Rescue squad presenter tells Gates County commissioners EMS is understaffed and seeks payroll support

A rescue squad presenter told Gates County commissioners that Gates County’s emergency medical services are under strain from rising call volume and regional pay competition and requested the county consider increased payroll support and capital planning.

The presenter said the service handled "718 patient contacts in 2026" as of the day before the meeting and that patient contacts have increased roughly 16% since 2022. He added, "We're averaging 1 and a half mutual aid responses into the county a week," meaning outside agencies are regularly asked to cover calls when local units are committed.

The presenter said the EMS industry experienced a roughly "33% increase in pay across the nation in 2022," and that private and neighboring providers have raised entry pay, citing a private transport company that raised pay "from around $20 to $34 an hour," which contributed to recent staff departures. He said the service has not increased staffing since a 2016 contract and has been using administrative staff to staff a third ambulance during busy periods for about 36 months.

Why it matters: large parts of the county fall outside a feasible 12‑minute response time under current deployment, the presenter said. He described response‑time mapping that shows roughly 233 square miles of Gates County are beyond the 12‑minute target from the central station and proposed two substation locations that would bring most residents inside a 12‑minute window.

Budget and equipment needs: the presenter summarized a pay‑study scenario in which about $316,000 would fund next year’s payroll to move from four providers per shift to five — effectively making a third ambulance available 24 hours a day. He also cited a $490,000 figure that would bring pay to the regional average under the study’s parameters. On equipment, he said replacing cardiac monitors is an upcoming capital need and gave an estimate of about $358,000 for that work.

Commissioners pressed for specifics. "What does the county fund now?" one commissioner asked. The presenter replied that the money currently earmarked for payroll is used for staff but that his budgeted deficit for the coming year is about $230,000, not counting overtime and other emergent costs.

A commissioner also urged more financial transparency if the county is to modify the contract, saying taxpayer funds justify defensible accounting. The presenter said an external CPA prepares federal filings for the organization and that a full external audit had been discussed previously but had been deferred because of cost.

Timing and next steps: presenters and staff said federal grant timing — including applications involving a member of Congress — could be incremental and that approvals would be driven by the federal process; no firm timeline was provided at the meeting. No formal motion or vote on funding or contract changes was reported at the meeting and commissioners moved on to the next agenda items after the Q&A period.

The meeting record reflects questions about vacancies, billing and collection practices, mutual‑aid frequency and whether the county should pay a larger share of staffing costs. Commissioners and staff signaled interest in further review and accounting detail before any contractual or budgetary change.