ST. PETERSBURG — This city could bring in millions of extra dollars if it pulled out of the countywide emergency services system and let firefighters take patients to the hospital, concludes a St. Petersburg-sponsored study.
"We aren't saying that we think the best option is for us to go our own way," St. Petersburg city administrator Tish Elston said. "Our last option would be for us to separate ourselves from the system. I hope that's not necessary."
It's unclear what the effect would be if St. Petersburg did pull out of the EMS system. At least one fire chief says it could bring the system to its knees. Paramedics Plus, the private company that provides ambulance service for the county under the name Sunstar, might not stay if its profit margin drops. And some smaller departments do not have the capability to provide transport.
"I've always said if St. Pete pulls out, the deck of cards crumbles," Largo fire Chief Mike Wallace said. "What's left would not be financially viable."
One possibility is that "the system simply fractures and goes back to the pre-1985 world where every agency fends for themselves," Wallace said. "I think we're going to be in for interesting times."
Palm Harbor fire Chief James Angle disagreed, saying that as long as St. Petersburg continued to provide mutual aid and participate in other ways, the changeover to firefighter transport would not bring down the system.
"I think the system could work with firefighter transport," Angle said.
Mark Postma, the chief operating officer of Paramedics Plus, declined to comment about his company's reaction should it lose the revenue from St. Petersburg's 39,574 emergency transports.
"I think that's a hypothetical question," Postma said. Paramedics Plus has a contract with the county until 2015, and "we're going to continue to honor our contract as the ambulance provider."
Postma also criticized the results of the St. Petersburg study, saying, "it's pretty clear who paid for the report."
Under the county's current system, fire departments are the first to be called to medical emergencies. It's the job of firefighter/paramedics to get to a scene quickly and administer preliminary medical help. A Sunstar ambulance also is called so its paramedics can take over from firefighters and take the patient to the hospital. The idea is to get firefighter/paramedics back on the road quickly rather than keep them tied up at hospitals.
Firefighter/paramedics are paid out of a countywide property tax. Sunstar paramedics are paid by user fees — mostly Medicare, Medicaid and private insurance. Paramedics Plus, the ambulance company, gets $218.40 per emergency transport. With a base price of about $521 per emergency transport, that leaves the county with about $303.
St. Petersburg and its firefighters have long argued that it would be better for firefighter/paramedics to take patients to the hospital in emergencies.
The county questioned St. Petersburg's conclusions about the amount of money that can be saved. Last December, the city hired TriData Division of System Planning Corp. to "independently validate" its staff analysis, Elston said. The city paid the company $37,000.
Coincidentally, Pinellas County hired a different company, Integral Performance Solutions, to study the entire EMS system. The results of that study, which cost $130,000, are due in January, County Administrator Bob LaSala said.
The St. Petersburg study came up with three options for the city:
• Leave things as they are. That, the study says, is an "easy but ineffective solution."
• Tweak the system so that St. Petersburg is allowed to do emergency transport and receive "increased stipends."
• Leave the system and take over EMS transport.
If St. Petersburg were to choose the third option, the study estimates the city would bring in between $4.32 million and $10.45 million per year in addition to the $12.5 million it receives from the countywide property tax. The actual amount would depend on several factors, including who bills the patients. If St. Petersburg took over billing, the projected revenue is higher than if the county continued sending bills.
But it's unclear whether the figures add up because the report appears to contradict itself regarding costs and personnel. At one point, it says three more rescue vehicles will be needed as will "35 additional (full-time employees) at an approximate cost of $2.5 million." Elsewhere in the study, a chart indicates the city is short 29 people should the change take place. In yet another place, the study says the "cost to add 23 additional personnel is approximately $2.5 million annually."
The study also appears to contradict information St. Petersburg gave the county when asking for funds. The study indicates that fringe benefits (insurance, retirement, etc.) would add about 40 cents for each dollar of salary. In other words, a firefighter/paramedic salary of $59,176 annually would actually cost taxpayers nearly $83,000.
But St. Petersburg told the county that it costs an additional 87 cents for each dollar of salary to pay for fringe benefits. Using that figure, the actual cost of a firefighter/paramedic with a $59,176 annual salary would be $110,659.
Steve Knight, St. Petersburg's rescue division chief, said the information is confusing. The consultant did not make clear that he was pricing different levels of transport — whether the city provided all transport or simply emergency transport.
If St. Petersburg provides only emergency transport and leaves the nonemergency transport to Paramedics Plus, it would have to add three more rescue vehicles and 23 employees at a cost of about $2.5 million, Knight said. The apparent contradiction in the salary/benefit information, he said, arose because the consultant took an average across the board.
Reach Anne Lindberg at [email protected] or (727) 893-8450.