BOARD OF COUNTY COMMISSIONERS. Consent Agenda Public Hearing

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1 BOARD OF COUNTY COMMISSIONERS d DATE: November 17,2009 AGENDA ITEM NO. 31. Consent Agenda Public Hearing Subiect: Approval of Revised Appendix.A and B to the Advanced Life Support (ALS) First Responder Agreement with the City of St. Pete Beach Department: Public Safety Services Recommended Action: Staff Member Responsible: Richard C. Williams, Director I RECOMMEND THE BOARD OF COUNTY COMMISSIONERS (BOARD), SITTING AS THE PINELLAS COUNTY EMERGENCY MEDICAL SERVICES (EMS) AUTHORITY, APPROVE THE RWISED APPENDIX "A" AND APPENDIX "B" OF THE ALS FIRST RESPONDER AGREEMENT WITH THE CITY OF ST. PETE BEACH. Summary ExplanationlBackground: The EMS Authority is empowered to set the levels of service that must be met by all EMS providers considering that the service funded may not be lower than the minimum level of service for those providers which existed as of January 1, The City of St. Pete Beach has continuously operated Rescue 23 since the early 1980s, therefore the request to continue operation is allowed as an exception to the Levels of Service for Emergency Medical First Responders standards contained in County Resolution (see attached). The initial FY2010 ALS First Responder budget and annual compensation for the City of St. Pete Beach included one (1) continually staffed Paramedic position and realigned the EMS coverage in St. Pete Beach to a single Paramedic ALS Engine at Station 23 in north St. Pete Beach. The City of St. Pete Beach evaluated the proposed changes and requested the funding and staffing for continued operation of Rescue 23 (see City Resolution , attached). The City did support the realignment of Rescue 22 to ALS Engine 22, serving Pass-a-Grille. The revised City of St. Pete Beach ALS First Responder budget funds two (2) continually staffed Paramedic positions for Rescue 23 with an adjusted compensation amount of $325,000. A budget action will be presented at a future Board meeting reallocating the funds. Including the full funding of Rescue 23, the overall compensation to St. Pete Beach for ALS First Responder Services will be reduced by $1 19,059 or 9.7% compared to FY On September 22, 2009 the EMS Authority approved the Master ALS First Responder Agreement, therefore only Appendix "A" and Appendix "B" have been revised for the City of St. Pete Beach. Fiscal lmpactlcostlrevenue Summary: The revised payment to St. Pete Beach is $1,108,691, a $325,000 increase over the adopted FY 2010 Budget. A budget action reallocating funds will be brought to the Board at a future meeting. ExhibitdAttachments Attached: Revised ALS First Responder Agreement -Appendix A Revised ALS First Responder Agreement - Appendix B Resolution St. Pete Beach Resolution Revised Page 1 of 1 w d

2 ALS First Responder Uaai%s Contractor Clearwater AuthsrOQ Funded Engine 44, Rescue 45 Rescue 46, Rescue 47 Rescue 48, Rescue 49 Rescue 50*, Engine 51 * - One position Authority Funded; Contractor may operate Engine 50 in lieu of Rescue 50 at its discretion. Contractor Funded Engine 45, Engine 48 Engine 49 Dunedin East Lake Gulfport Largo (including Belleair Bluffs) Lealman (rncluding Tierra Verde) Madeira Beach Oldsmar Palm Harbor Pinellas Park Pinellas Suncoast Safety Harbor St. Pete Beach Seminole South Pasadena Tarpon Springs Treasure Island Engine 60, Engine 6'1 Engine 62 Engine 56, Squad 57 Engine 58 Engine 17 Engine 38, Engine 39 Engine 40, Engine 4'1 Rescue 41, Rescue 42 Engine 43 Engine 18, Rescue 19 Engine 19, Engine 2 Engine 25 Truck 54 Engine 65, Engine 66 Truck 67, Engine 68 Rescue 2'1, Rescue 33 Rescue 34, Truck 35 Squad 26, Engine 27 Engine Engine 22, Rescue 23 Engine 29, Squad 29 Engine 30, Engine 31 Engine 32 Rescue 20 Engine 69, Engine 70 Engine 24 Squad 38, Rescue 39 Tactical Engine 4'1 Truck 42 Rescue 54 or Engine 54 Squad 65 Engine 33, Engine 34 Truck 28

