An aging Baby Boomer population and the opioid epidemic are putting extra strain on emergency services, leading the local EMS head to ask for additional crew members.
John Shelton, emergency services director, told the county commissioners recently that there is enough ambulance traffic to warrant adding another medic team.
It has gotten to the point that the county can’t manage shifts without seven trucks running all the time, he told the Board of Commissioners at a workshop to discuss budget needs.
In fiscal year 2016-17, Shelton pointed out, “County rescue squads were placed on standby for EMS 119 times because all ambulance units were out of service.”
This doesn’t fully tell the story of how thin the EMS has been, he added, as in that same year “there are well over another 300 times where only two units were covering the entire 583 square miles of response area.”
In 2015, he reminded the commissioners (two of whom weren’t on the board at the time) that the EMS established two quick-response units in Shoals and Beulah at the request of residents of those communities. This was to reduce the lengthy response time that could result from traveling to the southeast or far-west limits of the county.
Also, according to a letter from Shelton to county officials from October, the Westfield community is seeking a quick-response unit for the coming fiscal year.
“The personnel to man the units were taken from an existing ambulance crew on each shift,” Shelton said. He wanted to figure out if his department could manage this without creating staffing problems.
Unfortunately, the EMS has struggled to keep up with demand.
“We have tried to manage the shifts without the additional unit, utilizing part-time personnel and area rescue squads,” he said.
However, finding available people for part-time EMS work hasn’t been dependable, he said.
“There have also been extended wait times for patients needing transfer to resource hospitals, some that were considered emergent transfers,” he noted.
He offered the board four options for ways to battle the manpower shortage, all of which will cost more than $100,000.
Before discussing the options, Shelton brought up an integral part of the equation: the county’s contract with Wake Forest Baptist Medical Center about the AirCare helicopter.
The director said county ambulances make 3,500 trips a year to Winston-Salem to take patients to Baptist and Forsyth hospitals. In the past year, not a single helicopter transport has been necessary.
“The nationwide recommendation for helicopter use is 60 miles from the nearest trauma center,” said Shelton. Most trips to Winston are less than that.
Between flying the chopper out, finding a place to land, transporting the patient from the scene of the accident to the landing site, loading the patient up and flying back home, for short trips a helicopter doesn’t really save any time.
With some trucks able to transport blood for on-site transfusions, the level of service provided by AirCare isn’t as relevant.
The contract with Baptist says that Surry County will provide workers for AirCare, and the hospital provides $350,000 a year for their salaries.
“We are currently having difficulty covering the shifts, for not only this problem, but the number of people out with FMLA, injuries, surgeries, vacation and holiday,” said Shelton.
Just two-thirds of the way through the current fiscal year, Shelton told the board that his part-time worker budget was almost depleted.
One employee on D Shift has missed five months, and seven other employees have missed between nine and 12 weeks, including some on maternity leave.
One way to minimize the manpower shortage would be to pull back the four rotating positions on the helicopter, but Shelton said that would not be his recommendation.
Two of the four options he provided to the board included pulling the AirCare staff, but he reminded the commissioners that this would also withdraw the $350,000 in funding the county receives Baptist hospital.
Not only the salaries, but the county would take on many other costs that Baptist covers, noted Rhonda Nixon, internal auditor.
Things such as workers compensation, benefits, uniforms and protective equipment covered by Baptist would come to about $42,521 a year, Nixon advised.
The other two options from Shelton involved hiring eight more employees.
Bringing on board eight medics would cost $331,309 in the next budget. Or the county could go with eight spots that are a step down in qualifications, but also pay; eight EMT Advanced positions would run $292,260.
Shelton said he would suggest the cheaper option. An EMT Advanced team can handle most calls — except the most critical care.
He also mentioned those 3,500 trips to Winston-Salem. Sometimes the most advanced critical-care trucks are being used just for stable patient transports. These EMT Advanced could handle these trips and free up the medics.
There has been an increase in the number of 911 calls for critical needs such as cardiac arrests, strokes and drug overdoses, said Shelton, so the medics have plenty to do.
In fact, as of late February, he said the EMS already had resuscitated 33 people from overdoses and lost just four.
As this was a learning session, the board didn’t take any action on Shelton’s recommendation.
Reach Jeff at 415-4692.