Rural Healthcare

Below are my views on rural healthcare topics such as the future of ambulance service in Mitchell County, Mitchell County’s Department of Social Services (DSS), and the future of the Mitchell County Health Department.


I attended the Mitchell County DSS meeting and the Board of Commissioner’s meeting on March 2, 2020, and here is my latest take on DSS and where we should head.

1. Our local Director of the DSS needs to officially be notified of Community and Commission concerns of the operation of the Mitchell DSS and the conduct of the Director.

2. The Current DSS board, aka the County Commission, should step down from their duties and a new DSS Commission should be seated that consists of local DSS experts, professionals, citizens, and one County Commission.

3. The NCDHHS needs to be called in to conduct an audit of the financial affairs and cases of the Mitchell DSS.

4. A Special Panel of Review of 7 members should be called consisting of concerned citizens, DSS experts, human resource experts, and one county commissioner to interview current and former employees, and DSS clients to determine the efficiencies and quality of leadership provided by current Director.  The inquiry would be conducted without the DSS Director being present. This panel would gather information and form an opinion to be presented to the new DSS Board of Mitchell of their findings and any recommendations to improve services.

5, The County Attorney and a County Attorney from a different North Carolina County should advise the County Commission, the Special Panel of Review, and the new DSS Board of the required do’s and don’ts of this process

6. The new DSS Board should consider and act accordingly to the recommendations of the Special Panel of Review and any issues discovered by the NCDHHS audit.


After spending all of Monday, January 13, 2020, listening to the ambulance service providers present their bids to our County Commissioners I feel there are only 2 bids that need to be considered.  All the bids maintain the current manning of vehicles at present levels, provide employment opportunity to current employees, maintain current pay rates, and maintain the same number of vehicles in the county.

The HCA bid, which would be a continuation of our current service, was the highest dollar wise, but also is a cost-plus contract which opens Mitchell County to several unknowns, most importantly what the actual end cost will be in each year.

The Lifeguard EMS (a nationwide company) bid was the lowest bid and appeared to have all the bells and whistles with its nearest emergency backup vehicles being approximately 2 hours away in either Cherokee, SC or Knoxville, TN.

The second lowest, or highest depending on your view on life, was from Mitchell Medics which currently serves Ashe and Watauga counties. Being in Ashe and Watauga gives them a one-hour response time if Mitchell County ever needed an emergency backup vehicle. 

Because of the high dollar amount and being cost plus I would toss the HCA bid out of consideration.

If you only look at the cost Lifeguard would be the one to select to deliver service to Mitchell County.

If I were a current commissioner, I would select the Mitchell Medic bid. I base this not of the dollar amount but by the presentations they made.  They offered the possibility of a two base system which would shorten response time which is a concern for all emergency response systems.  They provided examples of what they do in Ashe and Watauga counties such as their involvement in local schools, volunteer fire departments, and community outreach efforts.  The presenters (one being the owner) appeared to have hands on experience and understood the needs and difficulties of providing services to rural counties.

I hope that our current commission will share the feedback that they receive from the references provided by each bidder. 

Meeting Minutes of the June 3, 2019 Mitchell County Commission in which the status of the Health Department was discussed.
https://www.mitchellcounty.org/june-3-2019-regular-session/

In August the Commission discussed the status of meeting with the Toe River Health District.

Diane Creek, Director of Toe River Health District, discusses facts and fiction about TRHD in this article.

The Graham County Board of Commissioners recently sent a resolution of support for expanding the state’s Medicaid program to legislative leaders and Gov. Roy Cooper. Read the NC Health News article about that here:
http://the Graham County Board of Commissioners, which recently sent a resolution of support for expanding the state’s Medicaid program to legislative leaders and Gov. Roy Cooper.

%d bloggers like this: