Texas city ends decades-long relationship with ambulance service
Mission city officials voted to drop Med-Care EMS and switch to fire-based EMS
By Dina Arévalo
MISSION, Texas — In a little over two months, residents here who call 9-1-1 during a medical emergency will most likely see an ambulance branded with the city of Mission’s logo respond to their crisis.
That’s because city leaders, on Thursday, unanimously voted to make Mission’s EMS service a fully publicly run enterprise.
In so doing, the Mission City Council also voted to sever a decades-long relationship with Med-Care EMS, the private ambulance service that has responded to a majority of the city’s emergency medical calls for 23 years.
“We’ve been asking for this for several years. We knew it was coming and the city has always done what’s best for the citizens,” said Michael Silva, a lieutenant in the Mission Fire Department, during the meeting’s public comments.
Silva also serves as one of the department’s certified EMTs, and as president of the Mission Fire Fighters Association, which is the collective bargaining organization that represents many of the department’s service men and women.
Every member of the city council voted in favor of terminating the city’s contract with Med-Care, save Place 2 Councilman Ruben Plata, who was absent from Thursday’s special meeting.
The termination will go into effect in 75 days, according to the exit clause of the contract, Mission City Attorney Victor A. Flores said.
For Mission firefighters, Thursday night’s decision was a win that was a long time in the making.
Silva, the union president, spoke of how it will allow the city to have more local control of its emergency medical services, and of how the department has invested years into cross-training firefighters into becoming EMTs and paramedics.
“As president of the organization that represents the men and women behind me, we’re ready to take on that task,” Silva said, referring to the dozen or so firefighters who filled the council chamber in support of the city-run ambulance initiative.
Over the last year or so, Mission has been working to build up a fleet of its own ambulances and to ensure that the city has enough EMS personnel on duty around the clock.
The city currently has three ambulances of its own, and recently entered into an interlocal agreement with Hidalgo County to receive a fourth. That ambulance is expected to arrive within a couple of months, according to Mission Fire Chief Adrian Garcia.
“In addition to that, we also have four interlocal agreements with surrounding EMS services that, again, have already been assisting us,” Garcia told the city council.
Both Silva and the fire chief thanked Med-Care for its long service to Mission but emphasized that it’s time to take the city in a new direction.
“Our community is also growing and evolving and there comes a time where we need to take the next step,” Garcia said.
“We’ve worked hand-in-hand with them and we’re proud of that, but it’s time to move forward. It’s time for the city to take on this task and we’re ready to move on,” Silva echoed.
But the council did hear some words of caution prior to making their decision.
David de los Santos, Med-Care’s business development manager and a Mission resident, urged the council to rethink severing the company’s contract.
“The company I work for, Med-Care EMS, currently responds to 75% of the calls in Mission. Mission Fire Department is handling 25% of 9-1-1 calls,” de los Santos said. “The concern I have is that Med-Care EMS will not be responding to the 75% local calls since the council is considering terminating our contract.”
He cited nationwide shortages in healthcare workers, as well as the added financial costs and liability concerns that come with the city taking on sole responsibility for ambulance service.
Those concerns were echoed by Dr. Ivan Melendez, who serves as Mission’s medical director for EMS service.
“Why in the world would you want to go in this direction when you’ve got plenty of stuff to do? Why would you want to add more stuff to your plate?” Melendez said.
“You’re happy with the people you’re with, they’re very competent, they haven’t had any issues,” he added.
Melendez then went on to answer his own questions by describing how many municipalities have begun to shift their philosophies when it comes to EMS service.
More often, municipal leaders are beginning to view ambulance service as a public safety mandate akin to providing police and fire protection.
He asked Mission city leaders if that has now become their own philosophy.
“I believe that the reason I’m standing before you is because that decision has already been made or I wouldn’t be here. You wouldn’t have started this a long time ago,” Melendez said.
But the doctor also cautioned the city to maintain its “focus” on viewing providing ambulance service as a public obligation, and not as a revenue generator.
“Move forward with your eyes wide open,” Melendez said.
“There’s going to be a lot going into expense. ... We absolutely can self-sustain, but that can’t depend on this commission. It’s got to depend on a competent administrative group of folks that understand billing, that understand collections,” he added.
Asked after the meeting if his fire department was ready to fly solo once Med-Care’s contract ends, Chief Garcia said yes.
“The training wheels have already come off. Our goal was to be prepared, right? And to be able to provide, have those ambulances ready to go,” Garcia said.
“Those training wheels have come off already. We’re ready. We’re ready to move forward.”
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