Comm. Is Divided
On Outside Firm
BY KRISTEN BUCKLES
Greene County-Greeneville Emergency Medical Services (EMS) will receive $285,000 from the county's savings to increase the ambulance fleet in an effort to strengthen the agency's position in an ongoing battle for revenue.
The Greene County Commission on Monday approved the transfer of funds from the county's undesignated fund balance to the EMS.
Of the total provided, $160,000 would be for the one-time cost to remount refurbished ambulance compartments onto new, 2014 trucks. Another $28,000 would cover the one-time cost of two hydraulic cots.
The additions would bring the ambulance fleet up from six trucks and two backups.
EMS Director Robert Sayne estimated that the ambulances would be in operation five days a week, 12 hours per day, for six months of this fiscal year. Staffing the ambulances would require four employees, accounting for the remainder of the cost.
Sayne assured commissioners repeatedly that EMS would bring in enough revenues through the use of the two additional ambulances to return the $285,000 to the fund balance by the end of this fiscal year on June 30, 2014.
Providing the extra ambulances will allow the county to better serve citizens and answer transport calls in a more timely manner, according to Sayne.
Transport calls (as distinct from emergency calls) include those to take patients from nursing homes to hospitals, from one hospital to another, or from nursing homes or private homes to dialysis treatments.
At the heart of the matter is that these transport calls, according to Sayne, are the most profitable and pose the least liability. However, the ambulance service has been so busy with emergency calls that the wait time for transports has lengthened.
In response, other emergency transport services have entered the county and are making these profitable transports, Sayne said.
This loss of potential revenue has prompted study by the Greene County-Greeneville Emergency Medical Services Board.
In September, the board voted to block other services from operating in Greene County, but the board has indicated a willingness to further study the issue.
According to County Attorney Roger Woolsey, any emergency transport service that operates in the county must have legal authorization from the board in order to do so.
He said that, to his knowledge, the Greene County-Greeneville EMS is the only service that has such an authorization.
In addition, he said the board may prohibit any other service from operating inside the county.
State law grants such authority to the County Commission, he explained.
However, in 1988, the County Commission passed a resolution shifting these responsibilities to the EMS Board.
Commissioner Jimmy Sams called for the commission to renew this 25-year-old resolution in December.
Commissioners had a lengthy discussion of whether or not outside emergency agencies should be able to operate in Greene County.
During that discussion, Commissioner Ted Hensley outlined his opinion on why outside agencies should be able to operate in the county.
Hensley called a meeting on Monday of the Long-Range Planning Committee, which he chairs, saying that Monday's County Commission meeting was not sufficient time to study the need for two more ambulances.
He called for the committee to take up the issue.
However, fellow members and commissioners objected, saying that they would receive more details in the meetings that were scheduled to immediately follow the Long-Range Committee's meeting -- the Commission's Caucus meeting and the County Commission meeting itself.
Lengthy discussion of the issue during the committee meeting repeated during the caucus session and into the commission meeting.
Hensley called for a detailed study of the county's EMS service, saying that government should be limited to only those services the private sector cannot provide.
He expressed concern that federal dollars may not be available in the near future and that the EMS board had not met for three years prior to other services' beginning their operation inside the county.
"No decision like this needs to be made unless there is 100 percent understanding," he said.
During the commission meeting, Commissioner Bill Dabbs provided commissioners with a copy of a petition containing about 170 signatures from Greene Countians saying that they wanted Cocke County-based Life Care EMS to be able to operate in Greene County.
Dabbs said he has also discussed the issue with area hospital officials, who, he said, advised him that it would be best to study the matter and consider allowing others to operate.
"If we close this door tonight, it means we're not going to listen to the will of the people," he said. "Greene County is a closed county. We want nothing in. This is a prime example of this right now."
Commissioner Lloyd "Hoot" Bowers disagreed.
Bowers, a member of the EMS Board, said that there are administrators of both hospitals on the board, and reminded commissioners that the board has voted against allowing other services to operate in the county.
Further, Woolsey reminded commissioners that the resolution before them on Monday did not address the issue of allowing or disallowing other services from operating in the county.
County Mayor Alan Broyles, who supported the ambulance proposal presented by Sayne, said it is necessary to provide the services to the citizens and that waiting for the EMS Board to make any further determination would not be beneficial.
Commissioner John Waddle noted that EMS is the one county department that turns back enough revenue to cover the vast majority of its own expenses every year.
In last year's $3 million EMS budget, the county only paid $130,000, he said.
Commissioner Robin Quillen also supported the proposal.
"Do I want to be responsible for one ambulance service, or do I want to be responsible for more than one?" Quillen said "I can tell you, one would be enough for me."
The commission voted 16-4 to approve the ambulance purchase.
Commissioners Hensley, Anthony Sauceman, Dabbs and David Crum were opposed.
Commissioner Rennie Hopson abstained.