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Like cats and dogs, it doesn't take much to reignite the ongoing feud between officials with Collier County Emergency Medical Services and the North Naples Fire Control and Rescue District.
The two agencies have been at odds lately over the level of medical services the fire district should provide in pre-hospital emergencies.
The latest squabble is over a new fire district office located in a North Naples gated community building. It's now spilled onto the tables of Florida Bureau of Emergency Medical Services investigators.
Fire district officials said the facility, situated in a geographic area between stations, was intended to provide a quicker response to medical emergencies "at no cost to the taxpayers."
But EMS officials, concerned the fire district is operating a non-licensed emergency medical service, requested state investigators examine the matter.
This latest quarrel - one fire official calls it an ongoing "parochial turf war" - appears to be another sign of continued miscommunication and distrust between the two first-responder agencies during a time when the county is trying to improve coordination of pre-hospital emergency response.
A blue-panel committee commissioned by the county to evaluate and improve the state of emergency response care is expected to offer recommendations later this year. Better communication between agencies is one issue already identified for improvement, wrote Geoff Moebius, a member of the panel, in an e-mail to both agencies.
On Aug. 12, the North Naples fire commission approved the extension of a pilot program that puts a firefighter-paramedic at an office in the Carlisle Naples, an adult-living community near the intersection of Airport-Pulling and Orange Blossom roads.
The idea, explained Jorge Aguilera, deputy fire chief of medical service for the district, was to put emergency responders in "an area of high concentration" of emergency calls.
Representatives from the retirement living center agreed to allow the district to have an office in the community at no charge.
In a prior news report about the Carlisle agreement, the Daily News used the term "EMS office" based on a press release from a public relations firm representing the Carlisle community.
Fire officials say they would describe it as "just an office."
Based on the five-paragraph news item, Jeff Page, the chief of Collier County EMS, and Dr. Robert Tober, EMS medical director from Collier County, filed a complaint with the state. The complaint reported the fire district appeared to be violating a statute that prohibits an agency from conducting or advertising to provide EMS without a license. Collier County commissioners would have to authorize that license.
In an e-mail to the Daily News, Page said plans for the office were never submitted by the fire district to county EMS personnel.
The lack of communication, he said, "does not allow for ensuring consistent quality care" for patients.
"No outline was provided for what personnel or equipment would be at that location, how they could be communicated with, or what hours of operation," he wrote in an e-mail to the Daily News. "This creates confusion in medical response."
Aguilera said the independent fire district doesn't have to communicate with EMS about where to locate its offices. He then noted that EMS officials make little effort to communicate with the district on similar matters.
As evidence, Aguilera pointed out fire officials weren't aware the county EMS was filing a complaint against the fire district until the district was contacted by state investigators. He characterized the move as retaliation for the district's continued attempt to provide more medical services to its citizens, which is at odds with the county's medical director.
The ongoing dispute between county EMS and North Naples fire officials began to make headlines last year when Tober refused to allow firefighters to give advance life support (ALS) treatment to patients on the scene of emergencies. Tober pulled advanced life-saving technique certifications from firefighters in North Naples and East Naples in 2009, citing that they didn't fulfill training requirements.
Since then, North Naples fire officials have continuously tried to regain their ALS program. In May, the fire district applied for a certificate of need with county commissioners to bypass Tober's authority and hire its own medical director. The certificate hasn't gone to a vote yet.
The fire district site in question is a small room on the first floor of one of the Carlisle's hotel-style buildings. The narrow room, which is adjacent to a bathroom, is just large enough to fit a desk, couch, TV, microwave, a small refrigerator and a firefighter or two.
"It's basically a closet, not an EMS station," Aguilera said.
County officials haven't even visited there, Aguilera said.
Nor have they been invited.
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