BAKERSVILLE — After resolutions appeared to have been made in December, the Mitchell County Board of Commissioners laboriously questioned representatives from Lifeguard EMS Service about an array of issues at the board’s regular session on Monday, Jan. 4.
Regional Director of Global Medical Response Dempsey Whitt was present to discuss how the board wanted to solve the issue of transports discussed at the commissioner’s regular session on Dec. 7.
In December, Whitt expressed concern to the board about the low number of transports EMS was conducting at the time and the issue was tabled for Whitt to compile more information and for the two new commissioners (Brandon Pittman and Harley Masters) to learn more about the issue.
At that meeting, Whitt said EMS was conducting far fewer transports than anticipated, which he explained was important because they receive a certain amount of revenue per transport which determines the budget and thus the subsidy they ask for.
Apparently the number the county provided to Lifeguard included transports out of Blue Ridge Regional Hospital, which Lifeguard did not conduct, and non-emergent transports, which Lifeguard began conducting in November.
Whitt said he needed to work with the commissioners to solve the problem and suggested two solutions.
First, there’s a 12-hour period of time when three trucks are in operation in the county, and Whitt suggested they use that third truck to conduct some transports from Blue Ridge Regional to Asheville during that time period, which would leave two active trucks in the county for emergencies and in-county transports.
The other solution Whitt suggested was to lower expenses by reducing the active vehicle during that 12-hour period.
At the meeting on Jan. 4, Whitt addressed the commissioners once again about the issue and suggested if they decide to allow the 12-hour truck to operate for non-emergent transports, they should put together a group so the process is clear to everyone involved.
“I would propose further, if that was the option the board would like to go with, that we put together a small working group, maybe a board member, an EMS staff member and someone from Stephanie’s office [911 Communications] and we sit down and go through exactly what that looks like,” Whitt said. “Then we go and propose that to the hospital, so they understand. I think it would be in all of our best interests that we all know exactly how that process should go.”
Whitt consistently said whatever the board desired to do about the transports, they would do.
However, after about 10 minutes of discussing transports, Chairman Matthew “Vern” Grindstaff turned the conversation to other issues the board has had with the EMS provider in the past.
“Dempsey, can you speak to the IV pumps as to their age and where they came from and their current condition?” Grindstaff asked.
“I haven’t physically seen the pumps, but I know they came from our BioMed department, so they are refurbished IV pumps,” Whitt said, looking to EMS Manager Jeff Edwards who was also in attendance at the meeting.
Edwards confirmed Whitt’s response. Whitt added he did not know how old they were but could find out.
Later in the meeting, the IV pumps were brought up again by Commissioner Jeff Harding, who said he went to inspect the IV pumps himself in mid-December along with Grindstaff.
“He [Jeff Edwards] was showing me how they [IV pumps] work and they were dirty,” Harding said. “I asked him if they were new and he said no. I later found out that these pumps were approximately 12 to 15 years old. Technology’s changed so much, so that’s an issue.”
Later in the meeting, Grindstaff touched on the IV pump issue again.
“Dempsey, on the IV pump situation that Mr. Harding is talking about, on Dec. 12…there was an IV pump on one of your trucks, that I have pictures of, with a maintenance stamp with a date of July of 2007,” Grindstaff said. “Calibration had not been done on that pump since the tenth month of 2018. And every time that pump would come on, it would flash ‘maintenance reminder’ on the pump.”
“That is correct,” Edwards said. Edwards explained they had received that particular IV pump from Mission Health.
Grindstaff went on to question if the trucks and equipment were inspected daily and by whom. Whitt said the crew was responsible for inspecting the trucks each day and should be reporting back to Edwards.
Grindstaff requested copies of daily truck and equipment inspections be submitted to County Manager Tim Greene, who would relay that information to the board.
Additionally, Grindstaff requested Whitt provide the board with copies of the purchase orders for the four ventilators and the two new trucks he reportedly ordered.
Whitt said the ventilators would be arriving in three to four weeks and agreed to submit a copy of the purchase orders and inspection records.
Masters said that as of Friday, Jan. 8, Whitt had not provided purchase orders to the board. In an email on Monday, Jan. 11, Greene said Lifeguard’s new representative, Josh Spencer, “is in the process of responding to the requests made at the January board meeting.”
Commissioners also questioned Whitt and Edwards about trucks logging in and out with 911 Communications, what size trucks they would be receiving later this year and local staff training with the fire departments.
Harding, after describing a recent incident in which his family member had to wait several hours to be transported to Winston-Salem for a ‘code orange’ surgery, said the county had a huge problem with transport.
“Am I upset? Yes. Am I upset because it was a family member? Yes. Would I be upset if it was anybody? We’d be having the same conversation,” Harding said. “Right now we have a huge problem with transport and we have a huge problem with communications.”
Harding went on to say non-emergent transports should begin the next day.
“I 100 percent agree that these transports need to start tomorrow, contingent that it is the 12-hour truck only,” Pittman said looking to Harding. “I agree with you wholeheartedly.”
After 30 minutes of back-and-forth on the topic, commissioners acknowledged they needed to delve more deeply into the specifics and define parameters for out-of-county, non-emergent transports, but all agreed transports needed to be allowed immediately.
Commissioner Steve Pitman made a motion to allow an emergency vehicle in the 12-hour period to conduct non-emergent transports out of county, contingent upon the two other emergency vehicles being available in the county during that time period. Pittman seconded the motion, which passed unanimously.
The commissioners will revisit the issue and determine further parameters for the non-emergent transports at the second regular meeting of the month on Tuesday, Jan. 19.