A recent proposal to create a fully paid EMS system has MCRS officials concerned. They say it’s not needed and as citizens, question the cost.

Though they may have asked for help to cover additional hours in the past, Madison County Rescue Squad officials say a fully paid EMS system isn’t needed.

Earlier this month, director of EMS Noah Hillstrom presented county supervisors with a staffing plan that would increase paid, or EMS, staff from 16 to 23 with three new medic hires. The employees would run 24 hour shifts with two 24-hour shifts daily staffed with two full-time medics each or four people each day to staff two ambulances. Employees would work two 24-hour shifts per week. There would also be one peak activity shift from 7 a.m. to 7 p.m. daily staffed with two paramedics at 40 hours per week. Four lieutenants, which assumes the promotion of one medic, would each cover two 24-hour shifts per week. The plan would also require part-time and over-time to cover shortfalls as well as times when employees are in training and unable to answer calls, vacation time and unpaid military leave. In total, compensation for employees would be approximately $1.4 million collectively.

The 24-hour staffing plan would effectively reduce the rescue squad and its volunteers to basically the backup squad, something rescue squad officials say isn’t needed and is at an extra cost to citizens.

Squad president Steve Grayson said the paid EMS system was created in 1999 when times were simply changing. Daytime call volume increased and gone were the days when volunteers could easily leave their jobs to run calls. As a result, the squad approached the county about hiring paid staff to cover daytime calls and EMS was established. Since then, EMS has consistently ran daytime calls, unless more staff is needed in which volunteers are alerted and respond. Volunteers cover nighttime hours, with each choosing a set day of the week. They are required to be at the squad house on their chosen day from 6 p.m. to 5 a.m. There is also a paid medic on duty every night to respond to advanced life support (ALS) calls. One medic is required to respond with volunteers to ALS calls whereas a medic is not needed for basic life support (BLS), or less serious calls. The MCRS does not have medics. Becoming a paramedic requires extensive training beyond that of an EMT so most opt to be paid rather than volunteer, Grayson said.

Over several months, including in January, MCRS requested additional coverage during nighttime hours from paid staff. The additional coverage resulted in the hire of three full-time paramedics. However, they didn’t ask for a fully paid system.

“We’ve always requested when we need help,” squad vice president and longtime member Wayne Jones said. “We haven’t requested that. I can’t understand why they would want to take over and have five medics on duty.”

Grayson pointed out that doing so would be at an additional expense to taxpayers.

Squad captain of operations Steven Dodson said sometimes currently there will be three medics on staff a night.

“We haven’t requested that,” he said.

The three said the volunteers, with the one paid medic for ALS calls, have no issues answering calls and that there has never been a missed call. Grayson said the rescue squad volunteers provide a service to the county, one they will continue doing.

“The rescue squad wants to do its duty, but we feel we’re being pushed out,” Jones added.

Grayson and Dodson said squad officials and members have tried to work with EMS and feel like they have an excellent relationship with their paid counterparts.

“We welcome the paid staff with open arms,” Grayson said.

He said paid staff are free to use the squad building which includes a kitchen, bunk rooms for four females and four males, and bathrooms. The county recently signed a lease on a property across the street for the EMS staff to provide additional space and running water, things not currently found in their home adjacent to the squad building. EMS is expected to move into its new building April 1.

Meanwhile, the county funds the rescue squad $100,000 annually as part of a memorandum of understanding between the two. In exchange, the MOU states the squad will ensure two ambulances are always available for use. The squad currently has five ambulances and a heavy duty crash track in addition to various pieces of medical equipment. Grayson said the county appropriated $100,000 annually to the squad long before the MOU was established so that was the number used in the agreement. The $100,000 covers the approximately $50,000 in annual maintenance costs to keep the ambulances running as well as $44,000 annually in insurance. The squad covers all costs associated with its building, equipment costs and other items. The county and rescue squad share some supplies and the county owns one ambulance.

“Everything at the squad building belongs to the citizens,” Jones said. “When we’ve expanded the building, all of that has come from the people who have supported us.

“We’ve always done the best we [could] and have used [our funds] to best fit the needs of Madison County,” he added.

Grayson, Dodson and Jones said the idea of a 24-hour fully-paid EMS staff brings morale down among their volunteers. It also causes questions to be raised in the community about the future of the squad with some asking if the squad is folding.

“We’re not ready to fold,” Jones said. “We appreciate what’s been done and we intend to keep doing it.”

There was also a question of putting the volunteer program under the EMS program, a suggestion included in a citizen-created report on EMS and MCRS in the county.

“We feel we shouldn’t be under a career person,” Dodson said. “If we want to be a volunteer, we should be under the established volunteer organization.”

There’s also a question as to how that would affect the squad’s non-profit status. Grayson said if under EMS, the squad would no longer be a 501(c)3.

Meanwhile, Grayson said volunteers have a love for giving care and a love for their patients. Dodson said they often see people they’ve helped who thank them for their service.

“Volunteers put a lot of time into it,” Jones said.

“I wanted to give back to my community,” Dodson said about deciding to volunteer. “I’m compassionate and caring. I get a better feeling when I can help someone.”

Jones said he was raised to care about others.

“I was raised in church to help people and help our brothers and sisters,” he said.

The three said there’s a family dynamic that comes with being a part of the MCRS. Grayson said there are often meals and fellowship between calls, in addition to the upkeep of the building and equipment.

“Everything is done as a group,” he said.

Currently, there are 10 people undergoing EMT classes. Each has made a two-year commitment to the rescue squad and will begin running calls once training is complete along with their precept, or shadowing, period. They’re likely to be fully running members by this fall.

There’s also a rebirth of the junior cadet program. There are approximately 10 students involved in the program which is meant to feed into the squad program. Students can become an EMT at 16. One student is now a junior member of the squad. At 17, he is able to run calls as an extra person on the ambulance. He can run as a member at 18.

There are also plans to host an additional EMT class once the current one finishes. Applications to join the squad are located online at

The bottom line, the squad isn’t going anywhere, and squad officials say it doesn’t need to.

“I don’t see a time coming when we’ll need 24-7 help,” Dodson said.

For more information about the Madison County Rescue Squad, contact Steven Dodson at (540) 718-2551.

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