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St. Pete threatens to pull out of EMS if funding cuts okayed

ST. PETERSBURG — Mayor Bill Foster says he wants to work out differences between the city and the county over emergency medical services funding, but, if all else fails, St. Petersburg will leave the system.

The city's departure could take one of two forms. If the county grants the city permission to transport patients, then St. Petersburg could form its own EMS system. If the county won't grant transport, the city could leave it up to the county to run EMS calls.

"I hand them the keys to the city and I'm out," Foster said. "I'm out of the medic business and I can focus on fire."

Foster made his comments Wednesday to the St. Petersburg Times editorial board. He was accompanied by city administrator Tish Elston and fire Chief Jim Large.

Pinellas County Administrator Bob LaSala said he had an agreement with St. Petersburg City Council chair Jim Kennedy and Elston to do nothing to "inflame" the already tense situation before Oct. 31. That's when the City Council and County Commission are scheduled to meet to try ironing out their differences. LaSala said he intended to stick to that agreement.

"I think anything I would say about that at this point would contradict that commitment," LaSala said.

"I will say this,'' he added. "There is a vast amount of data that speaks to these very issues — whether it is cost, call volume, implementation of new procedures, alternative ways of doing business — that have been studied, reviewed and will be discussed again. I think that all goes to the mayor's concerns and points of view. After that meeting, we can discuss this further."

LaSala, who says the EMS system is facing bankruptcy in 2013, has proposed changing the way the county determines the amount of money it gives to the 18 cities and fire districts that provide the service. LaSala suggests cutting personnel, eliminating rescue vehicles — the ones that resemble ambulances — and funding all firefighter paramedic positions at the same rate no matter their actual salary and benefits. LaSala has said if the districts and cities want to pay their firefighter paramedics more, use rescues, or have more staff, they can pay for those things themselves.

LaSala says service levels will remain the same despite the reduction in paramedics and emergency medical vehicles. Response times, he says, will stay within the county standard of having an emergency vehicle arrive within 7½ minutes 90 percent of the time.

Fire and other officials have argued that LaSala's plan will push countywide EMS costs onto the shoulders of local taxpayers. And, they say, service will suffer with fewer paramedics and vehicles available. In particular, they say, the 4½-minute average response time will be longer.

Foster agreed with those criticisms. The LaSala plan would give St. Petersburg $5 million in funding rather than the approximately $12.4 million it currently gets. Foster said LaSala has refused to budge when the two discuss the issue.

"There's been no wiggle room," Foster said. "I can't provide any level of service for $5 million and neither can they."

That big of a cut would mean losing paramedics from the St. Petersburg department. The result, said Foster and fire Chief Large, is that EMS response will take about a minute longer than it now does. Foster said that's bad not only for people suffering from extreme emergencies like strokes and heart attacks, but also accident victims. Those patients will be in pain longer.

"Lifesaving is one element, but pain mitigation is another service we pay for," the mayor said.

He and Large criticized the county's plan to send only ambulances to lesser emergencies for the same reason. It doesn't save money, they said, because the firefighter paramedics are still in a fire station being paid. And, the ambulance will be allowed a longer time to get to those lesser emergencies than the fire department would be. Again, Foster said, it's all about suffering.

"Why make you lay there for 20 minutes when we're right down the street?" he asked. "The idea that somebody has to be in excruciating pain for 20 minutes (is unreasonable)."

Foster said the city has cut costs and has offered several times to do more, such as absorbing some pension costs and providing fire transport. St. Petersburg and Pinellas Park have both offered to run pilot transport programs at no expense to the county to see if they work, but the county has refused.

The county is being contradictory, he said, because it does not want to adequately fund the city's EMS program but it doesn't want St. Petersburg to leave the system. Foster said he thinks that's because St. Petersburg brings in so much money to the county in ambulance transport fees, which are paid by those who use the system.

"We're too expensive to keep, but we're too expensive to let go," he said.

Despite the differences, Foster said he is optimistic that some middle ground can be reached. If not, St. Petersburg can ask the courts for help. But if all that fails, St. Petersburg will leave the system.

"At the end of the day, if you want St. Petersburg in the system, fund us," he said. "If we're such a burden, let us go."

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

St. Pete threatens to pull out of EMS if funding cuts okayed 10/22/11 [Last modified: Saturday, October 22, 2011 4:31am]
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