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Ambulance Fees Going Up 48% as Flagler Fire Rescue Makes Pitch For Big Budget Increase

| June 20, 2018

Flagler County's fire department os looking for substantial budget increases even as fees for emergency transportation will be doubling or more in some cases. (© FlaglerLive)

Flagler County’s fire department is looking for substantial budget increases even as fees for emergency transportation will be doubling or more in some cases. (© FlaglerLive)

The cost of an emergency ambulance ride in Flagler County is going up 48 percent, the cost of an extrication in a car crash is going up 60 percent, and the cost of an emergency transport by helicopter is going up by 106 percent.


The County Commission approved the fee increases among many others Monday evening, part of an effort to align Flagler County Fire Rescue revenue with those of neighboring counties, and to improve the fire department’s bottom line as it prepares to spend $1.5 million on new equipment and vehicles and several hundred thousand dollars more for pay increases.

The firefighters’ union is in negotiations with the county to institute a “step” pay plan, which would reward employees with a pay increase for each additional year of service, in addition to cost of living raises. The Sheriff’s Office and teachers have such a step plan in place. Firefighters do not, so a firefighter hired at the starting pay of $44,000 will not be making much more than that, other than cost of living raises, 10 or 20 years out. “If I hire somebody today they make the same as somebody or a little bit less than somebody who’s been here eight years,” Fire Chief Don Petito said.

The fee increases will not keep the county administration from requesting a property tax increase that the county commission is likely to grant: it has shown no indications against it, and every indication that it is willing to go along with the county’s various requests for budget increases, including for all its constitutional officers–the sheriff, the clerk of court, the supervisor of elections, the tax collector and the property appraiser.

Monday’s workshop gave commissioners the first detailed look at the fire rescue budget’s new demands.

Flagler Fire Chief Don Petito, left, and County Administrator Craig Coffey. (© FlaglerLive)

Flagler Fire Chief Don Petito, left, and County Administrator Craig Coffey. (© FlaglerLive)

Emergency transportation is usually paid at least in part and sometimes in full by the patient’s insurer, assuming the patient has insurance. But those costs are also often a surprise for patients who review their bills after a medical issue.

The fee for an emergency advanced life support ambulance transport was $465. It is going up to $690. A basic life support ambulance ride is going up 46 percent, from $400 to $584. Patients will be billed $11 per mile in an ambulance, a 16 percent increase. An evacuation by helicopter cost $4,700. That cost is going up 106 percent, to $9,700–still less, he says, than the $47,000 cost charged by the helicopter that services Flagler Hospital in St. Augustine. (See Flagler’s complete new fee schedule, with comparisons with other counties’ fees, here.)

Fees offset the fire department’s $11.7 million budget and the emergency helicopter’s $664,000 budget, though the fee increases are not reflected in the budget County Administrator Craig Coffey submitted to the county commission in a series of ongoing budget workshops: the fire department’s fees is actually projected to fall by $250,000, according to the proposed budget, and Flagler County Fire Flight (the emergency helicopter) shows its fee revenue static at $50,000 for next year, even though Petito says he hopes to see that jump by several hundred thousand dollars.

Petito attributes the discrepancy to two things: the county is switching its collection method and going back to a third-party provider (Change Health Care) to collect those fees instead of having the tax collector do it. And the county expects a lag between the time the provider will start collecting and insurers will pay. The fire chief says it is more prudent budgeting to plan on existing dollars, and reflect new collection fees only when those prove true.

Many county firefighters turned out for Monday's workshop on their budget. Click on the image for larger view. (© FlaglerLive)

Many county firefighters turned out for Monday’s workshop on their budget. Click on the image for larger view. (© FlaglerLive)

Petito in a long presentation to the commission on Monday outlined his department’s many needs by starting to contrast Fire Rescue’s budget with that of the sheriff. The two departments account for 19 percent of the county’s overall budget. But the sheriff accounts for 14 percent sheriff, and fire rescue just 5 percent. “If I take that 19 percent out and break it out even further, you see fire rescue is getting 24 percent while the sheriff ‘s getting 76,” Petito said. “So we kind of feel we’re being a little left out on that funding part.”

