CLEARWATER – After more than two hours of debate Dec. 20, Pinellas County Commissioners approved a contract extension with Paramedics Plus, giving the Texas company exclusive rights to transport service for at least two more years.
According to the terms of the current contract, the commission had to inform Paramedics Plus of their intentions to renew by Jan. 1, 2012. The alternative was to find another service provider by Sept. 30, the date the current contract expires.
County Administrator Bob LaSala and staff recommended approval of a three-year contract that included $10 million in savings over the life of the agreement. But commissioners were reluctant to tie their hands for that long in light of current proposals for changes in the countywide emergency medical service system.
Outgoing commission chair Susan Latvala favored the three-year extension.
“Until we find a better, cheaper way to do something, this contract is cost-effective,” she said.
The other six commissioners weren’t so sure. The majority of the public favored letting the contract expire – something that almost seemed a possibility after commissioners failed to agree on the first two votes.
They had three options to consider. Option 1, a three-year extension with a savings of $10 million. Option 2, a two-year extension with the possibility for a third year, allowed six-month pilots to allow fire departments to do emergency and non-emergency transport.
A third option, passed out to commissioners just before the meeting, prompted harsh words from Commissioner Ken Welch, who asked why it was received at the last minute.
LaSala explained that the county didn’t receive the offer until late Monday. Then it went to the county attorney’s office for review.
“Personally, I think the contractor dropped the ball,” Welch said.
LaSala said Paramedics Plus had presented the third alternative at the county’s request. Welch still wasn’t satisfied.
“I haven’t read it,” he said. “Are we going to take a break and let me read it?”
Later in the discussion, Commissioner John Morroni said he was responsible for the last-minute addition. He explained that he had been talking on the phone with Ed Armstrong, a local attorney representing Paramedics Plus, on another matter Dec. 16 when he mentioned he wasn’t happy with either contract proposal.
Morroni outlined what he would like to have in a contract, and Armstrong ran it by his client, who agreed to work on a third option, which was presented to the county on Monday. This option provided $2 million in savings in the second and third years of the agreement, but does not allow for pilot programs – something Welch and Commissioner Neil Brickfield wanted.
Commissioner Norm Roche pushed for a fourth option – three one-year extensions, which he said gave the county the most flexibility to move forward on potential changes. He said he couldn’t believe Paramedics Plus would “walk away” from $37 million.
Armstrong said his client would not accept a contract extension for only one year.
“I have no authority to give a one-year extension,” he said. “I’m trying to be responsive. But after a lengthy dialogue and observing the commission, we’re unable to determine which way the commission wants to go.”
He said his client had provided three options.
“We can’t make the numbers work for us with a one-year extension,” he said.
Commissioners made a number of suggestions and questioned details of all the options before Latvala attempted to shut them down.
“This is really, really inappropriate,” she said. “We don’t negotiate at the board table.”
“I respectfully disagree,” Brickfield responded. “It is not my job as a commissioner to just sit here and pick from a menu. We as a board have this assignment.”
Roche agreed with Brickfield, saying he understood the frustration everyone was feeling after a matter of public health and safety had turned political. He blamed state officials for some of the problem due to the restrictions of a Special Act that controls the actions commissioners, acting as the EMS Authority could make.
He had a message for the Pinellas County Legislative Delegation.
“Either lead, follow for get out of the way,” he said.
Robert Polk, chief of the Pinellas Suncoast Fire & Rescue District and president of the Pinellas County Fire Chief’s Association, joined the more than a dozen speakers urging commissioners not to renew the contract at all.
“There is a fourth option,” he said, explaining that extending a long-term relationship with a third party for transport would remove the urgency that’s been building the past few months.
“The fire chiefs are ready to turn this thing on,” he said.
Polk said he had polled every department “and we can do this.” He the switch to using fire department transport for emergency and non-emergency situations could happen in about seven months.
But, the commission still isn’t ready to embrace EMS transport by the 18 providers of first responder service. There was no argument that firefighter-paramedics were capable of doing the job. Commissioners say there are just too many unknowns, including cost. Firefighters say they can provide the service for less money. County staff says it will cost more.
A committee began work Dec. 22 on the scope of services for a request for proposal from businesses capable of operationalizing both the plan from the county’s consultant and that of Capt. Jim Millican with Lealman Fire Rescue and Lt. Scott Sanford, firefighter and paramedic with Palm Harbor Rescue. A separate firm will be selected by RFP to provide a financial review of the plans.
The Pinellas County Legislative Delegation gave a deadline of July 1 to get a financial review completed. LaSala said the county would do its best to get it done by then; however, he stressed that all standard procedures for RFPs would be followed.
In the end, the majority of commissioners went along with a suggestion by Commissioner Karen Seel to amend option 3, which does not allow for pilot programs and maintains Paramedics Plus exclusive rights to all transport services. She asked if Paramedics Plus would be willing to add an additional $2 million in savings for the current year, added to the $2 million in years two and three of the extension would bring the cost down by $6 million.
Seel’s offer won the favor of Brickfield, Morroni and Latvala. Bostock, Roche and Welch voted no.
Commissioners debated the matter of creating EMS districts to allow them to set different tax rates instead of one countywide EMS millage rate while Armstrong made a phone call to Texas to talk to decision makers with Paramedics Plus.
After a unanimous decision not to take action of separate taxing districts, Armstrong informed the commission that Paramedics Plus had accepted the proposed changes. The county attorney’s office will finalize the legal terms and commissioners gave the responsibility of signing the contract to Latvala.
The deal means Paramedics Plus will continue to be the sole provider of ambulance service in Pinellas for two years plus nine months, the time remaining on the current contract, with an option for an additional year.
The decision on the taxing districts means the commission will have to continue to charge one countywide EMS millage rate for at least another year.
In other business, the commissioners appointed their representatives to the committee charged with finding a financial firm to review the two proposals for changes to the EMS system. Morroni, who will be commission chair in 2012, agreed to serve. The commissioners’ other two appointees are Jay Ravens, director of finance for the city of Clearwater, and Kelly Triolo, who sits on the EMS Advisory Board and director of Nursing at Morton Plant Mease.
