Stat Zero: The EMS Crisis York County Can’t Ignore Anymore

YORK, S.C. - In northeastern York County, the River Hills/Lake Wylie EMS system is facing challenges and needs community support. It is running short on funding and may be at risk — not for lack of heart, but for lack of help.
For 44 years, this nonprofit lifeline has served its community without any county or state support. Now, amid a national paramedic shortage, rising emergency call volumes, a population of close to 306,558 in York County alone, and a complete absence of public funding, their ability to save lives is on its own lifeline.
Mary Cobb, the vice president of River Hills/Lake Wylie EMS and one of the system’s most impassioned voices, doesn’t sugarcoat the reality: “We hit stat zero most days,” she says — the code meaning no ambulance is available to respond to 911 calls. Lives hang in the balance while bureaucracy stalls.
Despite having a loyal squad of about 20, low pay and little benefits beyond paid time off, holiday pay and incentive shifts, they remain dedicated. Yet they struggle to staff one truck full time. Many potential hires walk away after learning of the poor pay and limited benefits, while others burn out from the emotional and physical toll.
With no funding from the county, River Hills/Lake Wylie, Piedmont and Atrium Fort Mill EMS all face the same grim truth: without structural change, patients will suffer — or worse.
When a River Hills/Lake Wylie ambulance is out of service due to staffing shortages, other units like Piedmont EMS or Atrium
Fort Mill EMS respond when available. But this means there’s one less ambulance in the entire system, which further strains response times during emergencies.
When every unit in the county is already tied up on calls, the system hits stat zero and in those moments, services have to come from other counties and North Carolina.
A broken model
Unlike all other counties in South Carolina and many areas across the United States, York County does not fund or operate its EMS system. Instead, it relies on nonprofit squads and hospital-affiliated services to provide lifesaving care. This model places enormous pressure on underfunded organizations like River Hills/Lake Wylie EMS which survive entirely off donations and billing revenue alone.
According to Cobb, York County can change how financing is allocated to help fund services across the county. She stresses that the system they’ve maintained for decades is unsustainable and unstable.
Atrium Health’s presence: Help, not hostile takeover
In April, Atrium Health received a permit for interfacility transports — meaning they can transfer patients between hospitals, but not respond to 911 calls. Some originally questioned whether this might signal a larger takeover of local EMS services.
However, others see Atrium’s involvement differently.
Atrium has already stepped in to support Fort Mill EMS, another nonprofit agency in York County, by funding its 911 operations and ensuring it can continue serving the community. For many, this shows Atrium is trying to help fill in the gaps left by a lack of government support.
Rather than a takeover, some view Atrium’s role as a critical lifeline — one that’s helping keep Fort Mill EMS alive in York County when no one else would.
The community keeps the lights on
The community has been responsive to the need. River Hills/Lake Wylie EMS is still operating thanks to generous donations and the unwavering commitment of its staff. Cobb is helping organize EMS Week to lift spirits and recognize the hard work being done every day.
“They keep showing up,” she says. “They love this place. But love alone won’t keep us alive.”
What needs to change
York County must act, whether that means funding nonprofit providers, centralizing EMS services or creating new partnerships.
One thing is certain: the current system is not sustainable.
As Cobb puts it, “We have the passion. We have the people. What we need is the support.”
How you can continue to help
The River Hills/Lake Wylie EMS team needs more than appreciation — they need real support.
Scan the QR code and donate whatever you can. Every dollar goes directly toward keeping ambulances on the road and skilled responders at the ready.
Your donation could help save a life.