By Nancy Lindsey\r\nThe Patrick County Board of Supervisors heard reports and opinions from four of the county\u2019s five volunteer rescue squads Monday night, but took no action.\r\nThree squads\u2014Ararat, Blue Ridge and CCDF\u2014were not in favor of a paid emergency medical services (EMS) system for the county. Vesta Rescue Squad said a paid service is needed to back up the volunteers, and a Smith River Rescue Squad spokesman said a private ambulance service is not the answer.\r\nJ.E.B. Rescue Squad did not send a report to the supervisors or have a representative present.\r\nMichael Fulk of the Ararat Rescue Squad said its stipend system, \u201cplus respect and encouragement of our personnel by each squad member, is our greatest strength.\r\n\u201cOur squad members treat each other and the other squads in the county with respect and gratitude for their willingness to be a volunteer,\u201d Fulk said. \u201cThe citizens of our area and any we treat through mutual aid realize right away that we are concerned for their individual welfare. They are important to us as neighbors, friends and fellow citizens, unlike a paid service which would only be a billing number.\u201d\r\nFulk said what hurts the squad\u2019s ability to reach all the citizens is primarily communication. \u201cSome calls are never heard as the radio service is so poor and text messages may get through or not.\u201d\r\nAlso, the squad needs more members, he said, adding that it is discouraging to have new members who can\u2019t get training for six months to a year or more.\r\nThe county has the opportunity to offer more training without the high cost to the squads, Fulk said. At one time, squads did not have to pay for EMT, EVOC or advanced life support (ALS) training because it was funded by the county and state, he said.\r\nThere should be more access for volunteers to acquire continuing education hours, and volunteers should not have to travel to Roanoke, Floyd, Martinsville, Richmond or Staunton to receive those hours, Fulk said.\r\nThe county should also help with restocking medical supplies, \u201ca monetary burden that should not fall to the squads,\u201d he said.\r\nAddressing the question of a paid service in Patrick County, Fulk said, \u201cDoes the board really think the citizens of Patrick County can be taxed more? And does the board actually think that the volunteers will stay once a paid squad is up and running?\r\n\u201cIt would be more feasible to pay a stipend to your volunteers, do a 20% increase in each squad\u2019s yearly money, so the squads can do more training and\/or the county needs to furnish the medical supplies and restocking,\u201d Fulk said. \u201cAlso, Patrick County does not have the call volume to provide 100% funding for a paid service. A volunteer is not going to pay for a paid service and also be a volunteer.\u201d\r\nBlue Ridge Rescue Squad member Billy Aldridge, representing both Blue Ridge and CCDF, said some people are pushing for a paid EMS system and some would like to see more help for the volunteers who have \u201ccarried the county for more than 44 years.\u201d\r\n\u201cBoth sides have good points and weak points,\u201d Aldridge said. \u201cIt all comes down to the cost. You have already raised the real estate tax rate 3 cents starting in the 2016-2017 budget year, stating it would go to the EMS system. Does this mean it only goes to a paid system or do the volunteers also get help from this tax?\u201d\r\nCurrently, each rescue squad gets about $16,000 from the county for building improvements, help with equipment or insurance on the building and units, Aldridge said. However, the insurance alone is about $8,000 a year, he said.\r\n\u201cThe squads and the volunteers have done an outstanding job with not only covering calls for years, but also keeping the doors open,\u201d Aldridge said.\r\nAldridge said he has learned that \u201csome of the volunteers feel abused and belittled by a small but very vocal group that is pushing for a paid EMS service\u201d and that while numbers of volunteers have dropped in the past eight years, the Virginia Office of Emergency Management Services (OEMS) reported that Patrick\u2019s response times were good and the agency had no problems with Patrick\u2019s squads.\r\nAldridge said he asked Steve Allen, emergency management coordinator, how many providers had showed up to be \u201cchecked off,\u201d or have their skills assessed, and Allen said less than 80 personnel.\r\nOther volunteers from fire departments and rescue squads have said they find Allen \u201chard to work with\u201d and that they feel \u201cdisrespected or talked down to or harassed,\u201d Aldridge said.\r\nA problem is that training and check-offs are only offered in Stuart, which is 27 miles from the Blue Ridge Rescue Squad, Aldridge said. Training should be done at all squads every month covering BLS and ALS skills, he said.\r\nAldridge summarized his comments, telling the board it has three choices: stay with the volunteer system and work to improve it, investing about $100,000 to pay stipends to ALS and BLS providers and drivers; start a paid EMS system with a total cost of more than $500,000, with one ambulance based in Stuart; or a combination of options 1 and 2.\r\nThe cost of a paid system will \u201ccontinue to increase every year forever as you add personnel and more ALS ambulances,\u201d Aldridge said. \u201cIn three to five years the EMS service could be your second highest department in the county budget next to the Patrick County school system.\u201d\r\nHe later added the LifeCare Medical Transports proposal for a paid service at about $262,000 a year as a fourth option.\r\n\u201cI would like to see us all pull together and help keep the volunteer system in place,\u201d said Pat Shouse of the CCDF Rescue Squad.\r\nValerie Foley, secretary of the Smith River Rescue Squad, said her squad is successful because of the strength of its on-call schedule and a lot of community support.\r\n\u201cWe bring peace of mind because people know we\u2019ll be there if we\u2019re needed,\u201d Foley said. \u201cWe have dedicated members.\u201d\r\nShe urged the board of supervisors and citizens to \u201cstop fussing at meetings.