"Moore Co EMS" by rdkearns | The Pilot: Southern Pines, NC

Moore Co EMS

Blog: rdkearns

January 23, 2011

I was the EMS Director in neighboring Montgomery County when Moore County EMS as we know it today was created. The two counties worked together to create paramedic programs in both counties and I saw firsthand the creation of an excellent EMS system emerge in Moore County. Certainly there were challenges that were faced as the integration unfolded with the various rescue agencies, fire departments that provided medical first response, etc. Nevertheless, all had one focus, to provide essential lifesaving response and work cohesively to that end.

While I am not as close to what we know today as Moore County EMS I have to say that many of those employees and volunteers remain committed to serving the citizens as they have for approximately 20 years now. I have worked with several counties through the years to identify places to save money but at the same time, focus limited revenue on what is essential; well trained/educated personnel and excellent equipment. Ambulance bases should be safe, not typically the most comfortable but certainly functional. As an example, if they lack adequate fire protection, those are simple decisions.

Moore County is in a unique situation with a dedicated tax levy for EMS as it should be and more counties should consider. There are two distinct costs for providing ambulance services; the response/care/transport event following a 9-1-1 call and the value of having equipment/personnel ready to respond (stand ready) when seconds count in saving lives. A tax levy is a great source for that "stand ready" cost.

I no longer know any of the commissioners but as taxpayer of Moore County, I do urge you (the honorable board of commissioners) to continue to support what I would like to think, you are proud of; a good EMS System. This study suggests the system has needs and has a dedicated fund that the citizens of Moore County voted to impose when the service was created. I’d love for you to cut my taxes if you feel that is appropriate but why not focus on the general fund and spend EMS tax revenues on the needs of the EMS system. Logically it would seem that if you have a balance in the EMS fund balance, and there are EMS needs, those funds should be spent to meet those needs.

This piece is just my personal opinion but if I ever need to dial 9-1-1 in Moore County, I’d like to think Fire, EMS, Rescue, Emergency Management, and Law Enforcement have, maybe not everything they want but certainly all they need to respond to my call. In my opinion, essential services for any government include a focus to serve its citizens, from education including a great community college, to public health and public safety and do that in a manner that is fiscally responsible. And to me, maintaining fiscal responsibility includes continued support of the EMS system and EMS fund that was voted in by the citizens of Moore County.

Respectfully,

Randy Kearns

Jon_D_Puckett 2 years, 3 months ago

Thank you Randy for a great response and thank you for being a big part of helping us get going 20 years ago. I enjoyed having you as an instructor then and credit you and Barry Britt for producing a great group of medics.

mooremedic 2 years, 3 months ago

Great opinion and thoughts from a true mentor and an outstanding EMS pioneer...it was an honor to have been trained by and employed by such an outstanding leader in EMS. I think back to those great times when you started that system and paramedic training program from scratch and feel good about seeing all that hard work pay off. As mentioned before we absolutely worked with some of the "legends" in EMS...I still see the evidence of yours and Mr. Britts hard work everyday and feel proud to have been a part of it. As a fellow taxpayer I share these sentiments exactly, thanks for sharing....

deepthought 2 years, 3 months ago

Wow! What emotion about some very real issues! But, let's consider some things that I've not seen directly addressed in this chain, which every American is going to have to face sooner than later. Namely, 1) What in the world really justifies an ambulance ride and 2) What really requires an ER visit? We have a very real culture of egocentric expectation that someone else fix our problems rather than our taking personal responsibility for our health and well being. Never let it be said that truly ill or injured patients should stoicly 'tough it out alone'. Many do, with serious or even tragic outcomes! However, the medical community is currently inundated with folks that could easily tend to their medical needs by a variety of other means other than activating 911. Ask those in the industry if this is not the case! Our government cannot continue to be successful in funding such waste, particularly with the economic pressures that we currently face. If we could cultivate more grass roots common sense treatment of illness, and wellness education in our communities (with a positive attitude) we would see less transport volume, less ER volume, and as a result, more ambulance and ER availability for the true emergencies. Might as well get started, because we cannot keep doing what we are currently doing. There is no Money Tree. What did America do during the Great Depression? During the World Wars? Pulled together. Recycled. Sacrificed. Planted Victory Gardens. Sound hokey? Stick around, Folks. There are practical things that we must "Get Real" about real quick! Spending more money is not always the right long-term solution.

