It's as close to a life-or-death decision as they make, so Lancaster County Council members want to get it right.
Fearing some response times well beyond the national goal, county leaders have their eye on a new space in Indian Land for an ambulance station. Lancaster County Council voted Monday night to have its administrator work out funding and other details. Council could have something ready for vote May 14.
"We're looking for a new site," said Councilman Brian Carnes, who represents Indian Land. "We've found one in the Bailes Ridge Corporate Park. We've been in negotiations with them for several months now."
The county has two ambulance stations in Indian Land. As the population there increases, at least one more is needed, officials say. County EMS staff told council in some situations, parts of Indian Land could have to wait 30 to 45 minutes for an ambulance. Most EMS units shoot for an average response time close to eight minutes.
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Steve Willis, county administrator, said waiting half an hour or more for emergency service isn't typical anywhere in Lancaster County.
"It's not normal that you would have a response time like that," he said.
But, he said, "If both units up there are tied up on a call and you get a third call, you're getting a unit out of Lancaster. It can take some time."
The issue is similar to what might happen if a third call from the southernmost part of Lancaster came in at one time. The difference is, the population density is much higher in Indian Land. Meaning that third call coming in becomes far likelier.
"At least in the panhandle, this would help," Willis said.
Carnes said even in that worst-case event, it would take several factors to push the wait for an ambulance beyond 45 minutes.
"I think (if) it was at rush hour, and that was from the EMS station (near Lancaster) to the very tip up at the North Carolina line," he said.
A new station at the site under county consideration not only would be closer for Indian Land residents, but it would be better situated to get to more of them from more directions. S.C. 160, U.S. 521, Barberville, Calvin Hall and Harrisburg roads — all would be more accessible for EMS than they are now.
"It gives us a lot more options for response," Carnes said.
Dr. Arnold Alier with the state Bureau of Emergency Medical Services said there isn't a hard standard for response times.
"There is not an official response time," he said. "The accepted standard is usually less than eight minutes. That's not a requirement, it's just what everybody strives for."
Variables can impact response times greatly. Urban versus rural areas, access to hospitals, population, traffic and other factors play a role. In 2016 there were about 675,000 emergency response calls in South Carolina. The average response time was just less than 12 minutes.
"There's a lot of three-minute responses, a lot of four-minute responses," Alier said. "So you can extrapolate. If that's the average then there were a lot of calls where obviously it's going to be way over that."
Which is why that "sort of illusive" eight-minute mark is more aiming point than standard.
"It isn't set in stone," Alier said. "It's more of a line in the sand."
Indian Land does have some backup now through Fort Mill Rescue. If a new station comes to the corporate park, it likely would have more staff than current locations.
"The plan is you would have two EMS teams there," Carnes said. "You'll have two full ambulances there and two full crews there all the time."
Willis said the new site would "probably mirror" some of the newer county stations, except that it would be the first two-unit station. The population in Indian Land is growing beyond what it is countywide, not to mention much of Indian Land's population is made up of seniors with the massive Sun City development there.
"The density up there is such that putting two units together makes sense in the panhandle," Willis said. "It probably doesn't make sense anywhere else in the county."
Like the eight-minute mark for response time, a general rule for EMS providers is to have a station for every 10,000 people. The county has eight now. It's population is about 90,000.
The county is looking at moving a station in Lancaster to a site closer to S.C. 5. Discussions involve a new EMS headquarters and training facility there.
"It's based more on trying to put it in a better position to have better coverage," Carnes said.
When seconds and minutes can be critical for patients, county leaders say decisions have to be made on the ability to cover and serve residents. Gone are the days when "cheap land" could drive decisions. The new Indian Land site is less than two acres. It will cost $150,000 even before inspections and other costs related to closing the deal.
The land could be purchased in 60 to 90 days — timing that has the county looking at best case scenarios, rather than worst case ones.
"In a best case scenario, maybe by the end of the fiscal year, next June (2019) sometime, we might have a new building," Willis said.
John Marks: @JohnFMT