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EMS under the microscope

WINTON – “You’re going to hear some things you don’t like.”

Those words from Solutions 4 Local Government’s Steve Allen were the beginning of his report about Hertford County Emergency Medical Services (EMS).

“These are my observations, opinions and recommendations based on my review,” Allen said.

Allen then laid out the existing conditions of the EMS department as well as areas of concern and recommendations after a thorough review.

One of the key areas addressed by Allen was the department’s response time, which rose from 10:36 (10 minutes, 36 seconds) in 2006 to almost 15 minutes (14:54) in 2007. He said one reason for the rise in response time was a vehicle was based in Ahoskie in 2006 and that area represents 55 percent of the calls answered by EMS.

An area he said concerned him was the chute time, which is the time from the call to the time the vehicle is moving. The chute time was 2:48 in 2007 after only 24 seconds in 2006, 1:18 in 2005 and 1:06 in 2004.

“Anything more than a minute is unacceptable,” he said.

Staff members are also being hurt by 24-hours shift, he said. Allen told commissioners 24-hours shifts were bad for the body and bad for the mind. He added that he wasn’t “high on” 12-hours shifts either because they were also tough on people.

“You have to remember these people are responsible for saving lives,” he said. “You need them to be mentally and physically alert.”

He also addressed the morale of the staff at Hertford County EMS.

“Five directors in two years doesn’t do much for morale,” he said. “That translates into a lack of focus.”

Allen also referenced the disintegration of the chain of command. He said county commissioners and other county leaders should not allow workers to come directly to them with problems, but should refer them to the proper chain of command.

Some staff members are not respecting the chain of command, Allen said, and should be held accountable.

“You have some staff that quite frankly I would send out the door faster than you can blink,” he said.

He also addressed what he called “politics and subterfuge.”

“I didn’t know what else to call it,” he said. “The best run local government is the one in which elected officials do the least. The staff needs to grow up and you don’t need to help in their whining.”

Allen said the department also had some hard working people who lived within boundaries and should be given the proper tools and support to do their jobs well.

The county EMS is currently short three staff members, which Allen said seemed to be normal within the department. He said it was important to do everything possible to fill positions.

From there, Allen laid out seven recommendations for Hertford County EMS.

First, he said the county should identify locations near or in Murfreesboro and Ahoskie to locate ambulances. He suggested cooperation with local fire departments or other rescue agencies.

“Winton makes no sense,” he said, referencing a map showing the bulk of calls coming from the Ahoskie and Murfreesboro areas.

He also said the Winton Rescue Squad had the tools to help the county.

“Winton is the most active rescue squad in the county,” he said. “They can cover most of the Winton and Cofield areas as first responders.”

Secondly, he suggested studying options for re-implementing the first responder program. Allen said the county could again work with fire departments to offer training as first responders if someone was interested.

The third recommendation was simple: do away with 24-hour shifts.

Allen also said the county needed to address the non-emergency transport currently being conducted by Hertford County EMS.

“You have three options,” he said. “One, stop it. Two, continue to do it, but hire staff to put on it. Three, contract it.”

Commissioners asked if the county had the ability to continue doing non-emergency transport at this time.

“You have the vehicles, but you do not have the man-power,” Allen responded.

He also told commissioners they should hire a Quality Assurance/Training Coordinator to help make sure staff was being properly trained and “not having someone stick a video in a television.”

A part-time billing assistant is also needed, Allen said, to make sure bills are being done in a timely manner.

“You have to stop hoping an EMT will be available to help process paper work,” he said. “EMTs have a job.”

The final recommendation was to “let the director direct.”

Hertford County Manager Loria D. Williams said she appreciated the bluntness of the report and the areas which were outlined for the county.

“Thank you, Steve, for a through presentation,” she said. “My recommendation to have you review EMS for us was for this very reason.

“The governing body and I want services the county citizens can be proud of, but also where safety is tantamount,” she added. “We won’t leave this one sitting on the shelf. We purposely sought good advice.”

Commissioner Curtis A. Freeman said he thought the report was good and brought up areas where there was a need. He also said commissioners did not undercut the chain of command.

“I and most of the other commissioners have an open-door policy when it comes to county employees,” he said. “I listen, but I direct them back to the chain of command.”

Commission Chairman Howard J. Hunter III added, “Thank you for an informative and educational report.”