Subject:
Title
Authority to advertise a public hearing to be held on October 11, 2016, regarding a proposed ordinance amending Chapter 54 of the County Code relating to emergency services.
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Recommended Action:
Recommended Action
Sitting as the Emergency Medical Services Authority (EMSA), authorize a public hearing to be held on October 11, 2016, for proposed updates to Chapter 54 of the Pinellas County Code relating to emergency services.
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Strategic Plan:
Ensure Public Health, Safety, and Welfare
2.1 Provide planning, coordination, prevention, and protective services to ensure a safe and secure community
Deliver First Class Services to the Public and Our Customers
5.3 Ensure effective and efficient delivery of county services and support
Summary:
The EMS Ordinance was put into place in 1988 and has served the needs of the EMS System well. At that time, there was a consideration for having an all Advanced Life Support (ALS) Ambulance fleet.
Due to the growth of transports in the EMS System; the sophistication of current call triage; the safe and effective services provided by our wheelchair transport providers; and healthcare reform to align service levels it is an appropriate time to consider allowing Basic Life Support (BLS) Ambulances by Sunstar and allow Stretcher Van services by our wheelchair transport providers, which also helps to stratify costs to the patient.
Background Information:
In 1988, EMS Ordinance 88-12 became Chapter 54 of Pinellas County Code establishing the Pinellas County EMS System with all ALS Ambulances and a prohibition of Stretcher Vans.
Staff recommends that it would be beneficial to add Basic Life Support (BLS) licensed ambulances by Sunstar through the Ambulance Service Agreement to focus on non-emergency transports. This approach will allow Sunstar ALS ambulances to focus on 911 and ALS non-emergency transports and be relieved of BLS non-emergency duties.
There are approximately 37,000 non-emergency BLS ambulance transports handled by Sunstar annually, which represents 26% of all Ambulance transports. These include transports to nursing homes and adult living facilities after hospital discharge; transports for dialysis, doctor’s appointments, wound care, and other medically necessary transports that require an Ambulance, but, not an Advanced Life Support (ALS) - Paramedic level of care. Staff is working with the Ambulance Contractor on an amendment to the service agreement if the ordinance change is approved.
Staff expects that there will be many benefits including a low cost to hospitals and patients; right sizing our response to non-emergency transports which will provide better transport data for future analyses to help decision support of aligning paramedics and EMT’s according to patient needs.
Stretcher Vans offer similar goals of reducing costs, reducing non-medically necessary transports by Ambulance; and still allow providers to seek Medicaid reimbursement. Wheelchair transport providers which are highly compliant with the EMS Authority’s protocols and requirements. Stretcher Van services can be implemented safely and effectively with the current providers. Providing services at the right level and price point is a worthy goal that will help EMS System adjust before further healthcare reform.
Staff recommends that the Pinellas County Ordinance and Code be updated to reflect BLS ambulances and permit the use of Stretcher Vans.
Fiscal Impact:
No anticipated net fiscal impact as the program is fee for service based. If the ordinance change is approved, the amendment to the ambulance service agreement will cause a reduction to the BLS reimbursement rate per transport to the ambulance contractor, thereby reducing cost to EMSA. The ordinance and associated fiscal impacts are consistent with the FY17 tentative budget. As part of the FY17 proposed budget, staff has recommended the addition of a BLS Non-Emergency user fee to the Ambulance Services user fee schedule.
Staff Member Responsible:
Craig A. Hare, Director, EMS & Fire Administration
Partners:
EMS Advisory Council
Pinellas County Fire Chiefs’ Association
Sunstar Paramedics
Wheelchair Transport Providers
Attachments:
EMS Ordinance - Draft - Clean Version
Pinellas County Code, Chapter 54, Article III, Emergency Services
Pinellas County Code, Chapter 54, Article III - Mark-Up Version
Advertisement Language for Notice of Public Hearing