EMSA: Remain Independent or Merge?
The nonprofit Emergency Medical Services Alliance (EMSA, as the local ambulance service is commonly known), with an annual budget of $18 million and 250 employees, was organized under a five-year contract that was only intended to bridge the gap toward a more permanent operational and funding solution. A deadline is rapidly approaching by which the partners are to specify their future intentions beyond the agreement’s expiration date of September 30, 2008.
There is a significant question about whether the City of Ocala, Munroe Regional Medical Center and Ocala Regional Medical Center will even remain as partners and what that decision means for both EMSA's governance and finances, since the two hospitals each contribute almost $1.7 million a year and the City $1 million.
A citizen's task force is currently studying the EMSA situation to make a recommendation to the County Commission. The options seem to be: (1) continue the current autonomous arrangement (perhaps with some financing modifications) or (2) fold EMSA into the existing County Fire-Rescue operation. No matter which option is selected, the County Commission remains legally responsible for providing ambulance service.
EMSA staff is concerned about whether the ambulance fleet will be folded into Marion County Fire-Rescue, as opposed to remaining a relatively autonomous organization. Additionally, the County’s Fire-Rescue operation would have some important integration issues to work out if it takes over EMSA (e.g., EMSA ambulance crews/paramedics needing training as firefighters; all county firefighters already have certification as paramedics).
Tell us what you think the County should do concerning providing ambulance service to its citizens.
posted by Blog Master @ 10:48 AM
160 Comments:
I’m a resident of the City of Ocala. The less the county government has to do with my life the better as far as I’m concerned. The thought of having that clown show down at the McPherson Complex in charge of getting emergency services to my door is not a comforting one, especially since my family has required ambulance services in recent years and may well in the future. The odds are the county commission will try to do it on the cheap and kill some people in the process.
Our family has used the emergency ambulance 3 times. Every time the county fire department and the EMS people both showed up. That is a waste of time and money since both were not required. Maybe combining them would cut down on the duplication.
If there wasn't any fire, then that's a dumb thing to send both groups.
A little background on the ambulance situation for some of the newcomers to Marion County. If I have missed something, PWF can correct me.
Historically, very few hospitals have owned/operated ambulance services in the State of Florida. This is typically a service provided by local government in one form or another.
Tallahassee Memorial (TRMC) and Munroe Regional (MRMC) were the lone exceptions until 2003.
Munroe assumed “full ownership” of the ambulance service in about 1981. Prior to assuming ownership, the county had always subsidized the annual losses of the service that had been provided by Munroe (to the tune of about $1.2 million in 1981). Once owned, Munroe absorbed these short falls for over 20+ years with NO local government subsidy or taxpayer support.
In 1999, Munroe was facing tremendous capital needs to provide acute care services into the future and the looming payment reductions on the federal/state level. Munroe identified the ambulance service, requiring an annual $3 million drain on operating funds, as an area for financial evaluation.
Munroe decided to get out of the ambulance business and worked to establish the current EMSA partnership (county, City of Ocala, and both local hospitals). This arrangement became effective in October 2003. Munroe committed $1.675 million/year for 5 years to the EMSA partnership.
Coincidently, Tallahassee (TRMC) in 2003 provided notice to Leon County that they were also getting out of providing ambulance service; leaving no hospitals in Florida currently owning/operating ambulance services.
This brings the situation to where it is today with the 5 year funding agreement for EMSA ending next October.
A great way to add 250 more firefighters to the county fire service. Just Do It!!!
My family and I have been fortunate and never had to use the local ambulance services. Also, I have no basis for concluding whether the County Commissioners would do a good or bad job of overseeing the ambulance service. From what I’ve seen, the county fire and rescue services are well managed and don’t seem to be run on the cheap.
My question for Mr. Creekbaum is: where would you come up with the nearly four and a half million dollars to keep the EMSA independent if the city of Ocala and the two hospitals can no longer support EMSA? An event with a high probability of happening because they are all pressed for budget money.
I checked out the EMSA budget and they lost over a million dollars in 2007, even with all their financing help. Looks like they will lose over a half million in 2008. No wonder the hospitals don’t want to touch emergency service! Can’t see the City taking over EMS.
WHO'S ON THIS BLUE RIBBON COUNTY COMMITTEE DECIDING WHAT TO DO WITH EMSA?
Some additional information about the EMSA situation.
1.) There are a couple of variations on EMSA remaining as a stand-alone operation: (a) privatization (good luck on that one!) or (b) establish EMSA as a new county department---not merged with fire services.
2.) Only 84 of 250 EMSA staff would need to obtain dual certification as fireman and paramedics.
3.) County Fire Chief Stuart McElhaney claims that he can reduce $3.3 million of expenses from the EMSA budget via a merger.
See article at:
http://www.ocala.com/article/20070803/NEWS/208030340/1001/NEWS01
If you think the County Fire Department is well run you better look at their overtime payments.
Hey "city guy"
Check your math...EMSA has actually done better than expected on the revenue side the past couple of years.
I R Educated
I’ve delved deeply into a couple of functions of local government, but I have neither the time nor inclination to add to the list. I’m not an authority on how to run ambulance services, and don’t plan on becoming one so I will not be offering specifics about this or an answer to the question this thread asks. There are people in government whose job it is to analyze this situation; I can’t do their jobs for all of them.
There may be legal or other reasons that those of us in the City of Ocala end up with ambulance services under the Board of County Commissioners, but I wouldn’t want to see this become a trend with other services, and I would hope the alternatives would be thoroughly examined. The best run functions at the county level are the ones with which the county commission has the least involvement.
I’ve dealt for years with the county commission, county administration, and private citizens appointed by the county commission to advise them. I’m not impressed, and I have many specifics to back that up. I don’t need to see their incompetence further demonstrated to make a judgment. In general, I don’t want the Board of County Commissioners providing my services.
I expect the county to be under significant financial stress for a long time to come because of its failure to keep up with growth and because of the substandard wages in Marion County. I’m sure they have people in their fire department doing the best they can with what they’ve got, but if you want to see an example of what I’m talking about, just look at the webpage for the county fire department where the chief says they are going to focus over the next five years on improving response times to large urban areas. In other words, they haven’t kept up with growth and the response times aren’t where they need to be. I don’t think we have that problem in Ocala, do we?
Why should those of us in Ocala want to climb aboard the county’s leaky ship? They’ll try to entice of us with loss leader financial come-on offers to perform various services, but in the long run the more we in Ocala have to do with the Board of County Commissioners, the more they will try to suck us dry to address problems elsewhere in the county.
5:11 PM
So what on revenues? I wasn't talking about that. I'm talking about the bottom line of operations.
Are you telling me my figures, given to me by the County, are incorrect on the profit/loss side?
I'm with Bryan Creekbaum on keeping the county out of city business.
Those idiots over at Mc Pherson would have the EMSA people reusing band aids and disposable syringes just to save a buck!!!
Last year, a prominent local attorney told me he thought County Attorney Gordon Johnston had “given up years ago trying to get the county commission to operate legally.” It’s quite an interesting institution.
I see where CFCC's Public Policy Institute is going to study what type of organization structure our local/county government should have. That's their agenda for 2008. I look forward to that. There is a lot of duplication and expense in the current city/county structure.
This comment has been removed by the author.
Why look forward to it when we already know the conclusion? It will be that consolidating county and city government will cure everything from financial overhead to foot fungus. The PPI has a habit of running studies with people who start out with conclusions and then do a search for data to support the conclusions they started with so they can get the name of the organization on what they think. Then, the Star-Banner editorial board, which has already declared that consolidation is wonderful, will embrace the findings of the corrupt process as a brilliant piece of independent research guiding the way to our collective future.
This is why their growth study chaired by a radical anti-growth activist went nowhere. I attended every meeting as a member of the public, and saw it first hand. It was one of the most intellectually dishonest exercises I’ve ever seen and embarrassing that it was associated with an academic institution. One of the Star-Banner editors compared it to an eighth grade book report. I would put more stock in what came out of Pravda in its heyday than what the PPI produces.
If you look at the research literature on government consolidations, you will see that the promised cost savings often prove illusory because of politics. Rather than wait around for the Great Consolidation Santa Claus to arrive, people in the city having trouble paying their bills would do better to move into an area of the county with a preference for a combination of lower service levels and taxes.
I prefer the effectiveness of getting city services from a government close to me and in tune with what I want, even if it means living with some inefficiency.
Disagree totally with Brian Creekbaum's subjective conclusions about PPI.
The Charter Government approach needs to be on the agenda (again) for citizens to consider. Hopefully, it will be one of many options evaluated.
Ditto.
The record of PPI is on Creekbaum's side, unfortunately. He is 100% correct on the study of growth. The bias was so evident that the collecge had to rewrite the report nad then did not release it with any fanfare.
The subject of EMSA is a difficult one. It starts with the Federal Govt telling all ambulance companies -- funeral homes in large measure in thos days -- they had to have what we today might call trained EMC technicians in every ambulance, and their insurance problems, coupled with training a whole new class, caused funeral homes to opt out about 1978.
We tried private ambulance firms, but they wanted very large subsidies, and Munroe offered to take over the service county wide. Once there was a Jacksonville firm, Lberty I believe, but they wanted only to cherry pick the most profitable areas and turn the rest over to the county.
I believe state law gives the countywide control to the county commission, and if the city took over service in the city, it would have to apply for the city area from the county. Problem is two fold:
The city wants "immediate response times" for their residents (who wouldn't) and the city has the most calls and is the most profitable.
The county has to look at the entire county situation, and you have to have the "profit" from the city area to help subsidize the long hauls from county areas.
I do not share Creekbaum's disdain for the county operations in general. The city has more severe problems than the county at this time. I would not want to be an elected official of either, the EMSA is a perfect example.
As for those who do not understand the dispatch of a fire rescue truck and an ambulance to the same situation, I assure you the first EMS to reach you is vitalm, and the fire people are highly trained and get people stable for delivery to the hospital. I was certainly happy to see that red truck pull up when I almost died from dog bite wounds 15 years ago.
Difficult problem with no good answer. Knowing what I know, if I was a county commissioner, I would bite the bullet, take the system over, merge it into the county fire department, and problebly look for another line of work at the next election. --pwf
The Blog Master said;
“There are a couple of variations on EMSA remaining as a stand-alone operation: (a) privatization (good luck on that one!)”
Not so fast there Blog Master!
Privatize to a consortium of personal injury attorneys.
“Why chase them (ambulances) when you can own them.”
It would be a form of courtesy transportation not unlike an auto dealer.
County gets off the hook, taxpayers are off the hook, injured “gets pre-qualified” for lawsuit so hospital can get paid. Estate planning, living wills, etc all taken care of in that special time of need.
A win, win all around.
Did someone mention out of box thinking?
That's a good one!!!
That PPI is a waste of CFCC's time and taxpayer money. The only reason it was created was to provide employment for the wife of a local Republican congressman.
I might have my mind changed with what happens on the health care study results. If something actually gets accomplished with the results from that study. It does look promising right now.
Glory Be! What’s happening to the Blog?
Misters PWF & Brian Creekbaum actually see eye to eye about the Public Policy Institute.
I can’t believe it!
From what I know, there aren’t many people in Marion County government who are impressed with Brian Creekbaum either.
How many advisory boards or volunteer organizations has he devoted time serving on? Other than his library interests, which were usually aborted by Randy Harris, what else does he have enough expertise in to make the wild ass accusation that those of us in county government or those associated with it are basically incompetent?
There are many people in county government who would find his subjective characterization demeaning and absolute b... s..., probably influenced by the fact there are those who dust him off because of his unusual personality and lack of respect for county employees.
PPI has taken on some good projects of benefit to the community. PPI as an institution is not the problem. The work of PPI is judged by how good or bad the members of a particular study group do their job. That’s appears to be the rub against PPI-inconsistent quality in the selection of work committees. I agree with a comment made above that the recent Health Care Study may prove the exception. It was headed by a person with decades of experience in local health care problems, Dyer Michell. Even though the group had 60 members, it came up with several great ideas to implement. Maybe their work will turn around some of the negative opinions about PPI.
Wishful thinking.
I’ll play County Commissioner on what I’d do about the EMSA situation. I would be on the side of taking over EMSA but not moving too fast in merging it with the County Fire & Rescue Department. In other words, dissolve EMSA’s current independent, non-profit organization status and manage it as a county department reporting to the County Administrator (not the County Fire Chief).
Let David Palmer, the Chief of EMSA, have two years to deliver on the strategic plan he has already developed. At the end of that time, the BCC can assess accomplishment and evaluate/determine the future direction.
This would also provide Palmer’s EMS operation a chance to identify and implement administrative overhead reduction opportunities via having some functions currently performed by EMSA taken over by county staff; doing this without potentially jeopardizing the quality of direct emergency care delivered by EMS paramedics. Importantly, as a stand-alone department, it would make it easier to manage some of the more complex transition issues in EMSA staff becoming county employees (e.g., pay, benefits, training, work rules, etc.). Additionally, it seems to me that the County Fire and Rescue operation, under Chief Stuart McElhaney, already has enough on its plate at this time without the added burden of absorbing another significant county function.
