07-A EMS 6 Mo. Status ReportPARIS
EMERGENCY
MEDICAL
SERVICE
Proudly serving Paris and Lamar County since 1979
The following information is presented to illustrate the financial status of the Paris
EMS for the time period of October 01, 2001 thru March 31, 2002.
Current FY
Previous FY
Difference
Si nificance
Call Volume
3817
3345
472
14.1% Increase
Debits
$1,335,206.50
1,017,670.50
317,536
31.2%Increase
This table illustrates call statistics. Call volume has increased by 472 calls or 14.1%
for the same time period. Call volume averaged 20.85 calls per day during this
time period with a peak volume day of 41 calls.
Debits increased by $317,546 or 31.2%. This can be attributed to increases in call
volume and our charges for service profile.
Current FY
Pro'ected FY
Difference
Si nificance
Cash Credits
783,567.67
662,500
121,067.67
18.3%Increase
Cash credits collected were $783, 567.67 as of March 31, 2002. Revenue
projections had anticipated $662,500 during the same time period. Therefore,
revenue collections were 18.3% above projections. The revenue projection
amount is an estimate based historical information of call volume and types of
payment sources.
Ex enses Maintenance/O erations are 5.4% above ro'ections
Expenses associated with Maintenance/Operations were $87,501 or 5.4% above
budget projections for the time period of October 01, 2001 thru March 31, 2002.
This is primarily because of increased personnel cost associated with workers
comp and overtime expenses as a result injuries and iliness. The net effect for
this time period is a reduction of the anticipated shortfall in the amount of
$33,566.67.
2
The new Medicare Fee Schedule was implemented April 01, 2002. Last minute
revisions by the Centers for Medicare/Medicaid (Health Care Financing
Administration) have lessened the impact to our projections of reimbursement
amounts from Medicare. Examples of the revisions include recognition of the
increased cost of readiness by expanding definitions of types of calls,
interventions used, and medications administered.
Therefore, cautious optimism is appropriate in that the revenue projections for
the 2001-02 fiscal year can be met. All of this depends on Trailblazers (Medicare
Carrier) ability to program and configure their computer system, train and
educate personnel in order implement the Fee Schedule in a timely manner.
Future negative changes in payment allowables are possible but not expected
at this time.
Paris EMS Billing/Administration staff is scheduled to attend training with
Trailblazer staff on May 30, 2002. The billing staff is in contact with Trailblazer
representatives on a consistent basis to ensure compliance with the new policies
while maximizing revenues.
AITACHMENTS:
The following attachments are made available as information to help foster
understanding of the contractual arrangement between the City of Paris and
Lamar County regarding the countywide emergency medical system.
As reflected in the news articles included in the attachments, the situation of
declining revenues is not unique or exclusive to our area. Nationwide EMS
providers are reacting to this situation either by decreasing readiness, reducing
capacity or increasing cost-sharing or a combination of all alternatives. See, for
example, the information in the attachments about the difficulties Grayson
County and Fannin County have encountered in merely retaining some kind of
ambulance service much less a long-term, quality ambulance provider.
Paris EMS is not advocating any of the above alternatives. Paris EMS is not
reducing readiness or capacity. Paris EMS is not increasing the cost-sharing
price. Paris EMS will continually strive to control costs while increasing revenues
through internal efficiencies and diligent billing strategies.
3
INDEX
A. 2001-02 EMS CONTRACT
B. MAYORAL CORRESPONDENCE REDUCING CONTRACT AMOUNT
C. EMS CONTRACT COST FACTORS
a. TOTAL COST FACTORS
b. EMS COMPONENT
c. DISPATCH COMPONENT
d. RESCUE COMPONENT
D. EMS CONTRACT HISTORY CHART
E. COMPARISON COST WORKSHEET
F. PUBLICATIONS/NEWS ARTICLES
5
PARIS EMERGENCY MEDICAL SERVICE
TIMELINE:
1979
City of Paris implements plan to provide ambulance service.
Previous ambulance providers include funeral homes, private
provider and hospital. Offer is made to Lamar County officials to
provide ambulance service countywide on a contractual basis.
1981
Paris EMS upgrades all personnel to Basic Life Support (BLS) level.
1982
Paris EMS upgrades level of service to Advanced Life Support (ALS).
1984
Paris EMS upgrades level of service to Mobile Intensive Care Unit
(MICU) using Paramedics.
Workweek modified from 72 hours per week to 56 hours per week.
1989
Non-Emergency transfer crew added to accommodate increased
non-emergency call load and emergency call overflow.
2000
24/7 Emergency crew added to increase readiness and
accommodate emergency call volume.
COUNTYWIDE EMERGENCY MEDICAL SYSTEM:
. THREE MICU AMBULANCES 24/7
• TWO ALS PERSONNEL PER AMBULANCE
• ONE TRANSFER AMBULANCE MONDAY - FRIDAY
. MULTI-ROLE RESCUE CAPABILITY 24/7
. FIRST RESPONDER NETWORK
. LOCAL DISPATCHING
4
. r
EMERGENCY MEDICAL SERVICES INTERLOCAL COOPERATION CONTRA:.:T
STATE OF TEXAS )
) KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF LAMAR )
WHEREAS, Chapter 791 of the Texas Government Code authorizes local governmenYal
entities, such as cities and counties, to cantract for the performance of governmental services and
functions by one governmental entity on behalf of another governmental entity in order to increase
the efficiency and effectiveness of both local governments; and,
WHEREAS, the City ofParis, Paris, Texas, and the County of Lamar, State of Texas,
desire to enter into a contract pursuant to said Chapter 791 whereby the Ciry of Paris will provide
emergency medical services to that portion of Lamar County located outside of the city limits of
Pazis in return for a contribution by the County of Lamar to defray the cost oF providing such
emergency medical services; NOW, THEREFORE,
This contract is made and entered into this the lOth day of September, 2001, by and
between the CITY OF PARIS, PARIS, TEXAS, a body politic, acting by and through its Mayor,
Michael J. Pfiester, duly authorized, hereinafter called CITY, and the COUNTY OF LAMAR,
State of Texas, acting by and through its Counry Judge, M. Charles Superville, Jr., duly
authorized, hereinafrer called COiJNTY. The parties hereto hereby contract and agree as follows:
1. CITY covenants and agrees that it will furnish and provide adequate emergency
medical service vehicles and related emergency medical services to all persons within the County
of Lamar, without regard to race, color, sex, or national origin.
