Wednesday, Mar. 2, 2005 | ||
Bad Links? | PTC doesnt know EMSs real costs
By PETER PFEIFER I have been making a series of statements that began after the Peachtree City Council demanded that the County Commission establish a new EMS tax district so they could totally divorce the city from the countys EMS service. Peachtree City has produced a presentation on the issue that they premiered at a City Council meeting. This report outlines their position and, when examined, illuminates what is wrong with their position. First, I will say that this production was prepared and presented by those who already had a point of view. It was not prepared to provide a basis for discussion or to provide the basis for an examination of the facts. It was put together to provide a propaganda piece for the Peachtree City Council meeting. Would you rather have information or more misinformation? The very first page says that their purpose is to: Eliminate Fayette County residents who live in Peachtree City from paying for EMS service twice. I do not know of anyone who wants to charge the residents in Peachtree City twice for EMS service. I do know of several people, myself included, that want Peachtree City and county residents and taxpayers to have the best possible service at the lowest possible cost. That is precisely why this issue should be discussed and the facts found. The script starts off with a purported history of Peachtree City EMS. This history discusses the city and the county emergency services. Let me quote something, Peachtree Citys EMS history is certainly not complete and fails to identify critical milestones and pertinent facts. Who said that? Jack Krakeel, director of public safety for Fayette County, who was asked to review the Peachtree City show. He said it. Who is Jack Krakeel? Jack Krakeel had been chief of emergency services for Fayette County and assumed more duties when we did some reorganization. What do others say about Jack Krakeel and Fayette Emergency Services? The department has been the recipient of numerous awards from many organizations such as the Georgia Association of County Commissioners, the National Association of Counties, the Federal Emergency Services Administration, the Georgia Emergency Services Department and the Office of Homeland Security. Jack was the 1999 Fire Chief of the Year. Fire Chief Magazine, a national publication for fire service professionals, named him to this prestigious award. Chief Krakeel is now the EMS column coordinator for this magazine. Jacks programs have been adopted and distributed across the nation. Talk to professional emergency services people locally, in the state and in the nation. Jack has received recognition, awards and accolades. They know who Jack Krakeel is. What else has Chief Krakeel said about the Peachtree City EMS presentation? Peachtree Citys EMS expenditures reflect the marginal costs with delivery of EMS services. Since this is a municipal budget, they do not attribute any personnel costs to the EMS function with the exception of one training position. Fayette County EMS budget is inclusive of all costs associated with staffing four ambulances 24/7. Let me tie this back into something I said a while ago. If you have an open mind on this issue, if a real comparison is to be made, and if real information is to be presented so that a correct decision can be made, we have to know the real costs of service. Because of the way the Peachtree City budget is prepared, we do not have this knowledge. Their personnel costs are free in their accounting. We cannot begin to decide if consolidation is the best way (or even if a separate tax district is the best way) until we can look at real information and real costs. Nothing Peachtree City has said or published changes this. They do not know how much EMS costs the taxpayer. How can they possibly decide if this or that alternative is more or less expensive? Jack also refers to the statement contained in Peachtree Citys study concerning consolidation. However, this would more than likely require an increase in the countywide mill rate to fund the additional .... Jack says, A presumptive statement that automatically assumes there would be an increase in the mill rate without knowing the actual costs of service delivery and revenue yields from patient transports. In addition, the overall impact on the county budget and resulting adjustment to mill rate would not be known without these calculations and other considerations in the budgeting of general fund revenues. This reiterates the truth that you cannot make a comparison or a decision until you know the facts, can you? And further, also regarding consolidation expenses, Chief Krakeel says, This (the expenses listed in the PTC report) is not realistic given the fact that under a consolidated environment, the revenue yield associated with transport revenue would substantially offset additional expenditures associated with county staffed units, future expenditures for additional ambulances to serve PTC would not be recognized since adequate capacity is available with adjacent EMS units, PTC would not have to incur additional expenses for personnel to staff their fire apparatus since they no longer would have to meet ambulance staffing requirements. In a little plainer language, this means that we can have ambulance service in the future, meeting or exceeding the current levels of service, without Peachtree City paying for more ambulances and paying for the people to staff those ambulances. That sounds less expensive to me. I will again refer you to a statement I made a couple of weeks ago: we know that consolidations have taken place in other locations. Why would they do this unless it gave as good, or better, service at the same, or lower, cost? And finally, Jack responds to the statement, PTC provides a superior service at an economical cost. Jack writes, My question regarding this statement would be based on (by) what performance measure does it provide a superior service: response times, out-of-hospital cardiac arrest survival rates, patient satisfaction measures, number of service complaints, number of training hours personnel receive annually, number of advanced practice paramedics, number of specialty certifications held by personnel, number of awards received from recognized institutions/agencies, unit hour utilization rates and others? The question of economical cost is totally predicated on the argument that a marginal cost approach is the correct methodology for allocating expenses associated with delivering EMS in PTC. Fayette County fully assigns all costs and therefore a cost comparative analysis between the two systems utilizing marginal cost on one side of the equation and full cost on the other is neither appropriate nor fundamentally sound on which to predicate an argument of economic efficiency. Chief Krakeel is saying something I have also said about the phrase from their report claiming that, PTC provides a superior service at an economical cost. If true, this would be good but it is an opinion and an assertion that needs some basis or reason for saying it. What is the reasoning? What is the comparison? What are the facts? What kind of leadership produces silliness like this and expects you to believe it? |
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