Consultant: Key West Fire Department should run EMS, not private company

Depending on the collection rate, the city could lose $364,000 or earn $15,000 per year if run by the fire department

By Sean Kinney
Florida Keys Keynoter

KEY WEST, Fla. — The Key West City Commission on Tuesday will hear from a consultant who recommends bringing ambulance service in the city in-house to the city Fire Department.

The commission meets Tuesday at 6 p.m. in Old City Hall on Greene Street. Harold Cohen, a consultant with TriData Division, System Planning Corp. of Arlington, Va., will present his recommendations.

Foremost among his findings: "The city of Key West should, as quickly as possible, take control of [emergency medical services], including emergency ambulance transportation."

Cohen says in a report he'll bring to the commission Tuesday that if the city decides to have the Fire Department provide ambulance service rather than continue to contract it out, the expected start-up cost would be around $650,000, which includes the purchase of ambulances. He says operations costs would be about $1.5 million annually.

Care/American Ambulance, formerly Lifestar, replaced American Medical Response in Key West in 2011 at no cost to the city. Care/American expected to make money by directly billing people it transports.

When American Medical Response had the city contract, the city paid it $650,000 a year, largely based on uncollectible ambulance rides for homeless people.

The Care/American contract expires Tuesday and the commission has already voted to pay the company $45,000 per month for up to a year until a transition can take place, either to the Fire Department or another for-profit company.

The Fire Department has a staff of 72 and an annual budget of $7.35 million. To bring 911 response in-house, Cohen projects the need for an additional 19 staff members (one EMS manager and 18 paramedic/firefighters) and an increase in the annual earmark to $8.925 million.

In 2012, the latest year for which numbers are available, Care/American responded to 5,388 calls. Using that figure, Cohen projected different collection rates against expected expenses.

With a 60 percent collection rate, the city would lose $364,169 each year in what he calls a "worst-case scenario." The "best-case scenario" is an 80 percent collection rate, which would earn the city $14,696.

"Very few 911 EMS systems are profitable," Cohen wrote. "The goal is to provide fast, effective and efficient EMS service. EMS transportation profit comes from non-emergency transportation."

That's called inter-facility transportation in the industry. Care/American managers have said they will continue that component of their business regardless of what happens with the emergency ambulance service.


(c)2014 the Florida Keys Keynoter (Marathon, Fla.)

Distributed by MCT Information Services

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