Will county save EMS provider?

Barnwell County may be in search of a new emergency service and ambulance provider if a solution cannot be found in the upcoming negotiations between the county and Medshore Ambulance.

A deadline of March 15 was agreed upon by Barnwell County and Medshore to renegotiate the terms of their three-year contract.

At the January 30 Health and Safety Committee meeting, Chairman Jerry Creech explained Medshore is losing nearly $450,000 per year due to the increasing prices of operation since the COVID-19 pandemic and are looking to renegotiate contractual terms with the county.

“Medshore is requesting this increase in subsidy because the costs to provide this essential public service on behalf of the citizens of our county have risen dramatically in the last two years – and particularly in the last 12 months,” states a February 14 press release from Medshore.

“Since the onset of the COVID pandemic in January 2020, Medshore Ambulance has shouldered the financial burden of increasing personnel costs, growing prices for fuel, and nearly triple the costs for medical supplies, and fleet-related expenses. In Barnwell County, the subsidy was last increased a year ago. At that time, Medshore and the county believed post-Covid economic pressures would ease or level off. However, the opposite has occurred, and inflationary pressures have further driven up costs,” states the press release.

“It’s not only Medshore that's been having problems, if you've been watching the news lately it’s Augusta, Aiken, everywhere is having problems with EMS,” said Creech.

The American Ambulance Association completed a study of employee turnover in 2022 and found that 39 percent of part-time EMT and 55 percent of part-time paramedic positions went unfilled.

According to the U.S. Energy Information Administration, diesel prices reached the highest they have been since 2008 in June 2022, and have only just begun to decrease to around $4.50 per gallon.

Much of these negotiations are scheduled to be discussed at the executive session at Barnwell County Council’s February 14 meeting, which will occur after The People-Sentinel’s press time.

Barnwell County pays Medshore $950,000 per year totaling nearly $3 million per contract term. The current contract is good until July 2024, and Creech hopes negotiations can be made to avoid a legal battle.

The contract agreed upon Medshore to provide four ambulances “each staffed with a paramedic and an EMT, on a 24-hour basis, seven days a week,” as well as providing a Quick Response Vehicle (QRV) also staffed with a paramedic on a 24-hour, seven days a week basis.

Medshore first reached out to Barnwell County on April 8, 2020 with a letter from Medshore’s Vice President of Operations, Jason Cooke, proposing a temporary amendment of the contract stating, “Barnwell County’s EMS transport volume has decreased by 28 percent. The Hilda Station ambulance (Medic 104) has seen a decrease from 1.0 calls per 24-hour period, to 0.6 calls per 24-hour period.”

Medshore first requested the county consider four options moving forward and have a response by January 17, 2023; however, the county requested more time. These options are to be discussed in detail during the executive session of the county council meeting on February 14.

“You have requested the county consider four options that are outside of the agreement within an existing contract and you have requested a response on or before January 17, 2023,” states a letter written by Chairman Creech to Medshore on January 10.

“It is our position that the contract is legally binding as written and that the county is unsure how your proposal is even feasible as a result,” stated Creech’s letter.

“Medshore’s current request to discuss adjustments to the contract has not been made frivolously,” states Cooke in a January 23 response to Creech. “The factors driving this request were beyond the control of Medshore (or any other contractor that would have been providing service)—post-COVID medical equipment and supply costs nearly double what they were when this contract began, record high fuel costs, unavailability of ambulance chassis due to manufacturer supply chain problems, and increased payroll costs due to a nationwide shortage of EMTs and Paramedics that, unfortunately, impacts rural areas even more dramatically than urban markets.”

In the Jan. 23 letter sent by Cooke, if county council is willing to engage in discussions regarding these matters, “we will share with the council information about the financial losses Medshore has already absorbed providing service to Barnwell County, and how it is unsustainable for Medshore to be expected to continue absorbing such losses going forward due to factors beyond its control.”

Cooke responded agreeing to give the county until February 28, 2023 in this letter, which was then extended to March 15.

“We made our case to them last week and they agreed to do that as a good faith effort, and that was due to the leadership of Chairman Creech to reach out to them to give us more time to work through this topic,” said County Administrator Tim Bennett at the Jan. 30 health and saftey meeting

This contract has been signed every three years since 2014, and was re-signed in July 2021 after a competitive bid process, according to a press release by Medshore.

In the summer of 2022, contractual requirements were not being met by Medshore and discussions were held by county officials on how to handle it. Between health and safety committee meetings and county council meetings, Medshore explained they were facing similar issues.

Now, negotiations are set to be made to determine if Medshore will continue providing ambulance services to the county. If a solution cannot be met, “Medshore will have to begin working on a plan to wind down its services, of course, with reasonable notice to allow the county to transition to another provider,” states Cooke’s letter.

“If council does decide to make an agreement with another company, we will assist the county for up to 90 days after the RFP comes out,” said Cooke in the Jan. 23 letter.

At the Jan. 30 health and safety committee meeting, Barnwell County’s Director of Emergency Management, Roger Riley, detailed new variants of COVID.

“This new strain is very similar to the very deadly strain of Delta that we had in the heat of COVID,” said Riley of the variant now called ‘CH1.1.’

So far, the new variant CH1.1 consists of 1.5 percent of cases worldwide, according to Riley’s report.

There is currently another strain on the move called XBB-1-5, which is much less deadly than CH1.1, and according to Riley, has already been experienced by most individuals in the form of a slight cold.

“CH1.1 has some concerning mutations that were seen in the Delta variant, and generally isn't seen in the omicrons, which is the XBB-1-5 that we’re seeing now,” said Riley.

“It has the potential to be immune to any vaccines and be much more deadly,” he said. “We just want to watch out, continue to hand wash and wear masks when you can.”