TVH Blog

Teton Valley Health's blog

Change at what cost?

Keith Gnagey

Keith Gnagey, TVHC CEO

It’s interesting when you read about a situation you think you know well and see it presented in a way that is quite different from your viewpoint. Such were my thoughts in reading County Commissioner Leake’s op-ed in the April 28 edition of the Teton Valley News. I’ve been focused on how the current hospital/fire team can deliver ambulance service and how we can make that better. We’re doing that today in the second year of our third consecutive five-year contract. We believe that our approach is delivering high quality ambulance service to the community.

Commissioner Leake is leading the charge to examine what changes should be made regarding how the county provides ambulance service. At TVHC, we are not opposed to change; we embrace reviewing existing programs and identifying areas in need of improvement. However, we are concerned about the direction of change and the potential abruptness of the ambulance change. Our doctors have stated that the current system is better for overall community health and safety than the systems proposed by the Teton County Fire Protection District. As an organization, we have stated that the proposed change would diminish the quality of care that we currently have and that it would hurt the hospital now and in the future. Nationally, EMS services are becoming more and more clinical; transferring services from the hospital to fire goes against that trend. And the varying cost projections in the numerous fire proposals lead us to question whether the cost to taxpayers would in fact be any less than it is now.

The fire proposals are not joint fire/hospital team proposals; they are proposals for fire to run most or all of the ambulance service. They were not developed by the fire district working with the hospital, as was our current contract. None of TCFPD’s proposals include the quality measures the hospital has put into place to track and improve on the service we provide. The proposals also omit hospital EMS training that we feel is critical.

Making the changes proposed by fire would be risky; the county commissioners would be betting on unproven costs, unproven staffing plans, unproven training and quality processes, and unknown governance issues.

At TVHC, we don’t believe these changes are necessary or financially responsible. There are no spending shortfalls; we operate within the agreed-upon budget. We should make the current fire/hospital team better, not eliminate it. In the end, however, it is the citizens of Teton Valley who need to make that call for themselves, and then to express their opinions to their elected County Commissioners. I would encourage you to consider: If someone proposed they could save you and your family money, and then quoted three different prices to do that work, would you then give them a blank check?

The BOCC (acting as the ASD) will meet Monday, May 9 to discuss the future of ambulance services in Teton Valley. Let your voice be heard. Contact your county commissioners and let them know where you stand on the delivery of critical emergency services in the valley. You can find phone and email information (as well as meeting information) at the county website, As always, you can find up-to-date information on EMS services in Teton Valley at


This article appeared as an editorial in the May 5, 2016 edition of the Teton Valley News.

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