Minutes 07/21/1983 EMPLOYEE ADVISORY MEETING - JULY 21, 1983
The meeting was called to order and the following members
were present:
Diane Flagg Debbie Lichliter
Jeff Page Denny Hare
Terry Lichliter
Also in attendance: Doug Greenfield , Dale Ginter and Marty
Ginter
OLD BUSINESS- Denny Hare advised that there is not enough
interested people to start a "School Car" for
transportation .
Diane has investigated the possibility of
renting a storage garage and A/C for standby
at 4A. on 951.
NEW BUSINESS- Diane has reassigned employees to advisory
board members in an effort to make contact and
exchange of information easier.
Denny Hare was elected secretary.
Doug Greenfield discussed results of County
Commission Meeting including the idea of
using volunteers . He needs input and concerns
from employees , based on facts concerning
possible volunteers in any EMS related function .
Examples : as drivers , 3rd persons , drivers
on 2 person crews and transport units .
Marco and Immokalee stations are getting new
A/C units in the bunkrooms and also the pos-
sibility of moving to the Marco station on
Barfield is being researched.
Terry Lichliter, Diane Lichliter and Diane
Flagg voiced employee concerns about overly
severe disciplinary penalties , non-effective
grievance procedures , complaints against
supervisors , and inconsistent enforcement of
the S.O.P. Doug agreed to the information
of a Pre-Disciplinary Review Board, composed
of employees and management. All employees
are encouraged to attend a meeting at the new
EMS headquarters , August 2nd, at 10 :00 a .m.
for the information of same.
Doug advised that any employees concerned of the
recent hepatitis outbreak, should contact
Roger Evans at the health department.
Doug Greenfield and the supervisors will
address the idea of the original on-scene
medic transporting in on the chopper of
serious patients rather than transfering the
call to the supervisor.
If your ALS card will expire within the next
few months (by September) , notify 520.
EMPLOYEE ADVISORY MEETING - JULY 21, 1983
The meeting was called to order and the following members
were present:
Diane Flagg Debbie Lichliter
Jeff Page Denny Hare
Terry Lichliter
Also in attendance: Doug Greenfield, Dale Ginter and Marty
Ginter
OLD BUSINESS- Denny Hare advised that there is not enough
interested people to start a "School Car" for
transportation .
Diane has investigated the possibility of
renting a storage garage and A/C for standby
at 4A. on 951.
NEW BUSINESS- Diane has reassigned employees to advisory
board members in an effort to make contact and
exchange of information easier.
Denny Hare was elected secretary.
Doug Greenfield discussed results of County
Commission Meeting including the idea of
using volunteers. He needs input and concerns
from employees, based on facts concerning
possible volunteers in any EMS related function.
Examples : as drivers, 3rd persons, drivers
on 2 person crews and transport units.
Marco and Immokalee stations are getting new
A/C units in the bunkrooms and also the pos-
sibility of moving to the Marco statipn on
Barfield is being researched.
Terry Lichliter, Diane Lichliter and Diane
Flagg voiced employee concerns about overly
severe disciplinary penalties , non-effective
grievance procedures , complaints against
supervisors, and inconsistent enforcement of
the S.O.P. Doug agreed to the information
of a Pre-Disciplinary Review Board, composed
of employees and management. All employees
are encouraged to attend a meeting at the new
EMS headquarters, August 2nd, at 10:00 a.m.
for the information of same.
Doug advised that any employees concerned of the
recent hepatitis outbreak, should contact
Roger Evans at the health department.
Doug Greenfield and the supervisors will
address the idea of the original on-scene
medic transporting in on the chopper of
serious patients rather than transfering the
call to the supervisor.
If your ALS card will expire within the next
few months (by September) , notify 520.
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EXECUTIVE SUMMARY
DISCUSSION OF EMS TASK FORCE REPORT
OBJECTIVE: To transmit comments received as a result of the
completion of this report .
