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Consultant suggests changes in EMS subsidy

Preliminary study suggests funding changes

A consultant has suggested that Pinellas County change the way it funds the emergency medical services system. The proposed change would see the county paying for fewer paramedics. The chart below shows the effect of the change at two different staffing levels.

Department Current Funding Funding using 3.6 paramedics Difference Funding using 3 paramedics Difference
Clearwater 5,067,389 4,176,700 (890,689) 3,543,100 (1,524,289)
Dunedin 1,319,990 1,139,100 (180,890) 966,300 (353,690)
East Lake 1,236,536 1,139,100 (97,436) 966,300 (270,236)
Gulfport 415,210 379,700 (35,510) 322,100 (93,110)
Largo 4,238,640 3,797,000 (441,640) 3,221,000 (1,017,640)
Lealman 2,224,053 1,518,800 (705,253) 1,288,400 (935,653)
Madeira Beach 362,622 379,700 17,078 322,100 (40,522)
Oldsmar 385,932 759,400 373,468 644,200 258,268
Palm Harbor 1,819,746 1,898,500 78,754 1,610,500 (209,246)
Pinellas Park 2,961,321 2,278,200 (683,121) 1,932,600 (1,028,721)
Pinellas Suncoast 969,501 1,139,100 169,599 966,300 (3,201)
Safety Harbor 914,683 759,400 (155,283) 644,200 (270,483)
Seminole 2,031,427 1,898,500 (132,927) 1,610,500 (420,927)
South Pasadena 710,173 379,700 (330,473) 322,100 (388,073)
St. Pete Beach 1,118,241 759,400 (358,841) 644,200 (474,041)
St. Petersburg 12,544,738 4,556,400 (7,988,338) 3,865,200 (8,679,538)
Tarpon Springs 899,739 759,400 (140,339) 644,200 (255,539)
Treasure Island 401,286 379,700 (21,586) 322,100 (79,186)
Total 39,621,227 28,097,800 23,835,400
Source: Preliminary EMS report, Mic Gunderson, Integral Performance Systems


A consultant who spent a year studying the county's emergency medical services system is proposing a radical shift in the way Pinellas divvies up tax money among the fire districts.

That change, says Mic Gunderson, could save countywide taxpayers up to $15.8 million a year, but most fire districts would see a drastic drop in money from the county. That could force cities and fire districts into some uncomfortable choices, including raising local taxes and laying off firefighters.

Hardest hit would be St. Petersburg, Clearwater, Largo, Pinellas Park and Lealman. St. Petersburg, for example, could lose up to $8.7 million annually in county funding; Clearwater up to $1.5 million.

"Keeping the (funding) status quo in place is not sustainable," Gunderson wrote in his preliminary report. "It also fails to address the inequities in funding between departments."

Pinellas County Administrator Bob LaSala said raising taxes or eliminating jobs is a possibility but not necessary if the districts are creative. That could include partnering with other districts or positioning units more efficiently.

"They have to reconfigure how they do business. There is opportunity for innovation and creativity in terms of how to meet the standards," LaSala said. "There are options. It is not simply, well, we pay more money or we fire firefighters."

Pinellas officials hired Gunderson's Integral Performance Systems in 2009 to study the $72.2 million EMS system because of spiraling costs. The county agreed to pay Gunderson $130,000 for the study, which originally was due last July.

The change in funding is the main recommendation in Gunderson's 86-page preliminary report. Among other recommendations and findings:

• Leave the basic structure of the EMS system as is.

• The 911 system should be studied with an eye toward making it more efficient.

• The current method of funding EMS is unfair and unequal among the fire districts.

• The ambulance system is running well overall, as is county billing for such services. No major changes should be made.

• Firefighter transport of patients to hospitals is not an option because it is more expensive than the current system, in which patients are transported by Sunstar ambulances, and would be less efficient.

• The countywide EMS tax should not be increased because the service can be provided within the existing funding and that "would not resolve underlying problems."

The meat of Gunderson's report regards proposed changes to the way the county pays fire districts to provide EMS first-response service.

The firefighter paramedics and emergency medical technicians use fire engines and rescue vehicles to answer calls. A rescue is the boxy vehicle that resembles an ambulance. Currently, the county pays for most of the rescues in the county and for the two paramedics that ride in them. The county also pays some districts for one paramedic who rides on a fire engine.

Funding the engine is less expensive for the county because it involves only one paramedic position and part of the vehicle costs rather than two paramedic positions and the entire vehicle cost. A paramedic position is equivalent to three paramedics — one for each of the three shifts.

Under Gunderson's plan, the county would pay only for one paramedic position on each of the 64 units it already funds. It would also take over the funding of one paramedic position on another 10 EMS units the districts now fund. If a district wants a rescue vehicle with a second paramedic, it would have to find the money elsewhere.

The districts are currently paid about $38.2 million a year. Gunderson's proposal would reduce that to an estimated $23.9 million to $28.1 million.

Those kinds of savings for countywide taxpayers mean less money for most districts. But some districts — Oldsmar, Madeira Beach, Palm Harbor and Pinellas Suncoast — could gain more county funding. Oldsmar stands to gain as much as $373,468 annually.

Clearwater City Manager Bill Horne said there are a number of things his council could do to avoid raising taxes or eliminating jobs. Deciding that will require a conversation with his firefighters and council.

"Let's have a countywide conversation around the study. Let's talk about it. Let's evaluate how we feel about this," Horne said. "Clearly, this study gives all of us a chance to evaluate how we meet our EMS needs from top to bottom."

That's just want LaSala wants to do.

Gunderson recommended that the new funding be implemented beginning Oct. 1, 2012, less than two years away.

Can that deadline be met if the County Commission decides to adopt the proposal?

"I think we have a compelling need to do what it takes to implement this program if it's the will of the County Commission and many of its partners," LaSala said. "Yes, it can be done."

Reach Anne Lindberg at alindberg@tampabay.com or (727) 893-8450.

.Fast facts

If you're interested

County Administrator Bob LaSala will give a presentation regarding the preliminary report to the County Commission at its Tuesday meeting. The meeting starts at 3 p.m. at the Pinellas County Courthouse, 315 Court St., Clearwater. The meeting can be watched live on Bright House Channel 622, Knology Channel 18 or Verizon Channel 44. It also can be watched live on the Internet by going to pinellas

county.org/tv. A video recording of the meeting will be available for viewing by computer at pinellascounty.org/tv/

totallist.htm.

Consultant suggests changes in EMS subsidy 01/22/11 [Last modified: Saturday, January 22, 2011 3:31am]
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