FEBRUARY 22, 2008

The Lake County Board of County Commissioners met in a special Department Workshop session, Public Safety, on Friday February 22, 2008, at 9:00 a.m., at the Agricultural Center, Tavares, Florida. Commissioners present at the meeting were: Welton G. Cadwell, Chairman; Jennifer Hill, Vice Chairman; Debbie Stivender; Elaine Renick; and Linda Stewart.  Others present were Sanford A. “Sandy” Minkoff, County Attorney; Cindy Hall, County Manager; and Susan Boyajan, Deputy Clerk.


            Mr. Gary Kaiser, Director, Department of Public Safety, stated that this presentation would be a little different from what the Commissioners had seen before, because they were going to display a lot of the things that they used out in the field and have the staff explain to the Board what they were doing.  He explained that the entire scenario that morning would be based on an incident action plan that they wrote for every event that they had, which was part of the National Incident Management System for disasters such as hurricanes, tornadoes, and plane crashes.  He stated that they would be given the complete picture of what the plan was, how it was going to be executed, who was responsible for what, and how it flowed.  He also pointed out that the personal accountability tags that they were given were what they used when people arrived on the scene, and the incident commander collected and maintained these tags to keep track of exactly how many people were on the scene and where they were.  He specified where in the room (or the parking lot) the Commissioners would go for each presentation throughout the program to give them an unprecedented, in depth view of what the Public Safety Emergency First Responders did.


            Mr. Greg Holcomb, Communications Technologies Manager, commented that the Communications Systems Division budget was $20,793,022, which looked large but their capital outlay, which contained their new radio system this year, was the majority of the budget for 2008.  He reported that some of the revenues that came in were from 911, cable franchising, and other emergency services fees, which made up about half the revenue; some interest income on reserves; and fines and forfeits from the surcharge from traffic violations.  He commented that the beginning fund balance was rather large this year because due to the legislature, they carried over some funds for some 911 system replacements that were going to have to happen.  He also went over the operating expenses for both systems and technology, including cost and maintenance of towers, phones services, electric services, and lease agreements.

            Ms. Harryette Hannah, Database Coordinator, went through the process for addressing a new subdivision, including naming the street and receiving a record that would be shown if 911 was called.

            Ms. Laura Nichols, Systems Database Manager, explained that they were responsible for issuing all addresses in unincorporated areas and several of the cities, maintaining the master street addressing guide, and maintaining the database for telephones and addresses of the streets.

            Mr. Bruce Thorburn, 911 coordinator, stated that cable television was in transition right now and that legislation passed last year that went into effect July 1 moved local authority for all intents and purposes away from issuing franchise agreements and given to the State of Florida, Department of State.  He specified that by July 1, 2009 all cable customer complaints would be going to the Department of Agriculture, but until that time, they were still required to receive complaints, but with no enforcement authority.  They also had to ensure that all Department of Revenue records were met and that the backup material was done, which was filed twice a year.  In order to show the Board the difference between where they had been and where they were going, he displayed an old analog 911 key switch and commented that analog would soon be gone and replaced by digital and computer equipment.  He then stated that instead of having the hand set and all the other equipment, it would be replaced by a computer screen and a wireless headphone with a mike, enabling the operators to have their hands free to do other things.  He also stated that the system would change from being a fixed-address technology to triggering a blinking dot on a map.  He mentioned that sometimes the milepost marker on a highway was used to determine who was responsible and the contact point for an emergency call from a cell phone caller who was on a highway.

            Mr. Gustavo Marquez, Communications Specialist, stated that they covered repairs, exchanges, warranties, broken clips, antennas, and other cell-phone use maintenance and reviewed 600 pages of cell phone bills.  He stated that they had a new radio service coming in, which resulted in new radios, new portable units, and the maintenance on those.  They also had to maintain the towers and equipment for emergency preparedness.

            Mr. Holcomb talked about some of the significant challenges that they were facing, which included a database that did not coincide with the Property Appraiser, the Tax Collector, or the GIS system in the County; revenue uncertainties due to future lost 911 revenue; rising of fuel costs; maintenance contracts; and staffing, especially with “ONE-DEEP” position responsibilities.


