Expedited-Bill No._-'-:'17:.--..!.!12=---:-_--:--=
Concerning:[[Fire and Rescue Service
-]]
Emergency
Medical
[[Servicesll
Tran;>oortation
lnsurance
Reimbursement
Revised:
5/15/12
Draft No. 4
Introduced:
April 24, 2012
Enacted:
May 15, 2012
Executive:
May 28,2012
Effective:
January 1, 2013
Sunset Date: --'-'N.>::.o""'ne==---_ _ _ _ __
Ch.
~.
Laws of Mont. Co.
2012
COUNTY COUNCIL
FOR MONTGOMERY COUNTY, MARYLAND
By: Council President at the Request of the County Executive
AN EXPEDITED ACT
to:
[[(1) authorize the County to impose and collect a reimbursement to recover costs
generated by providing emergency medical services transports;
(2) provide for a schedule of emergency medical services transport reimbursement
charges, waiver criteria, permitted uses of reimbursement revenues, and other
procedures to operate the emergency medical services reimbursement program;
(3)
prohibit a Local Fire and Rescue Department from imposing a separate emergency
medical services transport reimbursement;
(4) require the Executive to issue certain regulations to implement an emergency
medical services transport reimbursement program;
(5)
require a certain annual transfer be made as payment of residents' uninsured portion
of the emergency medical services transport reimbursement; [[and]]
(6) prov:idUbat County residents will,pay no out-oi-pocket expenses for an ememnQ!;
~cal
services transport:
ill
prohibit Fire and Rescue personnel who res120nd to a request for an.
e11:!~"y
medical services. transport from asking for any
inform~atiorLJelating to~an
individual's insurance
covera~
00
estaklish a Patient Advocate in the Office of Consumer Protection;
(2)
require
th~
Chief to report semiannually to the County Executive and County
Council regarding implementation ofthis Act;
(lill
require the County to conduct a public outreach and education
campaign;
anqJ]
ill
~e
health insurance providers to reimburse the
~oun1);:
for emeJ:gen,fY
medical transportation provided to insured
persQ!!~';
!22
specify that County residents will not pay any
out-o~ocket. ex~se~J.Qr
eme:r:g,ency medical transportatio..nprovided by the
Coun~
ill
require emergency medical transmtlatiml
f~es
to be waived forpon-County
residents witb low or moderate incomes;gnd
[(!l!l)]
~
generally amend County law regarding the provision of emergency medical
servICes.
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EXPEDITED BILL
No.
17-12
By adding
Montgomery County Code
Chapter 21, Fire and Rescue Service
Section 21-23A. Emergency Medical Services Reimbursement Program
Boldface
Underlining
[Single boldface brackets]
Double undedining
[[Double boldface brackets]]
*
*
*
Heading or defined term.
Added to existing law by original bill.
Deletedfrom existing law by original bill.
Added by amendment.
Deleted from existing law or the bill by amendment.
Existing law unaffected by bill.
The County Council for Montgomery County, Maryland approves the following Act:
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EXPEDITED BILL NO. 17-12
Sec.
1.
Section 21-23A is added as follows:
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21-23A.
Emergency Medical Services Transport Insurance Reimbursement
Program.
(a)
Obligation to Transport.
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ill
The Fire and Rescue Service must provide emergency medical
services transport under applicable medical protocols to each
individual without regard to the individual's ability to
~
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ill
Any personnel of the Fire and Rescue Service who resPQndto a
request for an emergency medkal services transport must not ask
for any. information. relating . to an individual's Insurance
coverage.
10
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12
(hl
Definitions.
indi cated:
In this Section the following terms have the meanings
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15
ill
Emergency medical services transport
means transportation
Qy
the Fire and Rescue Service of an individual
Qy
ambulance or
other Fire and Rescue Service vehicle used for
!!
similar purpose.
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Emergency medical services transport
does not
include
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transportation of an individual under an agreement between the
County and g health care facility.
ill
Federal poverty guidelines
means the applicable health care
poverty guidelines published in the Federal Register or otherwise
issued
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the federal Department of Health and Human Services.
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ill
Fire and Rescue Service
means the Montgomery County Fire and
Rescue Service and includes each local fire and rescue
department.
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Program
means the Emergency'- Medical--Services_TransPQrt
Insurance Reimbursement Program.
