By Marti Maguire
The News & Observer
PRINCETON, NC — The mostly volunteer group that has responded to mayhem in this tiny town for nearly 40 years is on the cusp of wrenching change.
Because of its own miscues, the Princeton Rescue Squad faces either demise or drastically reduced autonomy, Johnston County officials say. The county is poised to take tough action against the squad after violations such as falsifying departure times and improperly treating cardiac patients.
An advisory board decided Thursday that the squad must choose by next week among three options: pay for county paramedics until its own staff meets standards, allow the
county to provide paramedics permanently, or face being shut down entirely.
If Johnston takes over the squad’s duties, it would bring a noisy end to a group that, like many small-town rescue units across the Triangle, is politically entrenched but out of place in the changing world of emergency medical service in rapidly growing counties.
Outfits such as the Princeton squad were formed when volunteers with rudimentary first-aid training scooped up victims from mangled cars. But they’re now part of a system where nearly every 911 call demands a fully equipped and trained paramedic or EMT.
Higher standards for training and equipment save lives. But they also make it harder for rural EMS squads to stay in business.
“We’re doing a lot of good things in patient care, and it gets more and more difficult for smaller organizations with volunteers to be able to keep up with that,” said Patrick Harris, director of emergency services for Smithfield and a member of the county EMS advisory board.
Rapid growth and higher emergency medical standards have forced Triangle counties to play a bigger role in consolidating rescue services and weeding out squads that can no longer make the grade. As a result, the demise of the volunteer rescue units has rippled across the region.
In Wake County, separate squads in Wendell, Zebulon, Knightdale and Rolesville became Eastern Wake EMS. The Fuquay-Varina, Wake Forest and North Wake squads were dissolved into the county system.
In the western Triangle, the Hillsborough-based Orange County Rescue Squad was disbanded last summer by the county emergency services director, who complained of unprofessional behavior. Other county officials backed the move, saying the squad’s services were no longer needed. It was reinstated with limited duties.
In the past year, Johnston has taken over duties from what were once three local, mostly volunteer rescue squads. The county now runs EMS stations in Benson, Kenly and Micro.
The drive to provide higher-grade emergency medical service can result in a nasty fight between county officials and the chieftains of formerly all-volunteer rescue squads with tough political roots in the communities they serve, said Skip Kirkwood, head of Wake County’s EMS system.
Some squads aren’t shy about pulling political strings to ensure their survival.
“If you don’t have science, the only other choice you have is politics,” said Kirkwood, who has worked in EMS for more than 30 years in nine states.
County officials face a tough choice, said Kirkwood. They can either start from scratch, scrapping contracts with volunteer rescue units and starting an expensive countywide service or they can “deal with their history,” as Kirkwood put it, by pushing for consistency among existing rescue squads.
In the Triangle, there’s a mix of both. Johnston County now has its own rescue unit, but it also pays Princeton and five other squads to care for victims at car crashes and other emergencies, and transport them to hospitals. But Johnston hasn’t had a contract with the Princeton squad since July, when problems turned up in a review of 911 calls. The squad has since fixed some problems, but it has not met the county’s standards.
Higher standards
Johnston has no choice but to hold local EMS squads to increasingly higher standards, said Scott Blecke, county EMS division chief. A consultant’s report last year found the county, which is ultimately responsible for EMS care, held little sway over the local rescue squads it contracts to provide emergency services.
“We’ve got to be in the business,” said Blecke, adding that the stepped-up county role has riled some local squads. “Now they’re dealing with an agency that is trying to be the lead agency, and that is a foreign concept.”
Heavier demands for training and equipment may spell the end of the independent rescue squad.
“The rescue has kind of dissolved away from what it was,” said Ken Starling, chief of the Princeton Fire Department and a former EMS volunteer.
In a letter to Johnston’s EMS advisory board, county medical director Edwin Hartman said that he did not believe the Princeton squad’s leaders to be “capable of or properly disposed to guarantee the quality of medical care rendered by their employees.”
But former Princeton rescue squad chief Eddie Haddock, who resigned amid the dispute with the county, said the county keeps shifting expectations on his squad. The squad has hired a lawyer to explore its legal options, which could include a lawsuit. “Everything we’ve done, there’s something else,” Haddock said.
Adding to the chaos in Princeton is an expensive duplication at the home base it shares with the town’s fire department.
Firefighters bought a $450,000 truck used to pull victims from wrecked cars that now sits next to a similar truck owned by the rescue squad -- idled by the county after reports that the largely volunteer staff wasn’t bringing it on all calls. The county also dissolved the squad’s team of rescue divers, which it said lacked proper training records.
Haddock said the county is dismantling decades of hard work by his volunteers.
“My whole adult life, I tried to give back to my community, and I just don’t see anything I’ve done wrong for this to happen,” he said.