Of territory, rights, and EMS

The dispute between Bonita Springs and Lee County over who should run the EMS service spills over into court

The ongoing feud between a Florida city’s EMS department and the county historically charged with providing its ambulance service continues to simmer. In December, Bonita Springs bounced the Lee County units out of its fire stations, even though the county is still required to provide EMS services. It appears that nothing has changed since then. Both sides are inching toward their day in court, with one more attempt to try to resolve the contentious issues.

To be clear, I’m not taking sides on this issue — I’m sure that much of the discourse is not being reported in the media, so there are plenty of nuances and concerns that are unique to this situation. However, the city’s rights to provide its own emergency transportation must be balanced against the need of the region to preserve its ability to respond in an effective, efficient manner.

EMS left its provincial roots a long time ago; frankly, fire suppression has also been undergoing the same evolutionary process. For many towns and small cities across the country, consolidating their public safety services has yielded greater cost savings while preserving — or improving — services. It’s simply not cost-effective for these governments to maintain that level of self-identity.

And, at the sake of stating the obvious, given the cost of providing emergency care and transport, and the lack of adequate reimbursement, it seems odd that local officials want to burden themselves with providing another city service. Besides the direct costs, integrating those services into the regional plan so uniform coverage is achieved will create additional financial pressure.

Who will win this fight will come to light, in all likelihood, in the legal system. Until then, it’ll be the citizens who continue to be on the short end of the stick.

About the author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at Art.Hsieh@ems1.com and connect with him on Facebook or Twitter.

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