Rick Chap died four months ago on his kitchen floor in full cardiac arrest, his heart still, his pulse gone.
Fortunately for Chap, he lives just a mile from an Orlando fire station. With his wife performing CPR, a rescue crew from Station 6 arrived in less than four minutes, shocked his heart back to life and rushed him to the hospital.
"Their level of training is unsurpassed, and no one has more heart than these guys," said Chap, 56, who has made a full recovery.
Stories such as Chap's lend support to Orlando Fire Department administrators as they evaluate their decision to take over emergency-ambulance service. The department is 127 years old but began transporting most 911 patients to the hospital a little more than a year ago.
The decision, which many firefighters had long resisted, came down to money.
Two years ago, Orlando narrowly avoided laying off 46 firefighters thanks to an $8.3 million federal grant. Knowing the grant money would run out, Chief John Miller got the OK to bring in more revenue by buying a fleet of ambulances and taking over most hospital transports in town.
This week, Miller presented to city leaders the results of the first year of ambulance service. Though ambulance bills haven't brought in as much as the grant, Orlando officials are calling it a success.
The department handles the most-serious medical emergencies, and car crashes. Less-serious calls are dispatched to Rural/Metro, the private company that had handled all calls until the Fire Department took over.
From May 2011 to April 2012, the department handled 71 percent of hospital transports in the city -- 19,174 transports -- and Rural/Metro handled 29 percent.
During that time, the city billed patients, private insurance companies, Medicare and Medicaid $13.9 million.
With collections often low for ambulance services, particularly in urban areas, the city deposited $4.8 million for the year. That amounts to about $3.1 million after expenses, though that number will likely climb somewhat because there's a lag in insurance reimbursements, and some debts have been sent to a collection agency.
The revenue doesn't match the $8.3 million during two years from the federal grant, which runs out later this year.
Even so, city officials point out that the department is now bringing in at least a few million dollars and increased the quality of service to patients without hiring more firefighters.
Firefighters used to respond and begin treatment, then hand off the patient when a Rural/Metro ambulance arrived. Now paramedics maintain a continuity of care into the emergency room that experts say is better for patients.
"Sure, we'd like to have millions more in the bank, but I think we've done a fantastic job in order to help offset the taxpayers' costs," Miller said. "What we've done is add a higher level of service."
Deputy Chief Greg Hoggatt, who conducted the review, said he expects costs will come down and collections will increase going forward.
Transporting patients has meant more work for firefighters, particularly those at the three stations closest to downtown, the city's busiest. But labor-union leaders see it as a way to save jobs and prevent the closure of firehouses.
"This is the first time in Orlando Fire Department history that we generated revenue," union President Steve Clelland said. "So everyone in the department is pretty excited."
Jennifer Chap said her husband wouldn't be alive if not for the firefighters.
"This miracle happened because of the incredible speed and continuity of care provided by the Orlando Fire Department, its 911 service and its fire-based transport system that was there when literally seconds mattered," she said.
Copyright 2012 - The Orlando Sentinel, Fla.
McClatchy-Tribune News Service
