Division of Public Safety

1. Division of Public Safety

2. Mission To provide help to those needing it and the means by which to communicate that need.

3. Major Programs • Emergency Medical Services (EMS) • Emergency Management • Fire Protection • E-9-1-1 • Emergency Dispatching • Emergency Communication Systems (GCN) • Public Safety Information Resources • Public Safety Logistics

4. State Mandated • EMS • Florida Statute 125.01 • Provide ambulance service. • E-9-1-1 • Florida Statute 365.171 • Implement an emergency communications number "E-9-1-1" plan for enhanced 911 services • Emergency Management • Florida Statute 252 • Maintain County-wide Emergency Management Program • Emergency Dispatch • Florida Statute 401.015 • Regional Emergency Medical Communications System • Emergency Communication Systems (GCN) • Florida Statue 401.015 • Regional Emergency Medical Communications System • Florida Statute 282.7101 • Statewide System Of Regional Law Enforcement Communications

5. Comprehensive Plan Required • EMS • Goals 15, 22, 65, 68, 95 • Emergency Management • Goals 5, 66, 101, 102, 103, 105, 106, 109, 110, 111, 158 • E-9-1-1 & Emergency Dispatching • Goals 22, 65, 68 • Emergency Communication Systems (GCN) • Goals 13, 22, 65, 68 • Fire Protection • Goals 65

6. BoCC Directed: How We Operate • EMS & Emergency Dispatch • Ordinance 08-16 (Ambulance & Rescue Services) • Emergency Management • Ordinance 07-20 (Post-Disaster Recovery) • Emergency Communication Systems (GCN) • Ordinance 07-26 (Obstructing Telecommunication Network Facilities)

7. EMS Rules for Reimbursement • Rules for EMS Providers to Operate Under • Florida Administrative Code 64J-1 through 64J-3 • Florida Statutes Chapter 401 F.S. • Medicare Benefit Policy Manual Chapter 10 – Ambulance Services • FAC 596-4.015 Ambulance Transportation Services for Medicaid reimbursement. • Local County Ordinance: 08-16 • Lee Co. Administrative Code: External Fees 22-1 • Medicare • Reimbursement fee schedule established by the Balanced Budget Act of 1997. • Starting on 4/1/2002, established payments based upon reasonable costs. Medicare now pays 80% of the allowed rate. • Medicare allowable has increased every year since 2002 however this year is in doubt.

8. Expenses

9. Five-Year History

10. Budget & Revenue

11. Major Revenues Revenues have increased by 20.8% over the past five years.

12. Background on Major Revenues • EMS Revenue collateralized toward payment on 6 Capital Refunding Revenue Bonds and 1 Capital and Transportation Facilities Refunding Revenue Bonds. Series 1993B; 1997A; 1999A; 2000; 2004; 2006 • Last fee increase 04/05/2005. • E-9-1-1 • Land Line User Fee: $0.44 per line, no increase in 5 years. • Cellular Line User Fee: $0.50 per phone, no increase in 5 years. • Cellular User Fee is set by the State 9-1-1 Board. • Emergency Communication Systems • Revenues remain steady in past 5 years. • Intergovernmental charges to customers • Telecommunications tower rental • Fines & Forfeitures ($12.50\traffic violation per Florida Statute 318.219) • Hurricane Mitigation Fee • Revenues trend as development increases and decreases

13. Major Expenses

14. Approved Positions

15. Five-Year Status • No increases in fees in nearly five years. • Revenues have increased at 20.8% due to improved processes and adoption of technology. • Outsourced EMS medical kits supplier.

16. Where we are today?

17. FY 2010 Budget User Fee Based Ad Valorem MSTU $35,000,000 $30,000,000 $25,000,000 Total $45,159,018

18. FY 2010 Approved Positions • 370 positions approved. • 9 positions vacant. • Positions by Program:

19. Major Issues-EMS • Fire Service Ability to Sustain EMS Support. • Current Fire-Based Ambulance Service Stressed, Lehigh Acres. • Reduced Response to Certain Requests for Service. • Cost and Flexibility of Evolving Business Model. • Negotiations with Local 1826 for EMS road personnel. • Negotiations with IAEP for EMS supervisory personnel. • Acceptability of Medical Priority Dispatch Response Matrix by Stakeholders and Public. • MEDSTAR Air Operations. • Helicopter Replacement. • NTSB & FAA Findings & Requirements on Safety Standards. • Changing Rules for Reimbursement. • National Health Care Reform.

20. Major Issues – Emergency Management • Public expectations exceed current service level. • Relying upon the same volunteer base for increasing public demands.

21. Major Issues – Others • E-9-1-1. • Expecting implementation of regional and statewide 9-1-1 system networking. • Emergency Dispatching. • Aging Computer Aided Dispatch System (10 years old, 2 years remaining). • Replacement estimate @$2 million. • Anticipating State-mandated 208-hour certification course for 9-1-1 operators. • Emergency Communication Systems. • P25 (Project 25) Investment. • 800 MHz Re-banding.

22. Where are we going?

23. Three Year Projections

24. General Initiatives • Constructing Emergency Operations Center including data room. • Providing county employees emergency assignments training. • Improving cellular GPS technology for location information a major focus. • Offering 9-1-1 text messaging. • Providing emergency responders with graphic display of house or address.

25. Where are we going? • Who’s Public Safety’s Customers? • ‘Just in Case’ vs ‘Just in Time’ Business Model. • Align User Fees with Cost of Business. • How much should be on the back of the taxpayers? • Keeping up with real-time, wireless technology and Web 2.0.

26. Options for Reductions • EMS • Reduce Outlier Station Locations. • Judiciously Convert 24 to 12 hour Coverage. • Fully implement Medical Priority Dispatch. • Redefine Customer Base. • Emergency Management • Revisit Hazardous Material Contract. • Temporarily Suspend Hurricane Shelter Deficit Program. • Reduce 2-1-1 Support.

27. Options for Reductions • Emergency Dispatching & Communication Systems • Revisit Maintenance Agreement Contracts. • Develop Public-Public & Public-Private Partnerships. • Public Safety Information Resources • Continue reductions in unnecessary redundant technology. • Public Safety Logistics • Outsource Additional Services.

28. Enhanced Revenue Options • EMS • Increase EMS 911 Transport Fees • Increase EMS Inter-facility Transport Fees • Increase EMS Air Transport Fees • Emergency Communication Systems • Increase Fees to Subscribers • Increase Tower Rental Fees • E-9-1-1 • Increase Land Line Fee to $0.50

29. Action Requested of BoCC • Definition of Customer • Type of Service – 9-1-1 vs Healthcare • Kind of Service – Expectation Level • What Business Model? • Just in Case. • Just in Time. • Do We Increase Fees?

30. Questions?