Two local legislators are proposing a state law that would force the county to use firefighters to take patients to the hospital.
The bill would require the county to run its emergency medical services system according to a plan developed by two firefighters, Lt. Scott Sanford of the Palm Harbor Fire Department and Capt. Jim Millican of the Lealman Fire Department. Among other things, the bill would hand firefighters a monopoly in non-emergency transport — taking patients from nursing homes to doctors' appointments, for example.
Both emergency and non-emergency patients who use the ambulance would be billed for the service, as they are under the existing EMS system. In that system, patients are transported by a private company.
County officials and others say the proposal oversteps the Legislature's bounds by imposing a detailed plan on the county. They also say the plan doesn't work and will end up costing Pinellas taxpayers more money.
"At the end of the day, we will need Legislative help (but) let us work with the cities and fire districts to (find) a solution rather than imposing one," Pinellas County Commissioner Ken Welch said.
State Rep. Ed Hooper, R-Clearwater, one of the bill's sponsors, said he's just trying to help that process along. Everyone's been talking for 15 years, he said, but no one ever reaches an agreement.
"It's just amazing how long this has been ongoing," Hooper said. "They'll either start talking or they'll let fire departments do transport."
Pinellas' EMS system is currently set up so that, in most cases, when someone dials 911 for medical help, they get both a firefighter/paramedic and a Sunstar ambulance with a paramedic. The system is designed to have the firefighters get there first and provide immediate help. The ambulance arrives later, takes the patient to the hospital and provides help on the way.
The public side of the system is basically paid by a countywide property tax. The ambulance side is paid by user fees, mostly from tax-funded Medicare and Medicaid programs and private insurance.
County Administrator Bob LaSala has said the system is too expensive and is facing bankruptcy in 2013. He has proposed changing the formula for funding the 18 fire districts that provide EMS service. He and the County Commission have asked the Legislature to pass a law allowing them to make that funding change.
Firefighters, on the other hand, have charged that the system has a built-in delay that prevents patients from being taken to the hospital as quickly as possible. The delay, they say, is in the wait for the Sunstar ambulance. They say that could be cured if they transported patients. And, they say, having firefighters transport patients would cost less.
The Sanford-Millican plan is one of two firefighter transport plans that have been submitted to the county. The plan is incorporated by name into the proposed legislation, which is co-sponsored by state Sen. Jack Latvala, R-Clearwater.
Latvala is also sponsoring the county bill that would change the funding method. His co-sponsor on that bill is state Rep. Peter Nehr, R-Tarpon Springs.
Latvala declined to comment on his apparent support of two contradictory bills. He said, through an aide, that he is sponsoring both as a courtesy to opposing sides in the EMS debate "to get the issue before the delegation. I have not taken a position on either bill."
The Latvala-Hooper bill has caused the most comment.
It "takes out of the commission's hands the ability to decide what's best and most cost effective," assistant county administrator Maureen Freaney said.
Welch said the commission is in the best position to know what will and won't work in Pinellas.
"We're on the ground," he said. "We know what's happening."
The apparent attempt to micromanage the EMS system may cause legal problems, assistant county attorney Bob Swain said.
"If this passed, it would be a mess,'' Swain said, "and certainly some litigation would come out of it."
To make matters worse, they say, the bill provides no financial help from the state.
"This is the ultimate in the pre-emption of home rule," St. Pete Beach City Manager Mike Bonfield said. It makes "management decisions of how we operate. Again, with no money."
Tim Caddell, city spokesman for Pinellas Park, said his city is taking a middle ground. The City Council recently voted to endorse the idea of firefighter transport but specifically refrained from supporting any plan. Caddell noted that firefighter transport works in other areas as do other systems. Pinellas Park, he said, believes those other concepts should be considered. They may not work in Pinellas. But they might.
"We're saying take the time, figure it out, find out what works in this area," Caddell said. "But the firefighters' version of this, which was offered in good faith as an alternative to the LaSala plan, should be looked at and it's been dismissed out of hand."
Welch said he's in favor of looking at other ideas. Sanford and Millican are scheduled to present their plan to the commission during an Oct. 25 workshop just before members meet with the Legislative Delegation.
"I agree that everything needs to be on the table, but you need an unbiased fiscal analysis," Welch said.
That analysis has to demonstrate that any plan under consideration will solve the system's financial woes, he said. Fire transport "in its current form" does not do that.
Reach Anne Lindberg at firstname.lastname@example.org or (727) 893-8450.