The contentious EMS politics between city and county governments in Florida is bubbling up again, like a cauldron on Halloween. This time it appears that the county EMS service is essentially being booted out of a city’s fire station after county commissioners denied the city’s fire district request to provide its own ambulance service. The EMS staff will be stationed out of hotels until more permanent facilities can be located.
It’s truly unfortunate that the field providers are caught in the middle of what seems to be serious tit-for-tat politics. While having housekeeping services at work might seem luxurious at first, no doubt it will become pretty annoying to be based out of a hotel room — no supply area, no storage area, no cooking facilities. It’ll be grand for the other guests who are staying at the hotel, no doubt.
Governments have struggled to maintain services during this long economic downturn. I’m a bit befuddled by the notion that a city government would want to take on more work at a loss. Providing 911 EMS services is similar to fire suppression services — it costs money. While EMS does offer cost recovery abilities, it’s not nearly enough to offset the cost of operations. The smaller the department, the harder it is to cover costs. Taxpayers may be willing to pay additional taxes or assessments to support a local service, but it doesn’t sound like there has been citizen involvement in the process.
EMS billing is complicated and varies widely by district. Run volume and payor mix (percentage of Medicare, Medicaid, private and no-pay transports) directly affects what a district can recover. The changing dynamics of mobile health care will likely affect future reimbursements. And the cost of running government services continues to make the news, not just for EMS, but for fire suppression and other services.
Too bad this conflict is causing uncertainty in what happens next. I hope that the field providers continue to provide professional services to the community while the administrators try to work things through.
