By Kathy N. Ross
The Mountaineer
ASHEVILLE, N.C. 鈥� About 50 emergency medical workers delivered a strong, at times angry, message to N.C. Rep. Mark Pless during a roundtable discussion regarding bills that would eliminate county control of ambulance services and change certification standards.
Don鈥檛 fix what ain鈥檛 broken, the paramedics, medical technicians and emergency service directors said during a gathering at the Asheville-Buncombe Community College training center in Woodfin on Thursday.
The first responder community across the region has come out in opposition to two bills Pless introduced that would cause upheaval and chaos in the emergency services landscape. Nor were they happy at the what they said was a lack of communication between Pless and their tight-knit emergency rescue community, saying they were caught by surprise with these bills.
鈥淏efore you introduced two pieces of legislation that would directly impact tens of thousands of EMS professionals across North Carolina, it would have been wise and respectful to sit down with EMS leadership from across the state and ask, 鈥榃hat do you need?鈥欌�� said Kristy Bryant, a critical care and flight paramedic from Yancey County. 鈥淚nstead, you drafted legislation in a backhand (manner) and didn鈥檛 consult with providers.鈥�
One bill would change the certification process 鈥� doing away with state standards and instead using a less-rigorous National Registry exam. The other bill would strip counties of the ability of regulate ambulance services.
Their anger was mollified only slightly by Pless鈥� announcement that one of the bills, H.B. 675, has already been changed. In its original form, the bill would require all current emergency medical service workers to be recertified through a national registry.
Pless repeatedly declared that the bill would be amended so it only applies to new first responders starting in 2026, grandfathering current EMTs and paramedics.
鈥淓verybody in this room has nothing to be concerned about. None of your people are affected. You鈥檙e gonna be just fine, I promise,鈥� he said.
To his frustration, those in the room continued to express concerns about the needless burden recertification would cause 鈥� due in part to the fact that Pless鈥� promised language change doesn鈥檛 appear in the bill as listed on the General Assembly鈥檚 website.
That鈥檚 because it must go through approval in committee next week, Pless said, promising the change has been written into the drafts, however.
鈥淵ou keep going back to the same thing, and I鈥檓 not sure anybody is listening,鈥� he said.
Blindsided and unhappy
Speakers complained repeatedly about being caught off guard by the proposed legislation.
鈥淭hese bills were not done with the collaboration of anyone else in this room,鈥� said Mark Stepp with Blue Ridge Fire and Rescue in Henderson County. 鈥淲e had no part in this.鈥�
He asked the group of about 50 for a show of hands by anyone who had been contacted or asked for input about the bill. No one responded.
鈥淭he EMS association has a lobbyist, and the lobbyist, I told her a year and a half ago and she did nothing with the information,鈥� Pless responded, adding that the lobbyist only responded to his requests for a visit with a request of her own this week.
Later, he said he talked with others about the proposals before they were introduced, but only people he could trust, including EMS workers.
鈥淭hey are not in this room today and nobody will ever know who they are,鈥� he added.
Pless said there鈥檚 a reason he didn鈥檛 engage a broader cross-section.
鈥淚n order to get people to come to the table, you have to have people willing to sit down and talk about a situation and not turn around and go talk to someone else about that situation and create a line of communication that鈥檚 not even remotely clear where you鈥檙e going,鈥� he said. 鈥淚 don鈥檛 have a problem involving (others) if someone can sit down and have a 100% private conversation and work through the process and even if they don鈥檛 get their way they don鈥檛 run down the street and post something or say something. That鈥檚 not how I should be treated.鈥�
That confidentiality should be maintained until it is time for public input, he added.
鈥淎m I hearing you say you鈥檙e open to a public stakeholder meeting?鈥� one man called from the group.
鈥淣o, I am not open to a public anything. This is not public,鈥� Pless replied. 鈥淭he only reason we鈥檙e doing this out here is because these are professionals in this field and it is controlled at AB Tech and it is not an advertised public meeting. I cannot do a public meeting.鈥�
鈥淪ometimes you can鈥檛 talk about it until it becomes time for a public forum,鈥� Pless said. 鈥淯ntil it became time for a public forum, this bill was not meant to be run across North Carolina so people could decide the effects of it from something they heard.
鈥淚鈥檓 not supposed to be doing any meetings like this right now,鈥� he said. 鈥淚 have been told not to do anything public because of the environment we are in right now. I broke that rule in order to try to help some people understand.鈥�
Disrespect?
Several speakers at the session challenged Pless on his body language, stating that his posture, attention to his cell phone and his tendency at times to stare toward the ceiling conveyed disrespect and dismissal of their concerns.
They continued expressing their sentiments after the meeting.
