The struggle to bring paramedic-level service to all residents of Beaufort County is one of the Washington Daily News’ Top 10 stories of 2015.

The saga of countywide paramedic-level service started with Chocowinity EMS attaining paramedic status in early 2014 and quickly escalated, finally finding resolution in 2015.

What set events in motion was a disagreement in August of 2014, about whether Chocowinity EMS could make medical transports between Washington’s Vidant-Beaufort Hospital and Vidant Medical Center in Greenville. The county notified Vidant-Beaufort that Chocowinity EMS was not authorized to make such transports. Chocowinity EMS filed suit against the county, and in early November of 2014, District Court Judge Michael Paul gave the squad the go-ahead to continue intrafacility transports.

A month later, commissioners voted 5-2 to terminate Chocowinity EMS’ contract, giving the squad six months notice. At the time, Chocowinity EMS was the only paramedic-level nonprofit operating in the county.

The issue spilled into 2015, as commissioners and non-emergency medical transport companies expressed concern that the squad was infringing on the private business, with the assistance of taxpayer money. Chocowinity EMS’ board chairman Jay McRoy refuted claims they were using taxpayer funds to compete with those in non-medical private transports business — that Chocowinity EMS was only providing medical transports where a paramedic is required on runs from one hospital to another.

The ongoing dispute between the county and the paramedic-level EMS squad as to the legality of the squad’s intrafacility transports was causing increasing concern to residents on the south side of the Pamlico River. A June 30 deadline was set to resolve the issue and no resolution meant that EMS service would likely be farmed out to a for-profit EMS company.

In January and February, the uncertainty prompted a series of well-attended town hall meetings and residents to sign their names to petitions circulating through the Chocowinity Township service district. At the same time, commissioners formed a committee to study options.

“Politically, the residents cover the spectrum, from liberal to conservative, but if there is one issue that will unite the overwhelming majority, it is any decision made by the commissioners that even potentially jeopardizes our continued access to a rapid and capable emergency medical response,” Cypress Landing resident Bernie Dougherty wrote in a February email.

In March, more than 3,000 signatures from residents on the south side of Pamlico River were handed over to Beaufort County commissioners during the Board’s regular monthly meeting.

The concern, according to some commissioners, was not competition with private business. Instead, it was the viability of Chocowinity’s business plan. But two meetings between the Board’s EMS committee and Chocowinity EMS stakeholders later, a contract that was acceptable to all parties was created. The new contract specified that, outside of emergency calls, Chocowinity EMS can only make intrafacility transports that require a paramedic on board to oversee the patient.

“It’s never been an issue for me whether we were going to have service. The issue was the viability,” Commissioner Frankie Waters said in the Board’s April meeting. “The business plan is based on Vidant asking them to make transports (from Washington to Greenville). If it stops, it’s going to need to be subsidized. … I have a real concern whether this plan will work after 12 months.”

While expressing reservations, commissioners approved a new contract in a 6-1 vote at that same meeting — one attended by many advocates for Chocowinity EMS.

“I’m relieved, to be honest with you,” said Chocowinity EMS Capt. Shane Grier.

The lone dissenting vote came from Commissioner Hood Richardson, who objected to the contact’s approval because it had not been reviewed by the existing public safety committee.

The issue pinpointed the county’s need for a comprehensive, countywide plan for emergency services. As more county squads began providing paramedic-level service, John Flemming was added to the county staff as EMS director. Along with Flemming, EMS consultant David Schrader identified the gaps in service existing within the county as Blounts Creek, Bath Township and some areas of Pinetown — all areas that either relied on volunteer EMS squads or were at such a distance from local squads that response times greatly exceeded those recommended by the state. Since then, a $500,000 grant from Vidant Foundation has cemented a plan to fill those gaps with two Quick Response Vehicles (QRVs) manned by paramedics and an ambulance, also manned by paramedics, with the QRVs operating at strategic points on the north and south side of the Pamlico River and the ambulance stationed in Bath Township.

In November, commissioners approved the hire of 12 fulltime paramedics and four EMT-Intermediates to man those vehicles, in addition to 10 part-time staff to cover vacations, sick days and holidays. The vote was 6-1 in favor of the new hires, with Richardson dissenting.

Richardson said the cost of countywide paramedic-level service would total $3 million per year in coming years, which is a cost the county can’t afford.

“This is about money,” Richardson told the Board. “This is about business and you need to be careful about what we’re getting into here.”

Again, a committee was formed — this one to keep abreast of the financials, as well as the efficacy, of paramedic service in Beaufort County.