At the recent Blowing Rock Civic Association meeting about ambulance service to Blowing Rock, those in attendance were told that the town’s board of commissioners recently rejected a proposal that allegedly would have brought better ambulance transport services to Blowing Rock. All the town would have to do is pay an additional $382,000 per year.
Although we have heard conflicting reports from various officials as to whether that “new” service would be for a 24-hour, 12-hour, or 9-hour shift in Blowing Rock, the revelation that there had been a proposed solution was met by a degree of consternation by some of the BRCA members in attendance. Some were even outraged not just that the proposal had been rejected, but that they had not been consulted about the matter.
That might be the most expedient solution but, in my opinion, the board of commissioners did the right thing in rejecting that proposal. It was, in a word, silly, even an insult to the intelligence of anyone more familiar with the entire scope of the issue.
The vote, I am told, was 4-1 against it. The sole vote in favor of it was by Sue Sweeting. Knowledgeable sources tell me that it was Sweeting and county commissioner Larry Turnbow who concocted the scheme, so Sweeting’s vote is understandable, even if her rationale for proposing it is bewildering.
Blowing Rock taxpayers are already paying equally with all county taxpayers for ambulance service. It’s just that most of the residents and visitors outside of the Boone town limits are unlikely to receive equal service. What the Watauga County board of commissioners can’t seem to comprehend is that a Boone-centric ambulance service is no longer adequate when 60 percent of the Watauga County population lives outside of the Boone town limits, according to U.S. Census data.
It is hard to blame the private, for-profit contractor, Watauga Medics, that has been chosen by the county to fulfill its state-mandated responsibility to provide ambulance transport services to county residents. They try to reach as much of the county’s population as fast as possible given the terms and funding to which they and the county board of commissioners have agreed.
From Watauga Medics’ standpoint, a Boone centric service is the most cost efficient, even if not providing anything close to uniform response times throughout the county. So they bank the approximately $1.6 million a year that the county has paid them as a subsidy, then also collect another amount, reportedly close to $2 million, in billings collected from the people transported.
Long time residents and former town officials note that Blowing Rock town folks have been fighting this battle for about 40 years. Blowing Rock has been the most vocal about it, but the people in Beech Mountain, Todd, Zionville, Bethel, Valle Crucis, Deep Gap, Meat Camp, and Powderhorn, among others, have the same or similar lament. The ambulance response times are two, three, and even four or more times longer to serve some of those communities than the service to Boone residents, even though all uniformly pay the same county taxes.
Is the Town of Boone being asked to pay an extra $382,000 for each of the 24/7 ambulances currently based within the Boone town limits? If not, why should any community in the rest of the county be asked to pay that sum? And if residents outside of the Boone town limits are not getting equal service then they are, in effect, subsidizing the better response times to Boone residents under the currently contracted arrangement.
Public safety services — fire, rescue, law enforcement, and EMS transport — were never intended to be profit-generating endeavors. The irony, of course, is that only one of those services have the potential to recover some of the costs for providing the service: ambulance transport. That is a fact that Watauga Medics knows all too well because the business is getting the lion’s share of its basic costs paid via the Watauga County subsidy. In effect, the financial risk of being in business is significantly reduced and the profit opportunity through billings collected significantly amplified.
This is not just about Blowing Rock but as the second largest population center in the county, the case for Blowing Rock is the most obvious, especially when an ambulance bay and top drawer crew accommodations are offered to the county at little or no cost. And it is not just the folks living, working and visiting within the town limits, but everyone living within the 52 square miles of the Blowing Rock Fire District that are underserved.
And guess what? During the COVID-19 pandemic, that Blowing Rock population exploded, both in town and outside of the town limits. Thanks to the proliferation of broadband, a reputation for being a relatively safe community, and Watauga County’s general status as a “rural” area, urbanites discovered that they could work remotely from a place they would rather live, anyway. Of course, some will return to the cities once the pandemic fully subsides, but many others will stay, permanently.
