Emergency services stretched in Orange County

Might get new ambulance, but probably not more staff

Dispatcher Mike Reitz works at the Orange County EMS communication center in Hillsborough. DTH/Stephen Mitchell

Local officials agree something needs to be done about the county’s emergency response.

As population steadily grows, Orange County Emergency Services doesn’t have the resources or the personnel to keep up with the rising demand for ambulances.

And the problem won’t clear up for at least another year.

When county commissioners receive their recommended budget in May, it will not suggest they fund the 29 new staff members the Emergency Services department says it needs.

Orange County Emergency Services by the numbers

1,172 The number of calls Emergency Services
processed per day in 2009.


17 The number of minutes for the average paramedic response time. The department’s goal is a 12-minute response time.

220 The number of occasions last year someone in Orange County called for an ambulance and none was available.

210 The number of times an EMS unit took more than 15 minutes to respond in Chapel Hill last year. The number was 110 the year before.

Source: Orange County Emergency Services

Instead, County Manager Frank Clifton said he will recommend the department’s other request, an additional ambulance, which is a much cheaper alternative.

The move would help relieve — but not fix — the underfunded and overworked department, which in recent years has struggled to address a problem that threatens the lives of Orange County residents.

Struggling for resources

In an effort to reduce the department’s ambulance response time — which is five minutes worse than its goal of 12 minutes — Orange County Emergency Services director Frank Montes de Oca said his department needs $1.2 million from the county annually, as well as funds for a new ambulance.

The $1.2 million would go toward hiring 29 new staff members: 10 paramedics, 10 emergency medical technicians and nine 911 call processors.

“We’ve noticed they’re getting overworked,” Montes de Oca said. “Our system is saturated.”

But Clifton said he is concerned about whether the Emergency Medical Services division would be able to fill the positions even if it got the funds.

“There are far more vacancies than there are applicants for (paramedic positions),” he said. “It may not make sense to make 10 more positions if we can’t fill the ones we have.”

Filling paramedic positions is especially hard in Orange County, as the department often competes with more prestigious medical positions, said Capt. Kim Woodward, EMS operations manager.

Starting paramedics make only about $34,000 a year.

In the past year, at least two paramedics have left the department, and two emergency medical technicians will leave for physician assistant school, she said, leaving her with 18 paramedics out of the 24 she needs.

“We lose paramedics to the nursing profession, we lose them to the P.A. school and we lose them to medical school,” Woodward said. “The problem’s very specific to Orange County because of our demographics.”

One paramedic left for a system that ran fewer calls, she said.

Feeling the strain

But those who call for ambulances are already noticing the county’s shortage.

The demand for emergency services started increasing a decade ago and coincides with the rise in Orange County’s population, especially among the elderly.

The department began seeing more calls coming from places such as Carillon Assisted Living in Hillsborough, and needed more workers to compensate.

And the lack of resources is taking its toll: 220 times last year, someone in Orange County called for an ambulance but none was available, leaving firefighters with only basic life support skills to respond.

“That’s the most difficult number to live with,” Woodward said. “It’s frightening.”

The department continually tried to make do in the face of the rising population, said Laura Blackmon, county manager from 2006 to 2009.

“But it had gotten to the point where we couldn’t make do anymore,” she said. “We had to start making incremental changes.”

Orange County’s paramedics, who typically work 24 hours and take the next 72 off, are more often manning the ambulances every other day, Woodward said.

“Those little things impact your system significantly,” she said.

A department stretched thin

Montes de Oca said his employees’ workloads have increased about 50 percent in the last decade. The population since 2000 has increased 13 percent, and calls for service have increased 68 percent.

But the department’s resources have essentially remained constant over the same period, with only one ambulance added since 2000.

An additional ambulance, which if approved by county commissioners

would be available for use in three to four months, carries a $225,000 price tag.

Despite not having a full staff, Woodward said the additional vehicle could improve worker morale and eventually attract more paramedics to the department.

Wake County, when operating all of its ambulances, supplies one for roughly every 23,000 residents. Durham County has one for about every 22,000.

Orange County has one for every 25,000 residents, a number that shoots up to 31,000 during non-peak hours.

Without the county’s funds, the department will find it harder to recruit paramedics.

“But that doesn’t mean we should stop trying,” Montes de Oca said.

Contact the City Editor at citydesk@unc.edu.


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