Florence County Emergency Medical Services (EMS) has lost 15 employees since December 2011, leaving the department understaffed.
A couple employees retired and others left for different reasons, including going to work as paramedics at area hospitals.
Florence County Council held a special meeting Wednesday morning to address the problems.
"Florence County EMS has no competitive edge as far as recruiting and retaining qualified EMT's and paramedics," said Florence County EMS Director Ryon Watkins.
Florence County EMS currently operates seven ambulances from six stations throughout the county. Paramedics responded to 17, 658 calls in 2011 and transported 12, 255 patients.
Since 2000, the call volume has increased by 30 percent.
Watkins told council he's doing all he can do to keep paramedics and Emergency Medical Technicians (EMT's), but it's difficult because they can make more money and work fewer hours working for neighboring counties, private companies and local hospitals.
"The way our shifts rotate... It's not uncommon to have an employee with Florence County EMS working as many as 96 hours in a seven-day week."
Watkins adds when employees work that many hours, it takes a toll on them physically and emotionally. He says there are legitimate concerns about safety and fatigue, especially after working more than 24 consecutive hours.
Watkins gave council members three options to help deal with employee shortages.
Option one was to do absolutely nothing and let the situation continue to spiral out of control. He says if council goes with option one, eventually they may have to shutdown some EMS stations.
"One thing that we may have to consider down the road is if we don't have enough people showing up for work is possibility of closing stations temporarily," explained Watkins.
Option two includes an across the board salary increase for employees of 40 to 50 percent. The salary increases could cost the county $1.2 million dollars a year. Watkins says this would be good for his workers, but would do nothing to address the underlying issues of employees' work schedule.
Watkins strongly recommended council choose option three. It includes adding a fourth shift consisting of 15 full-time employees with hiring an additional 12 new workers.
"We have identified three positions internally that we can transfer to this new shift which would require us to hire 12 new employees. My recommendation is to transition to a modified 24 on 72 off schedule."
Council had several questions for Watkins following his presentation. They mainly wanted to know why they weren't made aware of his staffing problems earlier in the year.
"This issue came up basically at the 11th hour 59th minute and was not presented properly," said Council Chairman Rusty Smith.
Watkins says he's made the situation known to the county administrator, as well as to several council members. He says he's requested more money in his budget several times.
County council didn't take any action, saying right now the county just doesn't have the money to do anything.
They did vote to have a comprehensive study done on EMS and fire safety services in an effort to better retain employees and hire new people.
"I assure you we're all on the same team and we'll work toward making this happen," Smith said.
Council plans to choose a firm quickly to get started with the study. There is a also a committee consisting of fire and EMS officials to assist in the study.
They hope to have it completed in a couple of months. At that point, council is expected to make a decision as to how they're going to handle the staffing shortages with Florence County EMS.