Number
071510
Version
SUBSTITUTE 2
Reference
061570
Sponsor
ALD. DONOVAN
Title
A substitute ordinance relating to ambulance certification requirements.
Sections
60-1-3-a-0 am
60-2-4 cr
75-15 rc
Analysis
This ordinance revises and clarifies various provisions of the city's ambulance certification regulations. It further provides the following:
1. An 8-member ambulance service board is established consisting of a member of the public safety committee appointed by the president of the common council; the health commissioner; a public member appointed by the mayor and confirmed by the common council; the city homeland security director; the city emergency medical services director; representatives of 2 of the 4 hospital systems of Wheaton/Franciscan, Aurora, Columbia/St. Mary's and Froedtert, appointed on a rotating basis; and a designee of the Milwaukee county medical society emergency medical services committee.
2. The ambulance service board shall oversee development and implementation of an ambulance service agreement between the city and certified providers, for specifying rules, regulations, procedures and service standards for the safe operation of the emergency medical services system.
3. If an initial application or application for renewal for an ambulance certificate is denied, no fee shall be refunded by the city.
4. A certified provider shall furnish with the city a certificate of insurance insuring the provider against loss or damage that may result to any person or property, with a policy of $1,000,000 for any one person injured or killed, $3,000,000 for all persons injured or killed in case of one accident resulting in bodily injury or death of more than one person, and $3,000,000 for any injury or destruction to property of others in the case of accident. Private sector companies, not participating within the city's medical services system need not file insurance.
5. Certified providers shall:
a. Seek reimbursement from those requesting service from the Milwaukee emergency medical services system or any third-party payer, and provide the most economical service in accordance with accepted medical practice. The city will not be responsible for collection or payment of any charge for services rendered by reason of its having dispatched the service with the exception of services provided for the conveyance of police prisoners and those in protective custody.
b. Not pursue beyond a reasonable limit compensation for conveyance where a conveyed party has demonstrated an inability to pay the service charge.
c. Charge an ambulance rate, which is approved by the common council. The approval of the ambulance rate may be taken in conjunction with the common council's approval of the ambulance service plan.
d. Charge fees for equipment and procedures other than the rates established as described above. The fees shall be determined by the commissioner of health and approved by the common council. The commissioner shall review the fees on an annual basis, with any necessary adjustments being submitted to the common council for approval in conjunction with approval of the ambulance rate.
6. To provide effective ambulance service within the emergency medical services system, the common council shall take into consideration all information obtained through the certification process, including the service capacities of each prospective provider and the previous performances, if any, of each provider.
7. Service plans shall be approved by the common council annually commencing on January 1, 2008. The common council, with the recommendation of the ambulance service board, shall modify any service plan during the pendency of any service period, if one or more certified providers are not meeting the requirement of the ambulance service agreement.
Body
The Mayor and Common Council of the City of Milwaukee do ordain as follows:
Part 1. Section 60-1-3-a-0 of the code is amended to read:
60-1. General Provisions.
3. REFUND OF FEES BY HEALTH DEPARTMENT. a. [[If]]>>Except as otherwise provided, if<< an application for a license or permit issued by the health department is withdrawn, or if such a license or permit is denied or not issued, the following amounts shall be retained by the health department to defray the city's cost of processing the application pursuant to this chapter:
Part 2. Section 60-2-4 of the code is created to read:
60-2. Ambulance Certificate.
4. If an initial application or application for renewal is denied, no fee paid shall be refunded.
Part 3. Section 75-15 of the code is repealed and recreated to read:
75-15. Ambulance Certification Regulations.
1. DEFINITIONS. In this section:
a. “Advanced life support” (“ALS”) means advanced life support as defined in s. HFS 112.03(1), Wis. Adm. Code.
b. “Agreement” means the ambulance service standards agreement identified in sub. 2-b-2.
c. “Ambulance” means a certified emergency vehicle used to transport sick, disabled or injured individuals as defined in ss. 146.50(1)(am) and 340.01(3)(i), Wis. Stats.
d. “Ambulance rate” means the base fee for ambulance conveyance which cannot be exceeded by certified providers on city authorized dispatch.
e. “Basic life support” (“BLS”) means basic life support as defined in s. HFS 110.03(7), Wis. Adm. Code.
f. “Board” means the ambulance service board.
g. “Certified provider” means a provider from the private sector that applied for and obtained a certificate to supply services within the Milwaukee emergency medical services system as a certified provider.
