Ocoee fire chief proposes fire-based EMS transport

Ocoee Fire Chief John Miller presented a fire-based EMS transport plan for consideration by Ocoee city commissioners.

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  • | 9:35 p.m. May 10, 2018
  • West Orange Times & Observer
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By January 2019, the city of Ocoee could be fully equipped and prepared to launch its own fire-based EMS transport.

Ocoee Fire Chief John Miller presented the idea to city commissioners May 1. If approved, the fire department could begin providing EMS transport services by the new year.

The city’s current model involves a fire truck with contracted ambulance services following behind. Fire-based EMS transport would allow the department not only to be the first responders at the scene of a medical emergency but also to transport and continue care of the patient en route to the hospital. 

“It’s critically important — we’ve spent a number of years studying this and preparing for this,” Miller told commissioners. “It goes without saying for about 70 years, Health Central — the taxing district — provided the ambulance service and then the last 10 or so years, it changed over to private hands. It was Rural Metro and AMR, and I think what you’re going to see throughout the state of Florida (now) is that at least 90% of transports that are done in the state of Florida are fire-based EMS transport.”

Miller said adding fire-based EMS transport would provide an improved level of service and continuity of care. Services would be geographically deployed — there is one fire station in each of the city’s four quadrants — and surrounding hospitals include Health Central and Florida Hospital’s Winter Garden and Apopka locations.

Currently, Ocoee — which also serves Windermere — and Winter Garden do not have fire-based EMS transport. However, of the nearly 2.1 million people living in Orange, Seminole and Osceola counties, nearly all of them have it.

“Ninety-eight percent of the citizens (in these areas) are provided with fire-based EMS transport,” Miller said. “The model is changing to this new basis, so it’s our time, and we believe we’re prepared and ready to move forward with transport.”

The proposed transport model includes two full-time rescue units and a peak unit. Automatic aid partnerships with Orange County, Winter Garden and Apopka help further ensure each of Ocoee’s boundaries is covered.

Of the projected 4,081 EMS calls Ocoee could receive by the end of the year, Miller estimates 3,147 of them will end up becoming transports. Currently, 70% of EMS calls are advanced life-support emergencies and 30% are basic life support. 

Rates for an ambulance transport in Ocoee currently range from $747.11 for BLS to $1,067 for ALS-2 — the highest level of life support — plus mileage. With fire-based EMS transport, Miller hopes to bring the costs down — about $700 for BLS up to $1,000 for ALS-2 — to become more on par with rates in Orlando and Winter Park.

The peak unit, Miller said, likely would be used about 60 hours per week, during times when there’s a higher call volume. With an annual revenue from this unit estimated at around $471,731 and the annual expense of about $126,720 to pay the firefighters assigned to the unit, the total estimated revenue from the peak unit alone would be about $345,011.

The fire department has an ordinance that already allows it to provide the service and will present a resolution to establish the rates at the next commission meeting, set for May 15.

Pending commission approval, the next steps would be developing a billing agreement and transport policies and beginning training. The ideal timeline also calls for a three-month extended AMR transport agreement for the end of the year and hiring of additional personnel. If the projected timeline proceeded smoothly, fire-based EMS transport would begin in January 2019.

“It’s well thought-out … anything we can do to cover the costs of our firefighters and provide the additional — and what I think is higher quality — professionalism to our citizens, I think it’s the right time and that we are well prepared,” Miller said. “We have the staffing; we just need the additional support.”