Consultant recommends no major changes to Pinellas EMS system

Pinellas County’s emergency medical services system should not undergo major changes, a consultant’s draft report says.

JIM DAMASKE | Times (2002)

Pinellas County’s emergency medical services system should not undergo major changes, a consultant’s draft report says.

Pinellas has a stellar, world-class emergency medical services system that should not undergo major changes in order to save money, concludes a consultant's draft report released Thursday.

Instead, Fitch & Associates says, the system should be "tweaked" to reduce the number of firefighter/paramedics who work a 24-hour shift.

Fitch developed a recommendation it calls "CARES," for communitywide alignment of resources for efficiency and service. Under that plan, 19 fire-based rescue vehicles would work 14-hour days rather than 24 hours as they do now. Otherwise, the system would remain as is.

The estimated total savings from the change: $6.3 million, or about 5.5 percent of the overall $112 million EMS budget. The main cuts in funding would be in the amount that goes to fire departments. The money going to the county to run the system and to the ambulance company would be unchanged.

Pinellas County Commissioner Ken Welch said he had not fully digested the report, but noted it did not refer to a so-called hybrid plan with provisions for both fire and ambulance transport that the commission wanted studied. Welch said he is withholding judgment until he understands the rationale behind the failure to consider that idea.

Bert Polk, head of the Pinellas County Fire Chiefs Association, said he had not had time to read the draft.

Mark Postma, chief operating officer of Sunstar, the company that provides ambulance service, said, "We agree with the primary finding that the current system is the right fit for both Pinellas patients and taxpayers.''

Pinellas' EMS system is made up of two tiers: Firefighter/paramedics employed by the county's 18 city and district fire departments who are generally the first on the scene in medical emergencies. Patients who need to go to the hospital are taken there by Paramedics Plus, a private, for-profit company, that operates under the name Sunstar.

The system is paid for through a combination of a countywide property tax and ambulance user fees, which go to pay fire personnel, Paramedics Plus and county staff who oversee the system.

The cost has become a major issue in the past few years. Property taxes and ambulance fees have increased significantly. County Administrator Bob LaSala has repeatedly warned that the system is facing bankruptcy if spending is not reined in.

Two years ago, LaSala embraced a plan by a previous consultant that would have cut 25 rescue vehicles — the ones that resemble ambulances — and 150 or more firefighters from the system. The ambulance and county administration portions of the system would have been untouched. Fire chiefs, firefighters, city officials and others fought the idea because, among other things, it would push costs of a countywide service onto the backs of city and fire district taxpayers.

Two firefighters, Lt. Scott Sanford of Palm Harbor Fire Rescue and Capt. Jim Millican of the Lealman Fire Department, proposed remaking the system by eliminating the for-profit ambulance company in favor of having firefighters take patients to the hospital. The county administration would still receive its portion as now, but the rest of the ambulance fee would go to the fire departments to offset property taxes and save money. LaSala said the proposal would actually cost more than the current system.

County commissioners agreed last year to pay Fitch about $298,600 to evaluate both plans. They also wanted Fitch to evaluate a hybrid plan that would see firefighters transporting for emergencies only. Non-emergency transport would be done by the private company.

Fitch's draft concluded that the LaSala "model is theoretically achievable but lacks the realistic approach to make it implementable. Pinellas County fire and EMS are not in a state of disrepair that would require such a drastic cut."

The LaSala plan would also increase wear and tear on the vehicles left in the system, it says.

"The mileage traveled by the decommissioned rescues must be taken up by the heavier and more expensive engines and trucks, resulting in increased operational costs," the report says. "In summary, the (LaSala) proposal reduces personnel costs. Increased mileage on heavy apparatus increases operational costs."

Sanford-Millican, on the other hand, would not work because it would place too much stress on firefighters who would be overburdened by the additional work. Changing the plan to hire additional firefighters to spread out the work, the report says, could cost as much as $8.9 million more than the current system.

Millican declined to comment, saying he had not had time to read the draft.

"Both of these … are considered unrealistically high and dangerous,'' the draft says. "The Pinellas EMS medical director has expressed strong concerns related to fatigue from long shift lengths and excessive (workload) as a contributing factor in medical errors."

Anne Lindberg can be reached at alindberg@tampabay.com or (727) 893-8450.

Consultant recommends no major changes to Pinellas EMS system 05/30/13 [Last modified: Friday, May 31, 2013 12:12am]

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