CONSIDERATION: In December of 1982 the Chairman of the Emer-
gency Medical Service Advisory Council (EMSAC) created a Task
Force comprised of three (3) EMSAC members amd three (3) mem-
bers of the public to review the EMS Department . This body
was charged with reviewing all EMS activities to gain enhanced
knowledge of the system and make recommendations for improve-
ments regarding same.
This group worked for several months meeting with County staff
and other emergency support personnel to gain a better under-
standing of the comprehensive provision of EMS in this county.
At the completion of their efforts , for which they should be
commended, comments were solicited at the request of Chairman
Kruse through the County Manager . Attached is a summary of
these comments/recommendations and staff input where no comments
were received .
RECOMMENDATION: To transmit these responses to the Board of
County Commissioners and receive their comments or direction
regarding same .
PREPARED BY:
W. Neil lorril 1
Pub ' c Safet , Administrator
DATE: AP 7
WND/bm
cc : Task Force Members
Respondents
MEMORANDUM
DATE: July 1 , 1983
TO : Board of County Commissioners
FROM: W. Neil Dorrill , Public Safety Administrator
RE: Summary of Comments Received , EMS Task Force Report
As a result of the completion of the EMS Task Force Report , comments
were solicited at the request of Chairman Kruse by the County Manager
to respond to the primary categorical recommendations found in the
report . Response requests were sent to William Crone, Director,
Naples Hospital ; Richard Akin , Director , CHSI ; Richard Ruth , Personnel
Director ; James Giles , Fiscal Officer ; Mark Thiele, Purchasing Director;
Robert Tober, Medical Director; and this writer to coordinate any com-
ments received .
The following is a listing of both the general statement within the
report as well as any response received from the above . The full
response received is attached for your review.
I . Medical Monitoring Committee
" . . . suggests that a committee of retired emergency room physicians
be created to review run-sheet reports . . . urges increased use of
telemetry radio to receive/transmit instructions from phycisians
and reduce the amount of standing protocol . "
Response : The Medical Director is required by FL Administrative
Law (10-D-66) to review and critique each run report , paying
special attention to those involving paramedic procedures . He ,
in turn , will incorporate his analysis into the mandatory bi-
weekly training sessions or take any necessary disciplinary action
he sees fit . This written report also recognizes any significant
change in telemetry procedures is subject to the approval of
Naples Community Hospital . "Standing protocols , " as they are re-
ferred to , allow EMS personnel to begin certain routine prescribed
treatment without direct confirmation from a physician . Standing
protocol also removes problems associated with areas in the County
not able to receive telemetry signals and saves Emergency Room
physicians from having to communicate on every call .
II . 24-Hour Medical Clinic in Immokalee
" . . . urges a 24-hour Emergency Room be established in Immokalee ,
utilizing both federal funds and creating a MSTD to offset oper-
ating costs and reduce EMS transport costs . "
Responses : Richard Akin , CHSI, responded for both CHSI and Naples
Memo - BCC
July 1, 1983
Page 2
Community Hospital . He conditions his statements by predicting
an Emergency Room budget that would operate at the existing
CHSI facility which currently provides Emergency Room services
during the day, 6 days a week. The total budget for a 24-hour
facility requires an additional $600 , 000 in cost and recognizes
$75 , 000 in anticipated revenue for an adjusted operating budget
of $525 , 000. Mr. Akin has subsequently publicly stated that
CHSI has applied for a grant under the "President ' s Jobs Bill , "
which could operate this proposed facility for the first two (2)
years . Although it appears the chances for approval of this
grant are quite good , no medium or long term funding solutions
have been discussed . If the "deficit" of $525 , 000 were to be
provided by an MSTD , the property tax required would be 7 . 6588
mills for residents of the Immokalee area, using the boundaries
of the Immokalee Fire Control District , with an assessed value of
$68 , 549 , 375 . This compares with an existing total tax for
Immokalee properties , including schools , of 13 . 6733 mills , or a
56% increase .
