Council Resolution Tosses Decision to Hospital Systems for Joint Agreement on County EMS Operations
Two months ago, it appeared as if the Greenville County EMS operation would be turned over to the Greenville Hospital System. A deal had allegedly already been worked out with the County Administrator. The problem was that it had not been approved or even seen by Council and St. Francis did not like it at all. The deal, in their view, was stacked against their business interests. Then for the next several meetings of the Council, the Council chambers were filled with supporters of the Bon Secours St. Francis Hospital System. The hospital administrators made their case and accused the administrator of not operating above the table.
As opposition to the plan developed by the Administrator grew, Council members that were inclined to support the plan became skeptical. Finally, it was too controversial for the Council to decide and they approved a resolution drafted by Councilman Willis Meadows that asked the two hospital systems to develop a proposal for the two health systems to operate the EMS system jointly. They were given until the end of September to respond to the Council.
The text of the Resolution follows:
TO REQUEST REPRESENTATIVES OF THE GREENVILLE HOSPITAL SYSTEM AND BON SECOURS ST. FRANCIS TO MEET TO FORMULATE A PLAN FOR THE FUTURE OPERATION AND MANAGEMENT OF EMERGENCY MEDICIAL SERVICES FOR GREENVILLE COUNTY.
WHEREAS, Greenville County's foremost responsibility is to ensure the safety and health of its residents; and
WHEREAS, the mission of Greenville County’s Emergency Medical Services (“EMS”), as compassionate professionals, is to provide exceptional pre-hospital care in a timely and efficient manner to the citizens and visitors of Greenville County; and
WHEREAS, EMS is a unique public service system because it interfaces in multiple public healthcare arenas and plays a vital role not only in individual patient care, but also in the community's public safety and public health arenas; and
WHEREAS, the healthcare environment is changing and hospitals will no longer be reimbursed by fee for service, but instead hospitals' reimbursement will be based on quality of care; and
WHEREAS, the Affordable Care Act's reimbursement schedule for hospitals make EMS a vital part of being able to maximize the reimbursement for care for hospitals; and
WHEREAS, EMS' current compensation from Medicare and insurance is based on fee for service, and future EMS reimbursements may be changed; and
WHEREAS, EMS has a projected loss of five million dollars for 2016-2017 Budget Year, and any plan to change the operation and management of EMS must be based on a fiscally sound decision for Greenville County because a Mobile Integrated Health Practice (“MIHP”) will greatly reduce Greenville County EMS' income; and
WHEREAS, a MIHP will be important to both hospitals in Greenville and a successful MIHP must rely on collaboration of all providers of health services, and all providers must work together to improve access to the appropriate levels of care through the entire health continuum, otherwise population management efforts will not work; and
WHEREAS, a proposed agreement has been made to form a partnership between Greenville County and the Greenville Health System (“GHS”) for management and developing a MIHP, but GHS and Bon Secours/St. Francis (“BSSF”) have not agreed as to how to work together if a MIHP is developed.
NOW, THEREFORE, BE IT RESOLVED BY GREENVILLE COUNTY COUNCIL that Greenville County Council is asking that by September 30, 2015, GHS representatives and BSSF representatives meet together, without any County representation present, and formulate a plan as to how they can work together to develop a MIHP to improve access, outcomes and value for the citizens of Greenville County. This proposed plan should then be presented to the County so that a formal contract, which addresses several additional County issues, may be agreed upon by all parties in order to implement the plan.
BE IT FURTHER RESOLVED that in the event that either GHS or BSSF refuse to meet or are unable to find a workable plan, Greenville County will then look at alternatives to previous proposals and the current EMS operation. Any alternatives will include looking at the current management of day-to-day operations and medical oversight including the position of medical director for EMS.