Commissioners Discuss EMS Consolidation, Financing
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Moore County will need almost $5 million to upgrade its aging Emergency Medical Services program if the county is to follow recommendations by an advisory committee.
Public Safety Director Bryan Phillips brought the committee report to the county commissioners’ budget retreat last week. If the recommendations are followed, a proposal to drop the countywide ALS (Advanced Life Support) tax (now two cents) in the 2011-12 budget year may not be possible.
The committee findings prompted the commissioners to bring up a related subject — the recurring proposal to consolidate fire departments and EMS stations across the county, an example of which was the formation last summer of the new Cypress Pointe fire/rescue unit.
“Are we going to be pro-active or reactive?” asked Commissioner Tim Lea after pointing out that EMS base improvements might not be needed if the county decides to consolidate public safety services.
Commissioner Craig Kennedy warned that such consolidation must be approached with care because the county would be dealing with volunteers and communities that have provided their own fire and rescue facilities.
“You’ve got a lot of proud people here. In the beginning much of the land was donated. We need to nurture that,” Kennedy said.
The cause of volunteers had strong supporters in both Kennedy and Commissioner Larry Caddell.
Kennedy, whose father is the Westmoore fire chief, said volunteers help with a fire, then go home, bathe and dress to go to work, then must spend the weekend working at a barbecue fundraiser to provide equipment and supplies to make it possible for them to volunteer. Then volunteers must find time and money to take required training to remain certified.
“Most folks don’t realize that more firemen are killed in this country every year than policemen,” added Caddell.
Their comments came after Phillips reported a need for additional personnel because the supply of volunteers is dwindling.
Kennedy agreed that personnel are needed. He said that often when EMS is paged, the county asks the fire department for an ambulance driver because both paramedics are tied up attending one or more patients.
“It’s an expensive proposition to be a volunteer,” said Caddell, who pointed out that such volunteerism is expensive in all areas, including gas for their personal vehicles and the cost of replacing clothing damaged while in service.
Caddell said one of the toughest jobs anywhere is that of fire chief with the attendant responsibility of managing volunteers. His experience came through service a number of years as assistant chief in Carthage.
“You can’t manage volunteers the way you manage a paid staff. They can quit,” Caddell said.
The Emergency Services Advisory Committee’s findings call for $4,990,000 within a 10-year span, covering $3.8 million in capital improvements and $1,190,000 in salaries for 16 quick response positions and 13 other personnel for 12-hour staffing.
Phillips reminded the board that the county initiated its own EMS program in 1991 and some of the first bases are now in need of capital improvements, ranging for new flooring to furnishing upgrades. The North Moore and Union Pines bases need sprinkler systems and monitored fire alarm systems.
The need for updated equipment includes E-Series Zoll defibrillators, stretcher replacements, auto pulse, and laptop computers for the Zoll electronic patient care reporting system.
In addition, the county has problems with some base locations and with rental agreements on others. Phillips said the county pays $750 monthly rent for a building serving Crain’s Creek but the location is not ideal. The county rents the Pinehurst rescue building, but Pinehurst is dissolving its rescue squad.
If built in an appropriate place, the county could merge the EMS bases at Southern Pines and the airport.
Commissioner Tim Lea asked about a site at Sandhills Community College, but Caddell, a college trustee, said that proposal did not materialize. Caddell explained that Southern Pines wanted the college to donate the land but did not win a grant for which the town applied.
The need for locations that would better serve rural areas was mentioned along with the need to place quick response vehicles at Westmoore and Foxfire, later in Eagle Springs and Pinebluff, and eventually in Glendon and High Falls.
Phillips said the county needs to convert to 12-hour staffing, a change that would decrease risk liability and improve customer service. The county presently operates EMS on a 24-hour shift schedule.
EMS response time averages 11 to 13 minutes, and Phillips said the goal is to reduce the response time to below 12 minutes.
The committee recommended that the county maintain the Advanced Life Support tax at two cents for the 2012 fiscal year and use the fund balance to complete the needed system upgrades. The committee also recommended that the ALS tax be increased to three cents by the 2016-17 year.
County voters approved the EMS program in a referendum more than 20 years ago. The issue provided for an ALS tax, not to exceed five cents on the $100 property evaluation, to be levied on all property owners. Revenue from the tax covers operational costs as well as capital projects.
EMS taxes are supplemented by insurance payments, Medicaid reimbursements and donations, and the agency had a fund balance of $4.3 million at the beginning of the current budget year.
Although Board Chairman Nick Picerno questioned some of the revenue projections, he said the report had opened their eyes to the need for a comprehensive emergency services plan. It was Picerno who raised the possibility of cutting out the ALS tax in the coming year as a means of providing taxpayers with relief in the recessionary economy. He argued that the agency has a fund balance and can operate satisfactorily without ALS tax funds for one year.
The day and a half long retreat was held at the Senior Enrichment Center. The commissioners will use the findings to guide their budget planning process for the new fiscal year.
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Comments
Im_in_the_know 2 years, 4 months ago
Well i just think this is crazy. Of all the departments to cut from u cut money from EMS? Yea your right they dont need anymore money! Who even cares about EMS. No one! Until you need them in your time of emergency! Who wants an EMS service coming to there loved ones during a medical emergency with out dated equipment? And some of these EMS bases have furniture from 20yrs ago. Im sure none of the County Commissioners have old furniture in there offices.
I do beleive that each one of the County Commissioners should do some ride along time with the EMS service. Spend 24hrs in the life of an Paramedic! See how comfortable the furniture is, see how long it takes them to respond to a call, see how the equipment works, see how many times through out the day there are no trucks avaliable to respond to a call due to them being on another call. Its a whole different world! And after you so it from a different propective then make a vote on cutting TAXES!
mcguy1 2 years, 4 months ago
Well said!!! Standing ovation. The commissioners should take a trip into the Public Safety world and see just how things are. Some of the county citizens may think that Public Safety/EMS has some of the best up-to-date equipment that is out there. When really, its about as out-of-date as it gets. And to think that 6 24hr and 1 12hr EMS truck can supply the county of about 88,000 people the needed services, and some wonder why at times there are no trucks available. One decision that has been made that some still have not figured out is why a 12 hour truck was taken away and turned into a QRV(quick responce vehicle), staffed with one paramedic and can not transport a patient if needed. And to merge the base at Southern Pines and the Airport, why, what good will that do. Seems to me like it would leave area uncovered.