In terms of an actual tax, current residents of the Immokalee
area pay approximately $684 for a home and property assessed at
$50 , 000 . The additional tax necessary to support an Emergency
Room would be $382 . This appears to be an excessive tax burden
and other sound financing options will have to be explored .
III . Financial Monitoring Committee
. . "suggests a new committee be created to monitor all EMS expen-
ditures and revenues to make recommendations directly to the BCC .
. . . suggests all budget information be consolidated into an easier
system to determine total costs . F-. srgges'ts that major costs attri-
butable to employee benefits be taken into consideration in the
future . "
Responses : James Giles , Fiscal Officer , responded that the EMS
Department ' s fiscal activity is summarized in the same manner as
other County activities . For example , he states that certain EMS
financial reports use up to thirty (30) accounts to provide suffi-
cient detail to manage deparmental accountability . He also states
that sufficient detail involving a variety of financial data is
currently generated through five (5) computer and three (3) type-
written monthly summaries . He suggests that misunderstandings by
the Task Force might occur because of inherent differences between
public and commercial accounting and that governmental accounting
and its special requirements need to be understood by all users .
He does state that revised and condensed reports could be pro-
vided to EMSAC in addition to information they currently receive
at each meeting on revenue and fund position .
Richard Ruth, Personnel Director , stated that in terms of employee
fringe benefits , the way in which Collier County compares fringe
benefits to salary , 36% of gross salaries is a correct figure . He
states that this figure is for total eligible benefits (including
Memo - BCC
July 1 , 1983
• Page 3
paid sick and vacation days) and that such leave is not fully
taken by the vast majority of employees . In addition, he says
that the largest majority of operating expense for most depart-
ments is total personnel expenses of which the largest portion
is salary expenses . He indicated that dollar for dollar, sur-
veys indicate that while percentage of benefits paid to County
employees are higher, salaries and therefore total personnel
expenses are generally lower than those for other agencies . For
example, for the comparable employee of Firefighter/EMT, the City
of Naples has salary and benefit costs of $20 , 216 , compared to
$17 , 367 for County employees . This is a difference of $2 ,849 or
14% . In terms of true costs a comparison made on a percentage
figured against a lower salary is a poor and misleading statis-
tic , when County costs for this and other positions are consider-
able lower. Finally , he indicates that certain benefits have
escalated in both the public and private sector over the recent
past and some employers have elected to freeze certain benefits .
IV. Life Line Charges
. . . "recommends that adjustments for Advance Life Support charges
be made when an IV (intervenous injection) is started but when
no other medication is administered . (Results in a $60 surcharge
savings) . "
Response : The EMS Department is supportive of such a change and
is proposing that IV stabilization procedures , as well as a simi-
lar charge for a precautionary EKG, be implemented for the coming
fiscal year. This would result in a reduction of $8 , 400 in user
revenue .
V. Volunteers
. . . "urges recruitment of health service volunteers as well as
clerical and professional workers . . . further suggests contact be
made with Harbor City Volunteer Ambulance Squad in Melbourne , FL ,
as an example of this type of system.
Response: The EMS Department has contacted officials with know-
ledge of this Volunteer Ambulance Service in Brevard County .
This service. is a volunteer/paid service which supports the
Melbourne/Titusville area on the east coast . Although no easy
corelations can be made between this small suburban service and
our large countywide area , they have made excellent use of volun-
teers who serve primarily as EMT/drivers . The ambulance service
currently receives a County subsidy of approximately $250 , 000 .
Other sources of revenue include the need for large donations
($275 , 000) and a reserve fund originally targeted to make building
improvements . Although the service has been in existence for
sixteen (16) years , as technology and population have grown the
service has been plagued with turnover and routinely requires
ALS back-up support from the County EMS Department to supplement
their own fleet .
