as established
by the Mayor and Council and the rules and regulations of the CFDEMS,
successfully complete a fire background, drug and fingerprint check,
valid New Jersey driver’s license and must meet all of the qualifications
and requirements established by this chapter. Where an applicant has
been rejected by the CFDEMS, the applicant can appeal to the Mayor
and Council within 10 days of said rejection, and when the Mayor and
Council conclude after an appropriate administrative review that the
rejection was arbitrary, capricious or unreasonable, or otherwise
not in Cresskill’s best interests, the Mayor and Council may
direct that the application be accepted. All members must be approved
by the Cresskill Mayor and Council and shall service at the pleasure
of the Cresskill Mayor and Council. To be a line officer, a person
must be a member of the CFDEMS.
[Added 2-20-2013 by Ord. No. 13-01-1444; amended 7-9-2014 by Ord. No. 14-09-1466]
The day-to-day operations of the CFDEMS shall be managed by
the following officers:
A. EMS Supervisor. The EMS Supervisor shall be appointed by the Mayor
and Council on the recommendation of the Fire Chief and may be a regular
full-time employee of the Borough of Cresskill. The Supervisor will
be compensated at a rate of pay established by the Mayor and Council.
The Supervisor shall be the head of the CFDEMS for the Borough and
shall be directly responsible to the Fire Chief or his designee for
the efficiency and day-to-day operations of the CFDEMS. The Supervisor
shall:
(1) Be a certified emergency medical technician by the State of New Jersey;
(2) Possess a valid American Heart Association Basic Life Support (BLS)
for Healthcare Providers or equivalent CPR certification card;
(3) Possess a valid American Heart Association BLS instructor certification;
(4) Have completed ICS-400 and NIMS 700;
(5) Administer and enforce the rules and regulations of the CFDEMS.
(6) Have, exercise and discharge the functions, powers and duties of
the EMS;
(7) Develop and implement policies and procedures necessary to govern
the direct day-to-day operations of the EMS;
(8) Prescribe the duties and assignment of all members, ensuring that
all shifts are fully staffed;
(9) Delegate authority as may be deemed necessary for the efficient operation
of the EMS;
(10) Report at least monthly to the appropriate authority on such form
as shall be prescribed on the operation of the EMS during the preceding
month and make such other reports as may be requested by the appropriate
authority;
(12) Ensure that all members have and maintain current required certifications
and licenses;
(13) Act as the Medicare Officer for the Borough of Cresskill;
(14) Ensure that the EMS meets all requirements necessary to maintain
New Jersey Basic Life Support licensure;
(15) Collect, review and forward all time sheets;
(16) Ensure that vehicle and equipment maintenance is performed and maintain
a safe working environment in accordance with applicable state law;
(17) Interface with hospital staff and third-party payment contractors
to maximize efficient billing and collection procedures and practices;
(18) Organize, control and maintain all property and resources of the
EMS;
(19) Maintain a constructive relationship with the public, community organizations
and other agencies;
(20) Coordinate with the Medical Director to ensure that current, safe
and efficient procedures and practices are implemented;
(21) Provide in-service training on equipment, vehicles, and policy and
procedures;
(22) Coordinate training with other Borough departments for medically
based training;
(23) Review and provide feedback on patient care reports.
B. Deputy EMS Supervisor. The Deputy EMS Supervisor shall be appointed
by the Mayor and Council on the recommendation of the Fire Chief and
may be a regular full-time employee of the Borough of Cresskill. The
Deputy EMS Supervisor will be compensated at a rate of pay established
by the Mayor and Council. The Deputy EMS Supervisor shall be directly
responsible to the Supervisor. The Deputy EMS Supervisor shall:
(1) Be a certified emergency medical technician by the State of New Jersey;
(2) Possess a valid American Heart Association BLS for Healthcare Providers
or equivalent CPR certification card;
(3) Have completed ICS-400 and NIMS 700;
(4) Administer and enforce the rules and regulations of the EMS;
(5) Be able and available to manage absences and other problems involving
shift schedules, logistics and general supervisory duties, including
working open shifts to maintain required staffing;
(6) Delegate authority as may be deemed necessary for the efficient operation
of the EMS;
(7) Keep an accurate log of maintenance and repairs of vehicles and equipment
and report at least monthly to the Captain on such form as shall be
prescribed;
(8) Ensure that all members have and maintain current required certifications
and licenses;
(9) Ensure that the EMS meets all requirements necessary to maintain
New Jersey Basic Life Support licensure;
(10) Ensure that vehicle and equipment maintenance is performed and maintain
a safe working environment in accordance with applicable state law;
(11) Organize, control and maintain all property and resources of the
EMS;
(12) Maintain a constructive relationship with the public, community organizations
and other agencies;
(13) Submit a monthly activity report to the Captain;
(14) Perform other duties as needed to ensure efficient operations of
the EMS;
(15) In the Captain's temporary absence, oversee day-to-day operations
with the Operations and Training Lieutenants.
