BILL REQ. #: H-0825.2
State of Washington | 62nd Legislature | 2011 Regular Session |
Read first time 01/26/11. Referred to Committee on Local Government.
AN ACT Relating to requirements that cities and towns with ambulance utilities allocate funds toward the total cost necessary to regulate, operate, and maintain the ambulance utility; and amending RCW 35.21.766.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1 RCW 35.21.766 and 2005 c 482 s 2 are each amended to read
as follows:
(1) Whenever a regional fire protection service authority
determines that the fire protection jurisdictions that are members of
the authority are not adequately served by existing private ambulance
service, the governing board of the authority may by resolution provide
for the establishment of a system of ambulance service to be operated
by the authority as a public utility (([or])) or operated by contract
after a call for bids.
(2) The legislative authority of any city or town may establish an
ambulance service to be operated as a public utility. However, the
legislative authority of the city or town shall not provide for the
establishment of an ambulance service utility that would compete with
any existing private ambulance service, unless the legislative
authority of the city or town determines that the city or town, or a
substantial portion of the city or town, is not adequately served by an
existing private ambulance service. In determining the adequacy of an
existing private ambulance service, the legislative authority of the
city or town shall take into consideration objective generally accepted
medical standards and reasonable levels of service which shall be
published by the city or town legislative authority. The decision of
the city council or legislative body shall be a discretionary,
legislative act. When it is preliminarily concluded that the private
ambulance service is inadequate, before issuing a call for bids or
before the city or town establishes an ambulance service utility, the
legislative authority of the city or town shall allow a minimum of
sixty days for the private ambulance service to meet the generally
accepted medical standards and reasonable levels of service. In the
event of a second preliminary conclusion of inadequacy within a twenty-four month period, the legislative authority of the city or town may
immediately issue a call for bids or establish an ambulance service
utility and is not required to afford the private ambulance service
another sixty-day period to meet the generally accepted medical
standards and reasonable levels of service. Nothing in chapter 482,
Laws of 2005 is intended to supersede requirements and standards
adopted by the department of health. A private ambulance service which
is not licensed by the department of health or whose license is denied,
suspended, or revoked shall not be entitled to a sixty-day period
within which to demonstrate adequacy and the legislative authority may
immediately issue a call for bids or establish an ambulance service
utility.
(3) The city or town legislative authority is authorized to set and
collect rates and charges in an amount sufficient to regulate, operate,
and maintain an ambulance utility. Prior to setting such rates and
charges, the legislative authority must determine, through a cost-of-service study, the total cost necessary to regulate, operate, and
maintain the ambulance utility. Total costs shall not include capital
cost for the construction, major renovation, or major repair of the
physical plant. Once the legislative authority determines the total
costs, the legislative authority shall then identify that portion of
the total costs that are attributable to the availability of the
ambulance service and that portion of the total costs that are
attributable to the demand placed on the ambulance utility.
(a) Availability costs are those costs attributable to the basic
infrastructure needed to respond to a single call for service within
the utility's response criteria. Availability costs may include costs
for dispatch, labor, training of personnel, equipment, patient care
supplies, and maintenance of equipment.
(b) Demand costs are those costs that are attributable to the
burden placed on the ambulance service by individual calls for
ambulance service. Demand costs shall include costs related to
frequency of calls, distances from hospitals, and other factors
identified in the cost-of-service study conducted to assess burdens
imposed on the ambulance utility.
(4) A city or town legislative authority is authorized to set and
collect rates and charges as follows:
(a) The rate attributable to costs for availability described under
subsection (3)(a) of this section shall be uniformly applied across
user classifications within the utility;
(b) The rate attributable to costs for demand described under
subsection (3)(b) of this section shall be established and billed to
each utility user classification based on each user classification's
burden on the utility;
(c) The fee charged by the utility shall reflect a combination of
the availability cost and the demand cost;
(d)(i) Except as provided in (d)(ii) of this subsection, 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. The combined rates
charged may reflect an exemption or reduction for designated classes
consistent with Article VIII, section 7 of the state Constitution. The
amounts of exemption or reduction shall be a general expense of the
utility, and designated as an availability cost, to be spread uniformly
across the utility user classifications.
(ii) For cities with a population less than two thousand five
hundred that established an ambulance utility before May 6, 2004, the
combined rates charged may reflect an exemption or reduction for
persons who are medicaid eligible, and for designated classes
consistent with Article VIII, section 7 of the state Constitution;
(e) ((The legislative authority must continue to allocate at least
seventy percent of the total amount of general fund revenues expended,
as of May 5, 2004, toward the total costs necessary to regulate,
operate, and maintain the ambulance service utility. However, cities
or towns that operated an ambulance service before May 6, 2004, and
commingled general fund dollars and ambulance service dollars, may
reasonably estimate that portion of general fund dollars that were, as
of May 5, 2004, applied toward the operation of the ambulance service,
and at least seventy percent of such estimated amount must then
continue to be applied toward the total cost necessary to regulate,
operate, and maintain the ambulance utility. Cities and towns which
first established an ambulance service utility after May 6, 2004, must
allocate, from the general fund or emergency medical service levy
funds, or a combination of both, at least an amount equal to seventy
percent of the total costs necessary to regulate, operate, and maintain
the ambulance service utility as of May 5, 2004, or the date that the
utility is established;)) The legislative authority must allocate available emergency
medical service levy funds, in an amount proportionate to the
percentage of the ambulance service costs to the total combined
operating costs for emergency medical services and ambulance services,
towards the total costs necessary to regulate, operate, and maintain
the ambulance utility;
(f)
(((g))) (f) The legislative authority must allocate all revenues
received through direct billing to the individual user of the ambulance
service to the demand-related costs under subsection (3)(b) of this
section;
(((h))) (g) The total revenue generated by the rates and charges
shall not exceed the total costs necessary to regulate, operate, and
maintain an ambulance utility; and
(((i))) (h) Revenues generated by the rates and charges must be
deposited in a separate fund or funds and be used only for the purpose
of paying for the cost of regulating, maintaining, and operating the
ambulance utility.
(5) Ambulance service rates charged pursuant to this section do not
constitute taxes or charges under RCW 82.02.050 through 82.02.090, or
35.21.768, or charges otherwise prohibited by law.