CEO 88-70 -- October 19, 1988

CONFLICT OF INTEREST

CITY FIRE DEPARTMENT PARAMEDIC

EMPLOYED BY PRIVATE AMBULANCE COMPANY

To: Mr. Warren T. LaFray, Attorney (Clearwater)

SUMMARY:

No prohibited conflict of interest exists under Section 112.313(7), Florida Statutes, where a City of St. Petersburg Fire Department Paramedic also is employed by the only private ambulance company providing emergency ambulance transportation within the City. As the circumstances relating to emergency medical services within the City now are identical to the situation presented in CEO 88-56 regarding the City of Largo, the rationale of that opinion is applicable here. CEO 88-26 is revoked.

QUESTION:

Does a prohibited conflict of interest exist where a city fire department paramedic also is employed by a private ambulance company which provides emergency medical transport services within the city?

Under the circumstances presented, your question is answered in the negative.

In your letter of inquiry you advise that Norris Nagle is employed as a Firefighter/Paramedic with the City of St. Petersburg. You also advise that until we rendered our opinion CEO 88-26 he was employed on a part-time basis by the private ambulance company which is the sole provider of ambulance transportation services in the City and in the County. In essence, we are asked to reconsider our opinion CEO 88-26, which related to St. Petersburg Fire Department paramedics, in light of the facts and circumstances presented in CEO 88-56, which pertained to paramedics with the Largo Fire Department. You advise that the facts and circumstances relating to the City of Largo are identical to those in the City of St. Petersburg at the present time.

In CEO 88-26 we concluded that Section 112.313(7), Florida Statutes, would prohibit a St. Petersburg Fire Department paramedic from being employed by the only private ambulance company operating within the City, finding that the paramedic's employment with the private ambulance company would present a continuing or frequently recurring conflict of interest and would impede the full and faithful discharge of his public duties. There, we were advised that the private ambulance company charged its users a flat fee plus mileage and supply costs.

In CEO 88-56 we concluded that Largo Fire Department paramedics were not prohibited from part-time employment with the private ambulance company. At the time we rendered CEO 88-56, we had been advised that uniform provisions for emergency medical services transportation had been established for all of Pinellas County. We also had been provided additional information regarding the protocols applicable to City paramedics, regarding the frequency of transports by the City Fire Department, regarding the contract in place now between the County and the ambulance company, and regarding the uniform contract between the County and the City under which the City provides first responder services.

At the present time in the City of St. Petersburg, the protocol for paramedics is identical to that described in CEO 88-56, requiring all persons who are seen by fire department or ambulance paramedics as the result of an emergency request for medical assistance to be transported by ambulance to a hospital for diagnosis and treatment or a release form to be signed by the patient who refuses transportation. The County now pays a flat monthly fee to the ambulance company, although adjustments are made based upon such factors as outside work, inflation, and "stop loss payments" to cover transports exceeding the annual volume projected by the County. In addition, the contract provides for adjustments in the form of penalties for late runs by the ambulance company as an incentive for the company to provide timely services. Patients are billed a uniform amount by the County, regardless of whether they are transported by the City or by ambulance. The City also is paid a monthly amount by the County, but this amount primarily is tied to the combined number of transports by the City and the ambulance company. Finally, you have provided us with statistics which indicate that both the number and the percentage of City Fire Department transports has declined through the course of 1988 as uniform contract provisions have been implemented by the County.

Our concern in this situation, as expressed in both CEO 88-26 and CEO 88-56, is that the decision made by a paramedic whether to allow the private ambulance company to transport a patient not be influenced by regard for the interests of the paramedic's private employer. Given the method of compensation now in place for the ambulance company and the City; given the protocols which clearly express preference for transport by ambulance except under limited, emergency conditions; and given the actual experience of the City under the present emergency medical services system, we conclude that the rationale of CEO 88-56 is equally applicable to the subject St. Petersburg Firefighter/Paramedic.

Accordingly, we find that no prohibited conflict of interest would be created were the subject Firefighter/Paramedic also to be employed by the private ambulance company which provides emergency medical transport services within the City. As it appears that CEO 88-26 no longer accurately reflects the circumstances involved in the City of St. Petersburg, we hereby revoke CEO 88-26.