h. “Committee” means the committee designated by the common council as responsible for ambulance service regulations.
i. “Emergency medical services” (EMS) means those services which are required as a result of an unforeseen attack of illness or an injury. These include rescue, ambulance, hospital emergency department, communications and public education services.
j. “EMT” means emergency medical technician as defined in s. HFS 110.03(14), Wis. Adm. Code.
k. “Fire department” means the city of Milwaukee fire department.
l. “Incident” means each event that causes MFD dispatch, through its usual procedures to refer a request for ambulance transport service to a certified provider, by telephone or other electronic means.
m. “Milwaukee emergency medical services system” means a system composed of fire department personnel and equipment, and private sector personnel and equipment for the purpose of providing advanced life support and basic life support responses and conveyances within city limits.
n. “Milwaukee fire department dispatch” (“MFD dispatch”) means the dispatch center operated by the fire department at any location for receiving and dispatching all calls for emergency medical assistance.
o. “Private sector” means any person, firm, partnership or corporation within the city providing ambulance services on a fee-for-service basis.
p. “Service area” means a geographically defined area within the city assigned in accordance with sub. 13.
2. AMBULANCE SERVICE BOARD.
a. Establishment. An 8-member ambulance service board is established consisting of:
a-1. A member of the public safety committee appointed by the president of the common council.
a-2. City health commissioner.
a-3. Public member appointed by the mayor and confirmed by the common council.
a-4. City homeland security director.
a-5. City EMS medical director. This member shall not participate in disciplinary matters.
a-6. Representatives of 2 of the 4 hospital systems of Wheaton/Franciscan, Aurora, Columbia/St. Mary’s and Froedtert, appointed on a rotating basis biennually. A hospital representative shall not be a current medical director of a provider.
a-7. Designee of the Milwaukee county medical society EMS committee, who shall not be a current medical director of a provider.
b. Duties.
b-1. The board shall advise the committee on all matters pertaining to issuance, renewal, suspension, revocation and reinstatement of certified provider certificates, and shall, consistent with sub. 13, assist in the development and modification of service plans.
b-2. The board, with the assistance of the city attorney, the chief of the fire department and the certified providers shall oversee development and implementation of the agreement between the city and the certified providers, for specifying appropriate rules, regulations, procedures and service standards as required for the safe operation of the Milwaukee emergency medical services system.
3. CERTIFICATION. No one from private sector shall within the city act as a certified provider within the Milwaukee emergency medical services system without first having obtained a certificate as provided under this section. This section applies only to private sector providers supplying services to the city of Milwaukee emergency medical services system.
4. APPLICATION FOR CERTIFICATION AS CERTIFIED PROVIDER AND SERVICE AREA.
a. Application for certificates as a certified provider under this section shall be filed with the health department on forms approved by the committee. The board and the committee are authorized to require sufficient information to determine the qualifications of the applicant to engage in the business of providing basic life support and advanced life support ambulance conveyances to the Milwaukee emergency medical services system. The application signed in proper form shall be presented to the common council, for referral to the committee for its recommendation.
b. Each applicant shall be fingerprinted and shall furnish, together therewith, his or her name, date of birth, address, employer’s name and address, a statement as to whether the applicant has been convicted of any crime, misdemeanor or violation of any municipal ordinance other than traffic violations, and any other information required by the committee, subject to s. 111.335, Wis. Stats. On renewals of previously issued certificates, it shall not be necessary to fingerprint the applicant. If the applicant for a certificate is a partnership, all partners shall sign the application and be fingerprinted. If the applicant for a certificate is a corporation, the president, vice-president, secretary and treasurer shall sign the application and be fingerprinted.
c. The commissioner of health shall promulgate an appropriate initial or renewal application form to all providers by not later than September 1 of each year. All applications for initial or renewal certification shall be filed not later than September 30, to be eligible for certification for the next service period.
5. FEES. An applicant filing an initial application for a certificate as a certified provider or an application for renewal shall pay the fee required in ch. 60.
6. INVESTIGATION. Upon receipt of the application for a certificate as a certified provider, the matter shall be referred to the chief of police, who shall cause an investigation of the applicant’s moral character to be made for the protection of the public health, welfare and safety. As part of the investigation, the chief of police shall report to the health department all convictions, other than traffic violations, of the applicant, together with any other information in the possession of the police department as to the business conduct and moral character of the applicant.