Im_in_the_know 2 years, 4 months ago
I agree!! The whole Moore County Public Safety needs to be updated! From the initial call in the 911 center(dispatchers) to the Ambulances on the street! Peoples lifes are at state! And as for the merge of the southern pines station and the airport station i do also agree that this would leave a portion of the county uncovered! I would hate to be a citizen living on Youngs Rd or in the lower portion of vass. Its a long ride from the sandhills community college area to that area especially since they took the Vass transport truck off the road and made it a QRV!
fugitiveguy 2 years, 4 months ago
Maybe we should consider privatizing EMS as they now do in Hoke County
mooremedic 2 years, 4 months ago
I know this sounds like a good idea, just give the headaches to someone else.....but, do we really want to turn over our EMS system to a private company that relies on the bottom line? I can promise you there would be many changes going on if we turned the system over, and not many of them would be for the better.
rightwingpatriot 2 years, 4 months ago
even if its privatized the county will still have to pay the private company
None 2 years, 4 months ago
All you folks worried about the coming cuts in services here in Moore County that had your heads in the sand while the commissioners were railroading us with $95,000 (each) prisoner cell-suites multiplied by 192 need to get out your calculators and do the math. There will be cuts coming that nobody is expecting once the County's Financial Magician (T. Cary McSwain) gets through. He told everybody months ago that this would not be a good budget year. If anyone took the time to investigate his rather extensive public record as Administrator responsible for Richland County, SC's Detention Center from 1994 to 2005, it would be abundantly clear why we now have such a money/services draining boondoggle going up in Carthage that will get every last dime that it could possibly need in order to be the biggest and the best for decades to come. Better yet, ask the Sheriff if the Moore County Detention Center is in line of command to him or to County Manager T. Cary McSwain. The financial suffering for everybody except the prisoners that will occupy these $95,000 suites has only just begun.
None 2 years, 4 months ago
Just wait until the schools present their budgets, but according to some who support TPo3, Poorer County is prospering? At least that’s what he said in another blog….
CSmithson 2 years, 4 months ago
Nice, especially the brilliant concept of "merging" the Southern Pines base with the airport base. Because of political shenanigans at the county level, Southern Pines, the largest town in the county went without an ambulance anywhere near its population center. Ambulances typically responded from the airport or Aberdeen. Finally, the County put an ambulance in Southern Pines.
The concept of an ambulance at the proposed SP fire dept substation near the airport/college has nothing to do with the existing need and usefulness of an ambulance in central Southern Pines. The thouhgt was that when built the station could also house the ambulance currently stationed at the airport where the County currently pays rent to itself for the privledge.
Finally, we get to this concept of cutting out the EMS tax and funding the service through reserve funds for a year. This sounds like more short sighted thinking in the form of token tax cuts that mean almost nothing in real dollars to the average MC homeowner but add up to millions at the county level which could help buy new ambulances, fire trucks, etc. or help pay for some of this stuff we keep floating bonds for. What happens when reserve funds run out? You get tax hikes! Then you have to build up some reserves again. Why not hold things fairly steady, forget the meaningless feel-good "see, I lowered your taxes, have fun with that extra three dollars a month, please remember me at election time" tax cuts and do our best to weather this storm?
Nobody wants high taxes, but almost everyone wants high quality services like our schools or fire departments. You can only cut so much before the pulbic health, safety, and welfare are at risk.
mooremedic 2 years, 4 months ago
This is absolutely spot on....couldn't have been said any better, thanks Chris.
rightwingpatriot 2 years, 4 months ago
as allways chris you da MAN! im sooo glad we have level headed commissioners in SP
None 2 years, 4 months ago
I'm sure most of the taxpayers in Poorer County have a grasp on the political agenda of Caddell and Picerno. Nothing is passed without being in their personal interest ~ more software sales perhaps?
MooreoftheSame 2 years, 4 months ago
Absolutely the best response I have seen. Your information is 100% correct. You should write for the Pilot so that our citizens are not mislead.
JoeGarrison 2 years, 4 months ago
The Cypress point consolidation worked well more like it should be done in the future. We should invest in EMS and other essential services, and I think that the commissioners all agree on that. Again I think there are some on here who are showing their sour grapes from other issues like David Francis who continues to speak out of pure conjecture and speculation which shows his irrelavance on real issues. And of course others like Chris who are the loyal opposition in all things concerning the county:) Chris, we should get together for lunch again:)
None 2 years, 4 months ago
"showing their sour grapes from other issues" Yea ~ those taxpayers who take time to investigate, locate documents, and spend countless hours in Clerk of Courts offices across the state can be refered to as not showing their appreciation for the subliminal motives of commissioners with personal agenda's for financial gain. Ask D-I-L about Mr. White who founded SS, Inc. Now we're talking "real issues"!
None 2 years, 4 months ago
Nick Picerno's name does not appear on any public records in the Secretary of State's Office relating to Southern Software, Inc until 7+ years after Mr. White sent his secretary Kenny Joe James to Raleigh to found the corporation in 1988. Even then (July, 1995), Nicolas Picerno is listed as Vice-Pres/Secretary and William White is listed as President/Treasurer of Southern Software. Inc.
Bflat 2 years, 4 months ago
Just stand by....
None 2 years, 4 months ago
Funny how when the current 5 million dollar capital fund is brought up and politics are being played to try and make themselves look good by cutting the ALS tax then EMS comes up with a plan to spend all this money?....Why haven't they been spending it all along?.....why do they have inferior equipment and housing when the money is sitting there not being used?....who's responsible for this?.....how much is the life of your loved one worth?....someone needs to get on the ball and work out the issues....and didn't they just do a public safety study a couple of years ago?...so they're gonna waste money to study something that's already been studied and not acted on?....