Since 2014, the sheriff’s budget has gone up by $8 million while fire rescue has gone up by $1 million. Operating expenses have remained flat, capital costs have fallen. Ten firefighter-paramedics left during that period for jobs elsewhere, a trend the fire chief attributes to the static pay. In Miami, he said, a firefighter will start at $34,000, or $10,000 a year less than one starting in Flagler. But as soon as the firefighter passes the paramedic test, the pay increases by $1,000. And just by working there, the pay will rise to $70,000 over 20 years because of the step plan. It can rise further with promotions.

“When you come here you get hired at $44,000, and you stay at $44,000,” Petito said. “That’s what we’re trying to do is get that to where, we can explain to these people when you’re here 20, 25 years, you can make it to this point. Right now you can go anywhere else and have that picture painted for you. We can’t even paint that picture. So that’s what we’re trying to do for our personnel services.”

The step plan would help retain firefighters rather than make Flagler a training ground for other agencies. “It’s wonderful we provide that training,” Commissioner Nate McLaughlin said. “We also need to provide the incentive, so we’re not training for everybody else.”

The department will also need new equipment, and the county has budgeted $1.5 million for a new $490,000 fire engine, a $230,000 ambulance, a $120,000 attack truck (that battles wildfires), and nearly $400,000 for firefighters’ self-contained breathing apparatus, plus some additional equipment.

The department is also hoping to replace its nearly 20-year-old ladder truck, but that will cost between $650,000 and $700,000. It will also eventually have to replace its emergency helicopter, a $4 million charge (if new). Neither are in next year’s budget. The helicopter just had its engine, rotor and blades replaced, so the only thing that isn’t new is its skin, Petito said. It can go a few more years. But he’s requesting the addition of a pilot.

The county administrator will re-submit his general fund calculations to the commission at a June 25 workshop, with a proposed property tax increase. “We also have to increase the millage because we have some catch-up we have to do in some of these areas,” Coffey said. “We need to do some of that for our own folks but it takes money to do that.” The step plan firefighters are requesting will be part of that proposal.

“What that means is that there are some other things that aren’t going to get funded, because we have to take care of the people first,” Commission Chairman Greg Hansen said, without specifying just yet what those other things will be. “There’s going to be some tough decisions coming up here.”

The Fire Department’s Budget Presentation (2018)

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29 Responses for “Ambulance Fees Going Up 48% as Flagler Fire Rescue Makes Pitch For Big Budget Increase”

  1. John Dolan esq. says:

    I see the firefighters and police have Unions. What about the General Services and Public Works Dept. No Union representation here and that is why they haven’t had raises or promotions. Only the big shots get all the dough. Nice going Commisioners!

  2. Robert Lewis says:

    Flagler County raiding revenue any which they can. Tax & spend liberal leadership by Nate MacLaughin.
    What I want to know is if I live in Palm Coast and I have a car accident and need the jaws of life. Is Flagler County going to send me a bill? The only bill I get from Palm Coast is for my water.

    I don’t understand how I pay taxes for services, but have to pay again if I need help. That is the definition of double taxation. Government had reached into my pocket and yet again found a way to take more of my hard earned money. I guess they need the cash to pay for their sheriffs operations mess.

  3. thomas says:

    Suggestion….stop allowing the use of emergency vehicles for grocery shopping.

  4. Anonymous says:

    The budget and salaries are out of control!! The tax payers paid for the equipment and pay the salaries. For the few calls received annually for the budget and staff there is obvious some mismanagement going on that needs to be brought under control! Too many chiefs and not enough Indians. This is not a large county with a large footprint….cut wages and staff and keep the budget flat!!

  5. Agkistrodon says:

    I think a complete and fully transparent monetary audit of both Flagler County and the City of Palm Coast would be enlightening.

