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Firefighters Argue to Take Over Patient Transports

ORLANDO -- Orange County (Fla.) firefighters tried to elbow out a private ambulance company Tuesday and take over delivering most patients to hospitals.

Commissioners considered yanking the service from Rural/Metro Ambulance last year but balked because of uncertainty about the costs involved.

County officials are still dueling over those numbers with the company, which also handles Orlando's ambulance service.

Fire officials and the Orange County Comptroller's Office plan to argue at today's commission meeting that a takeover could net taxpayers from $6 million to $13.8 million in added revenues over five years.

Rural/Metro officials say those projections are too rosy, and a takeover could result in a service drop-off.

So far, three of the seven commissioners have voiced support for a county takeover. A fourth vote would be needed to push it through.

"We're looking for ways to conduct ourselves more efficiently," said Mayor Rich Crotty, who added he is alarmed by what looks like unnecessary overlap of county and private responders at emergency scenes. "It's not an efficient way to do business."

County fire Chief Carl Plaugher said taxpayers would be better off collecting the hospital transport fees that now go to Rural/Metro, but other concerns also merit the takeover.

With Rural/Metro in the mix, county firefighters are the designated first-responders to an emergency scene, leaving Rural/Metro workers to deliver patients to a hospital. But in some cases, Rural/Metro workers are tied up, and county firefighters handle hospital transports, as they already do in all of east Orange County. One small slice of the county is served by another company.

Plaugher said it is ideal to have the same crew arrive, provide care and then drop off a patient, referred to as a "continuity of care" goal. Plaugher said it's also good to more fully use firefighters who respond to increasingly fewer fires yet must still be kept on staff in the event of one. Providing ambulance service could fill those work gaps, he said.

"What I'm trying to do is the fiscally responsible thing," said Plaugher, adding that recent property-tax cuts have made each county dollar harder to come by.

But Rural/Metro officials say that for the county to provide its pledged level of service, Plaugher must beef up crews by more than he estimates and take on added start-up costs that would force taxpayers to lose money during the first five years.

"We believe the county is inappropriately staffed, and they want to grow it more," Rural/Metro division general manager Roger Duryea said.

In recent days, lobbyists with Rural/Metro, the firefighters union, which supports a takeover, and Fire Department leaders blitzed commissioners with their arguments.

But it is unclear whether the votes exist for a takeover.

Crotty supports the move. Commissioners Fred Brummer and Linda Stewart voted in October for the takeover, and both still favor it.

"I think it's going to decrease the cost and increase the efficiency for our residents," Stewart said. "There's no question in my mind."

Potential swing votes are Commissioners Mildred Fernandez, Teresa Jacobs, Tiffany Moore Russell and Bill Segal.

A compromise being floated by Duryea calls for the county to essentially rent the company's staff and handle billing collections to see whether the finances make sense.

That would allow the county get a closer look at actual costs without investing up front in equipment and staffing.

"It ensures the taxpayers won't be holding the bag at a later date," Duryea said.

But deputy comptroller Jim Moye audited the Fire Department's cost estimates, and he said that even using conservative projections, a takeover makes sense for taxpayers.

"If anything, they [taxpayers] may be making some money on it," Moye said.

CONTACT: David Damron can be reached at ddamron@orlandosentinel.com or 407-420-5311.


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