Some of the biggest screw ups I have observed and personally experienced as a businessman were a rush to totally integrate a newly acquired operation into the acquiring company. Frequently this resulted in not being able to obtain a thorough understanding of the real business opportunity (and at times problems) acquired before starting to change/reorganize it. Obviously, EMSA is not perfectly comparable to acquiring a business. However, a good business principle of “seek first to understand” before acting is very relevant.
The BCC needs to give itself more time to work with the EMS operation. A quick 1-1 ½ month study and recommendations from a citizens task force, while to be commended, is not the end-all answer to the future of the county’s (i.e., BCC’s) responsibility for the delivery of emergency medical services.
This comment has been removed by the author.
fiscal conservative said...
“Disagree totally with Brian Creekbaum’s subjective conclusions about PPI.”
The PPI’s growth study was billed as a study of an umbrella issue. It had potential ramifications for virtually every facet of life in Marion County, including the local economy. It’s a matter of public record that the PPI’s chair for this study of such great importance filed personal bankruptcy a few years before moving here and becoming chair of the study. Doesn’t sound very “fiscally conservative” to me or like the PPI has much of a vetting process for its bigwigs, but I do agree with the comment that the staffing of their studies changes greatly from study to study, leaving open the possibility that they have already produced, or will in the future produce, something more useful than their growth study.
Given that, according to the PPI webpage, the current publisher and editorial page editor of the Star-Banner and a past editorial page editor of the Star-Banner sit on the PPI Board of Directors, its must be a real challenge for the Star-Banner to produce objective news coverage of the PPI and the findings of its studies. By my observation, the Star-Banner functions as a largely unquestioning distribution channel for what the PPI produces no matter what the quality.
Pwf says…
“The city wants ‘immediate response times’ for their residents (who wouldn't) and the city has the most calls and is the most profitable. The county has to look at the entire county situation, and you have to have the ‘profit’ from the city area to help subsidize the long hauls from county areas.”
…a scenario that will be played out over and over as the Board of County Commissioners will continually use every technique they can lay their hands on to pull us into schemes for various services that are disguised attempts to impose the costs of inefficient development in unincorporated areas of the county on the citizens of the City of Ocala. The giant sucking sound you hear is a parasite trying to attach itself to its selected host.
It’s interesting how some of our politicians and their supporters in the local redneck mafia have spent years preaching the virtues of unfettered capitalism and individual responsibility and now we hear they may enthusiastically convert to socialistic wealth redistributors when it comes time to pay for services provided to rural dwellers who disproportionately vote for them. How conveeeenient.
It would be interesting to know what the financials would look like for an ambulance service operated for just the City of Ocala. We already have a fire department that responds quickly with trained personnel qualified to perform emergency medical work and the major hospitals are centrally located in the city.
Stan the Man,
Let me first seek understanding. What you seem to be saying is that a go slow approach to bringing EMSA into the County fold would be the best way to avoid any “screw ups”. Do you really believe that will happen with $3 million of savings on the table if County Fire Services takes over?
Brian Creekbaum: Go talk to our City Council about establishing a City only emergency ambulance service. They’ll laugh you out of City Hall! They are already looking for ways to get rid of functions, not add new ones. I guess if you have a serious automobile accident or illness while up in north Marion County (or any other non-City area), you would want them to send a City ambulance since you want nothing to do with a County ambulance service.
Oh, yes, and if you want a Marion County ambulance service it must mean you want no emergency service if you are in Alachua County or Maine or Japan. What a stupid comment that reflects the sort of local yokel mentality that doesn’t know there is a world beyond the Marion County line.
If consolidation of everything is so great, then call up Alachua County and all the other counties around us and tell them you want a merger and that the Marion County Board of County Commissioners will run the merged entity. See how long it takes them to stop laughing. If consolidation of everything is so wonderful, then why did counties that used to be part of our Central Florida Regional Library System cut away from it years ago to establish their own library systems? Local control. Local control. Local control.
As I stated above, I don’t have enough information to know how the ambulance service should work, but anyone in authority who claims it’s ridiculous for the City of Ocala to run such a service, or any other service, had better have the information to back that up. Some of the people down at City Hall have gotten way out of touch with what the citizens want on this. Ambulances aside, speaking of consolidation generally, I won’t be surprised if one of the council members ends up losing an election over pushing this stuff.
Oh, I almost forgot to mention solid waste. Didn’t Kent Guinn and other city council members tell the County to go stick in on that and come out fine on the deal? Someone please correct me if I’m wrong because my memory could be off.
I vote that we adjourn the meeting now and reconvene out at the County’s $5 million solid waste transfer station boat anchor to further discuss how wonderful it is to have the county commission in charge of your government services.
Consolidation will work just fine for me.
Thank you Mr Creekbaum or should we say Mr. Know It All for your opinion. And that is all it is, your opinion. I have mine and it is that the BCC will do just fine running the County and anything else the local cities want to give up to them.
If the commission wants to give up ambulance service to the city of Ocala, that's fine too. But as someone said, like it or not, it's the commission who controls the decisions on the service not the other way around. Creekbaum better get used to the county doing more for him, cause it's going to happen more and more.
I'm pleased as punch with the post Harris era of County Commissioners and their performance. They have some real challenges and are working well as a team to solve them.
I'll vote for two of them to return to office in 2008. I'll also vote for Mr. Amsden for Kessellring's spot. Fitos is also working well with the four other members and based on what I see, I would vote her to return.
Brian Creekbaum may not have a high opinion of our Commission, but I do. He is one vote and so am I, as someone already said, there are those who don't have a high opinion of him.
This comment has been removed by the author.
I’m as pleased as punch you are so happy with the post-Harris era on the county commission. I was happy to help bring it about and am happy that my prediction on the blog of how it would develop was dead-on accurate.
It would have been nice if a member of his own party had taken out Harris, but the brutal fact is there just wasn’t enough leadership in the Republican Party in Marion County to pull it off. It’s axiomatic that you can’t beat something with nothing, which is exactly what Republicans like some of the anonymous sniping weenies on the Politically Homeless blog confronted Harris with in the 2006 Republican primary.
Those of us in Ocala would be fools to make strategic long-term commitments with the Board of County Commissioners based on its composition and behavior over a few months. Furthermore, the county commission is always going to be more distant from those of us in Ocala than our city council and less able to represent our interests and, regardless of its composition now or in the future, the county commission is destined to face a vortex of problems for many years that those of us in Ocala should not allow ourselves to be sucked into.
If you want a real look at how urgently the Ocala City Council is looking to shed services, a claim someone made above, take a look at the scoping of their golf consulting project in which Council explicitly told the consultant not to even consider why Ocala is in the golf business or to consider shedding even one of the city’s two public courses. Oh, yeah, sounds like they are under a whole lot of pressure J. As I have stated elsewhere on the blog, three precincts in Ocala (containing some of the most influential people in Ocala) voted for the wildly unpopular sales tax for roads last year. I have not seen the evidence that our city council is under a bunch of pressure. I guess these pro-consolidation people have to resort to creating a false sense of urgency because their underlying arguments are so weak.
Creekbaum--the left hand Nancy Stacy!
I have a friend who is a retired local policeman. He tells me that only about 10% of the 911 calls are for fires. The other 90% are non-fire emergencies. So why would anyone want to fold the EMSA operation into the fire department? Seems maybe it should be the other way around in looking at which is the most used and important.
Don
(OTOW)
I'm not sure who Brian is speaking of at the PPI who filed bankruptcy but I would like to know.
The PPI is good at one thing:
Filling up shelf space with their hopeless "feel good reports". Every single project they create gets canned before the starting gun goes off.
So for around $ 500,000.00 a year (or so) I guess it's money well spent!
Man-about-town Chick Dassance should spend more time earning his pay as the big dog at CFCC and stop all of these luncheons. (On the taxpayer dime of course)
I would also like to know. Maybe it's not so.
All you people on here who think the Sheriff is so great. How about the Commissioners asking him to take over EMSA?
You may have meant that to be funny. Hey, that's a great idea!!
Mr. Creekbaum better rethink his comments about the great local government we have in Ocala vs. the County. The Downtown Project is turning into an economic fiasco and can be dumped right in the lap of our great City Council. What a bunch of thunderheads! They are beginning to make the County Commission look better and better.
I uniquely identified the person by position but not name, Christopher, because I was making a point about the PPI and didn’t think it necessary to include the name of the individual. I still don’t, especially since she’s not on the PPI’s current Board of Directors list on their website and, to my knowledge, has pretty much withdrawn from local involvement.
Many people know her name, which was well publicized at the time of the growth study, but it will not be me who posts it to a blog for chewing over by cowards who lack the courage to give their names when criticizing others.
I think it’s time for the Dr. Phil quote from his “Revenge of the Exes”episode originally broadcast September 20, 2006:
Dr. PHIL McGRAW: OK. Now one of the things that I have a problem with in this, now--and, of course, understand I probably should somewhat recuse myself from this because I'm in the tabloids all the time. And they're always dogging on
me in the tabloids about something, you know. And I got to tell you, I think
people who step up and say things anonymously are gutless cowards. Because
you have no way--you have no way of confronting them or dealing with it.
The episode concerned people anonymously posting negative comments about others to the internet.
8:06 AM on August 6
If you mean Creekbaum is sarcastic, arrogant, biased and feels the only correct point of view is his, then the Stacy comparison is on target.
Please, please don't demean Nancy by comparing her to Brian Creekbaum.
Who needs the developing story on downtown development problems to illustrate that the Ocala City Council makes mistakes when you can cite their airport firefighter training facility boondoggle of a few years back.
de Tocqueville observed a long time ago that democracy produces mediocrity. I prefer the mediocrity down the street I can keep an eye on to a more distant one.
From website of Republican Executive Committee of Marion County:
“…the most effective government is government closest to the people.”
Interesting that in a county dominated by the party that makes this statement we have some in that party who think we in Ocala need our government moved further away from us. Why, before you know it, these pro-consolidation people will be advocating a move to One World Government on the grounds it would be more efficient to cut overhead by having one HR director :-)
Hey Nancy's friend,
How about not demeaning Brian by comparing him to your friend.
I can't see where Brian is trying to manipulate the system by simply offering an opinion like the almighty Nancy Stacy has done.
im waiting for bro creekbiottom to have the guts he claims he has and name who went bankrupt. lol.
Won't hear from him. He's already walking a fine line.
I assumed responsibility for the accuracy of my original comment when I uniquely identified by description the person involved in that comment. Be prepared for a very long wait in getting the name from me. I don’t run errands for adolescents using their internet connections for anonymous schoolyard name-calling.
Your behavior is a perfect example of why I refuse to unnecessarily post the name here.
As I’ve said more than once, I’m no authority on emergency services, but a few days ago, I spoke to a friend in the Ocala Fire Department who says they respond to emergency calls with no fire because of their certification in providing emergency medical attention and because they have resources positioned to respond very rapidly.
Brian,
Ask him what % of calls are medical versus fires. I saw someone mentioned a retired policeman had said 90% were non-fire.
What does a bankrupt PPI member have to do with the EMSA comments?
A bankrupt former PPI member ?
Who cares.To attach a stigma to somebody because of bankruptcy is wrong, especially when 50% or more of bankruptcys are health care related.The mid does not automatically go bankrupt when people do.
With subprime loans, tightening of credit, mounting foreclosres etc, you, your neighbor or somebody in your family could be the next bankruptcy victim.
Highly leveraged real estate investors are falling like dead flies, especially land speculators who have no income from those propertys to float them. Tax delinquentcies are at highs not seen since the depression.
Piety proceeds the fall.
Clayton Ellsworth
To Clayton, Brain and a much lessor degree all of the folks with the same name (anonymous):
If Brian does not want to give out that name it's his business. I repsect that and others shouldn't hound him about it.
Second to address Claytons comments the only point I would stress is this. Many people in positions such as "directors" of "do gooder" organizations set themselves up for this type of public scrutiny.
If they do not desire public evaluation of their financial histories they might want to re-think their position in helping guide public policy.
I'm not pre-judging anyone here but my experience tells me to be very skeptical of certain things.
Thurow said:
"I'm not pre-judging anyone here but my experience tells me to be very skeptical of certain things."
Great comment. Probably explains the thinking of many about Thurow's failed runs for office.
so bc aint about to name the bankrupt ppi member. surprise, no, he's too smart to open up to lawyers that much.
ct sez some mite not want financial scrutiny of their money. maybe that is why he can't get elected in mc. lol.
"do gooders:
I know a former chairman and a long time participant of PPI. This citizen gave hundreds of hours of time to this as well as other community causes which have seen his generousity in time talent and treasure.[multi millionaire] A "do gooder "? you bet, God love him and the many others that care about our community and mankind.