Memo - BCC
July 1 , 1983
Page 4
VI . Helicopter
" . . . encourages stricter use of the County helicopter for emergency
purposes only, eliminating other non-emergency use . . . "
Response: The County has successfully utilized helicopters for a
variety of purposes for approximately ten (10) years . The two (2)
existing helicopters were acquired under federal surplus property
programs and are under a seperate budget apart from EMS activities .
Prior to certification and active use by the EMS Department , the
UH1B helicopter flew a ratio of 59%: 41% for emergency vs . non-
emergency flights respectively . In the fall of 1981 , with the
adoption of comprehensive helicopter rules and charges , combined
with certification of the one (1) helicopter as an Advance Support
Air-Ambulance, the EMS Department has enhanced the emergency rescue
and medivac use of this aircraft to 70% of total flights . Although
the helicopters continue to fly other missions for purposes ranging
from aerial photography surveys to pilot training and scheduled
maintenance, these appear justifiable in terms of total hours flown.
VII . Supplies
" . . . recommends all supplies over $100 . 00 be made through Central
Purchasing . . . purchasing procedure encouraged to obtain lowest
prices , as well as bulk purchases when proper storage is available . "
Response: Mark Thiele , Purchasing Director , responded that County
purchases operate on a decentralized format , by design . EMS pur-
chases comply with the current Board adopted purchasing policy and
accepted governmental purchasing practices . He goes on to say
that the EMS Department employs exemplary procurement policies in
meeting its needs . Competitive quotes are obtained in addition to
bulk purchases , where feasible, for all items over $200 . In addi-
tion, any purchase over $300 must be requested by the Department
Head and authorized by the Division Administrator . In no instances
are purchases made , under current finance rules for payables ,
unless there is available funding . One item currently being ex-
plored for possible cost reduction is linen service . While quality
control is a concern for this purchased service , a formal perform-
ance specification and bid could reduce the costs currently obtained
by quotes .
VIII . 24-Hour Shift
" . . . although currently adequate , a 12-hour shift may be advisable
in the future . "
Response : Analysis of current total run activity over the course
of last year reveals that the average crew will have four (4) runs
over a 24-hour shift . This number is well within industry standards
and should not increase dramatically for some time . A 12-hour shift
with 24 hours off would require that additonal crews be hired to
cover for sick leave and vacation .
Memo - BCC
July 1, 1983
Page 5
IX. Private Ambulance Service
. . . "urges a special committee be established to study this sub-
ject . . . suggests that previous experience in Collier County with
private providers be overlooked in terms of this option of
service . . . "
Response: Staff feels that although there is certain prejudice
in our feelings toward this matter , we should provide the Board
with the current status of private ambulance services in Florida .
According to HRS (State Licensure for EMS) , of a total of 67
counties in Florida, 49 currently have comprehensive (ALS) cover-
age by public providers . Of the remaining 18 counties , approxi-
mately five (5) services are run by regional hospitals , with only
19% from either rural counties without modern EMS coverage or a
private provider . No new EMS contracts have been let within the
past two (2) years for the provision of ALS coverages . Although
your staff stands ready to pursue whatever action the Board dir-
ects , we only mention the above as a comparative current state of
EMS under Florida Law.
WND/bm
C
MEMORANDUM
DATE: May 19 , 1983
TO: Neil Dorrill/Pu.lic Safety Administrator
FROM: C. William N. f# .i , .nty Manager
SUBJECT: EMSAC Special Task Force Report and Recommendation on
Collier County ' s Pre-hospital Emergency Medical
Service Program
Attached is a copy of the above report which was forwarded to
me , by Commission Chairman Mary-Frances Kruse , for comments.
Copies of this report are being sent to Neil Dorrill , Public
Safety Administrator; Dr. Robert Tober, EMS Medical Director;
William Crone, Administrator of Naples Community Hospital;
Richard Aiken, Director of Collier Health Services, Inc. ; Jim
Giles, Fiscal Officer; Mark Thiele, Purchasing Director; and
Richard Ruth, Personnel Director. I would appreciate your
reactions to all of the issues raised which you feel qualified
to respond to, and particularly those which are listed below.