\u201d\r\n\u201cWe don\u2019t want a private ambulance service paid by the county,\u201d Foley said. \u201cSquads want to do soft billing and pay their members. Emergency situations are more complex than in the past, she said; today there are mental and drug problems. \u201cEMS is no longer load and go,\u201d she said.\r\nCrystal Webb of Vesta Rescue Squad, answering a series of questions about strengths and weaknesses, said the squad has good officers and keeps up with state rules; has well-maintained and stocked equipment and a building in very good shape; and good morale.\r\nThe squad has positive outcomes to emergencies \u201cdue to provider availability and quick response times when volunteers are available,\u201d along with \u201cassistance from Steve Allen and Lamont Bryant to assist with EMS calls when volunteer EMTs are not available or when ALS support is needed,\u201d Webb said.\r\nWhen members are available, \u201cwe get an ambulance of caring, well-trained medical providers to people who have called 911 and we get them emergency medical help at the closest hospital,\u201d Webb said.\r\nVesta\u2019s \u201cdifferentiating factors\u201d are \u201ca dedicated group of volunteers who strive to provide the best possible care by completing required continuing education courses and skills check-offs required by our Operational Medical Director (OMD),\u201d Webb said.\r\nWebb said weaknesses include a shortage of members and the fact that many of those who do volunteer work outside of Meadows of Dan or can\u2019t leave their jobs to answer calls, resulting in some lengthy response times; attempts to recruit new members through open houses or social media have been \u201cmostly unsuccessful;\u201d and the drug box exchange at Pioneer Community Hospital can take an extensive amount of time.\r\nThe squad\u2019s ability to answer calls is hindered by \u201cprovider unavailability due to providers working outside of the county,\u201d Webb said. \u201cWe have paramedics and intermediate EMTs that work in neighboring counties instead of working here in Patrick County.\u201d\r\nWhen asked what the citizens of Meadows of Dan and Vesta dislike, Webb said, \u201cthey don\u2019t like the uncertainty of EMS response time and level of care. They don\u2019t like obstructive supervisors who put their own ego and opinions ahead of the good of the county citizens.:\u201d\r\nIn response to the question, \u201cWhat should we stop doing?\u201d Webb said, \u201cstop bickering and having unproductive discussions in public meetings. It\u2019s a waste of time and it undermines the confidence of citizens.\u201d\r\nWebb also said people should \u201cstop undermining Steve Allen\u2019s ability to do his appointed job;\u201d \u201cstop disrespecting the experience and the counsel of the volunteers;\u201d and \u201cstop allowing misleading statements concerning costs to be disseminated as if it\u2019s the truth.\u201d\r\n\u201cPatrick County needs to start an objective study of what surrounding counties have done to remedy similar EMS situations and then accept and learn from their experience,\u201d Webb said. \u201cPatrick County should draft two or three viable proposals with solid financial estimates for staffing and equipment.\u201d\r\n\u201cI don\u2019t think it\u2019s fair to get into a discussion when we haven\u2019t had a chance to absorb all the comments,\u201d said Peters Creek District Supervisor Rickie Fulcher. \u201cA lot of good ideas have been presented, and everyone needs to be working as a team. We need to find a solution that\u2019s best for the people of the county.\u201d\r\nFulcher told Aldridge that the tax increase (which was 2.5 cents per $100 assessed value, not $3 per $100) was not designated for anything when the board passed it.\r\n\u201cWe\u2019ll find a solution for this,\u201d Fulcher said. \u201cWe\u2019ve got to. We don\u2019t have any choice.\u201d\r\nMayo River District Supervisor Lock Boyce said there are several options in terms of funding. A paid service as proposed by LifeCare could cost $262,000 for 12 hours a day, 365 days a year, or twice that for 24-hour coverage, he said. Providing stipends for volunteers, as he suggested\u2014$50 for an ALS provider, $40 for a BLS provider and $20 for a driver, would cost about $260,000 annually, he said.\r\nThe county should definitely pay for volunteers\u2019 training, Boyce said.\r\nHe told the audience that there had been a \u201cbig misunderstanding about soft billing\u201d and that Joey King of LifeCare had warned the board that it could be illegal because there is no way to means-test the patient.\r\n\u201cIf soft billing is illegal, then Floyd County and Carroll County and some other counties will be going to jail with us,\u201d said Blue Ridge District Supervisor Karl Weiss.\r\nDan River District Supervisor Roger Hayden said he was \u201cunder the misconception that half\u201d of the tax increase was going to EMS. He said soft billing (when patients are not charged if they have no insurance or means of paying their bills) is bringing in \u201castronomical\u201d figures and could fund a paid service.\r\n\u201cI\u2019m not in favor of a paid service,\u201d Boyce said.\r\nLater in the meeting, Boyce made a motion that the board reach a consensus to allocate the \u201c3% tax increase\u201d to EMS.\r\n\u201cThere are two people on the board who are trying to tell us how to spend it and they didn\u2019t even vote for it,\u201d Weiss said.\r\nErika Cipko said the Patrick County Fire and Rescue Association reached a consensus recently that its members would work to get the meals tax approved. The board has said it would be designated for EMS if approved.\r\n\u201cWe as fire and rescue want to work with that,\u201d she said.\r\n\u201cI need a second on my motion,\u201d Boyce said, \u201cand that includes the meals tax.\u201d\r\nAfter several attempts, and several angry exchanges between Boyce and Hayden, Boyce\u2019s motion died for lack of a second.\r\n\u201cI think it\u2019s inappropriate and not good judgment to allocate funds from the 2.5-cent increase without knowing what we\u2019re allocating it for,\u201d Fulcher said.\u201d We still have a budget deficit. There was a big increase in the school budget. We need to get a plan in place before voting on it.\u201d\r\nCounty Administrator Tom Rose said there was also a deficit in the state budget which cancels out the 2% salary increases for state employees.