Borough of Cresskill, NJ Chapter 15 Cresskill Volunteer Ambulance & Emergency Services Company

[HISTORY: Adopted by the Mayor and Council of the Borough of Cresskill 9-7-2011 by Ord. No. 11-12-1414. Amendments noted where applicable.]

GENERAL REFERENCES

Fire Department — See Ch. 30.

Police Department — See Ch. 53.

§ 15-1 Establishment.

A. The Mayor and Council of the Borough of Cresskill deem it vital to the public interest to form, operate and control the Cresskill Volunteer Ambulance & Emergency Services Company (CVAES), to provide the services to be rendered to the residents of the Borough of Cresskill in order to protect and serve the general health, safety and welfare of the community.

B. From the date hereof, CVAES will operate under the alternate name of Cresskill Fire Department EMS (CFDEMS) and shall be under the direct control of the Cresskill Fire Department. Any references hereunder to CVAES will also apply to CFDEMS.

[Added 7-9-2014 by Ord. No. 14-09-1466]

§ 15-2 Purpose.

[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.

§ 15-3 Ambulance Committee.

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.

§ 15-4 Rescue apparatus, equipment and facilities.

[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.

§ 15-5 Membership qualifications.

[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.

§ 15-6 Bylaws.

A. Members of the CVAES may adopt bylaws not inconsistent with the terms and provisions of this chapter, which shall be subject to the approval or modification of the Cresskill Mayor and Council. Copies of any duly adopted and approved bylaws shall be filed with the Borough Clerk and shall be signed as read and agreed by all persons prior to membership in the CVAES.

B. The Cresskill Mayor and Council shall have the right to alter or amend the bylaws as it deems necessary or proper at any time upon majority vote of a quorum of the Mayor and Council at a public meeting.

§ 15-7 Standard operating guidelines.

A. Members of the CVAES may adopt standard operating guidelines not inconsistent with the terms and provisions of this chapter, which shall be subject to the approval or modification of the Cresskill Mayor and Council. Copies of any duly adopted and approved standard operating guidelines shall be filed with the Borough Clerk and shall be signed as read and agreed by all persons prior to membership in the CVAES.

B. The Cresskill Mayor and Council shall have the right to alter or amend the standard operating guidelines as it deems necessary or proper at any time upon majority vote of a quorum of the mayor and Council at a public meeting.

§ 15-8 Supervisor; Deputy EMS Supervisor.

[Added 2-20-2013 by Ord. No. 13-01-1444[1]; 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;

(11) (Reserved)

(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.

[1] Editor's Note: This ordinance also provided for the renumbering of former § 15-8 as § 15-11.

§ 15-9 Training Officer.

[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.

§ 15-10 Commissioner; Deputy Commissioner.

[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.

§ 15-11 Billing, recordkeeping and payment for EMS services.

[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.[1]

[1] Editor's Note: See § 1-15, Violations and penalties.

(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.