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A major shift in the way emergency medical services are provided to residents in Collier County, as well as the distribution of financial burdens, is underway, thanks to a prolonged battle between the North Collier Fire-Rescue District and the Board of Collier County Commissioners.

“This is not something simply relating to an area of the county 20 miles away, these issues will have profound implications here on Marco Island,” said Fire-Rescue Chief Michael Murphy of the Marco Island Fire-Rescue Department.

The state grants counties the ability to issue a Certificate of Public Convenience Necessity. The county then determines what agency they wish to allow to provide those services, which include Advanced Life Support and the transport of patients to hospitals within the county.

Marco Island City Council on Tuesday evening directed the city manager to request such a certificate from the county to provide ALS and transport certificates to handle its own emergency medical services in light of changes at the county level.

In Collier County, the county commission has determined that only Collier County EMS can transport patients to the hospital.

An extension of the permission to provide ALS services through local fire departments such as Marco has been done by “Inter-Local Agreements.” Those inter-local agreements to provide paramedic services to residents of the city of Naples, city of Marco Island, Greater Naples Fire District and North Collier Fire District have vastly improved the mortality rates for those stricken by strokes, heart attacks, trauma, drowning, children asthma attacks and other life-threatening emergencies by treating patients with paramedics on fire engines.

The North Collier Fire District was granted their own non transport certificate five years ago by the county and it was due to be renewed in the late fall of 2015. But the county commision has balked at renewing that certificate, and those services being provided by North Collier are due to lapse on Feb. 25.

With the lapse of that certificate, more than 100 certified firefighter-paramedics, positioned throughout the North Collier Fire District, will not be able to provide those advanced services to their constituents due to a turf war, personality conflicts and possible hidden agendas.

All of those units, equipment and personnel are paid for by North Collier Fire District taxpayers at no cost to the county.

In many cases those firefighter/paramedics are on-scene before the responding county units that provide the transport services. Those highly skilled professionals are administering the vital medications and treatments that can only be done by paramedics. The final decision could have life or death consequences for anyone living, visiting or just traveling through that area of the county.

“The North Collier Fire District has demonstrated it can and does provide exceptional services to those individuals which have need of skilled paramedics and their special lifesaving skills,” said Murphy. “Their district has proven their ability to work together with other professionals throughout the county during their 5 years holding their own COPCN.”

North Naples has received a renewal of their certificate for the last four years, causing some to question why the Collier commission is making such drastic changes to a system that has functioned so well for residents of that area.

This lack of compromise will cause the county to shift personnel, equipment and tax money to fill in that gap for services by incurring major overtime expenses and replacing those 12 units with three to four additional county units this year.

The county already runs a deficit providing these services and requires a transfer of close to $14 million each year in ad-valorem tax revenues into the EMS’s $20 million-plus budget.

The inability of the county to find common ground with the fire district on this issue will continue to balloon that shortfall in revenue and has the potential to cause a delay in services to the citizens on the island and the Collier County EMS budget to increase in future years.

Resolution on March 15 ballot

A non-binding resolution will appear on the March 15 ballot that asks whether residents of unincorporated Collier County support moving EMS into an independent taxing district with a governing body.

But there has been no public education, financial or level of service impact studies done on this critically important ballot question.

The city of Marco Island and city of Naples have been excluded from this vote. This will cause home rule for our two communities to be placed in serious jeopardy with EMS within our borders. The ability of the city’s own 28 fire-rescue paramedics to do their jobs may also be in peril, as will the health and welfare of Marco residents and visitors if Collier County EMS is made an independent taxing district.

“Marco Islanders already have fire-EMS services provided to them at the most cost-effective level found within the county. However, we are looked upon as a potential “cash cow,” in a plan that is being floated without any data, financial analysis or substantive support documentation,” said Roger Hernstadt, Marco's city manager.

A behind the scenes plan may result in EMS services being transferred to one of these “super-districts,” while having elected officials of that district dictating what level of services local residents may be receiving without our community having a voice.

“We will not be part of that process and be forced to fund a system we have no say in,” said Hernstadt.

The Florida League of Cities has favored the removal of the restrictions that prohibit cities from receiving their own certificates for ambulance services, in direct opposition to the Florida Association of Counties, which seek to maintain the status quo.

City staff will be writing a series of educational pieces that will appear in local publications shortly, in an effort to educate islanders and others regarding the issue.

“It is my hope that the issue can be resolved in a rational and educated way that protects Marco taxpayers, the excellent level of service we presently have, while continuing to provide all residents of the county with a first class system of emergency medical services,” said Bob Brown, city council chairman.

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