More than a dozen residents Monday night spoke to the York County Council to publicly voice their opposition to a hospital contract the county has negotiated for the last eight months.
The county is revising its contract with Piedmont Medical Center, the county’s primary ambulance provider. The council will vote on the contract – which revamps how ambulance times are measured and attempts to improve response – on Nov. 18.
Monday night’s public hearing provided residents with time to air concerns with the proposed contract, which has drawn staunch opposition from two volunteer rescue squads that also provide ambulance service in the county.
The squads have a similar contract of their own, also on the council table for a vote on Nov. 18, which will be the third and final vote for both contracts by the county.
Under current requirements, PMC must respond to 911 calls within 12 to 20 minutes, depending on whether patients are located in an urban or a rural area. In the proposed contract, the hospital and the squads will switch to a tiered system based on medical urgency, not geography.
If approved, the contracts require PMC and the squads to respond to 90 percent of all life-threatening cases within 10 minutes, countywide. But while the new standards appear to be a step up from current mandates, the squads and their vocal supporters argue that it’s the exact opposite.
“We fell short of the touchdown,” said Tim McMichael, Fort Mill Rescue Squad director. McMichael said the contract fails to address the intense competition between PMC and the rescue squads that has led to racing ambulances and fostered disagreement on standards.
McMichael also said the 90 percent stipulation doesn’t incentivize PMC to improve response in rural western York County, where some municipalities see average times of 16 or more minutes. He argued that PMC can be compliant under the new standard even with lagged response in the west, so long as crews can continue to respond to calls in urban areas quickly.
According to PMC’s 2013 annual report, the bulk of 911 calls came from urban centers such as Rock Hill and Fort Mill, where ambulance times are less than 10 minutes. The western portion of the county accounted for 7 percent of all calls.
Three council members – Joe Cox, Bruce Henderson and Michael Johnson – who worked closely onboth contracts, recently stated that hospital representatives didn’t agree with stricter standards including increasing compliance from 90 to 95 percent of all calls.
PMC’s spokesperson recently declined to comment on contract specifics to avoid any legal repercussions from disclosing matters discussed in private with the county.
Both PMC and the squads operate at no cost to the county. Unlike most counties, York County doesn’t pay for or subsidize ambulance services.
Several residents called the contracts a “money issue,” and urged the council to not deter volunteerism by making it harder for the squads to operate.
While both contracts continue much of the same language, existing squads cannot add ambulances into service until they have failed to meet tiered standards for a period of six months. A similar provision exists for new EMS agencies looking to serve in the county. By comparison, PMC can add or subtract vehicles to meet response criteria.
“Minutes are critical,” said J. Leonard Fleet, a retired judge who runs a dispute resolution firm in Clover and described himself as a “survivor of cardiac arrest.”
Fleet urged the council to look at the contract from a legal standpoint and suggested that it could become legally challenged by the rescue squads on anti-competitive grounds. “There are lawyers who are going to make a bunch of money.”
Both River Hills/Lake Wylie EMS and Fort Mill have had attorneys speak at several council meetings to contest the drafted contracts.
“There were no proponents in here, only opponents,” said Joe McCullough, attorney for River Hills.
McCullough hinted at legal violations that may be contained in the contract when it comes to procurement guidelines, which the county must follow when contracting services with outside groups, and what he viewed as the contract’s anti-competitive language.
“These are the people you represent,” he said as he addressed the council, pointing to the seated audience behind him. “Not a for-profit hospital.”