E1VtERGENCY b1EDICAI. SERVICES COlV7'RACI' - Page 1
.1
J
2. CITY covenants and agrees that it will comply with all safety requirements of the
law pertaining to the fumishing of emergency medical services and that all vehicles used as
emergency medical service vehicles will be distinctly marked and colored as required by State law
and City ordinances. The emergency medical service shall be referred to as "CITY OF PARIS
EMERGENCY MEDICAL SERVICE" and the vehicles used in providing said service shall bear
the City of Paris decal with the additional words "Serving PARIS and LAMAR COiJNTY."
3. CITY agrees that emergency medical service vehicle attendants will be certified by
the Texas State Department of Health under the terms of the Emergency Medical Services Act,
Chapter 773, Vernon's Texas Codes Annotated, and that each emergency medical service vehicle
shall be staffed with at least two emergency care attendants as required by Section 773.050,
Subsection (a) of Chapter 773, Vernon's Texas Codes Annotated.
4. CITY agrees to provide State of Texas Certified EMT Certification and to possess
an in-service training program agreement with the local hospital, in compliance with State of
Texas continuing education requirements.
5. CITY agrees that each vehicle used as an emergency medical service vehicle shall
be equipped with a two-way radio which transmits and receives on frequencies designated by the
FCC. The radio communications to and from said emergency medical vehicles and central
dispatch shall be in coordination with and by the knowledge of the Lamar County Sheriff's Office,
the Paris Police Department, and Christus St. Joseph's Health Systems, with the hospital
furnishing its own radio equipment.
EhQ?RGENCY 11~D[CAI. SERVICES CONTRAC'f - Page 2
6. CITY agrees that all vehicles used for emergency service and the equipment
1
contained therein will meet or exceed requirements in accordance with the Health and Safety
Code, Chapter 773, and that all emergency medical vehicles and accessory equipment shall be
subject to inspection by designated representatives of the COiJNTY, and, if at any tune same aze
not in compliance with the provisions hereof, or if any emergency medical vehicle is in need of
mechanical repairs in order to insure its satisfactory operation, the said vehicle must be removed
from service.
7. CITY agrees that it will answer all emergency calls within the lunits of the City and
County, that no person within the City and County shall be refused emergency service, that
transfer emergency service, when directed by a medical doctor, will not be refused, and to deliver
patients to Christus St. Joseph's Health Systems, North and South Campuses, in the following
manner:
(a) To the hospital campus that patient, his personal physician, or next of kin so
designate, or
(b) To the nearest or most appropriate hospital campus from the point of pick up of the
patient when the patient, his personal physician, or next of kin is not able or
available to make such determination, or
(c) To the nearest hospital campus from the point of pickup when a life threatening
situation exists.
8. CITY agrees, at all tunes during the effective period of this contract, to have
procured and kept in force and effect policy or policies of public liability insurance covering each
motor vehicle operated under this contract in the minimum amounts of $250,000.00 for bodily
injury or death to any one person and $500,000.00 for all persons injured in any one accident or
EIIERGENCY hIEDICAL SERVICES CONTRAC'f - Page 3
occasion and $100,000.00 for property damages arising out of any one accident or occasiqn.
9. CITY agrees to furnish the County Judge, Lamar Counry, an annual operating
statement relating to revenues, expenses, call statistics, and the status of delinquent and
uncollectible accounts, and that all non-medical records of the services rendered under this
contract, and uaining and certification records of all employees, be available for inspection and
review by such County Judge, or his designated representative.
10. CITY agrees to operate the emergency medical service operation in accordance with
the requirements of State law and applicable requirements of CITY and COUNTY as may be in
effect.
11. CITY agrees that during the term of this Contract it will have a minimum of three
(3) emergency medical vehicles which meet the emergency medical vehicle and equipment
requirements as set out in paragraph 6 above, manned with a crew of two (2) personnel each,
available to the citizens of the City and County twenty-four (24) hours per day, seven (7) days per
week.
12. COUNTY agrees that CITY shall be the exclusive, sole, and only provider of
emergency medical services in the County of Lamar.
13. COUNTY agrees that non-emergency transfer service from points within the City
or Counry to points inside or outside the County will be made at the prerogative of the CITY, and
that emergency medical service from points outside the County to any destination shall be made
at the prerogative of CITY and shall not be covered by this contract.
14. The COUNTY agrees to pay to the CITY forty per cent (40%) of the actual net
cost of providing emergency and transfer ambulance service to be computed through the last day
of this contract on a cash basis, with the COIJNTY making monthly payments of $33.267.00
EhIERGENCY hIED1CAL SERVICFS CONTRACf • P+6c 4
monthly towards the estimated twelve (12) month term cost of $399,206.00. The first of said
i
monthly payments to be made on the lst day of October, 2001, with a like payment being made
on the first day of each month thereafter.
15. In the event the charges paid by COUNTY are more than or less than the charge
that would have been made based on actual costs, the CITY will furnish calculations to COUNTY
during the month of January and COUNI'Y's monthly payments shall be increased or decreased
for the months of February through September by an amount which will eliminate the overcharge
or will make up the deficiency.
16. This agreement shall be effective and the term thereof shall commence on the lst
day of October, 2001, and shall expire on the 30th day of September, 2002.
17. It is further un3erstood and agreed that neither the COUNTY nor any of its agents,
servants, or employees shall be considered to be in the business of providing emergency medical
service, and the relationship between the parties shall not be considered to be that of a partnership
or joint venture, and that the status of the CITY shall be that of an independent contractor
providing services to the COi1NTY and its inhabitants in exchange for the payment of amounts
herein setforth.
18. It is mutually understood and agreed between the parcies that the payments made
by the COUNTY to the CITY shall in no way affect the right of CITY to collect the charges
hereinafter set out in paragraph 19 from persons for emergency medical service rendered, and it
is expressly understood and agreed that no one shall be entitled to free emergency medical service
under this contract, and diligent efforts shall be made to collect accounts outstanding in keeping
with good and ethical business practices.
EMF.RGENCY hff.DICAL SERVICES COM'RACf - Page 5
19. It is understood and agreed that charges for services rendered under the scoge of
this contract within the limits of the CITY and COiJNTY shall be per patient, per call, as follows:
(a) The following rates are established for emergency medical vehicle service for
residents and non-residents of Lamar County:
1. MOBILE INTENSIVE $400.00 plus $7.50 per mile
CARE iJ1VIT (AIICi) from point oF pickup within Lamar
County to point of delivery
2. ADVANCED LIFE
SUPPORT (ALS)
3. OUT OF LAMAR
COUNI'Y TRANSFER
SERVICE
$350.00 plus $7.50 per mile
from point of pickup within Lamar
County to point of delivery
$400.00 plus $7.50 per mile
from point of pickup to point
of delivery less than 125-mile
radius
4. NON-EMERGENCY $220.00 plus $7.50 per mile
TRANSF'ER SERVICE from point of pickup within Lamar
County to point of delivery
5. RETURN TRIP $215.00 plus $7.50 per mile from
point of pickup to point of delivery
6. PERSONAL $550.00 plus $7.50 per mile
PREFERENCE from point of pickup to point
TRANSFER SERVICE of delivery; and to point of return
outside Paris City Limits to point of
origin inside Paris City Limits
beyond a 125-mile radius
7. STANDBY $325.00 for the first hour and $60.00
for each additional hour on an as-
available, first-request, first-served
basis
(b) In addition to the established rates, a usual, reasonable, and customary charge for
medical supplies and service used or required in connection with emergency and
non-emergency transfer service shall be made.
