Gates County EMS urges pay increases and new crew to reduce long ambulance response times

The county'contracted emergency medical service told Gates County commissioners on April 2 that it needs increased county support to keep staff, replace aging vehicles and move toward a staffing model that will reduce long response times.

The EMS chief, describing two decades of change in prehospital care, said current staffing leaves the service vulnerable when crew members call out and that daytime staffing of a third ambulance has been paid for out of agency revenue only. The chief said the county'funded contribution for the most recent fiscal year was $1,059,685 and said a baseline increase to remain competitive with neighboring counties would be roughly $1,238,032. To add an on-duty supervisor/captain and enable flexible staffing to sustain a third ambulance around the clock, the chief said the agency would need about $1.42 million annually.

"If we were to get our captains off the ambulance and go from four full-time people per shift to five, it gives us the ability to start investigating the option of RSI and putting that second paramedic on the scene," the EMS chief said, referring to drug-assisted intubation and other advanced interventions that require two paramedics.

Commissioners and the chief discussed the county'wide consequences of slow response times. A map shown to the board indicated that areas outside the immediate station radius often see substantially longer response windows; the chief described a 12-minute target (roughly a six-mile radius) as a commonly used rural planning benchmark and noted urban standards have moved toward an eight-minute response time.

The chief also outlined capital needs: a replacement ambulance typically costs about $250,000 with equipment; a modern cardiac monitor costs roughly $55,000; and some ambulances in the fleet have more than 200,000 miles, with one chassis recently reported at about 319,000 miles and removed for refit. He said lead times for new chassis are currently 18'24 months.

Commissioners discussed phased approaches and revenue options, including the statutory possibility of a dedicated EMS tax district and other phased plans — from immediate salary increases, to vehicle purchases, to longer-term station/substation planning. One commissioner suggested investigating whether an existing Sunbury fire station or similar facility could be adapted as a substation or shared space to improve coverage sooner and at lower near-term cost.

The chief asked the board to consider three near-term priorities: (1) adjusting salaries to remain competitive so the agency can recruit and retain staff; (2) replacing vehicles and equipment as they reach end of service; and (3) planning for an additional full crew (a long-term operational change that would increase reliability and allow the agency to place a second paramedic on calls when clinically indicated).

Commissioners expressed support for continued discussion and for drilling into cost scenarios; several suggested a working group or recurring budget meetings with EMS leadership to develop a multi-year plan.

The meeting did not include a formal vote on new EMS funding. Commissioners directed staff to continue the budget process and to provide more detailed cost estimates and phased options for consideration in the coming budget cycle.