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Published: Tuesday, Nov. 13, 2012 / Updated: Tuesday, Nov. 13, 2012 06:55 AM

York County EMS squads fear future in Piedmont control

Volunteer rescue squads are bucking a York County plan to give their competitor, Piedmont Medical Center, power to make decisions about the care they provide.

The resistance comes as the county works to update how it does business with EMS providers. The county is seeking to create uniform standards of care and overhaul the way it dispatches ambulances.

But at a council workshop Monday night, members of the rescue squads feared that one part of the plan will give Piedmont, which runs a private ambulance service in competition with the rescue squads, the ability to put them out of business.

The question centers over who will select a medical control physician who, under state law, sets patient care standards for all EMS providers countywide and determines who gets to provide services.

Under the current proposal, the county would select a physician and an assistant with Piedmont’s approval, and Piedmont would employ them at no cost to the county.

Brian Murphy, a board member for Fort Mill Rescue, said EMS providers need an “impartial” authority making calls about emergency care and asked whether the county had considered alternatives.

York County Manager Jim Baker and council Chairman Britt Blackwell assured them that county staff members working on revising contracts with Piedmont and the rescue squads don’t want to bring harm to the county’s volunteer squads.

Having Piedmont provide the service would save the county money, said Assistant County Manager Anna Moore, who added that the county hasn’t examined what it would cost to hire their own physician for that service.

Charlie Miller, former Piedmont CEO, appeared on behalf of Piedmont.

Miller, who is working as a consultant for Piedmont during the contract negotiations, answered questions about ambulance service but didn’t address the rescue squads’ concerns about medical control.

A single standard

For years the county has contracted with Piedmont to provide private EMS services while volunteer squads have assisted without contracts with the county.

Over the years the rescue squads, especially in Fort Mill and Lake Wylie, have grown in size, some adding paid employees. Competition has grown between Piedmont’s for-profit service and the rescue squads, reliant on customers and donations to stay in operation.

Piedmont Medical Center and the county’s rescue squads have different medical control physicians that authorize them to provide care.

That means ambulances responding to 9-1-1 calls may be following different standards, said Gary Loflin, director of York County Public Safety Communications.

Those standards don’t vary much, said Leo Yakutis with River Hills Rescue, and the state must approve all of them.

While medical control physicians sets standards for EMS care, they are also sometimes asked in emergency situations to make calls about care, Loflin said. That’s when a single point of reference for EMS standards countywide would be beneficial.

Ending dual dispatch

The tension between the rescue squads and Piedmont recently led the county to change the way it dispatches ambulances.

Not knowing the exact location of ambulances, the county currently dispatches two ambulances to every emergency call – one from Piedmont and one from a rescue squad.

State and local emergency management officials have said that system, which sends ambulances racing to patients and the dollars they pay for service, must end.

The county is in the process of implementing a new system.

The county will require all EMS trucks to have GPS trackers on them. That way, county dispatchers can position trucks strategically and send only the closest unit to a call.

The system will end dual dispatch and the dangers associated with it while making the county’s EMS system more efficient, county leaders say.