7. HEARING.
a. Upon referral of an application for certification as a certified provider from the common council to the committee, the committee shall schedule a hearing thereon. Prior to the hearing, the committee shall submit the application to the board for its consideration and advice.
b. The applicant shall receive notice of the hearing not less than 10 days prior to the hearing. At the hearing, the applicant may be represented by counsel, present witnesses and cross-examine any adverse witnesses under oath, and receive a transcript of the hearing at the applicant’s expense.
c. At the conclusion of the hearing, a recommendation shall be made by the committee to the common council. Any member of the committee who votes to deny an application shall state the basis for the vote on the record.
8. CERTIFICATE ISSUANCE. The health department shall issue to each person qualifying under this section a certificate as a certified provider on which there shall be the person’s true first name, surname and middle initial, the number of the certificate, and the period of time for which the certificate is valid. The certificate shall be in such form so to avoid alteration. The certificate shall be maintained by the provider and be exhibited to any person requesting to see it. Furthermore, the health department shall assign to each qualified person a series of numbers, which shall be used to identify the provider’s ambulances. These numbers shall be placed on the front doors of the ambulances and shall be at least 5 inches high and in a color to contrast with the background on which it is placed.
9. APPROVAL OR DENIAL OF CERTIFICATE.
a. The committee may recommend the denial of any application for certification as a certified provider for any of the following reasons:
a-1. The applicant is not of good character.
a-2. The applicant has violated any of the required or prohibited practices set forth in this section.
a-3. The applicant’s previous certificate has been revoked for any reason whatsoever.
a-4. The applicant’s inability to substantially understand the required business regulations provided by this section.
a-5. The qualifications of the applicant, when compared with the qualifications of applicants receiving a recommendation of approval, is deficient in any material respect.
a-6. The applicant’s failure in the past or refusal in the future to act in accordance with this section or with the terms of the agreement.
a-7. The applicant’s physical location for operations is not within the city limits.
b. The common council may upon receipt of the recommendations of the committee for approval or denial of applications for certification as certified providers, grant the number of certificates which, in its discretion and judgment, the public welfare, safety and interest require. Thereafter, a list of those providers granted certification as certified providers by the common council shall be provided to the board for designation of service area assignments in a manner consistent with sub. 13.
10. INSPECTION. No ambulance shall be granted a permit to operate under the terms of this section until it has been inspected and found to be in a thoroughly safe condition for the transportation of the sick and injured. The inspection shall be made by the Wisconsin department of transportation, division of state patrol, which shall determine that the ambulance complies with all the requirements set forth in s. 146.50, Wis. Stats. Verification of the inspection shall be provided to the board at the annual certification hearing.
11. FINANCIAL RESPONSIBILITY.
a. A certified provider shall furnish the city with a certificate of insurance, issued by a company authorized to do business in the state of Wisconsin, confirming that the certified provider has been issued a current policy insuring the provider against loss or damage that may result to any person or property, the policy of insurance to be in the limits of $1,000,000 for any one person injured or killed, $3,000,000 for all persons injured or killed in case of one accident resulting in bodily injury or death of more than one person, and $3,000,000 for injury or destruction to the property of others in the case of accident. The policy shall guarantee payment of any final judgment rendered against the provider within the limits provided in this paragraph irrespective of the financial responsibility or any act of omission of the certified provider. The city of Milwaukee shall be named as an additional insured.
b. Cancellation. All certificates shall be executed by an insurance company licensed to do business in the state of Wisconsin and shall have affixed an affidavit of no interest. All certificates shall be approved as to form and execution by the city attorney before they are accepted by the health department, and shall contain a provision or endorsement by which the insurance carrier shall be required to notify the fire department by registered mail or personal service of the cancellation of the insurance policy. Notice of cancellation shall be received by the fire department at least 30 days prior to the effective date of cancellation. If at any time the policy of insurance is cancelled by the issuing company, or the authority of such issuing company to do business in the state of Wisconsin is revoked, the fire chief shall require the certified provider to replace the policy with another policy satisfactory to the chief, and in default thereof the certified provider’s certificate issued under this section shall be suspended until proof of valid policy is presented by a certified provider.
c. Exceptions. Private sector providers, not participating within the Milwaukee emergency medical services system, need not file the insurance required herein.
