Emergency Medical Services response times, employment and funding are tied to policies Durham County Commissioners will tackle heading into the 2017-2018 budget season.
During the commissioners’ first budget retreat in late February, they were told EMS has increased by about 50.4 percent in the county during the past decade.
Both a growing population and service delivery area are factors, said Jodi Miller, general manager of community and public safety.
During the 2012-2013 fiscal year, the county assumed EMS service previously provided by three volunteer departments, Miller said.
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“Looking at 2014 to present, we assumed full responsibility for the entire county,” she said.
During the 2014-2015 fiscal year schedules of staff were analyzed based on data of the number of calls and time of day calls were received.
The department implemented a dynamic deployment strategy, which looks at service data and where the calls come from, to place ambulances and staff in areas with a higher call volume, Miller said.
The strategy allows ambulances to be based in various locations, as opposed to just an EMS station.
A 2015 EMS facility and space plan evaluated where capital improvements are needed currently and in the future based on anticipated growth.
The study identified a need for about 17 more stations in addition to the existing six in the county to get closer to a “comfortable,” response time, Miller said.
Adding 17 stations gets closer to a 12-minute response time, she said.
Investments the county could potentially make compared to what it might cost for an overall response time of 12 minutes requires more conversations about what people in the community can live with, County Manager Wendell Davis said.
“You need to have some sort of semblance of understanding about what’s the right investment point and what we can live with in terms of service delivery on response times going forward, and that’s a critical policy decision,” Davis said.
Station 1 -- which is near Durham County Stadium -- has had a renovation or rebuild project in the county’s capital improvement plans for a few years, Miller said.
“Station 1 is in need of some TLC,” she said.
The county is working with a designer to understand if it makes better financial sense to renovate the station or rebuild it, she said.
Another three stations identified in strategic areas include: MLK Boulevard and the Fayetteville Street area, Patterson Road and Highway 98 area and Duke’s West Campus.
Those areas are on a 4-5 year timeline that the facilities study helps prioritize for budget purposes, Miller said.
“Also noted in some cases we’re going to have to purchase property and so knowing what those priorities are it helps us better plan on the service delivery side of EMS,” she said.
Commissioner Ellen Reckhow said when examining the system of facilities, she hopes land near schools or in the city is evaluated.
“Before we go out and start buying property, I sure hope we’ll scrutinize a lot of our property in terms of need and co-location,” Reckhow said.
The 2015 study identified an opportunity to “co-locate” EMS with a new city fire station, or fire station 17, in the eastern part of the county, Miller said.
The facilities study showed about $1.6 million estimated for a standalone station, and the county is looking at making a $1.2 million investment for the project.
“What are the opportunities to take this prototype and be able to replicate other places so there’s a better synergy and cost savings for both the city and the county,” Miller said of how the capital projects are being evaluated strategically.
In fiscal year 2013-2014, EMS started with 114 full-time employees. The number grew to 165 in the following fiscal year, after Parkwood Volunteer Service integrated with the county and another 15 positions were added.
In the 2015-2016 fiscal year, another eight full-time employees were added, and five were recommended for addition for the current fiscal year.
One of the challenges for staffing is hiring at the paramedic level, Miller said.
“It’s not just an issue in Durham,” she said. “ It’s is an issue that we’re seeing regionally, across the state and across the country. People are just not going into this profession in the numbers that they used to.”
To help with recruitment and retention, a “human-centered design” team is in place -- with the EMS team comprised of employees who’ve recommended communication strategies and developing a career ladder for retention, Miller said.
Another area to consider is a compensation study for paramedic positions that will be shared this month, she said.
In the meantime, she said it is easier to recruit at the emergency medical technician level.
A pilot program to start this spring would allow the deployment of basic life support ambulances with EMTS.
About 42 percent of the calls for EMS are for advanced life support.
The plan is to manage ambulance deployment to the more serious calls with advanced life services and basic life support with EMTS where needed, Miller said.