After months of meetings between Georgetown and Williamson County officials, City Council voted March 24 to move forward with a city-operated emergency medical services system.

"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," Councilwoman Rachael Jonrowe said. "We'll have to figure out how that process will happen as smoothly as possible, but we are basically going to become the medical provider."

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

"We're waiting on a plan from [the city]," Covey said, adding she was disappointed in the direction City Council took. "We really believe the regional perspective is best in handling this."

Georgetown will be the first city in the county to operate its own EMS system outside of the county's system other than the city of Austin.

Fire Chief John Sullivan said under the new plan the city would need to purchase two additional transitional response vehicles, or TRVs, which have the ability to respond to fire or medical emergencies and transport patients, as well as hire six full-time firefighter/paramedics. The plan will integrate the city's fire, police and EMS into one system, 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," Sullivan said.

City Council approved purchasing two TRVs and adding nine full-time firefighter/paramedics in the 2014-15 budget to respond to the growing number of medical calls to which the fire department was responding, he said.

Sullivan said the department responded to more than 6,300 calls in 2014. Of those 75 percent were medically related. Georgetown Financial Analyst Paul Diaz said startup costs for the program would be $1.17 million. City Council will consider a budget amendment to cover the additional costs in April or May, Georgetown Chief Financial Officer Micki Rundell said.

Jonrowe said the city will have continued conversations with the county to determine what role each agency will have as well as negotiate a mutual aid agreement, which would allow both agencies to lend assistance across jurisdictional boundaries when necessary.

"We're all going to have a discussion about the roles of the city versus the roles of the county," she said. "As the cities get bigger and we have a more urban setting, people have different expectations for the level of service they should be getting and who they should be getting it from."

Williamson County Medical Director Jeff Jarvis said the county will evaluate plans for how the county will move forward with its service to "efficiently and creatively care for the citizens in the county."

The county stations three ambulances with an additional ambulance for peak demand times in the city limits.

"We worked very, very hard to address the concerns that the city of Georgetown had, and we came up with quite a few different proposals without fracturing the system," Jarvis said.

Jarvis said once the city files for the necessary licenses, more discussions can be had about service territory and how the two separate systems could work together.

Councilman Steve Fought 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. "It's a single agency that we can hold accountable."

Sullivan said the department will begin filing the necessary paperwork, and once the budget amendment is approved the city can move forward with hiring the additional personnel and purchasing equipment.