Fla. County Ends ALS Contract with Fire Dept.


Aaron Hale, Naples (Fla.) Daily News | | Friday, June 25, 2010

A contentious agreement between Collier County and North Naples Fire Control and Rescue District about who can provide advanced life support on emergency calls is 90 days from being canceled.

However, little will actually change from the decision, said one fire official.

The three-year agreement to allow the North Naples Fire paramedics to provide advanced life support services to its citizens - which was suspended in October after allegations firefighter-paramedics were not fulfilling training requirements - will be finally put to rest. The County Commission approved a request by County Manager Lee Ochs to "provide written formal notice to terminate the Advanced Life Support Partnership Interlocal Agreement" in 90 days at its meeting Tuesday.

The measure was approved from the consent agenda.

As part of the agreement, either party could cancel the agreement with 90-day notification.

However, considering North Naples firefighters have been decertified since last fall, the commissioners' approval of the cancellation is little more than a nail in the coffin of that program.

"The agreement has been really nonexistent. It hasn't been an enforced agreement in quite some time," said Jorge Aguilera, deputy chief of medical services and community relations at the North Naples fire district.

Advanced life support, or ALS as it's commonly referred to by experts, is a program that offers paramedics a larger complement of tools and techniques for an emergency situation than the basic life support program, for which most of the county's first responders are approved. ALS techniques include administering IVs, inserting tracheal tubes in blocked airways and administering powerful drugs during serious heart attacks and allergic reactions.

The ALS agreement began falling apart in May 2009 when Dr. Robert Tober, the county's medical director, accused firefighter-paramedics in the North Naples and East Naples districts of cheating on a certification exam. An investigation by the fire districts found no substantial evidence to prove the claim, and the state Department of Health refused to look into the matter, citing a lack of substantial evidence.

Tober later concluded that firefighter-paramedics were not meeting ALS training standards and pulled all certifications for firefighters in those districts.

The medical director has repeatedly asserted it's a hazard to public safety to allow anyone but the highest-trained medical personnel to perform advanced life support techniques.

The East Naples fire district pulled out of the fight in March when it moved to vacate its inter-local agreement with the county.

However, North Naples fire officials have vowed to continue to pursue other options to allow them to reboot their advanced life support program.

"Every day that goes by is a bad situation for us not providing ALS," said Aguilera, who claims North Naples citizens would be safer if their firefighter-paramedics had a full complement of life-saving techniques.

The district has applied to the county, which controls Emergency Medical Services, for a certificate of need to provide ALS to its citizens through their own medical director - circumventing Tober.

Also at Tuesday's meeting, Geoffrey Moebius, retired CEO of Physicians Regional Medical System, provided an update on a blue ribbon panel's progress with studying pre-hospital care in the county. The panel is looking into effective and efficient ways to run emergency medical response in the county - including who should provide ALS.

Moebius asked commissioners for $40,000 to hire an expert who will examine data on systems of pre-hospital care. The expert would give the panel "quantifiable" information while the panel deliberates over the future of pre-hospital care in Collier.

The board approved the request.

Moebius said the panel would provide a full report with recommendations to commissioners in September.

Connect with Aaron Hale at www.naplesnews.com/staff/aaron-hale

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Related Topics: News, Collier County, North Naples Fire Control and Rescue District, Dr. Robert Tober

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