Pinellas County's Emergency Medical Service is like few others in the nation. Call 911 with a medical problem and even before the scope of your problem is known, rescuers are speeding toward you in multiple vehicles using emergency lights and sirens. While they are in transit, you speak to a paramedic who assesses your condition and decides whether to dispatch more units or call some back. It is a gold-plated system with a price tag to match, and Pinellas can no longer afford it. Today, Pinellas County commissioners are expected to take the first step toward making necessary changes that would balance economic realities with public safety.
County officials project an $18 million gap between costs and revenues in the EMS system in 2009-2010. Top managers from six Pinellas cities and Pinellas County Administrator Bob LaSala have been quietly working on a plan to bridge the gap. The first piece of that plan, priority dispatching, will be voted on today by commissioners sitting as the countywide EMS authority. The change is a prudent first step and would shift emergency medical dispatching from Sunstar, a private ambulance service, to the county's 911 center and would save about $500,000 a year.
While Sunstar uses paramedics to speak to the 911 caller and determine the proper level of response, the county's call takers will not have that medical training. They will rely on a computer software program that directs them to ask certain questions about the medical situation and use the answers to determine how many units to send. A second difference: While units are dispatched now as soon as a 911 call comes in, under the new process units will be dispatched after the call taker gets information about the medical problem. EMS officials say the new process won't delay dispatching of units, but they need to explain that to the public.
County officials reasonably contend that Pinellas' robust emergency response — at least one fire rescue unit and a transport ambulance are sent to nearly all medical calls — is not always required. Priority dispatching will be the first step toward overhauling the system. On March 17, county commissioners are scheduled to vote on other parts of the downsizing plan, including determining the standard response time for medical 911 calls and how many units the county EMS tax will pay for to meet that standard.
It is the declaration of response time standards and funding that most concerns the 19 fire departments that deliver emergency medical services in Pinellas. Cities and independent fire districts have relied on the EMS tax to pay the salaries of some of the dual-trained firefighter/paramedics in their departments. If the county decides all of those people are not needed for EMS calls, the fire departments may have to assume funding of those positions if they want to keep those firefighters.
Economic realities require that the EMS system be streamlined. It needs to be done with careful study, open minds and public input. The goal must be to ensure consistent, reliable and effective emergency medical service to Pinellas residents — at a more reasonable price.