I was asked to serve on PPI and had to decline. I am glad I did so. I would have been subjected to the pious and inane thinking of those that consider themselves eliteists, better and smarter than those who serve without reinumeration or recognition.
"I am not prejudging " You bet and the check is in the mail.
"
"Piety preceeds the fall"
Clayton Ellsworth
Sorry Clayton though my comments certainly do not apply to everyone participating in some form of public service there is a thin line here.
I have contributed too many hours to these "causes" only to find out the whole thing is a charade.
Usually a charade to extract taxpayer money from one group and give it to another. The final insult is when the "do gooder" who picks my pocket takes credit for the "do gooding".
Again sorry but that's reality my friend!
BTW Clayton...
When one accepts a position in any type of public service (which there is no compensation) they should never, ever have the expectation of even the slightest pat on the back. Those who quietly serve and are never recognized for that fact are the REAL heros.
CT:
Other than criticizing others and making sarcastic comments, what exactly are your volunteer contributions to Marion County?
It might help if we all understand how many important activities you are involved with.
I would ask the same of Mr. Creekbaum.
NO NAME.....NO REPLY
I see one of two scenarios for the future of Politically Homeless:
We will have honest conversations here under honest conditions (using your name) or the "anonymous" gang will kill this blog.
I feel that the spineless anonymous posters want that to happen.
It ain't!!!
So learn to use your name or find some other blog to flame!!
Thurow is correct. I personally regard questions on this blog about my volunteerism as nothing more than a form of insult, designed to demean my community contributions, so I generally don’t respond to them, especially from those who don’t even have the decency to use their names. There are too many people with names in Marion County who have been well-recognized leaders for years in and out of government at the county and municipal level who have personally expressed their appreciation for my activities for me to have an interest in even answering the question.
When someone linked a planned PPI study to emergency services, the subject of this thread, I made a related comment on the PPI’s track record, including its track record in vetting a previous study chair.
The PPI, which has some sort of association with a tax-payer supported educational institution and has a board of directors that includes senior government employees who are paid by taxpayers and who are obviously on the PPI board because of the government positions they hold, seeks to influence public policy in Marion County. Its study related to growth, for instance, sought to influence public policy affecting virtually every facet of the lives of hundreds of thousands of people in Marion County, including their jobs and property.
The PPI’s track record is fair game for public comment. So are the qualifications of the people it puts up to run its studies. When someone thrusts themselves into the public arena by attaching themselves to such an institution and its work, taking a lead role in the management of a study and in the authorship of its report, public releasing biographical information about themselves, and aggressively seeking media attention, the public is not required to close its eyes to elements in their background bearing on their qualifications.
I note that the county commission required personal financial disclosure of candidates for county administrator in 2002 to see how they were managing their personal finances, and they currently run background checks on people who want to ask for a quarter toward the purchase of a sandwich, which I regard as a somewhat less significant activity than using an organization and putting out economic analysis and the like to influence public policy for the whole county.
When I was solicited several years ago to work on the growth issue before the PPI growth study even existed, I obtained a copy of the bankruptcy case mentioned above from the federal government as part of my own vetting process of the individual seeking my assistance. I reviewed the case file at that time along with other publicly available information pertaining to it.
Clearly, people have a right to debate what is relevant to qualifications, but I caution anyone against making further comments about this subject intended to falsely portray me as dishonest or to falsely imply legal insufficiency in my actions. I’m very interested in making an example of someone in Marion County in this regard and have the resources to do it. Courts can and have penetrated internet “anonymity,” and I own a copy of the case file whose existence someone on this blog has questioned. Govern yourselves accordingly.
One point of personal privilege relating to some comments a ways back. I’ll put my record of supporting county government employees, including those under attack by the people they work for, and my record of protecting speech in Marion County with which I disagree, against the record of anyone in Marion County.
My friend in the Ocala Fire Department is a great guy who has been serving ably with them for quite some time. If memory serves me, he received an award for saving a child while off-duty. However, I don’t know him to be in management so I don’t know if he would be the best source for the statistics, which must exist in some publicly available report somewhere.
I posted my limited information to make the point that the “Fire” Department does more than respond to fires.
I am very new at this, so Please be gentle with me. First, I have also participated in a PPI group. The group I participated in was full of individuals who provided excellent thoughts, opinions and reccomendations. They were deeply concerned about every man woman and child in our community, Regardless of economics (or political status). I do know Dr. Dassance and I can tell you he is truly the man he displays "about town". He is no fake. We are blessed to have him in our community. Can we get to the subject that really is more important than you bashing each other?
A subject probably more important than most items on the County and City agendas. That is our local Emergency Medical Services. Please do NOT speculate on what we have now or what we may get in the future. This is TOO important for you, me, our children, grandchildren and aging parents to let pass by.
The very BEST thing you can do here is become informed...VERY informed! Please contact Chief David Palmer of EMSA, (873-6522) and ask to meet with him, his deputy and/or administrative staff. He/they will spend all the time you need to make sure all your questions are answered. He is a man of full integrity. You will NOT get smoke and mirrors. He will share with you his proposed budget and explain EVERY penny requested and spent. You can even arrange to ride an ambulance as an observer for a shift (if you think you will be able to handle it :-). After reading other blogs, it is pretty apparent, that many of Chief Palmers employees are opposed to the County Fire Plan. One blog says it best, it is in their being, there sole, that they are EMT's and Paramedics. NOT fire fighters! Why force someone to be a fire fighter if it is your calling to be a medicals care giver... Would you want to be forced to do a totally different job than you were called to do? I think not. Why Force a fire fighter to become a full time patient care giver? Oh I almost forgot, Chief McElhaney did not say he is forcing his paramedic/firefighter guys to work on an ambulance, but WILL force most of the ambulance guys to go to fire college and fight fires (not their calling)"Lordpleasehelp" And the 3 million savings??? make him prove it.. make him put in on a complete spread sheet.. and Hold him and the General (Pat Howard)along with each and every county commissioner accountable for this.
As for you City guys, PLEASE call Paul Nugent for his opinion. Well I can't wait, I'll tell you and you can call him to verify. Mr. Nugent wants the City Council to remain VERY active in the local ambulance service, in such that a city representative will sit on the EMSA Board, as a governing body, to assure the City residents are properly represented. If this doesn't happen, where do you think Chief McElhaneys ambulance service will prioritize their service? Surely not in the City!! Don't be fooled... you need to get involved and insist the City Council takes a strong stand here. If that doesn't happen. In terms of finance, Please understand, Ambulance service will never get in the black, there will always be a "loss". There will be a required subsity,the tax payer or someone else to pay for the "loss" Medicare only pays so much, 3rd party insurance only pays so much and those without insurance only pays so much (if any at all) but the service still appropriately provides the service. (Currently, in Marion County, we are fortunate to have the hospitals help offset the "loss" through over 3 million in contributions). Again, Chief David Palmer can explain every penny spent and collected. Thank you all for taking the time in getting my opinion. And PLEASE.. let's stick to the subject. This is truely a non-partism subject. Let's keep it that way!!
You make some excellent points!
It's good to get back on the subject. I'm tired of a couple of people raising ridiculous topics, with little value to the discussions. I could care less about the bankruptcy of a PPI participant.
I do have two questions for you that need your further explanation: (1) what happens if (more like when) the two hospitals no longer can afford to contribute to EMSA and/or (2) the City opts to handle its involvement via an MSTU?
Additionally, are you proposing that EMSA remain an autonomous organization? Where does it get the money over the long term to do so?
"Lordhelpus"
One of the problems that EMSA is going to have in remaining status quo is justifying the large amount of overhead in its budget. All you need to do is look at the EMSA pay scales and see the large salaries paid to admin. support vs. the EM Techs. It’s a travesty of injustice and inequity!
By combining with the county in some form or other, maybe a separate county operation, you are going to see much in the way of savings by cutting out some of the high paid admin.
It’s the County Commissioners who have to be sold on EMSA’s future. Nugent is a nice guy, but not sure he has the ear of the City Council on the EMSA issue. Also, the Commissioners are the ultimate responsibility on the decision about EMSA.
As a city resident, I'd like to see it remain independent. But that is going to prove very difficult financially.
Net Etiquette for the 22nd Century
Post comments that are related to the entry. If you must post a gripe to some other writer, email it to them. Don't make remarks about a poster that is not relavent to the discussion.
If you don’t like it, move on. If you don’t share a blogger’s opinions, don’t make it your mission to spam his/her blog with your vile personal attacks.
If you’ve accidentally posted repeat comments, apologize to the blog owner, preferably via email. You could post the apology with another comment.
Rude and childish behaviour just because you’re an anonymous commenter or are behind a pseudonym is unacceptable. As much as good manners is required in the real world, it works the same in the blogsphere. Use your name!
GOOD POINTS--BUT NOT RELATED TO EMSA!! YOU ARE VIOLATING YOUR OWN RULES.
I'M FOR TRYING TO KEEP EMSA AS IT IS. THE HOSPITALS AND OTHER PARTNERS SHOULD BE ABLE TO KEEP COMING UP WITH THE FUNDS FOR RUNNING IT. IT IS NOT A LOT OF MONEY FROM THEIR BUDGETS.
POSTS BY ANONYMOUS POSTERS ARE A MEANINGLESS WASTE OF BANDWIDTH.
USE YOUR NAME OR DON'T POST A THING!
IT'S TIME YOU PEOPLE STOP WASTING OUR TIME WITH YOUR FACELESS NONESENSE.
BTW
IF ANY ANYONE HAS A GRIPE MY EMAIL IS:
CTHUROW@YAHOO.COM
SEND ME AN ANONYMOUS EMAIL
Here is a radical thought. Why not leave it exactly as it is. Where do the hospitals get off telling this community that they don't want to fund part of EMSA anymore? Excuse me? EMSA is delivering customers to your door step and you don't see that as benificial and an integral part of you function in this area. Lets give them a choice then. Pay your share as you do now, or be prepared to pay a franchise fee (tax) that may turn out to be 2 times your present "contribution". City council be prepared to tell your constituents that their response time will go up if the City does not pay their fair share also.
Ok County Commission problem solved! Put on your big guy/girl pants and get it done.
Any thoughts out there?
(CT you don't have to respond since yes, I prefer to remain anom. Is not freedom grand?)
Geez isn't it ANNOYING when somebody keeps repeating stuff that absolutely NO ONE cares about?
Nobody CARES about anonymous posts!
I could do this all night!
Maybe I too should send my posts as anonymous!
Ain't freedom grand?
Why don't you check to see how many hospitals in Florida, private or community, have to contribute to ambulance service operations. Think you will have a difficult time finding any.
Here is another thought. Get rid of the EMSA Director and let Chief McElhaney do his job and then add 3 more paramedics with the salary saved. Get rid of the EMSA Finance Director and let the County Finance Director pick up that job and then add 2 more paramedics with the salary saved. I can keep going, and pretty soon we will have a very well staffed group actually doing something to save lives and improve our coverage of EMS.
I say staying as is makes no sense. Please Mr Thurow, don't respond to me! I'm just a brainless, faceless EMT, who might save your life someday.
P.S.: Mr. Thurow, Maybe if yu sent your posts as anonymous more people would actually listen to what you say and not discount yur thoughts because they don't take you seriously and frankly may not even like you. Runnning for office does make enemies.
Maybe you should go away or start your own blogger.
If you don't think that the county staff would grow admin wise if they absorbed EMSA I have some Florida swampland to sell you. Do not let the county get full control of this operation. Don't you remember how underfunded and bad the fire service was before the current chief got some support to fix it? When the county government can show that they can handle roads, garbage, water, growth then maybe we can trust them with our lives. Until then...
You aren't making sense. If the current Fire Chief fixed the department and it's running fine, then why can't he also run EMSA?Your logic is not very sound.
Give the Chief EMSA and we'll have a better emergency service. He's proved his ability and you have stated that.
I'm having difficulty in getting on. so I'm trying amanonymous. sorry
If the City opts for the MSTU it will be more fair for all city citizens in that the mstu will be across the board to ALL citizens (including me) Currently, as you may know, the city pays out of their general fund which takes $$ away from other important services. Mr. Nugent’s position is that if the City opts to go the MSTU route, then the City should have the right to participate in the decision making process of EMSA. Mr. Nugent may not have the ear of the City Council but you as a city citizen and tax payer do (or should). I have been disturbed in the past that seems as if the council has not shown much interest. This can change if all of you get them in the right direction.
In relation to the hospitals, First if any of you know any of the leaders of any of the local hospitals, please give them a word of thanks for their very active involvement in our local EMS service. This is through administrative support, direction and financial support. They never had to give one penny to this service and would still get the same patients (market share) they get now. They have provided a great service to our community. If (when) they pull out, the 3 plus million will have to be covered by increased patient revenues and more subsidy from me and you. It's that simple. Compare Marion county with other counties and I think you will find the subsidy there is the same. It is a necessary evil. At least EMSA can bill for services. I’ll use an old figure because I do not have a copy of EMSA's current budget.
