Bay County commissioners want to take over operation of the ambulance service, and they're counting on the current provider's cooperation. Bay Medical Center has provided ambulance service for more than 30 years, but its Certificate of Public Convenience and Necessity (COPCN) expires in December.
During negotiations to take the hospital private, commissioners made it clear to the joint venture partners that changes would come when the COPCN expired. Sacred Heart Health System and LHP Hospital Group leased the hospital and purchased its non-real estate assets last April and converted Bay Medical into a private, for profit facility.
Emergency Medical Services (EMS) transports patients to Bay Medical unless they request to be taken to Gulf Coast Medical Center. "Now that we have two for profit hospitals in Bay County, it's just not practical to have one of them operating the only ambulance service," said Commissioner Guy Tunnell. "We didn't make it a secret from day one that we needed to make some changes."
At Tuesday's board meeting, Emergency Operations Chief Mark Bowen outlined the county's options. Bowen endorsed a public/private EMS operation that would utilize county employees and county owned ambulances for 911 emergency transports, while calls for inter-facility transports would be outsourced to one or more private companies. "This is the model that is most common across the state," Bowen said.
Bowen said a public/private system offers opportunities to enhance public safety by combining EMS operations with city and county fire departments. All municipal fire chiefs in the county support such a move, he said. "A fully staffed fire department has time on its hand, but when you have a fully involved structure fire you need those personnel," said Bowen. "That's why the marriage comes about in so many different places across the United States... because it works."
In recent months, Bay Medical EMS has based ambulances in some county fire stations. Rick Smith, Vice President of Ancillary Services for Bay Medical, said it is an example of how the existing system can accomplish the goals Bowen outlined to the board.
"We would like to retain the service and really don't see why the county would look otherwise," said Smith. "I'm not sure why we would want to move away from such a model with budget constraints on the county the way they are… this is a service that we provide at no cost."
The county doesn't own any ambulances or associated equipment and faces millions in startup costs to bring EMS in house. According to Bowen, the system would be operated on a break-even basis. "There will be some costs on the front end of it that we will have to find funds for," Bowen told commissioners. "You can plan for capital improvement and it does have a margin that allows you to run this without a long term loss."
The commission does, however, have the power to decide who is awarded the COPCN. Tunnell is optimistic that the county and joint venture partners will come to an agreement. "Sacred Heart pledged then and they've given every indication all along that they want to be community partners," he said. "We're hopeful that we can work out something."
"I suppose we would, if that was the strategy that management went after or if that was the decision of the county not to grant us a COPCN to move forward," said Bay Medical's Smith.
Commissioner Tunnell said the county will privatize ambulance service if no deal can be reached with Bay Medical. "We can't go out and buy several million dollars' worth of ambulance equipment," he said. "We would obviously go out to bid... it wouldn't be a public private partnership, it would be strictly private."
Management of Lifeguard Ambulance Service, which provides inter-facility transports under a separate COPCN with the county, has said the company would pursue the EMS contract if it becomes available.
If the future of the county's EMS depends on competitive bids, Bay Medical management hopes history will be a factor in the decision making process. "We've provided the service for nothing, zero... so I'm not sure how much less of a bid we could come in at," said Smith.