1 Fire Based Medical Transport Better Faster Cheaper 10/10/2011
2 PINELLAS COUNTY HAS FOUR STATED GOALS To maintain the level of service To equalize funding among providers To contain costs To create a sustainable system Fire based transport achieves all of these goals and saves over $20,000,000 over the next three years!
3 GOAL 1: MAINTAIN THE LEVEL OF SERVICE Requests for Service Transports Mondays Request for service of both emergency and non-emergency responses peaks at around 35, with 27 of those requests actually resulting in a transport.
4 MAINTAINS THE LEVEL OF SERVICE This plan provides the following apparatus to meet the needs of the community. ALS Fire Apparatus 60 ALS Fire Based Ambulances 35 ALS Peak Time Ambulances 16 Total Fire Based ALS Units 111 This maintains our current average response time of 4 minutes and 30 seconds. Updated 9/30/11
5 MAINTAINING THE LEVEL OF SERVICE The IPS plan reduces the level of service by removing 23 rescues from the fire departments. This eliminates at least 166 firefighter/paramedic positions, therefore reducing your fire fighting force. The IPS plan increases the response time from the current average of 4 minutes and 30 seconds to 7 minutes and 30 seconds 90% of the time.
6 GOAL 2:EQUALIZE EQUALIZEFUNDING AMONG PROVIDERS EACH PROVIDER WILL BE FUNDED ACCORDINGLY PER UNIT ALS Fire Apparatus $360,000 ALS Fire Based Ambulances $720,000 ALS Peak Time Ambulances $360,000 IN ADDITION EACH UNIT WILL RECEIVE THE FOLLOWING FUNDING EMS ADMINISTRATION $20,000 VEHICLE REPAIR & REPLACEMENT $30,000 FUEL $8,500
7 Goal 3: COST CONTAINMENT This plan contains cost by funding each unit, rather than paying for each employee or for each transport The IPS study does not contain private ambulance cost The private ambulance contract has increased 97% since 2003 Since 2010 the private ambulance company has increased $4,135,044 compared to $435,303 for first responders The retail user rate has been increased 4 times in the past 7 years With these increases, expenses will still out pace income by 2013 according to the IPS study
8 Ambulance Expenses vs Revenue 2010 increased 10.15% 15% 2011 increased 3.3% 3% IPS study shows ambulance expenses exceed revenue by 2013 Chart from IPS Study
9 GOAL 4: PROVIDE SUSTAINABILITY TO DEMONSTRATE SUSTAINABILITY THE FORECAST CHART ASSUMES REVENUE TO DEMONSTRATE SUSTAINABILITY THE FORECAST CHART ASSUMES REVENUE WILL GROW BY ONLY 2.5%, WHILE EXPENSES WILL INCREASE BY APPROXIMATELY 4 % AFTER THE FIRST THREEYEARS.
10 Critical Components Critical Care Transport Funding ADDITIONAL SYSTEM COMPONENTS $ 847,491 Mental Health Transport $ 241,175 All Children's Transports $314,091 Tactical EMS Team $65,000 Long Distance Transports (Base + Mileage) $449,515 Medical Supplies $2,600,000 Eckerd College Marine Rescue $32,450 Patient Business Services (7 FTEs $35,000 Salary and 45% Benefits) Information Technology (2 additional FTEs - $75,000 Salary and 45% Benefits) Call taking and Dispatch (10 additional FTEs - $45,000 Salary and 45% Benefits) Fleet Services (1 FTEs - $50,000 Salary and 45% Benefits) Medical Supply Warehouse (3 FTEs - $35,000 Salary and 45% Benefits) Sub Total $355,250 $217,500 $652,500 $72,500 $152,250 $5,999,722
11 WHY FIRE BASED MEDICAL TRANSPORT Fire departments have evolved into a multidisciplinary force trained for an All Hazards response Firefighter paramedics perform many different functions for the cost of a single position Firefighter paramedics can easily assume the transport duties, without shifting costs to taxpayers Leading trend over the past 20 years (71% of Florida s population is g p y ( p p served by Fire Based Medical Transport)
12 Florida Fire Based EMS Service Provider Pop Served % of State Pop. Fire Based EMS 12,859, % Fire Based First Response 1,696, % Partial Fire Based First Response 2,033, % County EMS Service 1,149, % Private Ambulance Service 173, % Hospital Based Ambulance Service 176, %
13 FIRST RESPONDER MISCONCEPTIONS Pti Patients t are frequently transported td to opposite ends of the county Fact 90% of the time patients are transported to one of the three closest facilities With 14 hospitals located throughout Pinellas County, most patients are within 5 miles of the nearest hospital Updated 9/26/11
14 First Responder Misconceptions Myth the Private Ambulance Company is Cheaper Provider First Private Combined Fire Based Responder Ambulance Transport Total Cost $38,112,490 $31,842,312 $69,954,802 $58,453,500 Daily Cost $104,418 $87,240 $191,657 $160,147 Number of Units N/A 111 Hours of Operation ,331 2,472 Hourly Rate $69.06 $ $82.22 $64.79 Ambulance hours based on 12 hour or less shifts FACT; COMPARED ON AN HOURLY RATE FIRST RESPONDERS ARE 50% ; CHEAPER THAN THEIR PRIVATE AMBULANCE COUNTERPARTS!
15 BEYOND THE COUNTY S GOALS This Plan: Enhances the current level l of service Delivers a higher quality of service through continuity of patient care Breaks down barriers associated with priority dispatch
16 Priority Dispatch A concern that many fire departments share is the perception that taxpayers will feel abandoned when their local fire department does not respond Fire based transport would ensure that the local fire department is still responsive to its taxpayers With properly distributed, statically deployed units, wait times will be decreased for low priority calls.
17 Continuity of Care This model places fire based transport units in the busiest fire stations throughout the county which ensures the majority of the patients will have one lead paramedic providing care throughout the call In addition, those fire stations that do not have transport units will consistently be serviced by the same crews Fire Service EMS providers who work together as part of a consistent team routinely train together and receive ongoing feedback kfrom senior employees and supervisors, ultimately l this provides a more consistent level of service.
18 Fire Chiefs Association Lealman Fire District Palm Harbor Fire District Resolutions Pinellas Suncoast Fire District City of Pinellas Park Town of Kenneth City South Pasadena Madeira Beach Redington Beach Tierra Verde Community Association CONA of St. Petersburg Motion to Support Fire Transport
19 All Counties in red are serviced by Fire Based Transport Questions
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