EMSA's budget was say 14,000,000. 1/2 of the budget (7 million) was covered by patient revenue (insurance, Medicare, Medicaid cash etc) the other 7 million was covered as follows
MRMC 1.3 million
ORMC 1.3 million
the other 4.4 million was covered by the city (29% of 4.4 mil) and Marion County (71% of 4.4 million)
Now the hospitals are each giving 6.75 million (maxed out) and the City and County are picking up the rest of the "deficit".. However EMSA has worked hard in getting as much revenue from payers that they have consistently received more revenue than projected. which means the county and city has to pay less. The county millage rate was set at .21 for EMSA. The staff there worked hard to keep it down as much as possible (and at the direction of the Board of Co Commissioners) to the point, I am told, only required a .16 millage rate. The frustrating part, as I understand it is that the county, through its administration or back-door politics with the commission, kept the millage rate at .21 or possibly even higher... but is not giving EMSA ANY of that.. Instead, I am told that they are going to horde the money away, to buy things like "Bunker Gear" for EMSA people that will be FORCED to become firefighters, and buy ambulances and "stuff". (This 3 million "savings" will be depleted before the Chief's new Ambulance Service is up and running.. MARK MY WORDS! As for salaries, I do know EMSA hired an outside Salary and compensation company to study EMSA. They compared the EMSA salaries with the market and found they were low (even with smaller counties Lake, Sumter, Citrus etc.) There was a recommendation of an increase. Even General Pat Howard (who is on the EMSA board) voted in favor of the salary adjustments. There is heave competition for Paramedics in Florida including all counties surrounding us. EMSA has to compete to keep these guys from going away. So everyone should compare EMSA salaries with other EMS services NOT firefighters. EMSA associates are NOT over paid, if they are or will be making more than a duel certified paramedic/firefighter than that is not the fault of EMSA. As far as the administrative and support peoples salaries, they were included in the salary study. I do know the Admin and support staff doesn't make any where near the 3, 000,000 savings.. that is why there is great suspicion in this plan, which I am told that Chief McElhaney admitted his plan is only 70% complete. I was also told there are so many holes in his plan you could drive a fire truck through it. Please don't take the word from those trying to justify county take over, please do the comparison. The county Fire department has more Chief's, Captains, Lt's, supervisors than EMSA does.. I agree it has more employees but to make sure you are comparing apples to apples, judge things like span of control. Supervisor/employee ratio etc. I am told EMSA handled over 50,000 calls last year and that may be more than the County fire service. They transported 35,000 patients (revenue). Think about this $18,000,000 (or whatever their budget is now) for 50,000 calls and the fire service, over 30,000,000 budget for less calls? do you think the county can shave 3,000,000 out of the fire service budget and leave EMSA alone? I don't know but it surely is something we as tax payers need to stay on top of.
My thought and question is why can't EMSA stay as it is, Even if the hospitals pull out? Either way the county is going to have to pay, the county AND city will have direct control over the operation thru their governance on the board, and the City council AND county commission will still have control through the approval of the budgeting (Much like the sheriff does now) The hospitals can still sit on the board because Guys you really DO want our medical community involved in how our patients are cared for on the streets.. and even consider having the other cities (Belleview, Dunnellon etc) have a place on the board. Doesn't it seem "cleaner" and more representative than having one group of people running this vital service for everyone?
Again please contact Chief Palmer I know he will be happy to meet with each of you. The worst part is if the county commission chooses the fire merger plan, it cannot change back. We will all suffer.
I would caution everyone to be very suspicious. if you think EMSA is wasting 3 million dollars don’t you think someone on the finance committee and EMSA Board would have caught on by now?
One last thing. EMSA is audited yearly by Purvis & Gray The representive told out board that EMSA has done so well, if it was a publicly traded company, he would buy stock in it!.
Again thank you all for reading and providing excellent input!
A long comment, but interesting.
An issue that is more complicated than I thought. No matter what is done, better move slowly and not take any rash actions. Maybe the County Fire Department taking over the EMSA isn't such a good idea.
I'm no financial genius, but I don't see anyway to keep paying for EMSA services except for the County to pay if the Hospitals, etc. don't continue to contribute. I read the County has the legal obligation to do that. Correct?
A big factor would be does the County want to pay the EMSA bills and give up control to an independent EMSA with other local governments participating in oversight? I wouldn't.
ysohmuso cthorrow doesnt like anonymous comments. maybe next election he will want to have all votes signed so he can attack all those 1,000s of voters who reject him..again!
wonder why he posts a yahoo email since most mosts come from time he is supposed to be working for govt in stark.
see where bc is back to trying to intimidate folks by braging he can finance a law suit against blogger posts. he;'s the one who posted the crap abt somebody filing backruptcy which i think is still a legal way to manage excessive debt. get a life bc. lol.
The point about not letting the county take over EMSA is that the fire department was is bad shape and could very easily revert back.
Whenever there is a "budget crunch" they almost always cut the most visable service first as a form of slight of hand so that they don't get pressure to cut the real fat, or hmm properly manage growth?
Why should we care that other hospitals are not forced to "contribute" to the EMSA's?
If they won't contribute as a private public partnership then
a franchise fee paid by these Corporations (hospitals) makes sense. (Willing with a vote on a board or unwilling with a franchise fee and relegated to an advisory capacity)
This is no time to bring such a vital service with substatially increased funding by taxpayers and under county control.
The Chief of the fire dpartment has already been duped into believing that cutting capital expenses and maintenance will get him through the budget crunch.
Psst! The revenue shortfall for the state is projeced to be with us for the next 3 plus years. Anyone who thinks that deferring for one year is going to get it back next year and that they will then be able to play catch-up is a fool.
Please tell me what county employee in the future will be able to tell this or future generals/commisioners? Look if you continue to not fund replacement ambulances, traning, salary, etc you are going to be killing our citizens? and still think he/she would have a job?
Negotiate a deal with the current parties and let's not fix what does not need to be broken.
Hey Ferguson here's your "to-do" list for today:
1) You keep a record of every time and date I post. This way you can work on getting me fired. I want to show people here in Marion who and what you really are.
2) Loose 125lbs. I don't want to pay for your healthcare.
Anger management Thurow. You are beginning to sound like a very sick person. Now people will know why they should never vote for you for anything.
If you can't walk away from people picking on you, you have no place in politics.
By the way, this is about EMSA and we have yet to see anything on your opinion.
No, I'm not Ferguson.
C.T.: Hershey's designated Friday as National S’mores Day to mark the 80th anniversary of this chocolate delight.
Why don't you stay off the blog tomorrow and spend your time at work exploring all the various S'mores recipes. That might allow for more subject related discussion on the Homeless Blog.
Here is the site with millions of exploratory opportunities:
www.smoresfun.com
P.S.: Chocolate has a very calming effect if not eaten in excess.
NO NAME NO FACE NO MEANING
ANONYMOUS
ANONYMOUS
ANONYMOUS
ANONYMOUS
ANONYMOUS
Mr. Thorrow: FYI, I have spent most of yesterday and today today on the phone with Embarq in Shreveport, Dell in Bombay, Embarq in Altamonte Springs, Dell in Houston, Embarq in Altamonte, plus several sessions of direct chat with Embarq and Dell. In addition, this week and next, I am hosting 125 to 150 young boys and girls from the YMCA which keeps me far too busy to even read the blog until tonite.
I have no clue which part of whatever in the hell bothers you that you choose to credit to me. So go chase after someone else who cares whether you sign your name, or where you work and what you do when there. Someone who obviously has ticked you off but it aint me. --pwf
The people I care about know who I am, and
guess throw aint on the job at work tonite and cant boot up his computer to throw more crap on blog. who the hell is he anyway?
Contracting out may a solution.
Savings can be obtained from both greater efficiency and higher quality of service.
In Pinellas County, Florida, managed competition took the form of bidding among public and private providers for the exclusive right to provide non-emergency and EMS ambulance services for the County. Typically three or four bids have been submitted for the five year contract which can be renewed for an additional six years upon satisfactory performance.
The public fire departments formed a consortium to bid in two of the three times the contract was offered. The public fire department consortium offered the lowest quality and the highest price.
Equipment and ambulances have significantly improved since managed competition was initiated. Private ambulance companies in general have more sophisticated equipment than public providers. Monetary savings from contracting out have been estimated between 5 and 10 percent of local operating budgets, and the quality of equipment has been significantly improved.
Just a thought.
beats the hell out of me... but be quiet... he must be sleeping... Don't wake him!!
If you guys are interested in learning a little more about EMS and Fire from the employee's point..some is not real accurate, but it is as they "feel" check it out However, DO NOT tell CT where you went.
http://forums.ocala.com/eve/forums/a/tpc/f/8651007465/m/1711001146
I think it got cut off. Try this
http://forums.ocala.com/eve/forums
/a/tpc/f/8651007465/m/1711001146
Contracting is an interesting idea.
I notice no one responded to the question asked about how can EMSA remain independent if the hospitals no longer help pay into it. What about that, you who want it to remain as is?
Thank goodness! We are back to the topic. Bankruptcy and Thurow's opinion on ANON bloggers was getting old.
This is the idea.
Hospitals don't get a choice about funding. They are pressured into reality. Continue to fund at X dollars, or be prepared for a tax (franchise fee, local license, permit, assesment, what ever you want to call it) that will amount to Y. By the way Y will probably be 3 times X.
That's how some private/public partnerships are formed or in other words "Sometimes weddings require a shotgun."
Placing a franchise fee on the local hospitals to make up for the $1.7 million each is now contributing to EMSA is possible, but with ramifications to the taxpayers in the case of the not-for-profit “community hospital” (Munroe Regional) and/or to those needing hospitalization in the case of the for-profit “private hospital” (Ocala Regional).
Apply a $1.7 million or more franchise fee to Munroe and it will likely place it in a loss situation in a year or so, requiring taxpayers to make up the loss. Currently, Munroe does not ask for or receive any taxpayer money to operate. So if you don’t mind taxing yourself, the franchise fee you suggest will most likely get passed on to all of us. Realize Munroe is a special taxing district and can impose property tax millage for operations, but has never done so.
Comparably, a franchise fee applied to Ocala Regional may also impact its profit margin. However, it can raise prices to patients with much more freedom than Munroe and/or be more selective in patient selection than can Munroe (which has certain legal community needs requirements as a not-for-profit). Additionally, if profits are too adversely impacted by the imposition of a fee, Ocala Regional might decide to selectively shut down certain operations, or even sell or close its facility. This could result in a transfer of patient care loads to Munroe and a need for more money (most likely from taxpayers) to expand Munroe’s operation to cover for any of Ocala Regional’s actions.
Bottom line, imposing a franchise fee on two operations that already have razor thin profit margins does not seem a good idea. That is unless taxpayers are, in the case of Munroe, willing to pick up all or part of the fee imposed via increases in their property taxes; in the case of Ocala Regional, perhaps accepting a reduction in patient care services or potential closing of that hospital.
You may not have a very thorough understanding of how financially difficult a situation most of today’s hospitals face. This is particularly true for our two local hospitals that have an extremely heavy load of Medicare/Medicaid patients that receive minimal government reimbursements for treating those type patients. As you know, Medicare and Medicaid are continuing targets for reductions in payments to local hospitals by both the Federal and State governments to reduce their respective budgets.
Someone suggests a franchise fee on hospitals. Udnerstand that Marion County is required by state law to fund indigent care and at one time did put about $4 million (plus or minus) but in the dozen or so years has not paid a dime to Munroe for indigent care, but has given $1 million to Ocala regional. This year, the county has said it will likely drop the $1 million from Ocala Regional, and Munroe had to give up the EMS and ambulance service because of the narrow profit margins that hospitals now have. -- pwf
PWF and Stan are well versed on the hospital situation.
Hey night owl I think I did answer your question about what if the hospitals pull out... above Aug 8 at 11:01 pm.(The VERY long comment) Please ask if you need further clarification.
By the way everyone in that comment I said the hospitals are maxed out at 6.75 million... I left a "1" out.. it should read the hospitals are maxed out at 1.675 million each.
Again I urge you all to dig deep here. We MUST make sure the commission does not make a mistake that will leave the rest of us, our children and grand children suffering from this mistake. Jim Payton frequently has stated the frustration of dealing with the "sins of our fathers" (meaning past comission decisions). This will be one of them if he allows the merge in the Fire Service.
P.S. I am using anonymous because, for some reason, it will not accept my Blog name and password.
Oh Let me shed some light on the Fire department showing up on Medical scenes. This is a frequent question asked. I know on the surface it does look like a waste of tax money.
A lot of those calling 9-1-1 are very seriouslly ill or injured. An ambulance only has 2 people staffed on it. Occasionally they will have 3 people if they have an EMT or Paramedic student, or a new employee in training, but most cased only 2.
