Martin County fire chief urges renegotiation of Stuart interlocal agreement after maternity transfer incidents
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Summary
Martin County Fire Rescue Chief Chad Chancholy told commissioners the county's 2020 fee-based interlocal agreement with the City of Stuart created an operational imbalance and described multiple recent cases in which Stuart units declined or delayed care for laboring OB patients; the board unanimously directed chiefs to meet and consider a transport protocol to prioritize patient safety.
Chief Chad Chancholy of Martin County Fire Rescue told the board that the county's fee-based interlocal agreement with the City of Stuart, adopted in 2020, was intended to protect public safety but has produced an imbalance in mutual-aid responses. He said Martin County units were handling an outsized share of Stuart's 9-1-1 calls and described a series of incidents in which Stuart responders did not assume care for laboring obstetric patients, delaying transfers to facilities with obstetrical and neonatal capabilities.
"This agreement was public safety forward, but that's not exactly what happened," Chancholy said, recounting four cases dating from April 2025 to January 2026 in which callers or ER staff had to call 9-1-1 multiple times before a county unit ultimately transported an OB patient to an appropriate facility. He warned that a 20-minute delay in the dispatch/response/transfer timeline can be life altering for mother and baby.
Two emergency medicine physicians who joined the presentation backed Chancholy's concerns. Dr. Donald Wood, Martin County Fire Rescue medical director, and Dr. Peter Dayton, Cleveland Clinic's medical director for patient safety and quality, told the board that hospitals without staffed obstetrical and neonatal support cannot reliably provide the full continuum of care for laboring patients and that routing patients to facilities with appropriate services is the safer option.
Commissioners debated options including a chiefs-only renegotiation, a limited agreement for Martin County to handle hospital-to-hospital transports when Coastal Care or hospital transport resources are unavailable, and broader structural changes to mutual-aid dispatching. Commissioner Campey moved that the two organizations negotiate a focused agreement that, at minimum, gives Martin County responsibility for transports when hospital internal transport is not available and to convene a chiefs-only meeting (no elected officials) to renegotiate operational details. Commissioner Hetherington seconded the motion.
The motion passed unanimously. The board asked staff to facilitate a chiefs-level negotiation including both fire chiefs, medical directors, legal counsel and administrators and to report back on an agreed pathway for transport policy and any required changes to the ILA.
The board explicitly framed this action as operational rather than political: Chancholy said he sought to "remove the nonsense" and focus on patient-centered outcomes.
What happens next: staff were directed to coordinate the chiefs-level meeting and return with options and any recommended amendments to the interlocal agreement for the board's consideration.
