WINTON – Without paramedic service, Hertford CountyEMS has to look elsewhere upon receiving transport calls requiring that level of medical care.

Currently, Gates County Rescue & EMS along with Bertie Ambulance Service are capable of handling Hertford’s paramedic calls. But there’s another private company, one based in Ahoskie, that wishes to provide that high level of transportation from one medical facility to another.

At their meeting here last week, the Hertford County Board of Commissioners learned that MedEx Medical Transport is very close to completing the requirements of offering paramedic level care.

Jeffrey D. White, Chief Operations Officer with MedEx, told the commissioners that the company has been in the process of upgrading its services to include paramedic level for approximately one year. Those discussions included Dr. Joe Tripp, Medical Director of Emergency Medicine at Vidant Roanoke-Chowan Hospital, Hertford County Manager Loria Williams and the county’s EMS Director James Broglin.

“Even though the hospital in Ahoskie uses paramedic level transport companies, none of those companies are based in Hertford County,” White observed. “Each one is based out-of-county and has a minimal 30-minute response time to the hospital while we are one mile down the road (the company is located at 902 East Memorial Drive, Ahoskie).”

The latter fact, White said, is critical.

“When you are living in a rural community you don’t have access to high level medical care all the time,” White stressed, citing a 60-minute window in serious cardiac cases where a patient needs to have an immediate medical procedure performed. “We can offer faster response times and we’re staffed 24 hours a day, seven days a week.”

White added that when Hertford CountyEMS is transporting a cardiac patient to Vidant RCH for initial assessment and knows that patient will need to be transported to Vidant Medical Center in Greenville, MedEx can be contacted in advance and have a paramedic level transport unit standing by at RCH and “ready to roll to Greenville.”

“Sure, there is the opportunity to fly that patient by EastCare from Ahoskie to Greenville and, sure, they can make that trip faster than a ground unit can, but what if the weather doesn’t allow the helicopter to fly on a particular day when that transport is needed,” White noted.

Commissioner Johnnie Ray Farmer recalled the conversation between the county and MedEx last year when the company announced its intentions to offer paramedic level transport. Farmer wanted to know if the company had completed those requirements.

“We’re moving towards it,” White said. “We’ve hired a medical director, which is one part of the requirements. He’s been on staff for six months.”

White added that during the process he has been in close contact with Williams and Broglin.

“We were hoping that when the (Hertford County) EMS Advisory Council met to go over the franchises (permitted to operate in the county) that we would have an opportunity to speak with the council and let them know we were upgrading our status, but we weren’t given that opportunity,” White said. “We were advised to bring this issue before you, the commissioners, today.”

Williams said she was not aware of what conversations developed between White and Broglin.

“We did not receive a franchise application from ya’ll (one regarding paramedic level care), all we received was one for the regular level of service,” Williams stated. “You submitted the same type of franchise request for ALS intermediate level service.”

Williams recommended that the EMS Advisory Council be the first body to hear the paramedic level request.

“All of our franchises begin there; that’s where all of the due diligence and information is collected before any medical transport franchise is permitted, to include upgrades to paramedic level service,” she said.

Williams added that the county was currently collecting data that may possibly lead to upgrading its EMS department to paramedic level.

She also noted that when a franchise was awarded last year to Gates County Rescue & EMS to provide paramedic level transport out of Vidant RCH, MedEx was not yet at point to provide that level of medical care.

“We could not formally consider them (MedEx) at that time because they were not ready,” Williams remarked.

White said that in an April 30, 2015 letter sent by MedEx to Broglin, it clearly pointed out that the company was requesting approval from the Hertford County EMS Advisory Council and the county commissioners that they be allowed to advance to the paramedic level. He added that a copy of that letter was attached to their annual request to have their operational franchise approved by the county for another year.

“That letter was part of the franchise application,” he said. “What we are asking is for the opportunity to carry the advanced level patients out of Roanoke-Chowan Hospital who need transport to other medical facilities. We’re talking about paramedic level of care; the training they receive allows them to do almost as much medically that a registered nurse can do. Paramedics are critical care providers.

“What you have now is to wait for paramedic level providers to fly here from Greenville or come by ground from Gates County or Bertie County,” White added. “We’re right here in Ahoskie, one mile from the hospital; that’s good, responsible patient care because you don’t have to wait 30-to-40 minutes for a paramedic team to get here. And we can assist Hertford County while they are moving their EMS towards paramedic level.”

To operate at the paramedic level, White said it all begins with the franchise approval at the county level. That leads to hiring staff, writing protocols, gain approval from the state, and applying and receiving a narcotics license from the federal government.

“You have to ramp up your equipment; you have to ramp up your personnel; that takes some time, but it’s rewarding in the end,” White stressed. “The equipment has been purchased and the staff is ready; all we’re waiting on is your approval and then we can purchase the narcotics we’re allowed to administer as a paramedic level provider.”

Commissioner Curtis Freeman asked White was MedEx given a reason why the EMS Advisory Council would not hear their franchise request, which included the announced upgrade to paramedic level care. White answered that no reason was given.

“I would like to know why MedEx wasn’t allowed the opportunity to talk with the EMS Council; that would apply to any company that wanted to explain what they were doing,” Freeman said.

Williams said the next scheduled meeting of the Council was in November, but a special called meeting can be arranged at any time. She added that she received the April 30 letter, but it wasn’t attached to the franchise application.

“I understand that at some point, MedEx did not meet the criteria to make a (paramedic franchise) request; then at some point they became eligible to make that request,” noted Commissioner Ronald Gatling. “I’m asking what are the proper steps they need to take….it is here today, or does it first need to go to the EMS Advisory Council for them to make a recommendation back to us?”

“Under the franchise ordinance, all requests go to the EMS Advisory Council,” Williams answered. “It’s not a decision that James (Broglin) or I make. Franchises are granted in Hertford County by that particular council.”

Commission chairman Bill Mitchell thanked White for his comments and update regarding the MedEx plan to offer paramedic level services.

“We appreciate what your company does for the citizens of our county,” Mitchell said. “I do recall the discussion back when we granted Gates County Rescue & EMS a franchise to transport paramedic level patients from RCH to other medical facilities that when you (MedEx) became  (paramedic) eligible that we would make some consideration then.

“What has occurred with the inability to allow you all to come before the EMS Advisory Council, I have no idea why,” Mitchell continued. “You have made your point loud and clear here today and you have put the ball in our court for us to make a determination and that’s what we will do. I like clarity and I like simplicity, and it sounds like, to me, we had neither in this situation. But I will guarantee you from this point forward you will have clarity and simplicity. You will be hearing back from us.”