A patient having a heart attack, stroke, in respiratory distress, have been traumatized with internal bleeding, needs multiple IV's, several cardiac medications, CPR, (one person cannot do effective CPR, Intubate (Tube in the airway) Ventillate, Push Cardiac drugs, speak to the Dr (on the radio) for additional orders, Defibrrilate etc. delivering a baby, in the back of a moving ambulance (or non-moving ambulance) by one person is not is not the best care for the baby and mother (you have 2 patients) Unless the fire rescue is there The EMSA Paramedic will be in the back by his/her self and the EMT will drive the ambulance. it is nearly impossible for one person to handle this patient. In these cases, the fire rescue person (EMT or Paramedic) will ride to the hospital with the Paramedic to the hospital. The only other way to do this is to have a minimum of 3 people on an ambulance at all times, which currently will require approx 70 more EMT's or Paramedics (very expensive) Also many patients are VERY heavy and 2 people cannot SAFELY carry a patient down stairs, or down the narrow hallways of many mobile homes.. and moving a stretcher down very unstable steps with a 300+ pound person on the stretcher. There are times when the fire rescue is closer to the patient, and times when the ambulance is closer to the patient so the response times to get to the patient have improved almost 2 fold. Which is another reason I disagree with merging the ambulance service into the fire stations.. it will cause a deteriation in response times, when before, the ambulance was somewhere in between 2 fire stations creating a better chance that someone will get to you quicker.. Doesn't this make since? This and a hundred other reasons is why I am going crazy trying to understand why The Fire Chief thinks his plan is the best. errrrr
I'm sorry if I am babbling too long, but I am doing my best to educate those who are interested.
good, informative post. -- pwf
9:19 PM
Sorry, I overlooked your comments. My bad!
POSTING ANONYMOUS -- some of us, in addition to being politically homeless -- are less than super with computers.
Brian does his homework. He and PWF are both very informed -- sometimes disagreeing, but both spend time seeking information and answers. If we cannot agree, we can respect their efforts.
All this sniping at one another is really boring.
bw
First let me say that I don’t have a dog in this fight. I do not work for Marion County or EMSA. I have read the entire Blog and offer the following:
1- The County is statutorily responsible to have EMS delivered to their residents, both City and County. Yes, City residents also live in the County. The level of service provided is not dictated, but routinely, most EMS systems in this State improve each year as funding allows. The City may apply to the County for a COPCN (FS 401) if they desired to deliver EMS care to their residents, but approval is not guaranteed. If approved, the City would likely use their existing Fire Department to provide the service.
2- There is no requirement for Hospitals to chip in to the EMS system. As a matter of fact, many other Hospitals might view the relationship as having the potential for biased service delivery. I’m sure that’s not the case, but other Hospitals in a competitive market place might think they are not getting patients that should come their way. Complaints of Hospitals only getting uninsured or under insured patients are not uncommon in Florida. At any rate, it’s great they felt obligated to provide funding, but that is clearly their own choice.
3- Fire Based EMS is not any better or worse than a stand alone EMS System, but because historically 70-90 percent of the calls that Fire Departments respond to are medically related. Because the infrastructure exists, it is usually more cost effective to have a Fire Based system.
4- To state that Firefighter Paramedics are any less dedicated or competent than single certified EMTs and Medics is both insulting and totally inaccurate. In many cases, private or third service provider (County stand alone systems) personnel are folks that can not physically or mentally pass fire standards. Sometimes, they simply do not want to be a firefighter because they are good EMTs or Medics and want to do what they are good at. It really makes no difference, and will not change if the systems merge. There will always be a place for single cert EMTs and Paramedics in a consolidated system.
5- Almost every Fire Agency in this State requires their personnel to become EMTs or Paramedics soon after hire. Most require EMT as a minimum, and if I’m not mistaken, Marion County requires Paramedic in 5 years.
6- Numerous papers have been written on both sides of this issue. All that I have read are biased. Some rave about Fire Based others make the opposite claims. Fact is, the system you have can be good or bad based on a number of factors. The fact that the agency also owns fire trucks does not play into the equation.
7- Fire Departments retain their employees longer than most professions. The constant change in job functions reduces burn out. This is not true with stand alone EMS agencies. Go to the Department of Health, Bureau of EMS web site and read the Paramedic Shortage white paper. It clearly lists job burn out as a big factor in the problem. By being able to rotate people around, job burn out is reduced.
8- Scare tactics do not work. Those afraid of having their job changed are trying to scare their fellow workers, the public and the elected officials. These rumors are not at all factual. I ask you to take a break, and contact others that went through the same thing and see what they say.
9- Look at success stories. All across this State, as profit went away, we have seen Fire Departments take over EMS. I ask you to look at Hillsborough County, Pasco County, Hernando County, Jacksonville, Saint Lucy County, Martin County, Palm Beach County, Dade County, Broward County, Orange County, Cities of Miami, Hialeah, Kissimmee, Orlando, New Port Richey, Tampa and well over 100 other agencies that now provide very high level Fire Based EMS. I know of non that have reverted back to a third service or private provider once they made the switch. I have never heard one EMT or Paramedic state that they regretted the move. Most said they opposed it when presented.
10- I also agree that Dave Palmer is a fine upstanding person. I believe he received much of his experience while working for a Fire Department. I also think Chief McElhaney is a fine upstanding person as well. I think you will find the Fire Chief received much of his experience while working for the private sector. I think they will do a fine job working together.
Every time this happened, the support of elected officials that made the difficult decision went way up. Those that allowed the status quo to exist are not looked at as leaders by their constituents.
If I had a vote, I would vote to merge.
Roy,
(1) What works in other counties may not work in Marion.
(2) Why merge one operation with challenges (EMSA) into another one with even more operational challenges (Fire & Rescue)?
(3) Why not consider a reverse and have County Fire & Rescue merged under Palmer? He might be a better leader of the combined organization.
(4) There may be some personality/political factors in the decision that many of us don't really understand as well as we should to be able to suggest what is right or wrong.
To the Anonymous person’s response that gave a detailed analogy of why a fire apparatus also responds to a person in need. I agree with your opinion on that topic. Your rational is why this State has embraced the ALS non-transport model. As I’m sure you know, Florida has one of the most progressive EMS systems in the Country. Our ALS non-transport model is second to none.
Most systems operate with the understanding that the first medic at the patient’s side maintains control of the patient until the patient is turned over to an equal or higher lever of care. Many systems maintain a continuity of care through out the transport to the medical facility. That paramedic could have come from an engine or the ambulance, as they are equally qualified to care for the patient. It is often a decision of convenience to turn the patient over to the ambulance medic. It is usually not a medical decision, but one based on placing a fire apparatus back in service in a timely manner. It is not that the fire truck will be needed first, but most find it better to transport the patient in a triple K compliant ambulance instead of on the hose bed of a fire apparatus. Not trying to be sarcastic, but that is the reason, and not that the ambulance medic is any more qualified.
After reading the first part of your response, I was certain that you were going to support a fire based system. I was surprised that you advocated maintaining the current system simply because of ambulance placement. If the placement of ambulances is working and found to be essential to patient care, why would the patch on the medics sleeve or the decal on the side of the ambulance change that? If those ambulances are in the right place, is there a reason the County would have to relocate them? I have no idea what the response times are, so I can not give an educated opinion. Routinely, the placement of current and future Fire Stations are based on a growth projection, traffic patterns, population, distance from existing Fire Stations and response times. Conformity to NFPA 1710 has a specific response time element. That response theory works for buildings on fire or persons having a heart attack. Quick safe responses are essential.
I have debated similar issues numerous times. I always support the best system for the patient, and also the tax payer. It is a delicate balance. A Fire Based system does not always win both elements of that argument. Although I personally feel Marion County should move to a Fire Based system, it is simply because of they can now offer the most cost effective and efficient method of EMS delivery. I don’t know if that was the case when EMSA was formed. Marion County Fire Service has the infrastructure in place and the ability to seamlessly bring the two systems together. The EMSA employees that know the area would not loose their jobs. The level-of-service would likely improve over time. This may not be the case if some of the EMSA partners back out of the deal. If funding goes away, the options become limited at best. Starting a third service EMS system at this point would be cost prohibitive. If it is not going to be County third service or Fire Service, what else is there? There is no legislative requirement that anyone augment funding to EMSA. The County is only required to be sure a system is in place. There are no level-of-service requirements imposed on County Government. So if the County decides it wants to reduce expenses and cut or eliminate funding to EMSA, what can you expect to see? You will likely see reductions in EMSA’s expenditure side of the budget to match the reduced revenue side. As the cost recovery from patient billing continues to drop, something must happen.
This could translate to less ambulances and/or less EMTs and Medics to staff those vehicles. It seems that even if an EMSA contract is extended or re issued, the longevity is only as long as that contract. I can assure you; this argument will not go away.
To the Anonymous person that responded to my initial diatribe,
1- I could not agree more, EMS delivery is a local option that varies from place to place. I still feel that Fire Based would work well in Marion County.
2- I have no idea what challenges currently exist in Marion County Fire Rescue, and don’t feel qualified to reply in support or opposition of your statement. My only knowledge of problems with EMSA are fiscal in nature, and the County seems best able to over come those problems. Any other knowledge about EMSA was gained only from news articles and statements that have been posted on the IAEP web site. I have heard nothing but good at the State level about both agencies.
3- Dave Palmer seems to be a very qualified person and if he meets the requirements of FS 633 to be a Fire Chief, and is the best person for the job, so be it. This is not about individuals as they are all just cogs that keep the machine functioning. It is important to keep the system strong and leave the names and personalities out of the dialog.
4- I think you are very correct. Political motivation is obvious in many EMS systems around the State. I don’t know what they are in Marion County. I can point to several less than model EMS Systems that seem to only exist due to political clout. Do a google search of COPCN in Florida and you will join me on my side of the table.
Regardless of my personal beliefs on EMS Delivery, I totally support the efforts of the EMTs and Paramedics working for EMSA, Marion County and the City of Ocala. I hope wise well thought put decisions are made, and people replace fear with knowledge. Be safe, Roy
I live in the City. I say leave EMSA alone. I don't want 4 republicans and a DINO fouling it up. Worst case, keep it by itself if it has to be merged with the county. The less tinkering with it by McElhaney, the better for all citizens.
Sorry Guys I still, for some reason, cant Log on with my blog name..
ROY, Just how well do you know Chief McElhaney and Chief Palmer?
Clearthink'n
I'm with Roy. Merge the sucker! That's the only way you are going to reduce the expenses and get rid of some high paid people, including Palmer. Get on with it Commissioners. It's a no brainer decision and will save the taxpayers a bundle compared to the current EMS loss proposition.
I’m glad some people with knowledge of emergency medical services issues have shown up over the past week to discuss this topic. I notice that some of their comments reflect concerns about loss of control and/or influence by the City of Ocala as well as concerns about the track record of the county commission in providing services, all concerns that I raised in more general terms earlier as someone who is not well versed in emergency medical services issues.
I earlier wrote about the stress the county commission is under and likely to be under for a long time and the implications this can have for the services Ocalans get from the county commission. The county commission has in its portfolio a lot of inefficiently configured development populated by residents with demands for services for which they have difficulty paying.
Events over the past week illustrate my concern. County Commissioner Jim Payton said at a county commission meeting he is getting many communications from residents threatening to take out commissioners in elections because of rising County water rates in the offing. A county utility customer writes in a letter in the Star-Banner that the County’s on-line payment software isn’t operative. The county commission considered increases in fire and solid waste assessments before a near full house of concerned residents in the county commission auditorium with TV-20 carrying public comment about the Boston Tea Party. While an officer in a national beverage association writes in the Star-Banner about the importance of recycling, print and broadcast media are giving heavy attention to fiscal tightening that has led the county to reduce recycling facility hours such that frustrated residents are flinging their garbage on the roadside or into the woods. One blogger is concerned the tension in the long queues at these facilities could require intervention by law enforcement.
Compare this stress related to basic county services to the City of Ocala, where the City Council recently opted for the mildest proposed changes in employee benefits and where the big complaint is about the price of a round of public golf, and even there the complainers are generally not residents of the City.
Since he watches many more government meetings than I do, I recently asked Chris Curry, the Star-Banner’s county beat reporter who covered the City of Ocala beat previously, if his observations were similar to mine in that there is much more complaining in county commission meetings about the cost of government and the level of government service than in Ocala City Council meetings. He said that his experience was similar to mine.
I note that one blogger apparently knowledgeable about emergency medical services writes that the County is only required to be sure a system is in place and that there are no level-of-service requirements imposed on county government.
I’m curious if any of the folks with knowledge of emergency medical services can shed any light on whether any specific jurisdictions comparable to Ocala in population, density, and other relevant factors have their own emergency medical services and, if so, what the experience has been. I’m also curious if these folks have any thoughts on what the quantitative fiscal impact on the City of Ocala might be to maintain the current service level while going it alone with emergency medical services as we now do with fire services.