            Mr. John Jolliff, Deputy Fire Chief, stated that a majority of their budget went for personal services, and the operating expenses that were in the budget covered things such as utilities for the eighteen fire stations; apparatus repair and maintenance; and fuel and oil for the fleet.  He stated that they responded to a call every 35 minutes in the County and covered 1,022 square miles of unincorporated area.  He mentioned that the normal station rounds by an on-duty Battalion Chief who spent 30 minutes at each station took on average 6.5 hours to cover 100-136 miles.

            Ms. Kara Miller, Fire Lieutenant/Paramedic with Lake County Fire Rescue in the Mt. Plymouth area, told about the day in the life of a firefighter and some of the equipment they carried.  She related that a typical day started at 8:00 a.m., which began by getting a report from the outgoing shift relating what happened the day before and the status of the equipment on the trucks; and then making sure all their equipment was working properly and all their gear was ready to go.  The rest of the activities that made up their day included doing some type of physical training, doing some type of fire training, truck company operations, driving their area to get familiar with it and to make sure they knew where the hydrants and the streets were in the area, cooking and eating dinner as a group, and clean up.  They then went to bed at 10:00 p.m. and woke up at 7:00 a.m.  They also washed the trucks, made sure everything was ready for the next shift, ran calls that came in, and did reports afterwards.  She showed some of their equipment, including an SCBA (self-contained breathing apparatus) which weighed about 29 pounds and lasted about 15 – 30 minutes; a set of irons for forced entry into a building; a personal rope or bail-out bag; thermal imaging camera which allowed them to locate heat and fire in a building, to locate victims, and to keep track of the firefighters; fog nozzle; typical chain saw, usually used to cut through residential roofs to make ventilation holes; K-12 circular saw with a multi-use blade to cut through metal, concrete, and wood; and brush gear which allowed them more maneuverability and was a lighter weight.

            Lieutenant Bobby Ford stated that all employees in the field were dual certified, which in addition to being a state certified fire fighter, they were also an EMT or a Paramedic.  He noted that they handled natural disasters and vehicle accidents, where they might use hydraulic operations to cut open the vehicle or start medical care.

Mr. Chuck Blinco, Fire Lieutenant/EMT and a member of  the Special Operations Response Team (SORT), stated that the group has three fire stations dedicated to Special Operations and 29 firefighters who had to meet a minimum of 500 hours of additional training to get their foot in the door for Special Operations, including a 160-hour course in hazardous materials, which prepared them to deal with anything from drums on the side of the road to the methamphetamine drug lab response that they currently did with the Sheriff’s Office, as well as courses in search and rescue operations and building collapse.

Ms. Kathy Edwards, Firefighter/EMT at Station 109 in Clermont, serves as a Public Education Coordinator and a Juvenile Firefighters Intervention Network Coordinator and educates the public in fire safety issues.  She showed some equipment they used to educate children and special-needs adults, and some of the programs that they had available were “Get To Know Your Firefighter,” which was utilized in the day care facilities, and “Get Out, Stay Out,” for grades kindergarten to second grade, where they put the children in a simulated environment to teach them the importance of escaping and staying out of the way of a fire.  She stated that that they also had programs for kitchen fire safety for homeowners’ associations, which was adapted for the special-needs adults at Sunrise ARC, and did 25-30 community events, open houses, and parades utilizing the Fire Safety House.

Mr. Jolliff related three significant challenges of their department, which were staffing issues, continuance of progress toward compliance with established industry consensus standards, aging infrastructure, and fleet replacement and maintenance upkeep.



The Commissioners were taken outside in the parking lot for a demonstration of some of the fleet and equipment.  Mr. Rob Richardson, Radio System Coordinator, directed everyone to a portable tower system, which he related that Homeland Security asked Lake County to host for 18 months and which was integrated into their system.  He reported that this tower was worth $150,000 and that it had a five-channel trunking system and was used for special events.  Mr. Richardson stated that they had large generators in case the generators from the towers failed.  He also related that manpower was one problem that they were facing, and one of their goals was to increase their staff.

