A step — a small, tentative one perhaps, but a step — toward reforming Collier County's emergency response system is being taken.
The county manager's office is drafting an ordinance to create a Public Safety Authority, an important component envisioned in a year-old report issued by a panel of community health care leaders.
The job of the PSA, should it come about, would be to find the best methods for delivering pre-hospital care in the thousands upon thousands of instances in which emergency responders are called to deal with anything from an apparent heart attack to violent trauma.
The PSA, at least in theory, would make its findings based purely on medicine and without the politics that presently prevent a seamless, unified countywide emergency response system.
The group issuing the report, dubbed the Blue Ribbon Panel, decided that an independent PSA is needed to make unbiased recommendations to county commissioners, who would have final say over what the new system entails.
"We believe this authority has the potential to make recommendations to the (commissioners) which will save tax dollars and improve clinical effectiveness through consolidating and/or regionalizing pre-hospital services and by ensuring the standardization of equipment and clinical protocols," group members wrote summarizing their report.
County Manager Leo Ochs has called an April 11 meeting of area fire chiefs, EMS leaders and law enforcement officers to go over the draft of the PSA before it is presented to commissioners for consideration.
Ed Morton, former CEO of NCH Healthcare System and a member of the Blue Ribbon Panel, offered one example of what a PSA might recommend.
Through its research, the Blue Ribbon Panel found that the most important factor in emergency medical care is a quick response from medics trained in basic life support. Only in a relatively small number of cases are medics with advanced life support training required.
Collier County, with a population of 321,000, has more trained advanced life support medics than the King County/Seattle, Wash., area, which has a population of almost 2 million, the Blue Ribbon Panel found.
Although it may seem preferable to have more ALS medics, Morton said it can actually be counterproductive. The resources used to train and equip so many advanced medics might be better used to increase the number of medics versed in basic procedures, allowing for quicker response.
Plus, having so many ALS medics means it is difficult for any of them to get the field experience necessary to be proficient in vital work such as administering the right dose of powerful drugs.
But since fire districts in Collier County pay their firefighters extra if they obtain ALS certification, there is an incentive for an ever-growing corps of advanced medics.
One option that a PSA would have is to steer toward a tiered system like the one used in Seattle, where basic life support is sent first and advanced life support is sent only when needed.
Duane Billington, a local activist who has been studying issues surrounding emergency response and fire district consolidation, has been in contact with Jim Fogarty, director of EMS in King County, hoping he'll come here to discuss the King County model, which has been recognized as one of the best in the nation. Fogarty indicated he has a family wedding in Florida and May and would be willing to meet with local leaders then.
Establishment of a PSA would not necessarily mean the end of independent fire districts or fire district consolidation for Collier County. Fogarty points out that more than 30 fire departments in and around Seattle are partners in that area's emergency response system.
For years there has been talk and little else about reforming Collier County's patchwork of emergency care.
Now, maybe, that talk is turning to action.