[Added 2-20-2013 by Ord. No. 13-01-1444; amended 7-9-2014 by Ord. No.
14-09-1466]
The following position shall be appointed by the Mayor and Council
to fulfill the following duties. Such appointment shall not be a regular
full-time employee of the Borough of Cresskill:
A. Training Officer. The Training Officer will assist with the day-to-day
operations of CFDEMS. The Training Officer:
(1) Shall assist the Supervisor in preparing members and equipment for
drills and events.
(2) Must have a current EMT certification and, at minimum, an American
Heart Association Basic Lif e Support instructor card.
(3) Will assist in the review of all patient care reports for quality
assurance and in the absence of the Supervisor will be in charge of
quality assurance.
(4) Will assist the Supervisor in the creation of and administration
of a training program for new members and will assist in the creation
of and administration of a training program for all members.
(5) Will be responsible for training on all new equipment prior to the
equipment going into service.
(6) May be the computer administrator for CFDEMS.
(7) In the Supervisor's temporary absence, will assist in overseeing
day-to-day operations.
[Added 2-20-2013 by Ord. No. 13-01-1444]
The following positions are hereby established to supervise
the day-to-day operations of the Emergency Medical Services of the
Borough of Cresskill:
A. Commissioner. The Commissioner shall be a supervisor from the Cresskill
Police Department appointed to oversee all activities of CVAES. The
Commissioner will prepare a budget to be presented to the Mayor and
Council of the Borough of Cresskill. The Commissioner will oversee
all financial business and disciplinary matters and will oversee the
Captain on day-to-day operations. The Commissioner does not have to
be a certified EMT.
B. Deputy Commissioner. The Deputy Commissioner shall be a supervisor
from the Cresskill Police Department appointed to oversee all activities
of CVAES. In the absence of the Commissioner, the Deputy Commissioner
will perform all duties assigned to the Commissioner. The Deputy Commissioner
will take part in all disciplinary matters and will oversee the Captain
on day-to-day operations. The Deputy Commissioner does not have to
be a certified EMT.
[Added 2-15-2012 by Ord. No. 12-02-1424]
A. Purpose and intent.
(1) The provision of EMS services by EMS providers in the Borough of
Cresskill is funded primarily by local taxes, and the Borough of Cresskill
recognizes the need to bill for the provision of EMS services in order
to aid in the provision of those services.
(2) It is in the best interest of the residents of Cresskill to establish
billing and payment procedures in order to minimize any out-of-pocket
expenses for Borough residents.
(3) No person requiring EMS services shall be denied services due to
a lack of insurance or an inability to pay.
B. Definitions. As used in this section, the following terms shall have
the meanings indicated:
AUTHORITY
[Added 7-9-2014 by Ord. No. 14-09-1466]
(1)
The right to issue orders, give commands, enforce obedience,
initiate action, and make necessary decisions commensurate with rank
or assignment as provided for in all Borough of Cresskill personnel
guidelines, Cresskill Fire Department rules and regulations, and in
all rules, regulations, policies, guidelines and procedures of CFDEMS.
Authority may be delegated by those so designated. Any act(s) performed
without proper authority or authorization shall be considered to be
in violation of the rules, regulations, personnel policies, guidelines
and procedures of the Borough of Cresskill, Cresskill Fire Department
and CFDEMS.
(2)
All rules and regulations, policies and guidelines are applicable
to all employees of the CFDEMS.
(a)
One copy of the rules and regulations, policies and guidelines
shall be distributed to each employee of the CFDEMS. Employees shall
be required to sign and confirm receipt of document.
(b)
It shall be the responsibility of the individual employee to
maintain a current copy of the documents governing the CFDEMS, including
all additions, revisions and amendments as issued.
(c)
All employees shall thoroughly familiarize themselves with the
components and sections of all documents guiding the operation of
the CFDEMS and Borough of Cresskill personnel policies. Ignorance
of any provision of these rules will not be a defense to a charge
of a violation of these rules. It is the continuing responsibility
of each employee to seek clarification through the chain of command
for any rule that is not fully understood.
DEPENDENT
(1)
Any individual who is the spouse or an unemancipated child (natural,
adopted or stepchild) of a taxpayer or resident as defined below;
(2)
Any unemancipated child for whom the taxpayer or resident has
been appointed legal guardian;
(3)
Any individual who resides in a permanent domicile of the taxpayer
or resident and is claimed as a dependent for federal income tax purposes;
or
(4)
Any individual who resides in the permanent domicile of the
taxpayer or resident and is deemed to be a dependent under the health
insurance policy of the taxpayer or domiciled resident.