Mr. Jim Dickerson, Assistant Fire Chief, Operations, stated that Lake County’s fire services were the busiest in the region and covered an extensive area.  He showed some heavy extrication tools, which cost $20,000.  He pointed out some fire trucks, which he mentioned should last ten years and directed everyone to another truck, which he stated was seven years old, had 188,000 miles on it, and contained two motors and two pumps.  He explained that their replacement program was focused on making equipment and the fleet last longer.  He noted, however, that the county was large and that they ran a lot of calls, which put a lot of mileage on the fleet.  He also reported that there was $100,000 of equipment on every truck, which they tried to keep in the best shape possible.  He also displayed a Woods Truck, which were used for wild fires and related that they spent $75,000 on that truck, which saved at least three structures last year, and in comparison, Orange County spent $300,000 on a similar truck.  He showed a fire safety trailer and a Mass Casualty Response Unit, both of which were purchased with grant money.  He noted that grant money also paid for spine boards and a special operations response team for hazardous materials.  He also exhibited a Tower 112 truck that was used for the Four-Corners area, where there were buildings with multiple stories and garden apartments, commenting that it should last 15 years, as well as a Tanker 10 for the Astor area, which was a four-door tanker.


            Ms. Marjorie Boyd, Director, Animal Services, stated that during her twelve years with the County, she had seen a lot of change and growth.  She reported that in 2008, her budget totaled a little over $1.8 million, with over $1.4 million of that going for staff.  She commented that they drove over 57,000 miles every quarter and that it was a large area to cover, resulting in a fuel expense of more than $67,000 for over 25,000 gallons annually.  She also pointed out that a lot of calls ended up taking more than one officer and several hours.  She stated that they handled about 18 court cases every month at a cost of $1,200.  Other expenses included $2,000 monthly for animal feed and $3,000 per month for utility services at the shelters.  She related that one puppy or kitten could be linked to over 500 million births in seven years and that Lake County Animal Services handled a larger variety of animals than any of its surrounding counties.  They averaged a call for service every six minutes and a field response time of 37 minutes for the officer to respond to that call.

            Ms. René Segraves, Assistant Director, reported that in 2007, they had 13 animal control officers for the field operations and two dispatchers.  She showed a map that divided the county into four zones and showed in green the areas that they currently serviced, which she remarked was just about the whole entire county.  She related that their animal control officers were certified in many areas by the State of Florida and could issue courtesy notices, written warnings, or even citations; and they were also certified in chemical immobilization (dart gun), which was a last resort to catch an animal that could not be captured by any other means.  She reported that in 2007, they received over 21,000 calls.

            Mr. Tim Horschler, Animal Control Officer, pointed out an exhibit of an aggressive Burmese Python named “Big Bertha,” that was one of ten that they had to take care of at their shelter, who was over 18 feet long and weighed over 140 pounds.

            Ms. Segraves related that they had over 900 calls in reference to livestock, which were cattle or horses that were running loose and destroying property, and when the officer responded, they would do their best to safely confine that animal and call for a livestock rig.  She also pointed out that they received over 800 calls in reference to neglect and cruelty and showed some contraptions that they confiscated with the animals still in them at the time.  She specified that they had over 900 injured animals, including birds, eagles, sand hill cranes, and zebras and had responded to over 4600 calls about loose or stray animals, such as dogs, cats, chickens, and pigs.  She explained that their officers also attended training classes, such as the large animal rescue class.

            Mr. Horschler displayed some of the equipment used in their large animal rescue class and related that they took day and night training courses, in which they learned how to get large animals out of sticky situations, such as when a horse or a cow were stuck in the mud.  He showed what they used to right a trailer when it was turned on its side.

            Ms. Segraves told about some of the educational programs that their division did at schools, civic organizations, and homeowners associations to educate the public on how not to get bitten by dogs.  She mentioned that they received two awards because of their innovative programs from the Florida Animal Control Association (FACA) and the National Association of Counties (NACo).  She related that they responded to the fires in Sorrento in 2007 and were able to safely rescue some of the animals that were in peril and take them to their state-of-the-art holding facility, which could house up to 40 large animals and up to 60 smaller-variety animals.

