A plan for rescue squads

October 15, 2013 

While all involved in crafting a proposed deal covering the dispatch of emergency medical rescue squads in York County will admit it’s imperfect, it represents a good-faith effort to make the system more orderly and safer.

For decades, residents have relied on both nonprofit volunteer rescue squads and ambulances owned and dispatched by Piedmont Medical Center in an emergency. For a while, the different squads were able to operate in relative harmony, each carving out its primary territory.

But in 1995, the county agreed to a dual dispatch system that allowed for emergency calls to be sent to both the EMS squads and PMC. That heightened the competition among ambulance units to get to the scene of an emergency first.

The result often was a road race to the site of the call. And many times ambulances from both EMS providers and PMC arrived simultaneously, creating a situation in which panicked patients or their families were forced to choose between the two.

PMC officials have argued they have a contractual agreement with the county to cover emergencies throughout the entire county, and they must field ambulances accordingly. But members of volunteer squads say PMC has tried to squeeze their business and take over their traditional service areas.

PMC officials deny that, but of the five other EMS squads that had operated in the county, only two remain: River Hills and Fort Mill. The other squads in York, Hickory Grove and Clover no longer are active, but they could resume service under the new agreement.

Under the proposed plan, dual dispatch — and, it is hoped, dueling ambulances — would be eliminated. The county dispatch center would use newly installed geolocating software to send only the nearest ambulance to an emergency.

The plan also would address the issue of response times. PMC’s current contract calls for its ambulances to respond within 12 to 20 minutes, depending on whether the location is urban or rural.

Under the proposed new standards, response would be based on the severity of the emergency. Ambulances would arrive within 10 minutes to a “life-threatening” emergency, such as a heart attack; within 15 minutes to a less urgent emergency; and within 20 minutes to a non-life-threatening event such as a senior who has fallen.

Some critics, such as Councilman Joe Cox, worry that rescue squads still would have a hard time meeting the new time limits when responding to calls from rural residents, such as those in western York County. That could be a difficult issue to address.

Most ambulances, sensibly, are located closer to more populated areas where more medical emergencies are likely to occur. But we hope that the new plan will help ensure that rescue squads are available in less populated areas to respond to calls from rural residents on a timely basis.

Volunteer EMS responders are dissatisfied with some elements of this plan. We hope some of the differences can be ironed out during the two remaining public meetings before the first vote on the plan takes place.

One issue, the prohibition against volunteer squads — but not PMC — adding ambulances unless they can’t meet the required response times needs to be tweaked. Why would squads be prevented from adding ambulances unless they fail to meet standards? Also, allowing PMC to field as many ambulances as it wants to again raises the prospect of the hospital trying to take over the turf of other squads.

But even with these issues, we are gratified the council has decided to tackle this controversy and find a way in which all responders can work in harmony.

Just getting rid of the dual dispatch system would be a big step forward. As Gary Loflin, who runs the county’s dispatch center, noted, “If we could eliminate dual dispatch, we could have a system that’s second to none.”

We are certain that, despite disagreements, the first priority for all responders is the well-being of the patients. All involved, working together, should be able to hammer out an agreement that keeps that priority at the forefront.

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