Consistency
is the missing
EMS component

The maelstrom over the quality of county emergency medical services has taken many turns since the recent resignation of Medical Director Dr. Fred Obrecht, who said he didn’t have the backing of the county commissioners to hold squads accountable for missed calls and other matters.

EMS in Columbus County is provided by nine rescue squads, each their own non-profit corporation that contracts with the county to provide EMS.

Despite recent revelations, EMS here has seen great improvements in the last five to seven years, thanks in part to a 2-cent countywide rescue tax that allows squads to hire paid EMTs.

What’s lacking, however, is consistency. Commissioner James Prevatte hit it on the head Monday when he said it’s unfair for some residents to receive paramedic service while others get only basic care. Inconsistency in answering first-out calls is another concern.

There are few services required of the county more important than providing efficient and skilled care when a medical emergency occurs. The current board has a chance to rectify this and has both the moral and legal obligation to do so.

Creating a better system will take time, but time is of the essence.

The commissioners should begin by:
•Addressing the inconsistent levels of care that were raised by Prevatte. Everyone in the county pays the same EMS tax rate, so why shouldn’t they expect the same level of care?

•Addressing missed calls. The reply, “Well, they’re just volunteers,” isn’t good enough for someone who suffers needlessly from a slow response.

The issue of first-out calls isn’t the only area of concern, either. Because there are fewer volunteers available, especially during the workweek, second or third calls within a district are often not answered in a timely manner. Mutual aid agreements are in place among squads, but sometimes it’s 15 to 20 minutes or more before second or third calls are answered because of the distance involved. The county’s four medical transport companies should be included in any discussion about updating mutual aid strategies.

• Addressing how tax dollars and money collected from federal and private medical insurance is spent.

Commissioner Ronald Gore is correct to wonder why all squads aren’t required to bill for calls. Lake Waccamaw is the only squad that doesn’t bill but has the highest number of missed first-out calls. Logically, billing might allow the squad to better answer its calls if it had the money for more paid EMTs. The commissioners also need to examine if money provided to squads could be used to raise levels of care.

• Finally, the commissioners need to determine if contracting with nine, independent non-profit corporations is the best option for providing life-saving care. Most counties have their own, county-run EMS services where the county has tighter control over care.

Every county surrounding Columbus has this arrangement, and in some cases, county-operated EMS services and volunteers work hand-in-hand to correct many of the deficiencies that Columbus County is now experiencing.

With the current EMS infrastructure in place, making a change to county-operated EMS would be hasty without giving the major players – the squads, the hospital, the new medical director, the EMS steering committee,

Southeastern Community College and the state Office of EMS – the opportunity to fix some of the issues that have been raised.

The county commissioners should assign a team to formulate an action plan within 90 days.

One of the unfortunate aspects of this controversy is that as a whole, the county’s rescue squads do an excellent job, and dedicated volunteers carry much of the workload. Often, the most challenging scenarios – the bad wrecks, the cardiac arrests, the respiratory distress calls – bring out the best in Columbus County EMS.

Most EMS calls in the county are handled professionally and with a quick response.

But there are obvious holes in the system, and relying on a dwindling number of volunteers plays no small part in this.

Consistency and accountability are the keys because there is no room for error.