County Council has responsibility of due diligence before handing over EMS to GHS

Published on Monday, August 31, 2015

Should Greenville County transfer its award-winning ambulance service and EMS Department to The Greenville Health System (GHS) by creating something called a “Mobile Integrated Healthcare Practice (MIHP)?” To save money, the Greenville County Council is currently considering making just such a change on Oct. 1.

Greenville EMS has been operating at a loss for years. Consequently, the county has been looking for ways to reduce the cost of providing ambulance service to the community. Some believe a big part of the solution may simply be improving the process the county uses to seek reimbursement from insurance companies, Medicare, Medicaid, and “out-of-network” patients.

Nevertheless, last year, GHS proposed a plan to take over and operate the ambulance service. Under that plan, the county will relinquish control of its entire EMS Department.

There are several troubling aspects in the details of this 64-page proposal. Unfortunately some members of County Council seem to be willing to accept these shortcomings without any further due diligence. Obviously, that’s irresponsible.

Here are just a few examples:

• There is a high probability that patient choice will suffer, because this agreement creates a “monopoly” for GHS. It makes no provision for the County’s other large healthcare provider – Bon Secours St. Francis Health System – to participate in the MIHP.

• The proposal provides no mechanism for direct citizen input via the County Council, because EMS will no longer be a part of Greenville County administrative responsibilities.

• The broken promises of Obamacare are likely to trigger patient “trepidations” with this new arrangement, because it creates a monopolized EMS system controlled by a very large public healthcare delivery system – GHS.

• The proposed cost-savings estimates are unverified. Therefore, they may be exaggerated.

• The county is obligated to subsidize GHS $1.5 million annually for “operating support.” This amount automatically increases by $50,000 annually after just two years.

• All EMS assets, equipment, supplies, facilities, and employees will transfer to GHS without any compensation to the county. These things have intrinsic value, perhaps as much as $2 million.

• The county must replace all 22 ambulances currently in-service with new ambulances during the first four years of the agreement. This alone will likely cost more than $2 million.

The county must provide dispatch services to GHS free of charge.

• If GHS’ costs for providing ambulance services to the county exceed expectations, they have the option to renegotiate their annual subsidy.

• At termination, GHS is only required to return the ambulance fleet to Greenville County. There is no provision for an orderly transition of the EMS services back to the county.

• GHS could “steer’ patients to its own hospitals, and away from other providers like Bon Secours St. Francis

In conclusion, 911 operators must handle emergency calls with utmost care to insure a prompt and proper response to the needs of the patient. This should be the paramount concern of Greenville County Council. 

A MIHP may be a worthwhile, and less expensive, alternative to the current system. However, because the current system is so highly acclaimed and because it is recognized by its peers for service excellence and superior response times, County Council must take the time to find out if this proposal actually provides “value-added” before making any changes.

To do otherwise would be a serious dereliction of their duties to the citizens of Greenville County.

Ron Tamaccio

Resident of Greenville County

Ron Tamaccio is a retired professional airline pilot and senior military officer. After leaving those professions, he worked with the USDOT as a Regional Administrative Officer in Atlanta. He lives in Greenville with his wife, Patricia.





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