Item III - FINANCIAL MONITORING COMMITTEE, Item IV - LIFE LINE
CHARGES , Item V - VOLUNTEERS , Item VI - HELICOPTER, and Item
VII - SUPPLIES, would seem to be matters for which you and Doug
Greenfield should be primarily responsible.
I would also ask that you handle the codification of responses
received from the others I am sending copies of this report to,
with an overall reaction to each of the proposals, when the
results are in. At an early date , it would be desirable that
you schedule a meeting with me to review the report in general.
Enclosed is a copy of each of the other memorandums I am
sending out, for your information.
I believe the Task Force has accomplished its objective of " . . .
conducting an unbiased study of the Collier County Ambulance
Service . . . " . Some of their recommendations will be more
easily implemented than others , and some may not be possible at
this time. However, I think that the issues addressed are each
worthy of consideration, and compliment the Task Force for
their diligence and conscientiousness .
Please provide Your response on the above requests to Neil
Dorrill , Public Safety Administrator, for coordination, with a
copy to me.
CWN/pd-DI23
cc : Board of County Commissioners
Task Force Committee Members
H S
C I
F
COLLIER HEALTH SERVICES, INC.
Health Care With Dignity
Branch Office Main Office Branch Office
Everglades City Clinic Immokalee Health Care Center South Trail Clinic
305 W. Broadway Ave. 419 N. First Street 4 Joseph Lane
P.O. Box 166 Immokalee,Fla. Naples, Fla.
Everglades City, Fla.33929 33934 33942
Phone(813) 695-2581 Phone(813)657-3663 Phone(813) 775-2324
June 7, 1983
TO: Neil Dorrill
Public Safety Administrator
FROM: Richard B. Akin '
Collier Health Services, Inc.
SUBJECT: EMSAC Special Task Force Report
Attached is an estimated budget for providing 24-hour medical care
in Immokalee. Mr. Crone and I met and discussed this matter in some
detail, and agreed that I would respond to this particular request since
I have already investigated this possibility.
There are just a few comments that should accompany this budget.
First of all, it has been assumed that these services would be offered
as an extension of CHSI, so that no additional facilities would be needed.
Only emergency service would be offered. Also, this plan assumes that lab
services would be offered, if we could find qualified staff. No x-ray
would be available. Finally, the figures may lean slightly to the liberal
side, as it may be difficult to recruit physicians and other professionals
to work in Immokalee at such odd hours as Sunday evenings.
If you have questions or would like to discuss this matter further,
please call.
RBA:mr
cc: C. William Norman
County Manager
A. PERSONNEL
1. Contracted
Physicians (three @ $90,000) $270,000
Nurses (three @ $25,000) 75,000
Pharmacist (Part-Time) 10,000
Sub-Total $355,000
2. Staff
Clinic Aides (three @ $ 9,000) $ 27,000
Interpreters (two @ $ 9,000) 18,000
Lab Technicians (two @ $15,000) 30,000
Interview Clerks (three @ $ 9,000) 27,000
Bookkeeper/Insurance Clerk 10,000
Sub-Total $112,000
Total Personnel $467,000
B. FRINGE BENEFITS $ 19,040
C. TRAVEL $ 1,500
D. EQUIPMENT $ 1,500
E. SUPPLIES $ 25,679
F. CONTRACTUAL
1. Direct Patient Care
Phone-A-Gram (EKG) $ 1,225
Outside Lab Services 11,900
Medications 14,000
Outside Drug Referrals 1,525
Transportation of Patients 420
Malpractice Insurance 5,600
Sub-Total $34,670
2. Non-Patient-Care
Other Insurance $ 3,325
Auditing 4,550
Attorney 350
Computer Services 1,750
Custodial Services 8,470
Sub-Total $18,445
Total Contractual $53,115
G. OTHER
Advertising $ 3,210
Equipment Maintenance & Repair 2,800
Training 700
Telephone 5,775
Postage 1,750
Utilities 15,750
Printing 2,000
Total Other $ 32,085
(_ C
RECAP
A. PERSONNEL $467,000
B. FRINGE BENEFITS 19,040
• C. TRAVEL, 1,500
D. EQUIPMENT 1,500
E. SUPPLIES 25,679
F. CONTRACTUAL 53,115
G. OTHER 32,085
Grand Total $599,919
Less Revenue $ 75,000
Total $524,919
JUN 61MEMORANDUM
6Y: June 6, 1983
Neil Dorrill - DATE:
TO: Public Safety 'Administrator FROM: Jim Giles, Fiscal Officer
Re: EMSAC Special Task Force Report
This is to respond to the County Manager' s concern with Item III,
FINANCIAL MONITORING COMMITTEE, of the EMSAC Report, where the Committee
calls for a consolidation of ambulance costs and elimination of "duplication"
of similar items.
