Board of Commissioners - Special Meeting

Order, at this point in time, I ask for the pledge of the flag.

All right. So what's the plan of action here, David?

So when we met discussing last week's agenda, and it was originally a call for a workshop, the whole theory behind it was we wanted to make sure you had the information you need to make an informed decision before the 18th when you have to actually vote on the MSTUs. So this gives you and the public time to digest the information and make a decision Now, of course, when we did it, we said, well, we're going to make this a special meeting. So you can vote today if you wanted to. But again, our agenda is just to give you as much information as you need. And any questions you have, we want to be able to ask. So Joel last time mentioned that we have basically five options. And you can see one option is do nothing. Just leave things the way they are and stay the same. One option is the EMS MSTU, which we've been talking about. There are three options within the EMS-MSTU. And then one of the commissioners last week, Commissioner Hollingsworth said, well, we ought to put it on the ballot as a straw poll in November. So those are options. The third option is a sales tax. And we'll show you that you cannot do a sales tax this year, has to be in a general election, has to be started 180 days prior to that election. And we've missed that window for this year. So any sales tax, if the board wanted to adopt a sales tax, would have to be in 2028 election to be implemented in 2029. Use of EMS, MSTU until the sales tax is or is not adopted by the voters. That's always an option. And then finally, the fifth option is you say, well, this is what we're going to do. You're the budget officer. You figure it out. We'll do it within our existing budgets, and you'll have to make whatever cuts are necessary to make it happen. You may have additional options, and I'm more than happy to listen to them, but those were the five options that we felt were available to the board to consider.

What?

Are we going to talk about the office? Oh, you're not done?

Oh, we have more. So one of the questions we have is what is the impact of an EMS MSTU? So what you see in front of you is our taxable values from the property appraiser. You see the estimated cost for an ambulance that was generated. You see if you did an EMS MSTU for only the 1.6 AmeriPro contract, there's a net tax increase of zero. because you'll be decreasing the general fund property tax millage rate and increasing the MS2 millage rate exactly the same. So the other two options, that's option one, just what is now funding it through an MSTU versus the general fund. So if you do one of the other options, the full Monty, as I call it, is providing the MSTU with the purchase of the ambulances and the AmeriCorp contract As you can see, for a home value of 100,000, 200,000, or 300,000, the full cost would be, let's pick 200,000, middle price. The increase in taxes would be 237.34. The amount you would decrease on the general fund side would be 72.90. So you have a net annual tax burden in addition of 164.44. If we don't have to purchase the ambulance, how would that be impacted? So the bottom graph is without an ambulance purchase. You take out $1.6 million, that brings your $200,000 house to a tax burden of 164.72. You're still reducing the general fund side 72.90. So your net tax burden or increase would be 91.82. And for those people in the public that may not understand what a mill is, just added the definition of a mill so that uh because everyone's always saying well what is a mill so i gave you the definition are there any questions on these graphs the estimated cost for an ambulance is that just the ambulance itself but that's not the staff to staff the ambulance that is the cost of the ambulance and equipment but not the staff but not the staff of course you know depending on what ambulance you buy and what equipment you buy that can fluctuate but that is we we budgeted it on the expensive end rather than the cheap end and i just don't think you've seen that that was not including staff on the evidence 800 000 a year i don't think it is okay well this is the numbers we got from the fire department

$850,000 a year is a staffed ambulance, fully equipped, running all year long. That is not just the purchase of an ambulance.

I am correct. That's the cost of putting the ambulance on the road with the staff, am I correct?

Absolutely, yes.

So then we went to the, Jeff, Lance, and I went to the Lakeshore Hospital Authority on Monday, and we said, we'd like for you to buy us three ambulances. And this was their response. They didn't say no, but they didn't say yes. Their biggest concerns are they want to know that the county has a plan and that it's finalized that contains stable funding or sustainable funding so that it will be funded in future years, not just one year. And two, what is our staffing plan? If we buy you three ambulances, how are you going to staff them? And then finally, for them to do it, their attorney felt that we need to do it through an interlocal agreement.

So we've got services now for the next three years in our budget, right?

Well, we only do one-year budgets, but we know we've got a contract for the next three years with AmeriPro. We know that next year we're anticipating it being slightly under $1.6 million. So we're estimating at $1.6 right now. We know it increases 5% a year every year thereafter.

So if we get three ambulances from Lakeshore Hospital, and if we manage to figure out how to budget in an ambulance every year after that, we would actually end up with six ambulances in the next three years about.

If the county were to purchase two ambulances a year for three years, that would be six. get three ambulances next year into two per year it would be seven okay now the way that was proposed by the fire department to staff that ambulance uh two of them would be staffed one of them would be a backup in case something goes out for maintenance um but in cases of emergency could be staffed by firefighters and if you would like more details of course why don't you guys sit up front because they're going to ask you questions

um if you have any questions on how that works they're more than happy to tell you what their proposal is the staffing itself uh was misquoted in the in the paper today what was said what was meant was two of the ambulances would be staffed 24 hours a day seven days a week but you would have to hire personnel to staff days that third ambulance is a backup ambulance in case one of them has to breaks down or has to be serviced or whatever. But if that ambulance is sitting there and we go to where there is no ambulances available and a call comes out, we are not going to let that ambulance just sit there. Lance or I or Ronnie, one of our people on our office staff, there are medics and all up there, will grab one of our EMTs and we will jump on that ambulance and we will go to calls. So that is a... if it is in service and not out, it will be used as a backup truck. So that adds that backup into the plan also.

I would like to say these proposals that our department has prepared for you to consider is us as a backup to the current provider. So we are, the main provider is still going to be your current provider AmeriCorps. We are providing backup services, if you in the areas that we feel are not served.

Even just if you put them in the outlying areas of the county, you are going to help the whole county as a whole. You're not only helping those areas. because if you're covering that, that's one of these from up here that doesn't have to run out there to go to them. That cuts your response times. It leaves them open for more calls. You're adding two, it was the request. You're adding two to the service. So instead of five and a half ambulances, the county would have seven and a half ambulances available to it at all times, 24 hours a day. And,

then as a third ambulance as a backup at times of of high volume and need on the county side also so in fact what you're saying is ameripro still has to meet their rural times still has to meet their urban times what you're saying is we're going to place ambulances in the areas of the county that is very difficult to serve so if an ambulance responds they have to pull something from the city if we're responding they don't have to pull something from the urban area urban area has a lot more calls in the rural area so it allows them to give better coverage to everybody in the county jeff how many people you said have been to go to staff uh i guess you said two hours right two ambulances 24 hours a day seven days a week it takes two people per ambulance

You've got three shifts, so it takes six people total per ambulance that you want to staff. So two ambulances, 24 hours a day, seven days a week. In my budget that I had prepared and built for this, I had said 12 people for that and a 13th person that would be a supervisor for them. So a total of 13 is what I had budgeted in my budget that I prepared for that. and with that 13 Jeff that would enable you to like if somebody went out sick or something there's coverage still correct with that 13 no that doubt now during the daytime when that 13th person is there that could help cover that position absolutely but any time and this is what we've said all along over and over all through the years we've heard all about the how much overtime it costs and all that If you only have enough people to man your stuff anytime somebody's off sick or vacation, that's going to create some overtime. You just know way around that. It's just the way it is. We can't shut a road grader if man don't show up today, road don't get graded. You don't have an ambulance on the road, you can't say I'll wait till tomorrow to come to you. Don't work that way.

The other thing I'd like to add for the public, You guys know this, the public doesn't. Based on 24 on, 48 off, which is a standard shift for firefighters, there's a certain amount of overtime built in to the hours they work. So it's not like somebody who works 40 hours and everything over 40 hours is overtime. In their standard schedule, there is overtime. So you have to separate out what is the overtime that's built into their schedule versus the overtime for filling in and call-ins.

That's why their hourly rates are lower than a general person's hourly rate. A general person works 2,080 hours a year, Monday through Friday, 8 to 5. That's 2,080 hours a year. A fireman works 2,904 hours per year. It's their regular schedule if they don't work an extra day at all. So that's a big, good difference. In 24 on, 48 off, or the 48 on, 96 off that we do, same thing. 2,666 hours of straight time, 238 at time and a half. That's your built-in schedule. That's just the way it is. But because of the built-in overtime, hourly rates are lower, so it doesn't give up an enormous price tag on them, if you understand what I'm saying.

You've already built that in one.

That's already built in. That overtime is already built into your budget and built into the normal working time.

So when they talk about how much does a firefighter make or how much does an EMT paramedic make, you have to count that built-in overtime.

Correct.

Because you know they will get time and a half for that built-in overtime. Right. So if the base rate shows, say, $40,000, they're really making more than $40,000.

Jeff, on your built-in budgeting,

I don't have that in front of me I don't remember right off hand what I did was I pulled we pulled Merriam County who is actively expanding and putting it out now we pulled St. John's we pulled Putnam and right off the top of my head I can't think of another county but we pulled several of them when we got a an average of what they're doing for, because that's our competition. That's who we're going to have to compete against. And we had Swannies in there, too.

But that number, I mean, just a few calls, I may run them somewhere around 65. Do you agree with that?

The number for a paramedic on a box? No, I think it's a little higher than that.

Go, go, go. Minimum start.

For a paramedic riding an ambulance is more than a paramedic riding a firetruck. correct correct okay so when you're when you're looking and you're asking questions to these other counties that's right you ask where they're at because they boxer on an als engine that's a big difference a big difference it's harder to get people that to ride an ambulance than it is a fire truck it's just what feel i thought you said exactly what you said verbatim and you're right so there is a difference there

let me ask you something so if when we're now it's july when we're able to cause some you know if they aren't meeting their times ameripro that's when we can do some punitive damages right is that when that's starting to become effective okay so just hop you know just for in my mind so what if they start in the next couple months

making all their times are we saying we're going to do this even if they're making their times or i mean because if if i mean is that what we're saying you want to do that even if they're making their times that's my question i mean that's important that that is a do you think they're gonna do you know they're gonna make the time do you think they're gonna make it realistically hold on i mean please i'm sorry i don't mean to interrupt you What we do know is we can see what other counties run on an average calls per ambulance per year. And we can see what they will have to average to meet the call volume here. What is that number? Other counties, it's around 1,500 to 1,600 calls per ambulance per year is their average.

here is a little over 2 700 calls per year yeah because to realistically think that with five and a half ambulances that they can meet those times is unrealistic but but but now do we know they're just going to have five and a half ambulances we don't we that is all we but i'm just saying i'm just saying if in three months they're meeting their times and they got however many ambulances that's i think that's why we did the contract minimum of five and a half because we didn't have that before minimum five and a half and then They can put 10 in if they got to. Maybe they won't. I don't know. I'm not saying they will. I'm not saying they'll make their time.

Let me answer the question a little differently. If you could make a decision today, which the board can do whatever the board wants, you're not going to get ambulances for at least six months. So we're going to know. You're not going to hire people until you have ambulances. Why would you hire them if you don't have something to put them on? So you have, theoretically, best case scenario. Never count on the best case. Six months of seeing what their response times were.