            Ms. Tiffany Phillips and Ms. Michelle Perrier, Animal Shelter Technicians, explained about some of their shelter operations.  Ms. Phillips stated that in 2007, Lake County Animal Services was visited by more than 29,000 individuals inquiring about either adoption, reclaiming their own animal, or on many occasions relinquishing animals that were strays or could no longer be cared for.  The shelter staff consisted of nine shelter technicians, three euthanasia technicians, and one on-staff part-time veterinarian.  Ms. Perrier explained that in 2007, Animal Services received up to 15,400 animals, and each animal went through a standard check-in procedure, which included scanning for a microchip; then an adoption process after they determined that it was friendly and adoptable; and given its first set of vaccines.  She related that once the animal was adopted, it then went through a series of pre-surgery tests, including a heartworm exam, parvo check, and feline leukemia check; further vaccinations; and spay or neutering in their own in-house clinic performed by their on-staff veterinarian and shelter veterinarian technicians.  She pointed out that as a result of the monumental success of their in-house spay and neuter veterinary clinic, their adoption rates had increased over 70 percent, which has enabled Animal Services to extend their public assistance, beginning with their rabies vaccination program in which nearly 900 dogs and cats were vaccinated during the last two sessions.  Ms. Perrier related that Lake County Animal Services was the first in the nation to establish and operate pet friendly shelters where the owners and their pets could be evacuated and housed safely in the same shelter during a natural disaster, and they currently operated eight pet-friendly shelters with one backup shelter.  Ms. Phillips added that in 2005 they were awarded the NACo Achievement Award in recognition of their innovative pet-friendly shelter program.

            Ms. Boyd stated that one of the most significant challenges for their division was that their facility was overcrowded, since it was originally designed for 12 employees and 8,000 animals per year, and they currently had 31 employees handling 16,000 animals a year.  Their other two significant challenges were increased response time due to Lake County’s increased population and increase in public violence and threatening situations when responding to calls, making it dangerous for the officers every day.


Mr. Jerry Smith, Director, Emergency Management Division, stated that their main mission was to make sure the County was prepared, and they did that with a team effort of all the different departments across the County and partnering with the municipalities and different agencies in the County and the State.  He pointed out that they collaborated with their partners, coordinated the issues, and facilitated them for all of their residents.  He also noted that they were one of the few divisions that were responsible for all 300,000 citizens, pursuant to Statute 252.  He commented that he thought they were a bargain for the Board, because 40 percent of their budget came from grants.  He stated that through grants and with the cost of two personnel from the general fund, they were able to fund four full-time personnel, one part-time person, and volunteer expenses.  He stated that some of their operating expenses were for the satellite phones and the reverse 911, public education materials, and reprographics for training materials, grant applications, forms, and other printed material.  He pointed out that they had more people registered for special needs shelters than they had room for, but typically they did not always fill those beds up.  He stated that they had nine weather stations strategically placed throughout the County, so they would know whether it was safe to send someone out in a particular area.   They were excited that they had a conference call bridge, because they formerly had to pay a provider to be able to do that, and that enabled them to be able to keep their cities and other partners informed about what was going on.  He explained that they had those conference calls repeatedly during hurricanes.  He also mentioned that they had some small household generators.

Mr. Smith talked about some of their programs, stating that after Hurricane Katrina, they started the Public Shelter Registry Program, which had buses pick up people who did not have dependable transportation to take them to a shelter and back home when it was safe.  They were a huge proponent of NOAA Weather Radios, and one of their new programs, Disaster Ready Communities, aimed to get people to start thinking about personal responsibility for preparedness.  He also noted that coordination among all the municipal jurisdictions and agencies was a big undertaking involving hundreds of entities.

Mr. Sean Loughlin, Disaster Assistance Coordinator, stated that one key component of their budget was the Emergency Management Preparedness and Assistance Trust Fund (EMPA), which was funded from a surcharge on homeowners’ and business insurance.  He related that some of the items that were on the scope of work for this fund were to work statewide to decrease their shelter deficit, coordinate mitigation activities, coordination and collaboration, National Incident Management System (NIMS) compliance, participating in the State Hurricane Exercise, and communications with Florida Division of Emergency Management.  He also noted that the planning component was one of the most time-consuming parts of their job, particularly with submitting the applications for the Hazard Mitigation Grant Program (HMGP) and the County Emergency Operations Plan.  He mentioned that the Comprehensive Emergency Management Plan, which was the framework from which they operated, would be updated this year as well.  He reported that they currently had Lake and Sumter Emergency Recovery as their primary agency to deal with cases in the community where people needed help to assist them one-on-one with their long term recovery needs.

Ms. Dottie Jackson, Emergency Management Specialist, stated that the Special Needs Registry was one of her planning areas, and specified that Florida Statutes required all County Emergency Management agencies to maintain a database of special needs persons.  She related that they had three special needs shelters and worked closely with the Health Department in reviewing applications for the special needs shelter.  Another area of her planning activities was with the Health Care Facility Disaster Plans, and all 86 healthcare facilities, such as assisted living facilities, hospitals, and skilled nursing facilities, licensed by the State of Florida by the Agency for Healthcare Administration were required to submit a disaster plan to them for review and approval.  She stated that their projects and activities were based on many databases, including the Personal Resources Database, the Critical Facilities Inventory Database, Budget Database with four funding sources, and Mobile Home Parks Database.

