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Candidates disagree on EMS reform

While the candidates for the Pinellas County Commission might not agree on much, they are united on a couple of points: The county's fire and emergency medical services system has to be changed and the goal is to provide the maximum service at the minimum cost.

But the agreement ends there.

Susan Latvala, the Republican incumbent for District 5, said she's keeping an open mind until she sees the result of a consultant's study into the county's EMS system. She said the county cannot force consolidation of fire services. Her opponent, Democrat Bob Hackworth, wants to ditch the Sunstar ambulance system so that firefighters can transport patients to hospitals. He said fire consolidation has to be considered.

Calvin Harris, the Democratic incumbent in District 2, favors a hybrid system of transport in which the first at the scene would transport patients to the hospital. Challenger Norm Roche, a Republican, wants to improve communication among the fire districts, fire unions, county and other stakeholders by having them meet and try to work out their issues. He said he does not believe the county has a right to force fire consolidation.

The winners of the Nov. 2 election will be faced with an EMS system that is facing a fiscal crisis. The commission has avoided raising the countywide EMS property tax the past two years by cutting costs, raising ambulance fees and taking millions out of reserves. But doing that has just postponed the inevitable.

Spending for EMS for the next few years is projected to continue outstripping income. If nothing changes, the county estimates it will spend its emergency medical reserves by 2013. The account balance would be $0.

Several commissioners have hoped the results of a study into the EMS system will provide answers to cut costs while maintaining service. That $130,000 study was due in July but has been delayed and is unlikely to be delivered before the election. Even if the study has concrete suggestions, County Administrator Bob LaSala estimates it would take at least two years to implement them. That leaves the commission facing a big money problem.

"I think it's a shame where it's come to a point that it's a crisis," Hackworth said. The crisis has been caused by "a failure to do what should always have been done, which is look for maximum efficiencies."

Hackworth said he has a "gut feeling" that one of the best ways to save money is to dismantle the dual response system that has firefighter paramedics respond to emergencies and then go back onto the street while a Sunstar ambulance transports patients to hospitals. Firefighters could do the transport, he said.

A county study has said that allowing firefighters to transport patients would be more expensive because of the high cost of firefighter salaries, pensions and other benefits. Currently, the Sunstar contracts are with a private company that gets paid per trip. Trips are paid by the users. "I understand (that) argument; I just don't buy it," Hackworth said.

The system has to be looked at as a whole and, if so, the higher cost of firefighter salaries and benefits could be offset by having a more efficient system, he said.

Latvala said she's not necessarily opposed to firefighter transport. She said she's keeping an open mind about that and other issues, pending the outcome of the study.

"Do I see fire doing transport? Quite possibly," she said. "I want to see the study. ... It is a huge challenge to think about completely turning it over. ... We have to have the data (on costs). We have to know what is best."

Latvala said that, whatever needs to happen, the county will likely need help from the Legislature to give it the authority to act. And, she said, the county will also need the cooperation of all the cities and fire districts in Pinellas.

"You have to come to the table with your (fire or city) hat off and be willing to look at it a new way with the best interest of the citizens at the front of your mind," Latvala said. "We're all in the same spot. We all have to provide services to our citizens."

Harris, the other incumbent, said the commission has spent the past two years tweaking the system to save money. "The patches and piecemeal have not worked," Harris said. "The redundancies are killing us."

Harris suggests a hybrid system in which Sunstar and firefighter paramedics would co-exist. But they would not both run calls, and whoever answered the call would transport the patient. For that to work, he said, the costs would have to be worked out. In the past, he said, the county simply has handed over money to the cities and fire districts.

"All those principles need to change," Harris said. Finances need to be equalized so that the countywide system costs do not exceed those of the cities and fire districts.

Roche said the fire and EMS issues have been politicized rather than dealt with responsibly. The system is complex, he said, and deciding what to do to mend it encompasses many difficult issues. Those range from turf to resolving competing pension, benefit and pay scales in order to consolidate.

Added to that, he said, is the disjointed way in which the topic is being discussed.

"Everybody's throwing ideas out. Nobody's sitting down and putting them on paper," Roche said. "What we need to sit down and get going on is how do we get there?"

Candidates disagree on EMS reform 10/16/10 [Last modified: Saturday, October 16, 2010 4:30am]
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