Future of EMS dispatch in question for Pflugerville


Citing concern over response times to residents’ emergencies, Emergency Services District No. 2, also known as the Pflugerville Fire Department, decided in 2015 to purchase its own ambulances rather than wait to be allocated them by Austin-Travis County Emergency Medical Services.

ESD 2 covers approximately 100 square miles in northeast Travis County and all of Pflugerville, and it serves roughly 100,000 residents. In 2016, 3,141 of its calls came from within the city of Pflugerville, and 3,339 came from unincorporated areas surrounding the city, according to an ESD 2 report.

Prior to ESD 2’s decision to purchase ambulances, the city of Austin and Travis County were the sole operators of ambulances in the area, and county officials determined where the 11 units designated for the county could best be used. Two units were placed within ESD 2, but per a news release from the district, they were only available for use approximately 60 percent of the time in 2016.

As a result ESD 2 relied on units not stationed within the ESD for 40 percent of incidents in 2016. In 2016 each of these units not stationed in ESD 2 had a longer average assignment-to-arrival time than those that were designated for the area.

In spring 2017, ESD 2 rolled out the first two of its four total ambulances. In October the next two units began service, and the county and city removed their units from the area.

ESD 2 Assistant Chief Kevin Croegaert said the ESD owning its vehicles allows it to provide a level of service not available through the county or city.

“We are the only ESD  [in Travis County]that is now not going to be held hostage, to be left in the hands of the city of Austin to decide the level of service our customers get. We are in the position to provide a high quality of service regardless of what they do,” he said.

The purchasing of the ambulances required years of planning because constitutionally, ESDs are capped at collecting 10 cents of property tax per $100 of property value. ESD 2 has been at this maximum tax rate since 2011.

In 2013, ESD 2 proposed creating an overlay district to charge an additional 10 cents, but Pflugerville City Council and Travis County Commissioners Court unanimously rejected the proposal.

In 2014, ESD 2 won approval to increase revenue with a new half percent sales tax, which was added to an existing half percent sales tax approved in 2001. The margin was slim, however, and the 2014 sales tax received approval by less than 10 votes.

At the time Pflugerville City Manager Brandon Wade said he was looking into a “Round Rock model” for a municipal fire department that would allow Pflugerville to operate its own fire department and contract with the ESD to provide services to unincorporated areas comprising the rest of ESD 2. This would have allowed the fire department to gain funding from bonds through the city and would open up the department to greater revenue streams than those that are available to ESDs.

Terri Toledo, spokesperson for the city of Pflugerville, said Pflugerville works with the ESD as it works with other entities, such as the Pflugerville Community Development Corp. She said there is currently no plan to create a city fire department.

Automatic-aid implications

One substantial decision ESD 2 had to make when it decided to purchase its own ambulances was how to dispatch them. Up until ESD 2’s purchase, all ambulances were owned by the city or county with dispatch run by the city of Austin’s emergency services department.

This central dispatch allows all Travis County ESDs and city of Austin emergency departments to be part of an automatic-aid agreement. The agreement essentially erases borders  between Austin and the county, so whichever emergency unit is closest responds rather than whichever units are designated within a certain set of boundaries.

“You are basically operating as a virtual single fire department or a single EMS department,” said Josh Davies, Travis County Executive of emergency services in describing the agreement. “This is because whoever calls shouldn’t have to worry about who is responding.”

When ESD 2 purchased ambulances, ATCEMS did not have pricing in place for dispatch, so ATCEMS had to formulate it specially for the district.

In November 2016, Austin City Council approved charging ESD 2 a $20,000 annual fee per ambulance being dispatched through the central dispatch at the Combined Transportation and Emergency Communications Center.  In an email dated Nov. 2, ATCEMS Chief Ernesto Rodriguez explains how the $20,000 charge was calculated.

Rodriguez wrote the total cost Travis County pays to dispatch calls in the county is $382,000 annually. This covers the cost of receiving calls and dispatching one of the 11 ambulances. Broken down, and minus some money the county reimburses the city, the cost per ambulance is $17,363.63. ATCEMS added a $2,636 fee to setup and maintain a new computer-aided dispatch file with a specialized plan for ESD 2.

