In the first split vote since membership on the board changed after the November election, Macon County commissioners voted 3-2 to purchase 12 new defibrillators for ambulances in the county. At the recommendation of Emergency Service Director David Key, Commissioners Ronnie Beale, Kevin Corbin and Jimmy Tate cast the majority votes needed to purchase the equipment at a total cost to the county of $374,000 which includes a 1.57 percent interest rate over a 59-month period.
According to Key, the new equipment is definitely needed, with the age of some defibrillators exceeding 10 years, when the recommended usage is half that. The 12 devices for which the county gave approval will not only replace out-dated equipment, they will also consolidate devices, explained Terry Bates, EMS coordinator. “These machines will be used on every patient that rides in our ambulances,” said Key. “They are not just defibrillators, but they read blood pressure, take pulses, check for carbon monoxide, and do what before we needed two or three machines for.”
The new equipment is designed to allow emergency personnel to respond more efficiently and effectively to a wide range of problems. The new machines will allow the county's entire ambulance fleet to be updated, and will allow both Key and Bates to carry one device in each of their vehicles.
Initially the devices were slated to cost about $41,000 per unit, but because the county voted to buy 12 units, the machines were significantly discounted to $31,581 per unit. In addition to the cost benefit of buying the devices in bulk, Zoll Medical Corporation, the United States company who manufactures the machines, agreed to provide the county with three AutoPulse machines, a $48,000 value, free of charge.
The AutoPulse machines are automated, battery powered CPR machines that enable patients to receive consistent, medically recommended compressions while being transported to the hospital. The three AutoPulse machines will be distributed throughout the county with one in Highlands, one in Nantahala and one in Franklin.
In addition, Tim Nettles with Zoll worked out a trade-in deal for the county's existing equipment, which allowed the county an additional $30,000 to $40,000 in savings.
Originally, County Commission Chair Kevin Corbin suggested the county look at purchasing half of the devices this year and the other half the following year, but after both Bates and Key said that the current equipment could fail on the next usage. According to both Key and Bates, the same level of care would not be provided to individuals who received care with the older equipment versus the new devices. Corbin said after taking a long hard look at the numbers and cost saving possibilities, he believed it would be better to buy the equipment in bulk.
“It makes better economic sense to purchase all 12 devices,” said Corbin. “I do think that it is important to begin to build in a contingency plan for equipment like this, so down the road we aren't faced with this same problem. We need to look at a way to build it in the budget to get stuff like this on a rotating basis and to upgrade the equipment as it is aged-out.”
Commissioner Paul Higdon argued that while he believes all of the equipment is necessary, it is not financially feasible at this time. “I think we need to consider buying six this year, and then six the next,” said Higdon. “If we buy them all at once, they are going to need to be replaced again all at once and we are going to find ourselves in this same situation.”
If commissioners had decided to purchase six machines this year, the possibilitiy exists that the cost would revert to $41,000, costing the county $246,000 this year, and another $246,000 next year, and the county would have lost the $48,000 worth of additional equipment provided in the form of the three AutoPulse machines.
As it stands now, the county will be paying $78,058 a year through financing the equipment with BB&T. By financing the equipment, the county will incur about $16,000 in interest over the 59-month period. If they choose to do so, the county can pay the loan off sooner, lowering financing costs and reducing the overall cost of the equipment upgrade.
Several ambulance drivers were on hand during Monday night's meeting, and all pleaded with commissioners to follow through with purchasing all the equipment.
“If you did not receive all 12 devices, you are not going to all of a sudden be providing substandard care, are you?” asked Higdon.
“No, we will continue to provide every patient with the best care that we possibly can,” responded Key.
“But if you had this equipment, would you be able to provide better care for your patients?” asked Commissioner Ronnie Beale.
“In my opinion, yes, I think so,” said Key.
“I agree,” said Bates.
“I think this is an opportunity to provide citizens ... with the best equipment possible to ensure the health and wellbeing of everyone. You can not put a price on a life,” said Beale.
On a motion made by Beale and seconded by Tate, the board voted to purchase the equipment with Ron Haven and Higdon opposed.