Guest Commentary: The real issues are control and money

Dr. Jerry Swiacki
Chairman, Our City Our Ambulance, Marco Island

The Naples Daily News May 27 editorial relies heavily on Dr. Tober’s letter to the Collier County Board of Commissioners. Using fear tactics to justify his position, Dr. Tober provided inaccurate and misleading statistics. A reliable source with access to the county and Marco Island data indicated the discrepancies to me.

Dr. Jerry Swiacki

The questions you proposed are answered in the Fitch Reports of 2016 and 2018. They are available at This nationally recognized authority on emergency care analyzed the data provided by Collier County and the City of Marco Island.  They evaluated the personnel and capabilities of the Marco Island Fire/Rescue department.

The Fitch Consultants concluded that there is a need for expanded emergency medical service and Marco Island paramedics are capable of providing it.

You are concerned that non-residents cannot vote on the cost of a Marco COPCN. However, Marco Island and Naples were disenfranchised when they were not allowed to participate in the March 2016 straw vote for consolidation of county fire districts. Ultimately, ambulance service will also be consolidated in 2020 or soon after. 

Currently Marco pays 0.6 mils in taxes for Fire/Rescue services as compared to the rest of the county which pays an average of 1.8 mils. Marco businesses, property owners, and citizens do not want to pay three times more tax money to the county and have no voice on how the money is utilized.

Comments regarding the cost and expiration of medications are disingenuous. Most Marco Island paramedics are Tober certified but are not allowed to administer lifesaving drugs when riding on Marco Island vehicles. Marco paramedics cannot carry or administer Tylenol.  How much does Tylenol cost? Who wants to wait 26 minutes (Chief Butcher) for an anti-seizure medication when a Marco responder witnessing the seizure could give it? Presently Marco pays for its own medications, not the county.

Dr. Tober questions the availability and training of paramedics. Unless they are new inexperienced recruits, why should it take 2-3 years to train and replace a Collier County paramedic? There are many state certified, experienced paramedics who could be fully integrated into the system within 3-6 months. If Collier County paramedics are treated well and paid appropriately, why would they leave for Marco Island?  Presently we are interviewing three fully trained paramedics, none of whom are from Collier County.  The Fitch Report and Marco Fire Chief Murphy’s staffing requirements differ from Dr. Tober’s assertions. I have more confidence in a nationally recognized expert and my own Marco Island Fire Chief.

Dr. Tober fears fractionalization of emergency medical service yet holds the THREAT that the County might not cooperate with Marco Island if it receives its own COPCN. It is standard practice throughout the nation that hospitals, cities and counties work together through inter-local agreements. Collier County and Marco Island need frank and open discussions.

A 24-hour, fully staffed Emergency Room on Marco Island is not medically appropriate nor financially sound. Having readily available emergency ambulances for transport to an appropriate medical facility is medically appropriate and financially sound.

There are many highly qualified physicians in the county, the state, and across the nation who would be happy to accept the position of medical director for Marco Island, and work with the County.  Marco Island has been receiving inquiries from these individuals.

The real issues are control and money. Marco citizens want to control the level of their emergency care and are willing to pay for it. The county and Dr. Tober do not want to lose the control or money. I urge all Marco Island citizens to vote yes for the COPCN on Aug. 28.