Fla. county scales back EMS overhaul
With its revenue stream trending downward, county leaders were forced to scale back on an EMS improvement plan the council already approved
By Dustin Wyatt
The News-Journal, Daytona Beach, Fla.
VOLUSIA COUNTY, Fla. — In an effort to speed up ambulance response times, the Volusia County Council in February unanimously approved a plan to overhaul its emergency medical services.
But when Councilwoman Heather Post got her first peek of the proposed budget for next year, she was surprised to learn that some of the changes she fought for a few months earlier were gone.
At Tuesday's meeting, Post challenged county officials to explain how that happened. And when she wasn't satisfied with their response and continued to push administrators for answers, her council peers became agitated with her refusal to move on.
County Chair Ed Kelley accused Post of "attacking" county staff who are only trying to do their job. Vice-Chair Fred Lowry accused the councilwoman of "grandstanding" from the dais, and reminded her that policymakers aren't supposed to "micromanage" staff.
It's not micromanaging, Post replied, explaining that she just wanted more information about the budget she'll be asked to approve in September.
"If I'm making policy decisions on the budget of Vousia County, I'd like to ensure the numbers I've been given are correct. That's it," she said. "It's not rocket science."
Post was told that several factors, including a decline in transports, resulted in lower-than-projected revenues. That means the county can't afford to hire as many EMS workers as it originally intended in February. Instead of hiring 23,the county would be adding 15.
If the county wishes to bring back those additional eight positions, Kelley said the council would have to find a way to fund it. The county's proposed budget already includes a 6.75% property tax increase, which would bring an extra $16 million into the county's general fund. Some of that money will fund the modified EMS improvement plan.
"We are being asked to be prudent with money," Kelley said during Tuesday's meeting. "If the money is not there, we have got to find ways to cut, reduce, or whatever, all across the 40 different (county) departments.
He turned to Post, "What would be your solution?"
Post, who voted down the recommended tax rate last week, didn't present an alternative. She did not respond to calls or emails for this story.
Tuesday, Post said it "doesn't make sense" to her why the county council was told they could afford all of the EMS changes in February, and now are suddenly being told they can't.
County officials said a few things happened in a short amount of time that will impact future revenue.
Transports are down, they said. Data provided by The News-Journal shows that 4,155 people were transported by ambulance in February. In May, that number was up to 4,276. But by June, it had dropped to 3,975.
The county's Chief Financial Officer Donna de Peyster explained another unexpected change. The county used to contract with a company that paid transport costs for whatever Medicare wouldn't cover. The company dropped out in March, resulting in a loss of another $100,000 a year, de Peyster said.
Still, Post seemed unsatisfied with the answers provided.
"Council directed for a certain thing to happen, and that is not being done," Post said in the meeting. "I'm concerned by that."
Under the revised plan, eight of the 15 new EMS workers will focus strictly on transporting patients between hospitals. These inter-facility transports occurred about 13 times a day on average in 2018. Each transfer, some of which require traveling into another county, takes about two hours.
By assigning new ambulances and new staff to this function, more are available to respond to 911 calls.
The county also plans to hire two paramedics and two emergency medical technicians to work in Ormond-by-the-Sea, an area where response times have been slower. A plan to hire four paramedics to serve the Osteen area has been bumped back to 2022.
The county will still hire a nurse to work in the county's communications center to triage calls and seek other alternatives to ensure that the system is reserved for true emergencies.
The biggest deviation from what the council approved in February: the county had planned to hire eight more EMTs for inter-facility transports, for a total of 16 for this function. With eight fewer new positions, the county will instead take eight existing EMTs/paramedics and move them into this role.
County officials believe the plan, while a little different than the one council approved in February, will still result in a more effective and efficient ambulance system.
"Because the revenues are down, we had to, of course, make some choices," said the county public protection director Joe Pozzo. He called the final product "a pretty doggone efficient way to do business."
And the majority of council members put faith in staff to follow through with that promise.
"Sometimes the best-laid plans need adjustments," said Barbara Girtman.
Ben Johnson said the role of a manager is to look at operations and determine how things can be done better, more efficiently, while protecting citizens and tax dollars at the same time.
He told Pozzo, "I am pleased to say that I think you're working on that real hard."
Deb Denys told Pozzo that it's evident he's been successful since he took over the department last year.
"Dollars are tight," she said. "We get that."
©2019 The News-Journal, Daytona Beach, Fla.