1000 x 90

LETTERS/ Open Letter to the Watauga County Board of Commissioners

Dear Editor:

Balancing priorities is a good part of your job as a county commissioner. I respect the fact that you answer to many different constituent interests and the challenges that brings, but today I address you as a Watauga County taxpayer about an urgent, even life-threatening issue.

A key message: Life happens throughout Watauga County, not just in the largest town.

Real Case Studies, Real Medical Emergencies

CASE 1: In the summer of 2021, a mother and daughter were on vacation, staying at a bed and breakfast in Todd. They were both registered nurses. At one point during their stay, the daughter flat-lined. She had no pulse. Before administering CPR, the mother called 9-1-1, knowing she needed an ambulance.

The bed and breakfast owner told me that an ambulance never arrived. He said two had reportedly been dispatched, but one broke down and the other couldn’t find the address. Only because the mother was a trained healthcare professional and knew CPR did the young woman survive.

CASE 2: I recently spoke with the mother of a family in Bethel. I asked her what she thought about the county’s ambulance service. She didn’t hesitate in responding, “It is a joke out here on the west side. My son accidentally cut a wrist while doing his chores last year. We didn’t even bother calling 9-1-1 because we knew it might be up to an hour before anyone got here. So, my husband broke a few speed limits driving him to the hospital in Boone. That is what saved my son’s life.”

CASE 3: Just a few months ago, a woman passed out at her desk, at a business in Blowing Rock. The business owner called 9-1-1. The owner told me it was at least 30 minutes before an ambulance got there and the Blowing Rock first responders never arrived, even though the fire station is the length of a football field up Valley Blvd. and there was supposed to be an ambulance stationed there in the middle of the week and on a workday. Instead, the ambulance had to come from Boone. When I investigated why the Blowing Rock paramedics did not respond, I was told it was because they never received the call from the county dispatcher — even though the temporary practice of screening calls during COVID-19 was supposed to have ended a few months before.

CASE 4: Just a few months ago, a man became unconscious at a Blowing Rock church. As it happened, three physicians were in the congregation, and they told the person calling 9-1-1 to tell the dispatcher to send an ambulance immediately because the man appeared to be having a heart attack. Despite the doctors’ pleas, the dispatcher kept asking question after question after question, apparently trying to screen the call.  A Blowing Rock paramedic got there relatively quickly once the Blowing Rock Fire Department was notified, but I am told it took at least 20 minutes more for an ambulance to reach the scene, dispatched from Boone, from the time 9-1-1 was first called.

Those are just some of the stories. There are many others.

Is Watauga County Really Rural?

In preparing my research for this letter to you, I read where Stacker.com ranked the 100 North Carolina counties for their “ruralness.” Watauga County is right in the middle between the most urban and the most rural. It ranked 49th or 50th, from whichever end you were counting. And yet, the same Stacker.com survey reported that Watauga County has the 28th highest density population among North Carolina counties, just shy of 200 full-time residents per square mile. Take out the large percentage of land that is uninhabitable because of it being protected by national forest restrictions, conservation interests, or just being overly mountainous, and the population density of the county probably skyrockets.

For decades, this County government has hidden behind a claim that Watauga is a “rural” county, so can get away with a Boone-centric ambulance service to satisfy its state charter mandating that EMS services be provided.

But really, how rural is Watauga County when the latest U.S. Census reports that roughly 65 percent of the county’s full-time population lives outside of the Boone town limits. They live in subdivisions and neighborhoods like Echota, Sorrento Skies, Heritage Ridge, Ski Mountain, Powderhorn, Firethorn, Blue Ridge Mountain Club, Sweetgrass, Grandwood, Saddle Hills, Timber Creek, Westglow, Misty Mountain, and so many, many more.

They live in communities like Matney, Todd, Meat Camp, Zionville, Bethel, Valle Crucis, Mabel, Foscoe, Aho, and Triplett, to name a few. And of course, many among that 65 percent live in the three other incorporated municipalities: Blowing Rock, Seven Devils and Beech Mountain.

And that 65 percentage of population living outside of Boone swells considerably between May and November when the seasonal residents arrive in Blowing Rock, Valle Crucis, Seven Devils, Beech Mountain, and the other enclaves of seasonal residents getting out of the oppressive summer heat of the Piedmont and Coastal Plains in the South. To be sure, that population density number swells, too, with the seasonal residents’ arrival.

Blowing Rock’s population, for example, grows from about 1,300 full-time residents to between 6,000 and 8,000 from late spring to early winter. That doesn’t take into account the seasonal residents living outside the Blowing Rock town limits but in the Blowing Rock Fire District, nor does it consider the tourists finding recreation and play opportunities throughout the county. And they are doing so, increasingly year ‘round, thanks to climate change as well as to Chamber of Commerce initiatives to even out economic activity, particularly in the so-called “shoulder” months between the dead of winter and that May to November tourist season.

The Power of Compounding Interest

The 2021 Watauga Medics report mentions that the average annual increase in emergency medical calls over the past 31 years was 3.93 percent. On the surface, that doesn’t sound like much but anyone who knows anything about finance is familiar with the power of compounding interest over time. Although the annual report provides the numbers, it leaves out the critical point that from 1991 to 2021, those same 31 years, the number of calls increased from 1,782 to 6,273 — or a 252 percent increase. That is the cumulative effect of a 3.93 percent average annual rate of increase over 31 years. That same report discloses that the number of EMS calls in 2021 increased more than 14 percent over 2020, or almost three times that 3.93 percent historical average.

