The debate on how Pinellas County can get a handle on rising costs for the emergency medical services system has made its way into the race for the at-large County Commission seat.
Two of the candidates, incumbent Norm Roche and challenger Ed Hooper, an outgoing state representative and former firefighter, are facing off in the Aug. 26 Republican primary. The winner will face outgoing Largo Mayor Pat Gerard, a Democrat, in the Nov. 4 general election. They have all staked out distinct positions on the EMS question.
The debate over EMS has become heated at times between Hooper and Gerard, and began earlier this year.
Hooper proposed a hybrid plan that, among other things, would allow fire departments that have transport-ready vehicles to take patients to the hospital. Under the current system, all medical transport is done by a for-profit company that contracts with the county to provide the service. Fire departments are banned from transporting, even if they have transport-capable units, except in rare circumstances.
"The county pays a pretty good lick for all those rescue trucks that can't transport," Hooper said. The situation is that "we're going to buy this nice new vehicle but not use it for what it's (designed) to do. That doesn't make any sense."
Fire departments that have no transport-capable vehicles and no desire to transport still would rely on the private ambulance company. In those cases, he said, the ambulances would be stationed at fire stations, where the paramedics could stay until sent on a call. As things are now, ambulances are moved around the county and can be seen at convenience stores and other places waiting for a call. The ambulance paramedics sit in the vehicle with the engine on and air conditioner running while they wait.
Allowing those paramedics to relax at stations until they're needed provides "a better quality of life for those ambulance employees," Hooper said. There would also be savings in gas, and less wear and tear on the ambulances. And because fire stations are located around the county, response times would not be affected.
Roche also favors fire transport, but he sees it as an "all or nothing" proposal. Either all departments transport, he said, or no department takes patients to the hospital.
Hooper's proposal, he said, would bring back the problems of the past, when fire departments refused to serve anyone but their own citizens. The end result would be "haphazard transport," he said.
"I think it's flawed," Roche said of Hooper's plan. "Going backwards is not the right path to move forward."
Gerard said she believes the issue is "much more complicated than either side, certainly the fire side, talks about."
One complicating factor, she said, is the way the ambulance side of the system is financed. Paramedics Plus provides both emergency and nonemergency transport. Nonemergency transportation involves taking patients from one hospital to another, to a doctor's office or even out of county to another medical center. The county bills for both emergency and nonemergency transport, but Gerard said she believes the bulk of the revenue comes from nonemergency transport.
"I don't see our fire people doing that," Gerard said. That means fire would transport emergencies and the private ambulance company would continue to be in charge of nonemergency transport. But the finances of that would likely make the system unsustainable, she said.
The contract with the ambulance company is up next year. So it's likely that whoever wins the seat will vote on whether to renew the contract. If the county could "strike a decent deal with them, I would have them stay," she said.
Contact Anne Lindberg at firstname.lastname@example.org or (727) 893-8450. Follow @alindbergtimes.