12. REQUIREMENTS. All certified providers shall adhere to the following general conditions and specifications concerning Milwaukee emergency medical service systems incidents:
a. Seek reimbursement from those requesting service from the Milwaukee emergency medical services system or any third-party payer, and provide the most economical service in accordance with accepted medical practice. The city will not be responsible for collection or payment of any charge for services rendered by reason of its having dispatched the service relative to this section, with the exception of services provided to those individuals pursuant to sub. 18.
b. Not pursue beyond a reasonable limit compensation for conveyance where a conveyed party has demonstrated an inability to pay the service charge.
c. Charge an ambulance rate, which is approved by the common council. The approval of the ambulance rate may be taken in conjunction with the common council’s approval of the ambulance service plan, in accordance with the ambulance rate provisions of sub. 14.
d. Charge fees for equipment and procedures other than the rates established under par. c. The fees shall be determined by the commissioner of health and approved by the common council. The commissioner shall review the fees on an annual basis, with any necessary adjustments being submitted to the common council for approval in conjunction with approval of the ambulance rate under par. c.
13. SERVICE AREAS.
a. Criteria. In establishing and re-establishing the number and geographical boundaries of the service areas, the common council shall endeavor to provide effective ambulance service within the Milwaukee emergency medical services system. The common council shall take into consideration all the information obtained through the certification process, including the service capacities of each certified provider and the previous performances, if any, of each certified provider.
b. Assignment of Service Areas.
b-1. Service Plan Development. Following common council certification of one or more providers from the private sector as certified providers, the fire department shall propose a service plan and transmit it to the board which shall develop a proposed service plan to be utilized during the next service period. In developing the service plan, the fire department and board shall take into consideration all the information obtained through the certification process, including the service capacities of each certified provider and the previous performances, if any, by each certified provider. The plan shall include the number of service areas, the geographical size and boundaries of each service area, and a designation of a certified provider for assignment to each service area. The number of service areas shall be determined by the best interests of the Milwaukee emergency medical services system. The geographical size and boundaries of each service area shall be determined by the service capabilities and past performance of each certified provider to be assigned to a service area. Each certified provider designated for service area assignment shall, within 15 days of announcement by the board of its proposed service plan, file a written response of its acceptance or objection to the plan. Each certified provider accepting the plan shall also file with the board a properly executed agreement. The board shall thereafter submit the plan to the committee for its review and recommendation to the common council. Upon approval by the common council of any service plan for the next scheduled service period, the plan shall be implemented by the Milwaukee emergency medical services system for that period, subject to subd. 2.
b-2. Duration. Service plans shall be approved by the common council annually commencing on January 1, 2008. Notwithstanding such approval, the board shall recommend modifications of the size of the service areas and assignments of certified providers to service areas during the pendency of any service period, and the common council, with the recommendation of the board, shall modify any service plan during the pendency of any service period, if it is determined that one or more certified providers are not meeting the requirements of the agreement. The board shall also review the service plan and geographical size and boundaries of each service area on an annual basis, to determine if the certified providers are complying with requirements of the agreement and if service area adjustments are necessary. The board shall provide the common council with the board’s reasons for recommending or not recommending any changes in the service plan or service areas subsequent to the board’s annual review.
c. Revocation of Service Area. In addition to any revocation under the agreement or sub. 19, the board shall revoke the assignment of any service area for any certified provider no longer certified.
14. DETERMINING RATES BILLED BY PRIVATE SECTOR PROVIDERS.
a. The commissioner of health annually shall review and report to the common council by April 1 with respect to the ambulance conveyance rate established under par. c and recommend, if appropriate, an adjustment in the conveyance rate.
b. Upon request, the legislative reference bureau shall provide the commissioner with information from health-related cost indexes, including the medical care component of the Milwaukee consumer price index issued by the U.S. bureau of labor statistics.
c. The rate charged for conveyance shall be as follows:
c-1. For patients who are residents of the city of Milwaukee, for basic life support, $410 and, for basic life support-emergency, $410. When patients require treatment without transport, a $75 basic life support non-transport fee shall apply.
c-2. For patients who are not residents of the city of Milwaukee, for basic life support, $474 and, for basic life support - emergency, $474. When patients require treatment without transport, a $125 basic life support non-transport fee shall apply.
c-3. In addition to the charges provided in subds. 1 and 2, a charge of $12 per mile shall be assessed for mileage, mileage to be defined as the distance traveled with the patient in the ambulance from the point of patient origin to destination.
d. In those instances where a certified provider has a contract with any insurer or health maintenance organization with respect to establishment of fees for ambulance services for persons insured through the organization, the fees established in the contract shall take precedence over those in par. c and sub. 15, and the certified provider shall charge only those fees established in the contract.