Mr. Thomas Carpenter, Emergency Operations Manager, stated that the National Incident Management System (NIMS) was started after the terrorist attacks of 2001, which was a strategic, systematic approach to domestic incident response and that it was applicable across disciplines and jurisdictions.  He related that they have formed a partnership with Lake-Sumter EMS, the Villages Department of Public Safety, and Sumter County Emergency Management to form a core instructor group to teach all the required training with a very aggressive schedule for 2007, which has gotten good feedback.  He also talked about the EOC (Emergency Operations Center) activation process for known events such as a hurricane and no-warning incidents such as a tornado or wildfire.  He pointed out that with a known event, they had time to gather and analyze information and prepare, but with a no-warning incident, they had to do everything they did with a known event plus many more tasks instantaneously.  He also went through the organizational chart for the EOC, stating that the Executive Policy Group was the decision-making body that set the goals and objectives; the EOC Manager was responsible for making sure those goals and objectives were met; and they had 22 support emergency support functions with subject matter experts in those areas to make sure that the goals and objectives were carried out.  He explained the difference between the old and new EOC design, which was used from the time they activated for the Groundhog Day Tornadoes until the present, including completely new infrastructure with phones and computers in every work station and 11 new work stations.

Mr. John Walton, from Volunteer Lake, talked about the program for disaster-ready communities, which included mapping the neighborhood, preparing a contact list, taking care of people who needed treatment in their own neighborhood, and going through a 9-step checklist with items such as taking care of loved ones, shutting off water at the house main, sharing information gathered by teams, and placing “HELP” or “OK” signs in windows.  He commented that the key to the program was to keep it simple to present and to activate.

Mr. Smith went over their significant challenges, which included need of a dedicated EOC, special needs shelters and supplies, storage, and future technology upgrades.  He related that another one of their significant challenges was to get people to be prepared.  He also mentioned that they did not have generators large enough to attach to their shelters.



Ms. Marjorie Boyd gave the Commissioners a tour of some equipment and animals, including a horse, goats, and dogs pertaining to animal services.  She pointed out that because of the Florida weather, they recently changed to new style vehicles to transport animals, which had an inner and outside door and was air conditioned.  She also mentioned that animals such as goats and pigs were auctioned off if no one came to claim them.


Mr. Kaiser summarized that they have presented the many diversified functions that Public Safety performed on a 24-hour basis.  He explained that the Anatomy of an Emergency Incident would describe the critical thought processes that their emergency responders carried out when they were responding to an alarm.

Ms. Joanna Buchanan, Communications Supervisor, Lake-Sumter EMS Communications, related that this would be a vehicle accident located in the County at US Hwy 27 and CR 561, with reports of multiple vehicles, numerous calls being received, and several injuries.  She mentioned that they were a secondary PSAP (public safety answering point), meaning that the 911 calls that came in had already gone through the Sheriff’s Office or other agencies.  She commented that with this type of incident, all four of their 911 lines and four administration lines would be ringing.  She explained that the first thing that was important was confirming the location and getting a phone number.  She specified that they then found out exactly what was going on, what kind of vehicles were involved, whether there were any hazards, whether anyone was pinned in the vehicle or thrown from the vehicle, if everyone appeared to be conscious, and any obvious injuries such as serious bleeding, and they ensured the caller’s safety.  She related that they would be constantly updating the call at that time with the information received and would dispatch in multiple units.  They also would look to see if there was any type of mutual aid that they could request from another agency or county to see if they were closer to assist and give all the pertinent information to the corresponding crews to help them paint a picture before they got there.  She continued to explain that once the units were on the scene, they were getting information back from them and requesting assistance from specific responders.  If there were several patients, they would then call the hospitals and look into the possibility of other means of transportation, such as air support.  She pointed out that this was just one call, and they were still working all the other calls that were going on in both counties.

