EMS discussed again, still no resolution

By Nancy Lindsey
The discussion about improving emergency medical services (EMS) at the Feb. 29 meeting of the Patrick County Board of Supervisors was much more low-key than the Feb. 8 meeting, when furious words were hurled and nothing was resolved.
The two meetings had that in common: there was also no resolution at the recent gathering of supervisors, county officials, fire and rescue volunteers and citizens from all over the county.
The problem of short-staffed rescue squads and missed or delayed emergency calls was addressed at the meeting—one of many conversations held in recent months.
About 40 people attended the meeting, but only a few people spoke during the public comment period.
Jane Fulk of the Dan River District, a member of the Ararat Rescue Squad, said if the board decides to establish a quick response vehicle (QRV) and it’s headquartered in Stuart, it would have no benefit to the western part of the county.
Paying volunteers is a better solution, Fulk said, adding that her squad pays an advanced life support (ALS) provider $40 per call, an emergency medical technician (EMT) $20 per call, and a driver $10 per call.
Fulk also suggested the possibility of combining the Ararat, Willis Gap, and Claudville (CCDF) squads, with a similar combination in the eastern areas of the county, and having an ALS person available for all the squads.
Dale Puckett of the Dan River District advised the board to “make it easier” for a rescue squad member to obtain training and certification, which he said would improve recruitment and retention of volunteers.
Ray Wells of the Smith River District, a paramedic, agreed that some solution needs to be found, and it can’t be expecting an ambulance to travel from Stuart to Ararat for an emergency call.
Wells said he recently heard a situation in which a person needing emergency medical care had to wait 51 minutes before help arrived. In the meantime, dispatchers were “toning out” squads countywide and pleading for mutual aid.
Smith River District Supervisor Crystal Harris, captain of the Smith River Rescue Squad, commended all the volunteers who attended the meeting and work hard to help their neighbors.
“We’re trying to work something out,” Harris said.
“What the answer is I still don’t know,” said Peters Creek District Supervisor Rickie Fulcher, “but ideas are being brought to the table.”
The solution must be what works best for the rescue squads and helps them take care of their patients, he said.
Fulcher said his aunt had a stroke and she lay in the local hospital for four hours waiting for transportation to Wake Forest Baptist Medical Center in Winston-Salem, N.C.
“That is not acceptable,” Fulcher said. “Once a solution is found we’ve got to support it.”
Blue Ridge District Supervisor Karl Weiss, paraphrasing a comment made at the Feb. 8 meeting, said no matter what decision the board reaches, “it’s not going to create more time” for the volunteers.
“We’re going to do something,” Weiss said. “It’s a good idea to get all the input we can get.”
He said there are several ways to fund a paid service, if that’s what the board decides to do, including soft billing (sending bills but not actually collecting from someone unable to pay) and passing a restaurant meals tax.
Existing paid services should be doing inter-facility transports and transfers, not volunteer rescue squads, Mayo River District Supervisor Lock Boyce said. When those squads are gone to Winston-Salem, N.C. or Martinsville, it leaves their area of Patrick County “unguarded,” he said.
However, Boyce said, “no patient should be denied transport to an emergency center.”
Boyce said a QRV could not do patient transfers or bill patients for services.
Volunteers are not usually inundated with emergency calls, Boyce said, noting that Ararat Rescue Squad receives an average of three a week; Vesta gets “two-point something;” CCDF gets about six per week; Smith River receives five or six; Blue Ridge gets one call every two weeks, and J.E.B. Stuart gets about 25 a week.
With those low-call numbers, paid rescue squads would be “doing a lot of TV-watching and pizza-eating,” Boyce said.
Dan River District Supervisor Roger Hayden, board chairman, said the three squads in his district do not want a paid service, and the majority want to keep an all-volunteer service. He said training and certification should be done at the individual squad buildings rather than at a central location in Stuart.
If there is a paid service, why would the volunteers want to go on calls, Hayden asked.
“Because they want to serve their communities,” said Ronald Terry, assistant chief of the Meadows of Dan Volunteer Fire Department. “If you pay me $500 in cash, it’s not going to make me answer any more calls than I do now.”
Weiss said he is in favor of a paid ambulance service that can do soft billing and supplement the work of the volunteer rescue squads.
“I want to help the volunteers, not hurt them,” Weiss said.
Harris said she pushed former emergency management coordinators to get EMT classes started and recruit young members. “Young people should already be part of the EMS system,” she said.
Harris asked Steve Allen, emergency management coordinator, how many high school students finished EMS training this year. Allen said there were two from Patrick County High School and one from Trinity Christian Academy.
Harris said she had not done 30 years of volunteer service to get paid.
“My job paid my electric bill and my volunteer work paid my soul,” she said.
Fulcher said he was not in favor of a QRV. “The focus should be to get the patient to a facility as soon as possible,” he said.
Wells said there was a fact in the Harvard Medical School article mentioned by Boyce that should be pointed out. According to the article, BLS (basic life support) ambulances were shown to be more effective in saving lives than ALS ambulances.
However, the study was done in urban or metropolitan areas (not rural like Patrick County) where the closest hospital was five minutes away, Wells said.
Weiss said he had recently met a man in Christiansburg who was being honored for serving 50 years in a rescue squad and making 44,000 documented calls.
Weiss asked the man, “how can we get volunteers who’ll stay? It’s a different world out there.”
The veteran said his squad had 30 volunteers and paid for their training, but the problem was the same as in Patrick County: not enough time.
“I asked him if he would recommend going to paid squads, and he said, ‘absolutely,” Weiss said.

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