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Ambulance company ruled by cash, not kindness

Zebulon Osborne, contract manager for Florida Regional Emergency Medical Services of Mount Dora, recently expressed dismay and concern that his private, for-profit ambulance company was being criticized in letters to the editor. Osborne implies that his critics base their opinions on inaccurate information and are "misleading" the public.

Osborne himself purposely omits facts and misleads by indicating that his company is based on the "religious principle of helping others." Make no mistake about it: Florida Regional's chief religious principle is the generation of revenue.

Osborne indicates that his company's base rate of $242 with no in-county mileage charge would be a bargain for Citrus County, whereas the county-run EMS charges a $230 base rate with a $4 per-mile charge.

But he omits the fact that Florida Regional charges $6 per mile for out-of-county mileage, and charges for about a dozen procedures that are offered for free to the residents served by Citrus County EMS and the Spring Hill Fire and Rescue District.

Those exorbitant charges include $50 for a foam collar, $15 for every drug administered and $240 for a bogus procedure termed "critical care." Neither Citrus County nor the Spring Hill Fire and Rescue District charge for the above items, and their rates for intravenous lines, airway management and many other procedures average less than half of Florida Regional's.

Florida Regional's most outrageous charge, however, is $20 for what it terms "personal protection equipment." Paramedics in Spring Hill and Citrus County must be simpletons, because we call this procedure "putting on latex gloves." They are the same gloves that anyone can buy in a hardware store for 59 cents a pair. We pay under 10 cents a pair and charge nothing. Florida Regional should just include this $20 rip-off in their base charge, since gloves are worn on every call.

Was it Florida Regional's "religious principle of helping others" that assisted the company in developing this creative rate structure? Did a voice from above say, "Call it "personal protection equipment,' and they will pay?"

Osborne also intentionally misleads when he quotes Hernando's subsidy of $4.27 per capita, which is what each resident pays to subsidize his ambulance service. He conveniently omits the fact that his per capita math uses all of Hernando's 100,000-plus population, even though it only serves under 50 percent of that population. His true figure is closer to $10 per person when it is correctly figured with those residents outside the Spring Hill Fire and Rescue District.

Even with these exorbitant charges, and a higher Medicare reimbursement rate than the public services because of a very questionable practice of calling itself "hospital-based," Florida Regional still manages to claim it loses money _ and lots of it _ every year.

Since Florida Regional charges much higher fees to patients, gets higher reimbursements from Medicare, saves money with fewer employee benefits _ such as pensions and vacations _ than public EMS services, how can it possibly show staggering losses each year? It enjoys all the above and still gets large county subsidies (over $500,000 in Hernando and $900,000 proposed in Citrus).

The corporate name of this company, affiliated with the Seventh-day Adventist Church, has changed about eight times in as many years. It promises the moon but loses money. Yet county commissioners in Citrus and Hernando swoon to its defense. Why are they so enamored? Where are the profits going? How can a 20,000 percent markup on a 10-cent pair of gloves result in losses?

If there are profits to be made, why are they going to Mount Dora? What happened to the "Shop Hernando" initiative? Spring Hill enjoys an excellent reputation for EMS service; they are the hometown boys. Yet they were never even offered the opportunity to bid. Florida Regional's three-year contract was quietly extended a full year before it was due to expire.

In Citrus County, the commissioners authorized a study of Florida Regional's proposal by a health planning think tank considered experts. But when the conclusion reached didn't agree with the one that four of the commissioners wanted, they called the study invalid. When local paramedics proposed nearly $400,000 in cuts to their own budget, almost equaling Florida Regional's proposed savings, the medics were told their plan was flawed. When 4,000 people signed petitions to keep their EMS, they were ignored. A poll by a local newspaper revealed that 90 percent of the respondents were in favor of public EMS, but that also was ignored.

Proposals for a referendum to decide the EMS issue in November were termed "too complicated" to be explained on the ballot. But the same four Citrus County commissioners later pursued placing another issue on the ballot: whether to waive impact fees to attract industry. That's an easier issue for the voter to understand, right?

Could the fact that the hometown paramedics in both counties are unionized be a factor in why they are ignored? Perish the thought, because that would be illegal.

Citrus and Hernando counties have experienced similar growing pains over the years, as well as one other distinct similarity: The politics in each has smelled for a long time.

Kevin P. Mulligan is president of the Citrus County Professional Paramedic Association, Local 3251, IAFF. He lives in Floral City. Guest columnists write their own opinions about subjects they choose, which do not necessarily reflect the views of this newspaper.