Fire rescue to provide ambulance service

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By The Staff

Florida’s firefighters have provided both emergency medical and fire rescue services to residents for decades. Now Marion County Fire Rescue (MCFR) will add ambulance transport to its growing mission. On March 18, Marion County Commissioners approved an organizational structure that will enable MCFR to provide ambulance service countywide starting this October when the current ambulance service contract expires.

The current service, known as the Emergency Medical Services Alliance (EMSA), is a public/private partnership among the Marion County Board of County Commissioners, City of Ocala, Munroe Regional Medical Center (MRMC) and Ocala Regional Medical Center (ORMC). Together these four entities have funded the ambulance service, with a current operating deficit of nearly $8 million, over the last five years. The alliance formed in 2003, after MRMC announced that it could no longer afford to operate the ambulance service on its own after doing so for 25 years.

Facing tight budgets due to state tax reform and other issues, the three partners opted not to renew the ambulance service contract, thereby dissolving EMSA, effective Sept. 30. This prompted Marion County Commissioners to take action.

Commissioners diligently investigated all options before making this historic decision. In April of 2007, they appointed a citizen task force to study the issue and considered several operational models. Ultimately, commissioners decided that the fire rescue model was the most economically prudent and reasonable.

Unless you care about whose logo is on the side of the emergency vehicle, you won’t notice a difference in emergency medical response. We are committed to not just maintaining, but actually enhancing the level of service and quality of care when this transition occurs.

Our plan calls for immediately increasing the number of ambulances from 14 to 16 at off-peak hours and from 23 to 25 at peak hours. Over the next three years, we are expected to additionally increase that number to 22 ambulances at off-peak hours and 28 at peak hours.

You might question whether our firefighters are capable of providing ambulance service. After all, firefighters just fight fires, right? No, that’s a common misconception.

All dual-certified firefighter/paramedics and firefighter/EMTs across Florida have the same level of emergency medical training and state certification as any other emergency medical provider. Furthermore, both ambulance service and MCFR personnel work under the same medical direction and follow the same patient care and treatment protocols.

This is why you will often see a fire engine at the scene of a medical emergency involving cardiac arrest, respiratory distress, stroke or trauma. Dual-certified firefighters have the knowledge, equipment and medications to successfully change the outcome of those emergencies before the ambulance arrives. Plus, the fire engine crew is typically geographically closer and can respond faster.

Our dual-certified firefighter/paramedics and firefighter/EMTs also have 10 years of experience successfully transporting patients under the “Partnership for Life” program. In fact, our firefighters responded to 24,492 medical emergencies during the 2006-07 fiscal year alone, which was 75 percent of their 9-1-1 call volume.

Our ambulance model calls for 238 new positions. That means we could hire all ambulance employees, if those employees choose to work for Marion County. However, that does not mean those employees will have the exact same job title, job description or pay grade. We think this is a fair approach, especially considering local businesses and government agencies across Florida are laying people off or issuing hiring freezes.

We will offer 100 single-certified EMTs and paramedics who currently work for the ambulance service an opportunity to become dual-certified firefighter/paramedics or firefighter/EMTs within three years. MCFR will pay all costs associated with this training and certification. These job postings close May 16.

We will also offer 48 single-certified EMT and paramedic positions for ambulance workers who are unable to become firefighters. The single-certified EMTs and paramedics will serve on “High Performance” ambulances that will operate on 12-hour shifts and work in conjunction with other ambulances staffed by dual-certified firefighter/paramedics and firefighter/EMTs housed at MCFR fire stations. These job postings close May 23.

Although we have much more to do, preliminary budget figures indicate that we can accomplish this transition within or slightly lower than the current ambulance service budget. We additionally have no immediate plans to request any new positions over the next three years.

Marion County Commissioners are planning to fund the ambulance service out of the general fund rather than a separate Municipal Service Taxing Unit (MSTU).

M. Stuart McElhaney has served as the fire chief of Marion County Fire Rescue since 1994. You may reach him at 291-8000 or stuart.mcelhaney@marioncountyfl.org.