Some Lexington County residents concerned with ambulance response times question the county’s contract with a medical transport company.

The Lexington County Ambulance Response Solutions Team – a citizen group that has rallied to seek solutions to what they see as insufficient service, particularly in the Chapin area – has questioned the efficacy of the agreement with MedTrust, the private medical transport company that now handles a large amount of the county’s low-acuity calls.

The county entered the contract with MedTrust in December 2022, with the agreement set to last for five years.

The citizen group has pointed out that MedTrust was recently fined by the state Department of Health and Environmental Control and claimed that the company is being sent to calls beyond the low-acuity level they are contracted to handle.

MedTrust acknowledged both issues, but emphasized that they aren’t widespread and are being dealt with.

At a September meeting, the Ambulance Response Solutions Team reported that MedTrust had received a violation from DHEC for having uncertified individuals attending calls. According to the DHEC website, the department received a report that the company allowed uncertified personnel to attend five calls to provide primary care and that MedTrust was assessed a $750 fine.

According to Laura Renwick, senior public information officer for DHEC, the violation occurred in Berkeley County, where the company is based. She said MedTrust has incurred no violations in Lexington County during the past year.

MedTrust founder Josh Watts told the Chronicle that the company self-reported the June violations. He said that the company found out that the individual in question provided fake certifications from both the state and nation when they were hired.

To prevent such violations from occurring in the future, Watts said the company has implemented a pre-hire process to validate every certification through the state and national registry before the prospective employee can begin orientation.

When asked if it was aware of the previous violation, the county said it was “aware that the contract company is in good standing with DHEC, the regulatory agency for ambulance provider agencies, and is duly licensed to perform the services for which they are contracted to perform.”

As to how MedTrust is being implemented in Lexington County, Watts said that during the bidding process, they identified two areas in which the county wanted assistance based on strain to their existing systems, which led to the company beginning their role in two phases.

He said the first phase included MedTrust taking over low-acuity calls from facilities such as urgent cares, skilled nursing facilities and doctor offices. Watts explained these calls are different from a call coming from a patient at a house or a wreck, as the people in need of assistance are already with a health care provider.

Phase two, which started in June, includes low-acuity scene calls at a residence or another location. 

Watts said MedTrust units are dispatched by the county, which worked hard on the series of questions they ask during their dispatch process to identify the needs of the patient and assess whether MedTrust can handle the call.

Within the county, MedTrust has two headquarters, one located near Lexington Medical Center on Sunset Boulevard in West Columbia and one in Irmo. Watts told the Chronicle that they have 38 full-time employees and 10-12 part-time employees within the county, and on average they have seven to nine trucks deployed each day during peak hours.

During its September meeting, the Ambulance Response Solutions Team claimed that a former MedTrust employee had shared that some of the calls responded to by the company at medical facilities and doctor offices were more severe than what the company was contracted to handle.

When asked about how often MedTrust is being sent to calls above the purview of its contract, Watts said it’s happening with about 1% of the calls the company responds to in the county.

He said the county and MedTrust are working to lower that number, taking time at monthly meetings to identify the times the company was sent to calls outside its purview, listening to the calls to determine how and why the call was assessed incorrectly.

Watts added that sometimes assessing a call can be difficult, as some people may downplay or overplay the symptoms a patient is experiencing.

“Our goal is to identify with the county, through this root cause analysis, was there something that needs to change relative to the questions that are being asked, either on their side or on our side?” Watts said. “Or was there anything that was said that should maybe push this up to a different level of response in the future?”

“From a learning perspective, we're still relatively new into phase two. We're three months in and our goal together is to identify those things and just drop that number down.” he added.

Watts told the Chronicle that the partnership with the county has been an excellent experience. He said that from the beginning, the county wanted the process to be public and transparent, saying that he believes the county thought very thoroughly about what they wanted before entering the bidding process.

“The community really needs to put the time and effort and energy into something as important as EMS and make sure that whatever changes they're making, whether it's internal or a partnership or whatever, it's not done in a time of crisis,” Watts said. “It's done when you're able to be thoughtful about it and I think Lexington is a perfect example of that. They were not in a crisis, they had certain things that they were looking to make better and that allowed them to not rush it.”