Report recommends minor changes in Pinellas
Pinellas County, Fla., has a “world class” EMS system that should not be “fundamentally altered” to cut costs, concludes a report commissioned by the county and conducted by Fitch & Associates. In recent years county officials have raised concerns that rising costs and falling tax revenues were putting the system in financial jeopardy.
Updated June 2015
In Pinellas County, first response is handled by 14 city fire departments and four fire districts; Paramedics Plus, a private ambulance company operating under the name Sunstar Paramedics, handles transports. Sunstar supports itself by billing for mileage and transports, while the fire departments receive a combined $40 million from the county, or about one-third of their total annual budget, says Bruce Moeller, executive director for Pinellas County’s safety and emergency services.
Two years ago, a consultant, Integrated Performance Solutions, recommended cutting costs by decommissioning 25 fire-based rescue vehicles that respond to medical calls but don’t transport and eliminating 150 firefighter positions countywide. Not surprisingly, fire agencies balked, Moeller says, and fired back by calling for fire agencies to take over transports from Sunstar.
The Fitch report, a draft of which was released May 28, recommended against the earlier consultant’s proposal and the fire departments’ proposal. Cutting 25 rescue vehicles and laying off firefighters is too extreme, the Fitch report says. “Pinellas County fire and EMS are not in a state of disrepair that would require such a drastic cut,” the report reads. Nor would the fire agencies’ proposal work, according to Fitch, as that plan would lead to “unrealistically high and dangerous” crew workloads and unit hour utilizations on fire agencies’ transport units.
Instead, Fitch recommends a third plan, called “CARES,” or Community-wide Alignment of Resources for Efficiency and Service, which suggests minor tweaks to put a lid on costs. Under the Fitch plan, 19 fire-based rescue vehicles would have their shifts cut from 24 to 14 hours, eliminating excess capacity in the middle of the night, Moeller says.
A second part of the Fitch plan suggests trimming costs by changing who responds to the 24,000 annual low-acuity Alpha and Omega calls. Last year, county staff had proposed having only Sunstar respond to low-acuity calls, the rationale being that it was overkill to send both a fire truck and an ambulance to minor medical issues.
But in something of a surprise, the Fitch analysis says that fire agencies are better positioned to serve as first responders for Alpha and Omega calls and should call for Sunstar only if the patient needs transport. “Here in Pinellas County, we all agree that fire and EMS don’t both need to go to those calls—we just didn’t agree on who should,” Moeller says. “The county said Sunstar should go. Intuitively that made a lot of sense, but when Fitch did its study, they had a surprising finding. They said that Paramedics Plus is very, very efficient, and they don’t have much excess capacity, but the fire departments do. Fitch said the fire department should go because they have excess capacity.”
Fitch, which was paid about $300,000 for its analysis, estimates its plan would save a modest $6.3 million annually, or about 5.5% of the overall $112 million EMS budget, without jeopardizing clinical excellence. The plan was approved by the county board of commissioners, which also serves as the county EMS authority, at the beginning of August.
Name change for EMSC, new CEO for AMR
Emergency Medical Services Cor-poration, the parent company of American Medical Response (AMR) and other health-related services, recently changed its name to Envision Healthcare Corporation.
“The new name better represents our service lines and offerings,” says Ron Cunningham, director of marketing communications for Envision Healthcare Corp., which is based in Greenwood Village, Colo. “Emergency care is still a very important part of our service offerings, but it is no longer the only service we offer.”
Also in June, Edward “Ted” Van Horne became AMR’s new president, replacing Mark Bruning, who left in January. Van Horne began his career in EMS 24 years ago and has served in senior management positions at AMR since 2003. He holds a bachelor’s of science degree from Rochester Institute of Technology and an MBA from the University of Phoenix.
