A recent Sound Off asks why Fire Services does not provide rescue units and why we have a private EMS company. As a retired paramedic from the former Citrus County EMS system, I will attempt to answer.
In the 1980s, Citrus County had its own public Emergency Medical Service (EMS). It charged reasonable fees for excellent service and operated on an annual county subsidy of about $900,000 by the early 1990s.
Concerns about the subsidy led a newly elected county commission to look at privatization. Paramedics had also formed a union which affiliated with the International Association of Firefighters (IAFF). The union filed suit against the county and won a large settlement since the county paid EMS employees as if they were firefighters. In other words, EMS employees did not receive overtime once they reached 40 hours in a week, since firefighters were exempt from that overtime provision. In an effort to settle the suit, the union offered to drop it in exchange for being cross-trained as firefighters. The proposal would have created a paid combination fire/EMS department. The commissioners have a long history of kicking the can down the road and rejected the proposal.
Meanwhile, a private EMS company offered to take over the service and reduce the county’s subsidy. County employees and their union were vehemently opposed to the privatization scheme. More than 5,000 residents signed petitions opposing privatization. Despite the opposition, in 1995, the county commission voted 4-1 to contract its EMS to Florida Regional EMS.
Employees lost their pensions and health care benefits and were at the mercy of an autocratic employer that emphasized profit at the expense of employees and minimal patient care.
The company was plagued with problems over high turnover and response times which fell far short of those agreed to in the contract. In addition, an employee filed a whistleblower lawsuit in U.S. District court alleging Medicare fraud. A settlement was reached in 2000 and Florida Regional agreed to repay the U.S. government $20 million.
Within months, Florida Regional abandoned their contract and went out of business. The county scrambled to find a solution which resulted in Nature Coast EMS. A separate paid fire department was later formed as Citrus County continues to kick the can down the road. Hernando, Sumter and Levy counties, as well as most of the rest of the U.S., have rescue divisions to handle EMS within their fire departments.