York County pulls back on plans to overhaul ambulance system

jzou@heraldonline.comDecember 1, 2013 

The York County Council has pulled back on its efforts to overhaul the county’s emergency medical system because of legal concerns.

For nearly a year, several York County Council members have negotiated with Piedmont Medical Center, which operates the countywide EMS system, and two volunteer rescue squads in the Lake Wylie and Fort Mill areas to establish new response time standards and to end the practice of ambulances from separate agencies arriving at some emergencies. Instead of basing response time standards on location - for example, giving PMC more time to respond to calls in western York County than in Rock Hill - the plan had called for basing standards on the severity of the emergency.

But an amended proposal to be considered Monday night only eliminates the dual dispatch of ambulances. PMC will still be required to respond to calls in western York County within 20 minutes and Rock Hill within 12 minutes, which are standards established under the hospital’s existing contract. PMC says it exceeds those standards, averaging 16 minutes in western York County and just more than nine minutes in Rock Hill.

Other standards call for PMC to respond within 19 minutes in Lake Wylie and 12 minutes in the city of York.

The hospital and rescue squads operate at no cost to the county, but can be punished if they fail to meet county standards.

The county council had twice given preliminary approval to the new proposals but delayed final consideration in November. The delay followed a heated public hearing in which several speakers claimed the contracts were ill-conceived. Several attorneys representing the rescue squads threatened to sue the county. County Council Chairman Britt Blackwell said the delay gave county attorneys additional time to comb over the documents for any provisions that could become legally problematic.

As a result, the contracts were heavily edited with only the provision ending dual dispatch remaining.

The council will put the latest contracts to a final vote on Monday night.

Attempts at better response

The response time changes that had been considered by the county council called for life-threatening calls such as cardiac arrest to be answered within 10 minutes, while less serious cases such as high blood pressure would be allotted 15 minutes. Non-emergency calls for slips and falls would have had a 20-minute standard. PMC and the rescue squads would have been required to meet those standards on 90 percent of all calls.

That tiered model, which is similar to the system employed by the Charlotte-Mecklenburg, N.C., system, was conceived as a way to modernize and equalize response.

Council Vice Chairman Joe Cox, who represents western York County, led the push to adopt the new standards.

“We have improved nothing with this document,” Cox said. “I wasted 8 months of my time sitting in committee.”

Cox and councilman Bruce Henderson have been strong supporters of improving response times in the rural western areas of the county.

The rescue squads claimed the tiered system’s 90 percent compliance requirement would have worsened, not improved, response times. Squad leaders and several council members pushed to require 95 percent compliance.

The squads also said the proposals would have made it more difficult for them to add ambulances or for any new organizations to start an EMS service in York County. Those proposals have been scrapped in the amended contract to be considered Monday.

A Return to Ending Dual Dispatch

In January 2012, the state Department of Health and Environmental Control raised concerns about the county’s practice of sending ambulances from PMC and a rescue squad to the same emergency. County Councilman Michael Johnson said the latest contracts will formally end the practice by having the county dispatch only the closest ambulance to a medical emergency.

He said that in a “perfect world” the county would have assumed responsibility for determining where ambulances should be staged. That would have ended dual dispatch and improved response times, he said.

By staging ambulances, the county could ensure that ambulances are evenly dispersed in rural areas, improving response times in those areas, he said. While the practice was considered early in the negotiations with PMC and the rescue squads, the idea was dropped after staff members raised concerns about creating legal liability for the county.

Jie Jenny Zou •  803-329-4062

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