Clerk of Court
auditors warned Monday the mismanagement that led to Medstar’s shutdown
created problems that now threaten to bring down all of Lee County’s
emergency medical services.
In a draft report Monday, auditors
faulted public safety management for the poorly executed policies, lack
of oversight, infighting and secrecy that led to the downfall of the
county’s medical flight program, Medstar.
“All of Lee County EMS
is at risk of imploding, as the Medstar Program did, if the Public
Safety Department culture that has prevailed over the past several years
is not changed with the upcoming management changes,” according to the
report.
Lee County is looking for a new public safety director,
EMS chief and county manager, after the three posts were abruptly
abandoned in Medstar’s fallout. County Manager Karen Hawes will finish
out today and resign to a pay out of more than $250,000, according to
the terms of her separation agreement and payroll records.
The
Lee County commission called on Clerk of Court Charlie Green to audit
Medstar, after The News-Press exposed that officials failed to meet
federal safety mandates and erroneously billed patients for about $3.3
million in the run up to its Aug. 21 shutdown.
County officials
have one week to respond to the draft report, Green said. Once that
happens, Green’s office will issue a final report on the management
portion of the program.
Green’s auditors are also working to
figure out the erroneous bills county officials sent to patients and
insurers, he said. The report on that aspect of the program is due out
in the coming weeks, he said.
The management lapses that
unraveled Medstar date back to 2004, when officials expanded the program
from just carrying county residents to flying patients from all over
Southwest Florida, according to the audit.
Under then Public
Safety Director John Willson’s “hands off” approach, former Medstar
manager Rick O’Neal distanced the program from the rest of the public
safety department and its management hierarchy, according to the audit.
“There
was infighting among the top managers within Public Safety, and the
Director or Deputy Directors would not intervene to entice the
participants to work toward a common mission,” according to the report.
A
so-called “silo-mentality” emerged and blocked information-sharing at
all levels within the organization, including county management and the
commission, according to the audit.
The power struggle boiled
over after a helicopter crashed into the waters off North Captiva in
2009, according to the audit and former Medstar pilot Arnold McAllister.
With
the helicopter’s crash, ex-EMS chief Kim Dickerson won what McAllister
called a “personal beef” with O’Neal, who stepped down as the program’s
director.
Dickerson oversaw the grounding of helicopters for a “safety stand-down” in 2011, McAllister said.
“They basically read us the riot act,” McAllister said. “That ‘we work for them; things are going to be different out there.’”
“The perception I think she had is because Rick O’Neal didn’t like her, we were like a nest of traitors out there,” he said.
Another
problem the program faced was replacing the helicopter that crashed.
According to the audit, it was decided the county manager’s office
wouldn’t allow the program to purchase a new helicopter with the
insurance money.
Instead, officials bought a 10-year-old
helicopter for $2 million and spent an untold amount of money to upgrade
it, according to county documents.
Commissioners and county
management touted the purchase as a smart move that saved taxpayers
money in tough times, according to published reports and press releases.
But
today, three of the four companies vying to takeover Medstar for the
county won’t fly the aging air ambulance. One of those companies,
Med-Trans, noted it would be “cost prohibitive” to fly either of the
county’s helicopters, according to its offer to privatize Medstar.
A
fourth company, Keystone Med-Flight, states it will charge $1,200 an
hour to operate the helicopter – 60 percent more than the price quoted
to fly the county’s 24-year-old helicopter.
While mismanagement
and its offshoots caused Medstar’s collapse, "Ultimately the program
became dysfunctional because of federal (FAA) certification issues and
was shut down,” according to the audit.
County officials flew the
10-year-old helicopter for close to a year without meeting federal
safety mandates. They also billed for about $3.3 million in flights — an
action that violated rules and prompted a probe by the Federal Aviation
Administration that continues.
According to the audit, before
commissioners decide whether they want to reinstate Medstar or contract
a private company to step in, they should answer these questions:
•
Can Lee County Government rebuild a core competency with managers that
will achieve and maintain the necessary certifications to run an
aviation program or is the best practice to outsource the aviation
portion of the program?
• Will the primary service area be Lee County or will Medstar be expanded to a regional program?
•
Will the taxpaying citizens of Lee County be required to subsidize the
program or will patients and insurers pay for it through fees?
•
Should Medstar continue operating under the Public Safety Department or
would the service be more better run as a hospital-based service?
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