Who Is Doing The Counting?

Your EMS concessionaire contract with Watauga Medics aims for a countywide average ambulance response time of 10 minutes. According to Watauga Medics’ 2021 report, the average response time to Boone EMS calls was 7 minutes and 5 seconds. Because there are a good number of Boone calls as the county’s largest town, the faster Boone calls drag down the countywide average so you, the county commissioners, and Watauga Medics can boast that you are meeting your 10-minute target average.

But are you really? We have already pointed out that 65 percent of the county’s population lives outside of the Boone town limits. Let’s take a closer look at the data.

Counting Boone, there are 12 fire districts in Watauga County. In the same 2021 annual report penned by Watauga Medics, the only fire districts that met your 10-minute standard were Boone and Cove Creek (at around 9 and a half minutes). And that is only because a few years ago you added a base just outside of the Boone town limits, near Sugar Grove, that enhances the Cove Creek fire district’s service.

All of the other 10 fire districts, according to the Watauga Medics report, were between more than 11 and a half minutes and 25 minutes. Let’s restate that: Only Boone and Cove Creek were below 11 and a half minutes in average response times. Some fire districts were much longer.

Perhaps more alarming: what is accepted as the national standard for response times in most jurisdictions (except in Watauga County, apparently), is that 90 percent of EMS calls should be responded to in less than 9 minutes. I am not privy to the data, but I bet that 90-in-9 national standard was much farther out of reach in those non-Boone fire districts. It might require 17-25 minutes to contain 90 percent of the calls to the Blowing Rock Fire District and 30-40 minutes in Stewart Simmons or Beaver Dam fire districts, maybe even more, elsewhere.

Show Me The Money

To look at this issue from another perspective, according to various documents I have studied, roughly 65 percent of the property taxes to Watauga County are paid by owners of property outside of the four incorporated municipalities. They are outside of Boone. They are outside of Blowing Rock. Outside of Seven Devils. Outside of Beech Mountain.

Given the heavy distribution of population outside of Boone and from where 65 percent of the money is coming, even someone who didn’t take high school calculus might conclude that the people living outside the Boone town limits are currently subsidizing really good EMS service to Boone while receiving substandard service themselves. Does that sound fair? What will it take for you to recognize this disparity and do something about it?

Misplaced Priorities?

The recently built Watauga Community Recreation Center is a beautiful facility. It is a great place for kids of all ages to play and get some exercise.

But what should have been the county’s higher priority, a place in Boone to lift weights, swim and play basketball, or putting EMS assets in place to address the potential life and death needs of the majority of county residents who live outside of Boone? By charter, that responsibility and mandate was put in your hands by the State of North Carolina. How many EMS bases and ambulances could have been bought with that $40 to $50 million construction cost, as well as the large annual subsidy that will forever be required because operating revenue is insufficient to meet operating expenses at the new Rec Center?

Long before you folks were elected, the Watauga County Board of Commissioners apparently chose what they thought was the cheapest way to satisfy the state mandate for providing ambulance service. Maybe it was OK back then, but it isn’t working now nor has it for at least the four decades since Blowing Rock, for one, started petitioning this body for a 24/7 ambulance base.

In fact, Blowing Rock felt so strongly about it that at no cost to you they built a new fire station and included an ambulance bay complete with comfy staff quarters. Then, because the county refused to provide the needed service, the Blowing Rock Fire District board got together with the Town of Blowing Rock and phased out the once volunteer fire department in favor of a first-class roster of not only professional fire fighters, but 11 out of the current 14 fire personnel have the highest level of first responder certification. And they have certain physical fitness standards to maintain, too, something I doubt your for-profit concessionaire requires, based on the stories I have heard.

Because the county was failing in its responsibilities, the town and the Blowing Rock Fire District took on the added expenses to meet their constituents’ needs. From a first response standpoint that is great (when they are called), but there is only one thing missing: because of your county contract with Watauga Medics, neither the Blowing Rock professionals nor any other first responders in the county can transport. And that 5 to 20 minutes or more gap between first response and transport to the hospital could be the difference between life and death. In the case of heart attack or a stroke, it could be the difference between full recovery, partial recovery — or no recovery.

But all these years this county government has turned a blind eye to the need in Blowing Rock as well as in the many other areas outside of Boone. And approving a part-time ambulance to Blowing Rock, especially since the truck is frequently not even there during its prescribed hours… Well, that is not solving the problem at all.

The Masses, Marching with “Pitchforks”

Health crises, accidents, injuries and other tragic events do not keep 9 to 5 hours. They happen throughout the day and night. They happen throughout the week and month and in all parts of Watauga County.

In conclusion, I ask you: What is it going to take for the Watauga County Board of Commissioners to quit kicking this can down the road and take the necessary steps that result in a long overdue solution? An unnecessary death? A lawsuit?

The answers to the problem are there if you would only listen to the right people. Other counties around us, with similar demographics, have addressed the problem quite effectively and efficiently. Unfortunately, the Watauga County Board of Commissioners, historically, has been listening to the wrong people, apparently. I hope that changes.

Again, human life — with all of its joys, trials, tribulations and injuries — happens throughout Watauga County, not just in Boone.


David Rogers – Boone