Midway Fire Department may still move ahead with ambulance service plans
Part one of a two-part series
BY PAM BRANNON Gulf Breeze News news@gulfbreezenews.com

The Midway Fire District (MFD) may still move ahead with pursuit of its own ambulance service, no matter what Santa Rosa County Commissioners decide to do about their countywide service. According to Chief Stephen Demeter, the requested service may depend on what happens in the bid process that the county approved this week for their new county ambulance contract.

Midway Fire District contacted the Santa Rosa County School District in December to ask if they could be included on the school district's special election ballot this spring.

Officials from MFD planned to ask their own voters if they would like to have their own ambulance service operating from Midway Fire stations - if it did not cost voters any additional taxes. The School District already has a special election planned to ask voters all over the county to renew the sales tax that has been helping fund county schools.

"The superintendent of schools told us they would discuss the possibility at their January meeting," Demeter said. "We are hoping they will allow us to add our initiative for Midway voters only to their countywide ballot so we can have a referendum vote to present to the county commission. I have no doubt that if our residents are presented with the facts, they will vote to have their own life saving ambulance service right here, close to home 24/7."

Santa Rosa is the only county out of Florida's 67 counties that operates with only one private ambulance company providing all of its ambulance services, working off user fees with no government subsidy. The other 66 counties operate their own government funded service, backed up by a private company for non-medical transports, or are covered by combined private and fire-based ambulance services throughout their counties.

"Escambia County funds their own ambulance service on user fees only," Chief Demeter said. "Throughout the nation, 90 percent of all fire districts now operate their own ambulances. There are just none in Santa Rosa County operating that way. We are not trying to re-invent the wheel here."

Midway Fire District sent a letter to Santa Rosa County Commission in November asking the county to give them a certificate allowing them to start an ambulance service, providing two ambulances seven days a week, 24 hours a day to cover the Midway area. The Chief said the service would work also from user fees and not require any additional tax money. "Those ambulances could also work as a back up to Gulf Breeze or Navarre when needed," Chief Demeter said.

MFD cannot start their own ambulance service in Florida without the permission of their county commission.

"Florida is the only state left in the U.S. that requires a certificate from the county for an organization like ours to start their own service. Any place else in the country, if we wanted to start our own service, and our fire commission believed it had the resources and voted to do so, we could start it tomorrow," Demeter explained

Deborah Roche of Lifeguard Transportation, Inc., a private ambulance service, explains that each county in Florida can decide how many certificates of need to allow within a county for ambulance services. Some counties allow several, but Santa Rosa County currently only issues one certificate.

"They voted some time ago to only allow one certificate to be issued for the whole county. Nothing dictates that except the vote of the commissioners. They can allow as many as they want. But a commission decided several years ago that it would not be profitable for a private company to work in the county, operating on user fees only without any subsidy from the county, if too many ambulance services were competing."

March 2006 ended a tenyear contract between the county and private ambulance service Rural Metro, but the county extended that contract for a year while they took a look at what the county might need in a new contract with the current growth of the county.

Demeter said, "The current private ambulance service operating in the county has only five to seven ambulances covering the entire county, from north to south, at any one time. And none of those are stationed in Midway. They argue that it is not necessary for us to have our own ambulances in Midway, because they are meeting the contract they have with the county on response times. That is true; most of the time they are indeed meeting those contracted response times. But the response times required by Santa Rosa's contract are way behind current nationally recommended EMS response times, as well as response times recommended by the American Heart Association."

Deborah Roche of Lifeguard said, "I know some in the county think Chief Demeter of Midway is trying just to empire build. But after we met with him a few times, and have now talked several times, I don't believe that is true. I just believe he is frustrated with the level of service the county is requiring and providing right now, and is really sincere that he should offer better for the residents he is responsible for in his district. And right now getting their own ambulances is the only option he sees available."

But MFD cannot start its own ambulances rolling without county approval. So county commissioners would have to approve granting a second certificate of need within the county boundaries, and give that certificate to MFD in order for service to begin.

The county commission decided to wait before making such a decision until they received the final report from the Emergency Medical Services consulting company they hired last year to do a review of current county ambulance services. They hired Fitch & Associates from Missouri, an EMS consulting firm who has been serving municipalities throughout the U.S. since 1984.

The Fitch report was presented to Santa Rosa County in December. The "key findings" of the report do say that Rural Metro is now meeting the current response times demanded in the county's contract. But it further states that those demanded response times are "somewhat longer than recommended for optimal clinical outcomes." It recommends that in its new contract the county should achieve "system improvements" for patients.

But the report also recommends just keeping one private company to provide all the ambulance services within the county, and not allow Midway Fire District to have ambulances. The report points out that "Midway Fire District has recently discussed the idea of pulling out of the County's ambulance transport system and conducting transports for calls within their own district". The report said, "There is little doubt in the consultant's opinion that this would not be in the best interest of Santa Rosa County taxpayers."

In the key findings, the consultant wrote, "A loss of transport volume or fragmentation of service area would be detrimental to the overall system."

But Demeter said he believes this is the perfect time for the county to find out if any other private company would cover the county's ambulance needs without including Midway's district in the contract, since the county is getting ready to go out for bids on a new contract.

"There are four private companies that we know of now wanting to bid on Santa Rosa County's ambulance service. So I have suggested to county commissioners that they go ahead and ask for two bids from each company - one with Midway included, and a second bid from each with Midway not in the contract, allowing us to have our own ambulances. Let's see if there isn't someone willing to cover the rest of the county even if we have our own two ambulances here."

Roche said, "I do not think the county commissioners will vote to fragment the county to allow Midway to have their own service. And I personally do not think it is a good idea for Midway to have their own ambulances because of what it will start. Once Midway gets their own ambulances, it will only be the beginning of Santa Rosa County's fragmentation, as far as ambulance service. One fire department after another will move to have their own ambulances, and it will then be difficult, down the road, for the county to find any private company to service the rural parts of the county that have no fire departments who can offer ambulance service. Then the county will end up having to pay a subsidy to have those areas covered by a private company. I believe there is a better way to cooperation and working together, so Midway does not have to go to all the expense of their own ambulances."

Rural Metro was unavailable for comment Watch for Part Two in January 18 Gulf Breeze News.