Fire district consolidation takes on a new meaning in a concept developed by fire chiefs in Naples, North Naples and Marco Island.
The three departments have outlined a plan under which they merge, not with each other but with the ambulance service already operating in their boundaries.
Their idea is one of several that will be put forward next week when county commissioners meet with fire chiefs, EMS leaders and others in what is shaping up to be a watershed moment for emergency services in Collier County.
The three chiefs say their plan would better serve residents both inside and outside their districts and save money in the long run.
It is bound to meet with opposition, although from how many quarters is not yet clear.
Chief Steve McInerny of Naples, Chief Michael Murphy of Marco Island and Chief Orly Stolts of North Naples describe a plan that keeps the same number of ambulances as Collier County Emergency Medical Services currently stations in Naples (three) North Naples (six) and adds one to Marco Island, bringing the number there to two.
But instead of the ambulances and crews being part of EMS, they would work for the fire departments, becoming their employees. Collier County EMS would continue to serve the rest of the unincorporated area of the county as it does now.
The arrangement would be more efficient because only one agency, the fire department, would be sending units to a call. Presently, two agencies, the fire department and EMS, go to most emergency scenes. The unified command would mean in many cases only one truck would have to go, saving gasoline and wear and tear on vehicles, the chiefs say.
Because ambulance crews would be employees of a fire department, not EMS, a different set of overtime rules would apply to them, possibly yielding savings. Retirement plans would also change, offering another chance for long-term savings. Stolts added that he wouldn't want to see current EMS employees who transfer to a fire department be forced to take a pay cut, however.
The chiefs say the plan would work because they believe they can operate an ambulance for $900,000 a year. Based on the current EMS budget, the county spends a little over $1 million a year per ambulance.
The county would continue to collect property taxes for EMS and get all the revenue the ambulances generate through run fees. In turn, under a contract, the county would pay each fire department $900,000 per year per ambulance. The difference between the $900,000 figure the departments would charge and the $1 million the county now spends could be used to bolster EMS in the rest of the county, the chiefs say, deflecting the argument that the three departments serving the wealthiest areas of the county are seeking to separate themselves from the less affluent areas.
The chiefs admit they haven't examined certain county administrative costs associated with EMS so their annual figure for operating an ambulance could be off.
At the April 26 meeting they intend to ask county commissioners to direct the county staff to provide more details on the cost of administering EMS so they can refine their numbers.
Changing administrative costs are just one hurdle the idea, which the chiefs say is merely a concept and not a proposal, will have to overcome.
While the three fire chiefs say their idea is in keeping with the findings of a Blue Ribbon Committee that last year devised a list of recommendations to improve emergency medical service in Collier County, the vice chairman of that committee isn't so sure.
The committee's primary recommendation was for the county to establish a Public Safety Authority to review all aspects of emergency care with an eye towards medical efficacy, not politics, said Ed Morton, a former CEO of NCH Healthcare System.
The creation of a PSA is one item up for discussion at next Thursday's meeting. Moving ahead with a plan like the three chiefs have presented is premature, Morton said. "The cart is before the horse. First, put a PSA in place," Morton said.
He reserved judgment on the idea of folding EMS into the fire service. "I can think of some advantages and some disadvantages," he said.
Dr. Robert Tober, the medical director of what would be a scaled back EMS, likewise was reticent to talk about what the chiefs have put forward prior to the upcoming meeting.
"I have lots of thoughts on the subject. If I release them before the workshop, it will be an even more aggressive, hostile issue," he said ominously.
Marco Island's Chief Murphy insists the idea is entirely focused on better care. "What's it all about? When you dial (911) there's a certain level of service you expect."