Rescue Squad maintains A rating despite budget

By Stephen S. Glass


   Carter County Rescue Squad EMS Director Terry Arnold said Monday that the squad received an A rating from the state again this year despite a limited budget. In order to retain their high rating, the squad had to meet strict criteria for training and education for all employees -- a tough task that has been made more difficult by the squad's lack of funding, Arnold said.
   "It gets harder every year to pass inspection with an A rating," Arnold said. "In order to get that A, we have to have a paramedic and EMT-IV personnel respond to at least 95 percent of all emergency calls. We also have to meet strict guidelines on in-house training."
   Arnold says that with every passing year it also becomes more difficult to keep well-trained personnel at the Carter County stations. "We've got the lowest pay scale in the region. A lot of times we'll train guys and they'll go off and get higher-paying jobs somewhere else. Those guys want to stay here at home [in Carter County,] but they've got families to feed and bills to pay just like everybody else. Luckily we've got a lot of good guys who have stayed with us even though the pay isn't what it should be," Arnold said.
   "We do what we can for our guys," he said. "But most of our money goes straight back into services."
   Arnold said that earlier this year he gave the Elizabethton City Council and the Carter County Board of Commissioners what he considered to be a "realistic budget," asking the county for $475,000 per year, and the city for $221,000. The county currently commits $320,000 to the rescue squad; the city, $63,000. The county's contribution is up $70,000 from what it was two years ago, but last year's expenditures for the squad totaled $1.8 million.
   "We have to make up that difference in billing and insurance," said Arnold. "When I say insurance, I'm talking about Medicare and TennCare, and anybody who's ever had to deal with those knows that they can be tedious: There are a lot of things they just don't cover. We also have a lot of delinquent payments from people without insurance. But money is the last thing on our minds when someone is in cardiac arrest.
   "Right at $1 million of that $1.8 million is paid out in salary. The county and city only cover about half of that, so we don't even have any guarantee that our guys are going to get paid every two weeks. If we have a bad month or two, we could get sunk."
   Arnold said that the squad has managed to keep up with services in past years but has been unable to maintain buildings and equipment the way they should be maintained.
   "We're not going to cut services. We're still giving Carter County what it needs and deserves, but we've had to let a lot of other things go because of that."
   Arnold said that the squad has been trying for the last four or five years to procure funding to replace the roof on the squad's central station on Highway 91. For lack of funds, the job has been neglected.
   "We've tried to get up there and fix it ourselves with tar and sealer, but we're not professional roofers. Some of the leaks have been impossible for us to find."
   Arnold said that two years ago he got an estimate of $125,000 to replace the roof.
   On Sept. 5, a rescue squad employee slipped and fell in a puddle of rainwater in the building's garage, Arnold said. That employee has been out of work for the last month with an injured back.
   "We don't like to gripe, but things are getting tough," Arnold said. "I'm aware that things are tough for everybody in the county right now, so we've watched our money closely. At the same time, though, we're trying to keep up with the best technology and the best training -- but those two things cost money."
   Arnold said that his greatest fear is that the squad's lack of cashflow will eventually translate into reduced services for the county.
   "Statistically, we should have at least one advance life support truck on the road 24 hours a day for every 10,000 people in our area. Right now, we've got four ALS trucks that run 24 hours a day and two basic life supports trucks, which mainly take convalescent calls, running eight to five every day. There are over 56,000 people in Carter County, not counting the 700,000 or so people who visit Roan Mountain State Park every year. At the very least, we really need to have one other truck on the road."
   In the meantime, Arnold says that the Rescue Squad will continue to give A-quality service to the county.
   "In this line of work, you have to be ready to respond at a moment's notice. That's not going to change for us. If you call us, we're going to be there."