- March 17, 2022
East County will need to wait longer before it sees funding for Advanced Life Support in the budget of the East Manatee Fire Rescue.
The budget was approved with a vote of 4-1 during a Sept. 19 budget meeting, with only Commissioner James Carlino dissenting. Carlino said the lack of funding for ALS services, which is an initiative he has been pursuing, was his reasoning for voting against the approval of the budget.
"I cannot support a budget that doesn't give them what they want," he said regarding the county's taxpayers.
Advanced Life Support refers to firefighters who are certified as paramedics and can therefore offer a wider range of medical services including more advanced defibrillation and administration of certain drugs through IVs. Currently, West Manatee Fire and Rescue District, Southern Manatee Fire Rescue and North River Fire District operate ALS programs.
An important aspect of ALS that commissioners emphasized is the ability to transport an injured person more quickly, due to care having already been performed by the paramedic firefighters once an ambulance arrives on the scene.
The most recent version of the fire department's ALS plan was budgeted at $1,558,998 for the first four years.
The commission would now need to pass a budget amendment for ALS funding to take place this coming fiscal year.
Carlino said ALS services should receive funding equal to other main initiatives of the fire rescue, but the overall board chose to pursue two other projects: the hiring of three additional firefighters for a total of approximately $255,000, and the reconstruction of Station 11 on Wauchula Road in Myakka City for more than $4 million.
“Now we're 20 years behind the other fire departments, in the medical service that we provide to our taxpayers,” Carlino said.
Carlino accused commissioners who did not support ALS of postponing funding through a backdoor method, due to them reaching the preliminary decision not to fund the service during a Sept. 7 budget workshop, rather than one of the regular commission meetings, which he said are more well-attended by members of the public.
Carlino said he was absent from the workshop due to a medical appointment.
Chief Lee Whitehurst noted to commissioners that the department is substantially using reserve funds and has exceeded its total operating budget. Therefore, funding for ALS would have to come from reserves.
Commissioner Garry Lawson said the department was unable to afford ALS. He said although its $1.5 million cost did not seem like a large amount, he did not support use of reserves to fund the service, and if the department had to use reserves, they should be used for the station instead.
"I don't take money out of my savings to pay my operating bills,” he said. “I don't think it's a wise thing to do right now.”
During a Sept. 7 workshop, Lawson said decisions made at the meeting demonstrated the limited nature of funds. Commissioners scaled down plans to fund either an additional six firefighters, or the replacement of Station 11. The commission eventually settled on adding only three firefighters and postponing funding for the station to at least April 2023.
“The groundwork has already been laid with the budget,” Lawson said at the Sept. 7 meeting. “We’ve got ‘x’ amount of dollars coming in, and we’ve got ‘x’ going out, and our core mission is trying to get the things accomplished we have going on right now."
On Sept. 19, Lawson called ALS a duplication of services that overlaps with the ambulance services Manatee County EMS provides. He noted the fire rescue's Station 12 along Verna Bethany Road hosts an ambulance that belongs to EMS, and the fire rescue is looking to maintain a county-supplied fire medic at that station.
Deputy Chief of Administration Paul Wren said a fire medic is present on two out of three shifts at the station.
Lawson said the county’s ambulances are providing excellent service at other locations.
Commissioner Bob Conley agreed with Carlino that ALS would provide quicker transport, but he disagreed with some concerns voiced by Carlino that the item would be postponed indefinitely if not funded immediately.
"It's just not gonna happen right now, out the gate here," he said, emphasizing that the commission would return to the item in the future.
Commissioner Derek Foss said building Station 11 was a priority, saying there would not be one to provide ALS out of if it were not built.
He said he disagreed with comments from some commissioners that the development of Station 11 should be postponed. He said in his understanding, the purpose of scaling back hiring plans to only three firefighters had been to provide funds for the station.
Foss said when the union provided a vote on ALS, about 75% voted against an ALS program. However, he also said it had been reported to him by staff that most staff were not against ALS in principle but had fears of the program being mismanaged.
Carlino made a motion to amend the final budget to include ALS as a line item and fund the program from reserves as necessary, which failed 3-2, with Foss and Carlino voting in favor.
“That's what the reserves are for,” Carlino said. “We can fund it from that. We're not talking a lot of money to get ALS up and running. But they're not funding it, and using the budget as an excuse.”
Carlino said he would be open to exploring options for scaling down the proposal.
The proposal had already seen multiple revisions. After the commission declined a 10-year plan drafted by Whitehurst, he scaled the project down to a less ambitious four-year plan with a cost of $4,424,194.
A second four-year plan was then created and budgeted at $1,558,998. This plan aimed for the same goal of staffing two engines with paramedic firefighters on rotating shifts but lowered numbers of personnel below the goal of 18 in the previous plan.
During public comment, Lakewood Ranch's Michelle Jimenez-Baserva, an advocate for ALS, asked what it would require for the fire rescue to start a program.
“East Manatee has a great response time; it is EMS that is struggling,” Jimenez-Baserva said.
The East County division of EMS has an average response time of 9.5 minutes. The East Manatee Fire Rescue has an average response time of 5 minutes and 54 seconds.
“We just need to step up our game and do a little better," she said. "Because when you look at southern Manatee and North River, they got three men on a truck, and they got ALS, and we don’t,” she said.
Administrative Officer Kim Luther, speaking as a member of the public, said she was concerned by Carlino’s lack of attendance at the budget workshop on Sept. 7 for the second year in a row, which caused him to miss what she called a thorough vetting process for the budget items.
“I will always stand firm and will never support any initiative that will put our district at risk of going in the red while maintaining our communities and safety,” she said.