El Cajon Municipal Code Ch. 8.09 Fee for Non-Emergency Lift Assistance at Licensed Care Facilities

The purpose of this chapter is to enact a fee to recover the costs associated with the use of the 911 emergency system to dispatch personnel of the El Cajon Fire Department or its contractors and partners for non-emergency patient lift assistance at licensed care facilities. The intent is to provide a disincentive for the practice of using publicly funded emergency services to provide non-emergency assistance to a licensed care facility, which is required by law to provide adequate staffing to care for its clients.

(Ord. 5153, 5/13/2025)

For the purpose of this section, the following terms, phrases, words, and their derivations shall have the meanings given:

"Licensed care facility"

means a facility that is required by state law to maintain a license to provide health care, community care, congregate care, assisted living, and/or residential care services. "Licensed care facilities" include (but are not limited to) skilled nursing facilities; intermediate care facilities (including those providing developmentally disabled habilitative, development disabled, developmentally disabled-nursing, continuing nursing, services); congregate living health facilities; or nursing facilities, each as defined in California Health & Safety Code section 1250 (or any successor law to section 1250), but excluding acute care (i.e., hospital) services. "Licensed care facilities" further include any community care facilities subject to licensure from the State of California, Health & Human Services Agency, Department of Social Services pursuant to Title 22, Division 6, Chapter 1 of the California Code of Regulations, or any successor regulation replacing said chapter.

"Lift assist"

means a response by a fire department emergency response unit of the city, the emergency response unit of a private contractor of the city, or the unit of another public safety department providing automatic or mutual aid to the city, to a licensed care facility for the purpose of lifting a fallen person to a pre-fall position.

"Non-emergency"

means a determination, based upon an assessment by the commanding officer or paramedic of the emergency response unit, that there is not an emergency medical condition or medical necessity justifying the presence of the emergency unit at the facility.

(Ord. 5153, 5/13/2025)

Based upon the assessment undertaken by the commanding officer or paramedic of an emergency response unit dispatched to a licensed care facility and their determination that no emergency medical condition or emergency medical necessity exists, but the staff of the facility desires that emergency response personnel complete a lift assist of a fallen person, the officer shall declare the incident a non-emergency lift assist in their incident report. If the commanding officer or paramedic cannot reasonably determine that a non-emergency condition exists it shall be presumed that the response was for an emergency condition or medical necessity.

(Ord. 5153, 5/13/2025)

The fire chief, or designee, shall be authorized to charge a fee to the owner of the licensed care facility for each incident determined to be non-emergency lift assist at licensed care facilities. The amount of the nonemergency lift assistance fee shall be established by resolution of the city council, and shall reasonably relate to the cost of providing the nonemergency service to the licensed care facility.

(Ord. 5153, 5/13/2025)

Notice of the imposition of fees under the provisions of this chapter shall be sent to the owner, administrator, or management of the facility where the incident occurred; and may be served on the entity or person holding the license for operation of the facility.

(Ord. 5153, 5/13/2025)

In the event the fire chief, or designee, determines that the determination of a commanding officer or paramedic that their finding of a non-emergency lift assist was in error or there were other mitigating facts which the commanding officer or paramedic did not possess at the time of the incident, the fire chief, or designee, may waive imposition of the applicable fee(s).

(Ord. 5153, 5/13/2025)

A. Any party subject to a fee under the provisions of this chapter shall have a right of appeal to the fire chief, or their designee. A notice of appeal must be submitted in writing no later than ten (10) days after issuance of the notice of the fee by invoice or other document, and must be directed to the fire chief, at the address listed on the notice of fee. The written appeal should include the fee reference number and the party's reasoning why the determination of notice of nonemergency lift assist should be reconsidered.

B. Within thirty (30) days of receipt of a written appeal, an impartial review of the appeal shall be completed and a recommendation shall be presented to the fire chief, or designee, for final decision, which will be reported to the appellant in writing. Unless a notice of appeal is properly filed in accordance with this section within ten (10) days of the issuance of notice of fee, said fee is deemed final.

C. Any appeal of a fee must be conducted pursuant to sections 1.14.100 and 1.14.110 of the EI Cajon Municipal Code. Any conflict between this section and sections 1.14.100 or 1.14.110, shall be resolved in favor of the requirements in this section.

D. An administrative hearing to appeal a decision of the department to charge the fee is civil in nature and therefore the burden of proof required is a preponderance of the evidence. In such an appeal the administrative hearing officer shall only determine whether the violations of this chapter occurred. The administrative hearing officer shall not consider the appropriateness of the amount of the fine or whether the amount of the fee is excessive or creates a financial hardship on the facility; nor shall the administrative hearing officer grant the applicant any stay of execution or delay of enforcement of a suspension or revocation sustained following the hearing.

E. The rules of evidence in an administrative hearing to appeal a decision of the department to charge the fee shall be in accordance with California Government Code sections 11513 and 11514 as those sections might be amended from time to time. Except as provided in this subdivision (E), the provisions of administrative adjudication for the State of California (Chapter 5 of Part 1 of Division 3 of Title 2 of the California Government Code) shall not apply to any administrative hearing under this chapter.

(Ord. 5153, 5/13/2025)