Davidson County EMS reportedly stable, study finds growing strain on system
Leaders were told Monday that waiting for a crisis before making changes could come at a cost.
During a presentation to the Davidson County Board of Commissioners, consultants offered a detailed look at Davidson County EMS, including staffing, response times, ambulance availability, training, facilities and the growing demand being placed on the system. The overall assessment came with a warning.
Greg Grayson and Regina Crawford of NC Fire Chief Consulting described Davidson County EMS as a stable and capable system with dedicated employees, while pointing to increasing call volume, overlapping emergency calls, workforce challenges, geographic coverage and aging facilities as areas that will require attention. The discussion had less to do with ambulances and more to do with staffing.
The consultants told commissioners that EMS employees across all four shifts consistently raised concerns about communication and feeling disconnected or undervalued by leadership. The concerns were not simply about salaries.
When Commissioner Chris Elliott questioned whether employees were primarily concerned about pay or opportunities such as conferences and additional training, Crawford said both matter. But stressed that employees also want to feel valued, appreciated and engaged while maintaining some level of work-life balance in a profession that can take a significant physical and emotional toll.
Commissioners opened a broader conversation about what it takes to keep trained emergency workers in Davidson County.
Commissioners also discussed educational opportunities, career advancement and whether the county could provide stronger financial support for employees pursuing paramedic training. One idea involved reimbursing employees for training after completion in exchange for an agreement to remain with Davidson County for a specified period.
The discussion reflected a larger challenge facing EMS agencies across North Carolina: counties are competing not only with neighboring counties for trained paramedics, but also with hospitals and other healthcare employers that may be able to offer higher salaries or different working conditions.
The study also raised questions about whether Davidson County has enough ambulances available when multiple emergencies happen at the same time.
The county currently operates a 12-truck deployment model, according to the meeting discussion. Consultants suggested strategically adding peak-time units as one relatively immediate way to address overlapping calls and periods of heavier demand. Officials also discussed whether Basic Life Support units could handle some calls that currently occupy Advanced Life Support crews.
Facilities were another concern.
Consultants recommended bringing EMS bases up to modern and ADA-compliant standards and developing a five-year plan for facilities, staffing and system needs. Silver Valley was identified during the discussion as an area where distance and call volume may create coverage challenges. Commissioners also discussed the condition of Base 3 and whether it makes more sense to continue investing in a facility the county does not own or eventually construct a county-owned EMS base.
Another significant issue reaches beyond EMS itself.
Davidson County does not have a local cardiac catheterization lab, commonly called a Cath lab. Officials said some cardiac, stroke and trauma patients must be transported outside the county for advanced care, potentially keeping ambulances away from Davidson County for longer periods.
During the meeting, an EMS representative said work is underway with a Novant executive on a certificate of need for a Davidson County Cath lab. The representative explained that the effort is not tied to a specific healthcare provider and, if the need is approved, hospitals would likely compete to develop the service.
Suggestions included considering adding 911 call takers to help reduce the workload on telecommunicators, who currently may be responsible for handling complicated emergency calls while simultaneously managing radio traffic. Nicole Hope described a possible model that would separate some of those responsibilities during the busiest portions of the day.
Commissioners asked for something more concrete: priorities and numbers.
