The details
Only about 10% of the calls ATCEMS receives are for life-threatening situations, EMS Chief Robert Luckritz said.
Many of the remaining 90% of calls are a result of a growing number of Austin and Travis County residents using 911 as their “safety net health care system,” he said.
“There is a huge subset of the community that utilizes 911 because they don’t have anyone else to call.” Luckritz said. “Whether it's life-threatening or not, they need care. And so they rely on the 911 system and they rely on EMS.”
He estimates the department could divert 35% of the calls EMS receives to an alternative responder, such as a licensed counselor, physician, or opioid use disorder paramedic; or the calls could be handled via telehealth.
This move would free up ambulances for high-acuity emergencies and connect the low-emergency callers with more appropriate resources for their situation, he said.
“Ambulances are a limited commodity,” Luckritz said. “We only have so many ambulances in the community, and if we pull an ambulance to every single call as this volume increases, the concern, and what we need to address, is that that ambulance might not then be available for the high-acuity real medical emergency.”
The action taken
Commissioners approved increasing the county’s portion of the interlocal agreement with the city by 11% to $17.66 million.
The funding increase equates to $1.7 million additional dollars and will be used to fund the following:
- $693,322 for additional ambulance coverage
- $448,652 increase for Community Health Paramedics, a program that connects patients with more appropriate health care resources
- $588,728 for ongoing departmental cost drivers, such as supplies and equipment
Commissioner Brigid Shea said the uptick in nonemergency EMS calls could be related to the thousands of Texans who have been dropped from Medicaid—the nation’s health insurance program for low-income residents—since the spring. The drop in Texans insured in Medicaid began in April when Texas Health and Human Services ended the continuous coverage program that was active during the height of the pandemic.
“It's logical to assume that there is some relationship to the millions of people in Texas that got kicked off Medicaid and so now local communities are having to use tax dollars to pick up this cost,” Shea said.
Shea said gathering hard numbers on the relationship between Travis County’s uninsured population rising and the uptick in 911 calls is a “crucial data point” that needs to be explored.
What else?
Luckritz said sending a more appropriate responder for low-acuity calls—calls that don’t require intensive care—will also help patients avoid falling into medical debt.
“This cost is not just borne by the community. It's also borne by the patient. And so while we may have a robust charity program, once we transport them to a health care facility, there are additional expenses that are being tacked on.”
What’s next
The court also approved a last-minute addition from Shea which asked the county attorney to look into the relationship between Texans losing Medicaid coverage and a rise in 911 calls, and for legal strategies against the state.