EAERGENCY MEDICAL SERVICES COM[RACT - Pa6e 6
20. It is agreed that, if any patient dies while en route to any hospital, the pazamedic
in charge shall deliver the body of such deceased person to the nearest hospital and remain there
until a medical examiner or licensed medical doctor formally pronounces the subject dead. CITY
and COiJNTY agree that CITY will not be required to transport any cadavers from any hospital.
21. It is agreed that all calls for emergency medical service that are received by
COUNTY shall be referred to the CITY OF PARIS AMBLTI.ANCE SERVICE operated by
CITY.
22. In the event that the COiJNTY or the CITY desires to discontinue emergency
medical service at the end of this contract, being September 30, 2002, COUNTY or CITY shall
give written notice to the other party on or before June 1, 2002, of its desire to cancel service.
If COiJNTY fails to give notice of discontinuance of emergency medical service beyond the end
of this contract, CITY will deliver to COLTNTY on or before August 31, 2002, rates and contract
prices upon which it will deliver service, and thereafter, on or before October 1, 2002, COIJNTY
will execute the contract for service for the additional term upon the same terms and conditions
as stated herein.
23. The parties to this contract hereby covenant and agree that the amounts paid under
this contract and pursuant to the terms hereof fairly and equitably compensate the performing party
for the services or functions performed under the contract. Furthermore, the parties covenant and
agree that each party paying for the performance of governmental functions or services shall make
the payments required thereof from current revenues available to the paying parry.
EhiERGENCY 6ff.DICAL SERVICES CONTRACf - Page 7
EXECUTED on the lOth day of September, 2001.
CITY OF PARIS, PARIS, TEXAS
By: .
Michael J. Pfie , M or
ATTEST:
'`""{r CC~~k L j kK~'m'h,cmQ X\"'n
Mattie Cunningham, City Clerk
APPROVED AS TO FORM:
Larry W/Schenk, Ciry Attorney
By:
ATTEST:
Kathy Ma owe Cou Clerk
N ~
COUNTY OF
EMERGENCY MEDICAL SERVICES CON1RACf - Page 8
~
,
~ - ~7 c IY O '~1 pA, \ L%j~S~
a - -
September 18, 2001
Honorable M. Charles Superville
Lamar County Judge
Lamar County Court House
119 North Main Street
Paris, TX 75460
In re: Projected Ambulance Charges by the City of Paris for Service Year October 1, 2001-
September 30, 2002
Dear Judge Superville:
As we discussed in our recent meeting, and at your request, the City of Paris has made an
in depth review of both its projected revenues and its anticipated costs for providing ambulance
service to Lamar County for the service period October 1, 2001-September 30, 2002. As a
consequence of that review, I am pleased to advise you the City has been able to make certain
adjustments to its projected revenues for next year, due in part to recent EMS rate increases
adopted by the City Counci(. In addition, the City has also been able to identify modest projected
cost savings, which coupled with the revenue increase should result in total projected costs of
$341,509.00, or $28,459.00 per month, for ambulance service to Lamar County during the next
fiscal yeaz. While these numbers are based on projected costs and revenues, the City staff has
assured me they are confident these numbers reflect the maximum anticipated EMS expenditures
on behalf of L.amar County, baning any unforseen or highly unusual change. As I am sure you
will agree, recent circumstances on the national scene dictate that the only certain thing is
uncertainty.
Nevertheless, I am pleased to present to you this current information with regazd to the
City's adjusted anticipated cost for providing the same high quality ambulance service which the
City has been able to maintain in the past. During our recent conversations, you referred to our
ambulance service as a"Cadillac" service, a reference I received with some measure of pride.
The citizens of the City of Paris, (and through our contract, the citizens of Lamaz County) have
come to expect the City and the County to maintain the highest scandard of ambulance service,
and the City Council and the City Staff are committed to maintaining that high level of service at
the lowest possible cost. Indeed, the anticipated cost to the County for EMS service for this next
ensuing year, in spite of severe reductions on the part of the federal government and other
uncertainties, is now projected at a level lower than the projected level of cost for this current
service yeaz.
I anticipate in the next ensuing year the County and the City will engage in further
discussions, not only on matters related to ambulance service, but regarding other matters of
P.O. BOX 9037 • PARIS, TEXAS 75461-9037 •(903) 785-7511 • FAX (903) 785-8519
importance where the City and the County shaze a mutual interest. I sincerely hope this EMS cost
adjustment by the City is acceptable ro the County and will allow us to go forward as partners in
providing this most necessary service to our citizens.
If you believe an actual change to the convact which the City has previously approved for
forwarding to you to reflect these adjusted numbers is necessary, kindly advise me at your eazliest
opportunity. Otherwise, as you are aware, the proposed contract contains language in it which
provides for upward or downward adjustments based on actual costs and revenues, and it is my
belief the current contract will be able to serve the needs of both parties.
If you have any additional questions regarding this matter, please do not hesitate to contact
me.
Yours very truly, ,
00,
Michael J. Pfiester, Mayor
LWS/ap
Ae
EMS CONTRACT ESITIMATE
FOR YEAR ENDING 9-30-2002
Personnel
$1,663,615
Supplies
$127.600
Contractual
$46,000
Equip. & Building Maint.
