County Takes First Step Toward EMS Budget CutsBy Carl Wagenfohr CLEARWATER - The Pinellas County Board of Commissioners, sitting as the county EMS Authority, adopted two resolutions last Friday that began the process of reducing county funding of Emergency Medical Services (EMS) provided by the county's 19 Fire Districts and municipal Fire/Rescue Departments. But it did so in the face of universal opposition by those in attendance, including citizens, city elected officials, fire chiefs and firefighters/paramedics. The county was seeking to establish, for the first time, a county-wide Level Of Service (LOS) for EMS first responders, the paramedics that provide onsite treatment for the victims of medical emergencies. County Administrator Bob LaSala described that LOS as a county-wide response time averaging 4 minutes 30 seconds, and not exceeding 7 minutes 30 seconds 90-percent of the time. "We have received a lot of emails from people concerned that we are cutting service. That is not the case. The service and standard has been exceeded repeatedly for any number of years," said LaSala. "The question remains, should the EMS Authority pay for exceeding the level of service which it has defacto established and will be formalizing today. My standard is 7½ minutes 90-percent of the time, not 7 ½ minutes 96-percent of the time." In Clearwater, the defacto standard response time in 2008 was 7½ minutes 97-percent of the time, far exceeding LaSala's proposed county-wide standard. This exceptional performance represents what Craig Hare, EMS Division Manager of Pinellas County's EMS and Fire Administration, called "excess capacity" in the EMS system. It is also referred to by those with critical medical emergencies as life-saving responsiveness. That "excess capacity" in Clearwater, other municipalities and fire districts would become the target of County EMS budget cutting. Hare described as "Potential Reductions for Consideration" the "realignment" of 2 Clearwater Advanced Life Support (ALS) trucks into fire engines, eliminating 7 paramedics and ALS truck operating costs from the county EMS budget. Other, but not all, municipalities and fire districts would face similar cuts. Vice Mayor George Cretekos represented the City of Clearwater at the County Commission's Special EMS Session. He asked the commission to "delay these wholesale changes" and work together to "find a reasonable alternative." Cretekos raised several objections to the county's EMS cost-cutting initiative:
While most public comment was disputing the county's claims and disagreeing with the EMS proposal, an alternative cost-cutting proposal was delivered by a not-unlikely but often overlooked source - the firefighters/paramedics who deliver the EMS services in question. Scott Sanford, President of the Palm Harbor Fire Fighters Union, presented a proposal that he and other area firefighters union representatives developed. Sanford claimed that the county proposal would result in increased response times of first responders, a decrease in service to the community. He further claimed that ALS first responders will have to wait for extended periods on the arrival of Sunstar ambulances to transport patients to area hospitals. "There is no excess in the system," said Sanford, citing county statistics that only 64-percent of EMS calls are responded to within the 5-minutes recommended by the National Institute of Health and American Heart Association. Sanford's solution is to use the 25 existing fire department rescue/ambulances for patient transport, something that they are today prohibited from doing because of the county's contract with Sunstar for ambulance services. Those 25 trucks, Sanford said, responded to 41,000 incidents last year that resulted in patient transport. "Why don't we use them," he asked. Sanford estimated that $7.6-million could be saved by Pinellas County EMS by simply using ALS trucks for patient transport, units that are already being funded by the county. In addition to saving money, Sanford claimed that response times would decrease, and system efficiencies would improve. Combining the $7.6 million fire transport savings with other county EMS cost saving initiatives would amount to about $19-million in system savings, Sanford claimed, without reducing response times or decreasing levels of service. "This is about the residents; this is about the service that's being delivered - public safety," Sanford said, asking for consideration of his and other proposals before reducing the level of service to citizens. "We will take on an additional workload for little to no additional compensation to help you reduce your burden." The County Commission later unanimously approved the two resolutions, with Commissioners Ken Welch and Neil Brickfield specifically asking staff for a thorough analysis of Sanford's fire transport proposal. County EMS Administration will next begin negotiating with the municipal fire departments and fire districts to refine the cuts that will be necessary to meet county budget objectives. |