None 2 years, 4 months ago
Nick and Larry had to work out the logistics on how they could introduce new GPS software into EMS, since the company in Concord is now been eliminated from competition by hiring one of their principles, its game on.
rightwingpatriot 2 years, 4 months ago
@ Johnqpublic- Im not sure you know exactly what your talking about. They do spend the money. They got new ambulances, up dated the defibs and so on. The problem is maintaining the equipment. This stuff costs lots of money. Stretchers dont last for ever and get heavily used daily. The meds that are used costs$ and on top of that these medics are professionals who need to be paid.
deidretg 2 years, 4 months ago
Wow! Here comes the Marines (a figure of speech). A bunch of guys from the real world have arrived with excellent thoughts. I just hope they turn the volume on high and continue to tell it like is. There's gonna be some foot stompin' in Carthage this budget year, that's for sure and we will all be able to see that big dollar sign down the hill from the commissioners hotseats for years to come. This is going to be good.
rightwingpatriot 2 years, 4 months ago
hooah sir
NM1997 2 years, 4 months ago
In response to Mr. Garrison who stated the merger of Cypress Pointe has worked well, I don't think he has all the facts, and I believe consolidation of services has occurred but the services provided has declined. Cameron Fire Department used to respond to all of the EMS calls in the town limits, now they only respond to calls that dispatch gives a high acuity code of a Delta or Echo call. This lowers the level of care in the Cypress Pointe district, but no one seems to care.
The county EMS service needs major upgrades yes, I think we all agree on that. In response to the possible privatization of EMS, just look at the quality of care in the counties surrounding us, Hoke county asks for Moore County EMS to assist them all the time because they cannot handle their own calls, they rely on the bottom dollar and that is all, just as First Health.
In response to the needed upgrades that just magically appeared as the EMS tax might have been cut, the needs have been there for a long time, but the EMS administration was trying to phase it in slowly so as to not deplete the reserves in case of a major catastrophe that could possibly occur in a field such as Emergency Services.
rightwingpatriot 2 years, 4 months ago
it does not lower the lever of care.... Paramedics are a higher level than first responder. Vass has a paramedic unit 24 hours now instead of 12. The delta echo calls are life threatening and need immediate attention. anything lest is a priority 2 call. No need to tie up and ambulance and a fire truck on a BS call. Other than that i agree with you COMPLETELY!!!!!
oddmanout 2 years, 4 months ago
NM1997 has said it well. Even though EMS may have money in reserve it hasn't been free to spend. Public Safety is an ever changing and evolving world. Also has anyone heard how EMS has to wait on beds constantly? That has kept a lot of units out of districts and prolonged transport times. Our EMS does need a lot- it takes a lot to provide great EMS service.
used2bethere 2 years, 4 months ago
Why is Moore County afraid to go to where the problem is ? The people/person who manages the problem. If you are a business owner and you have a management system in place why does that management system get to just ask for more money when there is shortfalls and business is beginning to fail? It is the time and age of cutbacks. No more padding the clock for few select employess so they can get those few extra overtime hours. Why have a change in uniforms that are more expensive and do not stand up to the stress of the workplace ? Why not get rid of the deadwood of middle management the Moore County EMS ? Upper management of Moore County EMS has had a problem with trying to have champange tastes on beer money. There have been many expensive ventures that have been undertaken then ....NOTHING it is like being lead by a group of ADHD aflicted hummingbirds. Questions need to be asked about the leadership before anymore money needs to be thrown at an administration that is notorious for needless costly mistakes ....maybe not major money issues individually but in these tight and difficult economic times EVERY PENNY NEEDS TO BE REVIEWED. The majority of the EMS personnel that provide service to county are truly hardworking, caring, professional inidividuals and it is amazing what they do accomplish without a decent leadership in place.
johnqpublic 2 years, 4 months ago
I really hope that someones eyes are opened and the county manager and commissioners actually see the truth. Rescue squads are disbanding, being consolidated with Fire Departments or selling their ambulances and responding in cars and SUV's with the total number of ambulances being significantly lower now than in the early 90's when this ALS system was proposed. Do the QRV's the county is recommending really make sense? Who's gonna transport these people to the hospital? There is only a few rescue squads that can or will transport non emergent patients to the hospital and who can blame them? Ambulances are now having to wait for beds in the emergency room for 30 minutes to an hour on a large percentage of calls with the forecast of longer and greater frequency of hospital waits on a national level. Why does the county need a QRV in Foxfire when the current ambulance is 5 minutes away and the West End Fire Department has an EMT in Foxfire that responds to every medical call? What the county needs is MORE ambulances! They took a transport truck off the road in Vass to place a QRV in Woodlake. So now an ambulance has to come from the airport or the base at Union Pines for all calls in Vass, when those two ambulances are already busting at the seams.
Also lets find out what that ALS tax is being spent on for sure, it was voted on by the citizens of Moore County for an ALS Paramedic system and i'm not so sure that's what's happening.
deidretg 2 years, 4 months ago
"You've got a lot of proud people here. In the beginning much of the land was donated. We need to nurture that," Kennedy said. Well said, Mr. New Commissioner Kennedy.>>>>Boy, are you in for a rude awakening in this County run by 'Chairman Nick'. 'Chairman Nick' has just successfully plundered the county finances for $55.2 million in debt obligations, the majority of which is for a facility to house Larry Caddell's $350,000 of long-donated Southern Software equipment that will run the place, and he now needs desparately to find some place to cut $$$$$ and taxes in order to save face. Here is candidate Picerno's statement to the Moore County Chamber of Commerce in 2008 to the following question; "Everyday living costs for all citizens are escalating at a rapid rate. What steps will you take to balance these competing demands on County resources? ANSWER PICERNO; "First of all, we need to do a complete analysis of all spending in the county at present and make sure that we are spending each dollar for the 'needs' and not the 'wants'." What he actually did was to replace a years long Facilities Study that had already funded architectural services for a design of a new Government Center and Public Safety Facility to be placed on the County-owned Carriage Oaks property for an estimated $16,200,000 plus $1,000,000 in utilities upgrade (total $17,200,000) with what we have today, the not needed nor asked for Federal Sized Detention Center for at least $10,000,000 more and without a Government Center at all. The County's long studied needs were run over by somebody's wants. I suspect you, too, will have your share of disappointments concerning your well stated belief in what the County should do. Many of us have been completely run over by this financially irresponsible runaway train.
