[Adopted 11-22-2011 by Ord. No. 2011-08]
A. 
The agencies identified in § 20-5 are authorized as "permitted agencies" to provide Emergency Medical Services in the County of Shenandoah.
[Amended 6-6-2019 by Ord. No. 2019-06]
B. 
In addition to the permitted agencies, emergency medical services may be provided by state or federal agencies and agencies from other jurisdictions acting under mutual-aid agreements or provisions of applicable law.
A. 
Fees.
(1) 
There is hereby imposed a fee for the provision of emergency medical services by the permitted agencies, as follows:
[Amended 6-6-2019 by Ord. No. 2019-06]
(a) 
ALS emergency services: 150% of the Medicare rural allowed amount.
(b) 
ALS nonemergency services: 150% of the Medicare rural allowed amount.
(c) 
BLS emergency services: 150% of the Medicare rural allowed amount.
(d) 
BLS nonemergency services: 150% of the Medicare rural allowed amount.
(e) 
ALS 2: 150% of the Medicare rural allowed amount.
(f) 
Mileage rate: 150% of the Medicare rural allowed amount.
(2) 
Terms used in the foregoing table shall have the meanings prescribed by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, for use in the United States Medicare program. As the referenced Medicare allowances are altered, the rates in this section shall also change, ipso facto, without further action of the Board of Supervisors.
B. 
Exceptions.
(1) 
Notwithstanding the foregoing, no fee shall be imposed in two situations:
(a) 
Nonparticipating unit.
[1] 
No fee shall be imposed if the service is:
[a] 
Wholly provided by a permitted agency other than the County's Fire and Rescue Department; and
[b] 
The permitted agency has not entered into a fee-sharing agreement with Shenandoah County.
[2] 
This exception applies only if the service is provided entirely without the use of County personnel or vehicles.
(b) 
Uninsured County resident. No fee shall be imposed if, and to the extent that, the recipient of the service is a County resident without insurance applicable to the fee. No fee, and no portion of any fee, shall apply to any County resident without insurance for it, and thus no County resident shall be personally responsible for any fee or portion thereof. This exception does not apply to non-residents.
(2) 
Legislative intent. The two exceptions identified above reflect the dual, public-private nature of emergency medical services in Shenandoah County. It is not the County's objective to charge for services provided solely by private companies, unless there is an agreement in place allowing the private company to take an equitable share of the fee. Further, any fee system must recognize that County taxpayers are already financing a portion of the Emergency Medical Service Program.
The County shall use an independent contractor to charge and collect the fee imposed by this article. The County's Fire and Rescue Billing Technician, under the supervision of the County Administrator, shall oversee and give instruction to the selected contractor in accord with the provisions of this article.
This article shall apply to emergency medical services (as defined in Va. Code § 32.1-111.1) provided throughout Shenandoah County.
A. 
If any provision of this article shall be deemed to be invalid by a court of competent jurisdiction, all remaining portions shall nevertheless remain effective and shall be construed so as to uphold the Board's intent as expressed in the enacting ordinance, to the extent possible.
B. 
The passage of this article shall create no inference that the County heretofore lacked the authority to impose charges for EMS services.