Right, right. So, and that's important to me because I want to know. But the other question I have, what, because let's say all this, let's say they do make their times or they don't make their times. is there a reason don't how often do the firemen go don't firemen go to all the ems calls not all we go to all life threatening okay so that's like how many what percentage is that so life threatening is what we're most worried about correct i mean absolutely yeah yeah that's that's people's lives depending on you getting there in other words when you get there you got to do something right now there's not like a

you know it's not like a broken leg or something of that nature so we were asked several questions during the week about how ems calls are prioritized distributed are we sending people to non-life-threatening calls and that sort of thing so the way this county has done this for i think since 2010 2011 is we have emergency medical dispatch an emergency fire dispatch so it is a system that prioritizes calls based on the information that the people provide So when a person calls 911, the dispatcher will say, well, what's your emergency? They'll say, I've got X. And then the system gives them a list of questions. And based on how they answer those questions, it gives them more questions. You've got one dispatcher handling the radio traffic, one dispatcher talking to the person on the phone. It could even include CPR. Dispatchers have given CPR before over the phone. So you have different levels of service. Not every call is treated the same. And I'll let Jeff talk about Alpha and Omega versus Bravo, Charlie, Delta, and Echo.

Just so you understand what David's talking about this program. This is a nationally standard. It's a national standard. The program has been tested in court cases. It is a tried and true program, EMD, emergency medical dispatch. When the person the dispatcher puts in the type of call that it is in the beginning the program itself starts giving them questions to ask the way that caller answers that question like he said may prompt different questions but the program itself determines the level of the call because of the answers to those questions it's not dispatcher choice So y'all got to understand that. It's not a human choice of we want to make everything emergency and run all that. That's not the way it is. Now, understand also, when people call in, sometimes people are excited. What they tell the dispatcher, they're excited about things, may not be exactly what it is when you get there. But you also have that in the opposite direction. of people who will tell you what they say, and you get there, and that person's about to die. A lot worse off. And you don't think it is. So you can't, I mean, that is as close as you're going to get to a good way to dispatch and to get the calls rated.

Based on your fire call, when they call in and it determines what level of severity the call is, there's a difference between the levers the CHEP will get into. Not only does it then say how you have to dispatch it, but we call them fire cards. There's cards that say, based on this call and the information you got, you need to dispatch the following units. And the fire chief here from the city, same system. We all have the same system. We all use the same protocol.

So there's not one guy sitting there going, all right, y'all need to go here. It's actually a program. It's actually a program.

So based on how the fire chiefs feel a call should be responded to, they program into the computer a fire card that says, On this call, you will dispatch a fire truck and an ambulance.

Now, the different levels of calls. There's Alpha, Bravo, Charlie, Delta, Echo, and Omega. That's the call levels that the program sets out. Alpha and Omega are very low acuity calls. An Alpha call is somebody's been sick for a few days, not having respiratory or heart problems. Yeah, whatever. Stuff like that. uh when you get to bravo it gets a little as you go up the chain it gets a little more charlie through echo is considered life threatening emergencies that if somebody doesn't get to them care is not given then they could be their life could be in danger now Omega is basically a wellbeing check almost. Somebody calls, my grandma's blood pressure's high, I don't know if she needs to go to the hospital, y'all check on her please, dah, dah, dah. You go out, you do that. So when you have Alpha and Omega calls, the times that are required for an ambulance to get there go way up. You can see on your slides, they are way above what it is for a life-threatening call.

So these are required times.

These are the times of the contract. They should be doing it. This is what they should be needing.

I apologize. I didn't think about this in advance, but I just asked Lance to go ahead and have Jason pull the numbers, and we'll get back to you on how many calls of the 15,000 were Alpha, how many were Bravo, how many were Deco, how many were Echo. So you'll have that data when you make your decisions.

Do we have the data of this is what's required?

but do we have the data what we're actually getting that's what he's saying as far as the different levels he's going to pull that the different levels now you've got the data telling you how they're meeting their times right now yes that data is here that's what I do you have that Lance it's a slide but I'll let Lance we're we're doing this as a thank you Lance is the one who basically you would call the contract administrator who watches what they do and make sure that they're living up to the letter of their contracts and let Lance explain that yes I said this is something they haven't changed I said their numbers they haven't broke 70 percent yet May's the highest they were was 69.6 for their compliance times and that was in the urban areas so

So far, I've pulled first week of June, and these numbers are very similar for June.

I can't hear what you're saying.

I'm sorry. The number I said, do you see on the chart? I said, that's the response numbers for the compliance times you're hitting. I said, they haven't hit 70% yet. Pulling the first week of June, which is all we've pulled so far, they're maybe one, one and a half points above that. That's all they're at.

Basically, since they've increased to the five and a half averages.

Yes.

They're meeting one point.

They're low 70s is what we'll say. And the requirement is supposed to be 90 per the contract. So.

So based on what you're saying, Jeff, we know just from this data right here, they're not going to meet 80%.

90 percent realistically running five five and a half ambulances you're not going to meet it it's going to take seven to eight ambulances to get to be able to consistently meet those times whether they provide seven or eight ambulances whether we provide ambulances it doesn't matter that's what it's going to take to do the job so so they could in a month go do that but they might not you know so we don't know what they're going to do

You know what I mean? Go ahead. Go ahead. Go ahead.

Mr. Ford hit it last time. The fines for the month of May, $16,000. The cost to put an ambulance on for a year is $800,000. What are they going to do? It's cheaper to pay the fine.

I get it. I get it. I get it. And that doesn't make sense to me. It ought to be punitive. It ought to be $850,000. You know what I mean?

But unfortunately, we made that contract. So that's on us. As a business person, I play that game every day.

It's all about following up. When you're in a business to make a profit, which is the private services to do, you're going to weigh all that out. It's cheaper for me to pay fines every month than it is to add on this ambulance. But when am I going to add Daniels?

When? And you probably know, I don't know if I need to ask David this year, but when do they, how many funds do they pay before we fire them?

Well, Joel has made this comment very numerous times. This board, basically three strikes, they're out and per the language of the contract shall terminate the contract.

So the route that starts in July 1st, correct? Let me clarify that.

Okay.

It's three major failures. The minor failures are,

doesn't kick them out major what's a major this the time not meeting their time to major and that's all that's it yeah that's what you know but but but y'all go back to thinking what we've done over and over you know we we Columbia County went out of EMS business in 2011 since that point in time we're on our fourth fourth private ambulance service you just you it's A company that is in business to make a profit, when you're running 25, 30 people a year and all that stuff that you got, you're not wanting to make $100,000 a year profit. You're in it to make big money. So a county-run business doesn't have to be in it to make money. If we can do it and break even, that's awesome.

Let me ask you another question because I want to know why were we doing all right with ambulance service? Is the COPCM issue a problem? Is that what's causing one of the problems that we got so many people? Because it sounds like to me that an ambulance service, the 911, they don't make money on. They make money on the transport. So it's just like any business. If you give them a little one way, you get them, you know, they're able to do the other cheaper. It's like any business in the world. So have we brought on more of those in some way? Because remember, we didn't cost us anything to do ambulance, and I don't remember it being this bad back then. I haven't been here a long time, but what I'm asking is, is that one of our issues? Because even if whoever does it, does that affect you guys too? I mean, what does it do?

Robbie, I think this chart right here, if you look at it, tells a lot of the story too. We've got 15,000 calls a year in Columbia County. Look at the interstate hotels, truck stops, and parks. We've got more truck stops now. We've got more hotels now. That's true. We've got more parks now. And we bring in all these ball teams for these tournaments and everything. And that's a lot of our calls. They're at these motels. Some of them get hurt on the ball field, whatever. That's ambulance calls. But we bring in revenue from them coming here. You see what I'm saying? So we've got to look after them.

And that's one of the reasons I'd like to have a sales tax for it because then those people pay. You know what I mean? That's just my opinion. And I'm going to say this. Everybody pays.

We're at 7.5% right now. 7.5%. The only county in Florida, and I've done this research, that has an eight cent sales tax is Hamilton County. That's the only county in Florida. Would you need a whole penny? Well, I don't know, but I'm just saying.

I don't think you need even a half a penny.

That's a half a cent.

And I'm going to be honest with y'all. I'm not going to vote for raising tax unless the people approve it. If the people approve it, if the people go, I want you to do this, we'll do it. I don't have any problem. It's got to be approved by people. You know what I'm saying?

Here's what I'm saying. And Jeff's going to present a budget here in just a minute. And he's going to present a real number of what was collected last year by ambulance service. $4.2 million collected last year.

I heard that.

So if you take that $4.2 million and you go by his budget, you're funding these ambulances for a couple of million dollars a year when we're paying $1.6 now. You could put seven ambulances on the road right now for another $1. I think for the $1.6 million we're paying Americans over what you could collect. I don't see why we need a sales tax, an MST. It might not. We need to pull it out of our budget. And I'll say this too. I know there's a lot of talk about homestead exemptions going up and we're going to lose money. I've done some research on that. You know how many times homestead exemptions have been raised in Florida over since 1968? Four times. They never had to do an MSTU or anything else to absorb the cost of homestead going up. We're going to have to sit down and get right with our budget and look at the numbers, and we've got to find this money, and we've got to work with it. And that's what we have to do. And we've got a staff that needs to bring us something back to that extent.

And I know no commissioner here wants to raise taxes, ever. I know that. And I don't want to raise them. But the only way that I would vote, and I think we all agree, is if the people voted to raise them. And I don't know if you're going to get that. I don't think.

I think you're talking about such a minor amount of money to do that.

And that's the problem. We really don't know because you're saying the money we'll collect, 4.2, will offset some of it. That's a true number.

That was collected.

Right.

Last year. By the ambulance company, it was.

Now, was that for emergency calls only, right?

That's what they billed for. That was their total billing.

Okay. Just for, well, yeah, but that ambulance company was billing. Weren't they doing off calls too? No, they were just doing it down 911. Okay. So they're not. They weren't even doing CPOCM, no transport?

To clarify.

That's not part of it. Let me go to the next slide. There it is.

Yeah.

This is what was collected by counties. Now, remember, we have a three-year contract with AmeriPro. The vast majority of calls are going to be run by AmeriPro. So much of the billing is going to be generated by AmeriPro and paid to AmeriPro. We would only get a collection of those calls we bill for, which are the calls we run. So I don't want to confuse the two.

What... But we're only running two ambulances. We would bill for those two ambulances. We'd still bill for those two ambulances.

Other words, don't think that by putting on two ambulances, we're going to collect $4.5 million. Right, right. You're not running the call volume. What Commissioner Ford's been referring to is Columbia EMS's numbers that they give us. Because we contacted multiple counties, multiple agencies on dollar amount collected. That's what this chart is. Their dollar amount was $4.2 million. They did not do balance billing. Do y'all know what that, and I don't mean to, but do y'all understand what balance billing is? Balance billing is, right now, with Columbia EMS, if they sent you a bill, they accepted what insurance paid you and did not bill you for the rest, even your deductibles. AmeriPro does balance billing. So with Columbia EMS, constituents out there were not receiving ambulance bills if you had insurance of some type. With AmeriPro, if your insurance pays 80%, you're going to get the bill for the other 20%. And that's the way it is. So when you're looking at the $4.2 million collected, that was without balance billing. If you did it, you would do balanced billing, so that collection overall should be a little higher than the 4.2 million. So Ameripros should be a little over the 4.2 million. Now, if you take, if you're putting, take Ameripros right now, even if you go, and I said go with 900,000 in ambulance a year, that's high that should give you extra money to put back for you know saying that's your cost for ambulance per year so if you do that and you say uh five ambulances 24 hours a day would be 4.5 million then a half ambulance would be 450 000 so that's a total of four million nine hundred and fifty thousand dollars it should take you to run five and five and a half ambulances a year correct i mean that's that's my math that's easy math on that If you're collecting without balance billing, 4.2, you should be close to the 4.7 or 8 with the balance billing. So if you take that and you look at their numbers, that $1.6 million you're giving out to them if they only run those ambulance, that's their profit.

