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Home > Topics > EMS Management

Texas city may switch from county ambulance service to fire-based EMS

The city is considering bringing the service in-house, which may impact its relationship with the county

By James Draper
Kilgore News Herald

KILGORE, Texas — Whatever form of Emergency Medical Services the City of Kilgore maintains, it’s still expected to provide ambulance coverage not only within the city limits but outside them as well through an 11-year-old interlocal agreement with Gregg County.

It’s through that deal, officials say, that this year Kilgore has received $150,000 in roadwork reimbursement from the county with $125,000 more coming for other streets projects. Such funding – the city has netted more than $315,000 from the county the past 12 months, including social projects and economic development – extends back to the contract’s inception, averaging hundreds of thousands of dollars a year.

Currently, the City of Kilgore is in year six of a 15-year contract with Champion EMS, but Kilgore Fire Department has proposed a plan, still being refined, to take the ambulance service in-house. Council members discussed the idea briefly during their Aug. 1 workshop and, effectively split on the idea, aim to bring the proposal back for further review in coming weeks.

The group is also weighing whether or not to bring in an objective consultant to take a look at the EMS options in order to balance costs and revenues while improving coverage, both intown and to rural residents.

“Our basic premise with interlocal agreements is to provide fire and ambulance service in the unincorporated areas of the county,” Gregg County Judge Bill Stoudt explained Thursday. It’s up to individual cities to determine how they do so: “Whether the City of Kilgore contracts with Champion or the City of Longview provides it through their own city, both of them work for us.”

Adopted in 2003 and automatically renewed each year, according to the city’s standing quid pro quo deal with the county, “mutual aid” from Kilgore’s side comes in three itemized forms of coverage in unincorporated portions of Gregg County – fire protection (as well as rescue efforts), ambulance and pest control.

In return, the county “shall furnish men and equipment and shall perform some of the necessary street repairs and maintenance within the incorporated areas of the city,” such as street oiling and overlay, at the request of city officials and in coordination with city staffers. Through the agreement, the county’s labor force and equipment may also be directed to earth moving projects, excavation and similar work.

Notably, in signing the deal officials on both sides agreed mutual aid to the other is “secondary and subordinate” should it conflict with the best interests of their core constituents – the City of Kilgore is not liable to the county for damages or otherwise should it fail to fulfill its end of the bargain and vice versa.

Interlocal agreements with municipalities are an integral part of ensuring all Gregg County residents are adequately protected, Stoudt said, in return for ample county funding and support.

“The law mentions the word ‘pro quo’ – basically you’re receiving a similar value to what you’re providing,” he explained. For the city’s fire, ambulance and pest coverage “we do street improvements, we do pavement overlays, we do donations to Kilgore Library, we donate to the Kilgore Rescue Unit. It just goes on and on.

“We’ve got a good partnership with the city and mayor, working fine.”

Throughout the life of the agreement, Stoudt said, the city’s contracted ambulance service has given the county a pro quo conduit to the tune of several million dollars. Since 2003, county contributions – cash, reimbursement, matching funds, in-kind work and other passalongs – total $7.45 million.

For example, “Kilgore will provide the material and we’ll provide manpower and equipment to overlay a street. Or do work in a park. Or partner with them to do improvements on Hwy. 349,” Stoudt said. “All those things total up to a lot of money.”

It’s difficult fully quantify the relationship, Precinct 3 Commissioner Gary Boyd says.

“It’s service for service,” he explained, a balance that has to continue regardless of how, in this case, the city provides ambulances. Who that is remains city officials’ decision; either way, “They still have to provide that care even if they take that on themselves.”

Kilgore Assistant Fire Chief Mike Simmons is confident KFD can absorb the duties Champion is obligated to perform through its contract with the City of Kilgore.

That includes, he said, coverage in outlying areas for the county’s sake.

“Right now Champion is the contract provider out there. Champion is responsible for providing coverage out there,” Simmons explained. That coverage factors into the fire department’s overall strategy to take on the ambulance service. “We’ve got numerous plans. We’ve been extremely thorough in what we hope to accomplish.

“We’re going to cover any area we’re obligated to cover.”

