GCAS employees express concerns about private EMS

Last week, the Greene County Board of Commissioners voted to seek proposals from private ambulance companies, but members of the Greene County Ambulance Service (GCAS) are concerned about what privatization could mean for county residents.

GCAS Director David Doane, Field Supervisor Paramedic Amanda Harkness and EMT Angel McDermott met with the Greene County Daily World to provide insight into why ambulance employees have concerns about the discussion about potentially bringing in a private EMS company to cover Greene County.

In recent months, ambulance employees have gone before county officials to discuss concerns about employee retention. One of the reasons attributed to that loss was a discrepency in pay in comparison to other nearby ambulance services. Ambulance employees asked for a salary increase in an effort to provide incentive to keep people current employees and attract employees to fill the gaps. Though discussions have been lengthy among County Council members, there has not been an approved resolution.

At the last Board of Commissioners meeting, they decided to move forward with seeking proposals to potentially bring in a private EMS company in an effort to address staffing concerns and possibly save the county some money. Though, Commissioners President Nathan Abrams noted no proposals have to be accepted and seeking information comes at no cost to the county.

Harkness said she is concerned the request for wage increases may have been misconstrued.

“We need to attract people. It wasn’t meant to be taken as an ultimatum,” Harkness explained, noting many of the ambulance employees who have stayed in Greene County are doing so because it is home to them.

While discussing concerns about that privatization of EMS would mean for residents, Doane said one of the most common was regarding longer wait times and possibly fewer ambulances in the county.

McDermott has worked with GCAS for a few months now, but she previously worked for a private ambulance service.

In her experience, McDermott said the private industries dispatch their own calls.

“Generally when you call 911, it goes to our local dispatch at the jail. Depending on what is going on, they may be dealing with an emergent situation -- whether it’s fire or police or whatever -- it may be a minute or two delay before they can dispatch an ambulance. Hence the reason why a lot of people think it took 20 minutes for the ambulance to get there, but in reality it only took 10 minutes because we may have been dispatched at a later time than that call came in,” McDermott explained.

“When you start dealing with a private ambulance service, they may not always deal with your local dispatch service here. One service that I worked for in Vigo County, they used dispatch out of Indy. So, when a call came in, it had to go to Indianapolis dispatcher. You had not only the call coming in to the local dispatch, then it is being transferred to Indianapolis and they get around to dispatching the truck, so you have even more increased delay time.”

Though, McDermott noted, that’s not to say a private company -- if contracted through the county -- would not set up a local tie-in to the county dispatch.

Harkness relayed information from a former employee who now works for a private EMS company who said he would travel outside of the designated coverage area for transports. While they would have a truck stationed in the designated community, it would leave the area uncovered during money-making transports.

“The private companies are in it for the money,” Harkness said. “A lot of the money for an ambulance service -- regardless of if it’s privatized or a county -- comes from transfers, not so much 911s. Greene County General is our sponsored hospital, so they call us right away.”

Harkness said if a private company were brought in, there would be a concern about transferring individuals who need to go to a heart or trauma center, for example.

“When someone is having an active heart attack or active stroke or has been in a bad wreck, they need to go now and not wait an hour on those trucks to get here. Minutes count,” Harkness said.

McDermott said the trucks could be dispatched from wherever they are coming from, rather than waiting on ambulances already in the county.

“Let’s say they send one of those trucks to Mooresville to St. Francis, as soon as they are marked back in service, they are potentially available for runs in Greene County. That’s how they get around the loopholes in contracts. I am speaking from experience. I have run emergent from Indianapolis to Terre Haute to take a run there,” McDermott said. “You’re not only jeopardizing the citizens here, but you are jeopardizing those on the road with them running emergent and the crew, too.”

He explained once a private entity came into the county and potentially absorbed the current employees, and potentially forced out the old equipment, it could cost the county a lot of money to get the county service up and running again.

Harkness said she understands that the county has a limited budget and that bringing in a private entity would save money on not only salaries but retirement, health insurance and ambulance upkeep, but the bottom line should not mean taking away from patient care.

By working together as a county, Harkness said there are some free services provided to other county entities. For example, if the Greene County Jail needs a blood draw done, GCAS staff can stop by the jail and perform that task at no cost to the jail. Whereas, a private ambulance service would transport that inmate to the hospital across the county for the blood draw, during which time a jail officer or deputy would be tied up to oversee the patient, plus the transport would come at a cost.

Doane said as a county entity, they are also able to offer other services to local schools and organizations. For example, last week during 4-H Fair Week, organizers reached out to GCAS to request their presence during certain events. He said as long as there was not an emergent situation, they were at the fairgrounds on standby. They also provide a similar service for local schools during some events, free of charge, which is something a private company would not offer.

Doane added that bringing in a private entity is not something the county could just try then revert back to the old system of the county service.

“No matter what contract the commissioners would have with a private service, they could always disobey it or not follow it or not have enough trucks in the county. They can have an agreement that there will be five trucks here, but the company can go outside the county for runs. Or, the contract could say they have rules that if trucks aren’t fixed, the commissioners would get rid of them (the company) but how can you get rid of them?” Doane said.

McDermott said no contract is iron-clad, noting a situation in Morgan County in which the company came back after a year and wanted more money.

“Plus, with the county ambulance service, the quality of care is better,” McDermott said.

Doane said it’s no secret that the run volume has declined in Greene County, which means less money flowing in. Among other reasons, some nursing homes have closed their doors and residents have gone out of the county, thus reducing those transports.

The ambulance staff said there have been some misunderstandings about the staffing issues at GCAS. It was mentioned recently that there was a time frame when only one truck was staffed, but in reality, only one ambulance was available due to other calls and transfers.

Even with all of these concerns in mind, the GCAS employees said these are different scenarios that could happen, but are not definite. McDermott said even if a private company were only concerned about the money, she is sure the employees would be dedicated to their patients.

“Private companies aren’t horrible. They are people just like us, but when you’re dealing with a big company they just want to make money, but the people inside that ambulance are doing their job,” McDermott said.

They noted that another positive aspect of the county ambulance service is the residents, as taxpayers, get a say in the type of service they receive. For example, if there is an issue, a resident can reach out to the ambulance director or a county leader and the issue will most likely be addressed. Whereas with a private entity, McDermott said, “That complaint will likely fall on deaf ears.”

Doane said he is confident the Greene County Ambulance Board will make the decision that is best for the county as a whole, and he is believes in the members of the board.

Harkness said she hopes bringing in a private ambulance service is “Plan Z.”

“Let’s try 25 other things before we get to that point,” Harkness said.

One of those plans they have in mind is to redistrict the ambulance coverage areas. By shutting down one truck -- leaving four and Linton Rescue -- this would mean there are only two openings and no risk of anyone losing their job.

The Greene County Ambulance Board is set to meet Wednesday, July 24 at 9:30 a.m. in the Commissioners Room in the Greene County Courthouse.