  6. Anonymous says:

    The general service at the public works is nothing compared to her First Responders job so do your research put yourself in their shoes for a day and see the difference ignorance is all around us

  7. CJ says:

    Flagler County should institute a Fire Flight Air Medical surcharge on every Driver License and Registration.

    $2.00 per Driver License Renewal
    $1.00 per 1yr Registration Renewal
    $2.00 per 2yr Registration Renewal

    This could possibly keep the cost down on air medical transport for county residents, allow for an additional pilot and increase hours of operations.

  8. Lou says:

    My SS, interest on on my savings account fails to keep up with inflation. But my taxes keep going up. Why?

    Assisted living business is growing in Flagler, in need more and more services and I have to pay to increase government services? Business just received a huge tax cut, I sure didn’t.

    Frustrating that elected officials fail to communicate with the taxpayers.

  9. Ridiculous says:

    This is a joke. My sister recently had to take an ambulance from the B section to Flagler hospital. It cost almost $600. How much more do they expect us to pay? Next time, God forbid, I’ll just drive her myself!

  10. Melissa says:

    Thank you for finally taking the steps to pay our firefighters/paramedics what they deserve. They needed a step plan long ago.

  11. Melissa says:

    Few calls?? The county ran more than 17,000 calls last year.

  12. Ol’ Sarge says:

    Thomas- for your information, when and if the crews go to the store, it is on the way back to the station after a call…

  13. Anonymous says:

    @ Thomas is ok with you if our first responders eat so they have the energy to save lives?

  14. Greg says:

    It’s entertaining to read so many posts that so many people have no idea what they are even talking about.

  15. Kathy says:

    Are you serious? Say you get into an accident, but the firefighters are getting some lunch(they DO need to eat in the 24-48 hrs they are on duty) in their own vehicles, now they have to rush back to the station , get into their gear and take the engine to your accident to help you, and say that accident was 5 minutes from where they are eating or picking up food to go, but the station is 15 or 20 minutes away…hmmm then you would be upset over the wait time. Be realistic folks, these guys are on duty 24 hrs, they generally bring food to cook for the duration, but you have three shifts of guys sharing one kitchen, there is only so much room, so grocery runs are a necessity, and they are on duty ALL 24 hours, and need to be able to help you ALL 24 hours, so the units go with them ALL 24 hours

  16. Greg says:

    The rates are set by the State. Most of the people posting have no clue what they are talking about. When you are in need for a real emergency you’ll be glad when trained personnel arrive with equipment that works. Also you will be glad to say hi in Publix they have to eat also.

  17. Stanley Hardy says:

    17,000 calls? That’s a joke. where I used to word as a medic we routinely ran 14,000 a MONTH.

  18. 107 says:

    So now we are going to have a service here in Flalger County that we can’t afford to use! That’s priceless. It is about time that a forensic audit be conducted on the county and some measures be taken to reduce the out of control budget! Those that are responsible for the out of control spending apparently don’t care that it is the people who pay for all this! Keep the expense flat and do whatever has to be done to make that happen.

  19. Anonymous says:

    @ Kathy when you are on duty as a first responder you are never in your personal vehicle you are always in either your police car fire engine or ambulancev that is what they used to go and get a meal and if a call comes in they drop everything and get to that call

  20. County Firefighter says:

    Kathy, sometimes ignorance is bliss. When an engine or a rescue leaves the station they have every thing they need in the trucks to run any call.

    Stanley, thank you for your service. However I’m willing to bet where you worked was a bit larger population than Flagler county and you had a few more engines, rescues and personnel than we do. You cannot compare Flagler County to Miami-Dade or FDNY.

  21. Melissa says:

    @Stanley. Where and when? I would like to look that up to compare population and department size.

  22. Dave says:

    Just another reason for poor people to not call the police in an emergency. We cant afford to be rescued. Looks like we need privatized ambulances now that we will be charged more than our life is worth.

