4 goals to upgrade EMS
It wasn't on the agenda and it wasn't announced in advance, but Laurens County Council on Tuesday met as a committee of the whole to discuss potential upgrades to the Laurens County Emergency Medical Service. The committee agenda was placed on a podium in council chambers, and the committee meeting was scheduled to start at 6:30 pm. It started at 7:30 pm, after council spent an hour in closed session discussing the to-be-vacated-at-the-end-of-May position of county administrator. County staff was instructed to start setting up interviews with finalists, but council did not announce how many finalists there are. The EMS discussion lasted about an hour, in a meeting that stretched on more than 3 hours.
At its last meeting, Council Chairman Joe Wood ruled a speaker who questioned EMS response time to a call on I-26, James Hayes, out of order and told him to sit down. "Our EMS is not broken," Wood said at Tuesday's meeting. "It just needs some infusion of funds. We do not have citizens calling to complain about EMS. We have built an operation and had great success for 25 years. We have a private service provider agreement now. We have one private provider who, according to his own website, does not trust the county, says there are some unethical people in county government, says the lowest percentage of his patients comes from Laurens County. He says he will not let Laurens County Council tell him what to do, and he doesn't like the hospital. I think Greenville Health System (which operates Laurens County Memorial Hospital) is doing a great job.
"I have to question what (the private service) is doing here. They are here for the almighty dollar. ... Laurens County EMS is not a service to make money."
Council Vice-Chairman Keith Tollison said the council should focus on and prioritize 4 goals for EMS: 1. meeting the increasing number of calls; 2. lowering response times (11 minutes, 41 seconds average for Laurens County, 8 minutes national average); 3. bettering the retention of employees; 4. replenishing the aging fleet of ambulances. Council member Dr. David Pitts said the council has to balance improving EMS with fiscal reality - auditied figures presented Tuesday night show Laurens County is decreasing its fund balance (reserves) by $1 million a year, $5.1 million unrestricted for FY14-15, $1.8 million less than the year before. Council agreed there is virtually no way to cut $1 million in services to the taxpayers, and a very limited number of ways to raise new revenue. One way council has explored, and turned down, is a $20 per property fee with the money designated for EMS.
EMS Director Chad Burrell said the service can save money in the long run by participating in Emergency Medical Dispatch partnering with GHS Laurens County Memorial Hospital. Dispatchers would receive special training and computer software to triage calls to 911 based on the extent of a medical emergency (heart attacks are top priority, sprained ankles are lower priority). Dispatchers determine if a fully equipped ambulance or, instead, a transport ambulance or quick response vehicle is needed. A nurse would be available for consultations.
Burrell said the county could increase its per mile rate for transports (7,555 provided in 2015), enact a non-residence rate increase, and/or use collection tactics to recoup some of the $1.76 million in write-offs for people who won't pay their ambulance bills.
The total EMS budget is $3,389,328 - 58% of that is paid for by billable services, a projected $1,957,817 for FY 16. The Patient Payer Mix is 62% Medicare/Medicaid, 11% private insurance and 27% uninsured and private pay. The service's collection rate is 2.9% and it does not use aggressive collection tactics. The remaining 42% of the EMS budget is paid by taxes - a levy of 7.2 mills, projected for FY16 to bring in $1,400,051.
Council did not set a date for continuing its discussion of the Laurens County EMS. County Administrator Ernie Segars, who will retire in May, said council has discussed EMS upgrades for 2 years now, and it's time to decide and do "the right thing." Continued discussions, Segars said, would "cause stress" for the county staff.