LELAND — After less than two years operating its recently-acquired EMS system, the Town of Leland is working to accelerate the transfer of the program to the county.
The coordinated transition of handing Leland’s Emergency Medical Service (EMS) program over to Brunswick County is picking up speed; Brunswick County Commissioners approved a Memorandum of Understanding Monday that memorializes the county’s termination of the town’s EMS franchise agreement. In it, Leland waived its 60-day notice, increasing the pace of the county’s first proposed takeover date in September.
Accounting for expected attrition – that is, employees leaving the current programs – Leland’s manager David Hollis said at a Council Agenda meeting Monday the town requested the county conduct its transition “as quickly as possible.”
Brunswick County is projected to begin providing EMS service to Leland on July 1. The rapid transition has prompted concerns out of Leland Fire Rescue’s former president, Chris Watford.
Watford, who sold his non-profit to Leland in 2017, said plans to divorce the internationally-recognized department from its EMS base will reduce the quality of service to the district.
Town and county officials maintain service will stay the same.
Leland Fire Rescue
The town acquired the formerly non-profit Leland Fire Rescue in 2017, and with it, a debt-generating endeavor.
A joint EMS and fire department, nearly all Leland Fire Rescue firefighters are also paramedics. Most jurisdictions require firefighters to maintain basic-level EMT certification. However, paramedic certification is more rigorous, and not required for fire service personnel.
After the transition, new Leland fire personnel would not get on-the-job paramedic certification. However, existing fire-paramedic personnel would be permitted to keep up their paramedic certification. Brunswick County has offered employment to Leland Fire Rescue’s eight EMS paramedics as part of the takeover.
In North Carolina, counties are authorized to permit or terminate franchise ambulance service agreements. Leland Fire Rescue has provided such services since 1968.
From non-profit, to town, to county
Upon acquiring Leland Fire Rescue, the town created six new full-time fire positions and one full-time EMS role, effectively doubling staff hours at the department. One ambulance is manned 24-hours a day, with eight EMS professionals on staff.
Leland’s draft 2019-2020 budget calculates EMS expenses over $1.4 million, with EMS fee revenues at $605,000. This left the town with an estimated $813,000 shortfall.
On April 15, at a Leland Council Agenda meeting, Leland’s manager Hollis presented the EMS budget deficiency. He noted that nearly 40 percent of Leland Fire Rescue EMS service calls are fulfilled at unincorporated county property. Hollis said providing EMS service in Leland’s absence would cost the county a considerable sum.
He asked if Council felt it would be appropriate to ask Brunswick County to cover the full amount. Councilwoman Pat Batleman asked whether the town should prorate the request to cover unincorporated county ambulance visits, to which Hollis responded he wanted the county to provide the full amount.
“It’s a service that the county provides,” He said at the meeting. “We happen to have an EMS service that we’re providing. And because of that, the county doesn’t have to provide as much service.”
So, Council approved the funding assistance request.
Three weeks later, at its May 6 budget workshop meeting, Brunswick County presented another option: terminate Leland Fire Rescue’s provider franchise agreement and provide its own EMS service in the area.
On May 10, Leland issued a press release — before Council or its Public Safety Committee met publicly to discuss the topic– stating the town’s ongoing work to aid in the transition.
Despite reimbursements from Medicare and insurance companies, Brunswick County Emergency Services Director Edward Conrow said, historically, EMS departments don’t get the full amount requested back.
“With any medical service, you’re always losing money,” Conrow said. “You’re always in the red.”
When the county received Leland’s resolution, Conrow said he had concerns about setting a precedent for other districts asking for large sums to maintain their service.
“Is that a one-time fix?” Conrow asked. “Or is that going to be every year they want that?”
Brunswick County came up with an estimate that it could provide EMS service at a conservative $153,849 loss — costing $788,151 less, with the same eight personnel assigned to a 24-hour EMS unit. The county even conservatively accounted for $129,000 less revenue, Conrow said, and still came up with a final $659,151 difference in debt.
“We’re a bigger system,” Conrow said of the cost difference. “So we have a larger fleet of vehicles right now, so it’s easier for us to absorb it.”
Conrow said residents “won’t know the difference” once the change takes place. “It is a touchy situation. But we want to make sure we do it professionally and respectfully,” Conrow said. “We see that the county is growing fast and we want to makes sure that we stay up to par.”
Former president’s concerns
Leland Fire Rescue, which merged its EMS and fire services in 1998, positions itself as an “academic institution,” according to its former president.
“We were literally turning away volunteers,” Watford said. “Any other department will tell you the opposite.”
What makes Leland Fire Rescue different is its emphasis on EMS, which is married to its fire services, Watford said. About five in 100 emergency service calls actually require a fire-related response. With nearly all 911 calls requiring medical response, Watford said Leland Fire Rescue’s EMS-based model is progressive and effective.
“The two departments do not provide the same services. They are not redundant. They co-exist, and are better because of this co-existence,” he said.
Watford said the town’s 2017 acquisition of his non-profit was rushed — but it did not reduce service. On Twitter, however, Watford was more direct, calling it a “hostile takeover.”
This is some first class bullshit. Yet another broken promise by @Townofleland. Heartbroken to hear a truly innovative and transformative EMS department will be sent to the trash bin by politicians. https://t.co/T3yqLxsiG5
— Christopher Watford (@ecgwatford) May 12, 2019
What Watford can’t figure out is how the program ended up so far in the red under the town’s management, or why the town asked for a full reimbursement from the county.
“To assume that you should get paid for the difference, welcome to the reality of providing 911 services,” he said. “You don’t provide it to make money. You provide it to provide services to your residents.”
How the situation came about
Despite how it looks on paper — Leland presented a big ask, the county, in turn, opts to dissolve the franchise agreement — the county’s emergency services director said last week Leland actually initiated the transition.
“This wasn’t initiated by Brunswick County,” Conrow said Thursday. However, Leland insists this is not the case.
After Port City Daily attempted to reach Leland Fire Rescue Chief John Grimes with a request for comment on Watford’s concerns, Leland spokesperson Hilary Snow responded, saying, ” I think [Watford’s] concerns might be best brought to the county for any comment, since they are the ones who made this decision, not the Town, and will be funding the extension of county EMS services into Leland and the northern area of the county.”
When presented with Conrow’s statement, that the transition was not initiated by Brunswick County, Snow responded in an email: “The Town of Leland did not initiate the transfer of EMS service to Brunswick County. We checked with the county, and they confirmed they did not tell you that ‘This wasn’t initiated by Brunswick County.’”
Port City Daily followed up with Conrow and Brunswick County Manager Ann Hardy to help clear up the information, Hardy responded that she recommended the change to the Brunswick Board of Commissioners after receiving Leland’s funding request. “The county and town staff are working collaboratively to present plans for approval to our respective boards,” Hardy said. Conrow emailed a clarification, restating the same narrative as Hardy nearly verbatim.
On Monday, in Leland’s Agenda Meeting, Brenda Bozeman asked Hollis to request a County Commissioner attend the town’s meeting Thursday to discuss the transition. She voiced concerns raised by the public regarding maintaining the same level of service.
“They’re questioning us — and we don’t know the reason the county’s doing it,” Bozeman said. “And I’d like for them to tell us.”
Councilwoman Batleman wondered out loud why the county “chose” Leland – that is, of all the municipalities in the area, why the county chose to dissolve this particular franchise agreement.
“That’s weird,” she said.
Hollis responded, “I can’t speak to the reasons that the county has decided to do this. Other than that they are.”
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