For example, Simmons said, KFD’s plan is built around three ambulances in service with two in reserve, manned through current and to-be-hired personnel. Fire engines equipped with Advanced Life Support equipment could also be utilized if necessary.

“We’re going to bring more resources to the table, to this region, this area,” he said. Granted, Simmons added, the department doesn’t currently have access to all the information it needs to fully flesh out its strategy vis-a-vis rural areas. “The problem we’ve been having is finding out where they draw the line.”

The unspecified coverage area of the interlocal agreement is confusing, Simmons explained. The “unincorporated portions of Gregg County” are extensive, north to south and east to west, not necessarily adjacent to Kilgore’s boundaries.

Currently, Champion EMS (through agreements with multiple entities within the county) provides coverage in those areas, alongside other “mutual aid” ambulance services, such as the City of Longview’s in-house operation.

Adding equipment and personnel with additional training, Simmons said KFD’s project – estimated at $1.85 million in year one and $1.55 million in annual expenses going forward – will more than adequately cover the necessary area within and outside the city while reaping revenues that will at least pay for, and probably exceed, cost.

“Our priority number one is take care of our citizens first. Anything that we need to do out in the county, per agreements, we need to discuss and handle. We feel that we can provide a much more effective service overall to southern Gregg County,” he said. Allowing that, the department has to work alongside Champion and its extensive service area: “We’re not going to step on toes and cover areas they’re contracted to cover.”

During their Aug. 1 budget workshop session, the four council members in attendance discussed the issue only briefly, generally laying out their various opinions on one service versus the other.

“We have talked a bit about the EMS project, whether it’s the right thing to do or not,” council member Lori Weatherford said. “We don’t have everything we need to answer that question right now. What do we do as far as direction to the fire department to explore that? And what does it cost for them to explore it?

Voicing outright support for neither Champion nor KFD, Weatherford said the discussion itself could have a positive impact on service even if there’s no change in provider.

“I think even if we got protocols fixed in this process then we will have made a great step in better care for people.”

Mayor Pro Tem Harvey McClendon said he’s not in favor of spending money to bring the service in-house.

The city originally hired Champion EMS to spare Kilgore the budget burden, he noted.

“I’ve talked around town too, and I’ve had no interest to change,” McClendon said.

Being in the medical field, council member and East Texas Treatment Center Executive Director Merlyn Holmes said she sees areas where Champion is lacking and noted residents are voicing similar concerns, open to switching to KFD.

“I’ve talked to no one that’s in favor,” Mayor Ronnie Spradlin countered.

“Maybe I need to send my people to you,” Holmes answered. “I’ve got them standing in line.”

The city can’t know which solution is best until it’s studied in-depth, Weatherford said.

“There’s a solution to getting better care for the people, which is the bottom line for me,” she added. “There’s a solution out there, but we just need to be able to explore what is right.”

“There’s a lot more to this,” McClendon agreed.

Notably, the City of Kilgore has a contractual one-year termination provision with Champion EMS, city manager Scott Sellers said: if the elected officials opt for KFD over the contractor, the switch won’t be immediate. He recommended the council set aside up to $50,000 for an objective consultant to study the issue, especially in light of the provisions of the city’s interlocal agreement with Gregg County, and accurately project costs and revenues.

“This is a polarizing issue,” he reminded the council, adding this week, “From the outset I have encouraged a neutral third party that can objectively study the issue and return a report back to the city with potential costs and service territory.”

Spradlin agrees, emphasizing the need for the city to hold up its end up the deal with Gregg County.

“It’s a great relationship. They do supplement our streets and other work to a great degree. We want to do everything we can to maintain the best relationship possible,” he said. “I think this decision has such far-reaching consequences safety-wise and financially for the City of Kilgore that we need to perform the highest level of due diligence to be sure we know what we’re getting into – as far as expenses, as far as territories, as far as training, as far as everything involved – before we make a decision.”

For now, the quid pro quo is working, Stoudt said.

“If both parties feel like they’re getting their fair share then everything’s fine,” Stoudt said. “I’ve never had an issue, and I don’t think Kilgore has, in getting our fair share of the agreement.. I think it’s been a good partnership.”

———

McClatchy-Tribune News Service
©2014 the Kilgore News Herald (Kilgore, Texas)

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