No ambulance service shall charge more than the following rates:
(a) One Patient. The schedule of maximum rates that may be charged for ambulance service for one patient shall be as initially set by resolution adopted by the Board of Supervisors, and as adjusted thereafter as provided in this Chapter.
(b) Rates for Multiple Loads.
(1) Each additional stretcher or Gurney patient carried at the same time may be charged the full base rate for response to the call and half the mileage rate.
(2) Each additional sit-up patient shall be charged half the base rate for response to the call and half the mileage rate.
(3) This Section does not apply to contractual agreements.
(c) No Charge Transports. No charge shall be made for transporting uninjured or well persons who accompany a patient.
(d) Computation of Rates. All rates are to be computed from the time the ambulance arrives for hire until the ambulance delivers the patient to the appropriate destination, and is discharged by the patient or his or her representative, attending physician, or emergency receiving facility.
(e) Fees for Service, Supplies, and Equipment. When a ground ambulance has been dispatched and ambulance personnel and/or equipment are directly involved with patient care even though a helicopter transports, then the ambulance service shall be entitled to charge an appropriate fee for its service, supplies and equipment.
(f) Rate Adjustment. The current rates shall be adjusted in an amount necessary to properly compensate ambulance providers for changes (increases or decreases) in their direct and indirect costs based on the change in the Consumer Price Index (CPI) as set forth herein. The adjustments shall be made on July 1 of each year based upon the change in the CPI from January 1 of the proceeding year to January 1 of the adjustment year. The first rate adjustment shall be made effective July 1, 2005 based on the change of CPI from January 1, 2004, to January 1, 2005. The CPI adjustment shall be determined by multiplying the base amounts by the average of the percentage changes of the transportation portion and of the medical portion of the CPI for All Urban Consumers, Western Region, Los Angeles, Riverside, Orange Counties, California, as compiled and reported by the Bureau of Labor Statistics for the 12-month period up to January 1 of the adjustment year. The Health Officer shall be responsible for calculating the rate adjustments. Yearly CPI adjustments shall not exceed five percent for any single year.
(1) The CPI adjustment shall be calculated by April 15 of each year. The CPI adjustment shall be effective as of the first day of July of each year.
(2) If the selected CPI is discontinued or revised, such other government index or computation with which it is replaced shall be used in order to obtain substantially the same result as would be obtained if the CPI had not been discontinued or revised.
(3) In addition to, and not in lieu of, annual CPI adjustments, rate increases or decreases in an amount equal to the ambulance providers’ extraordinary increases or decreases in their cost of operations may also be granted. The Health Officer shall determine the application process for such extraordinary cost increases or decreases. Such extraordinary cost increases or decreases shall be subject to Board approval. Any rate adjustment due to extraordinary circumstances shall be effective ten days after having been published in a newspaper of general circulation within the effective service area, once a week for two weeks. This procedure may also be used to obtain rate adjustments due to changes in the CPI that are greater than the five percent cap under the yearly CPI adjustment, above.
(4) The County Health Officer at the time of any extraordinary adjustment under Subdivision (3) above, may request an audit of books and records of a permittee for the purpose of verifying revenue and cost data specifically associated with the extraordinary rate increase request. Such an audit shall be carried out by a person selected by the permittee and approved by the Health Officer. If the County Health Officer and permittee cannot agree on a person to perform the audit, then the audit shall be carried out by a Certified Public Accountant selected by the County Health Officer. If there is any charge, cost or fee for such an audit, such shall be paid by the permittee. The County Health Officer may deny any adjustment if an audit is requested and not produced. Every audit shall be done promptly, and within 30 days of the time it is requested so that there should be no undue delay.
(g) Collection of Fees Prior to Delivery of Services. Under no circumstances shall ambulance personnel dispatched on a Code 3 call attempt to collect for services provided prior to the delivery of the patient at an appropriate medical facility. In situations where the patient is not transported, the ambulance provider may not charge the patient for services rendered.
(h) Rates Applicable to All Ambulance Providers. At the direction of ICEMA, and when authorized pursuant to the local EOA Plan, the ambulance rates established under this Section shall apply to all providers of ambulance services which are subject to the regulatory authority of ICEMA.
(i) Under no circumstances shall ambulance personnel dispatched on a Code 3 call attempt to collect for the service prior to the delivery of the patient at an appropriate medical facility.
(j) At the direction of the local Emergency Medical Services (“EMS”) Agency, and when authorized pursuant to the local EMS Plan, the ambulance rates established under this Section shall apply to all providers of ambulance services which are subject to the regulatory authority of the EMS Plan.
(Ord. 2084, passed - -1976; Am. Ord. 2511, passed - -1981; Am. Ord. 3718, passed - -1998; Am. Ord. 3914, passed - -2004; Am. Ord. 3965, passed - -2005)