That's what they're making now. Now, I want to be clear on one thing, David. I'm sorry. No, you're sure. We know for a fact right now You're not going to run this county for five eminences.

Not in meet those times, no. You are not.

I don't believe so. So, you know, we need to look at a budget first. At least seven or eight eminences. When we look at this budget. We need to look at it. If we're talking, you know, I want to, what I'm saying is, I want an accurate account of what it's going to cost and what we're going to collect. That way we know how to budget.

So, the amount you're going to collect is hard to, to be accurate because we're just running two ambulances on the outside we do not know how many our call volume is going to be now we can take these other ones that have done collections and say you've ran x number of calls this is your amount collected so on an average you collect so much per call county-wide you know on something like that well putnam county right here that's what it is

they've done 13,000 calls, they collect $4 million. You've got to remember, so you can kind of base that out per call what you're going to collect. I mean, I think if you do the math on all these, you know, it should be it should equal out pretty, you should be able to get a graph of what each call will be. If you're doing 17,000 calls a year, you can get an average.

We can add a column and calculate that. The one thing I did want to point out about this call,

remember for columbia ams they collected 4.2 million on 15 000 calls but they don't balance b they run that many calls with that many calls to win because i'm hearing something about some people they didn't they didn't make it to the call they left that was the number of calls that came in that's not 100 necessary that they went to every one of those calls absolutely not and that would be true of every one of these counties in that chart

Those are the calls that came in, not necessarily the calls they ran.

Somebody told me, and tell me this number's right, 2,000 calls a year is six calls per ambulance a day. Is that right? 24-hour period, right? I think that's what it is. Somebody just told me, they said, if you could get to 2,000, you're saying 1,700 is more, a better window, right?

So let me put it this way. If you do the math, let me go back to that other chart.

the one that Kevin had emailed you previously. That would be seven ambulances.

If you increase the 5.5 by two ambulances, your calls per ambulance goes from 2,700 to 2,000. So adding two ambulances would reduce that 2,700 to 2,000.

That would put you, five ambulances should be able to do 10,000 calls a year, going to 2,000 calls per ambulance.

It would help.

Remember, these are averages. But that's still not target. You're supposed to be at whatever y'all said. I don't remember. I guess it matters what kind of calls.

Once you get over to 1,500, you start trying to budget or care for the next ambulance coming on that. By the time you get up to that 2,000 number, you're hoping you need that other ambulance to keep your times in a reasonable response time.

So when y'all go to a call, it's not every 911 call or what do you call it?

The fire department itself doesn't run to every EMS call. They run to all those that are considered life threatening. Now there is a caveat to that because we have such a great number of times when there is no ambulance to respond at all. We run to those calls no matter what level it is because we don't, my opinion, I don't think anybody needs to be sitting out there waiting for somebody to come help them. We are there. We have the personnel. We have the training. We're going to put somebody there to start the care to help. If I can help it, people are not going to sit there without somebody coming.

That leads to my next question. Why couldn't, and this is something probably y'all don't do, and I don't know how many counties do it. I heard one guy that knows a lot about it said Orlando does that or used to do it. If you're running a certain number of calls anyhow, what if the ambulance is, and this is just to save money. This is just another option. People don't like it, don't like it. But why couldn't, if you're driving a fire truck to that place and you're getting there and you're doing your ALS, it's ALS, it's them.

And you're doing an ALS.

Why couldn't those guys on that fire truck drive an ambulance instead? Put an ambulance at the fire station, and those guys are driving the fire truck. So what I'm really asking is, so the firemen are going to the real important bad calls, the ones that are gonna get us in trouble, the ones that people are dying or gonna die. Why can't they, instead of running a fire truck, which is a, I don't know how much they cost now, over a million dollars, and surely is harder to drive. Why couldn't they run an ambulance there and go? Because when y'all go, if this is true, when you go to an ALS call and they're in real bad shape and they're dying, you know they're dying. You're sitting there with your fire truck. Why couldn't you do something a little more unorthodox and have an ambulance there and run that ambulance to the call instead of a fire truck? I mean, I understand if it's some call where there's jaws of life needed or fire hazard or something. I understand that. But why couldn't we? You're going to go do it anyhow. You're loading two guys up. You're going. Why couldn't we provide you with ambulance? This is just me talking.

I understand.

Why couldn't you jump in that ambulance, go? If it's life-threatening and you're thinking the ambulance ain't coming, you could go to the hospital with them. You know what I mean? Because we're talking about life-saving because I remember you said people dying. And like you said, you're running calls now that you wouldn't run because you're worried that people aren't going. You know what I'm saying? You're actually running calls that y'all usually don't because of the lack of the ambulance. And you could do that with the ambulance. And then when you get there and we have that question of whether, you know, you got your code that goes in and it says not life-threatening, but it's a middle ground. You get there and you find out it ain't a middle ground. It's not that big a deal. They're hurt. Nobody's going to die. We can get them to the doctor. We'll stabilize them, get them right. Because, you know, I know it takes a little while to do that. I did learn that it's better to treat on the ground than in the ambulance. It's a lot more efficient. Is that correct? Correct.

It's easier. It's easier, yeah.

Okay. But what I'm saying is, couldn't we try that or that would save us money? Because I don't know when we'll get it. If we did the full-on fire thing, that's going to take longer than if we did this.

You're robbing Peter to pay Paul on that theory, okay? Okay. Let me try to explain. I'm not trying to be heated up, but I want to explain my thought on it. uh you you say if it's an ems call jump on it and go right well you're going to do it if you're available it's a different vehicle if you're available you're there you're going to run to it anyway yeah look at the number of fire calls and other calls in the county that the fire department already runs okay so you're saying if you have an ambulance at the north end and an ambulance in the south end those firemen are out on a fire call they're on a structure fire whatever it may be brush fire wreck whatever Then that ambulance just sits there with nothing to do, nobody on it. It just sits there in the bay and looks pretty. That doesn't work to me. You're robbing one to pay the other. So you're cutting one service down to pay for another. And that to me doesn't work. I mean, we're here. We're trying to come to enhance.

I get what you're saying, but is it 18 hours a day? I mean, unless it's to Bugaboo or something. If it's to Bugaboo or something, I get it. But how many – I'd need to see that number, too, to understand what you're saying. How many fire calls do you go out on a day compared to ambulance calls? You know what I'm saying?

So basically what you're saying, Rob, is we're going out of business to do an ambulance call. So we don't have any fires. Well, there's a lot at all.

Take the start of this year. Take the start of this year. All the brush fires and all that we have. We're running over 100 brush fires in a month. And a brush fire isn't like a medical call where you go out, you pick them up, you take them, you're done. You're on a brush fire for hours. You're on structure fires for numerous hours. And one structure fire doesn't take one station because we have already so few people at each station, we have to run four or five stations be able to effectively fight a brush or a structure fire and stuff so it's hard to give you numbers like that it's hard to get well no i even if i give you a number of this is how many fires we had that doesn't mean how many stations we had to send to it and that doesn't mean how many hours time that we put on that call so those make big differences in in the in the in the right but what i'm saying is when you're on a brush fire you aren't running ems calls right or no right then you're not so if you're on a brush fire every station is at that fire nobody's running ems you're you're on a fire and you're you would have to have one of our other stations that's not we say it with seven page stations in columbia county so if the three on the end south end of the county we have how many seven seven page so is there so when let's say let's just do a hypothetical you have a fire in fort why and you have that ambulance in an area around fort why no other fire station could take over that ambulance i know that's a hard question because no but listen the way it is we only have three als engines all the seven stations do not have paramedics okay so south end of the county is one that does if they're on a brush fire probably more than likely if they're on a fire the columbia city station at least one of either the Columbia City and the Ellisville, even on a brush fire. At least one of those. At least one of those others will be there on that same fire. If it's a structure fire, you're going to have the south end, Ellisville, Columbia City, and Station 48 at Racetrack Road down there at it. So your next closest people would be up here somewhere to come down there to hunt, to get that ambulance to go to that car. So you're really not on the north end. Take it the same way on the north end. If all of them are on a structure fire or a brush fire, somebody from Fort White, south end of the county, would have to come up here to get in that ambulance to go. So you've not helped your response times to that area by doing that.

I think we're kind of getting ahead of ourselves in terms of we have a contract for three years. Yeah, I know. It's just an option. So... We are not at a point where we are going to fully provide ambulances across the county. So if we are as a backup role, they can't come, we're coming. You know, that's one thing. But if our guys are all tied up, obviously the main responsibility is still with our contract provider. So we're not going to say, well, we're tied up so you can't respond either. So you got to remember right now, the next three years, we're in a contract. And they're the primary provider.

So how many, let me ask you this, let me ask you this. So how many, okay, so how many times or how many of the 10% of the worst ones do you not show up at? That's what I like to know. Because that's what we're talking about. You're talking about the fact that you're going to have a brush fire, however many brush fires. I'd like to see that number because if you're not able to do the ambulance 10% or 15% or 20% of the time, I still think it's a pretty good number to have that. I'm just talking about budgeting. We're talking about money. Money is what we're trying to save. And I'm just saying, I understand in the last month we've had some brush fires. I understand that. But like we said, we still have an ambulance service. We're just trying to boost them and help them. So to me, is it – I mean, are we – I'd like to see the number of times that every station is out on a fire, but it sounds like y'all are at almost every ambulance call. So it sounds like y'all even go to ones now that aren't even required for you to go to it. They're not emergency. So that tells me there's a lot of leftover time to, you know what I'm saying? I understand what you're saying. There's two uses for that fire truck and that ambulance. But if we're going to almost every one, What is your response on those 10% of bad calls? What do you think your response is on that?

We hit those. But I can answer your question about the hybrid service you're talking about wanting to run.

Is that what it's called, hybrid?

I ran it for 10 years in Suwannee County. I did it. Been there, done this. It worked in Suwannee County because you're a smaller county, 40,000 people, 6,000 calls a year. Eight ambulances available every day in that service. The shortcomings in it that Chief Crawford didn't mention, is when you take your firefighters from that station. We ran into it in Suwannee County. When you take your firefighters from that station, put them on an ambulance, three- to four-hour turnaround time, no fire coverage in that district. That's the problem with those systems. The new chief in Suwannee County the last two years has gone to four-man stations to stop that. That's what they've done to fix it because the hybrid system didn't work. Oh, so they're putting two guys on the ambulance? Yes, two and two because the hybrid system didn't work because their call volume exceeded it. It will work in a slow department. Our call volume will not allow it to work. I did it.

But they don't have a contracted ambulance service then. They were doing it all themselves. Yes.

But they had a capability for eight ambulances a day on the road is what they had at five stations.

And I'm just asking these questions because, I mean, we try to save money for the taxpayer. It's doable. It's doable. And I just – I just hate that a fire truck goes to every ambulance call. And even if you did what you do, if the fire truck went to the ambulance, let's say the 10% of the worst, and you get there, at least you're there in something. If you had to transport them, you could. That's all I'm saying.

It's a double-edged sword.

Because I know that you all get there in that fire truck, and the guy's critical, and you're just sitting there and waiting.

It's the perk is the way we run now with the ALS engine is when that ambulance does show up, that transport unit takes the patient. Now your fire truck is available to go to the next call, whatever the next call is that like you said, you're robbing Peter to pay Paul and it's leaving huge holes when you take your fire crews and put them on ambulance.