MooreoftheSame 2 years, 4 months ago
As I sit here and read through the commits I see that most of the people are in support of improving our EMS service. I can't help but see one person that appears to be a past employee or someone turned down for promotion. "Used3bethere" seems to have a grudge with the administration of Moore County EMS, which makes his commits worthless. As far as privatizing EMS as in Hoke County, AMR covers Hoke County and transport anywhere the patient request because they can charge more for longer transports. How would you like to know that your loved one died waiting for an ambulance because they had taken a sore foot to Chapel Hill? The county EMS serves Moore County citizens and only transports out of county if it is closer. A resident never receives a bill from EMS. The bill is covered by insurance and taxes. A private service will hound you for every dime that insurance doesn't pay. Is this what you want? The commissioners tell the directors to cut their budgets and don't spend and when a department like Public Safety ends up with surplus because of these cuts, they are penalized and looked down on. They have withheld making improvements because of their hands being tied and when they stand-up and ask for their money, people criticize them for delaying request. Please help me understand this.
None 2 years, 4 months ago
Perhaps "Usedtobethere" was an employee at some point, that doesn't diminish the fact that former employees who don't succumb to the political dogma, leave for various reasons or concerns. But keep in mind they have insider information that isn't always known to the public and as long as they are under the eye of politically influenced management, their voices are silenced. When I worked for the county in the '80's that was the case then as now. One has to guard their comments or opinions or else. Let someone with the county criticize Caddell, Picerno, or Melton and see how long they remain gainfully employed.
And why would someone receive a bill from EMS when we pay for it whether we use the services or not. The county is a business that is supported by taxpayers as well as revenue streams. Keep in mind that EMS will need more modern equipment when they move into their new offices when the Gold Bar Hilton is finished. Ever wonder what the cost will be for that move in addition to the other agencies that will occupy that building when they are in a building that is paid for.
None 2 years, 4 months ago
To Toda - Possibly you didnt understand what Mooreofthesame was saying. All of the surrounding counties pay ALS taxes also. However, they have private, contracted services such as AMR or FirstHealth that bill the tax paying patient for transport after the insurance is billed. In Moore County you as the tax payer are not billed for your transport. You also do not have to wait for an ambulance to come back from Chapel Hill or Duke because thats where the patient wanted to go. You have a good service in place that funds are constantly being cut from to save a buck here or there for the tax payer. When in fact all it does is hinder the life saving skills that are needed in the time of a crises because there couldve been better equipment or a faster response to your loved one.
None 2 years, 4 months ago
One can equate EMS with other county offices, too top heavy with political appointees. One person could manage the EMS system on one generous salary, as opposed to having too many high paid people doing none of the work...typical politics as usual.
None 2 years, 4 months ago
Toda, I stand behind my words. Usetobethre is spreading hate and lies. I too am on the inside and have firsthand knowledge of the inner workings of this system. If you do not work in it or have daily dealings with EMS or Public Safety, you have no way of knowing how much they do on so little money and community support. How about you spend your time helping rather than complaining.
None 2 years, 4 months ago
Well just found this reply and I please request clarification of your statment of lies and hate ...I have no reason to lie or hate only for my county of residence to have the best services possible. Is this not a desire for every citizen of the county ?
None 2 years, 4 months ago
Published county reports no less available to the public. And the money being transferred will be earmarked for the new digs at the Gold Bar Hilton. And much to your amazement, they will still be top heavy with generous salaries for those with titles.
I am helping to enlighten the public to the corruption in Carthage and the correlation between two unethical commissioners and their company. Complaining and sharing information as well as providing links to document assertions, is in no way complaining. Complaining is when TPo3 find out that they have spent this county into bankruptcy and we as taxpayers, must bear the brunt of their wasteful spending spree for decades to come. Ask Picerno or Caddell how much taxpayer’s money will be used to set-up the new offices in the Gold Bar Hilton, and their cut for the new computer equipment that isn't put out on state bid contracts! Should you perceive my observations as complaining, then so be it….wait until the housing market rebounds so they can reassess your property values, then let the complaining begin.
used2bethere 2 years, 4 months ago
In response to your statement "seems to have a grudge with the administration...makes his commits worthless" I need to point out that first and foremost when assumptions are made ...well I am sure your know what is said. Second the comments I made are NOT worthless. I raised very logical questions. If I had made JUDGEMENTS as you have it would have been a point that my comment was worthless but as far as I know and what I have always been told is there is no stupid questions and I WILL CONTINUE TO ASK QUESTIONS OF ANY COUNTY MANAGEMENT !!!! So please remind yourself that no comment is worthless when raised with point of inspiring thought.
None 2 years, 4 months ago
Everyone on here so far supports our EMS and other essential services and again all the commissioners support our public safety and EMS workers. The rest of the chatter is disgruntled and angry folks who have imaginary axes to grind and who find fulfillment in spreading mistruths, distortions and flat out lies.
None 2 years, 4 months ago
It isn't nice to accuse someone of lying. Isn't that what MrP did publicly in a commissioner's meeting and that was printed in the newspaper? And now, you're doing it, too.
None 2 years, 4 months ago
What imaginary axe when there are documents that support contentions that D-I-L passed over an opportunity to save the taxpayers of this county millions of dollars: September 15, 2010 Notes on Meeting with Moseley Architects and Bordeaux Construction.
"…who find fulfillment in spreading mistruths, distortions and flat out lies." Are you saying that F-I-L wasn't at that meeting and that he stated that the project for the 55.3 million dollar project was too far along to consider Moseley and Bordeaux's offer that would have saved taxpayers millions?
Then why did they have the meeting? Would you like to see the document, but that is just lies, mistruths and distortions perpetrated by county government.
Do you have documentation that supports your mantra of lies, mistruths, and distortions? Many of us would like to see those documents.
None 2 years, 4 months ago
This comment was removed by the site staff for violation of the usage agreement.
None 2 years, 4 months ago
The black helicopters may be coming to Moore County's Federal Sized JAIL soon enough, just like they do over in Harnett County.