  23. 107 says:

    What’s the point of having a service if the people in the community can’t afford it? Get rid of it if we are paying for what we can’t use! There has to be a better way. There apparently is no over-site and people are coming here from the North and turning this into where they came from. If we can’t afford it, we don’t need it! If you can’t make it affordable commissioners, do something different! This is another perfect example of Craig Coffey and his cronies going wild on the tax payers dollars. Time for Coffey to be fired and hit the road. Coffey has already outlived his limit of what a normal county administrator should be here…FIRE HIM!!!!! There are more than enough reasons why.

  24. Greg says:

    What if they are on another call what if you don’t even have an emergency and you call what if they drive a junker and it won’t start what if you can’t afford it what if they are buying dinner to deliver to a family in need no problem you call they will come with the jaws of life which are hardly used be glad you have 2 County services plus volunteers that show up to try to save your sorry ass

  25. Flatsflyer says:

    How about explaining what these rates are determined. All the labor is paid for by salaries that are budgeted, equipment like fire trucks, etc. are paid for already. Maybe charging for consumable supplies might be a consideration but how can rates be so high when our taxes already pay for 100% of what the fire department requests in their ever increasing budget requests? Something sounds fishy aren’t any of our elected officials smart enough to ask question?

  26. Nancy N. says:

    More than once I have been in Publix and seen our first responders come in – and then turn around a leave two minutes later when their radios went off with a call. These crews are on duty wherever they go, even if it means walking away from their dinner. I thank them for it.

    Saying “we don’t need these services if we can’t pay for them” is a position that comes solely from the hubris and denial of thinking you’ll never need them. All I can say to all of you is that one day it will be you or your loved one trapped in a demolished car, or lying on the floor unconscious – and then you will want the absolute best that money can buy on the way while you wait through minutes that feel like hours. Do you want that responding paramedic to be the one that couldn’t get a better paying job in a nearby county – other counties’ rejects basically, or do you want that person to be competent, experienced and well-equipped?

    Anyone who doesn’t think that paramedics are busy just needs to sit in the ER on a Saturday night like we did recently in a room with a view of the nurse’s station. In the couple hours we were waiting for my husband to be admitted to in-patient, we saw the same sets of paramedics all returning what seemed like three or four times.

    I’ve personally been hauled out of my house unconscious by one of these crews (seizure) and they have also helped a family member having a cardiac event. They are worth their weight in gold when you need to dial 911. We need to take care of them, for ourselves, our loved ones, and our neighbors.

  27. Jane Gentile-Youd says:

    Bravo to the Fire Rescue and Ambulance crews. On May 7 there were checking me from head to toe less than five minutes after my hubby Mark called 911. Comforting me and treating me like a princess – even making sure the emergency room doc was taking over before they left…. On the way to the hospital I was calm enough to ask if they are being treated good by the county because they deserved a gold medal for the care they were giving me. They laughed and said ” we love our job but we could use an increase in pay… They weren’t kidding… Let’s give them a piece each of the $400,000 we can save by dumping Coffey and his top Coffey Mate…..
    God Bless you guys. for everything you did for me. Oh yeah… First time in my life I ever had an ambulance.
    Hopefully the insurance companies will not increase the co-pays and it is about time Florida Hospital in Palm Coast has a trauma center because nobody will be able to afford a helicopter to Halifax anymore.. which is another issue for another day.
    Thank you to the great crew who took sure good care of me … we can’t afford to lose you – you are all worth your weight in gold for how you treated me

  28. Old Fireman says:

    Our department makes 1,120 calls every day. Do you know how many of those calls the public expects perfection on? 1,120. Nobody calls the Fire Department and says, ‘Send me two dumb-ass firemen in a pickup truck’. In three minutes they want five brain-surgeon, decathlon champions to come out and solve all their problems”. Chief John Eversole, Chicago Fire Department, circa 1995

  29. Mark101 says:

    Flagler County Fire Rescue, pay them they are worth every cent when they walk into your home and starting working to save your life.

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