Nearly Defunct NC Rescue Squad Finds New Purpose

Dec. 14—The Haywood County Rescue Squad is transitioning from a near-dormant stage into a new version of its former self.

The Rescue Squad ceased services in 2019 following a financial collapse and internal turmoil. To fill the void, Haywood County Emergency Services expanded its ambulance fleet and hired more drivers. With the county stepping in to absorb the Rescue Squad's former role, it's future was uncertain.

Now three years later, the Rescue Squad has finally found a niche — though its new mission is far different from the original intent to provide ambulatory and emergency services for Haywood County residents.

Since Haywood EMS added capacity when the Rescue Squad was struggling, it can now handle call ambulatory volume without the Rescue Squad's help. In fact, it's been more than a year since Haywood County EMS called on the Rescue Squad for backup, according to Allison Richmond, spokesperson for Haywood County Emergency Services.

Instead, the Rescue Squad now mostly provides ambulance transport for facilities and individuals outside the county. In Haywood, one of it's main roles is wilderness search and rescue, from lost hikers to high-ropes and swift water rescues.

It's hope is to gradually rebuild and become a player once more in the Haywood arena of emergency services. The Rescue Squad sends out a mass mailing to Haywood residents twice a year soliciting donations, which brings in six figures.

New start

The Rescue Squad, started in 1958, was the first paramedic service in the county, and the primary emergency medical unit for three decades.

But as population and call volume increased, Haywood County took over the bulk of the calls, with the Rescue Squad providing backup. It shifted its primary focus to on-demand ambulatory transport — taking patients between the hospital and home, or long-term care facilities to medical appointments.

Insurance agencies and government entities pay for such calls, but in 2017 there was a breakdown in the Rescue Squad billing process. The Rescue Squad ended up $269,000 in the hole, according to its 990 form, an IRS document required of all nonprofit organizations.

By 2019, 12 employees were dismissed and the organization lost its license to transport patients.

This year, the Rescue Squad resumed services again. It launch in March as a part time operation, and buy October had restarted its full-time medical transport service, operating one daytime ambulance six days a week.

That has gone well, said Chief Dustin Green, so the organization is poised to put on another ambulance in January.

Johnny Glance, a long-time board member and current chairman for the nonprofit, said the organization continues to do better and better each month. To operate one ambulance requires four emergency medical technicians — there are two employees for each 12-hour shift.

"The people we transport for are begging us to put on more ambulances, but we have to build slow and gain revenue to hire more people," Glance said.

Green credited several mail fund drives with helping the Rescue Squad get back on its feet.

"The way we've functioned until last year was on donations," he said. "We send out two mail fund drives a year and the county covers the insurance cost. We couldn't live off that, so we decided we owe it to citizens to generate revenue for the agency."

After the expense of paying fund drive service, the Rescue Squad nets between $65,000 and $100,000 annually, he added.

Rebuilding a base

Contracts are in place with facilities such as the Veterans Administration, Mission Hospital and various out-of-county medical or long-term care facilities. Call volume has increased to the point the board voted in December to add another ambulance, Green said.

The organization has four service vehicles that can eventually be put on the road, Green said, so the main cost will be pay ing for the $15-an-hour employees.

"Our cash flow is working well," Green said. "Typically in EMS services, you bill the insurance companies and there is a delay for processing, but we also have partners who pay direct," Green said.

In addition to the medical transport business arrangements, the Rescue Squad has a contract with the Haywood County Schools to be on standby during ball games and one with Haywood County to provide back-up services as needed.

Richmond said the last time the Rescue Squad was dispatched as backup to a Haywood County EMS call was Sept. 25, 2021. She said the Rescue Squad also offers EMT-level medical standby coverage for events through fees and contracts with the event hosts.

Haywood County 911 dispatches the Haywood County Rescue Squad initially under the following circumstances, she said: structure fires in the Saunook and Fines Creek fire districts; water rescues, high/low angle rope rescues, structural collapse, cardiac arrest, confined space, trench rescue, entrapments, wilderness or urban search and rescue, machinery rescue and animal rescues.

All other calls within the remaining fire districts are left up to each fire department and EMS to request dispatch for Rescue Squad as needed.

The current contract between Haywood County and the Rescue Squad states, "the 911 Call Center will use its judgment in weighing response time and capabilities of County EMS resources, volunteer fire-and-rescue teams and the Rescue Squad."

The reduced need for Haywood County Rescue Squad services inside Haywood is a direct result of its insolvency in 2019 that made it necessary for Haywood County EMS to fill the gap.

Past reporting in The Mountaineer indicated the major issue was failure to properly bill the individuals who received ambulance services.

The county made several efforts to work with the Rescue Squad but ultimately determined bringing the medical transport services — and its income — in-house would best serve the public need.

By hiring a mix of six EMTs and paramedics, the county was able to fill the need for nonemergency transports within Haywood and charges for the service covered the cost.

Green said past deficits shown on the Rescue Squad's 990 forms were addressed by writing off bad debt.

"They look at good debt and bad debt," he said. "Whenever we bill for patients, Medicare never pays the full amount, so there were still payments not collected. That's considered bad debt."

He said all the past employees who were laid off when the financial difficulties became apparent have been paid, as have previous loans.

"The Rescue Squad has not had any financial issues in the past few years," Green said. "We started back March 1, 2022, rotating part-time employees a few days a week to get our credit built up to make sure we had a viable solution. On Oct. 1, we went to full-time employees."

The Haywood County Rescue Squad has a volunteer roster of 60 with individuals spread across a number of specialities who are called upon when help is needed to respond to search and rescues or fire calls in the county.

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