Pinellas County has made a good start this summer on cutting the cost of its Emergency Medical Service system. Now the county must push forward to the next step: finding a new model that is the right size at the right cost for Pinellas' unique needs and today's economic realities. Next year's budget season promises to be tougher than this one; by the time it arrives, the county needs to know its options.
The County Commission, which is the countywide EMS authority, and the 19 municipal and district fire departments that provide first responders to all medical calls, have been embroiled in a power struggle this year because the county insisted on cutting costs rather than raising the EMS tax. County officials wanted the number of rescue units and paramedics reduced slightly in some fire departments. Fire chiefs contended the cuts would increase response times and put the public at risk. St. Petersburg even filed a legal motion to try to compel the county to pay whatever it costs for the city to provide paramedics.
The relationship between the county and St. Petersburg has been toxic for several years, but last week the county and city announced they had reached agreement in principle on their EMS issues. It is appropriate that each side gave some ground to reach the one-year accord. The city agreed to drop its legal action and avoid the expense of a court battle. The city refused to eliminate the rescue units the county wanted cut, but it did agree to cut three administrative positions in the fire department and use up to $450,000 of its own EMS reserve funds to help cover the cost of keeping the units. That is not a long-term solution, but it allowed the county to save just over a million dollars on its contract with St. Petersburg.
The county had faced an $18 million shortfall in its 2009-2010 EMS budget. It has now erased that shortfall with a combination of tactics, among them improving collection of ambulance bills, reducing the cost of its contract for SunStar ambulances, cutting funding for rescue units in some fire departments, pulling several million dollars from EMS reserves, and getting an unexpected lift from higher Medicare reimbursements.
The EMS tax rate will remain the same, 58 cents for every $1,000 of taxable property value. Because of declining property values in Pinellas, the tax will raise about $5 million less next year than it did this year.
Curbing 2009-2010 costs is merely the first step in a process that will be lengthy and controversial. County commissioners plan to hire a consultant to study Pinellas' dual response EMS system from top to bottom and recommend ways to restructure it so it will cost less. To encourage cooperation, the county should get input from the cities and fire districts in writing the criteria that must be met by consulting firms vying for the job. And it is essential that the county hire a firm that is a national expert in the field but free of ties to the fire service that could result in its objectivity and findings being questioned.
Some fire departments remain unhappy with the county's aggressive cost cutting, but it appears the county and its cities and fire districts will weather this year's crisis. Pinellas County's EMS system has redundancies and is too expensive for the long term. Change must come, and all of the local governments need to put forth their best effort to make it work.