Ambulance-Based Emergency Transport to Continue

A proposal to change Pinellas County's current medical response system to one that is firefighter-based suffered a setback during a recent County Commission meeting.

Commissioners approved a contract with Paramedics Plus, which allows the Texas-based ambulance service to continue to operate in Pinellas County for two years. County Administrator Bob LaSala wanted a three-year contract but did not get it.

The Dec. 20 vote came after commissioners listened to presentations and discussed and debated the complicated hot-button issue for hours. Commission Chair Susan Latvala expressed her support for a Paramedics Plus contract, despite concerns raised by other commissioners.

Commissioner Neil Brickfield questioned Paramedics Plus representatives about the pricing in one of the contract options they offered. Latvala scolded Brickfield, which began a heated exchange. 

"This is really inappropriate," Latvala told Brickfield. 

He replied, "I don't think it is inappropriate at all when we're talking $36-million-a-year contracts."

"We don't negotiate contracts at this board table," Latvala said.

Brickfield fired back, "Madame Chair, I respectfully disagree. I don't think our options or my role as a commissioner is to simply come here and pick from the menu in front of me, when I have questions and I think we can get different options."

The audience broke out in a round of applause after Brickfield spoke, then Commissioner Norm Roche jumped in.

"I concur with Mr. Brickfield. I can certainly understand the frustration you guys have felt. … In my personal opinion, this has left the realm of common sense and public safety and is now full-fledged politics and campaign, and I think it's unfortunate," Roche said.

Roche expressed his support for fire-based transport and also vented about lawmakers' role in the EMS decision-making process.

"We've got a Legislature that says it doesn't want to be involved, but has been pulling strings from day one behind the scenes. … Either lead, follow or get the hell out of my way, in my opinion," he said.

Commissioners wound up voting 4-3, narrowly approving Commissioner Karen Seel's idea to amend the third contract option offered by Paramedics Plus at a total savings of $6 million. Commissioners Nancy Bostock, Norm Roche and Kenneth Welch voted against the contract.

The decision put an end to Lt. Scott Sanford and Lealman Fire District Capt. Jim Millican's hope that commissioners would let the Paramedics Plus contract expire, creating an opportunity for a new fire-based transport system to be implemented.

The pair had been pushing for an alternative to the way crews respond to medical emergencies in Pinellas County. They say the current system is costly and time consuming because firefighters arrive at an emergency and treat a patient, then wait for a separate ambulance to take the patient to the hospital. Sanford and Millican say firefighters should provide initial treatment and also transport patients to the hospital.

"We are disappointed the county commission didn’t take advantage of the opportunity to save $20 million; however, we are heartfelt by the shortened time frame for Paramedics Plus. We will continue working hard and be ready to drive our first patient to the hospital on Oct. 1, 2014," Millican said.

During a special meeting about EMS issues earlier this month, the Sanford-Millican plan appeared to have won some support from Pinellas County lawmakers, who are responsible for legislation concerning funding of the county's EMS transport system. However, like county commissioners, the lawmakers have concerns about projected costs of EMS transport systems. During the meeting, the  recommending that county commissioners hire an independent firm to analyze:

• The current EMS transport system used by Pinellas County
• The Sanford-Millican EMS transport proposal
• The EMS transport proposal from Integral Performance Systems, commissioned by the county at a cost of $130,000. 

Lawmakers gave county commissioners a deadline of Jan. 1 to pick an independent firm to conduct the study.