None 2 years, 4 months ago
As you know well, Joe Garrison comes on here to support and defend his father-in-law. He has no way of dealing with the facts, and for the most part has probably never been exposed to the real truth and history of Southern Software because much of what transpired was before he married into the family. He can only infer that what is being said and supported by documentation, is just lies, eventhough those same documents are recorded public records.
deidretg 2 years, 4 months ago
That is an interesting as well as arresting quote to think about when applied to Moore County politics as we have experienced it here in recent years. Well worth thinking about, that's for sure.
localguy 2 years, 4 months ago
I would agree that Moore County EMS is in need of many upgrades. These folks cannot work the hours and schedules that they do without improvement in many facilities. I do wonder why equipment upgrades have taken so long because most services budget this along the way with a built in replacement period of 5 years. I applaud the improved response times to areas across the county. However, by placing quick response vehicles in this number, is a tight rope to walk. These vehicles are a cost to the county and the taxpayer but cannot bill for services. So now we have almost doubled the resources responding to the call for the same amount of revenue. Fiscally does not make much sense. Increasing the number of transport vehicles seems to be the wiser, and more fiscally prudent step. I applaud the work these folks do, we just need to maybe question their administrations ability to make wise fiscal decisions. A previous post states that a citizen never receives a bill from EMS. This is correct. However, their insurance is billed but because of the EMS tax it is treated as a co-pay and the citizen is not billed for the residual amount of the bill. If the tax is done away with then the citizens will receive a bill for service. So there is more at stake in doing away with the tax. Moore County is the only county in the state that still uses this type of system. Times are tough and leaders are looking for ways to cut taxes, and I understand why this could be an option. We just need to make sure they are well educated on the best avenues. Thanks for what you do.
NM1997 2 years, 4 months ago
In regards to people knocking the QRV idea, it is all about how the system is set up. A paramedic QRV is a great idea in conjunction with a BLS transport truck. So if the county put a QRV in the Foxfire area, West End F&R has a BLS truck, the north end of the county has both Robbins rescue and Highfalls F&R that have BLS transport trucks. But the Vass area does not. Vass rescue chose not to replace their ambulance when it broke down because the county gave them no economic incentive to keep it. That's a whole other discussion, but a QRV in the Vass area doesn't make sense the way the response system is currently set up. If Cypress Pointe would step up to the plate and put a BLS transport truck on the road that QRV would be worth while, but now what good is a medic getting to you sooner recognizing you are having a heart attack and not being able to get you to a cath lab any faster. TIME IS MUSCLE! When the county started the QRV program the units were in transport trucks staffed with one paramedic and still had transport capability. THAT MADE SENSE!
mooremedic 2 years, 4 months ago
Now you do have the right idea, BUT, we started the ALS system not only because of the need to have paramedic level care but also because of the VAST increase in the number of calls and the DECREASE in the numbers of volunteers that are able to take an hour or two off of work to transport these patients. I have the opinion that if we're going to spend money to pay operational costs for Rescue Squads to maintain BLS trucks and to staff them, then why don't we just spend the money on county owned and staffed trucks that are available 24/7? West End Fire Department staffs an engine at the Foxfire station with 1 or 2 firefighters that can respond in the engine to medical calls to provide BLS care until the EMS truck arrives. Now if you want the Fire Departments to "step up" and buy BLS trucks guess what taxes are going to go up then?...None of this stuff appears magically out of thin air. One thing that would really help the system is if ALL Fire Departments would provide medical first response, it's really a waste when EMT's are sitting at a Fire Department, wanting to help but aren't allowed. Now if they really want QRV's then the place to put them is in the highly populated areas with increased call volumes, then this QRV medic could respond to the greater number of calls and provide ALS care immediately. Another idea would be to place a 24 hour EMS ambulance in Vass with a QRV in Cranes Creek...
moorecitizen 2 years, 4 months ago
"have the opinion that if we're going to spend money to pay operational costs for Rescue Squads to maintain BLS trucks and to staff them, then why don't we just spend the money on county owned and staffed trucks that are available 24/7?"
The answer is simple. Because the volunteers do it cheaper. Take a look at thier budgets. 3 out of 5 calls dont require any ALS service and the volunteers with transport trucks provide coverage with response times the same or less for a fraction of the price. If you want to take this conversation to the idea of eliminating our volunteers (the ones who REALLY do it for the right reasons), you will probably have a fight on your hands that you cant handle. Give West End half the money per year you spend on an ALS crew and they will handle those 3 out of 5 calls with no problem, freeing up your trucks for true ALS calls and saving a ton of money................. but I bet you wont do it
mooremedic 2 years, 4 months ago
Okay, I don't know who you are or what part of emergency services you are involved with, BUT....I've been involved in Fire, Rescue and EMS in Moore County since 1985 and I remember how the system ran prior to EMS. I was a volunteer back when we, as volunteers, transported every patient and i'm not sure you can remember those days. Now you keep throwing out West End Fire Dept. for some reason, but what you're forgetting is that they also have had to supplement volunteers with career firemen and I don't know if they really want to take on transport duties again. They also have the duty and responsibility to fight fires, and in my opinion this should be their primary responsibility, so if you take away limited manpower to run medical calls then you have to add to the fire side of the budget, so it's a never ending cycle.
moorecitizen 2 years, 4 months ago
I used West End as an example because they were used in previous posts and I know they have a transport truck. I dont want to mix apples and oranges either. The fire service is a seperate service as defined by the general assembly and in Moore County, it has a separate funding source as well. I wont speculate as to what West End wants to do or what you say they were forced to do but my suggestion is to give departments like West End a funded option to serve that makes sense and let them decide what they want to do. Its a contract with the county, nobody is forced to sign one. I havent forgotten that paid men are supplementing the volunteers. I just think that is incorrect. The volunteers are supplements to the paid men. Our goal should always be to move toward paid staff while using volunteers to fill the gaps when needed and as long as they are willing to serve. I applaud your history in the county but it has little relevance when the issue is vision for the future. We have plenty of people who can tell us how we use to do it and how we do it now. What we need is people who know what we need to do in the future and how to get us there. They are missing from the management in the current system.
None 2 years, 4 months ago
"Moore County will need almost $5 million to upgrade its aging Emergency Medical Services program if the county is to follow recommendations by an advisory committee."
Catchy lead-in for the article...when the Grand Jury toured the present jail facilities and found only two problems: overheating computers (provided by Southern Software, Inc) and jailers marking the key assignments on the door to the cell blocks.
