Death and taxes

“How can we get what’s due us from the county?”

— Upper Hominy resident William E. Fleming

If it’s true that death and taxes are life’s only certainties, then it may follow that one should expect more of both in hard times.

That, at any rate, is what recent events seem to be teaching residents of the Upper Hominy Fire District, who are losing their cherished local ambulance service to county budget cuts even as their property taxes rise.

At an Aug. 13 community meeting, held to give district residents a chance to air their views, frustration gave way to anger. Resident after resident rose to berate the local Fire Department for not finding some way to keep their ambulance rolling, as had fire departments in Leicester, Barnardsville and Reems Creek (each of which also lost three county-funded staff positions).

Others placed the blame squarely on Buncombe County, which they accused of shortchanging rural districts. “Let’s get real,” declared Upper Hominy resident William E. Fleming, looking out across the Pisgah Elementary School gym at Board of Commissioners Chairman Nathan Ramsey and Commissioner David Gantt. “We’re all taxpayers, but we’re not all getting the same service. How can we get what’s due us from the county?”

Country roads

The chain of events that led to that scene in the gym extends back to the spring, when County Manager Wanda Greene told department heads to prepare for the worst by finding ways to trim as much as 7 percent from their budgets.

Whenever county departments are forced to slash jobs, they try to lessen the pain by cutting vacant positions first. As it turned out, Buncombe County Emergency Medical Services had plenty of those.

North Carolina, explains EMS Director Jerry VeHaun, faces a lack of paramedics and other emergency medical technicians that’s similar to the state’s chronic shortage of registered nurses. Currently, there are about 600 openings for paramedics in the state; training programs in N.C. community colleges turn out only about 200 graduates a year.

In the past two years, Buncombe County has found it extremely difficult to fill EMT positions. Some weeks, says VeHaun, not a single job application arrives. By the time Greene made her request for cuts, the department already had 14 vacancies — two more than the number of positions it needed to ax.

Under those circumstances, staff could be shuffled without anyone losing a paycheck. But the department still had to decide which positions to eliminate.

For years, Emergency Medical Services had been deploying its EMTs on two separate tracks.

Most were employed in the county’s own paramedic-level units, which used county-supplied equipment and ambulances. These units were strategically located in accessible, highly populated districts: two at EMS headquarters in downtown Asheville, one in the city firehouse on Haywood Road in West Asheville, and one each at the Weaverville, Enka and Reynolds volunteer fire departments. (A seventh unit, BCEMS6, which had been temporarily suspended on Jan. 1 due to the paramedic vacancies and the state budget crunch, was reactivated at the West Buncombe Fire Station on July 1.)

The county also placed 12 of its EMTs in four outlying fire districts: Leicester, Barnardsville, Upper Hominy and Reems Creek. These staffers worked in ambulances belonging to the local fire districts and alongside local personnel, who were often volunteers. It was these 12 positions that EMS suggested cutting.

To be sure, there was geographical logic to the recommendation. More centrally located in populated areas, the county units can reach more people faster and back up other units better than ambulances stationed in outlying fire districts.

And because the local departments were certified only at the EMT-intermediate level, paramedics assigned there could not provide advanced cardiac care or perform various other higher-level medical procedures for which they had been trained.

In fact, with so many paramedic positions unfilled, Emergency Medical Services had long been pulling its people out of rural fire departments to keep its own ambulances rolling. Chiefs at the outlying stations never knew whether the county EMTs were going to show up.

And however much sense the proposed cuts made from a countywide perspective, the affected districts looked upon the plan with alarm, fearing that local service would suffer and response times lag.

Budget blueprints

In June, when Greene was floating proposals to raise taxes to either 65.5 cents or 69.5 cents per $100 of assessed value, Nathan Ramsey came up with a budget proposal of his own that tried to address these fire districts’ concerns.

Ramsey, a Republican who’d been elected (with much rural support) on a promise to focus on essential services and hold the line against zoning and tax increases, floated a budget proposal based on a 62 cent property-tax rate. The plan called for: slashing all funding to outside agencies except Pack Place, delaying county pay increases, and curbing the rise in education spending. But Ramsey’s plan also gave Emergency Medical Services an extra $500,000 to save the EMT positions at the volunteer fire departments and raise salaries (in hopes of filling departmental vacancies).

Ramsey abandoned his proposal after Vice Chairman Bill Stanley, a Democrat, suddenly and unexpectedly proposed a budget on June 29 featuring a 59 cent tax rate — well below the previous year’s 63 cents but above the “revenue neutral” 57 cent mark that would have left the average property owner’s tax bill unchanged after the latest revaluation. Ramsey and David Young joined Stanley in voting for the plan, and the 12 EMT positions at the outlying fire stations were history.

For his part, Ramsey notes that when he originally proposed his plan, it offered the lowest tax rate then under discussion. Although he describes ambulance transport as one of the county’s “core services” and the outlying EMT positions as “certainly something that I would have liked to have funded,” he reports that the commissioners were “under tremendous pressure” once the state announced it was withholding millions in scheduled reimbursements.

The pain, Ramsey points out, was shared: property-tax bills rose, school budgets were pinched, and A-B Tech had to postpone plans for a new Enka campus.

What’s more, he says, the four affected districts also have the option of raising funds by levying local fire taxes. In this, Ramsey echoes Jerry VeHaun, who cites that fund-raising ability, rather than geographic considerations, as the chief reason EMS recommended taking the position cuts at the outlying departments.

Fire sale

Board members of those fire districts, however, take issue with the idea of a fire-tax option. The county, they note, locked them into two-year budgets last year; in addition, they were told about the cuts so late in the budget cycle that they wouldn’t have been able to submit requests for tax increases even if they’d been on one-year budgets. If the districts must raise taxes, which none say they’re eager to do, they would have to wait till next year to get county approval. And it would be 2004 before they would see any of the revenue.

William Fleming argues that it was “a copout” for the county to expect the outlying fire districts to pick up their own tab for ambulance service when central urban and suburban regions can simply enjoy the county-funded paramedic units stationed there. He calls it “blatant and open discrimination.”

Barnardsville Fire Chief Kevin Mundy agrees. The way events have unfolded, he says, shows that “when push comes to shove, outlying districts get the raw end of the stick.”

That hasn’t stopped Barnardsville, Leicester or Reems Creek from continuing to provide ambulance transport, however. By hiring new people, tweaking budgets, delaying purchases and increasing the workloads of both paid staff and volunteers, they’ve managed to keep their ambulances on the road despite the county cuts.

Only Upper Hominy, a small district with the lowest budget among the four, has decided that it lacks sufficient qualified paid staff and volunteers to man an ambulance, which requires at least one EMT-intermediate to treat the patient and one certified “medical responder” to drive. Ambulance service there is scheduled to end on Sept. 11.

In its place, the district plans on hiring three EMTs to work rotating shifts as “first responders.” Upper Hominy Fire Department board Chairman Ben Lunsford, who is himself a county EMT, explains that first responders will rush to the scene of medical emergencies and provide treatment until county paramedics can arrive from the Enka Fire Station with their ambulance.

The concept didn’t seem to impress those in attendance at the community meeting. Critics pointed out that the county ambulance in Enka makes a lot of runs, and when it’s busy, an ambulance would have to drive all the way from Haywood Road in West Asheville.

“The whole point of ambulance service,” argued Upper Hominy resident Mary Netherton, “is to get you to a hospital as soon as possible.”