MATTHEW MARLOW FACEBOOK POSTING

As Chief of Operations for the Greenville Rescue Squad, I feel compelled to speak plainly and directly about the proposed countywide ambulance service under consideration in Greene County.

This proposal — in both design and execution — is fundamentally flawed, fiscally irresponsible, and likely to harm, rather than improve, the emergency medical services (EMS) that our residents rely upon.

Let us begin with the facts. Greene County spent tens of thousands of taxpayer dollars contracting Fitch & Associates to study the EMS system. 

Yet even members of the County Legislature and their own EMS Task Force have since distanced themselves from the study’s findings — recognizing the outdated metrics used and questioning its value.

And we should not be surprised. Consultant firms are often paid not to deliver neutral truth, but to find whatever supports the conclusions their client wishes to see.

If this expensive study is no longer trusted by those who commissioned it, the obvious question becomes: what exactly was this money spent to achieve?

Worse, the plan fails to address the most critical issue facing EMS today: workforce availability. There are simply not enough trained providers in Greene County to staff this new system.

The salaries being discussed are barely competitive with current wages and certainly offer no incentive for providers from other regions to relocate here. In fact, the likely outcome is a loss of existing personnel — a fact acknowledged publicly by Chairman Linger when he stated: “If they want to leave, let them.”

County Administrator Shaun Groden was quoted as saying, “I don’t want to be the guy having a heart attack and the medic who shows up is in their twenty-fourth hour,” emphasizing that this is not a matter of inability, but rather fatigue. 

Unfortunately, that is exactly what this proposed system is still going to deliver — because without a dramatic investment in wages and workforce development, providers will still be working those twenty-four hour shifts. 

Only now, they will be arriving in Greene County after already working full shifts in Albany, Columbia, or Ulster Counties before coming here to fill the gaps.

The unfortunate reality of EMS — especially in rural America — is that until the work is valued and compensated as a true career, not just a stop-gap service, agencies will rely on overworked providers covering multiple jobs across multiple counties just to make ends meet.

Even more concerning is that county officials have openly discussed turning to local volunteer fire departments to supplement emergency medical responders in order to make this system function.

This is neither practical nor sustainable. To be clear: of the 26 fire districts in Greene County, only seven regularly respond with emergency medical personnel — and most of those individuals already work for the very ambulance agencies now being threatened by this proposal. 

There is no untapped reserve of EMTs or paramedics waiting in the wings. The simple math is unavoidable: there are not enough EMS providers in this county to staff the system as it exists today — and this proposal does absolutely nothing to address that shortage.

Instead, it risks turning already beleaguered, understaffed volunteer fire departments into unpaid workers for the County — a burden they neither asked for nor are prepared to shoulder.

Some have also criticized the Greenville Rescue Squad for refusing to participate in the Fitch study — painting us as unwilling to be part of the solution. That narrative is both false and deeply unfair.

Our refusal to participate was rooted in protecting the privacy of our personnel, avoiding the duplication of data already available, and declining to lend credibility to a process that, from the outset, appeared designed to validate a predetermined conclusion.

In a similar vein, I want to directly address our decision to withdraw Greenville Rescue’s ambulance from countywide standby assignments. 

This was not a decision made lightly — nor was it made to obstruct cooperation. It was made to protect the residents of our district

Far too often, these standby assignments were not the result of large-scale disasters or mutual aid emergencies — they were the result of other areas failing to plan for the call volume that their towns and districts regularly generated. 

Agencies were not maintaining enough ambulances to meet their communities’ needs, and the solution was to strip coverage from other towns — including ours — to backfill their shortages.

Time and again, our ambulance was being pulled not to cover an active emergency, but to sit on standby — often 10 to 15 miles away from our response area — with no other agency moved toward Greenville to provide backfill coverage.

In essence, our residents were left without immediate EMS protection, not because their ambulance was committed to a patient, but because the county chose to remove their ambulance to cover systemic gaps elsewhere.