EMS PROVIDER
CFDEMS and any public or private provider of EMS services
authorized to operate within the Borough of Cresskill.
[Amended 7-9-2014 by Ord. No. 14-09-1466]
EMS SERVICES
Ambulance services and emergency medical services performed
by any EMS provider in the Borough of Cresskill, whether paid or volunteer,
public or private.
RESIDENT
Any individual whose legal domicile is within the Borough
of Cresskill. Verification of domicile shall be based on voter registration,
a State of New Jersey driver's license, proof of filing a State
of New Jersey income tax return from a Borough of Cresskill address
or other proofs accepted under federal guidelines.
TAXPAYER
Any individual listed on the deed of ownership of any property
located within the municipal boundaries of the Borough of Cresskill
and his/her dependents, as defined above. In the case of a corporation
or partnership, only those individuals retaining an ownership of 25%
or greater shall be considered taxpayers. For the purpose of determining
an ownership of 25% or greater, adult married or civil union partners
may combine their ownership. A taxpayer's dependent, as defined
above, shall be considered a taxpayer.
C. Billing for service.
(1) All patients, whether or not residents of the Borough of Cresskill,
and/or their financially responsible parties, insurers or carriers
will be billed for EMS services provided by an EMS provider according
to the fee schedule established herein or at rates established by
the Borough of Cresskill from time to time.
(2) A patient who receives EMS services is obligated, at the time of
service or as soon as practicable thereafter, to provide the EMS provider
with all pertinent insurance and payment information to facilitate
the billing of third-party payment sources for services rendered.
The Borough or EMS provider may, at its option, and shall, where required
by law, bill insurers or carriers on a patient's behalf or accept
payment on an assignment basis.
(3) All patients, whether or not residents or taxpayers of the Borough
of Cresskill, shall be liable for any copayment or deductible amounts
not satisfied by public or private insurance, and the Borough or EMS
provider shall make reasonable collection efforts for all such balances.
The Borough may bill any applicable coinsurance carriers for such
amounts. Exceptions include only those instances where the Borough
or EMS provider has knowledge of a particular patient's indigence
or where the Borough has made a determination that the cost of billing
and collecting such copayments or deductibles exceeds or is disproportionate
to the amounts to be collected.
D. Billing to insurance companies and/or persons served; fees. The Borough
of Cresskill may contract with a professional medical billing service
for the collection of payment for services rendered by the CFDEMS
or Borough of Cresskill paid EMTs. Said bill shall be issued to the
insurance company for the person served, if any, or directly to the
person served if insurance coverage is not available. Fees to be charged
for EMS services shall be as follows:
(1) For ambulance transportation: $750.
[Amended 7-9-2014 by Ord. No. 14-09-1466]
(2) Per loaded mile for basic life support (BLS) mileage: $14.
(3) Oxygen administration: $75.
[Added 7-9-2014 by Ord. No. 14-09-1466]
(4) AED pads: $75.
[Added 7-9-2014 by Ord. No. 14-09-1466]
(5) Cervical collars: $25.
[Added 7-9-2014 by Ord. No. 14-09-1466]
E. Maintenance of records. The Borough of Cresskill and, if applicable,
its professional medical billing service shall maintain accurate records
of all Borough of Cresskill EMS requests for service, service calls
and EMS services approved and/or rendered by the CFDEMS or other Cresskill
EMS provider. All other EMS providers shall maintain accurate records
of the same for all requests for service, service calls, and services
approved and/or rendered by the EMS provider while on duty, as well
as all other records required by the Borough. Said records shall include
pertinent information about the general nature of the call and shall
identify the complete name, mailing address, place of domicile, location
and telephone numbers of all persons requesting and receiving EMS
services, as well as all pertinent and available insurance information.
F. Payment. Persons receiving a bill for EMS services shall make payment
to the Borough, its professional medical billing service or the EMS
provider who rendered EMS services, as appropriate, within 30 days,
or provide proof that they have submitted a claim to their insurance
carrier for payment within 30 days of receipt of request of a bill.
These provisions shall be subject to the following:
(1) Persons receiving EMS services who have health insurance to cover
ambulance and emergency medical services are expected to cooperate
with the appropriate billing entity to secure full payment for services
rendered.
(2) Due to the time requirements for the preparation and processing of
insurance claims, interest shall not be charged on Borough of Cresskill
EMS billings.