15. BASIC LIFE SUPPORT ANCILLARY CHARGES BILLED BY PRIVATE SECTOR PROVIDERS. Pursuant to sub. 12-d, certified providers are authorized to charge the following basic life support ancillary charges:
a. Airway
a-1. Oropharyngeal $1.94
a-2. Nasopharyngeal 7.68
b. Bag mask ventilator, 38.42
adult or pediatric
c. Bandaging
c-1. Trauma dressing 4.58
c-2. Kling 4” 1.96
c-3. 5/9” dressing 0.47
d. Blanket 8.92
e. Burn sheet 9.23
f. Cervical collar 26.31
g. Cold pack 1.76
h. Combi-tube/intubation 65.00
charge
i. Defibrillation supplies 85.00
j. Electrodes 2.33
k. Gloves 1.86
l. Head immobilizer 15.44
m. Hot pack 2.05
n. KED strap 23.21
o. Laryngoscope blades 7.37
p. Linens 5.69
q. OB kit with silver 22.83
swaddler
r. Oxygen and supplies 75.00
s. Personal protective equipment
s-1. Gown 4.58
s-2. Goggles 9.23
t. Prosplints
t-1. Full arm, large 23.45
t-2. Full arm, small 22.67
t-3. Combo 31.36
t-4. Full leg, large 49.21
t-5. Full leg, small 42.30
t-6. Wrist and forearm 14.12
u. Pocket mask 20.18
v. Resuscitation bag & mask 38.42
w. Splints
w-1. 12” 3.50
w-2. 18” 5.20
w-3. 24” 6.99
x. Sterile saline or water 3.47
y. Suction
y-1. Canister 5.82
y-2. Suction tip 2.71
y3. Tubing 3.02
z. Drug charges: drugs allowed by the state of Wisconsin emergency medical technician basic scope of practice and approved by the Milwaukee county council on emergency medical services, shall be charged at the same rates established under sub. 17-d.
16. CHARGES FOR ADVANCED LIFE SUPPORT PATIENT SERVICES DELIVERED BY PRIVATE PROVIDERS. Whenever a certified provider performs an advanced life support conveyance under the agreement, the certified provider is authorized to charge the same rates as established for the fire department, pursuant to sub. 17-a and b. When performing an advanced life support, certified providers are authorized to charge the same ancillary charges established for the fire department under sub. 17-c and d. These charges shall in no way be construed so as to circumvent the role of the fire department as the designated responder to advanced life support service calls.
17. CHARGES FOR PATIENT SERVICES DELIVERED BY THE FIRE DEPARTMENT.
The fire department shall bill for and collect all revenues generated from advanced life support conveyances and service provisions using fee schedules that have been adopted by the Milwaukee county association of fire chiefs and the intergovernmental cooperation council of Milwaukee county and the common council. The rate charged for conveyance and services delivered by fire department paramedic fleet shall be as follows:
a. For advanced life support for patients who are residents of Milwaukee county.
a-1. Paramedic non-invasive service and/or treatment without conveyance $75
a-2. Paramedic invasive service and/or treatment without conveyance $350
a-3. Paramedic service with transport Level ALS-1 $585
a-4. Paramedic service with transport Level ALS-2 $635
b. For advanced life support for patients who are not residents of Milwaukee county.
b-1. Paramedic non-invasive service and/or treatment without conveyance $125
b-2. Paramedic invasive service and/or treatment without conveyance $380
b-3. Paramedic service with transport Level ALS-1 $635
b-4. Paramedic service with transport Level ALS-2 $685
c. Advanced life support ancillary charges.
c-1. ALS supplies $70
c-2. Intubation $65
c-3. I.V. and supplies $50
c-4. Defibrillation $85
c-5. EKG $85
c-6. Oxygen and supplies $75
d. Drugs included in the Milwaukee county medical services program adopted by the Milwaukee county association of fire chiefs and the intergovernmental cooperation council of Milwaukee county.
d-1. Items approved in Drug Group 1 are charged a rate of $25 including: Albuterol, Amidoerone (30 mg), Altropine, Benadryl, Heparin Sodium by I.V., Lasix, Lidocaine, Ativan, Versed, Sodium Chloride, Solumedrol (up to 40 mg), Terbutaline, Diazepam, Dextrose 50%, Nitro Spray SL, Normal Saline (capped), D50, and Dtw.
