Beginning in October the Georgetown Fire Department will begin dispatching its own crews to administer advanced life support services for medical emergencies.

City Council approved the move to a city-operated emergency medical services system during its March 24 meeting after months of meetings between city and Williamson County officials.

“We had multiple good conversations. It was a long period of time that we discussed this, and at the end of the day, council decided that this was best for the citizens of Georgetown,” Mayor Dale Ross said. “The elected officials in Georgetown are now held accountable for all public safety in Georgetown, not just fire and police. … That’s the key driver.”

Williamson County has operated the countywide EMS system since 1975. Georgetown will be the first city in the county to operate its own EMS system other than portions of the city of Austin in Williamson County.

The program is set to begin Oct. 1, at which time the city would take over all emergency medical care in the Georgetown. Until the new program begins, Williamson County EMS will continue to provide services in the city, County Commissioner Valerie Covey said.

“We were curious how [the new system] was going to work for us,” she said. “I thought they were going to wait until we worked out a plan [before] they actually bought the equipment. … Now it’s time for us to figure out how all this is going to work, and we sat down for weeks and weeks to figure out how it would work.”

System creation

Councilwoman Rachael Jonrowe said City Council began to consider a city-run EMS system during strategic planning sessions in previous years.

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“It first showed up in our planning documents as a priority for the council, I believe, back in 2012 when we did our first [visioning session]. We talked about public safety as one of our top priorities and moving toward an integrated health response system,” she said. “I think it makes fiscal sense, and I think there is also a case to be made for the most local form of government being in the best position to implement a system that is going to be most accountable to the citizens.”

In 2014, Fire Chief John Sullivan requested funding in the 2014-15 fiscal year budget to purchase two transitional response vehicles, or TRVs, that can respond to fire and medical emergencies, and add nine full-time firefighter/paramedics to respond to the growing number of medical calls to which the fire department was responding, he said.

Sullivan said the department responded to 6,300 calls in 2014. Of those calls about 75 percent were medical emergencies.

“When I brought [the plan] up, it had to do with the fact that Georgetown is growing. We are trying to be responsive to it. We understand that 75 percent of our job is medical,” Sullivan said. “The fact is that we are one of the fastest-growing counties in the nation, and there is a real expectation that we must live up to and that is being prepared to meet the needs of the community before they happen, not after they happen.”

Sullivan said by moving to a city-operated system the city could increase efficiencies in the system, including improving response times and having smaller vehicles respond to medical emergencies.

City Council approved a $340,000 budget amendment at its April 14 meeting to purchase two additional TRVs and a second budget amendment at its April 28 meeting to fund six additional firefighter/paramedic positions.

Georgetown Financial Analyst Paul Diaz said the startup cost for the program would be $1.18 million.

By transporting patients the city could collect revenue that would help offset the cost of the program, Sullivan said.

County objections

County officials expressed concerns over the city's decision to move away from the county’s regional EMS system early in the process, Covey said.

During discussions between county and city leadership, Covey said many options were presented to prevent “fracturing in the system.”

“From our perspective we were trying to make [the system] stay regional,” she said. “Because I really do feel like that’s the best approach for what we have in our county. … A regional approach has worked well for us, and that was our goal.”

During the March 24 council meeting, city staff presented two other options to council members, including selling the TRVs to the county and staffing the city’s fire engines with the recently hired firefighter/paramedics to offer increased medical care with the county still providing EMS. The other option was to have an interlocal agreement between the city and county through which the county would be in charge of credentialing the city's paramedics and dispatching the units.

“We would have trained their people to the same standards [as Williamson County EMS],” Williamson County Medical Director Jeff Jarvis said. “The thing that is so frustrating is we bent over backwards and put all of our priorities on hold for the better part of last year trying to work with them and keep them integrated within our regional system and enhance the level of care they can provide. … And in the end it seems like they’ve had their minds made up the entire time.”

Councilman Steve Fought, who served on the city subcommittee to determine how to move forward with the city firefighter/paramedic program, said after meeting with the county he favored the city-operated system.

“In the end we’re going to do what’s best for the community,” he said at the March 24 meeting.

Sullivan said he would continue to work with the county.

“Toward the end when we talked in earnest about what [the regional system] would look like, the city was relinquishing an extreme amount of flexibility,” Sullivan said. “A lot of the control elements the county was instituting into the plan made it very difficult to become functional. [The plan] was setting it up to where financially [the city system] would become a much larger financial burden on the city than if we had gone down this path of doing it under our own license.”

The department will still need to establish a mutual or automatic aid agreement with the county that would allow the two organizations to continue to work together in cases of emergencies, he said.

Future of EMS

Sullivan said with the council’s approval he expects to apply for an operating license with the state by the end of May. The application will define the city’s service territory and will include other details, he said.

The department will station a TRV at fire stations No. 1, No. 2 and No. 3, Sullivan said. The fourth TRV, which will operate during high-demand times, will be stationed at Fire Station No. 5, he said.

When the system launches, each TRV will be staffed with two paramedics and, Sullivan said. Eventually, the TRVs and fire engines will be staffed with one paramedic and an emergency medical technician, he said.
“We are looking to improve not only the service in the community but the safety and the capability for medical, fire and rescue."

–John Sullivan, Georgetown Fire Chief

“We are looking to improve not only the service in the community but the safety and the capability for medical, fire and rescue,” he said.

Sullivan said each paramedic and EMT will receive training under the department’s medical director.
In May, City Council is also expected to consider an ambulance franchise ordinance that would regulate which outside ambulance services, such as Acadian, could operate within the city.

“[The ambulance services] are partners with [the department] in [its] provision of care to the community,” he said. “Their focus is on the nonemergency calls, but when an emergency comes in they are available to assist with that.”

Although the Commissioners Court has not taken any official action, Covey said it is most likely that the county’s four ambulances currently stationed in Georgetown will be moved.

“I would like to see [an ambulance] moved to Jarrell,” she said. “We have a location, and it will help the northern part of the county with response times.”

Williamson County EMS director Kenny Schnell said the county will look at its entire system to determine how it will move forward based on the city’s plan.

“Our goal is to reallocate our resources to where we need it in other parts of the county and provide the same level or higher level of care in service,” he said.

Covey said the county does not plan to cut any staff or services.

“Obviously the county will continue to grow,” she said. “That will play into what our needs are for employees and equipment. The overall regional model, with Georgetown being right in the middle of the county, will be impacted, we believe. Although our guys will continue to do the excellent clinical care and customer service that we’re known for, it still will be interesting to see how it will work.”