Mr. Braxton Bisceglia, Fire Lieutenant/EMT, Lake County Fire Rescue, commented that he would have 30 seconds to figure out what to do about this call and mitigate the scene.  He stated that their immediate responsibility would be to gather the information, repeat it back to Ms. Buchanan, and put on the bunker gear.  Upon arrival at the scene, he would give an initial report, including the number of vehicles; the type of vehicles that were involved; any hazards; any fuel leakage; the number of patients and their status, which would determine the level of MCI (Mass Casualty Incident); and any road blockage.  He explained that he would then establish a command system and determine if there was any extrication that would be involved, in which case he needed to decide if he was going to use a fire extinguisher or a hose line.  He mentioned that since there was a horse trailer involved, he had to contact animal control and special operations.  He also noted that he was constantly talking to his dispatcher.  He related that they then would try to de-escalate the call, clear up the scene, and get the road opened, and when everything had been taken care of and secured, he would go back to his station and do a report.

Mr. Lloyd Parker, Lake-Sumter EMS, commented that he and Mr. Bisceglia were concerned about a lot of the same things, because they operated as a team in the field.  He related that they were also interested in the location and making sure they were responding to the right place, as well as the other information that Ms. Buchanan was providing them, such as the number of vehicles, the number of patients, and the types of injuries.  They were particularly interested in any hazards, because they would then need to take the proper precautions, and wanted to be aware of any special considerations, such as extrication, entrapment, ejection from the vehicle, and extremes in age of the patient.  He also received continued information from the dispatcher, as it could change their level of response and the appropriate number of resources on the way.  He explained that when they arrived, they would size up the situation and look at the number of vehicles to estimate how many patients they thought they might have and stage the level of MCI from a 1 (small incident) through a 5 (large incident).  He noted that they had a predictable scale of response that was in their protocol based on that.  As they started to manage the scene, the first thing that EMS would want to do was to triage the patients and get the patients ready for transportation.  They then managed the transportation to local hospitals, trauma centers, or orthopedic trauma centers.  He noted that throughout all of this, they maintained accountability of all of their patients, which became more complex in a large accident with up to 100 patients.  At the conclusion of the call, they made sure the unit was clean and restocked, debriefed, and returned the vehicle to service.

Ms. René Segraves, Assistant Director, Lake County Animal Services, stated that they would initially receive their call usually from the Sheriff’s Office, and immediately she would dispatch the first available animal control officer to that area that was trained in large animal rescue, who would be able to approach the scene and contact them back to say exactly how many people were needed with their care unit to respond.  She explained that once they arrived on the scene, they would have to decide whether or not the animal was going to be removed before the trailer was up righted or if the animal’s injuries were such or that it was pinned in a way that they could not remove the horse safely.  She mentioned that they would have their veterinarians standing on call waiting to see whether they needed to do anything with the animal.  She added that they also would try to have photographs taken that would enable them to use that for training experiences, and they had to do reports.


Mr. Jim Judge, Executive Director, Lake-Sumter EMS, stated that they worked to weave themselves into the fabric of the community throughout Lake and Sumter Counties and that they covered 2,000 square miles.  He mentioned that they received the Industry Innovation Award from the Economic Development Council in 2003 and the Exceptional Employer Award in 2007.  He related that the ambulance service at one time was a for-profit hospital based system that decided to get out of the service, so the County formed an interlocal agreement between Lake and Sumter Counties in June of 2000 to form a unique, bi-county, government-owned, not-for-profit independent corporation.  He also commented that they had joint Board of Director representation between Lake and Sumter Counties, and the mandate to provide efficient, cost effective EMS services held true back in 2000 as it did today.  He went through the makeup of the Board of Directors, which included Commr. Cadwell as Chairman, and that of the Management Team.  He mentioned that Mr. Sandy Minkoff, County Attorney, was their corporate attorney and that the Lake County Clerk of the Court served as the Treasurer.  He stated that they had high call volume every day and that last year they responded to over 46,000 calls and transported over 34,000 patients.  He noted that their call volume was up over 7 percent from last year.