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EXPEDITED BILL NO. 17-12
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W
Imposition
Q[
reimbursement.
The
County
must
Impose
a
reimbursement charge for any emergency medical services transport
provided in the County, and, unless prohibited
Qy
other law, outside the
County under
~
mutual aid agreement.
@
Liability/Or Reimbursement.
Subject to paragraph eel, each individual
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who receives an emergency medical services transport is responsible for
paying the emergency medical services transport reimbursement.
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liD
Hardship Waiver.
ill
The Fire Chief must waIve the emergency medical servIces
transport reimbursement for any individual whose household
income is at or below 300 percent of the federal poverty
guidelines.
An
individual must request
~
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waiver on
~
form
approved
Qy
the Fire Chief.
ill
The Fire Chief may deny
~
request for
~
waiver if the individual
who claims financial hardship under this Section does not furnish
all information required
Qy
the Fire Chief.
ill
County Residents
-
Payment
Q[
[[Residents
']]
Uninsured Portion
Q[
the
Emergency Medical Services Transport Reimbursement.
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ill
County residents must not be reqyired to pay any out-of-pocket
expense relating to any. emergency medical. services. transport
because residents are deemed to
ha~aid
any co-payment.
deductible. or uninsured portion of the cost of each emergell£Y
medical services transport
thro~taxes
paid to the
Coun~
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[[ill]]
ill
Tax revenues the County receives must be treated as
payment, on behalf of County residents, of the balance of each
resident's portion of the emergency medical services transport
reimbursement charge that is not covered
Qy
the resident's
msurance.
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EXPEDITED BILL NO. 17-12
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[(ill]]
ill
The County Council must annually transfer from the General
Fund to the Consolidated Fire Tax District Fund an amount that
the Council estimates will not be covered
Qy
residents' insurance
as payment of all residents' uninsured portion of the emergency
medical services transport reimbursement charge.
(g)
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Restriction on Local Fire and Rescue Departments.
A local fire and
rescue department must not impose
£!
separate charge for an emergency
medical transport.
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ilil
Use
Q[Revenue.
ill
Except for the transfer received from the General Fund under
subsection
!11
the revenues collected from the emergency
medical services transport reimbursement must be used to
supplement, and must not supplant, [[existing]] fiscal Year 2013
expenditures f!.lmfopriated in the annual operating budget
resolution (not including any expenditures of revenue collected
under this program in Fiscal Year 2013) for emergency medical
services and other related fire and rescue services provided
Qy
the
Fire and Rescue Service.
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ill
The Fire Chief
mm~t
create a dedicated account in the firefup-A
for . the. reyenues collected from .
Program.
rciroJmrs~ments
under this
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This. acgount must only be used for. iJ!creased.or
enhanced fire and
r~ue
services above the level_appropriated in
Fiscal Year 2013, as provided in paragraph.
(1),
incl\.!di!1&_I!ew
field service
po~itions
related to expansion of 4
~~son
staffin&oI
QPening of new fir1L£tations; increased trainin,K.
cla~ses
.. or
capacity; facility fIlaintenance .and reJm.ir;J.le)Y_or replacement
apparatus, gear, or equipment.
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Not more than 30% of this
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account may be spent for personnel costs.
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EXPEDITED BILL NO. 17-12
84
W A
percentage of this account. which the Council must specity
annually in the operating budget resolution. must be used to
replace or augment apparatus owned and staffed by local fire and
rescue departnlents and training, gear, and equipment .for local
fire and rescue departments .. As part of the Executive's operating
budget submission, the Fire Chief must transmit a plan for use of
funds designated for local fire and rescue departments. The plan
the Chief transmits must specity:
(A) the amount of this account tl1e Chief recommends to
allocate to replace apparatus that is owned and staffed by
local fire and rescue departments in the next fiscal year;
and
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lID
the amount.ofthisaccount to allocate to training, gear, and
equipment for volunteers.
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ill
Regulations; Reimbursement Schedule.
The County Executive must
to implement the emergency
The regulation
adopt
~
regulation under method
ill
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medical services transport reimbursement program.
must establish
~
reimbursement schedule based on the cost of providing
emergency medical services transport.
The reimbursement schedule
may include an annual automatic adiustment based on inflation, as
measured
Qy
an index reasonably related to the cost of providing
emergency medical services transports.
