If the Haywood County Commissioners fully implement a report the board commissioned on the emergency medical services program, it could end up costing plenty — if it were fully implemented.
In general, the comprehensive study provided in July recommended building more medical service bases across the county and taking steps to reduce response times.
Commission Chairman Kevin Ensley said the study was commissioned last spring after he and Commission Brandon Rogers had heard several complaints about the service. Commissioner Mark Pless, who used to work with EMS, also raised concerns, Ensley said, so the board thought it was time to examine the EMS operations.
“We were mainly looking at the structure, staffing hours and the number of staff, particularly at the top tier to make sure we weren’t top-heavy,” Ensley said. “We wanted to make sure we had adequate staff.”
The good news was that the study indicated staffing levels were mostly adequate, but the study suggested adding another administrative position to implement the assessment’s recommendations.
The study was prepared by Charoltte-based Solutions for Local Government, Inc., at a cost of $18,800.
The document states it was impressive that Haywood has already dealt with a number of issues commonly encountered in similar EMS systems, including the existence of an Advanced Life Support (ALS) paramedic-level system, having an excellent training program, funding needed EMS personnel and having a relatively up-to-date vehicle fleet.
Challenges facing the system, however, include a growing population in the county that includes mix of municipal, suburban and rural communities, as well as the location and condition of its various facilities. A concern was also raised about incident response times.
By law, counties are required to provide emergency medical services, but there is some leeway in the type and quality of services that must be available.
The bulk of the 10 recommendations made in the report focus on lowering response times, largely through locating additional EMS operation facilities across the county.
Recommendation No. 4, for instance, suggests an $18,000 to $30,000 study to examine space needs for the service; while the next three recommendations are to purchase property in Clyde, Bethel, Maggie Valley and Canton to build base facilities.
The most recent EMS facility built in Waynesville was $2.1 million.
Most of the other recommendations address response time. One is to shift the hours on Medic 7 from 7 a.m. to 7 p.m. to 10 a.m. to 10 p.m. Another is to gather data on response times around the clock for three months to determine where other adjustments are needed.
The goal, the report stated, should be to set a desired response time and make sure that goal is achieved 90 percent of the time.
Currently, 46 percent of the 10,352 calls received for emergency medical services in 2018 were responded to in 8 minutes or less; but the 90 percent response time figure for 9,316 calls was slightly more than 17 minutes.
Commissioners can establish the level of service the county intends to provide, and it was recommended the EMS peer review committee be convened to discuss and draft specific EMS ambulance response time objectives to be submitted to the commissioners for approval.
It was noted the salary level for paramedics and advanced life support personnel is below the state average, and that 33 of 48 operations personnel had salaries below $40,000. All employees received overtime pay at one and a half times the regular rate in 2018.
But considering alternative options, maintaining the current shift configurations was recommended.
Haywood County Manager Bryant Moorehead said the commissioners have long considered having an emergency services base with sleeping quarters in Clyde, which is in the county’s center.
In regard to response times, Moorehead conceded 17 minutes is high, but said considering the county’s demographics, the level would never be below 9 minutes because of the way the county is spread out.
“The good news is most of the calls are in the band in the center of county where the population is,” he said.
Still, reducing response times is important.
“If you’re the person laying on the floor, 3 minutes can seem like an eternity, he said. “The key is to look at things that make sense.”
Ensley predicted the board would look at the report as suggestions to phase in as revenue is available. Now that the county has moved into the non-emergency and convalescent transport business, there should be some funds available for improvements, he said.
There will be a special-called meeting Monday at 3:30 p.m. where the Haywood County Commissioners will discuss the report and how to proceed. The regular commissioner board meeting will follow at 5:30 p.m.