That is not sound EMS management. That is gambling with people’s lives.

And the most frustrating part of this entire discussion is that there are other options. For the amount of money being discussed — or even less — real solutions could be explored that support and strengthen our existing EMS system without destroying it.

Agencies could receive supplemental grants from the County to hire staff, purchase equipment, and train providers where they find it necessary based on the needs of their community. 

Partnerships could be forged between the County and regional healthcare systems — such as Albany Medical Center — to bring definitive healthcare resources into Greene County, something sorely needed since the closure of Catskill Hospital.

Additionally, New York State has recently approved innovative programs such as Treat In Place (TIP) and Transport to Alternate Destinations (TAD), allowing EMS providers to treat certain patients at home or transport them to more appropriate locations for care.

These are forward-thinking solutions that are just now becoming available and, notably, have been entirely absent from this conversation.

Consider, for example, how Ulster County — faced with a similar report from Fitch & Associates and confronting many of the same EMS challenges — has chosen a far more responsible and collaborative path forward.

Rather than demolishing their existing EMS system, Ulster County has elected to supplement the budgets of their local EMS agencies — providing critical funding for Advanced Life Support (ALS) services, equipment, and workforce development. 

They are exploring long-term solutions and evaluating what future transitions might look like, but they have wisely chosen to give their system time to develop, evolve, and advance — without risking the collapse of current services.

They have taken the better route — measured, cautious, and built on partnership — rather than attempting to shortcut the process with one ill-advised leap into an unproven system.

Meanwhile, Greene County is barreling toward implementation of this countywide ambulance system in fiscal year 2026 — with no safety net, no workforce solution, and no demonstrated plan for success.

Even more concerning is that members of the County’s own leadership have openly admitted that this system — as designed — is unlikely to meet the needs of our residents in its first year.

There has already been discussion of “scaling up” in future years, acknowledging that the initial rollout is insufficient by design.

That should alarm every resident of Greene County. What happens to the person who calls 911 during this “scaled back” first year? What happens to the family who needs an ambulance, only to find that the system designed to save them is not ready?

Let me be clear: were this plan to create a county agency that paid its providers a true living wage — a wage attractive enough to draw EMS professionals from surrounding regions — and built a system that met the needs of Greene County from day one, I would stand behind it wholeheartedly. 

More than that, a living wage would address Administrator Groden’s very concern about the medic arriving in their 24th hour. By paying EMS providers enough to make this their sole career — not one of several jobs needed to survive — they would be able to work one job, spend time with their families, and avoid the burnout that is driving so many away from this career path entirely.

But that is not the plan before us.And I want to be very clear: these concerns are not mine alone. They are shared by many throughout the EMS community — from agency leadership to the line providers who respond to 911 calls every single day.

These are the voices of the people who live this job, who understand this system, and who care deeply about the communities we serve.

Unfortunately, their concerns — our concerns — are being ignored in favor of a plan that spends more, provides less, removes local control, and gambles with the health and safety of our residents — all while hoping to “scale up” later.

To make matters worse, the Greene County Legislature does not intend to leave this decision in the hands of the towns or the people who rely on these vital services. Instead, they plan to move forward with a vote solely among the members of the County Legislature.

This is not the first time a county-run ambulance system has been considered — years ago, when this idea was last proposed, the towns across Greene County rejected it, recognizing the risks to their local services.

Now, rather than risk the same outcome, the Legislature appears intent on forcing the issue through without the consent or input of the communities most directly affected.

Decisions about our healthcare and emergency services should never be made without the voices of the people being heard.That is not leadership. That is recklessness. The people of Greene County deserve better.

I urge the Greene County Legislature — at the very least — to place this decision in the hands of those whose healthcare and emergency services are directly at stake: the residents of this County. 

Better yet, I urge them to pause this process and seriously consider alternative solutions — solutions that strengthen and support our existing EMS providers, foster collaboration, and build a sustainable future without tearing down the system we rely on today.