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Fla.: Confusion arises out of state emergency-services certificate

Denise-Marie Balona
The Orlando Sentinel, Fla.
Distributed by McClatchy-Tribune Business News

ORANGE CITY, Fla. — The Florida Department of Health has launched an investigation into the city’s fire department after a senior Volusia County official told the state that city emergency workers were treating more-serious cases than they were authorized to handle.

State officials would not confirm the inquiry Thursday, but the city gave the Orlando Sentinel documents that show it began within the past few weeks.

Early last month, even though county officials said they wouldn’t get involved, former Emergency Medical Services Director Matt Zavadsky sent the state an e-mail saying the city doesn’t have the county certificate it needs to respond to emergencies requiring advanced life support, public records show.

City fire officials and City Manager John McCue said they never meant to do anything wrong.

They thought they had their Certificate of Public Convenience and Necessity and several county leaders assured them they could continue to respond to medical emergencies with advanced life support.

Advanced life support procedures, which include inserting breathing aids and administering intravenous fluids, require more training than basic life support procedures such as bandaging and performing cardiopulmonary resuscitation. Advanced life support requires a state license and a county certificate.

Orange City’s state license expires Dec. 21 but city rescuers stopped doing advanced support about two weeks ago, when the city received a certified letter from the state announcing the investigation and asking for records.

City and county officials said residents won’t suffer because the nonprofit EVAC ambulances arrive about the same time as city firetrucks. Still, city leaders feel duped.

“We were — basically, the way I understood it — good until Dec. 21,” said Fire Chief Herb Hoffman Jr.

State officials couldn’t detail possible consequences of such a situation or whether the state would take disciplinary action. The State Attorney General’s office determines sanctions “on a case-by-case basis,” said Lauren L. Buzzelli, a spokeswoman for the Florida Department of Health.

Specifics about who made a complaint, and whether one even exists, could not be confirmed Thursday.

A public-records request found e-mails from Zavadsky. In an e-mail dated Oct. 4, he told the state about Orange City offering advanced life support without a county certificate as an “advisory” and not an official complaint.

That day, Zavadsky, who could not be reached for comment, suddenly resigned. An investigation was soon opened.

County spokesman Dave Byron said Zavadsky acted independently and that the e-mail did not prompt the investigation.

Byron said the county didn’t renew the certificate because Orange City failed to meet an Oct. 1 deadline. It was supposed to finalize a plan by then to work with county paramedics and medical technicians when emergencies arise in or near Orange City.

The county required that of all its cities three years ago. Orange City, which already had a tense relationship with the county, is the only one left.

Negotiations were going along so smoothly, though, the County Council approved the city’s certificate in September — contingent on finalizing that agreement.

Council members and others said they were confident the two groups would iron out details before the city’s state license expires. Meanwhile, they said they wouldn’t interfere with the state license.

McCue said the county said afterward the city could keep offering advanced support.

For several hours Oct. 4, the fire department dropped to basic life support amid rumors the county snatched away its approval.

Two county leaders assured the city again that day that it could continue, McCue and Hoffman said.

Despite the investigation, the city and county are moving steadily toward reaching an arrangement.