Commissioners terminate county EMS provider

  • Watauga Medics Director Craig Sullivan (left) listens as Board of Commissioners Chair Matthew “Vern” Grindstaff asks questions. The board approved a decision to terminate Lifeguard as the county’s EMS provider and Watauga Medics is a possibility to become the next provider. (MNJ photo/Juliana Walker)

After months of contention, the Mitchell County Board of Commissioners terminated Lifeguard as the county’s EMS provider at its regular session on Tuesday, Jan. 19. 

After a lengthy closed session, commissioners emerged and began questioning Lifeguard Representative Josh Spencer. 

On Jan. 4, commissioners agreed to allow Lifeguard to conduct non-emergent transports with the county’s third EMS truck, which operates for 12 hours from 8 a.m. to 8 p.m., while the other two vehicles operate for 24 hours. 

“A couple of things about the transports, I think everybody’s got good intentions to do that,” Commissioner Jeff Harding said. “And I think everything has gone well with the exception of what we didn’t want to happen, leaving one ambulance in the county by itself.”

According to Harding, in the two weeks since the board allowed Lifeguard to conduct non-emergent transports outside of the county with the 12-hour truck, the county had been left with only one ambulance in the county on more than one occasion. 

Harding made a motion that the 12-hour truck would be the truck responsible for transports, especially late transports after 5 p.m., and that a 24-hour truck would not conduct transports after 5 p.m.

“Let’s be realistic, if the truck left at 5 p.m., it would get back at 8 p.m, so that would be the last transport of the day, unless there was a major code red,” Harding said.

Harding also made the recommendation for County Manager Tim Greene to meet with a representative from Yancey County to work out the logistics of their EMS conducting more transports and possibly charging Yancey for Mitchell’s EMS transporting one of their citizens. 

Harding’s motion passed unanimously. 

The discussion about EMS appeared to be wrapping up when Harding spoke up again and made another motion, this time to terminate Lifeguard as the county’s EMS provider.

“I move that the Mitchell County Board of Commissioners direct the County Manager to communicate the board’s intent to terminate the emergency medical service agreement between Mitchell County and Lifeguard Ambulance Service, doing business as American Medical Response,” Harding said. “The termination shall be effective 180 days after the delivery of the notice of Lifeguard as required in the medical services agreement.”

Commissioner Harley Masters seconded the motion, saying “I’m going to have to second, but this decision was not made lightly.”

The motion passed in a 3-2 vote, with Harding, Masters and Chairman Matthew “Vern” Grindstaff voting for and Commissioners Steve Pitman and Brandon Pittman voting against.

“That’s a very tough decision,” Pitman said. “I don’t disagree that there have been some items that they have left us hanging in the balance on. It makes for a hard relationship.”

Grindstaff added he committed several years ago to provide “top of the line” healthcare paramedic service to Mitchell County and said he continues to be steadfast in that commitment. He went on to thank the other commissioners for their hard work and service to the citizens of Mitchell County. 

“I have tried my best to do what in my view is the right thing for the people concerning paramedic service,” Grindstaff said. “I know there are other viewpoints that I respect greatly and I respect every board member here.”

Following the termination, commissioners also unanimously approved to send a resolution to Blue Ridge Regional Hospital requesting they improve patient medical transport from the hospital and station an emergency vehicle to be used for transporting non-emergency transports.

“The lack of a medical transport vehicle stationed at Blue Ridge Regional Hospital is a major contributing factor to the long delays occurring in patient medical transport and the availability of such a vehicle will substantially reduce the delays,” Greene said, reading an excerpt of the resolution. “And, whereas, the delays in patient medical transport cause equivalent delays in necessary medical treatment for the patient and inflict serious emotional distress on the patient and the family of the patient.”

In a quick turnaround, the board met with Watauga Medics Director Craig Sullivan on Friday, Jan. 22 in a special meeting to discuss what his company could provide in terms of EMS services. 

Watauga Medics, which is based in Boone, provides EMS services to Watauga County, Ashe County and most recently, Madison County. 

“I feel certain if you called any of the counties, they would say they are happy with the service we provide,” Sullivan said. “I try to keep good equipment, I keep good people and provide good service. To my knowledge, the counties are very happy with what we’ve done. I think what I do, I do well.”

Sullivan, who was a paramedic himself for 10 years before starting Watauga Medics, drove one of his EMS trucks to the meeting to allow commissioners to look inside. 

Commissioners inspected the vehicle, inside and out, while Sullivan answered questions about equipment, services he could provide and what the transition would look like if his company was offered the job.

“I know since Tuesday [Jan. 19], there’s been a lot of concern among EMS employees,” Masters said. “Can you explain a little bit to us about how that transition will go, will they all be provided to work with the same pay and all of that?”

“If I were fortunate enough to get to be your provider, I would offer everybody a job at the same rate of pay or higher with comparable benefits,” Sullivan said.

Sullivan also said he would be happy to help start a community paramedic program at no cost to the county, which would help paramedics operate in an expanded role by assisting with public health, primary health care and preventive services to the community with the goal of improving access to care and to avoid duplicating services. 

After inspecting the vehicle, commissioners and Sullivan returned inside to talk about needs, wants and concerns.

Harding highlighted the importance of EMS services having a good relationship with the local fire departments, which he said has not been good for a long time.

“Your dispatchers, your firemen, the folks at the hospital, we’ve all got to be on the same page, because if something bad goes down, we’re all going to be working together,” Sullivan said. “The thing that heals that is communication. All these people are key to the system.”

Last year, when the previous board was determining which EMS provider to choose, Watauga Medics made a bid of $1.455 million compared to the bid of $1.37 million Lifeguard made. 

Pittman asked Sullivan what the biggest cost in his bid was, to which Sullivan said “labor, without a doubt.”

Harding asked Sullivan if Lifeguard were to stop serving the county before the 180 days they were given, if Watauga Medics could get set up quickly, to which Sullivan said he could be up and running in an emergency quickly.

“I could be up and running in 45 minutes if I need to be, should that occur,” Sullivan said. “Whether you choose me or not, I’ll help you out.”

In a formal transition, though, Sullivan asked for a minimum of 120 days to make the transition if Watauga Medics was chosen. Because of this, commissioners will likely make a decision about a new EMS provider within the next 60 days. 

Sullivan departed the meeting and commissioners continued to discuss the possibility of Watauga Medics.

Pittman said he liked what Sullivan was offering, but expressed concern over the extra $85,000 cost per year, compared to the cost of Lifeguard.

“I really do like that he’s local, I like that he’s right across the mountain there and he’ll come down and talk to us and he has a lot of good things going for him,” Pittman said. “It would be a sweet deal if we could get that bid down some, though.”

Grindstaff said he appreciated that Sullivan seems to appreciate his employees. 

“He listens to his paramedics,” Grindstaff said. “I like that. He says, they’re the ones working on the truck every day and that matters.”

In an effort to listen to local paramedics as well, commissioners agreed they would like to meet with two Mitchell County paramedics to receive input about trucks and equipment. They also plan to request lists of equipment from other county’s EMS providers to determine what they will ask for from whatever EMS provider they choose.

The board plans to have a special meeting sometime soon to talk with paramedics to further discuss what they want from an EMS provider, although a date for this meeting has yet to be determined.