Clay County Emergency Medical Services put Erlanger WNC Hospital transfers on hiatus for a few days citing limited resources as one of the reasons. However, those transfer services resumed on Friday.
Transfers are not regular ambulance calls from an accident scene or home, but rather cover a medical transfer from a hospital to a nursing home or from a hospital to a larger facility for advanced medical care, for example.
EMS Director Ricky Lancaster said he had cut transfers for a few days, but no official action was taken.
“We have one transfer per week but sometimes there is more, sometimes we will have two per day. We had 72 in 2019 and 79 in 2018. Union General is a local hospital therefore we do not take any transfers from that hospital.”
Lancaster also explained that the number of calls the Clay County EMS receives has doubled. “In the past three months we’ve went from the usual six or so calls a day to 12 to 18 calls,” he said.
Transferring patients can also tie up a paramedic about six hours, forcing EMS to turn to mutual aid for assistance.
“During the time one truck is out of town for the six hours we are always worried about covering this county in case of an emergency, much less having two or three at one time and this happens more than anyone can realize,” he said. “Sometimes we are depending on Macon County or Union County to respond and as you know this will take from 30 to 45 minutes and for a resident having a true emergency this is too long to be waiting on lifesaving help to arrive.”
Clay County operates two trucks each day with four medics. They have a total of 16 full-time employees.
“I have been here for many years and seen the call volume increase over the years to where in the near future, if this trend continues, we may need to look into putting on another truck during the busier portion of the day to help ensure that our residents are covered when they call 911. With that being said my heart is in the service to our resident s and my job is to make sure that when they call 911 we have a truck here ready to respond to them. My worst fear is that someone has an emergency and we have no one to respond. I can’t imagine what it would be like to call 911 and there was no ambulance to respond to my family, friends or neighbors. When a patient is at the hospital they have doctors, nurses and an entire hospital staff there with them and they are in a controlled environment,” Lancaster said. “ I realize that patient may need to be taken to a larger hospital for further treatment but we are an EMS service and our main job is to cover our residents in our county during their time of need.”
Interim County Manager Debbie Mauney agreed that while these transfers stretch resources, the service is necessary and should continue. “Cherokee County has the same issue and so do other western counties,” Mauney said. “We’re working with Erlanger CEO Mark Kimball, commissioners from both counties and Clay and Cherokee EMS to come up with a solution. We all agree we’ve got to have that service — it’s critical. Morally we have this obligation to our citizens.”
Cherokee EMS responded with a statement to Kimball that Cherokee County EMS would no longer pro- vide transfer services to Clay County residents taken there by Clay County EMS unless the patient is a Cherokee County resident or Cherokee County EMS originally transferred the patient to Erlanger WNC and the patient meets flight criteria and flight services are unable to fly.
In the letter Cherokee County EMS Director Randy Wiggins said “It would not be fair to the taxpayers of Cherokee County to subsidize activities that should be the responsibility of Clay County EMS in service to their citizens.”
Clay County EMS has resumed its transfer services. When patients are transferred from one medical facility to another, the EMS bills that patient.
Because many small counties are facing problems of burdened resources, how does Lancaster think the transfer problem could be resolved?
“The best thing in my opinion is for the hospitals to have their own dedicated transport service to transport the patients from hospital to hospital. This is what private transport services are in the business to do every day. They have trucks just for this and they depend on these calls to ensure that they are successful. Whereas for us here in the county we are bound by North Carolina Ad- ministrative Code to ensure that we have an ambulance available 24 hours a day seven days a week to protect our residents,” he said. “My job as director is to ensure that we always have an ambulance ready to respond to our residents in their time of emergency. We will take these patients directly to the stroke center or trauma Center to save precious time for them. We have advanced over the past few years with the care of the Stroke and Heart Attack patients therefore this insures that they have the best outcome possible. We work with Northeast Georgia Medical Center in Gainesville for the heart attack patient and we are working directly with the cardiologist in treating this patient while getting them transported to the most appropriate facility.”