$47,600
Medical Expenses
$4,000
Audit
$2,000
Equipment
$154,980
Subtotal $2,045,795
Administrative Fee-6.5 % $132,977
Subtotal $2,178,772
Less EMS collections $1,325,000
Net Cast $853,772
x.4
County Share of Net Cost-40% $341,509
Per Month $28,459
b,
2001-2002 EMS Personnel
1 EMS Administrator $48,698
3 Shift Supervisor
$126,282
9 EMT II
$318,474
9 EMT f
$292,032
2 Transfer Crew
$51,012
1 Clerk IV
$24,934
1 Clerk III
$20,982
26
$882,414
Longevity Pay
$9,096
Sell Back Vac.& Sick
$16,053
Certificate Pay
$53,976
Overtime
$118,300
$1,079,839
Soc. Sec. 7.65%
TMRS 9.86%
Med.& Life Ins. $350
W. Comp. 2.50%
Unemployment 1%
$82,607
$106,472
$109,200
$24,038
$10,798
$1,412,954
C,
2001-2002 Dispatcher Personnel
10 Dispatchers $240,630
Longevity & Sell Back $5,000
Overtime $6,500
$252,130
Soc. Sec. 7.65%
TMRS 9.86 %
Med. & Life $350
W. Comp. .22%
Unemployment 1 %
$19,288
$24,860
$42,000
$540
$2,521
$341,339 X 25 %
2 Dispatchers $51,064
Longevity & Seil Back $1,000
Overtime $1.800
$53,864
Soc. Sec. 7.65%
TMRS 9.86 %
Med. 8 Life $350
W. Comp. .22%
Unemployment 1 %
$4,120
$5,311
$8,400
$115
$539
$72,349 X 100
$85,335
$72,349
Total Dispatchers $157,684
2001-2002 Rescue Truck Personnel
Driver
$32,448
Firefighter
$30,784
Certificate Pay
$4.498
Stability Pay
$2,405
Overtime
$4,000
subtotal
$74,135
Soc. Sec. 1.45 %
Retirement 10 %
Med. & Life $350
W. Comp. 1.73 %
Unemployment 1 %
$1,075
$7,413
$8,400
$1,213
$741
$92,977
Rescue Truck
Depreciation 5 °k $18,180
EMS CONTRACT HISTORY
$400,000
$350,000
$300,000
$250,000
$200,000
$150,000
$100,000
$50,000
$0 ;
90-91 91-92 92-93 93-94 94-95 95-96 96-97 97-98 98-99 99-00 00-01 2001-02
MContract $321,781 $372,000 $285,601 $317,748 $330,473 $338,128 $263,947 $207,991 $188,156 $180,706 $350,377 $341,509
■Actual $275,270 $266,050 $249,351 $315,518 $238,171 $283,123 $204,808 $207,016 $130,599 $182,038 $342,000
COMPARISON COST FOR THE AVERAGE TAX PAYER IN LAMAR COUNTY FOR
~ AMBULANCE SERVICE
PROVIDED BY THE CITY OF PARIS
1.
Taxable Value, City ofParis =
$1.019.160,711.00
2.
Taxable Value, Lamar County =
$1,613.724.489.00
3.
Percentage of the Tax Revenue
of Lamar County Provided by
Citizens of the City of Paris
$1,019,160,711.00
-
$1,613.724,489.00
=
63.15%
4.
Percentage of the County's
Shaze of the Cost of Ambulance
Service Paid for by Tax Payers
of the City of Paris
63.15%
x
40 %
=
25 %
5.
Total Percentage Share of the Cost
of Ambulance Service Paid for by
City of Paris Tax Payers
60% (amount in current contract for the
City of Paris to pay)
+
250/o (allocated shaze of City oF Paris Tax
Payers of the County Cost)
=
85%
6. Percent of the Total Cost of
Ambulance Service Paid for by
Non-City of Paris Tax Payers = 15%
7. Percentage of Total Runs in
the County = 11% which are also the most expensive
ambulance runs for the City to make
because of the distance, which costs
additional fuel, equipment costs, etc.
= 48.499
8. Total Population of Lamar County
9. Total Population of City of Paris = 25.898
10. Percentage of City Population to
County Population 25,898
- 48,499
= 53%
11. Percentage of Lamar County
Population Located Outside the
City of Paris 100%
- 530/o (amount of population in the City of
Paris)
= 47%
12. In other words. 47% of the nooulation of Lamar Countv receive ambulance service for
15% of the cost.
East Texas ambulance service threatens departure -
Monday, March 25, 2002
Daily Sun
Corsicana, Texas - East Texas Medical Center Emergency Medical Services
has announced plans to suspend ambulance service in Navarro County
unless city and county officials provide a$291,897 subsidy to offset low
Medicare reimbursement rates.
Members of the city council and commissioner's court will meet with an
EfMC EMS representative today in the City Government Center to hear the
facts for themselves. .
Navarro County got rolled out with Dallas County for Medicare
reimbursement," County Judge Alan Bristol said. "We are still a rural
county, but for reimbursement rate purposes, we're not."
Besides affecting the ambulance service's revenues, he said the lower-
paying classification hurts the hospital, the health department, Medical Arts
Clinic and local doctors in private practice.
"(United States Representative) Martin Frost's office has been trying to see
what they could do to get us changed back to rural because we don't have
the competition to justify those lower reimbursement rates," he said. "We
don't have the doctors or anything to drive the costs down."
EfMC EMS is a non-profit organization which serves quite a few counties in
North and East Texas, but losses in Navarro, Ellis and two other rural
counties have been great enough to necessitate a subsidy request.
"Basically, he's telling us that the subsidy he's asking for is not to make
them profitable, but just to keep them from losing so much money," Bristol
said.
Since the county cannot do without ambulance service, official's options
are limited by the Sept. 30 expiration of ETMC's contract.
"We can find another provider which would have to come in and start
from scratch," he said. "It might also be an option for the city to run an._
ambulance service, but the county has never done that."
Fire Chief Donald McMullan said the city and county will be looking at long-
term plans in the near future, but for now, he sees little choice but to pay
the subsidy.
"For the fire department to become involved in the actual ambulance
service part rather than working as first responders like they do now
would be a very costly project," he said. "The initial start-up costs
would be very high due to the fact you have to buy ambulances, hire
additional people and things of that nature."
He said his firefighters, many of whom are already advanced paramedics,
would have no problem manning ambulances, but he has doubts about the
financial considerations of a city-operated service.
"It's a decision the city and county are going to have to look at," he said.
"They will have to spend some time evaluating the cost of things and what
would be the best service for the community."
"For the short term, I don't see that we have a lot of choice," he said. "The
timing is bad, and we may not like the way it came about, but I really think
our options are going to be worse."
He added that it may be difficult to find another ambulance service for
Navarro County considering the low reimbursement rate classification and
ETMC's 29.5 percent collection rate.
Truitt Gilbreath, city manager, said it will be a struggle to find the city's
half of the subsidy in the current budget.
"The equivalent of $150,000 is 2 cents on the tax rate," he said. "We
wouldn't necessarily pay for it like that, but it's part of the whole revenue
picture if the ciry has to pay for."
He said council members and commissioners will consider both short-
and long-term solutions after Monday's meeting.
Kent Klinkerman
From: Ron Haussecker [washcoems@biuebon.net]
Sent: Thursday, January 24, 2002 5:09 AM
To: texasems-I@yahoogroups.com; chayes@verticalvillages.com
Subject: [texasems-L] County approves EMS agreement with cities
Seguin Gazette-Enterprise
The Seguin Gazette-Enterprise Thursday, January 24 .
