BETTER THAN HEARSAY - All Hands on Deck…Or Maybe Not

By Michael Ryan

CATSKILL - Potentially throwing a wrench in the gears, two agencies did not cooperate with an independent consultant’s months-long effort to assess emergency medical services throughout Greene County.

The nonpartisan study, financed by the county legislature to the tune of $100,000, is aimed at providing a wide-angle lens view of existing ambulance staffing, operations and costs.

Lawmakers opted to back the report following an ardent appeal from government leaders in mountaintop towns to address longstanding struggles within area ambulance response and transport.

While it is hoped something constructive will arise from the report, prepared by Fitch & Associates, a previous attempt fell by the wayside.

(Please see related story in our “Legislature Stuff” column, this week, detailing the consultant’s observations, findings, etc.).

Four options to the existing system were offered by Fitch & Associates who first explained the Methodology used in performing their task.

While their work was based in objectivity, they plainly pointed out what has been a nagging problem over the years in terms of resistance by agencies to get on the same page, possibly blocking any real progress.

“Emergency Medical Services are organized disparately in Greene County, with each town and village having to either provide or contract for service,” the report states.

“The system comprises ten agencies that provide emergency services for the county. [They] all work independently of each other, carrying their overhead expenses and direct labor costs.

“Fitch collected data using multiple resources and methods to analyze historical call volume, organizational data, and other information provided by agencies serving Greene County,” the report states.

“Consultants worked to obtain data to complete the Information Data Request from each EMS agency.

“Not all EMS agencies participated in a timely fashion, which caused a delay in the receipt, review, and analysis of data.

“It should be noted that Greenville Rescue Squad and Durham Ambulance

refused to complete the Information Data Request as requested. Many responses to Fitch’s Information Data Request were incomplete.”

Those shortcomings “caused a significant delay in the project and resulted in the data report being significantly delayed,” the report states, potentially inhibiting the county’s ability to make a fully informed decision.

“The primary objective is to ensure that geographical deployment and demand are staffed appropriately with the correct level of resources,” the consultants wrote, noting in their Findings section:

—“The EMS agencies within the county must begin to understand their costs for service to include net revenue per transport.

“Understanding how to calculate UHU and how to apply that is equally imperative. All EMS agencies should have equal formulas for obtaining and requesting subsidies from their municipalities.

“Without Greene County subsidizing the system through providing for dispatch and ALS fly car service, many of the agencies would collapse.

“With county funds being used to support the system, all agencies should be required to submit their annual finances to the county to maintain transparency on the use of taxpayer dollars.”

There has been much talk and speculation that a countywide system should be created, eliminating redundancies in terms of staffing and equipment, although nothing is close to being set in stone.

The consultants have included a list of four recommended options to the county in their Pathway Forward section of the report as follows:

—Option Zero…support the status quo through immediate no-cost and low-cost improvements and process changes.

—Option One…stronger system coordination. In this option, Greene County would take steps to increase and strengthen overall system coordination.

—Option Two…establish a Single Provider System with coordinated districts. This proposed strategy outlines a significant improvement opportunity considering geographical constraints and local expectations.

It involves the establishment of separate EMS districts under a unified EMS agency that would oversee operations. This approach promotes system-wide improvement with increased levels of coordination while providing system support through a single provider.

—Option Three…establish a single provider unified county system. Ultimately, a single-provider system offers the most affordable and efficient option to maintain acceptable system performance with the least tax burden.

In their “Conclusion,” the consultants write, “Greene County officials recognize that establishing reliable emergency medical services across

the county is vital for public safety and welfare and to support future economic development.

“Officials have had the foresight to recognize the need to evolve due to the current financial pressures all emergency services face across the Country.

“The options recommended provide the County with the strategic ability to decide the level of commitment needed from the County, local officials and the current EMS agencies.

“Ultimately, the county and the local municipalities must determine what they can afford to ensure an equitable response and baseline level of service for the provision of EMS in the future,” the report states.