LEE COUNTY — An audit of the Lee County MedStar program released on Friday only confirmed a mismanaged public safety department with a “toxic” morale issue.
The 21-page report put together by the County Clerk’s office cites poor management and insufficient certifications for the failures on the county-based helicopter ambulance program, and details the dysfunctional atmosphere.
"Management of the EMS program in the Public Safety Department needs significant improvement for better employee morale and compliance with Federal and State regulations," according to the opinion section of the audit.
Medstar was shut down in August after improperly billing patients for more than $400,000 despite not having the required safety certifications. As a result of the Medstar fiasco several top Lee County officials have resigned or retired including Lee County Manager Karen Hawes.
The audit, which was originally requested by the county commissioners, is now moot. On Nov. 20, commissioners unanimously voted to enter into a public/private partnership to provide helicopter based ambulance service so the audit will not impact the future of Medstar.
"The county surrendered a federal certificate issued by the Federal Aviation Administration rather than try to rebuild the Medstar program to a point where Lee County EMS could again service patients by its own air transport," the audit reads.
But the audit offers a few recommendations for the commissioners to consider prior to entering into a partnership with a private company, which has yet to be determined.
-- Will the primary service area be Lee County, or will the service area be expanded to a regional program?
-- Will the taxpaying citizens of Lee County be required to subsidize the program, or will the emphasis be on a user based fee system?
-- Should the helicopter's medical service continue operating under the direction of the Public Safety Department, or would the service be more appropriately run as a hospital based service?
The board will address these questions at the upcoming meeting.
The auditors, Chuck Short, Tim Parks, and Lawrence Haut, interviewed 25 Medstar employees, former employees and public safety management. They reviewed emails about Medstar from Oct. 2009 to this October, between public safety management, county management, county attorney, the commissioners, Medstar paramedics, pilots and citizens.
The findings were low employee morale, poor management and lack of implementation of recommendations to improve safety training.
The audit lists a couple examples of poor employee and management communications.
After a helicopter crashed in 2009, an older helicopter was purchased, despite four active pilots opposing the public safety management's request to purchase the 8-year-old Bell 430 helicopter for $2 million. The older helicopter required $1.3 million in pilot training. For the same amount of money spent, the pilots said, two new helicopters could have been purchased.
When expert consultants were brought in to conduct a safety audit of the public safety department in June 2011, all the recommendations weren't implemented before Medstar was shutdown, the audit said.
"The shutdown of Medstar program by the county manager was the result of the public safety department's management's failure to comply with FAA certification requirements for pilots and the 430 helicopter plus the alleged 'toxic' atmosphere within the rank and file members," the audit said.
Along with Hawes, former Public Safety Director John Wilson and former Deputy Public Safety Director also resigned due to the Medstar fallout.
Holly Schwartz, interim public safety director and assistant county manager responded to the audit in a memo on behalf of the county administration and said steps are being taken to address the issues detailed in the report.
According to the memo, a new public safety director will be hired at the beginning of 2013. Employee meetings have been held to discuss all issues, accept feedback and ideas for improvement and changes are being implemented. These are to improve "personnel procedures and additional support is being provided to staff can accomplish their tasks more effectively and efficiently."
The audit also reveals that patients wrongfully billed for Medstar helicopter service have been reimbursed. The county didn't have the proper federal certifications to bill more than $433,500. The FAA could issue fines and penalties for the violation, but the county giving up its certificate, could save millions. The FAA is also conducting an audit but has not yet released their findings.