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Population growth puts strain on Ala. county EMS

MedStar EMS in Baldwin County struggles with call volume as county changes from rural to suburban


A MedStar EMS ambulance.

MedStar EMS/Facebook

By Margaret Kates

BALDWIN COUNTY, Ala. — In his time as a state trooper, Baldwin County Commissioner Matt McKenzie noticed that the county’s primary emergency medical service provider, MedStar EMS, struggled to keep up with number of calls it receives.

“There’s times that they’re okay,” McKenzie previously told the Press-Register Lede. “But there’s some times that they’re really stretched hard on it. Especially with the summer coming here, it’s going to pick up a lot, with all the tourists.”

As Baldwin County grows and transitions from a largely rural county to an urban and suburban one, McKenzie said that access to healthcare is one of the primary challenges the county is facing. South Baldwin Regional Medical Center broke ground on an expansion last year, and Thomas Hospital in Daphne announced its expansion earlier this year.

But population growth in Baldwin County has strained emergency services, Dan Wright, deputy director of Baldwin County 911 says. Combined with the pandemic, it created a “perfect storm” that exposed the difficulties county emergency services were having keeping up with the influx of residents.

“Anytime an area grows at the rate Baldwin County is, coupled with the tourism we all enjoy, the emergency services are pushed to the limit,” Wright says.

More than 54,000 people visited South Baldwin Regional Medical Center’s two emergency departments in 2023, according to Taylor Lewis, a spokesperson for the hospital.

According to Wright, in the month of February, MedStar met the standard response time requirement set out by the county’s agreement with the company in 87.3% of calls. The goal, per the contract, is to meet the requirement 90% of the time.

This is a big improvement from a few years ago, in the first half of 2021, when MedStar was only meeting the response time criteria in 54% of calls, he says, due in large part to the coronavirus pandemic increasing the number of emergency medical calls.

Under the terms of the agreement between MedStar and the 911 board, an ambulance must respond within ten minutes in an urban area, 15 minutes in a suburban area and 20 minutes in a rural area.

MedStar has made substantial improvements in the last few years, Wright says, which is reflected in their improved response times. Nationwide, there has been a shortage of emergency medical technicians (EMTs) and paramedics for a few years, Wright says.

The company has been able to address staffing issues, Wright says, which has helped improve their response times. The company has been a “great partner” to the county, he says, and has been willing to address these challenges. Brad Jernigan, operations manager at MedStar, agrees. The company has been able to add more staff and vehicles.

The problem now, as Jernigan sees it, is ambulances—and EMTs—having to wait at hospitals with patients after they’ve been dropped off. While EMTs are under no obligation to stay until the patients have been accepted by the hospital, it would be “ethically and morally wrong” to leave before then, he says.

As a result, if a hospital’s emergency room is backed up, EMTs will wait with patients for up to several hours. This prevents the ambulance from being in the rotation for future calls, Jernigan says. He says that MedStar has had EMTs waiting up to seven or eight hours in extreme cases.

The number of people using the emergency rooms in Baldwin County have increased, Jernigan says. This strains resources and lengthens wait times, he says.

“Ten years ago, you could get in and out of the hospital in ten minutes,” Jernigan says. “Now, the fastest time is a half hour.”

“Our ED medical team works closely with EMS to register their incoming patients so the ambulance crew can be released and available to respond to other 9-1-1 calls and emergencies,” Lewis said in an email.

As of Tuesday afternoon, the average wait time at the South Baldwin Regional Medical Center emergency room in Foley is 19 minutes, according to the hospital website. For its freestanding emergency room in Gulf Shores, the average wait time is 20 minutes.

South Baldwin RMC is seeking regulatory approval from the state to build an additional freestanding emergency room in the Loxley area, Lewis says. The hospital has added providers at its main emergency room in Foley and opened the Gulf Shores emergency room in 2021 to try and keep up with the population growth.

MedStar is the primary emergency medical service provider for all of Baldwin County, with the exception of Orange Beach. Other ambulance services provide medical transport, according to Taylor Bufkin, a spokesperson for Baldwin County, but MedStar is the only emergency provider.

But adding another EMS provider isn’t necessarily the solution, Wright says. In his experience, there are a finite number of EMTs or paramedics in a given area. When a new EMS provider moves in, they don’t bring employees with them. Instead, he says, another provider would just split the finite resources between two companies instead of one.

Wright argues instead that there needs to be “open communication” between all of the parties involved in providing emergency services is necessary to resolve the issues facing Baldwin County.

“[Providers] need to be open about the challenges they face and just talk about it,” Wright says. “There’s not a single entity that can solve the problem.”

McKenzie says the commission met with MedStar to try to understand the problem and see if there’s anything the commission can do to help alleviate the problem.

“We had a meeting with them, it was probably right after I got in office, but we’re trying to look at something to help them,” McKenzie previously told the Press-Register Lede. “That’s one thing they’re trying to look at is not the tying up that vehicle, because there’s so many calls in the county.”

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