Commissioners Discuss EMS Consolidation, Financing
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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