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Serving Seguin and Guadalupe County since 1888
County approves EMS agreement with cities
By Chris Lykins
Gazette-Enterprise
1
Published January 23, 2002
SEGUIN - The Guadalupe County commissioners signed off on an interlocal
agreement that will keep the cities of Schertz and Seguin providing emergency
medical services to the unincorporated areas of the county into 2004.
The interlocal agreement sets payments of $470,000 for the contract period
lasting from Feb. 1, 2002, through Sept. 30, 2002. From Oct. 1, 2002, through Sept.
30, 2003, the county would pay $742,000, and for the last portion of the contract,
Oct. 1, 2003, through Sept. 30, 2004, the county would pay $783,000. County
Treasurer Larry Jones, who backed the agreement, said the EMS deal was about
getting quality service at an affordable price.
Pct. 3 Commissioner Jim Wolverton voted against the deai, saying he wanted
to see a guarantee that the county would get the services from the cities. In the
agreement, the cities stipulate that priority will be given to calls within "their own
jurisdictional boundaries."
Jones said that, while he understood Wolverton's wanting a guarantee, in the
18 years the city of Seguin had been providing EMS to the unincorporated areas, and
in the time that Schertz EMS and its predecessors, SAFES, had done the same, they
"had never, ever missed a call."
Jones also pointed out that the cities have back-up that they can use in the
event that all of their units are tied up within the city limits.
Seguin Fixe Chief Scotly MyCue said the city already has pre-arranged
agreements with surrounding cities like San Marcos and New Braunfels for just such
cases.
Following the session, Wolverton said he thinks for the amount of money the
county will spend, that it needs a guarantee.
°We need to know the people we are paying for are going to get picked up,"
Wolverton said.
Pct. 4 Commissioner Wyatt "Butch" Kunde said he had received phone calls
from constituents asking the county to stay with the cities for providing EMS service
and said the crews work well with the county's first responders.
The county also made appointments to the salary grievance committee,
z
approved an application for funding under Senate Bill 1074 for video camera and
recording equipment for all of the county constables and approved a grant application
for bullet-proof vests.
This would be the second year the county has taken part of the grant process
to replace and purchase new vests. Services
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cQ 2002 Seguin Gazette-Enterprise Inc. All rights reserved.
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3
Kent Klinkerman
From: Ron Haussecker [washcoems@bluebon.net]
Sent: Wednesday, January 16, 2002 3:32 PM
To: texasems-I@yahoogroups.com; chayes@verticalvillages.com
Subject: [texasems-L] City bites ambulance aid bullet
Galveston County Daily News
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1
City bites ambulance aid bullet
By Stephen Hadley
The Daily News
Published January 15, 2002
LA MARQUE - Contending La Marque had no other choice, the city council on
Monday agreed to increase the subsidy it pays each month to Rural/Metro Ambulance.
In a 4-0 vote, the city approved a measure to pay Rural/Metro $80,000 a
year, up from $75,075 it has been paying since October. Councilman Larry Crow was
absent. Before the increase the city agreed to pay in October, La Marque paid a
$42,000 subsidy each year.
Rural/Metro sought the subsidy increases from six cities in the area and
Galveston County because it said reductions in insurance reimbursements from
Medicare and private insurers were making it difficult to do business.
La Marque city leaders said that while they didn't like being asked for the
increases at the start of the fourth year of a five-year contract, they had little choice.
.
City Manager Carol McLemore said the alternatives were more costly. She said
the city could seek new bids for ambulance service but that costs would be
substantially higher than Rural/Metro's and service might be compromised.
"I feel like we are between a rock and hard place," said Councilman Richard
Torres. "I feel like the decision has been made for us, and we really don't have a
choice."
McLemore said representatives from the county and the six cities had been
meeting with Rural/Metro officials since July to talk about subsidy increases. She said
a review of the company's books revealed that the increase was warranted.
°There was a lot of soul searching and a lot of questions asked," she said. °I
think this is the very best we can do at this time."
z
Mayor Dennis Rygaard said that if there was a silver lining for La Marque it
was that the ciry's percentage of subsidy contribution decreased.
Before the talks with ambulance company officials, La Marque paid about 20
percent of the $215,600 subsidy. Now it will pay less than 16 percent of a$509,000
subsidy.
"We're really in a position where we are darned if we do and darned if we
don't," Rygaard said. "I don't think we have another choice."
Subsidies
Under an agreement to be voted on by signatories to an ambulance service
contract with Rural/Metro Corp., share of the subsidy paid to the ambulance company
is expected to increase.
Texas City: From $54,900 to $160,000.
La Marque: From $42,900 to $80,000.
Dickinson: From $42,900 to $85,000.
Hitchcock: From $18,000 to $40,000.
Galveston Counry: From $46,900 to $130,000.
Bayou Vista: $5,000 to $8,000.
Tiki Island: $5,000 to $8,000.
Other terms
• Response time standards will be lowered. The current agreement requires
the company to answer 90 percent of calls within 8 minutes and 59 seconds.
Under the new agreement, 80 percent of calls must be answered in that
length of time. The 80-percent requirement is the industry standard.
• Rural/Metro will be allowed to ask for annual subsidy increases not to
exceed 10 percent in a year. The current agreement limits increases to 5 percent.
3
• The company will be ailowed to consolidate its dispatchers in Pasadena. The
move is expected to save Rural/Metro around $125,000.
• Rurai/Metro will be released from a requirement to carry uninsured motorist
coverage. The company has workers compensation coverage and comprehensive
coverage on its vehicles.
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4
Kent Klinkerman
From: Ron Haussecker [washcoems@bluebon.net]
Sent: Saturday, August 25, 2001 2:05 PM
To: texasems-I@yahoogroups.com; chayes@verticaivillages.com; abaris
Subject: [texasems-L] MAST sounds alarm about Medicare rates - 2001-08-20 - The Business Journal
of K
MAST sounds alarm about Medicare rates - 2001-08-20 - The Business )ournal of
Kansas City
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Printable version Email story Check it out! Today's breaking news
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From the August 17, 2001 print edition
MAST sounds alarm about Medicare rates
Anna Jaffe StafF Writer
Metropolitan Ambulance Services Trust is facing a fiscal emergency as a result of
impending reductions in Medicare reimbursements. MAST officials said that without
increased financing from local and state governments, the organization could be
forced to scale back service.
MAST estimated that it will lose more than $10.6 million in Medicare revenue
during a five-year fiscal period as the new rates are phased in.
