News

Future of Texas EMS to be Determined Tuesday, Council Members Clash on Urgency

James Draper

08/25/2014

Aug. 23--City council members could decide the future of local Emergency Medical Services as early as Tuesday evening.

Time to make a decision, says one council member. There's not enough information, according to another; it's too early to vote. Hear it out, says a third. Study the issue objectively, says the city manager.

On Friday morning, council member Lori Weatherford requested an EMS vote be placed on the agenda for next week's regularly-scheduled meeting, to "Consider discussion and approval of transfer of Emergency Medical Services to Kilgore Fire Department, with appropriate funding and agreement to cancel the contract with Champion on the date recommended by KFD."

Weatherford tapped Kilgore Fire Chief Johnny Bellows to kick-off Tuesday's debate with an updated outline on KFD's long-developing strategy to take EMS service in-house from Champion EMS.

Working Friday to update his figures for next week's report, Bellows said some elements of the plan have evolved the past two months, but the proposal is practically the same as when he first presented it to the council in late June. Currently, with an initial $258,520 investment in Fiscal Year 2014-2015, the department aims to set up operations and, the next fiscal year, lease or purchase the necessary vehicles and other equipment while bolstering staffing as necessary to take over ambulance duties inside the Kilgore City Limits and outside them as necessary in unincorporated areas of Gregg and Rusk Counties.

Those costs, Bellows said, will be deferred until October 2015, when the EMS service would go into operation and begin collecting revenues to offset capital expenses.

According to KFD's draft numbers, projected revenues from the ambulance service would meet or exceed an estimated annual cost of $1.66 million.

Following their initial discussion June 24, council members have not officially weighed the matter but for a brief debate during their Aug. 1 budget workshop.

"I just finally decided we needed to move on this," Weatherford said Friday. "At some point you just have to go with what you know is right and get it out of the way, and it's one less thing for people to worry about."

Following Bellows' June presentation, Weatherford says her consultations with fire department personnel, industry representatives, local officials, residents and others have emphasized a pressing need for KFD to take over EMS duties from Champion -- the City of Kilgore is in year six of a 15-year agreement with the contractor.

"No one has a crystal ball, but based on the numbers I could get from talking with other fire-based services, billers and all that, I came up with some numbers," she explained. "Oddly-enough, they're almost exactly what the chief's numbers were, and I used different sources."

It's the same personal study, Weatherford added, that she devoted earlier this summer to researching the city's proposed water service agreement with the City of Longview.

"Not that I doubt anybody's numbers, but if I'm going to be responsible for spending substantial money, I want to do my own due diligence the best I can with the knowledge I have and the skills I can muster."

Kilgore Mayor Ronnie Spradlin says a vote on the fire-based EMS proposal is premature. The facts are being researched, but the council doesn't have them in hand to make an educated decision.

"It would be foolish to vote on something this important with so little discussion and so many questions," he said. "It's something that deserves some study, at least a workshop if not more."

The expense is a factor, one of many, Spradlin added, such as total territory, coverage on Interstate 20, how the decision would impact mutual aid agreements, how the program would be administered or how billing and collection would be handled.

"If this is something that citizens want, then knowing what the cost is is part of making the decision," he said. The topic is the first action item on Tuesday's agenda -- Spradlin is unsure how he'll respond next week. "I know I will do anything

I can to make sure to give this the study and discussion it deserves before a vote is called."

According to discussions with Champion EMS, Bellows said, "Kilgore is a moneymaker," and KFD's estimates indicate the same -- he calculates minimum annual revenues will be $1.575 million.

"To me those are very conservative estimates from everybody we've talked to," Bellows said, between representatives of other fire-based EMS programs and local officials.

KFD administrators are still concerned about how best to serve rural residents outside the city limits, but Bellows is coordinating with county officials and others toward a still-developing plan.

"We've met with the area fire chiefs. They seemed excited that we would possibly be assisting them," he explained. "I think we've done our homework. We met with Champion a couple of times over some of the issues that we perceive as not giving us as good of service as we would like for our citizens inside our city limits.

"They pretty much indicate that their hands are tied. Even though Kilgore is a moneymaker, they have to consider their entire service area."

During the June 24 presentation, Champion EMS Chief Executive Officer Stan Holden urged council members to be cautious in considering a switch from his organization to an in-house operation, noting the heavy subsidies the operation requires to stay afloat in addition to the shifting demands of the healthcare industry.