And whalla ~ we now have a 55.3 million dollar multi-story complex being built...what if the advisory committee found something really wrong with their current facilities in the Currie Building ~ 25 million perhaps.
emsfireman 2 years, 4 months ago
I don't understand why this county is wanting to do away with the RESCUE Squad in the county when in fact the ALS unit several time a week have NO unit available to run calls. There as some squad in the county that do run every call in the area and DO transport when ever they came. As far as Cypress Pointe there are a lot of rumors about how it has cost the County MORE money and there a problems with in the department. Yes I agree how can a PUBLIC SAFETY staff member also be a HIGH RANKING OFFICER in this department at the same time. I looks like to me everything they want they can get from the county. If you want to reduces the response time do away with the district line and send the closest unit to the call. That what we are here to do is help someone in need we should not be worried able whose area it is.
WhYnOt 2 years, 4 months ago
To emsfireman First of all I'm not exactly sure what you are trying to say due to the horrible grammar. I believe you were suggesting that the county is trying to get rid of the rescue squads. Now if you have been in this service for any amount of time and I mean longer than 2 years, you should know this is going to start a whole new argument that completely defeats the argument of upgrading EMS. If you want more ALS units and faster responses then why would you bring up "the outgoing of the rescue squads"? The Rescue squads and Fire Departments are all important to the inner workings of the ongoing response to emergency calls. No one is fighting against anyone. Most importantly it should be pointed out that we all work together for the best interest of the community. To be honest, most of us work both sides. We either work full time in Fire, Rescue, or EMS and when we go home we volunteer for a local Fire Department or Rescue Squad or both. So in turn when we are of work we are too "standing by" when the ALS units are all on calls or we are running calls ourselves. It is the life of a community servant. We all give a lot more than people who don’t have this career can ever imagine. So bringing up anything to do with someone getting rid of a department or trying to, defeats the argument of WE NEED HELP! Don’t you think? Let’s all try to be a little more positive. The truth of the matter is EMS needs to be upgraded and needs more ALS units. The county doesn’t need to take their money. Fire and Rescue also needs EMS to be upgraded so they are not on scene waiting for an ambulance with a 25 minute response time in an emergency situation. We all need to stand our ground and tell the county as taxpaying citizens and the ones who go out there and save lives we are in fact TIRED of it. Quit fighting amongst each other and go to the top! We love our jobs and thats why we continue to do them even after we leave work TODA! So for you TODA and anyone else who thinks you can imagine our lives, dont try, come live it.
moorecitizen 2 years, 4 months ago
Sending the closest unit should be a no-brainer. I disagree on the fact that you shouldnt care whos district you are in, but the districts should be drawn to reflect availability and capability, not turf wars.
deidretg 2 years, 4 months ago
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jboy 2 years, 4 months ago
Here is the issue with the current rescue squads. We have ALS units out in the county that have to go to every single call even if it is a nose bleed. But the BLS (Basic Life Support) trucks only run to the calls which are classified higher (Delta & Echo calls).
They do that because they have to make a certain percentage of their calls. So since no one shows up for the nonsense calls, they just don't run them. (You ask me, they should be dissolved and combined with fire if they want to behave that way.)
So the public is paying for the better qualified and trained staff of the ALS trucks to get tied up with calls that the BLS units could handle easily. Then all the rescue departments have to go on standby because the ALS trucks are out on calls.
This, if you ask me, is where we are wasting our tax dollars. Those BLS trucks should be going to and transporting these "broken toe" calls and leave the ALS trucks ready to run the more critical emergency calls. It makes me sick to know that the rescue squad that should respond to my residence is not effectively using the public funding which it gets.
NM1997 2 years, 4 months ago
There are 3 departments in the county that respond to ALL their calls whether they are emergency or as you call them nonsense calls. Seven Lakes EMS, West end fire & rescue and High Falls fire & rescue. These departments run all of there calls because they ARE here for the communities they serve. Also statistically 80% of all cardiac arrests are not dispatched as such, so why wouldn't you want first responders on EVERY call?
And just for your information Robbins rescue, Carthage rescue, Seven Lakes EMS, and Aberdeen fire & rescue have all transported BLS calls already this year. I don't know where you live, but sounds like you should take that up with your local department.
Also the rescue squads don't get ANY FUNDING FROM THE COUNTY to transport patients! The funding for having a transport truck was taken away by the county and the contracts that are in place don't even allow them to bill like the county does for a transport. So the departments that do transport, do it because THEY CARE about their communities!
moorecitizen 2 years, 4 months ago
Jboy you should do a little research. First of all, the squads do what the county contracts them to do. If they wanted them to go to all calls, they would put it in the contract. Secondly, several squads go to ALL CALLS even though they dont have to. Lastly, if you are too good to treat a broken toe, you are in the wrong line of work. An EMS professional has only one goal, to treat the injured and serve as a connection to definitive care when needed. Some of us have more training and more skills, but our mission is the same. Its not the job of the rescue squads to handle what you dont want.
NM1997 2 years, 4 months ago
Their contracts state they run all their calls, but they are only accountable fiscally for their delta and echo calls, which translates into that is all they are required to do, NOT what they are contracted to do!
moorecitizen 2 years, 4 months ago
If there is no accountability and no request for service, it is not considered a binder or part of the binding agreement. That sentiment is further codified by no fiscal responsibility. That easily translates to they are not contracted to do so, but simply permitted to do so. You really dont have a point here.
localguy 2 years, 4 months ago
The bottom line is the EMS folks have an important job and need the resources to do that job. There are pieces of equipment that may seem needless and expensive. Yes they are expensive and very often needed. However, is the money always being spent wisely. Probably not. EMS system design is a method of providing resources to the right people at the right time. Yes QRV's have their place, but they are a cost with no return. Depending on how the system is designed, if those first response vehicles have transport capability and a volunteer happens to arrive then yes they can transport that critical patient, but it is a what if. The EMS system started in 1991 with 5 transport ambulances and 1 QRV. By the mid 90's there were 6 transport vehicles. Our great county has grown since then and we have only 7 transport vehicles. We had 8 but they downgraded. Who goes backwards? In the article the Public Safety Director talks about average response times. Response time are important that is why systems now evaluate them to the 90th percentile (a more exact method of measurement) and no longer use averages. Averages are a thing of 10 years ago. The citizens need EMS and we need them to be at the right place at the right time. Does the Admin have the knowledge of how to make that happen, and do so in a fiscally prudent manner. Given their ideas I seriously question that. The sad thing is Mooremedic and others have great ideas, only I don't think they are in a position to make the needed decisions.
moorecitizen 2 years, 4 months ago
localguy........................ you make perfect sense. Its refreshing but only to a degree. Unfortunately "Localguy" knows more than the Public Safety Director which we citizens pay more than 100k a year for with salary and benefits.
