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Home > Topics > EMS Management

With ambulance service in limbo, Key West explores its options

Officials are seeking two more opinions on a consultants recommendation to bring EMS into the fire department

By Sean Kinney
The Florida Keys Keynoter

KEY WEST, Fla. — The Key West City Commission is getting at least two more opinions on a consultant's recommendation to immediately bring ambulance service in-house under the Fire Department.

Harold Cohen of TriData Services on Tuesday recommended the in-house transition during a presentation on the logistics of that move. But commissioners also want to issue a request for proposals asking private companies what it would cost to provide the service. That could take a month.

At the same time, the Key West firefighters union will put together an analysis with the help of the International Association of Fire Fighters, its parent organization.

Whichever option is chosen, it would replace the for-profit Care/American Ambulance. Care/American replaced American Medical Response in Key West in 2011 at no cost to the city. Care/American expected to make money by directly billing people it transports.

When American Medical Response had the city contract, the city paid it $650,000 a year, largely based on uncollectible ambulance rides for homeless people.

The Care/American contract expired Tuesday, and the commission has already voted to pay the company $45,000 monthly for up to a year until a transition can take place.

Tuesday, commissioners questioned City Attorney Shawn Smith about language in the Care/American contract that could have avoided the $45,000 monthly bill.

"Do we have any options regarding the lame-duck clause or are we bound by the month to month?" Commissioner Clayton Lopez asked.

"You're well past that," Smith said. "That ship has sailed. There was a clause in your original contract that if the city went out to RFP and if [American/Care] was not the successful respondent, they had a provision. Yes, things could've been done differently."

Commissioner Mark Rossi was skeptical of the no-cost deal when it passed in 2011. In that case, Cohen prepared the RFP that led to the contract with Care/American.

"Here we go again," Rossi said to Cohen. "You're the same guy that told me yeah, yeah, yeah, yeah, and I told you that night it wasn't going to happen. So now what're you telling us ambulance services are going to cost the city?"

Cohen said the expected start-up cost for bringing ambulance service into the Fire Department would be around $650,000, which includes the purchase of ambulances, and operations costs would be about $1.5 million annually.

With a 60 percent collection rate, the city would lose $364,169 each year in what he calls a "worst-case scenario." The "best-case scenario" is an 80 percent collection rate, which would earn the city $14,696.

"I bet the collection rate will be 45 percent," Rossi said. Mayor Craig Cates broke in: "You're not the expert. Please treat [Cohen] with respect."

"Let me say this, Mr. Mayor," Rossi said. "I respectfully request that the dais ask for a second opinion from somebody else." That was approved.

___

(c)2014 the Florida Keys Keynoter (Marathon, Fla.)

McClatchy-Tribune News Service
Distributed by MCT Information Services

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