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Tougher oversight has N.C. EMS hopping

By Peggy Lim
The News & Observer (Raleigh, North Carolina)
Copyright 2007 The News and Observer

For 15 years, helping organize an annual fundraiser was Hampton Whittington’s sole responsibility as a board member of the Benson EMS.

Now, the Smithfield lawyer must scrutinize the nonprofit’s spending, unravel thorny management issues and work out communication kinks. The learning curve has been steep for Whittington and his eight-member board.

But they’ve had to learn fast because Johnston County is demanding stepped-up oversight of EMS providers.

The county contracts with eight EMS agencies. Most of the squads, with the exception of Smithfield’s and Clayton’s, have unpaid, volunteer chiefs, said Dewayne West, county director of emergency services.

It is time for greater accountability, West said. Collectively, county money going to EMS providers has doubled in the past six to eight years, to $2.2 million, he said.

Proposed changes to an annual contract with EMS agencies, which county commissioners will review in March, include:

- A board with at least one nonmember citizen will manage the EMS agency’s affairs;

- The chief will serve only as an advisor to the board;

- The EMS agencies will provide quarterly copies of financial records and time sheets to their boards, which will meet within 30 days after the end of each quarter.

Benson’s board is working ahead of the changes because a county audit in the fall found that the agency’s cash reserves were too low. In December, some part-time employees also bristled after a switch in billing companies delayed their paychecks.

As with most rescue squads in Johnston County, the beginnings of Benson EMS were grass-roots. Wives helped their husbands with barbecue dinners to raise money.

“I really take my hat off -- for years it was nothing but volunteers spending two to three nights a week with no pay for doing it,” said Whittington, who has helped with raffles to raise about $20,000 a year.

But as the volume of calls has increased, certification requirements have gone up and volunteers have dwindled, money from the county has gradually risen. In the early 1990s, EMS agencies also began billing insurance carriers, Medicare and Medicaid.

Last year, Benson EMS received $366,000 from the county, about $300,000 from billings, and about $92,000 from other sources, including the town, memberships, fundraisers and donations.

At a board meeting last week, some EMTs raised questions about the agency’s money management. Whittington said some of the concerns, such as the lack of communication about late pay, were legitimate.

But he said: “I have seen absolutely nothing to indicate that there has been any money that has been misused for someone’s personal benefit. ... They’re certainly not bankrupt. And there has been no question ... about the quality of service being provided at Benson EMS.”

Whittington said the board is studying whether it needs to ask the county for additional money to cover mortgage payments on a substation that opened last year near Bentonville. It is also working to cut the number of employees who work overtime, he said.