The County' s financial reporting system is designed to meet the needs
of a variety of users: department directors, division administrators, the
county manager, special committees, elected officials, the general public,
etc. Accordingly, financial information is progressively summarized to
accomodate this hierarchy of reporting requirements . For example, under
the expenditure category Other Services and Charges, which includes all
operating expenditures other than personal services, materials and supplies,
or capital outlay, E.M.S. uses over thirty accounts. Most of these accounts
were created to meet management needs to track expenditures at a very
detailed level. If EMSAC perceives a need for less detail, we can design
a report showing expenditures by class within a category, which is less
detailed than the report required by management. This might reduce the
thirty or so accounts to perhaps nine classes of accounts. The compression
of object codes into the object class of Repairs & Maintenance, for instance,
would consolidate eleven E.M. S. accounts, for EMSAC reporting purposes .
The EMSAC Report does not elaborate on why it was "difficult to es-
tablish a total cost of the system. " E.M.S. is provided the following
monthly financial statements:
o Computer Print-outs:
° ° Expenditure Detail by Fund (CCOI)
°° Detail Listing of Revenues Vs. Budget (A203)
°° Detail Fund Balance by Accounting Distribution (A66)
°O Balance Sheet (F100)
' O Statement of Revenue and Expense (F140)
• Typewritten Reports:
°• Balance Sheet
°' Income Statement
" Statement of Changes in Financial Position
It is suspected that misunderstandings might occur because of inherent
difference between governmental and commercial accounting. The County' s
budget follows the governmental format in planning for the flow of funds
(usually cash) and may include expenditures for equipment and principal
on debt and revenues from inter-fund transfers and debt proceeds, which
for purposes of commercial, or proprietary, accounting is neither expense
nor revenue. It is important for the users of financial statements for
proprietary funds, which include enterprise and internal service funds, to
understand the uses of budgetary reports which indicate flow of funds
(governmental accounting) and income statements which match revenues with
expenses (commercial or proprietary accounting) .
FORM RDI inno_I
C
EMSAC Special Task Force Report Page 2
The Committee ' s recommendation regarding fringe benefits relates to
policies developed between the County Manager and the Board of County
Commissioners .
It is hoped that this memo adequately responds to the Committee ' s
financial reporting concerns.
JCG/bjm
cc: Board of County Commissioners
C. William Norman, County Manager
Proprietary Fund Managers
Joseph F. Warren, Finance Director
Egon Hill, Chairman, E.M.S. Advisory Committee
MEMORANDUM C
DATE: June 7, 1983
TO: C. William Norman, County Manager FROM: Richard B. Ruth, Personnel Director
RE: EMSAC Special Task Force
In an effort to better respond to the concerns regarding the cost of
fringe benefits as raised in the "EMSAC Task Force Report" several additional
surveys were conducted by the Personnel Department.
The first survey, Exhibit A, is asalary and Fringe Benefit Comparison
of Certified Firefighter/EMT's with six other jurisdictions. As indicated
in the survey, Collier County's rate of pay for this position is less than
any other with the exception of Palm Beach County. The average annual
salary of those jurisdictions surveyed was $14,834 compared to $12,964 for
Collier County for this particular position.