WhYnOt 2 years, 4 months ago
Very well said Localguy. And yet again I must point out to jboy and nm1997, the arguing over BLS and ALS responses and needs defeat the purpose of asking the county not to take out taxes! Quit arguing amongst each other. 90% of us work a full time position (maybe even on those ALS trucks) and then turn around and volunteer our time on the BLS services. Yes we get up in the middle of the night on our days off too. The point of this article is Moore County has some really bad ideas with pulling funds from any emergency service, whether it be Fire, Rescue, EMS, or Police. In the time of a crisis those funds are what provided your loved one with the life saving equipment, personnel, trucks, etc in their time of need. We all work together on scenes but yet on here in the community’s eyes we sound like we have nothing but hatred for any department other than our own. Take our concerns to the top and take a stand.
moorecitizen 2 years, 4 months ago
Thank you mooremedic. The reality is the ambulances are extravagant by their very design. To put it into perspective, you should post the exact cost of adding an ALS transport truck (truck and equipment only) to fleet per the latest numbers that Director Phillips provided the ESAC committee. Then I will post 3 quotes from the top 3 vendors of ambulances in the country for 1 fully equipped per NCOEMS standards ALS truck. You will be surprised but I wont. I think you guys should have great uniforms. I just dont understand why after 70 years of EMS its so hard to find one that works? No other agencies seem to have this problem. My opinion is that management is in some kind of keep up with the Jones race that is getting out of hand. We arent Wake County and dont have Wake County funds. I dont think it's a coincidence that the software we use just so happens to require the most expensive laptop on the market to run it either. Had the proper research been done, a less expensive more efficient software could have been purchased (like most other agencies use very effectively) thereby drastically reducing both the overhead expense and the maintenance of this costly system. AND the stretcher. Did those guys really think that adding a hydrolic function to an emergency use piece of equipment for moving patients was a good idea. Isnt the number one rule for emergency equipment to keep it simple. What happens if it gets stuck in the up position and you cant load it? Also, I know its easier on your back if you dont have to lift the patient and can just touch the button, but lets look at this with both eyes open. Once you lift the patient up, the EMS worker then has to hold the stretcher off the ground anyway and wait twice as long for the wheels to come up. This doubles the time you are holding the weight of the patient and lets not forget this............ the device ADDS up to 30 pounds of weight! in fact you are lifting more weight than before!! I dont mean to argue and respect your opinion. Mine is just very different.
WhYnOt 2 years, 4 months ago
You have a very compelling argument moorecitizen. I’m inclined to listen to what you have to say. However, mooremedic also has the right idea. I believe the two of you could make better progress with the county commissioners than we have in years. However I did see that you made a comment on BLS transport. The only problem with that is each Rescue or Fire/Rescue Department would have to house a BLS unit. With that in mind they would also have to staff enough people to be able to transport a BLS call, possibly wait an hour at the hospital for a bed, and still be able to make other calls such as fires, wrecks, or other medical calls that they are paged to. That has been the biggest issue with the paid Fire/Rescue departments and transports. Because what do they do if they get a fire call and their staff is at the hospital. Yes, there are volunteers. But volunteers also have jobs during the day. I'm not arguing with you because I think it’s a GREAT idea for the Rescue squads to transport BLS. But in an ever changing field unfortunately, it’s getting phased out with the merger of Rescue Squads and Fire Departments.
moorecitizen 2 years, 4 months ago
Is it getting phased out, or does the smaller weaker voice of rescue squads get a little overshadowed by the more robust and better organized fire departments? Im not sure either. Each department is different and some departments can provide more services than others. Thats not a bad thing because each area is different and the services needed in that area different as well. It may not be the easiest thing to do, but I see no legitimate reason why we have not been able to take an accurate objective look at each area and each district and contract the services need. Some areas dont need a BLS transport truck and some do. Instead of rubber stamping a form contract, lets actually ask and pay for what we need. Reward those that perform, nurture those having trouble, and have solid contingencies for those that dont or no longer can perform. Its not easy but its not anywhere near the "impossible" description some higher ups have used in the past. It should be common practice to utilize all available assets in the most appropriate way and foster the continued development and capability of those assets but for some reason, it has not been in Moore County. Its time for a change.
Skippy 2 years, 4 months ago
That's all good and well except that state law provides for a county to have a single EMS system with a single standard of care for all the citizens of the county. Counties may not design systems that allow for pockets of "haves" and "have nots" depending on which town or crossroads you live near!
moorecitizen 2 years, 4 months ago
I believe your referring to NCOEMS State Rule, not State Law. Furthermore the rules for EMS System Plans are specifically designed to allow for flexibility and many successful "model" systems do just that. Its the inflexible system that creates the haves and have nots. If you want an example, look at Moore County right now. The Standard of Care is set by access. The System Plan allows you to achieve that access by any strategy you deem necessary. It doesnt say anywhere that one size fits all. You should read up a little before you refer to "law". By the way, I just checked the OEMS website to see if Moore County was considered a Model System by NC OEMS and guess what.................. we were a no show on that benchmark too.
Skippy 2 years, 4 months ago
Yes, hydraulic stretchers are a good idea. VERY credible research performed by competent EMS professionals has shown that their proper use reduces back injuries medic back injuries by 50%. Agencies who use them reduce their workers compensation/disability costs enough in the first year to pay for the whole fleet. The average medic back injury costs about $225,000 per the NC Association of County Commissioners Risk Management people. Every penny you spend reducing back injuries is a good idea, both economically AND for the medics in the field. It wouldn't dawn on WHINYCITIZEN that maybe the folks running Moore County EMS are working very hard to do what is best for both the citizens AND the employees, would it?
