Fla. Commissioners Seek Agreement to Allow Fire District to Provide ALS
Sept. 22--Two weeks after voting to no longer allow the North Collier fire district to hire and train its own paramedics, Collier commissioners decided Tuesday to try to work out an agreement with the fire department that would bring its medics back under county control.
North Collier officials said they will meet with their attorney Wednesday night to see if they have any legal options to avoid entering an agreement with the county and to keep offering paramedic services under their own program, which they have run for the last five years.
The agreement will ensure that the fire district can continue to provide advanced life support to patients if an ambulance is late to the scene, said Commissioner Tom Henning, who proposed it.
"This is so everyone is trained the same, so we have the same delivery on the streets," Henning said. "We have interlocal agreements with Naples, Marco Island and some of the other fire districts. They're tailored to specific needs. If North Collier wants to provide that extra service, we can work out an agreement."
But North Collier has worked under paramedic and personnel-swapping agreements with the county before. It has always led to disaster, said Fire Chief Orly Stolts.
"We tried to work under the county's medical director Dr. Robert Tober for 11 years," Stolts said. "He accused our medics and EMTs of cheating on exams, he pushed for decertification so we could no longer practice, removed medications from out units without notice, refused to approve licenses, alleged malpractice and misused medical data."
Tober and the county's former Emergency Medical Services chief accused North Collier firefighters of cheating on paramedic exams in 2008 and 2009. The firefighters were cleared of any wrongdoing by a state investigation.
After the allegations, the fire district refused to work under the county's medical director. Commissioners gave the district a certificate of public convenience and necessity, which allowed it to hire its own medical director, train and supervise its own medics and determine which medicines those medics can use.
Commissioners renewed the certificate each year with little controversy, until it came up again early this month. North Collier wanted to expand the service to its new boundaries, which now include the former Big Corkscrew Island fire district. Henning, along with commissioners Penny Taylor and Tim Nance, voted to let the certificate expire rather than expand its boundaries.
Henning said that he would be willing to let North Collier keep its own medical director, if that's what it takes to come to an agreement. But fire officials believe that without the certificate commissioners plan to let expire, any of their medics would be required by state law to work under the county's medical director.
"The statute is pretty clear on that," Stolts said.
Any agreement would have to be negotiated and approved by a reluctant North Collier fire board.
The county's agreements with other fire districts typically place a county-trained paramedic, rather than a fire department's paramedic, on a fire engine. Fire engines and quick response vehicles typically beat ambulances to emergencies, so keeping a medic on a firetruck makes sure that if someone needs advanced life support -- an IV, lifesaving drugs or an oxygen mask -- a medic would be able to use that treatment if an ambulance is late.
Without a deal in place, North Collier's paramedics won't be able to use those treatments -- even if they are trained to -- and will have to standby and wait until an ambulance arrives, Stolts said.
"It's unbelievable," he said.
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