County Proposes EMS Cost-Saving Initiative
By Carl Wagenfohr
CLEARWATER - Times are tough for county and municipal governments in Florida, struggling with projected budget shortfalls caused by declining property values and state-imposed limitations on their ability to raise property tax rates.
To date, it has largely been the so-called quality of life services, such as libraries and parks, that have borne the brunt of the budget cuts. But the Pinellas County Emergency Medical Services (EMS) Authority has recently promoted a cost-cutting proposal that they claim would make EMS services more efficient and eliminate an annual deficit, amounting to $14.5-million this year, without increasing the millage rate.
The County-funded EMS services include the Sunstar ambulance service, which provides patient transport to area hospitals, and Advanced Life Support (ALS) first responders, the city and fire district paramedics who provide patient care at the scenes of medical emergencies.
County Administrator Bob Lasala explained during the February 24th Board of County Commissioners worksession that a committee consisting of Pinellas County City Managers, including Clearwater's Bill Horne, worked with County EMS staff to come up with the proposal that would "close the gap" between the anticipated EMS revenues and projected operating expenses to the tune of $17 to $18-million for fiscal year 2009/10.
Those cost reductions would come largely from implementing a Prioritized EMS Dispatch System, and by reducing what the County EMS Authority claims is "excess capacity" in the EMS System.
According to Craig Hare, EMS Division Manager of Pinellas County's EMS and Fire Administration, the prioritized dispatch system has already been approved by the County Commission and is in the process of implementation in the County's 911 centers. "That will streamline our call-taking process and reduce our ambulance contract by about $500-thousand annually," Hare said.
Pinellas County's call-taking process has been to automatically dispatch ambulance, ALS and engine units to emergency calls, resulting in what taxpayers have called a wasteful over response to some incidents. The new prioritized dispatch scheme has the 911 operator, rather than the ambulance paramedic, asking the questions and dispatching if it is a critical emergency. If it's not critical, the 911 operator will prioritize the call and dispatch only those units needed. "We always want to send the right equipment; we always want to err on the side of caution," Hare said.
Pinellas County currently funds 362 Firefighter/Paramedic positions and 65 ALS trucks distributed across 19 municipal fire/rescue departments and independent fire districts. The 2008/09 budget for these EMS services is $40.1-million, obtained largely from the county's .5832 mill EMS ad valorem tax.
With national ALS response time standards requiring a response time of 8 minutes 90-percent of the time, Pinellas County's current 7 minute 30 second 90th-percentile response time is considered a gold standard. But gold standards come under pressure during tough economic times, and Pinellas County EMS Administration has concluded, "This high Response Time Compliance points to Excess Capacity in the ALS First Responder Program that could be realigned."
In the case of Clearwater, the EMS proposal would eliminate county funding of 2 Clearwater ALS rescue trucks, now located at North Clearwater Beach and Countryside, and "realign" those ALS services into existing fire trucks at those stations. According to Hare, that realignment would eliminate county funding of 2 paramedics per shift, a total of 8 positions across the 3 shifts that Clearwater Fire/Rescue operates with. Additional savings would come from a reduction in supervisory costs, equipment maintenance and equipment operating costs, including insurance.
Hare predicted that the realignment would have little impact on Clearwater ALS response times; the 7 minute 30 second standard would continue to be met 97-percent of the time, and the current 4 minute 36 second average response time would be retained.
The Pinellas County Board of Commissioners is scheduled to hear the EMS cost-cutting proposal at a public meeting on March 20th.
Meanwhile, the Clearwater City Council will be briefed on the impacts of Pinellas County's EMS proposal at their next regular worksession. City Manager Bill Horne wrote in an email to the Mayor and Councilmembers, "Our staff effort on Mar 16th will be to give you the most coherent understanding of all the EMS issues that Clearwater needs to respond to."
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