I just don't know how many times y'all get called out a day on fires. That's what I was wondering. There are times that you call on a lot of them. It's hard to manage to know how much you really get called out.

I said Suwannee tried it and had some success, but outgrew it. And it's half the call volume we are.

Listen, I just hear you say Suwannee County has eight ambulances.

Yes, when I ran, they had five stations every day that ran crews. McAlpin had two ambulances available.

Their population is what?

Around mid-40s.

So we have double the population.

And they're all ALS ambulances?

Yes.

They're running eight every day. Yeah, they back down. We're doing the dual response. We ought to be high time, big time.

Yes, they've backed to five now, and they're running four-person every station now.

I mean, we have got to address this. And we have five because our contractor thinks that's enough right now.

Yes.

Because the minimum required by contract.

And I want people to understand, we didn't tell them they only have to have five. We told them a minimum.

Word in there. This is the minimum. Exact word for word.

If it takes them ten, it takes them ten. Or pay the fine. Let me ask you a question.

Or get fired.

If you don't pay the fine, they fire you.

They wait until the last day possible. let's talk about this letter from lakeshore hospital authorities if i'm reading this letter correctly they're saying yeah we'll buy you the evidence if if it's legally possible we'll buy you these evidence but we want to see a plan We want to see how you're going to man these animals, how you're going to put them out there. We want to see a plan and we want to get a local agreement. So what I'm saying today is we need to come up with a plan today.

Before we can do anything, we can talk about this and throw it back into and do all these what ifs all the time. But before we can do anything. you have to make a commitment to whatever your decision is, you have to make that decision, then we can build the plan to make it work. We can't come out here and build a plan if we don't know what you want.

So having said this, to be honest.

I'll make a motion right now. I'll make a motion right now that we take the money we need to make this plan move forward. and put it toward these emirates so we can order these emirates. We've got over $5 million sitting in contingency right now. We can send that money to the side. We can buy these emirates. And if the Lakeshore Hospital Authority buys them, that's great. That gives us money to man these emirates. But at the end of the day, if we make a motion right now and we do it right now, we're looking at January before we got these two emirates on the road. I don't think we can wait. I know South Indian County can't wait. I know the North Indian County can't wait. And I'm putting a motion on the table right now that we put the money out there. We set it aside at a contingency to cover the cost of these ambulances, and we order ambulances today. They got three ambulances set there. How many ambulances you got there that can come? They said they can have it six months. You got three. So we got... These animals are available if we move quick. We've got to give them a timeframe right now to order them to get them here by January. Now, I'm just telling you, the south end of the county, the north end of the county, we have got to provide that. I mean, that's our obligation to our constituents. Public safety is our main obligation. And we have got to move forward with this. And I make a motion right now that we set the money aside. I continue to cover the cost of these three emphasis. and hope that Lake Shore Hospital Authority comes through with this money to help us out. And if they do, we let them cover the cost. But we cannot order these ambulances unless we have money set aside for these ambulances. That's the law, or that's how we have to do it. It was made clear at our last meeting. You brought it up about ordering the ambulances at the last meeting, and the money has to be there for the order. We take the money out of contingency for three embassies. We set it aside. And we hope Lakeshore Hospital Authority comes through with the money. But I make a motion right now. We move forward with two embassies. I don't have any faith that it's going to get any better with this Ameripro company. And I know the outskirts of the county is suffering big time. You're suffering. Your end's suffering. My end's suffering. And we need to move forward with this right now. I mean, it's a no-brainer for me. And I've seen the numbers. I thought at the end of the day, it's going to take about six months for the billing to start coming in after we start running these ambulances. But a lot of the cost for the employees will be covered through billing. So I got a motion on the table.

Discussion? I mean, we have a contracted ambulance company. And we're saying right now that they're not going to meet their obligation. They haven't so far because they're in that area where they don't get fined. If you ain't spanking the youngin', they're not going to do what you tell them. So when we get them in July, July 1st, that's 15, 12, 13 days.

Two or three weeks away.

I can't see my watch. can see what they do and if they keep doing what they're doing i'm ready i'm willing to revisit but right now we have a con and and to me we're the taxpayers are paying 1.6 million for this and if we go and spend those money for ambulances i expect some money back from ameripro or somebody that could be because it's a double bid i mean we're we're doing their job for we're going to get money back if we buy them but you know what i'm saying but quick. We got two weeks before we know where they put another. I mean, what if in two weeks they put two more ambulances on or three more or whatever and they start meeting their times? We're sitting here spending a lot of money and I know y'all say they're not going to, but we don't know that. And if they know they're going to lose their contract, they might do what they're supposed to do. And I know how corporate America is. They're slow walking us just like every ambulance company does everybody. So we can make them do their then I'm willing to talk about something like that you know do something but I understand we do need right now we need them we might not need them in three or four weeks or five or six weeks if we don't act right now on amnesty so that just kicks the can down the road another year well we don't take it a year it kicks it however many months it takes for us to a couple months to take see what they're going to do how many people have to die in that six months or another seven months because they're not getting amnesty service

How many people south of the county or north of the county have to die?

Sir, hold your remarks for me. You'll have an opportunity here and then.

So in the grand scheme of things, AmeriPro is failing us right now. Everybody knows that. Everybody knows that and realizes that. We're willing to spend this money to help them do their job. We maybe should have, hindsight 2020, maybe should have done this with our previous provider. help them that was a local guy um i think we should have we should have reached out and done this then to kind of help them along because we're helping a company along that's we know is private and they don't have anything to do with columbia county other than being here to make a dollar so our other company was local and we didn't we didn't help them we just kind of set them down the road and i'm not i mean that's nothing we can do about it now but hindsight 2020 i think if we're going to do this for them we should have done it for our previous customer too

And do we get a lawsuit from the other guy? Right. The other guy that bid on this contract. Is he going to come and sue us and go, well, we would have had a better price if we had known you were going to put ambulances on there to help us. You see what I'm saying? There's a lot of unknowns here. I don't know if anybody's ever done this. Do you know anybody that's ever done this in a county where they took and started supplementing a private ambulance company? Robbie, I agree. There's a lot of unknowns here.

There have not. But one thing we do know. That could be solved in a couple months. One thing we do know is we're not getting service to our constituents right now. We do know that.

And we didn't for the year before. How many years before? How long have we had this problem? It's not. How long was the other provider on the last provider?

So to answer your question, there have been other counties that have hybrid systems.

Yes. There are counties? Yes. Who's that?

Well, I know for a fact Sumter, you just talked about Suwannee, they had a kind of hybrid system. But they're not. Sometimes these hybrid systems are for a short period. Sometimes, you know, who knows? I mean, it just depends on how well it works out. But in Sumter County, they had a private provider. COVID hit. It didn't work. Marketplace changed. So they went to a hybrid system. They kept that hybrid system for, I think, Lisa, is she here? I don't remember what they said, but for several years and their board made a conscientious decision because of the villages and the growth and that sort of thing to not have a hybrid system but go to a full county system with 22 ambulances.

Let's see. We're backwards. We're backwards. If you want to talk about a hybrid system and all, we're backwards. Typically, You have the county EMS system and all, and if they're getting overwhelmed, you ask, you do a little contract, you ask a private system to come in and help you out. You don't have a private ambulance trying to run everything and a county system having to help them out. So we're backers, if you want to look at it in that effect.

Okay. Number one, is anybody here from Maripro that's willing to step up and answer any of these questions?

They were willing to come. We told them come next week on the 18th. You did what? We told them they should be here on the 18th, so they're coming on the 18th.

Okay, Lance, if you don't mind. Lance, how have we approached them or have we approached them as a question, but ask what are you going to do to fix this problem?

yes and have not been through i think i emailed stint to the local operations and him and i talk almost daily he has made requests from his uppers for more units and like you said big business and crickets we got that all in writing not not after i can get it i'll send it okay and you know because as we said this or i heard robbie think uh

lot of unknowns and and I agree I understand exactly the point that rocks making you know because I don't know where works contractual but right now you're talking about 200 let's call it $300,000 unit is what we are paying them for five and a half years a year know have we even went down the road like i like what jeff said earlier today he said irregardless whether we do it or whatever we need more trucks running up down the road in the discussion i don't think nobody in this room debate that so have we sat down with them and said okay what's it going to take to bring four more here because i mean if we're if we're really i mean i understand where the contract is and i'll tell i'll say it publicly it's a weak contract we've had two of them in the road weak weak weak and uh so but that's on us you know so my point my simple point is it's all about mathematics and business you know any businessman in this room they know the net profits only thing keeps their doors open but my point is simply this you know have we went in there and done that the rough number from our meetings that's a heck of a lot cheaper what we're talking about so the rough number from the meetings it goes right back to that collection chart that they showed you yeah go back to that that four and a half million there would pull from this county

That's how their numbers are based. That's why the five and a half they pulled. And from the numbers I understand from our meetings, and I may be off, roughly $800,000 a truck for additional trucks, however many you want to put on, from Ameripro. And that's why we chose the five and a half, because we couldn't afford the next two, but the two steps above.

But we're paying them $1.6 for five and a half ambulances.

Yes.

So what would it cost us realistically to get them to do three more ambulances?

No, 800 a truck.

No, wait, wait. That's not right.

The numbers, the spreadsheet, right now they're collecting $4.5 million on 15,000 calls. That's where the 1.6 comes in. If you have them add trucks, it's going to cost them $800,000 a truck. Their collections aren't getting any bigger. So you're going to pay more per truck for every truck you add to that from them. that's the rough number he threw with 800 000 per ambulance i heard joe say at the last meeting that they have said a million dollars a truck they were that truck as many as you want to add his exact words as many as you want to add but you're going to pay for them

You can't go back to the play.

It sounds like it sounds like to me that we're not going to have fire service about the middle of July. What it sounds like to me. So this ain't going to solve that. We're going to go with another company at some point. So what I'm saying is if they're telling you that they're only going to do five and a half ambulances. And they're going to keep meeting these same times. We're not going to have to worry about AmeriPro in July 31st.

October 1st. Take three months.

Wait, what?

It'll be three months for them to get their three major compliance in a row. It'll be three major compliance. Oh, it has to be monthly? Yes. Oh, okay.

Even if they hit it? Say they do hit their three major compliance. You can't tell them just to get out and think anybody else can build a service and come in that quick and do it. We've seen that over and over now. Ameripro is a big, big company. I'm sorry, I'm getting excited. Ameripro is a very big company. They couldn't come in and do it that quick. Century couldn't come in and do it that quick. to think that a county-based ambulance could come in and do it that quick cannot be done i said that before the contract was given to columbia ems you cannot build a a decent service in that short amount of time so even if they hit their three compliances and in october you can't tell them to get out because you physically don't have somebody else that can come in and just take over their compliances we don't need to get them out we If they make their compliance, it's not an issue. But if they don't, you cannot kick them out.

You don't have somebody to replace them. Aren't they right now? I mean, they do this for a living all over the United States. Aren't they right now looking at it and going, all right, guys. want to make compliance we're going to get kicked out for three aren't they already working on that thinking ah we better get us and thinking about pulling people or what i mean they're a business and they've done this before and i don't know how many times do we have any information about them being kicked when they're not in compliance and then they you know what i'm saying i mean if they don't get in compliance in other counties they kick them out right but they're all over the place and they're still working so I'm just, I'm just wondering in July, are they going to July, those three months, are they going to become compliant and then they're compliant? You know what I mean? I can't believe that they are just here to play around with us until July 1st and then go, we're not doing anything else. And we want y'all to kick us out because that's not going to look good on their business. It's not going to look good on their work, you know, in their business. The other counties are going to look at that and go, what? They're just, you know. So I have to believe that they're a corporation that's going to try to stay. So I'm just asking y'all. I mean, is this something they do all over the United States? I believe they all slow walk you the first three or four months. I believe they do. Because they want to make more money. And then when it comes to where we can actually find them and fire them, they get in compliance with what they're supposed to do.