(3) After providing EMS services, the Borough shall transmit all pertinent billing information to the Borough's professional medical billing service for collection as set forth in Subsection
F(4) below. The professional medical billing service shall be responsible for receipt of payment and proper recordkeeping of its collections as provided in its contract with the Borough of Cresskill. Payments received by the professional medical billing service shall thereafter be transmitted electronically to a designated account of the Borough of Cresskill to be administered by the Borough of Cresskill Chief Financial Officer (CFO). In addition, the professional medical billing service shall simultaneously transmit a transport report to the CFDEMS or its designee for its review and approval and transmit a copy to the Borough CFO or his or her designee. The squad shall prepare a reconciliation report and shall monitor the operations of the professional medical billing service, including billing activities and receipt of funds.
(4) The professional medical billing service shall be responsible for
the initial billing and two follow-up billings. Costs associated with
the professional medical billing service shall be as provided in its
contract with the Borough of Cresskill. After three attempts to collect
said claim, the professional medical billing service shall notify
the Borough of Cresskill and relinquish rights to that billing, unless
otherwise directed by the Borough Administrator. The Borough of Cresskill
may turn said delinquent accounts over to a collection agency that
will be compensated on a percent of cash collections of the delinquent
accounts. The Borough of Cresskill reserves the right to determine
that a bill is uncollectible and should be written off.
(5) The Borough of Cresskill may, either directly or through any third-party
billing agency with which it has contracted for billing and/or collections
for emergency medical services, make arrangements with patients and/or
their financially responsible parties for installment payments of
bills or forgive any bill or portion thereof so long as the Borough
determines that the financial condition of the patient requires such
an arrangement and the patient and/or financially responsible party
has demonstrated a willingness to make good-faith efforts towards
payment of the bill.
(6) A patient, including a Borough resident, for whom the Borough of
Cresskill has not received payment from a third-party payer on assignment
and who receives payment directly from a third-party payer for EMS
services rendered by the CFDEMS or other Cresskill EMS provider is
obligated to remit such monies to the Borough in the event that the
Borough has not been paid for services rendered. Patients who do not
remit such monies may be held liable for costs of collection in addition
to the charges for emergency medical services rendered. Any person
who shall violate the terms and provisions of this section shall also,
upon conviction, be subject to the penalties provided in the general
penalty provision of this Code.
(7) Payment procedures for all other EMS providers shall be as set forth
in the contract between the Borough and said EMS provider.
G. Procedure for third-party EMS billing.
(1) The Borough of Cresskill is hereby authorized to enter into a contract
with a third-party billing agency for performance of EMS billing and
collection services; provided, however, that the following standards
for such third-party billing contracts are met:
(a)
The third-party billing agency has in place a compliance program
conforming to standards set forth in the Office of Inspector General's
"Compliance Program Guidance for Third-Party Medical Billing Companies,"
63 Federal Register 70138, as amended.
(b)
Neither the billing agency nor any of its employees are subject
to exclusion from any state or federal health-care program.
(c)
The billing agency is bonded and/or insured in amounts satisfactory
to the Borough of Cresskill.
(2) A detailed listing of patients who utilize emergency medical services
and/or transport provided by the Cresskill EMS will be compiled by
the Borough of Cresskill. This information will be transmitted to
the third-party billing agency. The information will be subject to
the confidentiality requirements of applicable law. This information
will include, at a minimum, the following:
(a)
Name, address and telephone number of patient.
(b)
Name, address and claim number of insurance carrier, if applicable.
(c)
Date, time and EMS chart number.
(d)
Point of origin and destination.
(e)
Odometer reading at point of pickup and destination.
(f)
Reason for transport/patient's complaint/current condition.
(g)
Itemization and description of services provided and charges.
(h)
Signature of the patient or authorized decision maker.
(i)
Name of receiving physician or nurse.
(j)
Names, titles, and signatures of ambulance personnel, when possible.
(3) The third-party billing agency shall obtain the information from
the Cresskill EMS and will bill the patient and/or his/her financially
responsible parties, insurers or carriers, according to the fee schedule
established herein.
(4) The fee for emergency medical services, transport miles per trip
and nontransports where aid is provided shall be established by the
Mayor and Council.
(5) The Mayor and Council shall annually review the fees for services listed in Subsection
D above and adjust said fees based on the recommendations of the Borough Administrator and the Chief Financial Officer and in accordance with the federally approved Medicare fee schedule.
(6) The Borough of Cresskill may, in its discretion, bill additionally
for material, vehicle, and personnel costs in the case of major or
unique incidents.
(7) The Borough Administrator may promulgate rules and regulations pursuant
to and not inconsistent with this chapter, state and federal law and
such rules and regulations, which rules and regulations shall become
effective upon approval by resolution of the governing body of the
Borough of Cresskill.