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Texas city asks county for greater EMS subsidy

Mineral Wells says it is continuing to make a large number of EMS calls and asked commissioners for a greater subsidy to offset operational costs and losses

By David May
Mineral Wells Index

PALO PINTO, Texas — The City of Mineral Wells says it is continuing to make a large number of EMS calls in the county and on Monday asked county commissioners for a greater subsidy to offset operational costs and losses.

Palo Pinto County commissioners on Monday spoke with Mineral Wells City Manager Lance Howerton and Fire Chief Mike Pool, with exchanges at times terse. County officials have begun meeting in workshops to prepare its 2018-19 fiscal year budget.

Despite the county and Emergency Services District No. 1 contracting last year with Denton-based Sacred Cross EMS for $650,000 a year to provide 24/7 emergency medical response service in the portions of the county outside Mineral Wells and ESD No. 2, city officials say since Oct. 1 they have made 260 ambulance runs in the county, which they say amounts to 25 percent of the total EMS calls in ESD No. 1.

At present the county agrees to provide Mineral Wells EMS an annual subsidy of $18,000 – two years ago it increased its subsidy by an additional $34,000 to offset costs related to a high number of runs before Sacred Cross EMS was contracted.

City officials on Monday asked the county to consider a subsidy of $150,000 for the coming year.

Howerton told commissioners based on the city making a comparable number of EMS calls to those made by Sacred Cross EMS in the county, the city feels its subsidy is valued far below the county’s contracted EMS provider.

“I think you can see there is no equity in that,” said Howerton. “We do think it is only fair and equitable to close that gap.”

City officials said the requested increase would help cover losses realized from its EMS calls into the county resulting from lower ambulance run reimbursements from insurance companies, Medicare and Medicaid and from a high number of transport refusals, which data provided shows run about 28 percent overall on EMS calls. The city charges $500 for transports but typically receives between $300-$350 from insured providers.

According to city records provided between October 2017 and June 2018, it billed $1.07 million in EMS charges and collected $331,879 – about one-third of the billed charges.

“We are not asking for parity but we are asking for equity,” Howerton said.

The city has a state-designated EMS service area that extends north to the county line and south to the ESD No. 2 boundary along busy U.S. Highway 281 then west essentially to the Brad community on U.S. 180.

Before Scared Cross EMS was contracted, the city was making calls across the county, including Possum Kingdom Lake and Strawn, as a result of declining reliability on volunteer departments. Last October, Mineral Wells City Council voted to limit the city’s EMS calls to its designated service area. Discussions have been had whether to request the state reduce the city’s designated service area.

The city is in a three-year public service staffing plan that includes adding more fire and EMS personnel. The city added three positions mid-year and plans to add six new fire/EMS positions over the next two budget years, unless it is able to obtain a SAFER grant that allow the hiring of those positions sooner.

Pool said the number of calls the department handles within the city and in the county continues to strain resources and affects response times.

“We need to figure out what we are doing going forward,” Pool told commissioners. “It is still a load on our system. Our system is definitely overloaded and the county is part of the problem. Our call volumes have grown.”

The county and city have been at odds over EMS service after the county rejected the city’s proposal for about $1.2 million to add equipment and personnel to cover ESD No. 1 calls. The city then wanted the county to increase the subsidy or face the possibility of the city reducing its response area.

Precinct 4 County Commissioner Jeff Fryer suggested the city is still upset over rejection of its proposal.

“I still think you are going to end up paying spending that much before it’s said and done,” Pool said.

“Maybe,” Fryer responded.

Fryer questioned why the city did not submit a new proposal when ESD No. 1 called for bids for contracted EMS service. Sacred Cross EMS and Possum Kingdom East VFD submitted the only bids for the contract.

“We weren’t asked to make a bid,” Howerton said.

“You didn’t need to be asked,” said Fryer. “You know how it works.”

Fryer said it appears the city is now “jumping on the coattails” of the Sacred Cross EMS contract amount to seek more money from the county.

Pool said there is a palpable lack of partnership between the city and county on the EMS issue.

“We are like a city without a county,” Pool stated.

Howerton said the city at present is not seeking a reduction in its designated EMS service area.

“There is no threat here,” he told commissioners. “We want to be good partners with the county.”

Howerton asked commissioners why Sacred Cross EMS’ service is worth 20 times more than what the city is reimbursed for its county EMS calls.

“Our level of service is excelled by no one who provides service in the county,” the Mineral Wells city manager stated. “We are just here for fairness and equity.”

The county has agreed to provide two-year start up funding for Sacred Cross EMS from its reserve funds while revenue from the new ESD sales tax passed last November comes in to help fund the service. The next step for the county is to try and put in place a new ESD overlay district in ESD No. 1 outside Mineral Wells and ESD No. 2 to levy a property tax in support of county EMS service.

ESD No. 2 currently uses a sales tax in its district, which covers Santo and the county’s southeast quadrant to financially support Santo VFD’s ambulance service, which remains an operation manned by volunteers.

Commissioners on Monday took no action on the city’s request and will consider it in making its FY 2018-19 budget decisions. The county currently operates on a $19.5 million annual budget, including a general fund budget totaling $14.1 million.

Copyright 2018 Mineral Wells Index