That's what we hope. Here's what they're going to do. They're going to do the math and they're going to say, all right, we get $1.6 billion. If we have to put five more eminences on here, a million dollars in eminence or $800,000 in eminence, we're going to be in the hole. $500,000 or a million dollars. Why are they going to operate a business losing a million dollars a year? They're going to want to quit. Yeah, exactly. They're going to want to leave. If these are true numbers, I mean, you can't operate a business going into the whole thing until they have $2 million a year.

So you believe they've already given up on us pretty much because they know, they got to know.

They got to know what they're complaining about. Robbie, here's what I'm saying. If they really wanted to beat these times, they would not have two trucks a day running transport. They would have them two trucks hauling people to the hospital. And they're not doing it. That's not what I'm saying.

They're not doing it. So you're telling me that what we're saying right now is that AmeriPro does not intend to follow their contract.

I don't think they followed it yet.

Well, because we can't do nothing to them. We can only do something to them starting in July.

I would think. that any company that bid on a job, got the job, executed the contract, has every intention of complying with the contract.

Right. They do that. There were 15,000 calls when they bid on that contract. Yeah. So they know.

Public record.

They do this way more than we do.

Public record.

Yeah. How many Ameripros are there? Are there all over the United States?

There are. You had two other firms that bid on this beyond EMS and this. They were at 2.1 and 2.2 million. Right.

So what I'm saying is, I just can't see Ameripro just throwing it all away because they just don't want to make the times. And I don't like the way this contract was done. I don't know how to do a fire contract. But it should have been, and I don't know what the standard is, industry standard. What is the industry standard on contracts? Do they give them a crank up period, Lance? So this is a normal crank-up period, what we're doing right now. So let me ask you. I don't know how much experience you have with other companies in some other county or whatever, but when they hit in their crank-up period and they know that now it's go or you're gone, do they do better? That's what I'm asking. Because, I mean, if they go up, so they get fired.

Let me answer the question a little differently. We have this contract. Because this is where the scope of work when we went out to bid two years ago. The same basic contract that Columbia EMS had because they were our backup provider. So when they came in, they came with the same basic contract. So that's why the terms weren't changed much. Just a little tweaking here and there that we could all agree to. But this is the contract. If you want a different setup, a different contract, I would think you would need to go back out to bid. You could do an emergency procurement if you wanted. If for some reason you hit that magic three terms you're out, they can't just walk because you have to have transition, and they know that. At the other hand, you as a county can't stand up a full-blown EMS system in that timeframe. Because again, if you order ambulances six months to a year, hiring people takes time. The advantage of the private firms in that situation is most of them will say, well, we'll reallocate resources, which is what they told us. And they just hadn't done it until the very end.

So the only time they did anything was... That's why I don't, is it normal for us to give them three months to start complying? Is that normal in contracts?

Well, in this type of service, you have to have a ramp-up period and a ramp-down period because nobody can walk in, no matter what they told you, nobody can walk in day one.

Even the county?

Nobody. It's not possible.

But you keep asking about is this normal contract, ramp-up, ramp-down? A ramp-up time. yeah in contracts like that you have to have a ramp up and you can do that but no this is not normal statewide because normally you go you pull all your county statewide majority of them do not use a private service to run number one okay that's what you're saying so but in private services private services are in it to make a profit county services are in it for the personnel in the county the people that's the that's your big difference

But it's just like whenever the system, I'm not going to say failed prior, but all the issues at that time, the board and administration, they didn't work out their problems, and that's why they went private. And, of course, it was a completely different business model back then to where it was like that. I heard Jeff say it many times, and I know he's telling the truth because I know Herb Sellers, too. If Jeff could get on the phone or whoever that person may be, Herb's got a problem with the phone.

back in those days when herb had a century and century did make the times for uh for their first five years of their contract you could call say this is what the issue is not the answer was always i'll take care of it thank you nowadays there's a you blame the hospital you blame the people you blame the weather you blame whatever else it is it's it's different it's a different world well the there's all kinds of

solutions i guess from every different angle this thing i mean just my little bit of checking around one of the biggest things that has put a lot of county over and above in some of your bigger counties there's all these emergency centers that are popping up everywhere it's it's it's myself and uh dale had a conversation and it's time that we as a community we go sit down with shams shams teaching hospital is a funded hospital by the tax credit state of florida and I don't see no which way whatsoever if I'm not mistaken in Alachua County there's eight different drop zones right now with the new hospital coming on that they can take an emergency vehicle and that 100% kills you know I ain't gonna say kills but that alleviates a lot of your call times right there 100% it alleviates a lot of wait times at a hospital but Jeff wait times I'm just going to say the jury's out on that because I went sat down also at a local hospital that's that's a gimmick in my opinion well I agree with you not you not you no I'm agreeing with you on this you know because that's that's not that's not we got that story but that was uh untold so I I was agreeing with you on that one I wasn't disagreeing the ERs and stuff like that that you're talking about there's so many in Alachua County and all you are correct they've added

standalone ERs, Shands and North Florida both have. The south end of our county can utilize those because they are in fact closer to go to than they are to come up here. So that helps us on the south end of the county also. Now the north end of the county, there is nothing close. This hospital here is all you got. So there's nothing ER-wise, it can change on that.

Jeff, on the EMS bill of revenues that we got here on screen, is this still up there? Yeah, okay. Who got these stuff? Who collected these stuff?

Well, Chief Hill collected most of them.

Okay. And who did you get them from, Lance?

Basically, who you call is either their finance department or somebody like me, the assistant chief or the chief of departments.

Okay. And the only reason I say is that I'm not going to sit here and point out the clerk. But David, I asked you for some all of the numbers in the last meeting, and I guess time hasn't permitted. But what I'm getting from the auditor, nobody works for the county, nothing like the auditor, these numbers are not correct. I just figured that's the easiest way to go get the true, accurate number. And that's from the person that audited the books. that turns into their annual report that doesn't match up to these numbers I know three of them that's only three I checked okay well most of them were the chiefs of departments where these numbers came from understand I mean they didn't have it they sent me to their billing department they're finding that came from them totally understand and the billing All that projected number, that's all a number. But the audited numbers is what the month, the audited receivables is what you can actually reinvest or spend.

We can pull that from their audits.

That does not match up to 3D for a fact.

We can pull that from their audits. We will pull it from their audits.

So which three does it not match up to? I'm going to take that.

That's okay.

Make your own calls. They're all right there. Call the auditor if any one of the counties takes that job up to that. Do your own work.

So what I will do, Every county typically has their audits online. We will pull their audits and see what their audits say. That's what I asked you to do. I know we have not had a chance. You guys have been keeping my phone very busy. Having said that, I just conferred with the clerk. You have a motion on the floor, but no second.

You know, it all comes down to money. We all know it comes down to money. And it's not our money. It's the taxpayers' money. I get that. that we're not making our times. We weren't making our times for how long? How long was the other company here?

One year.

One year. So we weren't making times in. So obviously we got a problem. This company is nationwide. And I believe and I may be completely wrong, but I believe they're going to do what they have to do to not get fired. Right. I mean, they're going in July, August and September. They're going to they're going to they should. They're going to do something to make their times better. So we're spending one point six million of the taxpayers dollars. And how much is all this you're talking about is going to cost? to start this up with ambulances, if we get ambulances.

Your biggest startup cost is your ambulances, because that's your equipment. And your personnel is a yearly running thing.

So it's 12 people per ambulance, correct? 13.

It's six people per ambulance, because you have three shifts, two people per ambulance per shift. So there's a total of, in the budget I had wrote, I had done out, it was a total of 13. 12 to man to two ambulances, 24 hours a day, seven days a week, and one person admin to manager.

And what's that going to cost? I don't have the numbers with me.

So in the numbers that were put together by the fire department for the study that was done for the MSTU, let me go back to that first slide. If you did without the purchase of the ambulance... Running our current contract plus personnel generated that. I believe that was about $3.5 million.

So $3.5 million for what now? Just the people you hire?

Our current contract plus the personnel. The lowest number, which is just the reduction in accounting, well, that's that. So it's $3.5 million to $13 million. But I can get you those numbers. It's in that study.

Just look at this. On an average, is taking $850,000 a year to run your ambulance. That's your personnel, that's your equipment that you use, that's your fuel, that's all of it that goes. I, just to be safe, so that nobody could say I come up in a shortfall, I said $900,000 an ambulance per year to run. So if you're saying that, say, Nine and nine is 18. That's a 1.8 for run two ambulances a year, 24 hours a day, seven days a week.

Let me explain it this way. Let me explain it this way. Lance and I were just talking about this. The three and a half million that's in your study for the MSTU that you got last week,

and a half million was for the personnel plus the america pro contract right so if you take 1.6 off that three and a half that's about what you're talking okay so about 1.8 to 1.9 million more money to to get the two ambulances 24 hours a day seven days a week but you understand as a person that's once you know that Money's tight, especially for people that are going to have to pay for this, the taxpayers. We're going to spend, and I believe your numbers, is we're going to spend double plus another $300,000 or $400,000 to get two ambulances to bolster a contract that we don't know what they're going to do in a month. If they're going to put another ambulance on, they're going to do better with service. I just have to believe that they're going to do better because nobody wants to lose a contract unless the contract is worthless and they don't want to do it. So you get what I'm saying? I get what you're saying. I'm looking at a gamble here that when we spend that 1.8 million and all of a sudden Ameripro without our ambulances comes up to 85 or 90%. And then you see what I'm saying? I mean, it'll be taxpayers paying double what they were paying, but then Ameripro's up to par. It's a hard decision because you don't know if they are, and if they don't do it, then we've got to fire them.

But we can't. That is your problem. Well, after the three violations— Even after three violations, if they do them the first three months, you cannot fire them because you don't have anybody to put in their place. Right, I understand. So they know that. At the end of the day.

But you have to start making a different decision. And then that's when you're not just doing two, you're doing, you know what I mean? Yeah. You've got to really go out and spend some money.

So at the end of the day, our job is to bring you the information. I understand. So that you can make an informed decision. We're not here trying to convince you. We're not here trying to sell you. I know.

we got to gather all this information i mean we know what the information is put to emphasis on the road we've got this jeff

What are we going to be able to do different, Jeff? The gentleman that came up a couple weeks ago explained to us about staff issues and, of course, the things that Columbia EMS went through. How do I feel comfortable that we're going to be able to do something during not being able to attract help?

We have a little bit of advantage over a private company on several different reasons. One, we have a retirement system that the county pays into, a very good retirement, high risk. Private systems don't have that retirement system. At best, they have a 401K that you pay into yourself. We have insurance. Our insurance has gotten better over the years. The cost to the employee out of pocket has dropped. That is better than you're gonna get from a private service. So there's two things right there that puts extra money in your pocket, even if you're paid less. a year so that's two things now hold on they pay more but hold on but no there's one more that uh job security like i just said we're on our fourth ambulance company since 2011. they come in they don't know that they've got a job after that five-year contract running out there is not a job security county systems typically have job security You know that the county's not going to shut down in five years and go to a different county. Private services, you don't. So you can attract more people that want to build a career and stay in that service and stay in that place.