This cost has quadrupled, for a total of $80,000, for the four ESD 2 ambulances. The district pays the Austin Fire Department a fee of $26.40 per call, for medical and fire incidents, for service at the dispatch center.

With limited revenue totaling
$18.9 million and close to 10,000 calls coming from ESD 2 annually, Croegaert said the ESD has seen a strain on finances resulting in the ESD looking for alternative dispatch services. He said ESD 2 has started looking for alternative dispatch service providers for the next budget year. The FY 2017-18 budget shows major planned expenditures of $9.77 million for payroll and $2.6 million for employee benefits. This, with a number of other costs, totals to $18.63 million in overall expenditures.

“There is a belief that [CTECC is the] only dispatch service, so you just have to pay whatever they tell you to pay,” he said.

Croegaert said through his initial searches, the ESD has discovered it can obtain dispatch services for less than what the city of Austin is charging. Should ESD 2 elect to use a different dispatch provider, automatic aid, which Davies said is universally agreed on as the gold standard for emergency services, could be at risk.

Croegaert said AFD has confirmed automatic aid would not be able to function in ESD 2 without all entities being on the same dispatch system.

Should ESD 2 leave the automatic-aid agreement, a mutual-aid agreement would still be available, in which  ESD 2 would still volunteer its units to go to nearby incidents. However, should ESD 2 be on a separate dispatch system, those taking calls at the CTECC would add additional time to emergency responses by having to relay calls between dispatch systems.

In an email to members of the AFD executive team, Austin Fire Division Chief Palmer Buck expressed concern that ESD 2 might leave the agreement.

“ESD 2 is seriously considering contracting with a private vendor for dispatching services,” Buck wrote Sept. 18. “If they do we lose our ability to have an effective and seamless response with ESD 2. While mutual aid will still be available, our ability to effectively respond to calls on the border of the two agencies will be seriously degraded.”

This parting of ways would not only hinder service within ESD 2 but also in areas of the county surrounding it. With automatic aid intact, any resources available in ESD 2 are used for emergencies within ESD 12 or 13, which are remote to other city and county resources.

Davies said he wants an agreement to be made between ESD 2 and the city for dispatch services.

“The folks who decide on these costs need to come together and figure it out because the last thing we want is for an ESD to depart that partnership, especially when we are talking about [merging]all of Travis County and Williamson County,” Davies said, referring to a potential deal to link dispatches between the two counties for an automatic aid-like agreement. “We are going in that direction and not the other.”

Croegaert also said he hopes to negotiate an agreement so ESD 2 can remain on the same dispatch.

“At some point, when you reach your dime, the decisions could be made for you,” Croegaert said. “Do you let firefighters go, or do you do dispatch?”

ATCEMS Chief of Staff Jasper Brown said the ATCEMS is currently working with ESD 2 to review its cost structure.

“We want to make sure we are being responsible and not trying to make money off of anybody, just trying to recoup our costs off the services we provide,” Brown said. “We are working with ESD 2 now; [the dispatch fee]may go up, or it may go down as they add more units into the system.”

Addressing response times

Travis County is also looking to improve emergency medical response times for areas served by ESDs.

There is a notable gap between the response time standards for emergency medical services units in the city of Austin compared with the surrounding areas of Travis County. Even in life-threatening incidents, emergencies taking place within the city must be met with a response time that is
2 minutes faster than in the county—9 minutes, 59 seconds compared with 11 minutes, 59 seconds.

These standards are even met at different rates. The most recent data from August shows that medical emergency responses within the city of Austin meet the standard response time
94.4 percent of the time, and emergency responses in the county meet standard 88.59 percent of the time.

Davies is trying to narrow this gap and demand a higher quality of service for Travis County from the city of Austin, which as of August, owns almost all of the ambulances in operation throughout the county. The only other ambulances in operation are owned by ESD 2.

For this reason Davies initiated changes to the long-standing agreement between Travis County and the city of Austin in August. He, along with others in ATCEMS, is trying out a new agreement that is predicated on performance. This agreement mandates that for a set fee, the city of Austin must meet Travis County’s performance standards.

“The performance model will work; there is no doubt about it,” Davies said. “Because you will only pay or continue the arrangement if whoever is providing the service is meeting the performance, and that is what is not happening today.”

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