Some rescue officials are suggesting merging volunteer rescue squads with fire departments to improve emergency medical response in Gaston County.
They also say that no matter what happens, the county must find a way to provide the squads with more funding to keep them running.
Rescue squads have been losing volunteers in recent years, making it harder for them to respond to an increasing call volume. And some critics say that they aren't needed because fire departments and paramedics with Gaston Emergency Medical Services are already doing the job.
But Gaston County's eight volunteer rescue squads remain an integral part of its emergency response system.
Some days, rescue squad volunteers say they feel like the forgotten cousins of firefighters and paramedics. They can help pry victims from wrecked cars, treat patients and take them to the hospital, or search for someone lost in the river or woods.
But they don't respond to all of their calls for service. They don't have the medical training to provide advanced life support. And they don't receive anywhere near the level of public funding as volunteer fire departments, which have taxing authority.
"We feel like we're pushed aside, even though we do a lot," said Randy Neill, chief of the Cherryville Rescue Squad.
GEMS, the only emergency medical services provider in the county with highly trained paramedics, is the primary EMS provider in Gaston County. Rescue squads and some of the county's 27 volunteer and city fire departments are staffed by emergency medical technicians, who cannot provide advanced life support.
On average it takes GEMS 10.7 minutes to respond to an emergency, nearly two minutes longer than nationally recommended standards.
GEMS directors blame slow response times, in part, on rescue squads that don't answer all of their calls. That leaves the more highly trained paramedics tending to less serious calls. An Observer analysis showed that GEMS, on average, is unable to meet nationally recommended guidelines for response -- less than nine minutes -- on six out of 10 calls.
The biggest problem for squads is funding, officials say. Gaston County provides and maintains two ambulances for each rescue squad. The squads also get paid to take patients to the hospital. Some are paid $15 per call and others are paid based on the number of calls they answer, ranging from $35 to $72 per call.
The squads also rely on their own fund-raising, which can bring in as much as $50,000 per year to help pay for equipment, medical supplies and utility bills.
But fund-raising also can raise questions. Last year the State Bureau of Investigation began investigating what police called a misuse of tens of thousands of dollars at the South Point Lifesaving Crew. The SBI plans to present its finding to the district attorney next week.
Even with fund-raisers, rescue squads don't usually bring in enough money to hire full-time crews during the day when volunteers are at work and unable to man the stations.
In August, for example, the Cherryville Rescue Squad hired four part-time emergency medical technicians at $9 an hour to cover the daytime shift. But the squad couldn't afford to keep them for long and hasn't had the money to start paying those employees again, Neill said.
They're stuck in a Catch-22: The squads can't make money without answering calls, and they can't always answer calls because they're volunteers. And when they do answer a call, it can take up to two hours to treat and transport the patient and fill out the paperwork. During that time the crew isn't taking calls, and thus not getting paid.
In other cases, GEMS has to transport because the patient needs advanced life support. If that happens, the county pays the rescue squads even less money for the call.
"You've really got to transport a lot of folks to keep the bills paid," said Joe Smith, former chief and member of the board of directors for the South Point Lifesaving Crew in Belmont.