CLEARWATER – Commissioner Norm Roche continues to oppose the use of consultants to solve the county’s problems with cost of emergency medical services.
The Pinellas County Commission approved 6-1 a contract Sept. 6 with Fitch and Associates LLC for an operational analysis of emergency medical services and fire deployment and response. Roche voted no.
Commissioner Ken Welch started the discussion wanting assurances that the scope of work was broad enough to encompass the commission’s directive to study a variety of systems.
Commissioner Neil Brickfield echoed Welch’s concern. Assistant County Administrator Moe Freaney assured Brickfield that the wording was sufficient.
“I see single (option), not plural,” Brickfield said.
County Administrator LaSala said Fitch was charged with looking at “what would work within Pinellas County,” but would not be looking at an “unlimited number of approaches.”
Pinellas County and local firefighters are at odds over the most affordable way to deliver emergency medical transport. Firefighters rejected a study done by the county’s consultant. The county rejected a plan from two local firefighters advocating emergency and non-emergency transport by local fire departments in lieu of a private ambulance company.
The Pinellas County Legislative Delegation got involved and gave a strong recommendation to have a third-party accounting firm to do a cost-analysis. The county preferred to have the systems “operationalized” first to get a better idea of involved costs.
Fitch won the bid to provide an operational analysis of the current system, the county consultant’s study and that provided by local firefighters. The commission also asked the company to look at hybrids consisting of a mix of ambulance and fire-based transport.
“They’ll look in-depth at these three and any other in their professional judgment might work,” LaSala said.
“I have a whole lot of concerns about this agenda item,” Bostock said. “I’m worried we’re not going to get the information needed for decision-making.”
“We’ve got a great model now that worked great for 30 years,” Brickfield said. “I don’t know if it will work for another 30 years. But I would like to know that in eight months, we’ve looked at the whole thing.”
Commissioner Chair John Morroni said he was surprised the vendor had not attended the meeting, adding that he also was concerned about the options.
“The point is I don’t want to see one or two things,” he said. “I want to see a lot.”
“As quickly as possible,” Bostock added.
Commissioner Karen Seel asked if the study could be done in less time than eight months.
Assistant County Administrator Moe Freaney said although the work probably could be done in six to eight weeks, the contract called for the maximum amount of time.
“We want them to have proper time to vet out all the stakeholders,” Freaney said.
Seel asked if time could be gained by putting out the bid for an accounting firm. Freaney said it would be best to wait until the analysis is done. Seel pointed out that the bid process normally takes 60 days.
The commission is looking to stop the upward spiral of costs for EMS. A millage rate increase was expected to pass at the final budget hearing on Sept. 18. The EMS millage rate also increased last year.
Roche questioned the license agreement for the software to be used in the process. He questioned whether the county’s computers could run the software and if staff could provide for the consultant’s other needs. He also had security concerns. County Administrator Bob LaSala said the process would be coordinated with Business Technology Services.
“I’m not on board with this,” Roche said. “That’s not a reflection on Fitch.”
“This is incredibly frustrating,” said Commissioner Susan Latvala. “We did a study. It was a beautiful report on how to save money. That’s what it is all about, making the system more affordable. But it turned into everyone getting what they want. Making everyone happy is not our job. … It’s insane to say have many options. Let the experts do their job. And don’t pick it apart when it comes back in. … This is just crazy.”
“This is the reason I won’t support this,” Roche said. “I don’t think we know what we’re doing. I want a study that will hand this board numbers, not recommendations. We’re already in a-half million on this.”
“I think we’re making it more complicated than it is,” Welch said.
He outlined five options – the current system, the county consultant’s recommendations, the firefighters’ plan, a hybrid of fire transport for emergencies only and a hybrid that used fire department transport only by those departments that are willing and able.
“We’ve all worked very hard,” Seel said. “We need to know what the cost is to do the different models. We can get into the political later.”
Brickfield said the county consultant’s study was “very nice, if we operated in a vacuum. But we work with cities and the state. We all have stakes and a say in it.”