"This is an effort by the federal government to cut costs," said John Sharp,
MAST's executive director. "But it jeopardizes the health of Americans who have a
right to expect high-quality ambulance service. It's not only immoral, it's stupid."
Sharp said MAST's cost,per transport is about $438.30. The Medicare rates are
more than $100 less than cost.
The loss in revenue could deal a crippling blow to MAST, a nonprofit public trust
that provides emergency services to 17 municipalities in the Kansas City metropolitan
area.
Until 1999, MAST operated at a modest profit. But recent modifications in
Medicare payment rules have hurt the organization's finances. In each of the past two
fiscal years, MAST lost more than $1 million. Within the month, MAST probably will
exhaust its cash reserves and need to borrow money to sustain its operations, Sharp
said.
MAST's financial picture will deteriorate further once the new Medicare
reimbursement rates take efFect, which could be as soon as Jan. 1.
z
Dr. Deborah ]antsch, chairwoman of the MAST board of trustees, said the
organization already is tightening its belt.
"There are business things we're doing successfully to improve the situation," she
said. "But that doesn't mean it's not going to come to crunch time."
The effect of the decreased Medicare payments will be cumulative in nature,
Jantsch said.
"It gets worse each year, until it reaches staggering proportions," she said.
Without financial relief, MAST officials said they would be forced to scale back
service, which could include longer response times, fewer ambulances and less
training for employees.
The reductions in reimbursements are part of the implementation by the Centers
for Medicare and Medicaid Services, formerly known as the Health Care Financing
Administration (HCFA), of a first-time fee schedule for ambulance services. Previously,
providers received payment for "reasonable charges," which varied from community to
community.
In 1997, as part of the Balanced Budget Act, Congress mandated that HCFA work
with the industry to come up with a national fee schedule. Providers helped determine
the service levels included in the schedule, and then HCFA set the rates.
When HCFA released the proposed rate plan in September 2000, providers were
stunned.
"The rates they were assigning to the various service levels were shocking," said
Steve Haracznak, executive vice president of American Ambulance Association, a trade
group based in Washington, D.C., that represents ambulance service providers. "They
are really low."
Haracznak said the proposed fees are so low that they won't just inflict pain but
could force some providers out of business.
Ambulance service providers already are lobbying federal, state and local officials
for relief.
Two bills that would provide some relief are circulating in Congress.
3
"Everyone is asking for money, and we just had a major tax refund that took a lot
of the money away," Haracznak said. "We've had a receptive ear from members of
Congress. But what it comes down to is how much money is available."
MAST officials also are looking to local and state governments for help. Sharp said
they hope to persuade Missouri and Kansas lawmakers to increase Medicaid
reimbursement rates.
But even that will not be enough, he said. To maintain current service levels,
MAST would need Kansas City to double its indigent-care subsidy, which is $1.76
million for the 2001-02 fiscal year.
It may be tough to seli to the Kansas City Council, said Councilman Ed Ford, who
also is on the MAST board.
"While MAST serves a lot of indigent people in the metro area, only Kansas City
provides a subsidy," Ford said. Consequently, he said he thinks many of his colleagues
will look to other municipalities to kick in their fair share.
Observers said cities such as Kansas City, Kan., and Riverside are unlikely to agree
to such a plan and might simply seek ambulance service from another company.
In the meantime, MAST officials said they are hopeful that they will secure the
assistance they need.
"Without some additional help from state and local governments, we simply won't
be able to ofFer the same quality service that we do now," Jantsch said.
"We're hopeful that we'll be able to get the funding we need because that's not
where we want to be in Kansas City."
Reach Anna JafFe at 816-421-5900 or by e-mail at ajaffe@bizjournals.com.
Copyright 2001 American City Business Journals Inc.
Click for permission to reprint (PRC# 1.1652.471293)
4
Kent Klinkerman
From: J. Hoskins Uhoskins@cox-internet.com]
Sent: Tuesday, April 09, 2002 10:07 PM
To: texasems-I@yahoogroups.com
Subject: [texasems-L] Fannin County may request proposals for EMS services
Fannin County may request proposals for EMS services
BY VICKI GRAVES
HERALD DEMOCRAT
BONHAM Fannin County Commissioners discussed preparing a request for proposals
for emergency medical services at a meeting Monday. Cities in the county might
combine with the county in requesting proposals and paying for services.
County Judge Derrell Hall met with Bonham City Manager Bill Funderburk, Bonham
Fire Chief Mike Baker and the city managers of Honey Grove and Leonard last week.
They talked about how to put together an RFP for ambulance service and whether or
not they would like to do it individually or do a single RFP (request for proposal) that
would cover the county and all cities.
"It's obvious there will probably be a single provider countywide," Hall said. "My
feeling is that the best thing to do would be to go together, under an interlocal
agreement, to issue a single RFP for emergency medical services that would cover all
the cities and the county."
Hall put together a 20-page RFP that contemplates that all of the entities, with the
exception of Bells-Savoy and possibly Trenton, would rather go ahead under a single
RFP.
He has set up a meeting for Friday afternoon with all the mayors and ciry managers.
They will talk and make sure this is what everyone wants to do.
Hall's RFP includes a schedule. "I think it goes without saying that time is pretty
critical and the sooner we get an RPF published, the better off we're going to be," he
said.
It's going to take 60-90 days to get a new company in place and get their vehicles and
1
personnel here and communications set up, Hall said.
"I'm proposing that we try to be ready to issue this RFP Monday," Hall said, "If we
have to have a meeting Monday morning to take action, we need to do that."
A pre-bid conference is set for the 29th and the proposals would be due back by May
15.
A committee to review the proposals could be comprised of two members of the
Commissioners Court, a representative from each participating city and one
representative from the medical community, who would have expertise to know
whether these companies would be able to perform as they say they would.
That committee would meet on May 15 and 16 and be ready to make a
recommendation May 17. Contract negotiations would start then and be completed by
the end of May so that the new contract would be here not later than the first week of
August.
"East Texas has told us they will stay until the end of September, but their preference
is to leave earlier, if possible. So, my suggestion is that we join forces," Hall said.
City officials of Honey Grove and Leonard have expressed not only a desire to be a
part of an interlocal RFP, but also an interest in being paying partners of subsidies for
ambulance service, Hall said.
"I think we all need to get prepared," Hall said. "Ambulance service is going to cost
big money."
Public forum
A woman who lives on County Road 2131 said her road is so bad when it floods that
everything on CR 2130 floats onto her road.
"There's big chunks of wood and everything else washing down our road," she said.
Her family built up their driveway twice and the rock has been washed away, she told
her commissioner, Dewayne Strickland.
