President’s Update – June 28, 2023

The five Skidaway communities (The Landings, South Harbor, Modena, Marshes, and Thrive) are considering the addition of a dedicated Skidaway Island ambulance at the McWhorter Drive Fire Station #5. This ambulance would be owned, operated, and maintained by Chatham Emergency Services (CES), the authorized provider of fire and emergency medical services for Chatham County. This dedicated ambulance would be in addition to the existing CES fire and emergency medical resources and would respond only to Skidaway Island medical emergencies unless there were a mass casualty incident in Chatham County and surrounding areas.

The purpose of this dedicated ambulance would be to reduce the ambulance response time during medical emergencies. As mentioned in previous President Updates, as part of our strategic planning initiative, The Landings Association (TLA) is conducting a community survey to gauge the community’s opinions on the issues at hand. As part of this survey, we plan to ask questions about this ambulance proposal. Through this article, I am updating our community on this proposal so that you have adequate information to express your wishes in the survey.

Currently, our island has a robust emergency medical system in place. When there is a medical emergency in The Landings, Landings Security, along with the volunteer Skidaway Island First Responders and the Fire Engine 5 paramedic, responds to the emergency. Depending on the emergency, an ambulance is also dispatched, or it may be dispatched based on a request from on-scene emergency personnel. The team of on-scene emergency personnel has the resources and training to conduct the critical evaluations (Airway, Breathing, and Circulation – ABC) essential to maintaining the victim’s life. The Paramedic also is equipped with the resources, including prescription medication, equipment, and training, to begin treatment for the vast majority of conditions that exist. For critical conditions that the emergency team is not equipped to handle, such as internal bleeding, coronary artery blockages, arterial brain blockages, etc., rapid transport to a hospital is typically required.

The average response time, based on 2021 data from CES for an ambulance to arrive at a medical emergency on Skidaway Island was 15.06 minutes for emergencies and 18.02 minutes for non-emergencies. This is compared to countywide times of 10.32 minutes for medical emergencies and 14.51 minutes for non-emergencies. Adding an ambulance to the McWhorter Fire Station could reduce the time for an ambulance to arrive at the scene of a medical emergency. However, this assumes the ambulance is not dispatched to another emergency, in transit, or waiting at the hospital.

The ambulance proposal calls for the ambulance to be exclusively used by the people on Skidaway Island. Once a patient is delivered and accepted at an area hospital, the ambulance would return to the McWhorter Fire Station #5 unless there is an  emergency event on the direct route of the returning ambulance.

As mentioned above, to determine whether the Landings community would like to participate in this CES-provided Skidaway Island ambulance, we will include questions in the upcoming survey. Below is a list of details we believe are important for each resident to be aware of when responding to the survey:

• A dedicated Skidaway Island ambulance has the potential to save lives by reducing the response time for transport to area hospitals.
• The current Skidaway Island ambulance average call volume is three calls per day, with two of the three calls requiring transport.
• The Skidaway Island ambulance would be in addition to the existing Skidaway Island medical support, including First Responders, Fire Engine 5 paramedic, and off-island ambulances.
• If the Skidaway Island ambulance is out on a call, a second off-island ambulance would be dispatched and respond as necessary (same as the current practice).
• CES has evaluated the economics of placing an ambulance on Skidaway Island and has determined that the operating cost of supporting a dedicated ambulance will exceed the potential reimbursements from various sources, including Chatham County’s subsidy, patients’ insurance, Medicare, Medicaid, etc., resulting in an estimated shortfall of nearly $380,000 per year to provide this service.
• The cost for the ambulance service initially would be based on historical trends and may change based on actuals (as determined by CES).
• According to CES, in 2021, there were a total of 672 Skidaway Island ambulance transports, with 52.55% from the assisted living facilities and 47.45% from the remaining Skidaway Island population, including The Landings. Note that the 672 transports are 2% of the total 33,430 transports in Chatham County in 2021.
• The current ambulance proposal calls for every property owner on Skidaway Island, estimated at 4,975 properties (4,420 in The Landings), to contribute approximately $76 per year to pay for this service. Note that The Landings residents would pay 89% of the cost.
• Skidaway Island is one of the few places in Chatham County that has full-time (24/7, 365 days per year) paramedic support. This service, used by all Island communities, is fully funded by The Landings Associations, that is, the Landings residents. To date, other island entities have not been willing to contribute to this vital service.
• The cost of this ambulance service per property owner would require participation by all Skidaway Island communities and the ability of each community to pay annually.
• According to the Savannah Morning News, our area hospitals are suffering from a critical shortage of medical workers, resulting in long wait times where patients must wait in the ambulance until the hospital emergency room staff can accept them. This situation, known as “wall time,” currently lasts between ½ to 2 hours, with an average time of 63 minutes, and impacts about 20% of the ambulance transports. This not only increases the waiting time for patients to receive complete medical attention but also means the ambulance is not available for additional transport. (Guan, Nancy, “No room at the ER? Savannah hospitals blame the rise in patients, length of stays for EMS delays,” Savannah Morning News, 23 March 2023, https://www.savannahnow.com/story/news/fire/2023/03/21/savannah-hospitals-cite-increase-in-sicker-patients-for-bed-delays/70014680007/)
• Given the issues at the hospital as well as the possibility of other emergencies occurring at the same time, the availability of our Skidaway Island ambulance would never be guaranteed for a patient in need.

The proposal for a Skidaway Island ambulance could provide lifesaving support to our island residents and should be considered seriously. Your Association needs to hear your thoughts and asks you to provide your feedback through our survey when it is implemented later this year.

One additional follow-up from my last President’s Update: The Association’s Governance Committee has completed its update of The Landings Rules and Regulations, and our legal counsel has conducted a legal review to ensure the changes comply with all governmental regulations and our governing documents. These Rules and Regulations will be issued for community review shortly, and I ask each of you to take the time to review the rules and comment as you deem appropriate.

Thank you, and enjoy your summer!