Written by: Sam Garrett
During a June 17 Watauga County Board of Commissioners meeting, commissioners unanimously voted to purchase Watauga Medics, Inc. The purchase price of $1.7 million includes a fleet of nine ambulances along with one station located in Boone.
Commissioner Ronnie Marsh shared his insight on the decision making process.
“From its formation, the ambulance service in Watauga County has been privately owned and operated,” said Marsh. “We have been very fortunate to have had good partnerships with local owners. During the past few months, we received notification that the current owner intended to retire and not renew the contract at the end of this calendar year.”
When the commissioners realized the contract would not be renewed, they considered various options for moving forward in ownership. Ultimately, they concluded that the best future for emergency medical services in Watauga County was a county-owned and operated system.
“I have been a proponent of a county-owned ambulance service since I first ran for commissioner in 2020,” said Commissioner Todd Castle. “Not only did the commissioners agree to purchase Watauga Medics during the June 17meeting, but they also prepared a schedule to replace some of the older chassis. In addition to the $1.7 million, we will be spending quite a bit of money on new units.”
Commissioners explained the necessary differences between private and county ownership.
“Craig Sullivan and Watauga Medics gave the county good value for the service we received,” said Marsh. “However, like most businesses, they need to turn a profit to survive.”
The county previously entered a multi-year contract with Watauga Medics.
“A benefit to a county-owned ambulance service is that we do not need to turn a profit,” said Marsh. “I look at ambulance service just like fire service and police. It is a service to the community.”
“The goal of a for profit business is to make money and increase revenue,” said Commissioner Braxton Eggers. “The goal of the county is life safety.”
In addition to safety, commissioners communicated multiple benefits to having a county-owned ambulance service.
“Watauga County was one of the last four counties in North Carolina under private ownership,” said Marsh. “Discussing this purchase, we realized that under county ownership the service would be directly accountable to the citizens through building community trust and participation in shaping the future of this service.”
The benefits do not end there.
“It also leads to better transparency in operations and financial management,” said Marsh. “EMS now directly intertwines with the other emergency agencies in the county, law enforcement, fire, communications and emergency management.”
The transition will occur in late 2025 and early 2026. Work has already begun to mitigate any potential interruptions.
“During the transition period there could always be some challenges, but it is our intention and desire that the public experience will go unchanged,” said Marsh. “Our goals are to improve efficiency, response times, patient care, and staff retention.”
The county has reportedly purchased new ambulances to replace some of the aging fleet. The purchases are expected to simplify the replacement schedule.
Staffing is another focus area in preparation for the transition.
“An EMS Director will be hired to guide the new department and make recommendations to us for developing short and long term goals,” said Marsh.
Commissioners say they are aware of the public’s interest in costs associated with the decision to purchase Watauga Medics.
“Financial oversight is always a catalyst in ownership of a service,” said Marsh. “Returning the annual supplement to the county that was budgeted to the previous owner helps infuse the new EMS budget to a certain degree. In time, we will have a complete operating cost, but in full transparency, our citizens must understand the cost for services now lies with Watauga County.”
The county will secure a contract with a third party billing company to submit claims and track collection of Medicare, Medicaid, insurance, and private payments for ambulance and EMS services.
“Our focus would be to make a profit, but our guidance will be to break even,” said Marsh. “However, our main, overall goal is to provide the best EMS service to Watauga County, period.”
Another benefit of a county-owned ambulance service is that the staff will have access to the benefits available to Watauga County employees, which is expected to help with retention.
In addition to the Boone station, commissioners are considering options for ambulance services for Blowing Rock.
“Before I was even sworn in after the last election, we began searching for a location for an ambulance to serve Blowing Rock,” said Castle. “We tried to purchase a piece of property in December, but the landowner wasn’t interested in selling.”
That development prompted the county to look for another property on the 321 corridor to house an ambulance.
“There are two or three parcels we are looking at now,” said Castle. “I have been working with Blowing Rock Town Council Members Doug Matheson and Pete Gherini, as well as Town Manager Shane Fox to identify a location.”
Watauga County commissioners and the county manager have prioritized securing a new base for Blowing Rock.
“[It] will happen sooner rather than later,” said Castle. “But right now, we need to catch our breath and get through this purchase and transition, then we put pen to paper and get a solid plan in place for a base.”
Commissioners are confident that there will be noticeable differences following the transition.
“Watauga County will attempt to provide enhanced services compared to what we have experienced in the past,” said Eggers.
Castle asked for the community’s support.
“I hope folks in the county will be patient with us as we navigate uncharted waters, as we’ve never had a county-ran ambulance,” said Castle. “This is new to all of us.”
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