I'm not surprised that the people of the City of Ocala don't complain about the cost of services. As Mr. Creekbaum previously stated, that's where all those moneyed, politically savy and many long-time elitist residents live. They are the smart ones and have enough money to not be concerned with cost of government. The other people in the County are not as fortunate. Just because Mr. Creekbaum has no problems paying his bills, others may not and don't. Go ahead Ocala, pay for your own emergency service. Just that much less I'll have to give to the County. Better yet, take over EMSA and as a civic duty, run and pay for everyone's emergency service. That would be even better.
I totally disagree with the comment above. There are not enough smart citizens involved in watching over our City of Ocala government. Unlike the County, where more citizens are active and vocal, the City attracts fewer outspoken and active critics to what’s going on. It’s not that the City is doing a better job than the County, which it is NOT, it’s that there are fewer people interested. Maybe they are all out making a lot of money and don’t have time. More City residents had better get interested, because we are about to get clobbered with requests for more money to operate City government.
brian creekbaum said:
I note that one blogger apparently knowledgeable about emergency medical services writes that the County is only required to be sure a system is in place and that there are no level-of-service requirements imposed on county government.
I’m curious if any of the folks with knowledge of emergency medical services can shed any light on whether any specific jurisdictions comparable to Ocala in population, density, and other relevant factors have their own emergency medical services and, if so, what the experience has been. I’m also curious if these folks have any thoughts on what the quantitative fiscal impact on the City of Ocala might be to maintain the current service level while going it alone with emergency medical services as we now do with fire services.
Brian,
The State of Florida has a method of assigning the task of EMS delivery to areas within the State. This is called the COPCN process. A COPCN is a document that is issued to a County, City, Private EMS Provider, Hospital Based Provider etc. In an effort to keep control at a local level, many years ago it was determined that the County was the best level of government to be assigned this duty. Things work well as long as the assigned provider does their job. But what happens it the provider fails? The County must step in and make things work. This is very unlikely when a City assumes responsibility, but has happened when a private provider is loosing so much money providing the service that they either go out of business or choose not to resubmit a proposal when a contract expires. Often, a private entity will not say anything about their concerns until the very last moment. This is so they don’t see their work force run to other agencies and so patients continue to pay their bills. This sometimes leaves the County in a less than desirable place to negotiate. When faced with a problem such as that, the County would likely look to their Fire Department to make things work. After all, they have the trained personnel and are more than willing to jump in.
That said, I will attempt to answer your question. Cities similar in size, density, and population of the City of Ocala provide EMS service, as do Cities that are larger and also Cities that are smaller. The size of the system, in service units, and assigned personnel should be somewhat related to the number of transports generated in a given period. If not enough transports are generated, the system could loose money. If the City generates too many transports, it could mean longer waits for a unit to arrive. To be profitable, the system must also generate enough transports of people that pay their bills. This usually means insured patients. With changes in reimbursement policies, and other factors, the provider must aim at a moving target. I would guess that the City generates a good size portion of the EMS calls in Marion County. The question is, do the City transports generate sufficient revenue to support itself? If the answer is yes, the City’s choice becomes a little easier. That might seem like the end of the issue, but the remaining call volume in Marion County might not be sufficient to pay the bills. You will recall that I mentioned that the County must make the system work. Because the loss must be made up from somewhere, they have a few choices available to them. They could impose an MSTU that assesses a millage on properties within the service area, or they could off set the losses through general fund dollars. There are other options, but I’m sure you get the picture.
Now, if you’re still awake, we need to get back to the COPCN process. Because the concerns on the entire system, the County might not wish to grant the City a COPCN for transport. The City Fire Department must have the desire and ability including available Paramedics to provide the service and the funds available to cover any short falls in the system. If the City is willing and able, they must “request” that the County issue a COPCN to for transport. I have no idea if the City has a desire to provide the transport service, as I have not read anything on that subject. The City of Ocala is already providing ALS non-transport service.
https://ww2.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP#theBottom
The more variables, the more a system opens itself up for possible failure. Multiple partners would reduce each partner’s individual liability. If all partners were required by Statute to participate, your current system would be much safer. Because none of the partners are required to participate, I would not feel as comfortable as a medic working in such a system. Because many of the long term employees came from the original hospital system, they feel a certain level of security with the existing system. The do not want to go to a fire based system. We saw a similar response in the Tallahassee area when the hospital system stopped providing the service. The reaction is understandable. While I understand their concerns, it means nothing coming from some guy on an internet blog. I would simply suggest that they speak to non area affiliated experts, members of agencies that have experienced this and citizens in some of the Counties that have seen this happen in their area. While I sense that some contributing to this list have a general distrust for (City and or County) government, I think there are enough ways to provide and insure oversight, that this could be a model system that will provide a true value for the dollars spent. Be Safe, Roy
Ahh, Mr. Desoto you are truly wise. Basically anytime the citizenry have the opportunity to consolodate services they should jump at the chance. As far as the comments about the commissioners not having the ability to "run" the service, that is total BS, there is not a county or city commissioner in this state that has that ability. However I can assure you that the fire department leadership does have that ability, furthermore fire departments employ over 70% of the EMTs and Paramedics in this state and make up 60% of the EMS providers. Clearly they are the majority with the experience and expertise to run EMS. Citizens of Marion County don't fall prey to the propaganda about fire based EMS , you will hear everything from people will die to response times will increase. I can tell you from the perspective of being in a system that was consolodated, we improved our system performamce through cross training and effective utilization of resources on both the Fire and EMS side.
Just my Humble Opinion
Joey
This was forwarded to me, and I could not believe what I was reading.
To the Pinellas County guy that is bragging about Sunstar. I worked for AMR before they lost the bid to Paramedics Plus. I know all about Sunstar. I now work full time for a fire department in Pinellas County and can only say that you have got to be kidding if you think your system is good. You must be in management and have never had to sit in a parking lot with the ambulance idling all day. You should give it a try and while your there, see what your employees have to say about you. If you believe that the private provider in P-County is more sophisticated than the fire departments, I think they need to step up the drug testing at Sunstar. You also never mentioned how expensive your system is to operate. You should paint “costs more – provides less” on the side of your ambulances. You need to fix your problems before you start giving advice to others.
Wow we sure get alot of posts when the union smells membership!
Hey Pinellas guy.. are you speaking about AMR or Paramedic Plus?? I have heavily studied BOTH systems and there truely IS a difference. You confused me when you said "Sunstar" because Sunstar is the official Pinellas Connty EMS name for the previous "AMR" AND current "Paramedic Plus"!! (as you already know) Please advise so I can study your comments. Thanks
Why are we talking about Pinellas County? No one cares what an unhappy ex employee has to say about another EMS program. Can we PLEASE stick to the original post? Should EMSA remain independent or Merge?
Sorry, but some of us really care about this. JM
Joey Walnuts said...
"Ahh, Mr. Desoto you are truly wise. Basically anytime the citizenry have the opportunity to consolodate services they should jump at the chance."
I couldn't agree more. That's why taxpayers need to fight to be sure all these duplicate political positions in the cities and county living off the tit of us taxpayers get eliminated and replaced by one government system. Do this and we may not have to worry much about tax releif. Things will take care of themself.
An interesting comment about unions (one sentence) is buried on the blog that raises several questions. Could there be economic self interest on the part of the union currently representing the Marion County Firefighters? Is EMSA unionized? If so, what union? Is it possible that the MCF Union smells 200 or so membership fees? I’m not jumping to conclusions, would just like to add to the considerations of the merger issue.
uHey all I am very sorry this is so long I did TRY to shorten it, but Couldn't
Back a few days ago (Aug 8) "lordhelpus" posted a comment. I have studied this and feel he or she is pretty educated on the Fire/EMS situation. Please join me and study what really "is". As someone pointed out, it does really seem the Fire Union guys are pretty much pushing this Fire Merger because of Union Membership.
These are the FACTS as I know them.
EMSA's budget is reviewed and severely scrutinized by a "finance Committee" appointed by the EMSA Board, who, in turn is approved by the County Commission and City Council. BOTH the EMSA Finance Committee AND ENSA Board falls under the sunshine (no board or finance meetings out of the public watch)
The finance Committee is composed of:
1. Mr. John Garri, Finance/Budget Director Marion County Clerks office
2. Mr. Don Corley, Finance/Budget Director, The City of Ocala
3. Mr. Jeff Biaocco, Chief Financial Officer (CFO), Ocala Regional Medical Center/West Marion Community Hospital
Mr. Rich Mutarelli, CFO, Munroe Regional Medical Center and TimberRidge Medical Center.
These people KNOW and Understand financing in the Health Care industry AND government Tax revenue/ expenses better than most of us on this blog. They are very conservative on Budgeting/spending/revenue etc. You all could not ask for a better group of people to represent Everyone’s interest. They ARE VERY tough during the budget process. Merging over to the fire service will NOT protect our Tax money any better.
Here's just one reason why:
EMSA Did ask for additional funding to add additional resources.. by the time it got through the Finance Committee, EMSA Board and the Board of County Commissioners, EMSA wound up receiving ZERO increase from the City or County Tax Payers. You can decide if this is good or bad for you. I know many of the folks at EMSA and I know they can make it work. HERES THE PROBLEM.. EMSA (or I should say the Marion County EMS Transport agency) has, already been allotted, in the Tax Rolls, a .21 millage rate to pay for EMS Transport services. If you live in the county, you will see it on your tax notice. Well EMSA Staff and Finance committee (as mentioned above) worked to reduce EMSA's budget that it only required a .16 millage rate, but they are STILL requiring all County Tax payers to pay at the rate of .21. Why?
NEXT YEAR THEY WILL PROPOSE TO BRING IT UP TO .40 Why?
SO How can you say or indirectly suggest EMSA is financially irresponsible?
Relating to the Salaries (admin or others), Please compare them with other services that provide EMS Services. EMSA had an independent salary and benefits company do a complete study. They compared EMSA to many surrounding EMS Services and other EMS services (who are EMSA's "competitors") and found some positions needed an increase. The EMSA Finance Committee and Board approved the recommendations of the company. (One note you should know Pat Howard, County Administrator is on the EMSA Board and voted to approve the recommendation)
EMSA runs 56-60,000 calls per year, staff's 250 employees and transports 35,000+ patients per year.
Please compare their salaries and benefits with surrounding counties, and even state wide county EMS services. I think you will find they are in line. Then compare the Marion County Fire Service, the Ocala Fire Department with other FIRE departments and see if they are in line.
PLEASE PEOPLE understand EMS and FIRE's Vision and Focus is NOT the same (and shouldn't be). There are truly those Called to be Paramedics, Called to be Fire Fighters, Called to be Law Enforcement officers even though all 3 professions work closely together on many of the same calls. Please respect that and help keep it that way.
OH BY THE WAY, what is Chief McElhaney proposing to do with the additional millage increase not given to EMSA ? Well ask him. He will be using it to buy Fire Suits (Bunker Gear) for EMSA EMT's and Paramedics after he forces them to go to fire college and do a job they were NOT Called to do!!
Dang no wonder I'm going crazy. I guess he has to take it from the Tax payer since he can no longer get it from the State Department of Environmental Protection Agency (When they caught him using Gas Tank Inspection money to buy more fire Chief Vehicles) Let's all wake up!
O.K. here's part of the previous post you should consider.
islordhelpus said...
A subject probably more important than most items on the County and City agendas. That is our local Emergency Medical Services. Please do NOT speculate on what we have now or what we may get in the future. This is TOO important for you, me, our children, grandchildren and aging parents to let pass by.
The very BEST thing you can do here is become informed...VERY informed! Please contact Chief David Palmer of EMSA, (873-6522) and ask to meet with him, his deputy and/or administrative staff. He/they will spend all the time you need to make sure all your questions are answered. He is a man of full integrity. You will NOT get smoke and mirrors. He will share with you his proposed budget and explain EVERY penny requested and spent. You can even arrange to ride an ambulance as an observer for a shift (if you think you will be able to handle it :-). After reading other blogs, it is pretty apparent, that many of Chief Palmers employees are opposed to the County Fire Plan. One blog says it best, it is in their being, there sole, that they are EMT's and Paramedics. NOT fire fighters! Why force someone to be a fire fighter if it is your calling to be a medicals care giver... Would you want to be forced to do a totally different job than you were called to do? I think not. Why Force a fire fighter to become a full time patient care giver? Oh I almost forgot, Chief McElhaney did not say he is forcing his paramedic/firefighter guys to work on an ambulance, but WILL force most of the ambulance guys to go to fire college and fight fires (not their calling)"Lordpleasehelp" And the 3 million "savings"? make him prove it.. make him put in on a complete spread sheet.. and Hold him and the General (Pat Howard)along with each and every county commissioner accountable for this.
