By J. Brian Ewing
News & Record
EDEN, N.C. — With seven ambulances to cover a county of 93,000 people, Rockingham County regularly has just one — or none — available for emergencies.
The cash-strapped county now faces a difficult decision: add ambulances and paramedics or create a new tax that would let volunteer rescue squads operate ambulances part time to fill the gaps.
In December and January, there were 103 instances when Rockingham was down to one or no ambulances for some period of time.
Of the county’s seven ambulances, six are outfitted for the most life-threatening emergencies.
The state requires counties to provide emergency medical services but does not set a ratio for ambulances to population. However, the widely accepted ratio among emergency services officials is one advanced-life-support ambulance per 10,000 people.
That puts Rockingham County about three ambulances short.
Last year, the county’s 911 center received 95,244 emergency calls. About a quarter of those were for EMS.
Rodney Stewart, EMS operations supervisor, said he hopes the ambulance situation is a top priority.
“We’re running out of trucks or down to one truck several times a day,” he said. “The other concern is the stress that’s causing on our people.”
Stewart noted that in trying to keep up with the call volume, EMS workers aren’t getting enough rest between calls.
Larger metropolitan areas aren’t immune to these EMS concerns either.
Guilford County EMS often goes down to one or no available ambulances, emergency services director Alan Perdue said.
“This is an issue that impacts many agencies who operate with limited resources across the state,” Perdue said.
Guilford County offsets the issue with a management system that includes computer software that can identify times and places ambulances will most likely be needed. The county has franchise agreements with rescue squads and a local ambulance service to attend to patients whose lives are not in danger. They act, too, as support when county ambulances are tied up.
Both Moses Cone Health System and High Point Regional Hospital operate their own ambulance services to carry patients to other sites within their organizations.
Despite all that, Perdue said Guilford County has reached a point where as demand grows, it will need to add resources to maintain the level of service that’s been the standard.
Nonemergency trips
In Rockingham County, ambulances aren’t always tied up on emergency calls. The vehicles are also often called upon to take patients from one place to another, such as a nursing home resident to a doctor’s appointment.
Those trips, billed to the individuals or businesses requesting service, bring in extra money that helps pay for EMS, Stewart said.
Payments for emergency and nonemergency calls aren’t itemized, so it’s unclear how much of the $3.1 million the county made in EMS collections last year came from nonemergency calls.
The county’s three volunteer rescue squads - in Madison, Eden and Reidsville - are called upon when ambulances are tied up, but the volunteer squads can’t perform advanced life support, such as administering drugs or starting intravenous therapy.
And they rely on a network of volunteers, which can lengthen response times.
Last fall, the squads asked the Rockingham County commissioners to establish a 1-cent tax increase to raise extra money for the squads.
Now, Rockingham County gives about $96,000, split evenly among the three rescue squads each year.
“We continue, as volunteers, to keep up with the call volume, keep up with the equipment and the training, all on the budget of fundraisers and we just can’t do that anymore,” said Steve Boles, assistant chief of the Madison rescue squad.
Combined, the three squads have five ambulances.
Boles estimated that with the $600,000 a year the tax could raise, the squads could pay for two responders on each of three ambulances during the busy daytime hours.
Without the money Boles said there will be cuts. Since rescue - not ambulance service - is their focus, those cuts might mean parking the ambulances.
Expert advice
Government efficiency consultant Steve Allan has spent the past three months evaluating EMS and the rescue squads.
He is expected to issue some recommendations to the Rockingham County commissioners Wednesday.
“There are a lot of well-trained and well-prepared people being asked to do a lot with very little,” Allan said.
The county has maintained its vehicles, equipment and training but doesn’t have enough of any of it to keep up with demand, Allan said.
Allan has done similar studies for more than a dozen other North Carolina counties and says the issues facing Rockingham are common.
“They’re trying to cover too much area with not enough resources,” Allan said. “They need a more sophisticated management system.”
Commissioners Chairman James Kallam says if Allan recommends adding additional ambulances and/or staff then the commissioners need to find the budget for it.
“I’m going to move forward with what he says. That’s what we hired him for,” Kallam said. “I feel like we do need to look to expand in that area. We just don’t have enough ambulance coverage across the county.”
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