Sub committee Named
To Compose Standards
For Ambulance Svces.
Operating In County
BY KRISTEN BUCKLES
It is still too early to tell if Greene County-Greeneville Emergency Medical Services will be able to meet all the needs of Greene County's citizens regarding non-emergency ambulance transports.
The Greene County-Greeneville Emergency Medical Services Board made this determination at Director Robert Sayne's recommendation during an earlier-than-anticipated meeting on Thursday.
The board had originally scheduled to meet in January, but Sayne called a December meeting after the County Commission, meeting in November, approved the refurbishment and addition to his fleet of two out-of-service ambulances and the necessary staff for them.
He told commissioners at that November commission meeting -- and board members on Thursday -- that he has no doubts that these additions will allow the EMS to meet the needs without other ambulance services operating in the county.
WAIT TO VOTE
While an early agenda for Thursday's meeting had scheduled the board to move forward with a vote on whether to allow other ambulance services to continue to operate, Sayne called on the board to delay this vote.
He said that EMS is working with 911 to avoid long wait times for patients needing transports and that he has already sent the two ambulances to be refurbished.
The director said he anticipated having the new hires and ambulances in place by the second week of January.
He said that "within a week, easy" of obtaining the new ambulances he will know if the county is meeting all the calls in a timely manner.
Sayne said that a vote on Thursday, however, would be "premature" until the trucks are answering calls and EMS is "sure we are able to cover the costs that we are getting."
Board members had originally called a meeting in September, voting then to prevent other ambulance services from operating in the county, after Sayne reported that these services were responding to the non-emergency transport calls that are highly-reimbursed from TennCare.
However, in October the board "backed off that," Greeneville Mayor W.T. Daniels noted Thursday, after officials received numerous phone calls from citizens reporting that EMS could not meet the need in a timely manner because of the agency's emergency response calls.
"As long as we can provide the service and guarantee that service, hey, I'm all for it," Daniels said.
"But if we can't, there's no way I can vote for the exclusive right for Greene County to provide service when there's no way we can do it."
Others agreed, and the matter quickly boiled down to the fact that many members did not have a clear understanding of the board's role.
The board, which had not met for four years prior to its September meeting, represents the public, approves and regulates the application of services, and oversees what state law deems an "essential service," County Attorney Roger Woolsey explained.
Woolsey described the board as the "sole authority to regulate transport services within Greene County."
"At this juncture I would probably advise that you be aware: private ambulances are operating," Woolsey said. "[The board] needs to regulate what is a proper fashion."
In order to do this, he said the board should determine what standards are set by the state or other applicable institutions and determine whether the board would deem these standards high enough for Greene County.
Non-emergency transports are often made between nursing homes, hospitals and dialysis centers.
Fresenius Medical Center had representatives present on Thursday, including social worker Alice LeGard, who also questioned the committee about wheelchair transports.
LeGard explained that Northeast Tennessee Transit (NET Trans) until recent months provided wheelchair-bound patients with transportation six days a week but no longer provides this service on Saturdays.
Greene County-Greeneville EMS does not provide this service, and the center had to turn to Cocke County's Life Care EMS, which provides some transport services and agreed to also provide the wheelchair transports for Saturday dialysis patients.
LeGard expressed concern that, should Life Care be banned from the county, some patients could not get to the center.
"We had patients that had no alternatives," she said. "Would citizens not want more choices? You're closing down the choices. It's hard when you don't have resources."
Greene County-Greeneville EMS does not provide this service because it is not "financially feasible," Sayne said.
The county does not have a wheelchair van and only transports stretcher-bound patients, he added.
"It's not going to hurt my feelings if they come in to pick up wheelchair patients," Sayne said. "But if they pick up stretcher patients, that's a different story."
However, Dr. G. Greg Marion, Life Care's director of business development, said that it would not be financially feasible for the company to provide one service and not the other.
Marion also told the committee that he feels the company has been vilified by the board and County Commission as "the ambulance service that was improperly coming into Greene County."
He explained that the company came only on request, met with County Mayor Alan Broyles before operating, and set contracts stating that facilities the company serves should first call Greene County-Greeneville EMS and only request Life Care if the local EMS was not able to respond.
"We came to this county because we were asked to come to this county -- because nursing homes, hospitals and individuals were not having their needs met," Marion said.
He also noted that an ambulance service from Church Hill has made what he said have been far more calls in Greene County than his service, yet it has never been objected to in the meetings.
Woolsey questioned where he could find the number of calls the Church Hill service has answered, noting that he has never seen their ambulance in Greene County.
Greene County-Greeneville EMS workers at the meeting also expressed their doubt about this service responding, saying that it may have been bringing citizens from outside the county.
911 Director Jerry Bird also said that they have not dispatched calls to this service.
However, Fresenius representatives and hospital representatives who serve on the board said that the Church Hill-based service "routinely" provides transports for them.
This discussion prompted some high emotions in the meeting, resulting in debate between attendees that ended when board member Lloyd "Hoot" Bowers called for a point of order.
"Shut them up," he said. "This is a board meeting."
The high emotions seemed to continue, however, as Bada Elliot, an EMS employee who was acting as secretary for the meeting, requested to speak and chastised the board for letting four years pass without a meeting.
She called out the elected officials on the board, saying that many of them have served for a long time and should have "stepped up and asked why" there had not been a meeting.
Elliot also asked that the members "run a call" with an EMS squad, talk to the employees and get an understanding of what they face.
Both mayors objected to these statements, however. Daniels said that officials are well aware of issues at hand and get feedback from the community often.
"All we're trying to do is make things better for this community," Daniels said.
Broyles said boards need only meet when there is an issue to discuss.
The committee concluded the meeting by voting unanimously to approve a motion by Daniel Wolcott, president and chief executive officer of Takoma Regional Hospital, to form a five-member subcommittee to compose standards for ambulance services operating in Greene County.
Many members had already called for statistical data, including Chairman and Greene County Health Department Director Shaun Street, in addition to Commissioner John Waddle and Commissioner Ted Hensley.
Wolcott will chair the subcommittee, which will also include Chuck Whitfield, president and chief executive officer of Laughlin Memorial Hospital, Greeneville Fire Department Chief Mark Foulks, Sayne and Bird.
The full committee will next meet on Thursday, Feb. 13.