Strickland told her she has the same problem everybody north of Bois d' Arc Creek
has. There are too many surface acres that drain into that area, and there's no way
for the water to get out.
2
LifeTech shuts doors
BY JERRIE WHITELEY
HERALD DEMOCRAT
With a little more than two years left on its contract to provide ambulance services in Grayson
County, LifeTech EMS shut its doors Wednesday morning.
The closure left people in the Van Alstyne and Whitesboro areas without ambulance service and
Grayson County once again facing an ambulance service crisis. It also left more than 50
employees in the Grayson County and north Collin County area without jobs.
Grayson County Purchasing Agent Jeff Schneider said the city of Sherman had already agreed to
have its ambulance crews cover the areas served by LifeTech on a very short-term basis when
Bells-Savoy Ambulance Service stepped up to the plate with a longer range, though still
temporary, plan.
Under the plan a task force approved Wednesday morning, Bells-Savoy Ambulance Service will
provide an ambulance for the Van Alstyne azea and another one for the Whitesboro Area.
Bells-Savoy will provide the rigs and 24-hour attendants for both towns for $22,000 a month.
The county, Schneider said, will pay the $22,000 and then collect reimbursements from area
communities based on the percentage of LifeTech's contract they were paying.
Jackie Miller, pazamedic and supervisor with Bells-Savoy Ambulance Services, said the business
just happened to be in the position to help.
"We had just recently added a second ambulance to run Monday through Friday from 8 a.m. to 5
p.m. and we had another one that could be ready in a day or so," Miller said. She said the
contract Bells-Savoy has with Grayson County to cover the east part of the county required only
one ambulance so the other two were available to fill LifeTech's void.
Miller said some of the peopie who worked for LifeTech also worked part-time for Bells-Savoy,
so it made sense for them to stay on and help with the ambulances in Van Alstyne and
Whitesboro.
"I have just been so impressed with the way everyone just started working together to get this
problem solved, at least on a temporary basis," Schneider said. He said local leaders started
trying to find a solution as soon as word spread that LifeTech's crews were not paid this week.
Schneider said the county received a letter saying LifeTech would pull out of its contract April
19. He said the peopie who had been working for LifeTech even agreed to work without pay to
keep the ambulances running, but insurance concems forced the company to close.
"LifeTech lost its insurance coverage and they were going to be charged $1,000 a day for
running the ambulances without insurance," Schneider said. He said the decision to close meant
LifeTech defaulted on its three-yeaz contract. Grayson County had agreed to pay the company
$184,800 a yeaz to provide ambulance services.
"We had already paid for this month," Schneider said. He said the county is out about $7,200 for
the month. Other cities that were part of the contract between LifeTech and the county had
already paid the ambulance service for a full year.
He said it is unlikely anyone will be able to get any money back from LifeTech anytime soon.
Grayson County Attorney Joe Brown told a meeting of county and rural city officials that he will
file notice with LiFeTech's creditors that the county's contract with the ambulance service entitles
the county to part of LifeTech's accounts receivable, but he did not expect that to be a quick fix.
Brown said the notice would be the first step in a long legal process that would probably put
Grayson County people in a line of creditors seeking money from LifeTech.
Brown also told the assembled group that seizing two of LifeTech's ambulances was allowed
under the county's contract, but it probably would not be wise to use those ambulances to provide
services to area residents.
"There are some concerns there about who actually owns the ambulances and about insurance,"
Brown told the group. Grayson County Precinct 4 Commissioner Gene Short asked how long the
county could hold the ambulances and Brown said the contract was not clear on that point. "But
the county has no long-term interest in those ambulances," Brown said. Schneider added that the
contract clearly would require the county to lease the ambulances from either LifeTech or the
company that actually owns the ambulances.
After speaking with Van Alstyne Mayor Benny Edwazds, Schneider said the LifeTech
ambulance seized in Van Alstyne probably would be returned to LifeTech.
The second ambulance might be held for a back-up in Whitesboro for a while, Schneider said.
Schneider, Short and Precinct 1 Commissioner Johnny Waldrip all said the county will be in a
stronger position to seek a new ambulance service provider now that Bells-Savoy has taken over
for LifeTech.
"It certainly leaves us with more options than we had before," Schneider said. He said the county
is aiready talking with at least one ambulance provider and has been contacted by a couple more
providers.
He said no matter which provider the county ends up selecting, the new contract will most
probably cost more than the one with LifeTech.
Bonham FD may run three ambulances
BY VICKI GRAVFS
HERALD DEMOCRAT
BONHAM The Bonham Fire Department might start running three ambulances in a
countywide ambulance service. With Fannin County joining incorporated cities in a single
request for proposals for ambulance service, Bonham City Commission members held a
workshop Monday night to discuss the possibility.
At the workshop, Fire Chief Mike Baker presented information to the Commission and city
manager.
"We went through cost projections, revenue projections and some protocol," Baker said, "I asked
the commissioners questions about the possibility and the feasibility of the fire department
running EMS. As we all know, East Texas EMS will be leaving no later than Sept. 30 of this
year."
Baker came away from the workshop with the feeling that the Commission seemed to have a
favorable response, he said. However, the Commission made no decision. The topic was a
discussion item only, but Baker said he got the impression that he needed to move forward with
his research and put together a package in order to respond to the RFP the county has issued.
"Pll take our findings from our reseazch and announce them to the City Commission on May 13,"
he said.
The cost projection Baker gave the City Commission was approximately $910,000. It would cost
the city that much each yeaz to run three ambulances, he told city leaders.
"With revenue projections at about $670,000, wc would be asking a subsidy from the coimty,"
Baker said. "The city of Bonham will be putting aUout $250,000 into tliis ptroject and will ask the
cowlty for about that same amount, to help offset Lhe deficit.
Regarding additional employees, Baker would add 14 employecs to the Pire department to take
care of EMS service. At least 10 of those would be at paraniedic level and all BFD employees
would be trained as fire and EMS personnel, he said.
Baker also asked for an administrative secretazy position to help keep up with all the paperwork.
"He ran through the numbers and showed what it would cost, using the estimated city budget,"
said City Manager Bill Funderburk. "We would continue the same service level we have today,
running three ambulances, countywide."
Baker said there are several things that have to happen between now and then, if BFD even does
it. But the City Commission has the numbers and wili convene again for a regulaz meeting May
13. At that time, the Commission will decide if Baker will turn in a proposal. "They will Say
yea or nay," Funderburk said. "So, we'll see if we want to be a player in this."
Talk of new ambulance services continue
BV" MARY.IANIi FAR,ViBR
I IERALU UENOCRA f
Future plans for countywide ambulance service change daily as the fire departments of three
cities are now considering expanding seivices.
