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Column: Making the Pinellas EMS system less costly, more efficient

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The Pinellas County Emergency Medical Services system is nationally and locally recognized for its excellence. In fact, it is known as one of the most clinically sophisticated in North America. Our complex system uses both public fire departments and a private ambulance company, and it has served us well since 1981. But as technology, medicine and communications efficiencies have progressed, our EMS system has not kept pace. The system has become bloated by unrestrained spending that serves to significantly threaten its financial and long-term sustainability.

In 2009, the county began examining this situation and started negotiating with the cities, their fire departments and the fire districts. In 2012, we hired a team of well-respected international experts and conducted an in-depth study on our EMS system, including whether the county should change its system from private ambulance transport to allow the fire departments to do all medical transport. It is important to remember that Pinellas County will continue to spend more than $38 million annually in emergency medical services, the highest level per capita nationwide. It is also important to remember it is the cities' responsibility to pay for fire services.

We insisted on an inclusive process. Our experts worked closely with the city fire departments and districts. With their input and information, the experts used a sophisticated computer model to generate a thorough analysis of the operation of our EMS system. The study found that our system should remain fundamentally unchanged — with the exception of improving efficiencies and reducing unnecessary costs. In support of that finding, the study pointed to extensive overstaffing of the EMS system. The overstaffing and unnecessary EMS costs were calculated to be $2.3 million annually in taxpayer dollars spent by the county.

The analysis also found there are too many fire department first responders working overnight. The study noted that peak demand is actually two to three times higher during the day and early evening hours, and we simply don't need the same number of first responders in the middle of the night. In fact, in the absence of traffic, emergency responders can travel further more quickly. The study also found that eliminating this overnight inefficiency would still allow the system to meet its same high level of service.

Next, we studied how to fairly and appropriately recapture that annual $2.3 million in taxpayer spending from the 18 communities and districts in our system. The county and its expert team methodically examined all of the fire department and EMS budgets and staffing to determine which fire departments were over capacity and which were not. Of those 18 communities and fire districts, we found that only five communities were overstaffed during the night shift. We also learned that of the $2.3 million in excessive spending, nearly $1 million of that occurs with overstaffing in St. Petersburg. The remaining $1.3 million is spread among Clearwater, Largo, Pinellas Park and Lealman.

In fairness to all of our communities, the County Commission has provided direction that each of those five will have county funding reductions. Those reductions will be allocated proportionately to the level of their current overstaffing. The reductions will be phased in over three years to allow for attrition and fiscal planning.

The remaining 13 communities with EMS funding will remain the same or be increased to ensure they are able to maintain our level of service. In the spirit of teamwork, Sunstar Paramedics, the private ambulance company, also agreed to a $2.5 million reduction in their funding.

Of course, we understand that no one likes to face a reduction in funding. But our job is to make the tough decisions, and to view every issue from the best interests of the broad community and taxpayers. Last year, the commission unanimously rejected a property tax rate increase for EMS and instead favored developing a fair and financially sustainable approach to our system.

We have been laser focused on creating efficiencies, implementing cost containment and "right sizing" the EMS staffing needs for all of our citizens. We will now be able to balance our EMS budget and to fund our reserves appropriately.

Today, we stand together with a plan that will continue to rein in the escalating costs of the system and treat both our taxpayers and our community's fire departments and districts fairly and reasonably. Most importantly, our citizens will continue to receive the same high level of service Pinellas County has always provided to them.

Karen Seel is chair of the Pinellas County Commission.

Column: Making the Pinellas EMS system less costly, more efficient 04/04/14 [Last modified: Friday, April 4, 2014 1:30pm]
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