d-2. Items approved in Drug Group 2 are charged a rate of $30 including: Calcium Chloride, Epinephrine (I.M. or I.V., not by EPI-PEN), Dopamine, Lidocaine, and Sodium Bicarbonate.
d-3. Items approved in Drug Group 3 are charged a rate of $40 including: Morphine, Narcan and Normal Saline.
d-3-a. Epinephrine by EPI-PEN $85
d-3-b. Adenosine $80
d-3-c. Glucagon, up to 1 mg $80
d-3-d. Solumedrol, 41-125mg $50
e. Mileage. In addition to the charges provided in pars. a to d, a charge of $12 per mile shall be assessed for mileage, mileage to be defined as the distance traveled with the patient in the ambulance from the point of patient origin to destination.
18. CONVEYANCE OF POLICE PRISONERS AND THOSE IN PROTECTIVE CUSTODY. Certified providers under contract with the city for payment for conveyance of police prisoners for medical treatment, those incapacitated persons in protective custody and those in need of emergency detention, in situations where the person conveyed is unable to pay for conveyance, shall be paid a rate equal to 60% of the conveyance rate and mileage charge in sub. 14 and 60% of the services fees charge in sub. 15. Charges for services rendered by the fire department under this subsection shall be paid a rate equal to 60% of all patient services delivered by the department pursuant to sub. 17.
19. VIOLATIONS.
a. Suspension and Revocation. The common council may, subsequent to a hearing conducted by the committee, suspend, revoke, deny or not renew a certificate issued under this section for any reasonable cause which shall be in the best interests and good order of the city, including, but not limited to, the following findings:
a-1. Conviction of a violation of this section.
a-2. Where the committee, on hearing of evidence, determines that the certified provider has been violating any of the provisions of this section even though the certified provider may not have been convicted in a court for this violation.
a-3. Conviction of a criminal statute or city ordinance involving moral turpitude.
a-4. Violation of a city ordinance where the violation is connected with or a part of carrying on the business for which the certificate is issued.
a-5. Failure to obtain any permit required under the ordinances of the city or laws of the state of Wisconsin, or employing persons not authorized to do any specific work as required under the ordinances of the city, or the laws of the state of Wisconsin.
a-6. Failure to comply with any of the provisions of the agreement.
b. Hearing.
b-1. Whenever the committee has scheduled a hearing for determining whether to recommend suspension or revocation of a certified provider’s certificate, the certified provider shall receive written notice of the hearing not less than 10 days prior to the hearing. The notice shall specify the nature of the complaint against the certified provider.
b-2. The certified provider may attend the hearing and be represented by counsel, may present witnesses and confront and cross-examine any adverse witnesses under oath, and may obtain a transcript of the hearing at the certified provider’s own expense.
b-3. At the conclusion of the hearing, the committee shall make its recommendation to the common council. If the recommendation is to suspend or revoke a certified provider’s certificate, each member of the committee voting in favor of the action shall state the basis therefore on the record.
b-4. The certified provider shall be provided with written notice of any recommendation of the committee. If the recommendation is to suspend or revoke the certified provider’s certificate, the provider may, within 10 days of the notice, appeal the recommendation by filing written notice with the city clerk. If notice of appeal is filed, a copy of the transcript of the hearing shall be provided to each common council member at least 3 days prior to the common council vote on whether to accept or reject the recommendation of the committee.
c. Penalty. Anyone who acts as a certified provider without having obtained a certificate to do so, or who violates any other part of this section, shall upon conviction be subject to a forfeiture of not less than $100 nor more than $250, and in default of payment, be committed to the county jail or house of correction for a period of time not to exceed 10 days. Each day in which any person shall operate as a certified provider without having obtained a certificate, or after revocation of the same, shall constitute a separate offense.
20. ANNUAL REPORT. The fire chief shall present an annual status report to the common council on all fire department advanced life support billing activities, including descriptions of the amounts invoiced, collected and outstanding, no later than June 30 commencing June 30, 2008.
LRB
APPROVED AS TO FORM
_________________________
Legislative Reference Bureau
Date:_____________________
Attorney
IT IS OUR OPINION THAT THE ORDINANCE
IS LEGAL AND ENFORCEABLE
________________________
Office of the City Attorney
Date:____________________
Requestor
Fire Department
Drafter
MET
3/6/08
LRB08091-2
13