4 A lxesoluthon OF THE PIINELLAS C8mTV EMERGENCY MBEDHCm SERVICES AUWBMTTJI' IESTmLISBmG LEVELS OF SERmCE FOR EmRGENCY &ledi[gal%'erst PONDEW IN ACCOmPhNCE WITEX THE mqu1mmen'its OF CEEAffaTEW LAWS OF FEODA, At3 AMENDED, WMEEAS, The Florida LegisPature in Chapter , Laws of Florida, as mended (the "Acf9), established the Pinelkas County Emergency Medical Services Authority ~("Authority") which was snbsequently approved by referendm of the electorate; md WE.REAS, the Board of County Cowmxaissioneas is estab1ished as the governing body of the Authority; md WEEAS, the Authority is obligated to provide hding for the reasonable and customary costs associated with the provision of emergency medical services pufsarmt to the AcP; and WHEEAS, the Authofity is empowered to set the levels of service for all emergency medicall services that must be met by EMS providers, provided that the service f4jnded may not be Iswea than the m%muna level of services for those providers which existed as cpf Smuary 1,1889; and WHEmAS, the PautlhoriQ has previously made provision for First Responder Services k ugh long tern service agreements with the EMS providers without making any legislative determinations regarding the appropriate Ievel of services for Pinellas County; and WmE.AS, at its public work session held on Febmary 24,2009, the Board sf County Commissioners, sitting as tile Autho&y heard a comprehensive staff presentation regarding legislative history, system operations hisbay, past and current methods of system financing, response statistics, dispatch strandads and process and EMS needs in each of the 19 municipalities and fire districts which provide EMS first responder services; and

5 WHEmAS, at a specid meeting Itadd on March 20, 2009, the Board of Comty Commissioners, sitting as the governing body Authority, took public comment om the establishment of levels of sewice as provided herein; and WHEREAS, given the varied distribution of population withiin Pinellas County; the name of the trportation inhtmctwe; the placement of fire stations, andl the idationship between staffing and system cost, it is necessary that the Board of County Comissioners exercise its legislative authority as the governing body of the Authority to assess Ihe needed service levels for EMS senices throughout the county, evaluate the factors impacting service levels, and the costs of providing those services, in order to establish the county-wide service level which will be hded by the Authority for tbe V ~ Q - EMS pro$ders; mr% Mereas, in support of the approvals herein, the Board of Comty Commissioners makes the following legislative findings: 1. The Authority cmently contracts with 119 municipalities md independent fire distmicb to provide advanced life support Erst responder services. These services are supported through a county wide ad valorem levy md funding from other system revenues, with payment made to the various providers bas4 upon a system af negotiated contram. In the pat these eontracts have allowed for certain automatic cost increases whch did not always accurately track the cost of providing services. 2. That while there is no mandated speciffc legal standard for response times for ALS fist responders, by agreement, the providers in Pinellas County have agreed to a response standad for emergencies that AES ~KSP responders will be on scene within 7 minutes and 30 seconds of dispatch by emergency operators at the 91 1 center 90 percent of the time. This results in an average response time below &is standard. Despite some variability among districts, dhe county-wide system response time cunrentiy exceeds this standard, which the Authority finds is the result of excess response capacity in the system. 3. Due to certain changes in the Iaw which effect the revenue generated by the EMS system, the Authority finds it is in the public's interest to increase the efficiency ofthe system and to the extent possible eliminate excess capacity ta ensure the ability to

