Since January when County Administrator Bob LaSala unveiled his proposal to radically change the way emergency medical services are funded, he and other officials have traveled up and down Pinellas to drum up support for the idea.
But no group has endorsed the plan. That could change this morning when the EMS Advisory Council meets. The council is a 21-member group created by state statute to provide advice about Pinellas' EMS system to the County Commission.
EMSAC will support the proposal if its executive committee has its way. The committee voted last week to recommend that the group support the new funding approach.
Under the current system, the county collects property taxes, which it parcels out to the 18 municipalities and fire districts to provide EMS. Each district receives a different amount depending on the individual costs, particularly personnel. Salaries and benefits for paramedics, the county says, range from $80,000 to $134,000.
In all, the county pays for 62 vehicles, the medical equipment on them and 85 positions. The 62 vehicles could be fire engines or rescue vehicles (the ones that look like ambulances). The 85 positions include three firefighter/paramedics (one for each shift) and the replacements for them when they are ill or on vacation.
Under the proposal, the county would pay for 72 vehicles (all fire trucks), the medical equipment and 72 positions. The county would pay for only part of the fire truck because it's also used for fires. The savings would come from the elimination of rescues, which require two people, as well as lower vehicle cost.
The biggest savings would come from personnel — the county would be paying for 13 fewer positions. And the county would average the salaries of all firefighter/paramedics across Pinellas and give every district the same amount per position. Districts that pay less than the average would essentially make money on the deal. Districts and cities that pay more than the average would have to come up with the excess.
"That's going to be a more efficient model," Assistant County Administrator Moe Freaney said.
Freaney and LaSala say the plan will save money and not affect the "standard" of service, which is a requirement that a firefighter/paramedic respond to a medical emergency within 71/2 minutes 90 percent of the time.
Many fire and city officials are skeptical that the plan will work as advertised.
Currently, the county has 86 vehicles (not including Sunstar ambulances) that respond to medical emergencies. The county pays for 62 of them and the individual cities and districts pay for the other 24.
But under LaSala's plan, 14 of those vehicles could be eliminated — about a 16 percent reduction in the countywide EMS fleet.
At some point, Largo fire Chief Mike Wallace said, "you're going to have a huge vacuum of medical units because they're going to all be tied up at a fire. … How is that not going to impact the delivery of emergency medical services?"
Wallace is head of both EMSAC and the Pinellas County Fire Chiefs Association. He said the 71/2 minute standard was set back in the 1980s while the current system was being set up. It's an artificial number, he said, that had more to do with politics and encouraging fire departments to enter the system than with anything health related. The 71/2 minutes was the average response time of the slowest department in those days.
Nowadays, the average response time for the entire county is four minutes and Wallace said the fire chiefs believe that's the number that's likely to change under the new plan. A longer response time might not matter for a stubbed toe, but for someone having a heart attack, stroke, or other severe trauma, a fast response — five minutes or less — can be the difference between life and death.
Freaney said the county may not lose 14 vehicles. The departments, she said, can always pay for them with local funds. As for the longer response times, dispatching fewer vehicles to nonemergencies will help keep vehicles available for heart attacks, strokes and fires.
But it's going to be harder for cities and districts to fund extra vehicles as the county pushes more expenses onto local shoulders. Wallace said Largo has already decided to eliminate a rescue vehicle in the Ridgecrest area because the city can no longer afford it.
Reach Anne Lindberg at firstname.lastname@example.org or (727) 893-8450.