rdkearns 2 years, 3 months ago

I agree that we must develop "get real" solutions to the evolving healthcare crisis. My suggestions are aimed squarely at "service issues" for Moore County EMS. It is my opinion and I believe the data would support; Moore as with many counties across the country, can correlate the growth of EMS demand to three key drivers; overall population growth, increase average age of the population (median as well but to keep it simple let’s stick with average/mean) and the demise of general health and well being of the population. Regarding population growth; unless you cap the population to what it was in the early 90’s, expecting a service generally staffed at the same level today (as it was in the early 90’s)to sufficiently meet today’s volume demands, defies logic. Regarding the aging population, that is what it is. Regarding general health, so long as people drive without seatbelts, smoke cigarettes, or have an unhealthy diet; healthcare needs and volume growth will continue unabated. Moreover, during my career as a paramedic, (more than 20 years ago) the number of patients I saw who were overweight, obese and morbidly obese was minimal. Today, the typical EMS system is purchasing specially designed stretchers, equipment and ambulances to address a very dangerous trend across the nation. Obesity can be directly attributed to declination in overall health, increased risk for stroke and heart attack, increase fall risk with injury and poses one of the greatest career ending perils for medics through just meeting the demand of moving this segment of the population. As to the abuse side of EMS, that element is there but generally reported in a disproportional relationship when compared to actual needs, and exacerbated by treat and no transport programs becoming the aim of the legal profession (because medics are human and don't always recognize every issue that could evolve into a life threatening situation). So, we generally suggest most patients go to the ER for evaluation including the patient with a kidney stone, a toothache, or the intoxicated patient; and while some may need to go to the hospital, however, most don’t have life threatening needs that will be addressed in an ambulance by a paramedic. By implementing a user fee for EMS several years ago, Moore County did somewhat impact the "free ride" mentality for those with questionable EMS needs, but that only applies to those in society who are mindful of their financial obligations. Nevertheless, the aim of my blog was directed specifically at the question regarding the EMS system in Moore County; with service levels in terms of a quantity and quality sufficient to address the needs of the citizens of the county. If there are demonstrated needs such as was demonstrated by the report, and there are funds available that were collected from the citizens of Moore County (a tax that was voted in by the citizens of Moore County) those funds should be spent for those needs. Randy Kearns

deepthought 2 years, 3 months ago

Thanks for the clarification...It is my hope that the observations were not taken as criticism of your blog, but rather to expound upon that segment of users and abusers that do indeed feel entitled to free healthcare. They do often include the morbidly obese (a truly alarming trend toward 500lb plus debility thanks to a number of factors), but also those with paper cuts, Restless leg Syndrome, toothaches, hunger, and so forth. This surely is impacting response times and system overload. Isn't there something that can be done to inform and educate the public proactively, rather than reactively? Also, another stressor for the existing system is the loss of those volunteer transport units that have had a diminishing role in the tiered response plan that we enjoyed twenty years ago. Is there some way that the volunteer element can be recaptured? Many volunteers have left the scene of battle in disgust for system abuse, and inability to peacefully coexist with the infrastructure. Those QRVs need readily available transport unit backup while the front line units stand in line at the ER waiting for beds.....Surely this isn't only about our aging and growing population.

deepthought 2 years, 3 months ago

Has interest waned in this debate? Our limited attention span will prove our undoing if spending more money is left to be the political 'easy button'.