Bonita Springs fire officials aren't giving up on a plan to run their own advanced life-support ambulance transport service.
And with the ongoing turmoil involving the county's emergency management services — including the shutdown of the Medstar air ambulance program — this time the odds may be in their favor.
At the end of 2012, fire district officials submitted a second application for certification necessary to run their own ambulance-transport service. They initially submitted an application in 2010, but confusion over financials prevented the Lee County Commissioners from making a decision. They voted 3-2 to have the issue heard by a hearing officer and examined by a forensic auditor last April.
As the county begins to review its EMS program, commissioners are slated to revisit the Bonita Springs proposal at a March management and planning meeting.
"Senior staff that initially balked at the idea are now on board with that request," Commissioner John Manning said.
The fire district needs a county-approved revision to its Certificate of Public Convenience and Necessity for at least three advanced life support transports, which proponents say would lessen their reliance on Lee County Emergency Medical Services. About 80 percent of Bonita Springs patients are transported to Collier County hospitals, fire officials said.
"The initial reason we wanted to do it is to expedite patient care and get them to a hospital quicker," said Bonita Springs Fire Chief Joe Daigle. "We're already there treating them. With this we wouldn't have to wait so long."
Bonita fire officials are proposing to manage three ambulances on 24-hour shifts, and to add a fourth if needed. Currently, Lee EMS provides two ambulances that work 24-hour shifts, and one that works a 12-hour shift.
In the application, the fire district said the additional ambulances wouldn't cost taxpayers any money. The cost of the ambulance leases would be passed on to patients who use the service. The district currently has the manpower to staff the ambulances, which Daigle said is the biggest cost.
And allowing the fire district to run its own program would free ambulances for other parts of the county, Daigle said. Lee County EMS officials estimated last year the proposal could save the county about $300,000 annually.
"This is such a no-brainer," said Joe Mazurkiewicz, former Cape Coral mayor and consultant to Bonita Springs fire district.
But not everyone is on board.
When they voted against the program last year, some commissioners were concerned the savings estimate wasn't accurate, that separating services would lead to inefficient patient care and that it would require tax increases. Commissioner Tammy Hall said she would prefer they work on improving the county's ambulance program before handing over additional responsibilities to the fire districts.
"At this time I don't think it's a good idea to start breaking up the EMS program," Hall said. " I haven't seen any evidence that would change my mind. If we start piece-mealing it, efficiency starts getting lost."
After commissioners voted the proposal down last April, they agreed to have an auditor examine the numbers. But the debate over the Bonita Springs ambulance program was sidelined when county officials learned about mismanagement of the Medstar program.
As part of the Medstar fallout, two opponents of the Bonita Springs ambulance proposal left the county under commission pressure. And in November, former Commissioner Brian Bigelow, who opposed the proposal, was replaced by Commissioner Cecil Pendergrass, who could be the swing vote.
"I want to make a decision that's best for all of Lee County," Pendergrass said. "The main thing is to provide service with less cost to citizens and make sure we're not duplicating services already being provided."
Pendergrass said he needs further clarification on financial viability and overall logistics.
"I'm concerned with more layers of government with Bonita Springs residents paying extra," he said.
Commissioner Larry Kiker, whose district oversees Bonita Springs, said he also wants more information. Kiker, who replaced Ray Judah — a supporter of the proposal — on the commission, put the discussion on the March agenda.
"I think we need to have a good honest discussion with everyone about how to best handle that service," Kiker said. "If it comes down to a choice in terms of pros and cons, I'm usually one that's going to favor the municipalities."