Deltona ponders whether to start ambulance service

BEACON PHOTO/SARAHROSE MINISTERI

By Al Everson
Beacon staff writer

posted Jan 29, 2013 - 3:54:31pm

After years of talking about the idea, Deltona is once again thinking about using the Fire Department as its primary ambulance service.

Deltona’s fire chief said firefighters have proved their ability to provide emergency medical services (EMS).

“Fire-based EMS transport is not a new idea,” Deltona Fire Chief Frank Staples told the City Commission in a workshop Jan. 14. “It is somewhat of a revenue stream ... and there is better patient care.”

Commissioners agreed to further study the proposal, but would not commit to a timetable for implementing it or budgeting the needed funds.

The city officials also decided to confer with surrounding cities and the county government, to talk about whether a special taxing district should be set up to designate territorial bounds and allow cost-sharing.

“We can never be exclusive and say we will never go outside Deltona,” Staples said.

Deltona, the chief noted, already has mutual-aid agreements with neighboring cities and the county.

“If you’re going to look at doing it regionally, why not consider a special taxing district?” asked City Commissioner Chris Nabicht, a retired Deltona fire marshal and division chief.

“Exactly,” Mayor John Masiarczyk responded.

“That’s a special district apart from the city,” said City Attorney Becky Vose.

Since Volusia County government absorbed the EVAC ambulance service, and with changes ahead in national health-care policies, Deltona will review the advantages and disadvantages — and the costs — of setting up its own emergency-medical transportation system.

The price tag has been estimated at more than $2 million, but officials believe the city service would be superior or equal to EVAC’s first-responder services, and could offer a new source of revenue for a city with a low property-tax base.

Deltona’s action signals that the long-running debate about breaking up EVAC’s emergency-medical transport monopoly is intensifying again, as cities look to carry patients to hospitals and charge for the service.

EVAC was established in 1981 as a private nonprofit foundation. The County Council had granted EVAC the exclusive right to take injured and critically ill people — especially those suffering heart attacks or strokes — to hospitals.

The monopoly on ambulance service was countywide, extending inside city boundaries.

Then, the County Council made EVAC a county agency in the fall of 2011.

For the most part, Volusia County has maintained a two-tier medical-emergency protocol, which calls for both EVAC and local fire departments to scramble to emergency scenes.

If a fire department’s medical-rescue personnel arrive first, they may render emergency treatment and stabilize patients, but may not rush them to the nearest hospital except under extreme conditions in which EVAC is unable to respond quickly enough.

Firefighters trained as paramedics or emergency-medical technicians must wait until an EVAC unit arrives to pick up the patients, load them aboard an ambulance, and transport them to a hospital emergency room.

Critics of the two-tier system say it shortchanges victims, as caregivers may change between the first treatment and the trip to a hospital.

“It’s very frustrating,” Staples told the Deltona City Commission. “You lose that continuity of care.”

The EVAC monopoly appears to be cracking. Edgewater and Ponce Inlet have set up pilot programs to offer emergency-medical transport through their fire departments.

Staples reminded the City Commission that most of the Deltona Fire Department’s emergency calls each year are medical, and providing ambulance service would allow the city to charge the ill, the injured or their insurance companies for lifesaving services.

The Deltona Fire Department logged more than 9,000 calls last year, Staples noted, and 6,825 of them — about 76 percent — involved medical problems, including such things as an elderly person’s fall, auto accidents, heart attacks or strokes, or even treating victims of a structure fire.

Of Deltona’s 6,825 medical calls during 2012, 3,791 culminated in an ambulance trip to a hospital. EVAC, not Deltona, is the agency that bills for those runs to the hospital.

“We get no revenue,” Staples said.

Staples estimated the city could net approximately $1.4 million per year from an ambulance service. The Deltona Fire Department already has two ambulances in its fleet.

“We may have expended a lot of materials on the patients, but we don’t get reimbursed,” Nabicht said.

Before deciding whether to add ambulance service to the Deltona Fire Department, commissioners want to know more.

If Deltona establishes its own emergency-transport service apart from the county and EVAC, the city will be bound to follow through on its decision, Mayor Masiarczyk noted.

“If you take it, you’ve got it. There ain’t no giving it back,” he said.

— al@beacononlinenews.com

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