The ongoing change to EMS coverage in Beaufort County is one of the Washington Daily News’ Top 10 stories of 2016.

A story two years in the making, the county made headway in the effort to provide the same level of EMS service to all Beaufort County residents this year. In 2015, most volunteer squads went paramedic, but after a study done by consultants revealed gaps in service in key areas in the county — Blounts Creek, Pinetown and the Bath area — the county officially launched Beaufort County EMS in February, purchasing three Quick Response Vehicles and an ambulance and employing 16 paramedics and EMTs to man them in strategic spots. The move narrowed response times from 20 minutes to four to five minutes in places such as Blounts Creek and Bath, according to then-EMS Director John Flemming.

Also in February, at the annual retreat, the Beaufort County Board of Commissioners talked about the county taking over all billing for EMS service in the county and initiating a uniform 3.5-3.9 cents EMS tax per $100 property tax valuation for all. Existing EMS squads would continue to operate independently as subcontractors for the county, and each continue to receive money accrued through county billing, as well as from supplemental income from the county general fund.

In March, Washington’s City Council voted to hand over EMS service to the county altogether, to go into effect on July 1, the beginning of the 2016-17 fiscal year. The decision would have affected residents within Washington city limits, as well as in Washington Township, for which EMS service has been contracted to the city by the county for several decades.

In April, city and county officials, as well as other EMS stakeholders sat down to a meeting to work on the issue, which led to city officials extending that deadline to June 30, 2017. The Town of Belhaven’s issues with county-controlled EMS also cropped up early in the year, when Belhaven’s Board of Aldermen decided the town would not pay a $152,000 bill from the county for EMS service in 2015, service that was subcontracted to White Oak EMS after Vidant Pungo Hospital closed its doors in 2013. Commissioners decided in 2015 to add a second truck to Belhaven’s coverage which meant a $60,000 increase for the town that pays roughly 25 percent of the total bill. Commissioners elected to reduce the bill to $89,100, as they acknowledged that the town did not approve the decision to add service, but Belhaven Mayor Adam O’Neal was adamant that Belhaven residents should not have to pay more for EMS service than other residents. At the time, $89,100 represented about a 7 cents per $100 tax valuation where the next highest was Pantego’s 5 cents per $100 valuation. The town board voted to pay the county $62,000 instead of the $89,100 owed.

In May, the Beaufort County EMS Oversight Committee met to iron out a few issues dealing with uniformity of EMS service. For the Aurora area, it was decided that EMS patients east of the intersection of N.C. highways 33 and 306 would be transported to Carolina East Medical Center in New Bern, while all those west of the intersection would go to Vidant Beaufort Hospital in Washington. The fate of Bath Community EMS was also decided, as its roster had shrunk and was only able to respond to 24 percent of its calls. The committee opted to shut the facility down as of July 1, and plans are underway to make the facility a staging point for Beaufort County EMS.

Also in May, White Oak EMS announced it would relinquish its service of the Belhaven/Pantego area to the county. Commissioners elected to buy an ambulance and other equipment from White Oak owner Ricky White and Beaufort County EMS took over the area’s EMS service.

By July, Chocowinity EMS’ financial problems were on the county agenda, as Chocowinity EMS Board of Directors’ Jay McRoy asked commissioners for a non-emergency transport ambulance franchise and $50,000 in additional funding to keep both of the squad’s ambulances staffed and operating until the end of the year or revenues came in from the non-emergency transports. At stake was shutting down operation of one ambulance, when Chocowinity EMS handles 1,000-plus calls a year. Commissioners opted to refer the ambulance franchise issue to the oversight committee, as some believe taxpayer-funded EMS squads should not be in competition with private ambulance companies operating in the county. They also declined to give Chocowinity EMS the $50,000, instead advancing to the squad tax revenue the county had yet to collect in order to keep the second ambulance afloat.

In August, the EMS Oversight Committee made no recommendation about whether the county should grant Chocowinity EMS an ambulance franchise, after a meeting in which the squad’s practices were strongly questioned by committee members. One issue was that Vidant Beaufort Hospital’s calls to the squad to make patient transports to Vidant Medical Center in Greenville often went unanswered. In September, commissioners voted in favor of giving the squad the franchise.

Also in August, Washington’s City Council decided to revisit the idea of giving up EMS service to the county, but by October, the city and county were once again at odds, when county commissioners voted to take over the service to Washington Township (Old Ford and Clark’s Neck areas) that Washington Fire-Rescue-EMS had provided for decades.

Commissioners weighed three options: to renew the contract with the City of Washington at $157,255, an increase of 2 percent over last year’s contract; contract with the City of Washington to provide a dedicated EMS unit for the area, dedicated to EMS calls only — the unit would not respond to supplement fire calls — for approximately $572,000; or have Beaufort County EMS provide paramedic-level service, which would be offset by billing revenue and cost the county approximately $121,000 from the general fund. However, that cost to the county’s general fund was very likely underestimated, as a county EMS consultant used a figure for estimated billing revenue that Washington city Manager Bobby Roberson and Chief Financial Officer Matt Rauschenbach said was inflated. City coffers stand to lose not only the $154,000 contract with the county but the billing revenue as well.

But the outcry over the county’s decision hasn’t been limited to city officials and first responders—residents of Old Ford and Clark’s Neck have lodged their complaints as well. While a Beaufort County EMS plan to cover Washington Township is in the works, the proposal to house the ambulance at Old Ford Volunteer Fire Department has prompted feedback from many people in the area. The primary concern is that placement of the ambulance at Old Ford would move it farther away from the more populous areas of Washington Township where most of the EMS calls originate, primarily along U.S. 264 west of Washington and up Market Street Extension, north of town.

Commissioners have said they will revisit the issue during upcoming budget meetings.