Lancaster County Council heard a presentation from the Indian Land Fire Department on a proposal to operate under a non‑transporting EMT license and provide expanded on‑scene medical care.

Chief Greg Nicholson told the council the department currently operates as medical first responders and is limited in treatments it may provide. "Right now, we are emergency first responders, which is the lowest level of response you can have on the EMS side," Nicholson said, adding that Indian Land runs a large share of calls in its district and is seeking the higher EMT level to provide interventions such as advanced airways, epinephrine for anaphylaxis, albuterol for respiratory distress and basic diagnostic checks like blood glucose levels.

The chief said the department has roughly 38 certified personnel — about 35 EMTs and two paramedics, by his estimate — and that the start‑up cost for the change is approximately $43,000, which he said is already included in the department's 2025–26 budget. He said ongoing annual costs would depend on medical control and supplies but estimated about $25,000 per year. Nicholson also said the department carries insurance and had coverage for medical incidents; "We have an insurance policy ... that covers all of our firefighters up to a million dollars for any occurrence on medical or fire," he said.

Why it matters: council members and staff raised questions about response times, duplication of services, liability, recordkeeping and regulatory structure. Nicholson said dispatch-to-enroute time averages about 80 seconds and that on‑scene arrival is often under four minutes, but mutual‑aid delays for transporting ambulances have produced much longer waits at times. He said mutual aid entered the Indian Land district 64 times in 2024 and 48 times so far this year, illustrating gaps the department says it could help fill before a transport ambulance arrives.

County EMS and legal staff explained constraints. The county EMS director told council that EMS will follow whatever direction the council provides on structure and oversight. The county attorney said the Department of Health and Environmental Control (DHEC) licensing is key: "The DHEC number actually goes to the fire department itself, not the district," she said, and advised staff would provide legal input on permitting, medical control and any necessary ordinance changes.

Council concerns and next steps: members generally expressed support for improving life‑saving care but pressed for more information on chain of command when a transport ambulance arrives, legal liability and the operational details of two licensure regimes operating in the same county. County staff said medicines and controlled supplies would be purchased and managed under the fire department's medical control and could not be shared across separate EMS licenses. The county attorney offered to research ordinance implications and to return with legal options; the EMS director noted the change is likely feasible only in the Indian Land consolidated district because of staffing and an "80% rule" requiring an EMT to be on scene a high proportion of the time.

Council members requested quarterly data if the change is implemented — including response times, medication use and operational costs — to evaluate the program. No formal vote to authorize the license change was taken; county staff and the county attorney were asked to return with legal and operational recommendations and data to support a possible future decision.