"This takes a lot o£ sugar ouf of Yhe pie," Whitesboro Fire Chief Barry Besfe said, when
tallcing about attempts to get a new, privately-ow-iied aaibulance provider to come to
Grayson CoLmty. Life Tecli Ambulance Service closed at 7 a.m. April 17, putting pressure
on each city's fire depar[ment, first responders, and ambulance service.
Slierman Fire Department immediately began making transfers to and from hospitals and
nursing homes, which was the hole in Shernian that Life Tech dug by 'rts closing. Before
April 17, Life Tech made the transfers aiid Shernian FD provided emergency ambulance
ruus.
Bells-Savoy EMT Service placed an ambulance and staff at Whitesboro and Van Alstyne on
a temporary basis, filling in where the now-defimct Life Tech left of£ Urayson County is
paying Bells-Savoy EMT S44,000 each month for its temporary support.
Shernian
Shennan City Manager Scott Wall coufirmed Yhat Sliennan FD may continue the transfar
service. "We are still studyiilg it and will liave to do some analysis of the cost benefits to the
taxpayers and what future needs we will have before giving it to the (Sherman CiYy)
Coiuncil to look at," Wall said.
Shern,ian FD Capt. Doug Blackliwn said the fre departmenYs staff has been busier fhan
usual in Lhe past 10 days. They are now averagiizg nine fransfers and 12 emergency runs per
day, which Blackburn said breaks down into five runs per day, per ambulanee.
Sherman FD also jumped in aixi agreed to back Lip ambulance service around Grayson
Cowity. Friday morning, Blackburn said, a Sherman ambulance was sent fo Gordonville
because the Wliitesboro-based ambulance was on another call. "Right now, we have iio
choice. IYs kept evarybody busy, but we're hxndling it."
"I know webe been given little notice of departure twice by the private companies that were
doing transfers," Blackburn said.
Wall said there are several things to look at before presentiizg the numbers to the Shernlan
councilors. "Not every bill gets paid," Wall said. "Our collection rate 'rs somewhere under
50 percent on emergency runs."
Van Alstyne
Fire Chief Robert Lewis told a crowd of about 35 people at Thursday night's workshop in
Van Alstyne that the Van Alstyne Fire Department is ready and eager fo provide coverage
to the south end of Grayson Coimty. Lewis's proposal, if approved, will put two amUulances
in service on the south side of'Grayson County.
Mayor Benny Edwards opened the rouitd-table meeting by asking everybody to keep an
opcn mind. Eclwards appointed a task-force last week to rcview a proposaPs income and
expenses as laid out by L,ewis. He called the Thursday meeting to hear the committee's
findings. Mike Harris, previous owner of MTS Ambulance service, acted as consultant and
presented his findings to the committee.
Johu Houx, chairman oi' Van Alstyue Economic Development Corporation, asked what
alTernatives the city has if it doesu't put the fire deparhnent's proposal into action.
"Is our alternakive to relinquish ow- destiny to soineone else again? A private ambulaiice
service is iu a profit-makinb business," Hotix said. "A city-owned busincss is not requirecl to
make a profit, only to break even." The last two private cotnpanies have failed to serve the
county, Houx said.
Grayson Coimty Purchasing Agent Jeff Schneider and County Commissioner Johnny
Waldrip were there to oPfer inforniation and get the feel of the group.
Edwards said much depended on commitments by Howe, Gunter and Grayson CoLinty
Mark Miller w2s one of severa] Gunter residents at the meeting. Miller said, "We are in
support of liaving a good ambulauce service and this type might possibly bc the most cost-
effective solution. We need to have solid numbers to put it before our City Council."
Saici Schneider, "We haveu't had a cliance to real1y cruncli your (Van Alstyne) mmibers aiicl
we need to really re-look at some of them. Right now, the county is in the same shape as
anybody else." Schncidcr said, "We iieed to slow this thing down. We have ambulances in
place aiid several weeks to work this out."
Schneider told the group there will be another meefing Mouday for furfher discussions.
"The wcst (Whitesboro in west Grayson County) is just now getting started and must crunch
their numbers aaid make their proposals to tlieir City Council," Sclmeider said, adding that it
all has to figure in the miz.
County Comniissioncr Johmiy Waldrip said, "Webe got some Yime to serioiisly put this
whole tliiiig together."
Howe Crty Councilor Jerry Cainpbell, who is 31so assistant fire chieC, said, "You malce surc
Van Alstyile is comforfable and the moiiey is worl<ed out and ihen bring it to us."
Whitesboro councilors discuss new EMS seivice
BY I4Y FONVII.I ff
HHItALD DEMOCRA'1WHITESBORO Tlie recent collapse oF Lif'e Tech Ambulance service is keeping small
Grayson County cities in linibo.
City councilors met in a special, called council meeting to discuss what opfions they have
and devclop a plan, both long aild short term, for ambulance service in their area.
Whitesboro Fire Chief Bury Beste stood at the podium answering questions and giving his
professional opinion to ciLy officials ou what he thinks is the best course of action in the
maTter.
"This is strictly a day-by-day deal," Beste said. "Tliere are a lot of unanswerecl questions
and litfle t'ime to auswer them."
Mayor W.D. Welch explained to the audience which options the ciCy is looking at.
"We arc cithcr goiug Yo have to pay a larger subsiciy to someonc," Welch said. "Or, we'rc
goiiig to liave to undertake the project ourselves at some cost. At least for the short nm
we're covered, but thaT cotiild change immediately."
Welch told councilois they will ueed to be prepared to authorize some expeuditures, "just to
make cet-tain that this doesn't fall apart," he said. Paying for service fi-om Life Net ( another
ambulance service) costs more Chan double what Life Tech charged. If Van Alstyne decides
to stait a scrvice with Howa and Gunter, Welch said, and with no othcr alteruatives being
presented, "we're going to have to go into the business."
Beste presented some rough mmmbets to the Council explainiug lie would be comfortable in
running an ambulance service for Whitesboro with aS100,000 start-up and a$300,000
yearly buciget. He also suid he could get service up and rtmning within 30 days if necessairy.
There are still issues to work out with paying paramedics, azui more importantly, where the
eity is going lo find the iiecessary funds. Tlte off-[he-cuff estiinate Life Net gave
Whitesboro totaled about $800,000.
"Of course, none of us have that kind of moncy," Welch said. "What that's saying is the cost
is going way up to keep the ctu-rent level of serv'rce we have now."Welch said he plans to
talk witli neighboring towns to see if they wanf fo join forces and cover costs. Welch also
said a direction of which steps the city is goiug to take will surface in a few days.
WhitesUoro has leased an ambulance which will stay in the city for the time being, niamied
by staLe certified volunteers.