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1 ! fGtChY°rcr~~ t. f L.~. <br />Prepared 4/17/03 <br />Emergency Transportation Transition <br />From Orange County Rescue Squad to Emergency Management <br />Progress Report <br />In North Carolina, counties are mandated to provide, or ensure the provision of, <br />appropriate Emergency Medical Services (EMS) to those in need of such services. <br />EMS includes medical assessment, necessary stabilizing treatment, and ambulance <br />transportation. Not all patients require every component of EMS, but each county must <br />ensure that all components are available to its citizens. Throughout the state, there are <br />many different models for providing this service. <br />Orange County has three primary functional areas for EMS: <br />• Emergency assessment and treatment <br />• Emergency transport <br />• Convalescent (non-emergency) transport <br />Over the past few years, the County has periodically evaluated how it provides <br />emergency and convalescent patient care and made various changes in how it delivers <br />these services to patients. For example, in 1994, the Board of County Commissioners <br />elected to privatize non-emergency transportation by granting non-exclusive franchises <br />to two private corporations. <br />The most significant change in the system occurred in 1996 when the County <br />implemented the award winning Initial Response Paramedic Program. This service <br />delivery model provides for paramedic response on every medical emergency call <br />received by the County's 911 Center. The responding paramedic, who is a County <br />employee, assesses the patient's needs and, if necessary, treats the illness or injuries. <br />When medically necessary, Orange EMS & Rescue Squad (OEMSRS) staff provides <br />emergency transportation in accordance with an existing contract between the Squad <br />and the County. <br />The existing contract provides for the Rescue Squad to staff ambulances and provide <br />space in squad stations to house the County's ambulances. Squad staff is comprised of <br />a mixture of non-paid volunteer, part-time paid, and full-time paid personnel. As <br />compensation for providing staff and housing ambulances, the County pays the Squad <br />a monthly stipend. It is also important to note that in addition to the stipend, Orange <br />County purchases and maintains ambulances and emergency response equipment and <br />supplies for the Squad to use. <br />In recent years, the Squad has faced challenges with regard to staffing and <br />volunteerism. Examples of the challenges include a decline in the number of volunteers <br />that it has been able to recruit and retain along with a decrease in the amount of time <br />