County Administrator Bob LaSala agrees Pinellas' emergency medical services system needs to be fixed, but he predicts it will likely be at least two years before taxpayers see any concrete changes.
The delay will give a consultant a chance to study the system and for officials at all levels to discuss issues, agree on a fix, then set changes in motion. In the meantime, taxpayers are left in a bind caused by escalating costs and a poor economy that LaSala expects to get worse before it gets better. "We haven't reached bottom yet," LaSala said Thursday.
As it is, LaSala and county EMS officials are poised to offer four options Tuesday to the County Commission for funding the system for the 2010-11 tax year that begins Oct. 1. All involve increases in the countywide EMS property tax rate. Two would also increase the costs of ambulance rides. The goal is to eliminate the estimated $13.6 million shortfall for EMS services expected in the coming fiscal year. Total EMS expenditures for next year are estimated to be about $87.6 million, which includes about $39.6 million to the 18 fire departments that provide first-response service; $35.7 million to Paramedics Plus, the private company the county contracts with for ambulance service; and $12.3 million for other costs, including personnel, operating and capital expenditures.
LaSala said he is hamstrung by state law in trying to hold costs down when it comes to giving money to the 18 cities and fire districts that provide EMS services. The law requires that the county pay the actual expenses incurred by those groups in providing firefighter/paramedics and other equipment, he said. Almost all of the 18 have asked for more money in the coming year - mostly for increases in salaries, health insurance, pension costs and other personnel-related costs. The average countywide increase in compensation per paramedic is 6.33 percent, or $5,901, county figures show.
Compounding the problem are the wide cost variations from department to department for paramedic/firefighters. "I have all kinds of thoughts and ideas of the most cost-effective way to provide EMS," LaSala said. He declined to name any of those until after the consultant's report is finished. The target date for that is July. After that, LaSala said he wants to shop the report to the cities, fire districts, city managers, mayors and other groups. Then the report and comments will go to county commissioners, likely in December or January. County commissioners then can decide what, if anything, to do with the recommendations. If commissioners decide to change the system, they'll probably have to ask the Legislature for help. But even if the commission acts immediately upon receiving the report in December or January, that will be too late to get a local bill before the Pinellas legislative delegation in time for the 2011 term. It would have to wait for the 2012 legislative term. Assuming a bill passed that term of the Legislature, it would become effective in mid or late 2012 at the earliest. Until then, LaSala said, "We recommend nothing other than holding the line as much as we can on the overall cost of the system and the payouts to the departments ."
LaSala said a resource group of city managers he set up to discuss and help pilot the EMS issue might be able to come up with a temporary agreement that would help hold down costs until permanent changes can be made . "Do I think that's likely? No. But I'm an optimist," LaSala said. And, the economy, which he projects will get worse, is on the side of change: "I believe they are being very, very deliberate, very aware of the need for a fix. The compelling need of the circumstances we are in just cries out for a fix."
Anne Lindberg can be reached at firstname.lastname@example.org or (727) 893-8450. Follow her at twitter.com/alindbergtimes.