Commissioners discuss possibly privatizing EMS

In an effort to address concerns about the staffing of the Greene County Ambulance Service, the Greene County Board of Commissioners have decided to move forward with putting together a proposal to potentially seek a private emergency medical services firm.

Commissioners President Nathan Abrams said due to the Greene County Council’s inability to address the staffing concerns in recent meetings, the commissioners want to be proactive by having a plan in place.

At the April 2019 meeting of the Greene County Council, paramedics with the Greene County Ambulance Service went before the council to address dire staffing concerns that are leaving some of their shifts uncovered -- therefore leaving some trucks unmanned. In an effort to address the public safety concerns, with a lot of discussions, the council voted to approve the 20-year, .2 percent Correctional or Rehabilitation Facilities (CRF) Income Tax. The goal of the newly-imposed CRF tax was to take the pressure off of the Public Safety Tax enacted in January 2018. The jail bonds would be shifted to the CRF, thus allowing the county to use the Public Safety Tax for the narrow scope of public safety officials allowed by law.

In a nearly two-hour special meeting of the council on July 8 to discuss wages for county employees, no decisions were made, thus not passing the raises requested in an effort to retain and attract paramedics.

“Whether it was the inability or unwillingness of the council to do something, that puts the commissioners where we need to do something,” Abrams said.

In order to be proactive, Abrams said the commissioners will be seeking proposals from private emergency medical service companies.

“This didn’t happen on a whim,” Abrams explained, noting a lot of research has already been put in to understanding the numbers surrounding the ambulance service because in addition to the loss of staff, the Greene County Ambulance Service has lost quite a bit of money in the last few years.

Information provided by Auditor Matt Baker, upon request, showed that at the end of 2017, the Ambulance Service had a total fund balance of $528,606.53. At the end of 2018, the fund balance showed $137,146.64. As of this week, the fund has a balance of $771.

“We are not pointing blame at anyone. It’s just the nature of the healthcare system,” Abrams said.

In terms of PERF (retirement) and insurance benefits for the EMS employees, the county paid more than $700,000 -- not including salaries.

Now that the commissioners have decided to move forward with seeking proposals, the Ambulance Board will put together a list of recommendations as to what kind of service Greene County would need from a private company, then work with County Attorney Marvin Abshire to put the specifications together to seek the proposals.

“We don’t have to act on any of them. It doesn’t cost us anything to see what is out there. We are not saying the county EMS is going away or not. We just want to know what our options are. I feel like we need to know what our options are,” Abrams said.

Abrams stressed the importance of the Ambulance Board playing a big part in this process because there are many different scenarios that need to be considered.

The commissioners expect it to be a couple of months before they see the proposals, and they have already discussed some of the pros and cons of bringing in a private company.

One of the concerns about bringing a private EMS company to the county is ensuring Greene County would have proper ambulance coverage when needed. Abrams stressed the county has great ambulance employees now, but the lack of staff is a cause for concern.

“They are not able to provide the service for the county now. That’s one of our concerns about looking at a private company is making sure we get the coverage we need,” Abrams said.

Commissioner Ed Michael, who also serves on the Ambulance Board, said there have been instances where there is as little as one ambulance working to cover the entire county due to staffing issues.

“We’ve been to the point here in the recent past, where we had one ambulance active in the county on duty, and of course Linton Rescue is always on call. But, out of six ambulances, we’ve got one. There are times where we have all of them busy at one time because they are out of the county on transfers, so we had to call an ambulance from another county. It doesn’t happen often but it does happen,” Michael said.

In terms of current employee retention, Abrams said if the county were to move to a private EMS company, he would hope the company would look at the loyal employees already familiar with the county.

Abrams and Michael stressed this seeking of information is not meant to convey a lack of confidence in the current Ambulance Service employees or the Greene County Council, but is instead a means for the Board of Commissioners to continue looking into what is best for its residents.

“We can’t compete with private businesses (salary). They are a for-profit business and they have people in place that understand how to make money.”

Michael noted the Ambulance Board has been trying to operate the department like a business, but as a county entity, that effort isn’t comparable to an actual business.

But, Abrams stressed, this is just the preliminary stages as the board works to ensure the residents of Greene County have ambulance services available. There is no timeline in place to move forward. They are just seeking information about the direction they should take.

“We are looking at this now just to see what’s available. We have to start somewhere because we could be in a corner here real easy so if we have to come up with a different plan, we can. The commissioners are trying to be proactive instead of reactive,” Abrams said.