Amid continued concerns from local residents about Lexington County ambulance response times, particularly in the Chapin area, the county provided some insight into how things are going.

The Chronicle reached out to the county seeking numbers on response times and emergency medical personnel and clarity on their procedures ahead of a story published a couple weeks ago addressing issues brought up by the Lexington County Ambulance Response Solutions Team, a community organization that has rallied to push the county to improve.

The county has since provided answers to those questions and offered data in response to the Ambulance Response Solutions Team’s concerns and claims.

Response times

The team’s overarching concern is response time, expressing concern that some residents, particularly in Chapin, are left to wait longer than they should for emergency medical assistance.

The county provided a document detailing average Lexington County EMS response times for Chapin compared to the county as a whole for April-June and July-August of 2023. The call times are broken down by severity, going from law acuity to medium to high.

For April-June, Chapin saw an average response time of 10:43 for high-acuity calls, 14:01 for medium and 21:48 for low. In July-August, the average response time was 10:09 for high-acuity calls, 14:25 for medium and 15:39 for low.

In the county at large, the April-June average was 9:40 for high-acuity calls, 11:26 for medium and 14:50 for low. In July-August, the county average was 9:29 for high, 11:08 for medium and 12:18 for low.

For April-June, county EMS responded to 336 calls in Chapin and 9,596 in the county at large. For July-August, there were 244 calls in Chapin and 6,231 throughout the county. Chapin accounted for 3.64% of the county’s call volume for April-June and 3.92% for July-August.

Ambulances in service

The Ambulance Response Solutions Team has also expressed concern about the number of ambulances in service and the way they’re being deployed.

Jason Resnick, a former Lexington County EMS employee working with the team, provided statistics stating that in 2003 the county operated 14 vehicles during the day and 10 at night, and now in 2023 the county is still operating with 14 during the day with a minimum of seven at night.

The team has additionally expressed concern that some of these vehicles in use are Quick Response Vehicles, which are often unable to transport patients to the hospital.

The county said its EMS has a fleet of 29 ambulances, adding that full staffing would allow for the deployment of 20 ambulances during the peak time of day. The county stated that in the last 10 years, four new trucks have been added to the fleet, with an average of five trucks being replaced each year to ensure optimal readiness.

The county added that their ambulances average 50,000 miles per year versus a family car averaging 10-12,000, leading to the ambulances accruing 250,000 miles every five years.

The county told the Chronicle there is a constant rotation of ambulances through its Fleet Services Department having scheduled maintenance performed. It added that there are spare ambulances that are available to cover for scheduled maintenance, unscheduled breakdowns, ambulance collisions and more.

When it comes to how the county’s available fleet is deployed, it uses a “Hybrid High-Performance Model,” meaning the county uses the historical call volume in the areas it serves to guide where ambulances are stationed.

According to the county, it uses a mix between both a traditional fire station model and a truly dynamic model. With the fire station model, ambulances respond to emergencies in their assigned area and only that area, while the dynamic model prioritizes placing ambulances in position to cover areas with high call volumes.

“Based upon Lexington County’s significant population density changes from our more rural southern and western portions, to our more suburban towns and cities, the efficient 911 system must be a hybrid of these two models – covering both geographic area and historical demand,” the county said. “Additionally, as the number of available ambulances decreases, EMS continually redistributes the available ambulances to provide the maximum coverage to our entire County at any particular time.  As additional ambulances are available, they are placed in the most appropriate geographical location.”

The county added that ambulances aren’t technically headquartered anywhere and that the hybrid-dynamic model allows for roaming ambulances and more widespread coverage.

The county uses multiple softwares to ensure ambulances within the county can get to their needed location as efficiently as possible. One of these is the Mobile Area Routing Vehicle Location and Information System (MARVLIS), which assists in determining the best location for ambulance placement at any given time with available ambulances that are not already engaged on calls.

An AVL/Routing and Predictive Routing Software is also used by the county and was implemented in 2010. This system allows EMS to maximize existing resources and places ambulances at the most appropriate location to minimize response times. This system is updated every other month, with new roads, neighborhoods and subdivisions being added.

Recruitment and retention

A key factor impacting the county’s ability to deploy its fleet of ambulances is staffing them, with the Ambulance Response Solutions Team criticizing the pay it offers as not being sufficient to attract enough personnel.

Retention and recruitment continues to be an ongoing struggle, the county admitted, emphasizing its a problem locally and nationally. The county emphasized that hiring emergency service employees is not a simple task. 

The county said it has 18 EMS openings at present, 13 of those being for providers out in the field (including two lieutenants and 11 paramedics).

The county added that it has hired 38 department employees in 2023. 

The county said it has 165 positions, all 12-hour-shift employees, who answer emergency calls.

The county emphasized it has increased pay 24% over the past two years, and establishing a contract with MedTrust, a private ambulance service, to help respond to low-acuity calls, which the county said has been a tremendous retention incentive.

The county added that all of the county’s public safety received a 7% cost-of-living adjustment and 3% merit increase for the 2023-24 fiscal year, adding that fire and EMS received an additional 5% increase and can earn up to another 4% for pursuing additional education.

The county said it is able to offer competitive pay and incentives that both attract and retain employees. The county offers EMT employees a starting pay rate of $46,487 and paramedics a starting pay of $53,132.

Per salary.com, the average salary for an EMT in South Carolina is $34,915, with the average for a paramedic being $45,699.

Community satisfaction

With the Ambulance Response Solutions Team having criticized the county’s transparency when it comes to EMS issues, the county told the Chronicle that it takes any concerns from the community very seriously.

“The county strives to maintain a stream of communications between public safety and the communities we serve,” it said. “We remain committed to working with all of our citizens to provide the best emergency medical care.”

According to the county, it remains transparent by making all financial documents accessible to the public, having a phone and email directory and has a public information officer assisting in disseminating important county information to the public and media.

Speaking to Chapin concerns, the county told the Chronicle that its officials have attended two community meetings at the Timberlake Country Club and hosted a meeting at the County Administration Building to answer questions and provide information to citizens.

The county told the Chronicle that it has received no complaints from a municipal government about EMS response. It added that the department has received 11 complaints about response times in the past five years, stating that all complaints were investigated, with all but five having been deemed unfounded.

Jordan Lawrence contributed to this report.