Here's even more evidence that Pinellas County's emergency medical service system has long needed revamping: Some fire departments that provide emergency medical service may have been misleading the county about how much the service costs, but the county wouldn't know it because audits of the departments' spending weren't required. Such lax oversight may have contributed to the high cost of Pinellas' dual-response EMS system. The county is working to increase accountability and bring down costs, but it isn't getting the cooperation it should from all EMS providers.
A special report last Sunday by St. Petersburg Times staff writer Anne Lindberg called attention to a history of inadequate financial oversight by the county and a lack of financial transparency by some fire departments. Neither side, it appears, kept accounts in a way that assures taxpayers that their EMS tax dollars have been spent only for EMS.
In 1980, Pinellas County voters agreed to pay a special tax for a countywide EMS system. The county collects the tax and pays 18 municipal and independent fire departments to provide the paramedics and equipment for Advanced Life Support first responder service. Since each fire department has its own equipment needs, pay scales and union contract to consider, the contract with the county didn't pay a set amount for the service, but instead attempted to cover each department's actual EMS costs.
Until recently, the county just took each department's word for what it spent and wrote the check. That laissez-faire attitude changed when the economy tanked, EMS revenues no longer paid all the bills and rumors spread that some fire departments were using the county EMS money to cover other costs that should have been borne by city taxpayers.
Starting with this year's budget, the county began requiring departments to be more accountable. They had to fill out a line-item budget for their EMS costs. It was a reasonable requirement that should have been put in place when the system was created.
But some departments have been less than cooperative, failing to identify the county-paid paramedics by unique employee number, as the county requested, or providing information in a way that made tracking spending difficult. In cases where numbers were provided, some departments appear to have charged the county more for paramedic salaries than those paramedics actually were being paid.
Since the county has not made a habit of auditing the departments' EMS spending through the years, county officials don't know what is accurate and what isn't. The county also didn't require the fire departments to return unspent EMS money at the end of the year, leaving an avenue for departments to quietly use leftover EMS funds for non-EMS items.
County Administrator Bob LaSala, hired in late 2008, deserves credit for pushing for more accountability in the EMS system. He was backed by county commissioners, who had to use reserves to balance the EMS budget last year and face another big shortfall this year. The line-item budget was a good first step toward more accountability. The county also will require each department to get an outside audit of its EMS spending and may ask that unspent EMS funds be returned, as they should be.
Public officials owe taxpayers transparency and accountability in the spending of tax dollars, but some Pinellas fire departments appear to be trying to avoid that obligation. That's inappropriate and shortsighted. With tax revenues falling and EMS budget gaps looming, all EMS providers should understand it is smart to be able to prove that every dollar was spent wisely and as voters intended.