As for you City guys, PLEASE call Paul Nugent for his opinion. Well I can't wait, I'll tell you and you can call him to verify. Mr. Nugent wants the City Council to remain VERY active in the local ambulance service, in such that a city representative will sit on the EMSA Board, as a governing body, to assure the City residents are properly represented. If this doesn't happen, where do you think Chief McElhaneys ambulance service will prioritize their service? Surely not in the City!! Don't be fooled... you need to get involved and insist the City Council takes a strong stand here. If that doesn't happen. In terms of finance, Please understand, Ambulance service will never get in the black, there will always be a "loss". There will be a required subsity,the tax payer or someone else to pay for the "loss" Medicare only pays so much, 3rd party insurance only pays so much and those without insurance only pays so much (if any at all) but the service still appropriately provides the service. (Currently, in Marion County, we are fortunate to have the hospitals help offset the "loss" through over 3 million in contributions). Again, Chief David Palmer can explain every penny spent and collected. Thank you all for taking the time in getting my opinion. And PLEASE.. let's stick to the subject. This is truely a non-partism subject. Let's keep it that way!!
7:47 PM, August 08, 2007
Yes, EMSA has a union. It's IAEP local 631. After looking at their web site, I think they might be a little worried about loosing 200 or so membership fees. Just another thing to consider.
Wow, that was a long post. Hard to believe it was that long and said nothing new. Did you type that while you were parked at the kangaroo station waiting for a call or just copy it from other blog posts?
Anyone know how much Palmer makes a year?
Here's the scoop on the Union situation.
First the last writer is correct. EMSA does have a Union, they currently are working through negotiations.Most likely, by the time they get the contract completed and ratified by the members, and approved by the EMSA Board, EMSA will 1. be merged in the Fire Service, 2. remain as a 3rd Service (as currently is) 3. Become a separate department of the county 4. Be taken over by a private service. The contract and various laws will determine whether or not EMSA's union will or will not be null and void when any of the above happen. If the fire service takes it over, the EMSA crews might become part of the IAFF (If the IAFF will take Single Cert (non-firefighters) I am not real familiar with the IAFF's rules. If that does happen YES the Marion County Local IAFF will gain 150-200 more members. So You can see it will benefit the union. However, the issue will immediately be the EMSA EMT and Paramedic pay vs the Firefighter pay.. there will be a battle.
I was enlightened by something someone told me. The County Comission cut Firefighters out of Chief McElhaneys Budget, and WOW (light bulb illuminates) he (probably out of the sunshine) told the commissioners, if you give me EMSA, I can make them (the EMSA guys) firefighters. This will allow me (the Chief) to increase the "needed" Paramedic Firefighters without getting more money from the taxpayer.. Another words Use (screw) the employees of EMSA to subsidize the fireservice. The already busy EMSA Paramedics/EMT's will now have to run calls all day and then fight fires "at night when it has slowed down" Oh I forgot to say, Cut the EMT/Paramedics salaries to match that of the Firefighter. thereby "saving" the taxpayer 3.000,000.00 LOL!!
What are you smoking? Chief McElhaney ain't about to cut the EMSA paramedics pay. He will double cross the stupid County Commissioners and get the union to push for equalization of the firefighters pay with those of EMSA. Ever heard of whipsawing? There goes that $3 million savings and he can blame it on that damn union. Now it's gonna cost $3 millon more!!! McElhaney ain't no dumb bunny---can't say the same for others.
By George I think you've finally got it!
Like I said it is all about Union's.
A union power struggle. Just what we need if merging the EMS with the Fire Dept.!
Nothing like giving all life and death services (fire, rescue, and transport)to one Union. Talk about leverage in negotiations.
Roy Desoto wrote…
“In an effort to keep control at a local level, many years ago it was determined that the County was the best level of government to be assigned this duty.”
Anything the state puts at the county level is in the hands of governments that differ greatly in population. Based on U.S. Census Bureau figures as of July 1, 2006, Florida counties range in population from Liberty County at 7,782 to Miami-Dade County at more than 2.4 million.
If Ocala were a county, it would rank in the top two-thirds of Florida counties in population. Ocala has more than six times the population of the least populous county in Florida and a population greater than the combined population of the five least populous counties in Florida.
We also have a relatively high population density, which generally means Ocala can deliver services much more efficiently to its citizens than they can be delivered to rural parts of Marion County and other rural parts of the state. Yet, Ocala’s population is much less than that of the largest counties in Florida, making our local government much more “local,” much closer to its citizenry.
I don’t know how this shakes out with emergency medical services, but generally, the government in Ocala has a great combination of critical mass and “localness.” Providing a government service at the municipal level should always be an option that we in Ocala examine.
It would be interesting to know more about cities similar to Ocala that provide emergency medical services -- why they do it, what the service is like, and what their financials look like. If I understand Roy’s answer above, he doesn’t have enough data at this point to say what the numbers would look like for Ocala if it provided its own emergency medical services. I wonder if Ocala city officials know what these numbers would be. I think it is their responsibility to know.
One of the problems is that Ocala's financials are not as green as they once were. The "golden egg" -- the city owned electric utility -- is being pressed hard to support the percentage of city government that it once supported, and that is one reason the council is looking at operations that do not return sufficient money to justify their existence. --pwf
Hey guys read this ...Anonymous said...
"Wow, that was a long post. Hard to believe it was that long and said nothing new. Did you type that while you were parked at the kangaroo station waiting for a call or just copy it from other blog posts"?
This person is refering to my blog 8:27 PM, August 15, 2007
What did this person contribute to our discussion? I cut and pasted a blog… but I told everybody up front I did.. Did anyone else learn something new on the blog I sent Who is this ignoramious? Can anyone guss what type pf person (or who he or she is affiliated with? Anyway lets continue the meaningful discussion.
Anyone know how much Palmer makes a year?
8:50 PM, August 15, 2007
Reference to Palmers Salary, compared with similar sizes of EMS Counties he is in line with them in the upper 90's. Can you (or will you) tell me what McElhaney's salary is? or have you even bothered to check? Is it in line with similar Fire Chief positions in other counties?
So let's get back to the mature meaningful conversation
If the County Commissioners have half a brain, there is no way they will ever let the City Of Ocala have its own EMS. It makes absolutely no financial sense for ALL the taxpayers of Marion County.
If the taxpayers in the city who pay city taxes want to pay for city EMS then the County Commission should approve it.
Maybe it is in the best interest of ALL taxpayers to do away with the city of Ocala, why not all cities in the county. All city services gone, no city government no city police. We will be all cared for by the County Commission. Wait let's not stop there get rid of all county government let Tallahasse run it all.
Brian,
I am certain that the City of Ocala would be able to run a great EMS system. I am just as confident that Marion County could also run a model system. The City of Ocala demographics you provided are interesting and obviously would be part of a decision making matrix if the City was ever going to move in that direction. When the lawmakers decided who should be involved in the decision making on this topic needed a methodology. At that time, they felt the County was the logical place to place that responsibility. The existing process is not without controversy, but it is the system that has existed in Statute for many years.
You are correct that Counties differ across this State in size and density. Rural Counties face numerous challenges, as do urban Cities and Counties. All these factors could impact an agency’s ability provide EMS delivery in a given area. I would think that City officials would have a difficult time determining with a great degree of accuracy the profitability of a City run system without knowing some of the variables. Some variables to consider are the amount of transports generated, amount of new personnel needed, required vehicle fleet, equipment needed, billing costs, percentage of collection and a host of other items. They would also need to determine if they are only going to 911 responses, or going to transport non-emergency and inter-facility transports. It would be a time consuming exercise if they want to be somewhat accurate. Most EMS systems do not make money. Most just try to keep the losses as manageable as possible.
I find it interesting how many posting to this list have preconceived opinions of what will or will not happen if merged with the County (or the City or possibly both). There are numerous models out there, and variations exist even between similar models. It is very possible that those with a “calling” to be an EMT or Paramedic could be allowed to work in that capacity. The ambulances will need to be staffed, so why not use those good people where they perform the best. Especially if that’s where they want to be. I personally liked to rotate on and off various types of vehicles just to keep things interesting. Usually ambulances run more, and sometimes the crew may want a break once in a while. If more are cross-trained, it allows that flexibility. It also helps prevent skills degradation and burn out. I would guess that some that would come over would not be able to become fire fighter II certified due to a number of reasons. Those people would most likely be grandfathered, but those details could be worked out long before a merge were to occur. I seriously doubt that there is a plan set in stone, as there are way too many what ifs.
This is a very passionate issue. Men and women that have served the community are now concerned about their livelihood, their family’s well being and the citizens they protect. This is a very big deal to them and their families. I am sure that members of the fire service in Marion County also care about this issue, and I’m certain it’s not about increasing union membership. The vast majority care about the people they run with every day. It is also a very important issue to both Chiefs. While their opinions might differ on this issue, they both share a similar vision, and that’s to provide a great service to the citizens and visitors to Marion County. If the folks that are directly impacted want to create a win-win for everyone, I would suggest you all start holding hands and stop the rock throwing. Regardless what happens, I would ask that people not toy with the emotions of these fine men and women, and like my mom always told me “if you can’t say something nice, say nothing at all”. Just my pennies worth.
Be safe, Roy
Is it true that EMS personnel have to wait with their transports in the ER until Monroe or ORMC gets around to relieving them? If so, it seems to me that there is a very expensive asset out in the parking lot out of service along with EMSA paramedics. Hospitals get to increase ER staff without having to pay for it while at the same time negatively affecting ambulance response time. What would be a reasonable typical turn around time? How is it monitored? What happens when a hospital frequently violates it due to inadequate staffing?
We have too many "Anonymous'" here" (if the Blog master will fix the problem where it will take my (and other peoples) name and passwords... maybe we can respond to each other better.
Reference the city having their own ambulance, Unfortunately, the County Commission is the one who has to approve the certification for anybody (including the City) to have an ambulance in their jurisdiction. If you haven't noticed, the mentality of the county commission is that of anti-anyone who has a different (or maybe even a better) way. The dissention between the city and county is unbelievable.
Approx 30% of EMSA's transports come out of the City and the other 70% from the county and other smaller cities. Personally, I wouldn't blame the City if they tried to get their own Ambulance Service At Least they will Know the city Citizens are being considered as a priority! They already Own 30% of EMSA (property, ambulances, people etc) so it (the start up costs) should not be too much of a burden for the city tax payer (me included). McElhaney, however pulled a fast one.. he is showing (in his fictitious plan) 5 ambulances dedicated to the City 24 X 7.. he has yet to guarantee these will remain in the city at all times . again mark my words if the people in the villages or on HWY 200 (in the county) become short... the "city" ambulances will disappear! Make sure your city councilmen get the terms in writing and "at arms length". I am also letting them know what to look out for.
To Roy: I am sure there are cities that have their own services separate from the county but I do not know specifically. I will try to find out for you.
Roy, Please understand I and many people who agree with me, are not trying to bash county fire services, but am merely trying to desperately point out that EMS people who have been Called to be Paramedics and EMT's should NOT be forced to become firefighters. There should NEVER be a "grandfather" period because when these people applied for a job originally, they went to an EMERGENCY MEDICAL/TRANSPORT AGENCY NOT a FIRE FIGHTER AGENCY. That would be like EMSA taking over the fire service and forcing "called" fire fighters to become ambulance/transport paramedics/emts. or a police department or sheriff's office taking over an ambulance service (which I am told there are sheriff's offices who do or have run ambulance services) and having their police officers or deputies permanently work on an ambulance.... It's fine if an individual applies for a position and understands they will have to work as a fire fighter/emt/paramedic on a rotation basis, but 100 % of EMSA Medical folks applied for their jobs to work as an EMT or Paramedic ONLY. If they were interested in firefighting, don't you think they would have applied to the City of Ocala Fire Rescue or the Marion County Fire Services? and to take them over and Force them to become something they were not intended (called) to do is way beyond anything that makes any since? I was recently told that Lake/Sumter has 25 openings for Paramedics (NON-FIRE) and Citrus County has 8 or 10. Putnam County has 4 or 5. Non of these Surrounding counties require to have duel certification, and at least Lake/sumter and Citrus Counties pay and benefits are comparable to EMSA's. How many of EMSA's people, do you think, will move on to these counties if they are forced to go to fire college to work for McElhaney? A LOT.. Many of EMSA's people already live either in those counties or close to them. It would be nop sweat off their backs. EMSA has worked very hard to recruit and train employees in-house, and after 3 or 4 hard years, they are to the point where they are will be at (or very close) to full staffed by September. I was also told that EMSA has recruited a number of full time employed Just because of the benefits, fair salaries and Paramedic Training program. And now someone is coming along and screwing this up. Pat Howard and Stuart McElhaney was hoping and waiting for EMSA to fail over the 5 year span, but to their unbelievable disappointment, EMSA has become stronger than anyone could imagine. So I think everyone should leave them alone., except for congratulating them for a JOB WELL DONE!!
