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County delays decision on new Silver Valley EMS base amid staffing questions
Summary
Commissioners heard a detailed briefing on EMS staffing, overtime and the county—s ALS/BLS mix and asked staff to pursue consultant options before advancing a new Silver Valley base plan.
County commissioners and EMS leadership spent an extended Sept. 8 discussion reviewing EMS staffing levels, overtime and operational options tied to a proposed Silver Valley emergency medical services base.
Commissioner Casey introduced the item and said Silver Valley would fill a coverage gap between Denton and Thomasville. County EMS leaders provided comparative pay and vacancy data for neighboring systems and noted that Davidson County pay is at or above several peers for most classes; staff said pay alone is not the only driver of vacancies.
EMS leadership presented operational data showing vacancies and overtime for comparable counties and a locally tracked measure of how often county ambulances were out-of-service in a month. Staff said the department runs 13 daytime units and 12 nighttime units and that keeping all units staffed with at least one paramedic is the staffing pressure point. The presentation showed 88 authorized frontline EMS positions and repeated shortfalls in live staffing that can leave one or more trucks downgraded from ALS to BLS on any given shift.
Staff described different models used elsewhere, including Forsyth County—s approach of using smaller ALS chaser/rapid-response units and heavy hospital integration; that system deploys many paramedics in a way that preserves ALS access despite staffing churn. Davidson County officials said they do not currently have the hospital-level resources Forsyth uses and that some state hospitals provide easier handoffs, complicating the county—s options.
EMS Director and staff urged caution before committing capital to a new base at Silver Valley while vacancies remain. Director-level staff asked commissioners for direction to solicit consultant analyses of countywide EMS deployment options, to pursue in-house recruiting and academy strategies and to hold the Silver Valley building design/bid until staffing and system design questions are resolved.
Commissioners asked staff to bring back options for recruitment (including local academies and joint training), for partnerships with hospitals and for a consultant to study system redesign and long-term capital needs. The board did not approve construction funds or a building contract at the Sept. 8 meeting; staff retained authority to keep ordered ambulances in the procurement pipeline.