We've also got six months to put out applications and try to hire these people.

So the other thing that this board talked about, I think Commissioner Parnell brought it up, is you can start the scholarship program. We know that it's less than $5,000 to get somebody from the start through paramedic. It takes about a year and a half. But once they do their EMT, they can still work. While they're in school, they can still work. So we can start getting people to help us supplement it while we're educating them to become the paramedics that we need. And they would have to then make a commitment to stay with us for X number of years.

Great. We had a discussion the other day. Let me ask you all something. How long has it been we haven't been making our times? We were at 80% at one time. I was told five years.

So we haven't been making times in five years. We were at 80% in my career. So what happened is you had –

You had lifeguard. They were there for five years. I think it was five years. They lost the bid when you went out to bid again. Century won the bid. Century was sold to a large corporation. That corporation came to us and said, if you want us to still continue providing your services, you need to pay us $1.5 million. We need a subsidy. So we said, well, we can't do that. We're going to go out to bid. So when we went out to bid, that's where we ended up with Columbia EMS. They've been on board, I think, just slightly over a year. They looked like they were gonna get there. They were making all kinds of improvements. They got to a point and then it stopped improving. I mean, that is correct, right? So you can't say that we've never made our time or that some of our private providers haven't made their times. Like I said, Century did a really good job making We know recently it is a problem, and we know that we have 15,000 calls a year, and we know under the current contract we have five and a half ambulances.

I think we ought to call to question.

You need a second.

I'm going to call to question. I think that we need to make some kind of decision today in what we're going to do so that Lakeshore Hospital Authority will be able to help us out with some money But if we don't do something today, right now, this meeting, they're not. They're not. They can say they're crazy people down there.

I don't believe that, Everett. I don't believe that. I don't believe that if we don't make a decision today. It doesn't say it in that piece of paper that we've got to make a decision today. I don't believe that. But follow me.

David, if you've got to do this, go ahead.

But we still know our constituents. Better response time, I don't care.

what we have to do we've got to do something so and that's my theory about it so are you seconding my motion now what was your motion and explain your motion exactly what you said my motion was to set the money aside for the ambulances so they can go ahead and order the ambulances that was my motion and take the book they we got five over five million dollars in contingency fund we can take that money out of contingency set it aside for the emphasis And we can present a plan to man two ambulances and put them on the road. And hopefully, Lake Shore Hospital Authority will follow through with what they're saying here and buy the three ambulances for us. But they're saying they're not going to do anything until we present a plan to them and do an interlocal agreement. If I'm reading this letter correct, that's what I'm reading.

Not only that, not only one year.

long-term solution that's how you want to fund this yeah that's the thing the contingency does it for one year we can only do a budget for one year we can budget for the rest of this year and then we'll have to budget again next year that'll just have to be in every budget

You talk about kicking it down the road, that's what we're doing there.

What do you mean kicking it down the road?

You're just saying we're just going to work year to year to year.

It'll be in January before we can ever put these on the road to start with.

So we would have it in our next year's budget. But how about the shortfalls that we know are coming and the increased cost that we've got coming this budget year? Have you prepared a, what does it say, have you presented, prepared a mock budget to how you fund this, along with the other known shortfalls that we got coming in 26-27. And then also remember... No, no, no, they can answer that.

So that's why we're here today, to give you the information so you can make a decision next week on the MSTU. If the MSTU fails, then we have to go back and proceed.

Okay, but that's my point, David. We got two options. You go to MSTU or you don't. So do we have a mock budget for, if you go with it, do you have a mock budget, do you not go with it? That could solve a lot of this conversation that we had here today. And that first screen I found this thing this morning that shows that net cost, we have not done the citizens of Columbia County, we have not done them right. by sitting there, and we're going to have a conversation about this. This needs to be presented. That man out there should have had this number out there on the public service announcements. This is a real number. We're fortunate. Some of us, we don't live week to week. There's a bunch of people who live week to week and still scratch pay. If you don't believe me, look at that big list of unpaid taxes sitting over there. So my point is simply this. I'm not rushing into it. I'm not rushing into it.

So to answer your question.

The thing is, the $2 million contingent for this year, then if we look at our budget, where's the $2 million going to come up next year? the next the following year and the following i know but the following year and the following year when when the governor's doing his deal you know when we commit to something like this it's not just two million it's it's a rise in cost to the taxpayer forever Yeah, that's right.

We're going to collect so much money a year no matter what. We're going to collect that money. We just got to budget it responsibly to cover what we need to cover. It's not going to cost the taxpayers a dime more.

Taxpayers are going to pay the same thing they're paying now. If we go from paying 1.6 to 3.6, it's going to cost the taxpayer more money.

Taxpayers are taxed what they are taxed. It's our responsibility to do the budget and cover that.

It's not going to cost the taxpayers another dime. And you have to take away services at some point.

What services? We're taking away service right now. We're not servicing our constituents right now. So let me ask you a question. Would you rather us not have ambulance service for our constituents or maybe pay one less road a year?

Maybe not pay some $2 million dirt roads. I get it.

Whatever we have to do.

Because that's the push that we've got going on right now is to pay dirt roads which cost a million over three times as much. So I don't want to get into that. But what I'm saying is you've got $2 million. we got two months in my or one month in my opinion before we start seeing either a change in ameripro or not a change and two million dollars is two million dollars it's more than double what we're spending now it's still taxpayers money and when you take two million and you take it out of the budget especially with the budget coming up and the new the new law about property tax which i agree with completely you you you're going to cut something and I don't know what you're going to cut and I don't know what you're not going to fund, but it's tough when, when you want to spend that kind of money. And in about, and in four to six weeks, we're probably going to get a little answer on whether the people we hired to do this job are going to start doing their job or not, you know? And, and I believe they will because I'm hearing even the fire department says they're not just going to say to heck with it and not comply. Because we're going to hold them to the fire to comply. And if they comply in two months and we just put it to $2 million, we don't have to spend it. Or we just, no, we told them we're going to, we give them a plan and then we don't use our ambulances. You know, that's not.

I agree, Rock, at the point that, you know, because what I think you're saying, Rock, is that the MSTU, that's not even a conversation number. whatever you do in a month's time you know i understand jeff it sounds like y'all found the location of three available units or something like that you know point is is that i want to see how we're going to fund this because without a shadow of a doubt without no guarantees of receivables there ain't a guarantee in that that that list that you just put up there i haven't seen a guarantee yet but my point is simply this okay because i had a firefighter a five-year firefighter asked me a question day before yesterday and i he's right he okay so when we go into the ems business he said which i am for you know are we going to adjust our firefighters numbers up to accommodate that and he's got a point if he wants to ride an ambulance yeah but this is my point is that if he wants to become a sole operator he wants exactly exactly and that's what i'm saying we this budget that's coming up guys this how many millions of dollars worth of capital profits we got on the books right now 100 million dollars You know, that doesn't fall out of the sky. Well, I love my dog. At the end of the day, this is more important than any capital project. It's more important than any road. Okay, if you knew right now, outside of operational costs, what have you, that you had to go in there and cut $2.5 million out of our budget that we agreed upon last year, where would your recommendation be?

Well, I'm glad you asked that because I've been looking at it. Right now we take $3 million a year right out of general fund and we put it in capital projects. $3 million a year. We take another $1.5 million a year, put it in transportation trust. Now transportation trust is already bloated. If you look at it, it's already a bloated budget. And another thing about transportation trust, it's been stated in here several times, you can't use some of this money on nothing but roads. The only money you can't use on anything else besides roads is the gas tax money. That is a fact. Now, there's plenty of money there. You can find $3 million easily. You take $2 million that you're transferring into capital projects, There's $2 million right there. You take $1 million out of transportation trust, and really, you could take $2 to $3 billion out of transportation trust if you wanted to. So where is he? There's that. Mr. Kirby. We got $4 million inside for road pavement. We've done $3 million for years. Maybe we go back to $3 million right there. With a $90 million deficit? I don't think that's good business. That's a number that's out there that's just a hypothetical number. Do the math. We're never going to meet that. Do the math. We're never going to meet that. Do the math. Where are we going to come up $90 million? That's my point. We're never going to meet that number.

Never you are. And $4 million towards a $90 million problem? Probably.

All right.

We got a motion on the floor.

And I understand.

Did anybody second it or not? No. No? Okay.

Hold on. Hold on. I want to say something. Just one thing. You know, we're talking about hypotheticals. We're talking about a hypothetical here. If AmeriPro comes up with their contract in three months, we're sitting here spending $2 million. That's all I'm...

So how many people have to die in those three months? We got people right now that can't even get an ambulance.

I don't want that to happen.

You know, Robbie, I'm going to just say this. If I was you and Tim and all my district was right inside the metro area right here, I would be fine with ambulance service just like it is. I don't have that luxury. I've got Wilson Springs. I've got Three Rivers and Stakes. That's a remote area, way out there. If an ambulance has to come from Lake City just to get to there, it's 30 minutes, minimum. Minimum, if they're ready to roll right now. Everett has that same problem. Mr. Parnell has that same problem. So that's 30 minutes to get there. That's probably an hour before they get to any hospital or whatsoever. Now, hopefully they're getting the treatment they need to help them. But 30 minutes is a long time if you're having a heart attack or you're laying there And don't get me wrong. I get these stories. I get these phone calls weekly, weekly of these people doing this.

Under no circumstances.

I know we need to do something.

i want to do so why are we kicking it down the road what we i don't understand that none of these numbers all these numbers that they've got here i don't know what the budget is where the money's coming from to do that we what did we say we bought what what's the golden saying that's the county commissioner you never spend non-recurring monies on occurring recurring issues continuously money recurring every year that's right that's recurring every year so what happens when full white gets blown off that next hurricane There you go. You got FEMA? No, you got FEMA. There's still crap on the side of the road in Suwannee County. You know what? Yeah.

So that's more important than people's health or getting to the hospital?

Gentlemen, can we... That's exactly what I'm not saying. Just to get us back on track.

We're not acting... Oh, we're going to set this aside for the end. We're setting this money aside. Yes. I'll second the motion.

Thank you.

Got a motion.

Got a motion, got a second. Any further discussions?

Mr. Chair, I want to understand the motion. It is to keep money in contingency so that we can order the ambulances. I will then have to build into next year's budget whether they're donated or whether we're paying for it because they will not be here in this current fiscal year.

Okay, but just to clarify, Rock is a motion. Are you saying the order of Rock? Okay, that's not what I just heard here. I just want to get that clarified.

That's why I wanted to get it.

I want the same story. Okay, so please, for the record, restate your motion with detail.

I'm saying we set the money aside in a contingency to order these ambulances and give Jeff to go ahead and order these ambulances tomorrow or today. I don't care. And move forward with the plan demand these two eminences and put and get them on the road sometime in january it sounds like to me might be in february now but i mean that's my motion all right so got a motion to say any further discussion so we want to we want to order the eminence go ahead and spend the money now we won't pay for them until january yeah but we have to have the money set aside we can't order them without money provided to them But that's one thing.

The previous discussion was how we're going to replace that. How we're going to fund it after we spend that, how we're going to get that money back.

So we're going to order three ambulances that we're not 100% sure as how. I want to come up with a resolution to do that. I'm not comfortable when we've been presented a plan to be able to fund that in January.

