WINDSOR – Bertie County has three choices when it comes to Emergency Medical services.

That’s the opinion provided by Stephan Allen, an expert on the subject who spent three months assessing the EMS and rescue services operation in Bertie County.

Allen’s report, given at the December meeting of the Bertie County Commissioners, said the county could do one of three things:

–       assume responsibility for EMS, including personnel and costs;

–       contract EMS out to a private vendor; or

–       address, organize and support the system that is in place currently.

Allen said his recommendation would be to take the third option.

“I would suggest you not jump out there and bite off more than you can chew, but figure out how you can help with upgrades at Askewville, Colerain, Lewiston Woodville and Bertie (rescue squad) in that order,” he said.

The report took a look at the current conditions for emergency response and then made recommendations about the future.

Currently, there are four EMS agencies serving the county. They include two squad that are certified EMT-Basic – Askewville EMS and Lewiston Woodville EMS – and two that are EMT Intermediate, which are Colerain EMS Inc. and Bertie County Rescue Squad.

Askewville is the only all volunteer unit while Bertie is a paid service. Colerain and Lewiston Woodville provide a combination of paid and volunteer.

In the issues and observations section of the report, Allen noted one of the main issues is that there is no “system” for Emergency Medical Services.

Currently, Emergency Management Coordinator Rickey Freeman serves in the dual role of EMS Coordinator, but is only loosely responsible for the organization of EMS response.

Allen said there were several important factors in an EMS system, one of which was quality assurance being an integral function and priority of supervision.

“That is not in place system wide,” he said.

Allen said currently each of the four squads handle quality assurance on their own, but no one makes sure it is held to the same standard county wide.

Another key issue is response time which is the total time it takes from when the call comes into the 9-1-1 Center until an emergency vehicle arrives on the scene.

Factors for response time include the distance that must be covered, the speed at which the vehicle is able to travel and the conditions under which it travels.

Allen said some of the key organizations studying response time suggest that basic life support being available in three to four minutes with advanced life support skills available in six to eight minutes.

The average response time in Bertie County has dropped from nearly 12 minutes in 2008 down to 10 minutes and 43 seconds in 2010.

Allen said the higher response times are not out of the ordinary for a county like Bertie.

“For a rural area such as this, it is not unusual to see higher response times,” he said.

An area Allen did have concern, however, is the chute time or the amount of time between the call and the rescue personnel being in the vehicle and moving. In 2010, that time is four minutes and 41 seconds, but Allen said it needed to be less than two minutes.

According to the report, Lewiston Woodville currently has the longest chute time at approximately five minutes and 45 seconds followed by Colerain at 5:34 and Askewville at 5:06. Bertie Rescue is currently at 2:22.

Also at issue is the availability of personnel including volunteers.

Commissioner Norman M. Cherry Sr. asked how Allen suggested the county balance paid personnel and continue to utilize the important volunteers that had always served citizens.

Allen said he believes the county is doing well with that and that volunteers will continue to be helpful in Bertie County.

“You have a bunch of good volunteers and I think they’ll stay with you,” he said.

Other issues included collections and revenue as well as having no trauma center closer than Greenville.

As for recommendations, Allen’s strongest suggestion was to hire a full-time EMS Coordinator. He said Freeman was doing the best he could with the amount of time he had and the number of job responsibilities he already had, but could not devote the time needed to EMS.

The total cost for the position was estimated at $54,600.

He also suggested that response time would have to be addressed eventually.

“It’s a beautiful county, but you have some wide open spaces and you can’t just wave a wand and be there in three minutes,” he said.

To address that issue immediately, Allen suggested assuring funding for daytime personnel, providing an additional ambulance in Windsor and providing a quick response vehicle (QRV) and personnel.

In the future, he suggested a second QRV and the possibility of adding a new EMS base in the eastern part of the county.

Allen also provided further suggestions; including closest unit response, dispatch and communications, collections and post response facilities.

As for county initiatives, Allen suggested establishing a form document for EMS response time standard, identifying and documenting objectives with regards to level of care provided and upgrading GIS software to enable EMS call location mapping.

“This is some very important information that we need to spend some time with,” Commission Chairman L.C. Hoggard III said. “We appreciate the information and we will be looking over it exhaustively in the near future.”