Holden could not be reached for comment Friday.

With a maximum proposed tax rate already set for FY2015 -- following a vote during their last meeting, council members can ultimately adopt, but not exceed, a rate of 0.45 per $100 valuation for the coming year -- Bellows said the city's initial $300,000 investment would likely be pulled from cash reserves.

Preparing his outline for Tuesday, "I'm considering asking for less than probably $300,000 this first year to go ahead and spin up the administration, set up our (Standard Operating Procedures) and guidelines, make our contracts (and) begin making our purchases.

"We've talked to people who will allow us to purchase the equipment yet we would not make a payment until actually October 2015 so at least the first year we would have a very low initial investment. Then that budget year of (2015-2016) is when we would actually begin paying for it and then that year we would actually receive revenue to help recover the cost."

Contacted Friday, council member Neil Barr said he's been drawing residents' feedback on the general idea.

With the fire department's research, "I'm for it, and I'm willing to vote for it," he said, but not Tuesday: it's a chance to listen to the report, Barr said, and kick-off a substantive debate, but the decision can wait until the community has a chance to weigh in. "Not take a vote, just discuss it, get a feeling ... then let's do some selling on it or some non-selling on it. Somebody may convince me it will work, some may convince me it won't work."

After meeting with Good Shepherd Medical Center CEO Steve Altmiller earlier this month, Barr said an EMS switch could negatively impact the city's relationship with GSMC, which jointly-subsidizes Champion EMS along with Trinity Mother Frances Hospital.

In the event Good Shepherd pulls out of the Kilgore local emergency room in any dust-up over Champion, Barr says, another council member told him "(Longview) Regional says they would be glad to have us ... I don't know for myself. I didn't hear it from the hospital's mouth."

It's another element to consider, Barr explained, though he's confident KFD can handle the initiative.

Such a plan might not work under others' leadership, but "I think it would work for Johnny Bellows. I think he has the leadership ability to make it go," Barr said. "In the first year we don't have to do anything but just get ready. I think we will look a lot better the next year, the first year we're in business, than anything we've had before."

Barr said his constituents are responding positively to the idea.

"The biggest complaint I've had (about) Champion, from the ladies I've talked to and the men I've talked to, they had to wait for an ambulance to come from Carthage, from Tatum. There's all sorts of excuses, but they had to wait on an ambulance," he explained, quoting one woman: "I'd feel more confident if the Kilgore firemen were looking after me."

Council members Harvey McClendon and Merlyn Holmes could not be reached for comment Friday.

Kilgore City Manager Scott Sellers has been advocating for an outside consultant to study the complex issue and develop a recommendation for the city.

"My position all along has been, if this is a venture that the city council would like to pursue, it can be advanced at any time -- it does not need to be advanced during budget adoption. However, if it does move forward, then a methodical study from an outside entity would be appropriate as a next step," he explained. During a previous budget discussion, Sellers proposed the council budget $50,000 to bring in a firm to review the data. "Our fire department has put forward numbers, Champion EMS has put forward numbers ... each of these entities is directly-impacted by the ultimate decision to proceed. This is where an objective third-party expert can verify the information.

"No official study has been conducted on this topic. I told the council that I would identify companies that specialize in these types of studies and request proposals as a next step. That information has yet to be delivered."

Weatherford said she'll spend the weekend developing a list of pros and cons on the issue -- multiple voices have contributed to information she's disseminated on social media and elsewhere, expanding and correcting the information when necessary.

Champion EMS is focused on its business model, Weatherford contends, while KFD is developing a strategy that is either financially balanced or revenue-positive for the City of Kilgore while also improving service.

"For me it comes down to the moment a Kilgoreite dials 911," she said, beyond Champion's bottom line. "Our mission statement is to protect and serve the people of Kilgore and beyond. That's part of the discussion too, is to make sure that everybody else is taken care of in whatever way their governing bodies decide to do it."

It's time, Weatherford says, for Kilgore's governing body to make a decision -- the council's Tuesday meeting begins at 5:30 p.m. at City Hall, 815 N. Kilgore St.

"Given our best information, we believe we can support this business model. I can defend it and I'm proud of the work we've done. But we are never going to be able to get this to where everybody agrees. I just have to do what's right in my heart. Everything we do as a council, doing our best to protect lives and property is the most important thing we can do."