Guest commentary: EMS and fire districts ... There should be no separation of emergency care in Collier

I have researched information about the North Naples Fire District (NNFD), other fire districts and Collier County Emergency Medical Service (EMS).

The fire districts and EMS are unionized and have collective bargaining.

Here are statistics for the three largest fire districts and EMS:

NNFD covers 70 square miles; has a budget of $24.6 million in fiscal year 2011; has 159 employees; has average salary and benefits of $144,000; responded to 226 fire calls (in fiscal year 2009); responded to 5,361 rescue and medical calls (with county EMS).

East Naples Fire District (ENFD) covers 104 square miles; has a budget of $18.1 million in fiscal year 2011; has 93 employees; has average salary and benefits of $112,877; responded to 150 fire calls; responded to 3,568 rescue and medical calls (with county EMS).

Golden Gate Fire District (GGFD) covers 93 square miles; has a budget of $11.1 million in fiscal year 2011; has 69 employees; has average salary and benefits of $87,700; responded to 265 fire calls; responded to 3,424 rescue and medical calls (with county EMS).

Collier County Emergency Medical Service (EMS) covers 2,025 square miles; has a budget of $24.1 million in fiscal year 2011 ($11.4 million paid by transported patients); has 168 employees; has average salary and benefits of $97,800; responded to over 34,000 medical calls.

These statistics raise several questions:

1. Why is there such a big difference in salary and benefits between these three fire districts?

2. What could justify the average $144,000 salary and benefits in North Naples?

3. If they consolidate, will average salary and benefits for all personnel be $87,700 or will it be $144,000? You guess!

4. Since salary and benefits comprise about 80 percent of total costs, won’t fire costs and property taxes for fire service balloon?

5. Is this why NNFD proposed consolidating with tax rates increasing from 1 or 1.5 mills to 3.75 mills? The current county property tax rate is only 3.6 mills for all county services.

6. How will fire service be more efficient and cost effective? That’s what the voters said they wanted.

7. The total budget for all county fire districts and city fire departments is $68.4 million in fiscal year 2011. How many real fires (not just calls) did we have?

OK, I’ve asked a lot of questions. Most of them I can’t answer, but someone should answer them. I do recognize that the financial absurdity has occurred, over many years, with the separate fire district tax producing too much revenue. Fire commissioners used the extra money for unnecessary salary and benefit increases, rather than reducing taxes because the money wasn’t needed.

What are we going to do to correct the problem? Is this the result of collective bargaining? If so, the public needs its own union to fight for its rights, because the fire commissioners are doing a lousy job protecting the interests of taxpayers.

As a physician, I oppose any separation of emergency care in the county. EMS should be in charge of all emergency medicine services and should not be fractured by separate EMS services in various fire districts. One medical director makes sense, both financially and to consolidate all training of the best treatments.

How should it work? We have a very capable county EMS organization that doesn’t need to be duplicated by the fire districts; it needs to be augmented by them. Firemen should fight fires and assist in emergencies with basic life support (BLS). Fire districts should be outfitted with oxygen, defibrillators and other equipment for BLS. They can take the initial actions to stabilize the patient for EMS paramedic treatment and transport to a hospital.

Sheriff’s deputies should continue to be taught basic life support. The sheriff has over 1,300 people, with many deputies on the road. They may arrive first at the scene and can also provide BLS, which is the most important first-line treatment in saving lives.

In conclusion, we should not dismantle a world-class county EMS system because NNFD wants to justify their huge budget and very inflated salaries and benefits. My fellow physicians have already outlined the serious problems with the separate North Naples medical service in a series of letters to the editor.

Did anyone ask the people living in North Naples if they want fragmented, less experienced medical service? I know I don’t.

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