Mr. Judge reported that their budget this year was about $25 million, and they received subsidies from both Lake and Sumter Counties and user fees.  He listed the historical collections by type from October 2000 through September 2007, noting that 51 percent of their patients were Medicare, 23 percent self pay, 17 percent commercial, and a small percentage were Medicaid or contracts.  He opined that they were probably below the average in the State of Florida for ambulance service charges and that they tried to use the dollars they collected from third party billing to offset the cost of the service to keep taxes down.  He specified that the average Advanced Life Support transport charge was about $475, but a lot of their calls involved allowable or write off amounts of up to 40 percent of this charge.  He stated that they were currently working with the legislature on a direct pay issue to try to eliminate the problem of not being paid by the insurance company directly and the loss of about half a million dollars in revenue a year as a result.  He talked about the “When to Call 911” educational campaign, which addressed the problem of inappropriate use of ambulances and 911 calls and educating the public about how to use the 911 service and commented that they have had positive feedback on this campaign.  He mentioned that they started with 12 ambulances in 2000, and they currently had 27 ambulances covering Lake and Sumter Counties as well as fully advanced life support equipment and QRV’s (Quick Response Vehicles).  He reported that EMS had 258 total positions, with the main staffing in field operations.  He clarified the difference between EMT training, which required about 250 hours of emergency room time, classroom, and ambulance training, and the Paramedic training, which required about a two-year program consisting of about 1100 hours.  He reported that one of the benefits of their system of having only one state EMS license were that each of the agencies did not have to go out and jump through a tremendous amount of hoops and that it saved tax payer dollars.  He also mentioned the success of their rural wellness check programs, where they made daily visits to people throughout Lake and Sumter Counties, especially in the northeast part of Lake, for medical well checks, including immunizations.  He added that they served as a conduit to link those residents to other services, such as transportation needs, food banks, and wheelchair ramps.  He commented that they were involved in their community through agencies such as March of Dimes, United Way, The Altoona Food Bank, and Junior Achievement and were on standby service at over 195 events each year.  He was proud of the fact that the State called on them to help the neighboring counties and other areas for disasters such as Hurricanes Katrina and Ivan.

Mr. Judge reported that they were a very heavily regulated industry by Florida Statutes and the Florida Administrative Code, and they had easily passed all the many unannounced inspections, since the crews did a tremendous job keeping up with Statutes and the Rules.  He talked about their busy Communications Center, which was located in Mount Dora, which received over 210,000 telephone calls annually and dispatched a total of 95,000 fire and EMS calls.  He stated that in addition to that, they also coordinated all the inner-facility transfers and worked with Emergency Management on REVERSE 911®, and they had statewide communications capability.  He related that they provided dispatch services for 11 different fire departments, excluding the Cities of Clermont and Groveland.  He pointed out that they had their own internal Emergency Operations Center and had mobile vehicles with dispatch capabilities, as well as a mobile command vehicle that they acquired through a grant.  He commented that he was thankful to the Commission and Chief Kaiser for taking the lead on the 800 megahertz radio project, and reported that in addition to the 800 system, they also were mandated by State law to have a comprehensive UHF system, which was a statewide medical channel.  He described some of the other technology upgrades, including Electronic Patient Care Reporting (EPCR), which reported an extensive amount of patient care information and data needed for billing, statistics and field review; the Drivecam System, which improves driver safety and was expected to result in a 30 percent reduction in their liability insurance; Computer Aided Dispatch System, which provided map-centric technology to the EMT responding in the vehicle to pinpoint the location of  the call; and the Hospitals MED Channels Narrowbanding. One of the projects they were working on for the future was a Mobile Data Terminals and Automatic Vehicle Location System, which would let them know where the closest vehicle was and would simplify routing.  He mentioned that they utilized several helicopter services and that it was not uncommon to have three or four helicopters on a scene, since they saw a tremendous amount of trauma in Lake and Sumter Counties, due in part to people that did not use their seatbelts.  He concluded with a quote from Chief Dennis M. Sargent, Leesburg Fire Department, stating that Lake-Sumter EMS was the glue that held all of the fire departments in Lake County together.  He commented that prior to Lake-Sumter EMS, many of the departments operated independently and did not communicate with each other, but now they had almost a complete communication center and were working with all of the agencies and the operations group, which was especially important during disasters.


Ms. Cindy Hall, County Manager, stated that she wanted to hand out information before the Commissioners left from the Budget Department that some Commissioners requested which contained a line by line cost of programs in the general fund and a backup section to it of items that they could possibly discuss at the budget workshop on Tuesday.

 Commr. Cadwell stated that he and Ms. Hall had met with all of the constitutional officers to discuss matters pertaining to Tuesday’s workshop and to ask for suggestions, and he commented that they all were willing to do whatever they could.


There being no further business to be brought to the attention of the Board, the meeting was adjourned at 12:10 p.m.