Buncombe EMS seeks $2.5M boost amid slow response times

Buncombe ambulance
HELP WANTED: A Buncombe County Emergency Medical Services staffer shows off an ambulance to Enka Middle School students in 2019. The county's EMS is requesting $2.5 million in new funds to address staffing shortages and slow response times. Photo courtesy of Buncombe County

When Buncombe County residents have an urgent problem, they call Emergency Medical Services. When EMS has an urgent problem, it calls the county Board of Commissioners.

As presented by Rafael Baptista, Buncombe’s director of performance management, in an Oct. 19 briefing to the board, the county’s EMS is requesting over $2.5 million to address several daunting challenges. A combination of increased demand due to the COVID-19 pandemic and low staffing levels, he explained, has led to emergency response times well above national standards.

Over the past year, Baptista said, Buncombe’s emergency call volume has grown by 18%, with more than 1,000 of those calls pandemic-related. He estimated that meeting those calls in a timely fashion would require 13 ambulances. However, the county only funds personnel for 11 ambulances, and due to staffing issues, the full fleet has been operating on just 29 days of the past 92.

For 90% of calls, the county’s “chute time” — the interval between when an ambulance is dispatched to an emergency and when it actually heads toward the location — is 195 seconds or less; the goal for the same metric set by the National Fire Protection Association is 80 seconds, more than twice as fast. Of Buncombe’s emergency calls, 90% see an ambulance on-scene within 18 minutes of dispatch, while the NFPA standard is about nine minutes.

At the same time, Baptista continued, the county’s 911 call center is also understaffed; the percentage of calls answered within the state standard of 10 seconds has dropped from 96.2% to 90.5% over the last year. And Buncombe personnel are covering some dispatches for the city of Asheville, which has staffed only 10 of its 20 budgeted call center positions.

In response, Baptista suggested that Buncombe adopt several new pay incentives for EMS and 911 staff, including bonuses for overtime, night shift work and on-call duties. He also said the county should fund positions for two additional ambulances, as well as purchase two “quick response vehicle” SUVs to give EMS staff greater flexibility.

A formal budget and personnel request is expected to go before the board at its next regular meeting Tuesday, Nov. 2. Money would come from the county’s current cash reserves.

County tax revenues beat projections

Regardless of COVID-19’s public health impacts, the pandemic does not appear to have done any damage to the county’s balance sheet over the past year. According to Don Warn, Buncombe’s finance director, general fund revenues for fiscal year 2020-21 exceeded $351 million — nearly 5% more than the projected $334.6 million.

The biggest driver of the surplus, Warn explained, was higher-than-expected collection rates for property taxes. While the county had expected 99% of taxes to be paid, it actually collected 99.65%, netting an additional $7.3 million.

By percentage, however, sales taxes generated the biggest windfall. Budgeted at $30.1 million, those revenues came in at $37.1 million, or more than 23% higher than expected. “Consumer spending just came back a lot stronger than we thought it would,” Warn said about the difference.

Combined with low county spending (about 5%, or $17.7 million, less than budgeted), the revenues have created a sizable reserve of cash. County Manager Avril Pinder estimated that between $17 million and $19 million could be available for currently unbudgeted expenses throughout the year while still leaving a reserve of $49.8 million, the minimum allowed by county policy.

“Our community’s coming out of the past 18 months in a lot better position than we all thought we would,” said board Chair Brownie Newman. “There’s a number of different obligations that are likely going to be showing up at our door, where some of these available funds will be requested. But there are some good opportunities.”

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About Daniel Walton
Daniel Walton is the Assistant Editor of Mountain Xpress, regularly contributing to coverage of Western North Carolina's government, environment and health care. His work has previously appeared in Capital at Play, Edible Asheville, and the Citizen-Times, among other area publications. Follow me @DanielWWalton

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