And no, the medium duty ambulances in the Moore County fleet are not extravagant. They are standard medium duty trucks like used in Orange County, Wake County, and quite a few others. They cost a bit more than the light duty trucks but last twice as long and are safer for patients and crews. Taking that shot is just looking for something to fool those who don't have insider knowledge of the ins and outs of EMS. I believe that the word is "disingenuous"? Or maybe you really don't know what you are talking about!
moorecitizen 2 years, 4 months ago
I wont really engage in the name calling although it would be fun. Feel free to mimic an adolescent child who is about to get his allowance cut by his parents and call any names you like. I wonder if Skippy is the Ken Skipper guy that Mr. Philips has trouble controlling. The VERY credible research you speak of was done by the manufacturer. The study was also done in a controlled environment with back braces on all employees and a strict lifting technique was applied. It had no real world value and isnt considered credible. It made for a nice picture in a magazine though. And if they are so great, why arent you buying more of them and why arent they sweeping the nation? You probably think "NEW COKE" was a good idea too! Your attempt to misconstrue my previous remarks with google research wont change the fact that you dont pay your people what they should be paid and we are NOT WAKE COUNTY and dont have their budget. A tank is safer for patients too. Is that what you will buy next? no-one will argue that safety isnt important and no-one has.
MooreoftheSame 2 years, 4 months ago
“If you would not be forgotten, As soon as you are dead and rotten, Either write things worth reading, Or do things worth the writing.” - Ben Franklin
I have heard great ideas and some constructive criticism in some of these previous post. There are a few, however that state that they are currently employed with Moore County and are no longer happy working for the system here and they have become the spoiled apple in the barrel. It only takes a few bad apples to ruin the rest. It is okay to voice ideas and suggest change, but the problem arises that when you bash your employer in a public forum you have crossed a line. In the military I followed all orders whether I agreed with them or not. I never called the local paper and disclosed my hate for my CO or what I thought about his intelligence. I never openly discussed what I thought about our Commander and Chief even when I hated his policies.
Stop writing what is not worthy of words and start doing things worthy of reporting.
mooremedic 2 years, 4 months ago
Thank you for serving out country Mooreofthesame...please elaborate on your service career, i'm sure we're all interested to hear about it....
None 2 years, 4 months ago
Perhaps if one would take time to review the salaries of those who have titles, one could see where the budget is being spent ~ and not on those who actually provide direct medical care to those in need....
MooreoftheSame 2 years, 4 months ago
Well, is everyone completely dizzy from going round and round. From the beginning to the end and back again, it all comes down to how to best spend the reserve funds or cut out the tax for a year and survive on the reserve funds. Uniforms have to be bought every year no matter what style is chosen. What does it matter, the people voted on the change and got what they asked for for "morale's sake". It will never matter what stretcher is bought as long as the general public continues to pack on the pounds. We will always need transportation and whether is is a ambulance or a QRV it will be costly because it will be stocked with equipment that cost nearly as much as the vehicle itself. Management will always be the bad guy no matter who is put in control. And yes, EMS people will always be whinny little kids. Of all the public safety fields, they are the youngest at a mere 40 or so years. They still have a lot of growing to do. And I agree with "Skippy", we owe the citizens an apology for shaking their faith in EMS with our commits on this blog.
moorecitizen 2 years, 4 months ago
The faith was shaken by the actions of "Skippy", not the blog. Sorry MooreoftheSame, I just dont subscribe to the lackadaisical attitude of "it is what it is." Most of the problems on this block are trivial when dissected or examined individually, but they add up to large potential or current problems. Who knows whats going on that the bloggers havent blogged about. We just want to make sure somebody is minding the shop here. How much overspending is acceptable in this economy? How low does morale need to go before its not simply blamed on the individual but their is ownership from management? The citizens need to know about these problems so they can bring them to their commissioners attention to ensure proper oversight. I also want to say that i dont believe any comment on this entire blog was intended to diminish the quality of care given by the staff of our EMS system. As a whole, they are dedicated professional people and provide the absolute best service they can with what they have to work with. That was never an issue but Skippy would certainly rather try and halt these conversations by diverting the real issues which seem to revolve around himself and upper management. We need reassurance on these issues and we need it validated by someone other than the people in question.
JustWondering 2 years, 4 months ago
Ok, Moreoftheame, you speak in the begining of others spreading hate and lies. I can't help but wonder after reading all of your post, how big of a hypocrite you really are???? One moment your putting someone else down for their grammar, then you turn around and apologize for everyone, then you put down your peers by calling them whinny little kids...I dont think your parents would approve of your MORALS now... You have taken every oppirtunity to put others down, you should apologize to the citizens and your peers..... Furthermore you talk of people getting online and bashing their employer, in your few post you have completly demoralized a whole service... And to think people like you and "skippy" say morale is great and its a personal problem if its not... You should be ashamed!!!! So who is spreading hate now????
None 2 years, 4 months ago
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TChristopher 2 years, 4 months ago
I personally thought this article was a win for Moore County EMS with EMS not losing their 2% tax this year. That to me was a wonderful thing and a huge step in the right direction for the county commissioners. My hope for the future was to see more taxes come for the needs of the EMS budget instead of more tax cuts. I too am a very PROUD Paramedic, whose not scared to say who I am, and I love my job. I also volunteer on a fire/rescue department and can’t understand for the life of me why this article has turned into such a huge argument amongst our own people. Of course there are things to be changed, there always are. But a win is a win. So lets be happy for that.
johnqpublic 2 years, 4 months ago
hmmmm, did you read the same article we read?....just to let you know nothing has been approved, neither to keep the tax, cut the tax a half cent or to cut it out completely....
TChristopher 2 years, 4 months ago
"The committee recommended that the county maintain the Advanced Life Support tax at two cents for the 2012 fiscal year and use the fund balance to complete the needed system upgrades. The committee also recommended that the ALS tax be increased to three cents by the 2016-17 year."
To me thats better than a recommendation to cut the taxes. So johnqpublic, since you've had so much to say on here why not come forward with who you actually are?
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Moore Co EMS by rdkearns 2 years, 3 months ago