When Pinellas County commissioners meet Friday to consider further changes to the countywide Emergency Medical Service system, they will face predictable protests from those who deliver EMS service — city governments and fire districts that complain the changes may lengthen emergency response times and create new inequities in the system. While county commissioners should listen, they should remain focused on streamlining Pinellas' expensive and redundant EMS system.
The countywide system was established by the Legislature and county voters in the 1980s to ensure EMS services were uniform throughout the county. The County Commission, as the EMS Authority, contracts with 19 city fire departments and independent fire districts to provide Advanced Life Support first responders to all emergency medical calls. The county also contracts with a private ambulance company known as Sunstar to respond to those calls as well and transport patients to hospitals. The system produces exceptionally quick response times. But it also creates unnecessary duplication for many calls, and it is too expensive in an era where government has to deliver services more efficiently.
With an $18-million gap between expenses and revenues projected for the 2009-2010 EMS budget year beginning Oct. 1, county commissioners finally are moving aggressively to overhaul the system. Earlier this month, they approved a change in 911 dispatching that may result in fewer units being sent on some calls. Friday, commissioners are scheduled to vote on two EMS-related resolutions.
One resolution seems noncontroversial on the surface. It would formally set the level of service the 19 fire departments must achieve: a response to 911 emergency calls within 7 minutes 30 seconds 90 percent of the time, which is the current standard. Because the response time is even quicker now in some areas, the county has proposed repositioning some equipment and manpower, and that concerns fire officials.
A second resolution lists pages of new criteria the county will use to determine the cost of delivering EMS first responder services. For example, for the first time each of the 19 fire departments will be required to submit a line item budget for their county-funded EMS work. Departments also will be required to return any unspent money to the EMS Authority. Some fire departments have used countywide property tax dollars meant for EMS to subsidize their firefighting operations, and that is inappropriate. These changes would enable taxpayers to see more clearly how their tax dollars are being spent.
The cities argue they have had little time to grasp the impact of the proposed EMS changes on response times and city budgets. Some want Friday's vote delayed so they can research those issues. Some want county commissioners to instead raise the countywide EMS tax rate now set at .58 mill (it can go as high as 1.5 mills) to cover the upcoming shortfall and spend next year developing a new EMS plan. There already has been plenty of talking; it is time to take action.
Raising the EMS tax would be a short-term fix that would not address the fundamental issue. Pinellas' EMS system sets the gold standard for response times, but it is inefficient and too expensive. While the economic recession is painful, it also creates opportunities to make tough decisions that were avoided as long as tax revenues kept rising. Unless credible evidence is presented that public safety would be jeopardized, the County Commission should move forward Friday.