That's my only point. David, do you think you can come up with a plan

in the budget next year to put these hamlets on the road if this commission directs me that's what my job is so i will say this if you set aside the money in reserve and you don't spend it because it's set aside in reserve it will fall into reserves next year and you could reappropriate it out of reserves for the purchase that does not cover tim's issue which is how are you going to cover the reoccurring expenses that's a completely different issue you can find it in the buttons if you have what you're doing that's what this board directs you tell me that's your priority that's my job we still have to decide it's going to be a lot coming out of it that we set to the side if we're going to get programs we can say we can do it a lot of workshops well you know what at some point i'm going to say if this is your priority this is the impact of that priority how do you want to deal with it

I'll just go on the record to say one more thing. I 100% think we need assistance, 100%. We've got to do something for the north end of most, but we've definitely got to do something for the populated parts of the south end. There's not enough information here presented today that I feel comfortable going forth with. Do I think we can come up with it with many more discussions? Absolutely so. There's graphs on here today I ain't seen yet, but my point is simply this. I 100% support it, but I'm going to do it the right way.

Well, time is of the essence, I'll just say that. And my people, I'm getting calls from South End County. My constituents need ambulance service in South End County that they're not getting right now. And I know Mr. Parnell is getting some of the same calls I'm getting.

Aren't we getting Ameripro to replace themselves in different areas, one north of town up there? Right, I'll send you my next question. They've got one in the South End County now, but they're never there. Quentin Street.

So what happened is I met with Suwannee River Economic Council. I said, you know, we're looking at Five Points Elementary. You've already set aside $100,000 to buy into Five Points Elementary, and we still have to do an interlocal agreement so that we can guarantee you what we're getting for our $100,000 that we put into Five Points. We talked to them about would you be willing to move to Five Points Elementary, which is right across the street from where they're at. because Five Points is not as good a location for the ambulance service. They said, yes, that's where you think we could go. Here's our concerns. Can you address them? If you can, we're happy. I now have to meet with AmeriPro, take them over to the building so they can go inside and see, does this fit what you need? Because right now the building is set up. As you know, it's an old school classroom. It is kind of like Columbia City. It was designed to be one big room with a bathroom. They put in a little wall so they could have two separate offices at the time that they needed. Has no kitchen facilities. They would have to determine, can they convert that facility into something they can use? Until they see it, I can't guarantee you one way or the other.

The reason I like Quentin Street is because you've got so many arterial roads. You've got Gum Swamp. You've got 41 North. You've got two ways to get on the interstate, east or west. And you can go straight north. You know, we say we need to have it on the north end. Well, let's don't put it up all the way in the north, you know, north of Deep Creek, because then you're limiting where. So at Quentin, you know, or if you had something a little north of there, I don't know.

So the one issue is if they're going to locate on Quentin Street. we would want to put our ambulance somewhere else. So you're not duplicating coverage.

If we had an ambulance. Yeah, yeah. If we had an ambulance. If we had an ambulance. Take them to Five Points, if you will. Take them to Mershon Road as well, because that's not in Deep Creek. It's in Fallon Creek, but there's a nice facility there that's unused that we do. Pretty close to the interstate. It's close to the interstate. You close to 441. You can shoot north or south in that direction to get to the itinerary. If you need to, you can go south. I agree with you on that. Mershon Road would be great. You can go right there in Fallon Creek. I mean, you can get wherever you need to get to from right there. um i think that would be a good fit for it as well uh it might even be better than five points because i believe that that mobile home is going to have kitchen that i believe so everything they need there right unless they took it out and they put it there but i don't know no the mobile home that we have in mrung road is a fully functional mobile so i think that's because there's a fire fighter they can jump on 441 and go right up that tent and they're there so okay i think that would be a better fit for the north side

before we get off the record again or off the path we got a motion in the second on the floor and Kevin Rock anybody else have any more questions I mean my only issue I want to get it up there but motion on the floor is to Mr. Ford put a motion on the floor to set aside $500,000 and pursue purchase of ambulances immediately i didn't mean i'm sorry 1.6 the million the money it takes to make that three i'm sorry i'm sitting here looking at a 500 number how much is it 1.688 right yeah so if you're just acquiring the equipment three million dollars aside three million oh for the ambulances and and the cost of man for a year oh okay now it ain't gonna take that much but that's that was my motion

So what was requested of Lakeshore Hospital Authority was $1,629,335. And that will come off of that.

If they pay that, that will come off of that. Okay, so your motion is $3 million, right, Robert? That's what I want set aside right now to the ambulance service. Yes, in order of emphasis.

Okay, got a motion, or do you still want to say confirm me? Got a second.

All in favor say aye.

Aye.

Aye. All opposed? Aye.

Aye.

Mr. Barnum? I mean, I need to see a little bit more information on this. I want to get it up there, but I want to see a little bit more information on this. We got to fund it somehow. So I'm a little, I just need to see more information on it.

That's all, yeah. Well, more information just going to kick it down the road another five or six years.

I think if we, two weeks isn't going to kill us, I think. Just my thought process, I don't know if they go two weeks. If we look at next meeting, see what Mayor Perez will say, and go from there. Mayor Perez may step up, they may not. It might be cheaper for them to say, we're going to just pay the fines than it is to get an ambulance. So, of course, we're going to pay that every month.

And then once they do that three times, we shut them down.

We shut them down. Still got to get an answer. That's right. All right. So I do want to kind of hear what they have to say on 18. And then we kind of make.

Why was they not told to be here? I thought they were going to be here. I mean, you called him and told him not to be here, David. I really don't understand.

I was a little confused about that, too.

They needed to be here. Yeah. I mean, everybody thought they were going to be here today. That's what they were here for. I mean, that's what we called this meeting for.

So we did not call them. They called us, and we thought we were going to be talking about the MSTU, and that's why they said come on next week.

We need them in a meeting, because I want to hear what they're, you know. But we've only been, how long have we been in this new ambulance service? 90 days, y'all said? Yeah, I just think, you know, we can't, we can't. make them do right until July 1st. I don't like that.

I just like this vote. We're going to hope nobody dies because of this.

Jeff, in these PowerPoints here, is your full budget here, sir?

Full budget for ambulance service or full budget for the fire department?

Jeff's proposal will be able to fund this because I'm trusting Jeff's numbers here and I think it's pertinent that

are you do you have it completed yet jeff the full budget for the implementation of two ambulances is in the mstu study it's in your addition the addendum of the mstu study that you received last week i understand that's in there but also it is not in these slides okay okay but what i'm asking jeff if you would please compile that because i feel like you're covering

You made a good point. I come up with this number, but I put this amount of number in there. But I'd like to see the detailed part of it there because I trust, I'll be honest with you, I trust your numbers better than I do the MSTU research.

So the numbers in the MSTU study are line item accounting provided by Chief Crawford, what he believed the cost would be. Okay. What you're asking for is in supplemental, the background material of the MSTU study.

Okay, okay, okay. Is that fair enough, Jeff? I mean, that's cool.

I would ask Ms. Parham could you tell Mr. Crawford what information you need to make a decision I mean you want more information what information do you need I would like you to direct that to Jeff so he can get you that information well I think yeah go ahead well I think it was we need to see what it what is the actual cost of where it's going to the recurring is going to

no no no where the money recurring and all comes from that's out of my wheelhouse um i can give you the cost and i will give you i will prepare and give to y'all uh on the 18th a budget 100 line item budget every line item of what it should cost to run the two ambulances 24 hours a day seven days a week i will give you that but Where the money comes from to fund all that, that's above my pay grade.

And, Kevin, I think something else is concerning you, Kevin, is we have an ambulance company that may step up to the plate finally when they have to, when we're able to find them. I mean, it's just like a kid. You're a little kid. You don't do nothing until you get spanked, and then you go, okay, I'm going to do that now. I just believe that that's the best thing I can come up with to explain it. They aren't under you better do it or you're not going to. be here anymore. They're not under that yet. And that's what bothers me. I don't know why it takes three months to get them on something like that. That's our contract and we got to live with it.

We don't have a problem with the man sitting down there saying, I can have 10 eminences here in an hour if I need to.

Yeah, he can do it. I'm sure he can, but he doesn't have to because we don't have any way to make him do it. But in about three weeks, we're going to have a way.

Well, I take a man at his word, but I can't take a man at his word no more.

Well, then every ambulance company we have for five years has been so nominative.

Jeff, do you have a budget for next week? if if it's not all feasible if it can be done you know the hospital they have a prn for nurses and all that is there a way that you can incorporate a prn analyst person or firefighter whatever occasion to be to run the ambulance put it into your budget and see what that would cause because usually prn jobs they don't you don't have uh insurance you don't have retirement we would build that in that that that was part of my ability anyway so you already so you yes you already you already

expect to hire prm people that and that cuts down on your actual overtime for other personnel that are already here but that's still an extra cost because if somebody's off sick or vacation they're getting paid their regular time and the prm person will still be an additional above that little bit of cost but you but when a lot of times when i say it causes overtime part of that's what i'm saying is it is causing extra time but it's being put to a PR in person. I guess I don't say things quite right sometimes.

No, no, no. That's fine. That's fine. Homeless is understand there. That's because I didn't believe we need to go back to . So I wanted to ask Commissioner . Go ahead, Kevin. I do believe we would benefit in a few years when the county could take it back over, I do believe that. I just want to make sure we have the funding, a way to get the eminences staffed and all that. So if PR ran or however we need to do it, we seem to make sure to get staffed. But I would like to see it go back to the county in a few years, what we need to be. But we have to prepare for that now. With the tax cuts coming and this property tax thing coming, we've got to find the money for it so that we don't exclude other services and all.

So to answer the question that Commissioner Murphy asked, The MSTU was the proposal to fund the ongoing costs of the system. Now that I'm hearing from this board, you don't want to pursue that. I will have to investigate other ways in which to fund the ongoing costs of whatever you decide service level you wish to provide.

Well, we know every year there's about a $5 million increase.

Now, if you put that where it's at,

it just says five million dollars a year new money so do you take the cut you're not looking at a substantial amount difference it's almost like taking the rollback rate if we were to do the rollback rate last year would be about the same thing so you know all we have to do is make our budget look kind of like it is right now and we're covered so next year's a good year because

Anything that gets voted in November won't affect next year. That's what I'm saying. But if the November referendum gets approved, we will lose $10 million in year three. I think it's $7 million in year two. So we have to start planning for that as well.

That's on our current revenue though, David. That is on the current revenue, what we're talking about right now. When you're talking about new money coming in every year, you're not losing that much money. I mean, I guess you could say you are because you're counting on that $5 million a year. But really, if it's $5 million a year of new money, you're losing $5 million that year.

Right.

So basically, you've got to find it in your budget to cut $5 million.

And we could grow and have growth. We know several projects that have not been put on the tax rolls yet that will be.

You've got B&B coming on.

You've got 4775 coming on.

But at the end of the day, those numbers – were not part of this discussion, which is why they were not prepared. This discussion was, what do you need to know to make a decision on the MST?

And I get we go up every year, you know, around $5 million, but we also go up in cost every year. It's just like anybody, like me and you, buying something at our house and it goes up in cost.

Well, let's think about this here. Let's think about this for a minute. In 2008... economy went and just failed. I think some of y'all are here. 2008. They didn't raise taxes. They didn't pass an MSTU. They cut the dang budget to make it fit and do what they could do. They cut out some projects. They didn't do anything. You know, I guess what I'm saying is that's our job. That's David's job. We've got to do that if that's what we've got to do. But I just don't know why you want to run around saying the sky is falling, the sky is falling. We can't do this. We can't do that.