鈥淚 have never, and I do mean NEVER been so disrespected by an ELECTED official as we, a group of highly educated, highly intelligent and highly experienced paramedics and firefighters were today,鈥� wrote paramedic and EMS instructor Vickie Tweed. 鈥淚 have NEVER seen the total and complete lack of respect that I saw today from N.C. Representative Mark Pless. While someone is talking TO him he was kicked back in his seat, on his phone or had his chin resting on his hand. It was as if what we had to say was a nuisance to him.鈥�
EMS issues
At one point, Pless said his bills were an effort to get N.C. emergency management people talking about shortcomings in their system 鈥� shortcomings he described as a lack of staff, a need for a certification and educational program that better encourages students to finish the courses and patient backups in hospital emergency rooms due to lack of transports.
鈥淵ou bring people to the table when they think something is wrong,鈥� he said. 鈥淟et that fact sink in before you get too far out in front of your skis. You鈥檒l never have change if you can鈥檛 get people to recognize the seriousness of taking care of EMS. Sometimes you have no choice but to take shake the world in order to have a conversation.鈥�
Other speakers said Pless was trying to fix the wrong things.
鈥淲hat is desperately needed is a way to increase funding for our training 鈥� so we can be better prepared for the next Helene, the next COVID,鈥� said Taylor Jones, Buncombe County EMS director. 鈥淲hat I鈥檓 asking for desperately is, how do you increase funding for EMS? What I don鈥檛 want to do is undermine the high-quality standard that North Carolina has.鈥�
Different standards
While some of those present seemed somewhat relieved at his promise that existing emergency workers would not have to go through the expense and time-consuming process of additional certification, that reassurance earned Pless only slight relief.
Those present strongly protested the proposal to remove the awarding of contracts for ambulance service from county control. And they complained that the national registry system had less vigorous standards than the ones they were operating under now.
Pless defended his bills, arguing that the national registry and more uniform certification would provide more emergency workers. Without stating the institution, he referred to an emergency medical training program that he charged had forced almost half of its students to quit before it was complete.
鈥淚 don鈥檛 want people working in my organization that can鈥檛 pass the state test,鈥� said Bryant. 鈥淪ir, some students don鈥檛 need to be in this program. That鈥檚 not failure; that鈥檚 called filtering.鈥�
During the aftermath of Helene, she said, squads who came in from outside states 鈥渨ere blown away by the strength of our protocols.鈥�
Many students enroll in beginning emergency medical courses before realizing they are not suited for the profession, said Madelyn Johnson, EMS coordinator for Asheville-Buncombe Technical College. The instructors鈥� roles are to support those students in whatever decisions they make, she added, and sometimes that means allowing them to find a career for which they are better suited.
Kristin Sullivan, an EMS instructor and member of the Reems Creek Fire Department, also questioned the different level of standards. She is certified by the state, she said, not under the National Registry 鈥� if H.B. 675 became law, that would mean she would be holding her students to a different, lower standard, than the one under which she is registered.
Hospital concerns
Pless said his motivation for House Bill 219, which would remove county governments鈥� right to control ambulance services through franchise agreements, came from problems he heard about from hospitals. He claimed patients are backed up in emergency rooms because of transport issues, he said.
鈥淚 have had conversations with my hospital. My hospital has a problem getting patients out of the emergency room, getting them out of the halls,鈥� he said. 鈥淭his is a statewide problem. There are people in my office in Raleigh who have this same issue. All these people are experiencing similar issues with no way to fix it.鈥�
Lessening county control over ambulance services should provide more means of transport, he said.
He has had no objections from the hospital association lobbyists over his EMS proposals, Pless added.
He did not convince his audience.
鈥淓MT/EMS is not broken鈥� Bryant told Pless. 鈥淲e are rooted in the community. Allowing a private company to take over EMS would undermine decades of public investment, decrease transparency and jeopardize patient care. We don鈥檛 need privatization. We need partnerships with state and local leaders who understand the needs of their community.鈥�
Rescue Squad role?
Pless denied charges from several speakers that H.B. 219 was a move to ensure Haywood Rescue Squad would receive funding from nonemergency patient transports. His son is chief of the Haywood Rescue Squad. While Pless has served on its board of directors in the past, he is no longer on the board.
When the Rescue Squad almost folded in 2019 due to a failure to bill agencies including Medicaid for reimbursements, the county expanded its own EMS service, adding vehicles and staff to pick up convalescent, or nonemergency, transports. Now that the Rescue Squad has been rebuilding, many believe Pless is trying to help the agency make a comeback.
Pless did not respond to a follow-up phone call from The Mountaineer, requesting information on whether he had talked to any active emergency personnel outside the Haywood County Rescue Squad about this legislation, how long he had been working on or discussing this proposal before it was introduced, or whether the discussion Thursday would change his approach to the proposed legislation in any way.
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