Cities consider local firefighters’ EMS proposal

Article published on Monday, Sept. 12, 2011

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	Capt. Jim Millican with Lealman Fire Rescue is co-author of a plan to change Pinellas County’s EMS system.

CLEARWATER – Two Pinellas County firefighters are proposing an alternative to the county’s proposed changes to deliver emergency medical services that they say will save county taxpayers $20 million over the next three years.

Scott Sanford, president of the Palm Harbor/Oldsmar professional firefighters, and Jim Millican, a captain in the Lealman Fire District, have authored the Pinellas County EMS Providers Cost Containment and Sustainability Model, which utilizes fire-based medical transport over the current system, which uses private transportation.

Sanford and Millican have made presentations to county leaders on the concept and are now pitching idea to city leaders around the county.

They say the plan meets the county’s four goals, which are to maintain level of service, equalize funding among providers, contain costs and create a sustainable system.

“What we have is a dog with six legs now in Pinellas County,” Millican said during a recent Barrier Islands Governmental Council meeting. “We’re proposing a model that’s been done a lot. We’ve met with the county administrator and he said it’s up to the individual municipal governments in the county to approve it before the county can act. So we’re asking (government leaders) to take a look at it and see if it’s a concept they want.”

Millican explained that fire-based medical transport is now the trend nationally and across Florida where 71 percent of the population is served by a fire-based EMS system, as opposed to a private system.

The proposed plan calls for fire-based medical first response through the 18 local fire departments in the county but expands the contract with cities and fire districts to provide medical transport in both emergency and non-emergency situations.

The plan, Millican said, would maintain the county first responders’ current response time of four minutes, 30 seconds.

It calls for 35 fire-based ambulances operating 24 hours a day out of the busiest fire stations and 16 others across the county during peak times. Mondays at 3 p.m. are now the busiest time, Millican said.

The proposed plan would equalize funding among providers by using a flat fee based on the type of unit being funded, as opposed to funding the agency on reasonable or customary costs. Millican said this provides benefits for both the county and the agencies providing the service.

One of the biggest benefits, he said, is the fact that the county will no longer be obligated to fund changes in pay raises and pension costs because it will be funding the unit only.

The proposed unit funding would be $360,000 per year for an advanced life support fire apparatus, $720,000, ALS fire-based ambulances; and $360,000, ALS peak time ambulances.

In addition, funding per unit per year would include $20,000 for EMS administration, $30,000, vehicle repair and replacement; and $8,500, fuel.

Under the proposed plan, the county would fund 25 new ambulances the first year and 10 the second year.

The plan would contain costs by providing the flat fee per unit, as opposed to the per-transport cost that is currently in use and has increased three times in the last seven years.

The plan provides sustainable savings for a minimum of 10 years, assuming a 2.5 percent annual increase in revenue.

The proposed plan estimates income at $84.9 million in 2012 and expenses at $87.2 million. However, in 2013 the trend would change with estimated income of $85 million and estimated expenses totaling $79.9 million. By 2021, estimated income would outnumber expenses by $12.8 million.

The plan would also continue to fund critical care transport, mental health transport, transportation of children, the county’s tactical EMS team, long-distance transport, medical supplies, Eckerd College marine rescue, patient business services, information technology, dispatch, fleet services and the medical supply warehouse for $6 million per year.

The plan provides for cuts in the county budget in two sections. They are the elimination of the contract with Paramedics Plus (Sunstar Paramedics) and the elimination of funding for BayFlite. The transition would create as many as 200 new positions and fire departments would be encouraged to give employees of Paramedics Plus first priority. Article published on Monday, Sept. 12, 2011 Copyright © Tampa Bay Newspapers: All rights reserved.