The regulation may require
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each individual who receives an emergency medical services transport
to provide financial information, including the individual's insurance
coverage, and to assign insurance benefits to the County.
Reporting.
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The Fire Chief must submit a report . to the
County
Ju~
1
of
Executive and County Council not later than January land
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EXPEDITED BILL NO. 17-12
111
each year regarding
include:
im~entation
of the Program.
Th_~ [~ort ~hould
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ill
the number oCcalls for emergency medical services durinJL1h¥
reporting perioq;
ill
ill
(kl
the. number and type of. emergency medical services provided
during the reporting period; and
any other information relating to implementation of the Program
that the County Executive or County Council request.
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Patient Advocate.
.
The Office. of Consumer Protection must employ a
Patient Advocate to:
ill
develop and imolement a m;ogram for customer service as
aJ2ill1;
of the Program;
ill
ill
develop and. staff
a
help desk for Mestions regardin,lL the
Program; and
serve as a liaison with any vendor retained by the
Coun~to
implement the Program to assure higlLquality customer service
and prompt resolution of questions and concerns.
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ill
Outreach and Education Campaign.
The County Executive must
implement a public outreach and education campaign before and durigg
implementation of the Program .. This campaign shQuld include:
ill
informationaJ mailers to County households;
distribution of information through County)nterneL.and web­
based resource..s;
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ill
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ill
ill
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radioanc.l television public service announcements;
news releases and news events;
information translated into Sj1anislk, French,
Vietnam~and
Chines~, Korean~
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other
lan~es0l:s
needed;
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EXPEDITED BILL NO. 17-12
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ilil
ill
extensive use . of County Cable Montgomery and other PublM;
Educational. and Government channels funded
bythe
Cou~
12Qsters and brochures made available at CounD' eventsL2,1). Ride­
On buses and through Regional Service Centers.
librarie~
recreation facilities, senior centers, publi&..schools, MontgomeIY
College, health care providers,
venues: and
([}
hospital~nicsooLcand
other
special outreach to senior and "New American" communities,
Sec. 2. Expedited Effective Date.
The Council declares that this legislation IS necessary for the immediate
protection of the public interest. This Act takes effect on January 1, 2013.
Sec.3. Implementation.
The County may collect the emergency medical servIces transport
reimbursement authorized by County Code Section 21-23A, enacted by Section 1 of
this Act, [[may be collected]] for any emergency medical services transport that
occurs on or after July 1, 2012. [[Collection]] The reimbursement may [[occur]] be
collected retroactively to [[that]] July
1.
2012, or any later date during the first fiscal
year the emergency medical services transport [[fee]] reimbursement is implemented.
Sec. 4.
Fire and Rescue Service Enhancements in Fiscal Year 2013.
Subject to appropriation
2
the Council intends
reven~
th~
to the extent sufficient
achieved. revenue generated by the Emergency Medical Services
Transport Insurance Reimbursement Program aillhQrized in
Coun~Code
Section 21
~
23A. enacted in Section 1 ofthis Act
2
in Fiscal Year 2013 should be used to fund the
following enhancements to the County Fire and Rescue Service in Fiscal Year 2013:
ffll
Service Restoration:
Place one ladder truck in the first
ba~lion
bacJs:
163
into service with dedicated 24-hour
staffi~
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EXPEDITED BILL NO. 17-12
164
{bl
Apparatus RfJJk1cement Funding:
I.:!l!Lone tractor drawn . ladder truck,.l
one Engine
Compan~and
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5 EMS units for system unit remonse
improvements.
fI;l
Facility Maintenance and Imll!!lJLements:
Conduct a strategic facility
assessment. develop . a maintenance . and improvement plan for all
LFRD- and County-owned fire and rescue facilities
12Qssible based on. available funding. begin initial
repairs to these
faci1ities~
and~o
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the extent
and
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maintenan~e
fjjl
Training:
Provide system training for career and volunteer personnel,
including core fire. resQll4EMS, t.eclID,ical rescue,
Jmd
driver training
classes.
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{!ll
Fire and
.
Rescue Equioment:
Buy personalp.rotective ewiI2menL
I2Q11able fire, rescue, technical rescue, and EMS equipment for career
and volunteer personneL the training academy. and operational units.
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Approved:
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Roger
Date
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Approved:
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lsi
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This is a correct copy o/Council action.
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~ lb.~
Linda M. Lauer, Clerk ofthe Council
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