Thursday, January 27, 2022

The 9-1-1 on Marco’s Emergency Service

By Maureen Chodaba

On March 15, 2016 many voters in Collier County will be asked to vote in a “straw ballot” regarding the future of their EMS and transport services. You may ask, and rightfully so, just what is a straw ballot? Merriam-Webster Dictionary defines a straw ballot, also known as a “straw vote” or “straw poll” as “an unofficial vote taken (as at a chance gathering) to indicate the relative strength of opposing candidates or issues.” goes on to say that the idiom’s origin “may allude to a straw (thin plant stalk) held up to see in what direction the wind blows; in this case, the wind of group opinion.”

Marco Island residents will not be included in this straw ballot, as Marco Island is an incorporated city in Collier County. That being said, one might think that our island need not be concerned with the issue at hand. However, many feel that we should indeed be concerned as the proposed changes could affect Marco Island in the future.

Here are some facts:

Collier County’s Board of County Commissioners has approved a straw poll question to create an independent fire and emergency medical response district that would provide services to unincorporated Collier County; by definition, those areas not within the boundaries of an incorporated city; in other words, not the cities of Naples or Marco Island. The straw vote is being presented although there has been no public education or outreach regarding current service level or financial impact of this plan.

Collier County currently receives its certificate to practice Advanced Life Support for emergency medical and transport services from the State of Florida. The County Commission has determined that only Collier County EMS can transport patients to the hospital.  However, Inter-Local Agreements have extended the permission to provide Advanced Life Support services through local fire departments such as Marco Island, Greater Naples Fire District and North Collier Fire District. Thanks to these agreements the mortality rates have greatly improved for those with life threatening emergencies in these districts, primarily due to short response times to 911 calls on Marco Island. Our Marco Island firefighters are trained as paramedics to work on their own, or side-by-side with trained county personnel. In an emergency, they can provide lifesaving treatment whether arriving by fire truck, ambulance, or other emergency vehicles.

Here is the Inter-Local Agreement in action. Marco Island and Collier County work together with the Office of the Medical Director to set and regulate a high standard of care. Marco Island taxpayers pay Collier County over $3 million each year for county EMS plus $1 million in transport revenues collected for ambulance services by the county. Marco Island receives one full-time ambulance staffed by Collier County and Marco Island paramedics, and also a six month, twelve hour per day seasonal ambulance. Funds remaining in the balance pay for EMS services off the island to serve as a backup.

Marco Island residents currently pay 2.1 mils for all city services, and only .6 mils of the 2.1 mils for our fire and paramedic fire units. Just to give you an idea of what that really means, defines “millage rate” as “the amount per  $1,000 that is used to calculate taxes on property. Millage rates are most often found in personal property taxes, where the expressed millage rate is multiplied by the total taxable value of the property to arrive at the property taxes due.” Here is a scenario. When some fire districts recently combined to form the Greater Naples Fire District, residents were taxed at 1.5 mils for fire services. Some districts that would become a part of the proposed consolidated independent district currently have millage rates of 4.2 mils. Some fear that a district that would absorb others with such high millage rates could not possibly operate at a rate as low as 1.5 mils. Keep in mind that 1.5 is more than double what Marco Island is paying now.

So what does that mean for Marco Island? In creating an independent district, Collier County appears to be leaving the fire/emergency medical services business. This could mean that our Inter-Local Agreement between the county and Marco Island would no longer exist. According to state law, Marco Island firefighter/paramedics could then only provide very basic medical services with no Advanced Life Support whatsoever. Under the consolidation plan, some officials are concerned that Marco Island could be forced to join the independent district in order to maintain Emergency Medical Services. However, especially with regard to response times, Marco Island is geographically located quite a distance from independent district’s boundaries. Officials fear the loss of local control could result in the Marco Island Fire Station being left with diminished on-site ambulance service or paramedics. This could result in delayed response time for life-threatening emergencies, decreased quality of care, and potentially increased expenses for taxpayers. The Collier County government has provided very little community outreach and information regarding plans towards establishing this independent district. At this time, Marco Island government and residents have no reassurance, or vote on this issue, which could greatly impact our future.

But maybe we don’t have to remain silent. The straw poll vote is, by definition, non-binding. However, if it is supported, our County Commissioners will most likely view it as approval to proceed with their proposed plan. On February 16, 2016 the Marco Island City Council directed City Manager Roger Hernstadt to request a Certificate of Public Convenience Necessity (COPCN) from Collier County. This certificate, if issued by the county, would enable Marco Island to maintain its own Emergency Medical Services and transport if the city is dissatisfied with the county’s plans for the unincorporated area. Marco Island City Council Chairman, Bob Brown, has written a letter to all Marco Island residents outlining the details and urging them to voice their opinions and concerns to our government officials. Chairman Brown states, “In the past fiscal year, Marco Island taxpayers contributed over $3 million per year to the county EMS system. Our voice should be heard in how this money is spent.” He goes on to say, “As residents, your voice can be heard even without a vote in the straw poll.”

Of course, Collier County officials can begin to provide Marco Islanders affirmative reassurance by passing an official resolution supporting Marco Island’s right to self-determination regarding paramedical and ambulance services, and supporting the city’s efforts to obtain and renew a city COPCN, should islanders want an alternative to the county’s emergency service levels.

We may not be able to be a part of that wind that determines which way that “straw” will blow, but we can still send some “wind” of our own…the wind of Marco Island opinion.

Here is a list of our government officials you may contact:


Leo E. Ochs, Jr., County Manager



Chairman Donna Fiala, District 1


Vice-Chair Tim Nance, District 5


Georgia Hiller, District 2


Tom Henning, District 3


Penny Taylor, District 4



Rep. Kathleen Passidomo


Rep. Matt Hudson


Senator Garrett Richter


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