The York County Council has postponed its final vote on ambulance contracts after legal concerns were raised in a public hearing earlier this month.
Chairman Britt Blackwell said the council will not vote Monday on contracts with Piedmont Medical Center and two rescue squads so members will have more time to review the contracts and consider changes. No date for a final vote has been set, but Blackwell said the council hopes to put both documents to a final vote as quickly as possible.
The county has worked closely with Piedmont Medical Center and the rescue squads to overhaul response time requirements and to end the dual dispatch of ambulances in certain areas. The rescue squads operate in the urban areas of Lake Wylie and Fort Mill. PMC is obligated under its contract with the county to respond to all calls.
The issue has been contentious during negotiations with both groups over the last nine months, with public discussions lasting several hours and critics charging that the contracts contain “anti-competitive” provisions and are deferential to PMC, the county’s sole, for-profit hospital.
Hospital representatives say they operate a complex system at no cost to county taxpayers. PMC’s Emergency Medical Services system meets all of the response time requirements established in its current contract with the county. Unlike in many other counties, no York tax dollars are spent on ambulance service.
Under the current contract, response time standards are based on geography. For example, the current standards call for an ambulance to arrive within 20 minutes in western York County and within 12 minutes in Rock Hill.
The proposed changes would base response times on medical urgency regardless of location. Life-threatening calls such as cardiac arrest should be answered within 10 minutes. Non emergency calls for slips and falls will have a 20-minute standard.
Facts, Not Threats
One provision in the proposed contracts that concerns some county council members and rescue squad leaders involves how Piedmont and the rescue squads add ambulances.
The current proposals allow PMC to add ambulances as it sees fit. But for a rescue squad to add an ambulance, it would have to miss response time standards for six consecutive months. Gary Loflin, director of the Department of Public Safety Communications, said the provision was added to ensure the county dispatch system can keep track of ambulances and agencies.
The proposed contract provides an exception for any new hospital in York County to apply to operate an ambulance service, but the contract is unclear about whether the applications would have guaranteed approval.
Blackwell said the council is concerned about any legal challenges and is having county attorneys comb through documents to ensure any new hospitals built in the county will have rights to operate their own ambulance service. He also wants to ensure that a patient is allowed to choose which hospital to be taken to.
During a Nov. 6 public hearing, several rescue squad members and local residents cautioned the council about the possibility of a legal challenge because of what some believe are anti-competitive provisions.
“You get my attention by pushing facts, not threats,” Blackwell said.
Councilman Michael Johnson, who helped lead the negotiations with PMC and the rescue squads, said that the county is taking the concerns seriously. “You don’t want to invite a lawsuit you can easily avoid by removing a section,” he said.
A New Hospital, But Not a New System
Both PMC and Carolinas Medical Center based in Charlotte have been locked in a nine-year battle over the right to build a hospital in the booming Fort Mill area. It would be the county’s second hospital.
CMC, which is part of the Carolinas Healthcare System, was awarded the right to build the hospital in 2011 by the state’s health department. PMC has appealed the decision before a state administrative law judge. A decision is expected any day.
Chris Hummer, president of CMC-Pineville, said he has been following York County’s ambulance negotiations. He wants to ensure patients can choose the hospital where they want to be transported.
In a letter sent to Blackwell in October 2012, Hummer said “past and present policies by PMC have, at times, compromised such choice.”
Amy Faulkenberry, spokesperson for PMC, disagreed. She said “patients are given a choice if their medical condition doesn’t automatically dictate that they be transported to the closest facility.”
Hummer also said if CMC wins the Fort Mill hospital appeal and any other legal challenges, it doesn’t plan to create its own EMS system in York County.
“You got three providers already, Hummer said. “The last thing we need to do is flood with more providers, more variation. I see us doing nothing short of wanting to work with Piedmont [Medical Center] and the rescue squads.”
He added that even without the Fort Mill hospital issue, CMC is focused on ambulance service because the system has facilities in Pineville and Steele Creek that draw patients from York County.