Bartow's Emergency Medical Technicians and paramedics -- like their first response counterparts in the fire department, sheriff's office and dispatch -- are working 24 hours a day, seven days a week on a limited departmental budget.
"We try to do the best we can for the people of Bartow County," EMS Director Larry Owens said. "Our commissioner has tried to do it the cheapest possible way he can."
The overall 2012 budget for EMS is down $141,400 from 2011.
Like other departments, the majority of the department's $3,704,100 budget is designated for employee salaries, benefits and insurance. A total of 40 full-time and 34 part-time employees divide $2,070,000 in salaries. Administrative personnel, such as Owens, take one furlough day each month while EMT's and paramedics do not receive paid holidays.
Considering EMS never closes and ambulances are called out all hours of the day, the department has $105,000 for gasoline and fuel costs, and $190,000 for vehicles. The department has six advanced life support ambulances across five stations in Cartersville, Cassville, Adairsville, Emerson and Euharlee. A seventh truck is available Monday through Friday for the department's busiest time of day from 10 a.m. to 8 p.m.
"You gotta have fuel to run it," Owens said. "The ambulances get about six miles to the gallon."
While paramedics are certified in advanced life support, the department must operate under a physician as their medical director.
"We practice under his license," Owens said. "The drugs we give to the patients, he has to OK. We can't function without him and we have to pay him for that."
Next to the $70,000 cost for medicine that ambulances carry for various illness treatment -- such as nitroglycerin, lasix and morphine -- general supplies account for $30,000.
"That's everything we need to operate," Owens said. "A backboard is $200 and there's all kinds of stuff we've got to have. If we put someone on a helicopter and we've got them stabilized on the backboard, sometimes we get it back, sometimes we don't."
Owens said more patients are beginning to be airlifted -- a call EMS never likes to make.
"If we fly you from here to Atlanta, you know what the cost is?" Owens said. "It's $14,000."
Locally, a base EMS charge for a non-emergency call and transport to Cartersville Medical Center is $425 and an extra $13 per patient loaded mile in transport. In comparison, Floyd Medical Center charges $375 as a non-emergency base and $12 per patient loaded mile.
Each EMT and paramedic also must go through re-certification every two years and instructors are required to participate in a training class each year.
EMTs and paramedics differ in their training levels. Paramedics receive more advanced training for pre-hospital care while EMTs receive a similar, but lower level, training. Compared to a hospital setting, paramedics would be the equivalent of an RN and an EMT would be similar to an LPN.
For instructors, travel costs are are set at $2,000 when a trip to a class in Savannah occurs each year. Training for other paramedics falls under the department's dues and fees, set at $3,500. Full-time employees are required to complete 48 hours of re-certification over a two-year span.
Licenses also must be obtained for each ambulance, costing $21,000.
"We have to pay $1,400 to the state for every ambulance we own," Owens said. "That's not just our first-line trucks. We've got 13 or 14 trucks. Some [are] spares in case one tears up and we've got to pay for them, too. It's to renew our license as an ambulance and emergency service."
A new ambulance, un-equipped, costs approximately $140,000. The high cost calls for the county allotting $10,000 to the department for vehicle repair and maintenance throughout the year.
Other equipment, set at $40,000, is designated to coincide with general supplies as needed. Items such as stretchers -- which cost $4,500 each -- and heart monitors -- $30,000 each -- are necessary and required items in an ambulance.
"Sometimes [other equipment needs] vary," Owens said. "[It can be] if we buy an extra monitor or other equipment that we need if it tears up during the year or if we need another stretcher."
Full-time employees are allowed $300 per year for uniforms. A total of $20,000 is designated for that purpose.
"They can buy shirts and pullovers and pants and boots. Which, they don't get much for that price," Owens said. "Shirts are $38 each and pants $48 each."
Although the department's main function is to respond to medical calls and emergency situations, other services are offered.
"We offer to the general public CPR and first aid," Owens said. "When they call, we can set up [a class] for companies or individuals. We do charge for it because we are charged for the cards and everything else."
The classes are taught through the Georgia Heart Association and cost varies depending on which type of certification citizens desire or for both.
While the class is geared toward individual residents, a training session on a different topic is offered to county employees.
"We offer defensive driving classes to the county employees," Owens said. "Anyone that drives a county vehicle is required to take a defensive driving class."
Three instructors, including Owens, oversee the class on their days off from regular EMS duties.
To register for a class, call the non-emergency EMS line at 770-387-5160.