I'm not saying that.

Well, that's what it sounds like to me.

But you're not hearing right. So at the end of the day. We just got to be diligent about the changes. I think we're diligent every year.

At the end of the day, this board, not this board, but a previous board voted to reduce the millage rate from 8 point something to 7.8. That's right. You said that's what we're doing.

That's right.

That was our job then to figure out how to implement.

Okay, so with the research that you've done on this, if this were to pass, what effect or does it have on the MSTU?

I've heard a couple different stories.

It distinctly says law enforcement and schools. It doesn't say MSTUs or nothing like that. MSTUs are an adaptable part of property tax. So my question is that because I'd just like to see what I know what I was told yesterday, and they weren't 100% sure, but I know where they were swaying.

I like to assume worst-case scenario.

Sir?

I like to assume the worst-case scenario. Correct. Because then it can always get better. I would assume, I would go into this with the worst-case scenario of any property tax reduction would be a property tax reduction as well in the MSTU. And if I'm proven wrong, it means the MSTU doesn't have to be set so high. And you set the MSTU every year.

That's how they suggested when I was talking to them yesterday. And I think that's what we're going to do. You've got to work on the worst-case scenario. Because nobody knows. We're fixing to get a new governor.

Let me ask you a question. Would y'all have a problem if I made a motion to allow Jeff and Lance to come up with a contingency plan in two to three weeks if these numbers are still at 60% or 62%? I mean, we've got to start planning. So why don't we allow them to just present us a contingency plan if we do have to get rid of a member? I mean, that's going to take some time. we need to have a plan in place we would just which if we didn't have this bid with AmeriPro at the time that we could fall back on I suspect we would still be working with Columbia EMS right now and I you know maybe maybe we should be I don't know but I'm just saying at the same time Jeff and Lance need to be working on a contingency plan that we can fall back on if we have to move on foot forward and do something. Because I'm telling you, I'm convinced we are going to have to step up to the plate and do something here with EMS. I mean, I'll make a motion that we have them come bring us back a contingency plan.

I mean, I don't know that you need to vote on that. I mean, if Jeff and them are willing to, I don't know.

Jeff, you come up.

You got something on your mind, please. Well, first and foremost, and then I'll let Jeff speak.

if you were to have to terminate the existing contractor you're going to have to do an emergency procurement you're just going to have to because you don't have the time frame to gear up and having said that then i'll turn it over to you here's the thing that i talked to joe last week the last meeting after that meeting was over i talked to joe and joe told me he said and he's not here today but he told me it's in the contract they don't say you can they don't say you you If you want to, you can. It says you may. That means if they fail three times, You've got to fire them. I think it says shall, to be honest with you. So you don't have a choice is what I'm saying. That's right. You've got to fire them.

Now, Jeff, what are you going to do? We didn't shall do it on that previous one.

Well, that's what it says in there. I'm just telling you, Joe said that himself at the last meeting. After the last meeting, I talked to him about it. He says you don't have a choice. If they fail three times, three strikes, and they're out, it's all in the contract.

Am I correct? That's my understanding of the contract, absolutely.

So I'm just telling you all, You better be prepared here.

The question I see, if you don't mind me interrupting, the question I see is, do you want to have to keep a private ambulance service in this county, or do you want it to go back to the county at some point? That is a decision y'all are going to have to make. Do you want it to be a private service from now on? Excuse me. If like Commissioner Parnell had said he would like to see it come back to the county at some point, two or three years down the road, you need to make that decision now. Because like I've said over and over and over, if you want us in the business three years from now when this contract runs out, we got to start now. We can't wait till year two to try to do it because you cannot physically build a decent EMS service, and that is short of a time. The cost to jump into one at that point in time would be enormous if you had to try to do it all at once. The only way that you could feasibly do it, manpower, equipment, personnel, everything, is to step into it. So that is the decision you have to make now. Not necessarily today, but I'm just saying that is the decision that you all have to make Do I want private, and I'm willing to say I want to try to keep private from now on, or do I want to go back to county at some point?

Mr. Ford, I think that's what you're asking, Jeff, correct? A contingency plan to possibly do that, correct? Or if we have to fire people. because I'm telling you, Joe told me we don't have a choice. Well, okay, so maybe, and I'm just going to assume we don't, but what Jeff just said, I'll back Jeff 100%. We do not have the funding. Do we have the back? We don't have the possibility. If we did have to fire them, our only other option is to go to the next guy and probably pay him more money because what Jeff just said is exactly right.

But even at that, what we've, proven over history over time with getting new ambulance services even these big companies like ameripro can't come in and do it that quick nobody can make your steps right now that is the question that's all i'm saying with that and like i said that that that is the decision it's all totally up to y'all on how you want this to be

in the future budget time is coming right now right we're getting our budget right now and maybe we can pretend like what we can what let's see what we can cut to get it you know so for this upcoming budget depending on what the board chooses to do you would either do just the private contract or you would be to the hybrid system and that's the choice that you will have for this year then for years three and out

a whole different discussion and you can develop a plan for whatever direction ultimately the board wishes to go i'll tell you i'm to the point we cannot leave public safety to a private company i think public safety will have to be done in-house when i say public public safety i'm talking about fire and rescue it's going to have to be done in-house That's the only way we have a control over it. Fire it in-house now. I know. I'm just saying, fire and rescue. All public safety needs to be done in-house, in the county. Most counties in Florida do do it in-house, and I know why they do it now. I can see it. I mean, you know, one thing I have learned, you can't do the same thing over and over and over and expect different results.

You can't do that.

Anything else, David? before I ask for a public comment?

Like I said, it's just that right now, for the next three years, you've got a private contractor. It's a question if you just want to stick with the private contractor or if you want to provide ambulances and a backup capacity.

So you're comfortable with the additional information that we're asking you to bring forward when they think it's correct?

Yes. And AmeriPro needs to be here.

They will definitely be here.

okay uh with that being said uh i'll open the floor up to public comments because uh i know one constituent sent me a good email i'm gonna i'm gonna call on him first so he has a lot of good information in there i appreciate it ben just give your name my name is ben lofster so i've written this down a couple different times and i keep changing it based on new information here's my latest

Why did we so quickly pay Columbia EMS $100,000 to void our contract? And then we wrote such a lopsided contract with Ameripro based only on their verbal promise that they could solve all of the problems. Now we are paying more money for the same level of service or worse. Now they are saying that they can provide the amount of ambulances that we require as per numbers. You know, we need 10 ambulances, you know, for the amount of calls, but they would charge an extra $1 million per ambulance if that's what we wanted. I think the only answer to getting the number of ambulances that we want is to bring the service in-house. If we do bring ambulance in-house, what will we do differently now than what we were doing in around 2011 when we disbanded the in-house EMS to break a union or something? I'm not really sure. Anyway, now what we need to decide is if we want to bring EMS in-house and if we do want to bring it in-house, we need to start now finding a knowledgeable team leader and start the process of beginning exactly how we're going to move forward in a couple years when we're done with AmeriPro. But we also need to figure out if AmeriPro is going to just pay the fines and give us bad service or if they're going to step up and do it. And we'll know that shortly. But no matter what we do, we can't fix it today. But we need to have systems in place going forward to resolve this long term. We all know in our own business, if something goes wrong, you do a knee jerk reaction. You can fix it, but it will cost you five times more than what it would if you had planned you know, what you're going and doing. You know, when something bad happens, you can fix it, but it'll cost an astronomical amount. We want it fixed, but we don't have the money to pay astronomical. So let's get a plan for, in my mind, bringing it in-house.

Thank you. Thank you. Anybody else? Ma'am?

My name's Katherine Ashworth. First of all, rural calls are fewer than urban calls, so it's not going to pay, you can't expect to recoup your costs at hybrid. But if AmeriPRO was sincere, even though David had said, you know, you don't need to come, they would be here. They knew this meeting was here today and they'd want to hear the input. I'm wondering about a resort fee to help recoup some of the costs. We all wonder what's going to happen in November with the referendum. Personally, I don't We'll be voting no. I think we need the tax base. It's gonna come from somewhere, whether it's income tax or whatever, but we have to prepare just in case. Maybe a quarter cent, people, the public doesn't want taxes, but we have to have it to run our governments. You know, resort fee, a quarter cent tax increase on gas, because this is what hits the tourists. And you said that there are a lot of tourists that are using the EMS. that helps them pay for it. And then, what was the other thing I was thinking about? It's gonna take time. I spent 12 years as a volunteer firefighter over in Baker County. These guys, if they take it over, they know the county, but bringing people in, they don't know the roads. You have GPS, but that's not, you can't count on GPS. And they don't know the people. They go on a call with somebody that's a frequent flyer, that's gonna be the new guy. It takes time to build a new EMS.

Thank you. Anybody else? Okay. David, I think you got your walking orders. Sir, have you got anything?

Yes, for two things. One's not related to today's meeting, but just for the boards, knowledge going forward the clerk has decided to take the responsibility of seeking all the reimbursements for all of our grants so just while refreshing my mind um we funded the personnel i think she's doing a great job teamed up with others of getting these grant reimbursements under control but i just want for everybody's knowledge that's how it's going to work moving forward the second thing mr chair are two comments about the transportation truck I heard the word bloated. Keep in mind, unless you just stay at home, and I completely agree with this board, the need for ambulances, but unless you just stay at home, all constituents use your road system. All constituents. Say that again. I couldn't hear what you said. All constituents use your road systems unless you never leave the house. So we will always do whatever we have to work with, whether that's less or more with roads. And as far as that being just an ambiguous number on the $90 million, you have 650 miles of roads out there currently, paved roads. We're leveling and paving for 330 a mile, meaning $330,000. We'll just put an inch and a half top of the mile for 220 a mile, meaning $220,000. You can run that math, 220, that's $143 million in inventory. So let's just assume a third of it needs to be done today.

okay i think we could do basic math that's about 50 million okay thank you sir okay that's the quietest attorney we've got sitting in here here and uh outside of harlem so yeah i was just gonna add one more thing um you know everybody's assuming this property tax thing's gonna pass I looked at some polling the other day. I don't know if it's going to pass or not because the polling don't look that great for it. And one of the major concerns of it is there's a lot of people don't pay property taxes in Florida. A lot of people don't pay property taxes in Florida. So their concern is most of those aren't going to vote for property taxes to go down. because they think that they're going to be put under somewhere to cover that cost so i can tell you that the polls i was looking at the other day don't look too promising that they're going that's going to pass now do i i've always said i thought it was going to pass but once after reading and reading this stuff about why they have concerns about it not passing makes a lot of sense i mean so I don't know. We might be worried about something that may not never happen.

I'm reading the same poll you are, too. I've seen that poll out there. But also, I've seen the poll that said Ron DeSantis wasn't going to be governor.

He's been here eight years. I would like to know what numbers you know. What's the difference in property owners? and non-property owners in our county or any county. Are there more people that live here that vote that own property or don't own property? I would think it would be less. I don't know.

Well, your population numbers are between 70 and 75,000. Right. We know there are 24,000 houses that we send garbage trucks out to.

Oh, so you're right. They are in the minority. So people that own property in the minority. And that's why I don't...

When you say $70,000, you're talking about kids.

Yeah, yeah, yeah.

So it may be almost even.

That's true.

Well, I look at it by half and half.

But in my mind, property tax.

I mean, I've said the same thing. I'd be highly surprised if it don't pass. There's still a lot of concerns about it, whether it will or not.

Okay, we are adjourned. Thank you.

Thank you very much.