In addition, out of the seven jurisdictions surveyed, six of them
indicated benefit packages of thirty (30 ) percent or more. The average of
those surveyed was 32.7 percent.
Thus, the most meaningful comparison to be made would include both
the total salary and benefit cost of the position. In this case, only the
City of Ft. Myers and Palm Beach County total compensation packages are less
than Collier. The average annual salary and benefits for this position is
$19,706, while Collier County pays $17,596. In comparing Collier County to
the City of Naples for the Salary and Fringe Benefits Collier pays $2,898.00
less for the Certified Firefighter/EMT position, see Exhibit B. The only
two areas that Collier County's benefit costs are higher than the City of
Naples are Health Insurance and Retirement.
Next, it was decided to compare salary and benefits for the Senior
Automotive Mechanic position since the position was formerly with the County
prior to moving to ARA Services Company, see Exhibit C. It is evident here,
also, that ARA pays a higher salary at $14,560 compared to $13,538 for the
County, but lower benefits at 27% compared to Collier's 33%. The total
compensation package for this position as was paid by the County is $501 .00
less than the ARA Service Company.
In summary, this does not say that we shouldn't be concerned with
the escallating costs of benefits and in fact may be forced to reduce
expenses through co-sharing of health care costs and other cost containment
programs. However, it is important in comparing benefit costs that we
recognize that certain jurisdictions may pay higher salaries but less benefits.
Q •C
R. B, th
RBR/rs €))\
cc: Neil Dorrill
Public Safety Admin. ,U 10
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MEMORANDUM
TO: C. W. Norman, County Manager
THROUGH: E. C. Smith, Administrative Services Director
FROM: M. G. Thiele, Purchasing Director
RE: EMSAC Report Review
DATE: May 31, 1983
'
I have reviewed the EMSAC Report, pursuant to,your request, particularly
Section VII, "Supplies". The report recommends that Central Purchasing be
utilized for the purchase of all items in excess of $100.00; purchasing
procedures should be instituted to obtain lowest prices; and, bulk purchas-
ing should be considered.
The County Purchasing Department presently operates on a decentralized for-
mat, by design, due to staff size. The Purchasing Department concentrates
on large purchases and reviews all smaller purchases. All EMS procurement
complies 100% with the Board of County Commissioners ' Purchasing Policy and
with accepted government purchasing practices. To institute central pur-
chasing for all EMS acquisitions would require Board direction and an in-
crease in staff.
The Emergency Medical Department, in our opinion, employs exemplary procure-
ment practices. Approximately $3,000 in pharmaceuticals and medicines are
acquired directly from the Naples Community Hospital monthly. Medical equip-
ment in excess of $200 is acquired only after obtaining competitive quotes
from vehicle supply firms like Aero Products (Orlando ) and Emergency Medical
and Safety Supplies (West Palm). Institutional cleaning supplies are pur-
chased through the County Maintenance Department through the County Buyer
(Paul Starnes) who continually shops prices and state contracts. Wash and
wax for the vehicles is bought in volume 30 gallon drums from Alpha Chemical.
These outlets afford the lowest, competitive prices .
Bulk purchase is only feasable when there are storage facilities available.
With the completion of the new EMS building, bulk storage will be provided
for. Bulk purchase, however, should only be performed where there is a
realized savings . Moore Medical Equipment offers prices competitive with
Hillsborough's.
One item that could be possibly purchased at a savings is linen service
(approximately $6,000 per year) . Steps are presently being taken by EMS to
provide specifications to Purchasing for formal bidding. As this is a ser-
vice, the Board Policy does not mandate formal bidding, but good purchasing
practices dictate a formal bid could provide better economy.
Please let me know if I can provide any further information.
MGT/jsw
\J
CC: Neil Dorrill, Public Safety Administrator 1 '
Doug Greenfield, EMS Director