Clearthink'n
Reference to the hospital holding ambulance crews up.. YES it is very true. A good "turn around" should be about 20-30 minutes per patient. (Longer if a Cardiac Arrest or Trauma, or Very sick patient due to the additional paperwork) All Marion County Hospitals and the Villages hospital(the worst) have held up ambulances 45 minutes to over 1 hour. The villages has held them up to a record of 4 hours!. You will need to contact the individual hospitals for a detailed explanation but basically, there are many "admitted" patients in E.R. Beds because the In-house beds are not available, which backs up the R.R.'s and thus the ambulances. I am told that some hospital beds are "closed" because the hospitals do not have enough nurses to care for those patients (Nurse to patient ratio) which causes a ER back-flow problem which causes an ambulance wait time increase. MRMC, ORMC and West Marion (who have their CEO's on our Board) have worked hard to reduce this problem, but the population increase is not helping the situation... Typically the summer is slower than the winter here, but not this year.. and the hospital profit margin is so thin now-a-days that they simply can't afford to spend large dollars on adding more and more beds.. So to answer your question more quickly YES :-).
Clearthing'n
Thank you for that answer. I am sure that there is no argument that the ambulance and it's crew are not provided to the hospitals as an extension of their workforce. The response time county wide is severely dependant on the avialbility of those crews and equipment.
Shortage of beds, nurses, ER staff is a hospital problem. The underlying conditions(lack of medicare reimbursement, to many non Emergency visits, not enough capacity, tort reform, insurance, and on and on) are issues that require solutions and leadership.
This kind of mismanagement leads one to wonder if someday we will notice garbage piling up on the streets and a marked decrease in the number of garbage trucks running around. The reason will be that there was no more room at the dump and we had to keep the trash somewhere.
You're right. There are many hospital and health care related problems that need leadership. Leadership at the National & State levels. We need a President who will step to the plate and tackle many of the problems you outlined in your comments above. And here in Florida we need a Governor who is also willing to do the same.
What do we have, a lame duck President and a Florida Governor more interested in positioning himself for bigger and better things in the political world at the expense of not tackling the tough issues because that might hurt his bogus popularity rating. Until both of these yahoos are removed from office, the medical problems you mentioned will never have solutions. Yes, true leadership starts at the top!
There is also plenty of room for improvement at the local level.
Agree and that is happening, but 80%-90% of the solutions must come from legislative action at the national and/or state levels. That's where the shafting of local health care is happening. What can local government do about federal reductions in medicare/medicaid or tort reform or shortages of doctors/nurses because of our education system?
I guess your right there is absolutely nothing local elected officials can do.
It's so sad that they have you convinced of that.
Oh, there is plenty local elected officials can do (e.g., EMSA)! Just not the issues with health care insurance, doctor shortages, and other problems requiring legislative attention. I'm not optimistic about that either. Cliff Stearns, for example, is running around visiting with wrestlers and pharmacies while our health care and education systems are going to Hell. No, not a very reassuring picture.
Anyone know when they will make a decision on this? No one has written anything for a few days, and I was just wondering.
Star Banner: Keep EMSA as a stand-alone county department.
http://www.ocala.com/article/20070826/OPINION/208260323/1008/OPINION
One big shoe has dropped on the future of EMSA. Monroe Hospital is not going to fund EMSA when the contract runs out. Not good news for EMSA wanting to stay independent.
Not to worry.. MRMC knows how the County Commission works. The commission has done nothing but critize MRMC for everything they they have done or attempts to do for the good of the community. Perhaps they have thrown their arms up and said "what the hell, why do we need to take this immature abuse from these ignorant children, the commission, the administration and bureau chief (fire chief)" The co commission, wants the ambulance service. Why?? It has absolutely nothing to do with providing the citizens with good patient care.. EMSA already does that better than the county can ever do. They just don't have the guts to admit it. The county commissioners despirately need something positive to spread during the civic luncheons and while on the campaign trail. As you know, there are many pissed off voters, and they need something. anything!!
I just feel bad for those who have dedicated their lives to NON-FIRE public service ie: True patient care! This being the EMSA folks. NOT just the Paramedics and EMT's but all those who make it happen every day! they are the ones who are going to get screwed, unless YOU make an issue out of it. I am sure Ocala Regional will follow. The City of Ocala may follow unless you city guys make a very big stink.
It may be that the EMSA even under the County stays as an independent department. Have seen that mentioned on the Blog and in the Star Banner.
I find this a very interesting Blog. While it appears based on the last postings, the current EMSA system may no longer continue to exist as it has in the past. I am very sure that the Citizens of Marion County (and the City of Ocala) will continue to receive quality prehospital care.
Looking from the outside, this is what I see. One hospital has dropped out of the plan. I would venture to say, the second hospital is considering dropping as well. There is no requirement for the City of Ocala to continue to support the system with funding. In a tax reform environment, and a possible super homestead constitutional amendment over the horizon, why would they want to spend City tax payer dollars to fund an EMS system if they don’t have to?
That said, the 2 players are EMSA (as a self supporting business with no subsidies) or the County. It seems that the current cost to do business is more than EMSA can generate by ambulance billing. They could reduce the cost of doing business, but that would likely translate to fewer ambulances on the road, aggressive billing, and increased transport fees. That leaves the County. You will recall that there is no requirement that the County help fund EMSA. And if you ask yourself, why would the County wish to continue to fund another system when they could run it themselves?
Breaking down the available options you have fire based, County third service, Private EMS (for profit and/or not for profit), and contracted service. I'm not sure if the market would have many Private EMS companies competing for an RFP, but with some of the billing concerns mentioned, it is not likely.
They could create an assessment that allows the County to be a contract manager that is responsible for overseeing the provisions and benchmarks of the EMS service. The County would seek bids from those seeking to provide the service. There are several models out there with varying levels of success. While this may sound good on the surface, many feel that these are very expensive systems for the taxpayers to support. Opinions vary. I'm sure they will take a look at this model.
The third service EMS model is a County run EMS system. The system is non-fire based. The employees are County employees that receive County benefits. This was a very common model in Florida for many years. They worked well for a number of years.
The EMTs and Paramedics made substantially less than their Fire Service counterparts, and they were not entitled to special risk pension benefits. About nine or ten years ago, the EMS community successfully lobbied that these fine men and women deserved Special Risk pension benefits and the Counties had to absorb the associated additional funding costs. This followed by a shortage of available EMTs and Paramedics in the work force, and a demand for higher wages has eliminated the cost savings. In most cases, it is no longer cheaper to have a third service system in Florida. Many have slowly merged with the Fire Service. I can name many fire based EMS systems that have formed, but have a difficult time thinking of any new third service providers that have been created in the last ten years.
The County has seen fit to staff a Fire Department, and it will continue to grow. The trend has been and will continue to be a cross trained fire service. While that is the case, there is still usually a place for single cert EMTs and Paramedics even in a fire based system. Someone needs to be in the ambulance, and the single certified EMTs and Paramedics usually get this assignment. The true savings comes from the reduction of duplication of resources. By combining the systems, usually a better system emerges.
The County could take over EMS and create a Fire Based system. That could mean it is only “based” out of the fire system and would allow EMS to be a division the works together with the fire side of the house. The details would need to be worked out, but I’m sure it could be done, and done well.
Just my humble opinion,
Roy Desoto (sorry, the system won't let me log on today)
To "just my humble opinion" I can't log on either.
Marion County (and the city of Ocala) will continue to get quality care IF it is done correctly and the commission doesn't just automatically approve the County Fire Chief's plan. They need to sincerely evaluate all the options and evaluate the Task Forces' recommendation(s).
Please take into consideration many fire fighters have no desire (from the heart) to do "Medical Calls" to some, this is beneath them. Many EMT's and Paramedics have no desire (from the heart) to deal with "fire Calls". This is not just simply something you can say to each of them "Just get over it, and do the job". Well I guess you can, but how efficient and professional do you think either of them will be if they are not interested in the "assigned task"? My wish is that ALL will understand that these two jobs are totally different, and the focus, mission values are not the same. Please do not lay this burden on either the fire fighters or Medical Care specialists.
I agree that the other hospital will probably follow suit, since the County Commission cut the 1,000,000.00 funding to help them pay for the indigent care they provide in the community (Which is more than 1,000,000.00) I wouldn't blame them if they opted out. The commission, under the fire chief's direction, decided to screw the hospital and take their assistance away. MRMC has been providing this care without county assistance for a while (which is why an aspirin costs $5.00) and there is no thanks. Also MRMC Provided the Ambulance service for over 25 years at little or no cost to the county taxpayers (other than "user fees") and the County Commission, the administration and fire chief has made jeers and jabs at MRMC. With this, why in hell would any one of the hospitals want to partner with the county? So I don't blame either one of them for saying "Screw You" to the commission. All you have to do is sit in a couple of Co. Commission meetings and see the arrogance coming out of their mouths. At least it has gotten a little better since Randy Harris was voted out, but there are still a couple. (and I'm not necessary a democrat)
The City may still demand to be involved with the decision making process of EMSA. I am sure they are considering options... You are correct, they do not have to, but they are smart enough to know the city citizens will not be a priority to the County Commission, regardless of what Chief McElhaney's plan will show. And they clearly know it... again all you have to do is sit in a couple of Co. Commission meetings and witness the jabs, sneers and smirks the commission displays when discussing the city.
I, too, am sure the Task Force will look at different models.
Relating to reduction of duplication, the Chief himself indicated, in his Task Force presentation (a plan only "70% complete"), that he "knows" with adding EMSA to the county, 1. the I.S. (Computer Services) will need additional people. 2. The HR department will need additional people (as they are having hard enough time keeping up with current HR duties (specifically to the additional demands the County Fire Fighter, and Fire Officers unions has placed on the county) 3. The fleet maintenance people will have no problems because the county fleet maintenance division has a hard enough time keeping up with the current vehicles. He stated he is considering keeping the current billing staff, which has done a remarkable job. The only thing left is purchasing/logistics people and administration. No one at the fire service has any real experience or knowledge on how to run an Ambulance service. So I ask you, where exactly is this 3 million savings without degrading the patient care? especially when you add an approximately 20% of salaries to the state retirement program. Sure it can be done, but at what expense? I, and you, I suspect, want to make sure the right people show up at my house with the right equipment, knowledge, compassion, skill and "DESIRE" to attend to my or my family’s' needs.
There is only room for 24 "single Cert" people in the Chief's plan. What about the other 150? Yep forced to become Duel Certified. Work like hell during the day running medical (8, 10, 12 calls,) and at night and "when it's slow", make them fight fires.. while the golden fire fighters get to rest throughout the day running 3 or 4 calls (and not transporting patients). Now how do you think the EMSA people will take this? Not very well. His plan is already proving that EMSA people are 2nd class citizens.
For other counties who have went the Fire Service route, I am sure some have worked out well. Particularly those smaller counties, but the bigger the county, the greater the problems, and believe me, the fire service unions across the country will not stand for EMS division of the Fire Service get more attention or stroking than their fire fighters. And most Fire Chief's are too much of a wuss to put the attention (funding) where it really belongs. If you don't believe me, look at the current county/EMSA budget. I was told (and verified) that EMSA's budget was not allowed to increase at all the upcoming year, that it only required a .16 milage rate to the tax payer, but that the county is still going to charge the tax payer at a .21 milage rate. The extra money will be used to buy "Bunker Gear" for EMSA people when they are forced to become duel certified fire fighters. The following year it could increase to .40. So the money is there, they just need it to "supplement" the fire service, to "add" more firefighters in the fire service and again, screw the ambulance service or the people they serve.
I do wish everyone would understand FIRE services and EMS services are two different things. If it were not, the hospitals would have fire fighters, wearing bunker gear, or Police Officers with their guns and badges work in their Emergency Rooms taking care of the sick and injured. I can only hope the powers to be in Marion County and the City of Ocala can see the real difference. Oh and one more thing, the fire services across the nation frequently boasts that about 75 to 80% of their work is Medical calls. So I ask why isn't the $$ flowing to the real medical services? why do we want to spend a quarter of a million on a fire engine that runs only 20% of real fire calls instead of buying 2 or 3 ambulances to handle the other 80%. Somehow, I think our priorities have gotten mixed up in this county and throughout the country. Driven by the very strong fire unions.
If you all have a chance, please review the forums from Robert Bickler, "What EMSA means to the Citizen" It is helpful.
http://forums.ocala.com/eve/forums?a=tpc&s=3821034465&f=4741034465&m=7731009546&r=3781032746#3781032746
To the fellow that replied to Roy Desoto’s last post. Your response is not a factually based response, but a very biased slam at fire based EMS. Regardless what the political nuances are in Marion County, Fire Based EMS is quickly becoming the nationwide model for EMS delivery.
Your comments are not new. The same arguments have been brought up time and time again, and have always been shown to be without merit. All of your anti-fire sentiment nullifies any chance of a factual debate on this important subject. At some point, the current system will cease to exist. It will eventually become a fire based EMS delivery system. The single cert people will continue to exist just like they have in every other merged system across this State.
It is sad that your mistrust of the County has jaded your view. Giving half truths, and partial quotes does not make something fact. I would suggest that you contact others that have been through this issue. At some point, the citizens of Marion County (municipalities included) will no longer wish to fund a very expensive EMS delivery system that duplicates efforts and can be better handled by the Fire Service. It may not happen now, but it will happen.
Johnny Gage
Post a Comment
<< Home