Uncharacteristically, in the heart of this past winter there was hardly an empty driveway to be found in Blowing Rock. Getting in and around Main Street was problematic the whole time. It might just as well have been the middle of summer or peak season for the leaf peepers. I have a hunch that Blowing Rock’s population numbers will be somewhat greater when the next census is tabulated.
In one sense, Blowing Rock taxpayers are already “paying up” for EMS services. Because the county board of commissioners has, over the years, refused to put an ambulance in town — and they have that sole right and control — Blowing Rock Fire & Rescue felt it had a responsibility to its constituents to beef up its ranks, to at least provide the very best in first responder service, even if they could not transport.
During the BRCA meeting, Town Manager Shane Fox reported that Blowing Rock Fire & Rescue employs 14 full-time fire and rescue professionals. They rotate between the three stations that now exist within the Blowing Rock Fire District. Eleven of those 14 professionals, Fox said, hold the highest possible certification as paramedics. Arguably, as a group they are a cut above most, if not all of the EMTs or paramedics employed by Watauga Medics. If you have a problem, you want the Blowing Rock Fire guys to be your first responders.
The Blowing Rock first responders are on the scene very quickly, but they are not allowed to transport. And it is that gap between the time Blowing Rock first responders arrive, get you stabilized, and then five to 15 minutes later the Watauga Medics ambulance arrives that might well be the difference between life and death when it comes to heart attacks, strokes, or serious injury.
So as a result of beefing up the first response personnel, Blowing Rock taxpayers have already seen increases in their tax bills. But what might be more subtly troubling is that when two or three firemen doubling as paramedics are called out to tend to injuries from an auto accident or a heart attack, the personnel for fire coverage is somewhat compromised. What happens when things start happening simultaneously?
Because the town of Blowing Rock picks up the tab for all of the fire and rescue personnel employed by the Blowing Rock Fire District, the Blowing Rock taxpayers are footing a good portion of the bill for providing fire and first response services to the people living outside of the town limits, but within that 52-square mile fire district. Is that fair?
I don’t yet have hard numbers, but based on my preliminary survey it looks like the majority of the 100 counties in North Carolina fulfill their statutory responsibilities to provide ambulance transport service with county-owned operations, not using a for-profit contractor. That includes highly urban jurisdictions like Wake County, as well as more rural jurisdictions such as Cleveland, Catawba, Burke, Avery, and Caldwell counties. Those county-owned jurisdictions tend to have more ambulance bases, more ambulances, and more crews. Their annual operating costs are greater than the counties choosing a private contractor, but then they also recover a significant amount of revenue through billings and collections as a result of the transport services used.
When it comes right down to it, the counties with their own ambulance services understand that the value of a taxpayer’s life is the same, wherever he or she lives within their jurisdiction. They have a state-mandated responsibility to protect and preserve each life. And they don’t thumb their noses at industry established standards for ambulance transport services. They understand why those standards are important. They own them, and they deliver.
I recently joined the new Watauga Community Recreation Center. It is a marvelous facility and, if I can find the time to get there often enough, maybe I can stay healthier than if I didn’t belong.
But at a cost of more than $40 million that the county spent on it, and raising property taxes to pay for it, was that the right decision for the county board of commissioners to have made before fixing the current wide disparity in delivering an important public safety service — ambulance transport — to all county taxpayers? Where, exactly, are Watauga County’s priorities?
That same $40 million would have paid for an estimate two decades or more of better ambulance transport services to all residents. So far, I haven’t seen any big tournaments drawn to the Rec Center that might put heads in beds, to increase the county’s occupancy tax and sales tax revenue (one of the well-advertised selling points for building the facility), but it is far too soon to judge, especially given the pandemic-imposed limitations.
Then again, is lodging, restaurant, and gasoline revenue a more important priority than preserving and protecting a human life?
For the town to spend $382,000 a year (at least this year) even if it is for a 24/7 ambulance base may well be the most expedient solution for Blowing Rock. But it is hardly fair, does not address other attendant problems like control, training and certification, and ignores the larger problem for the larger county population. The most expedient is not necessarily the best and kudos to the majority of Blowing Rock’s town council for recognizing that reality.