Dual-Dispatch Ambulance Plan Criticized in South Carolina

Every time someone calls 911 with a medical emergency in York County, dispatchers send two ambulances.

They send one ambulance from Piedmont Medical Center and a second one from the local rescue squad. Whoever gets there first takes the call.

It's called "dual-dispatch," a system that started years back, and some emergency officials say it's inefficient and problematic. The issue has been under study for the past year by a group of rescue squad captains, York County staff, two county councilmen and Piedmont Medical Center representatives.

"Something's gotta be done," said Cotton Howell, York County's director of emergency operations. "It's just counterproductive."

Howell is in charge of dispatching every ambulance in York County. There's got to be a better way, he said. Dual-dispatch puts too many speeding vehicles on the road, and it ties up ambulances that could be used for other calls.

"We run out of ambulances a lot of times, during the day especially," Howell said. "We have to start prioritizing calls. We have to decide if your emergency can wait."

The study group has met monthly to talk about how to streamline ambulance service countywide, coordinate training and share resources. But a majority of the York County Council recently opted not to hear an update on the group's progress.

Councilman Perry Johnston said he was disappointed that Councilmen Buddy Motz, Curwood Chappell, Roy Blake and Rick Lee wouldn't let him read the update.

Johnston and Chairman Steve McNeely, who have attended the meetings, leave office at year's end -- and they leave the informal group's status in flux.

"Without the rescue squads years ago, we would've had nothing," Johnston said. "Now for the County Council to turn their backs on them is a travesty, a total injustice."

But the council hadn't authorized any groups to meet about EMS service, Motz said. He said it wasn't appropriate to hear the report, but Motz hopes that in the future, the council can sit down with the squads and Piedmont and work something out.

"I didn't have any idea what they were meeting for; nothing was brought about their mission," Motz said. "I had no idea what their direction or what their goals were. I'm still amazed they were meeting all this time without any reports to the council."

Squads: Do or die

A couple years ago, the future of some rescue squads looked bleak. With third-shift textile work disappearing, many squads suffered from a lack of daytime volunteers.

In 2005, The Herald learned of closed-door meetings between McNeely and Piedmont CEO Charlie Miller. The two came up with a preliminary agreement that would allow Piedmont to be the only ambulance service in the county, in exchange for a 24-hour Piedmont health care facility on the western side of the county.

"They were basically getting ready to do away with the rescue squads," said Billy Allen, captain of York Rescue Squad. Some of the squads realized they needed to step up their efforts to provide 24-hour service and get members trained to higher standards.

Since then, Allen said he has brought the squad to being a nearly around-the-clock service staffed with paramedics about 90 percent of the time. York Rescue now charges for its services and pays staff on some shifts.

"I do think the meetings have helped," Allen said, referring to the study group. "Buddy Motz said he didn't know about them, but everyone in the county knew about them. There haven't been any back room meetings. It's really just been a gathering to try better the York County EMS system."

Squads versus Piedmont?

No one agrees what should be done about the ambulance dispatch issue; the group's report suggested further study.

Piedmont's Miller says any change to the current system will mean a change in the county's contract with his hospital. For at least 10 years, Piedmont has been required to provide ambulance service countywide -- and is required to work with the rescue squads.