6 finmmce the system on a seastaimable basis without requiring increases in the tax rate borne by the citkens. 4. The emergency medical sewices system currently uses a dual response model. lhis involves the use of advanced Iife suppolrf first responder vehicles staffed by fire department perscamel and advanced life support transport vehides staffed by the ambdmce contractor. First responder vehicles are deployed fpom fve stations apld the ambulances are: deployed through a more flexible system. Hn general7 this allows for a more efficient use of first responder vehicles as it requires less time spent with Plhe patient by the Fbst Responders. 5. Hsa determining the service levels approved hereim, th~ Authority has considered the staffmg pattern of each provider, the deployment of their personnel, historical and mbcipated workload, the distribution of population in fhe area served by each provider and system available to emergency equipment. In evaluating an appropriate response time, the Authority has also considered the county wide automatic aid agreements whemh each provider agrees to assist other providers responding to fire and EMS emergencies and the flexible depfoymep1t of the mbdmce comtmctor 9YAich utikes Wiansport vehicles, 6. Bulrsuf to Resolubon 09-31, the Auohority approved staff recomemdadons to change dispatch protocois which would stredine the dispatch process and in some cases change the number and type of vehicles sent to a patient. While staff bdieves &at this will result in a reduction in both ALS first responder and Ambulance responses, those assumptions are not relied upon in setting the levels of service. 7. Mile a uniformity of staffing and sewice delivery is desirable, the Authority finds that given the vaxiation in access, trait patterns and station placement, that some variation between providers and mas of the county is unavoidable. 8. The Authority also intends to exercise its authority to designate districts for the provision of services within the county in order to implement the levels of service established herein.

7 OF COUNT'Y bdy af the AuBbtggell.iity9 jiaa regala~" session dudy assembled this 20th day of M~BI~, 2009, thak Section 1, Based upon fie sgedfic legislative findings and, pursuant to its authority under the act, the Authority hereby, adopts Ihe levels of service as set forth h the attachment t~ this resslutiorn, Sedion 2. The level of services set forlh herein shall take effect on October 1,, Section 3, Fhe: Autho* recommends md emcowages the EMS service providers to comullt with EMS Admbistration for available assistmce in developing deployment plans. In a regular meeting duly assembled this 20th day of March, 2009, Commissioner 1Latval.a offered the foregoing Resolution and moved its adoption, which was seconded by Comissioner Welch md upon call the vote was: Am: Harris, Seel, Latvalla, bli~rsoni.~ Welch, and Brickf ielld, NAYS : Hone ABSENT AND NOT VOTING: ~ostock,

8 APPROVED AS TO FORR/r -IFFICE QF COUMR AnOTifif Rtr,: Attorney

9 , St* Pete Beach Rescue a2 and Rescue 23 have been in continual operation since the midng8s9s.and are eligible for county funding under the City of st. Petersburg 1989 litigation; and TfKE-xE the City of St. Pete Beach has been working with Pinellas County staff since Mar& aosg to address the hnding shoda]i! in the county's EMS budget; and the City of St. Pete Beach $as been willing to accept the proposed loss of funding for Rescue 22 and Rescue 23 based upon the criteria for call volume establiishedl by the Pinellas Board of County Commi40ners, with the understanding that all agencies ~dvouldl be treated in a consistent manner; and, the proposed ETog/~o Pinellas County budget contains funding for thirteen qescurss in IEPjinelk County that qppali-fy for funding under the St. Petemburg litigation but do not meet the adopted county criteria for- call volume in 2008; and the citizens of St, Pete Beach are entitled to the same level of EMS funding as the dtiaens being sewed by these thirteen rescues; NOW$ BE IT W S O L by ~ ~ the: City IS~OBI off %he City of St, Pete Secrtion B e Pinellas County continues b &ng Rescue ag for FY'20og/lo in the mount of $32fip060, '. Section 2.;There are hnding sfio~ds faced in the EM$ budget and St. Pete Beach is willing to accept the loss of rescuelevel funding for Rwue 22, even though Rescue aa is one of only two being cut hut of the sixtken rescue units %hat do not meet the adopted county criteria. Section % Pinellas County reviews the EMS service delivery in Pinellas County in the coming year to develop a system that addresses both service delivery md cost ebciency for dl agencies in a fair arld equitable manner, Section 4. A copy of ehk resolution is transmitted it(p the Pinellas Boaid of County Comissioners and Pinellas County.&hilniSiTat~~. Sect@ R, This Remlution shd take effect hmediaee1iy npon its passage and adoption.

VOTING STATISTICS - PRESIDENTIAL PREFERENCE PRIMARY ELECTIONS PINELLAS COUNTY, FLORIDA

VOTING STATISTICS - PRESIDENTIAL PREFERENCE PRIMARY ELECTIONS DEMS REPS OTHERS PRECINCT EARLY VOTING CAST (includes Municipals) 1972 278,689 136,535 134,366 7,788* 169,342 1,984 N/A 171,326 (includes nonpartisan)