EMS goes up for bids in Bastrop County

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BASTROP, Texas (KXAN) – After months of complaints about the EMS service in Bastrop County, Commissioners are taking bids from new ambulance providers.

The current provider – Guardian EMS – has faced criticism about unprofessional dispatchers and paramedics and ambulances failing state inspections.

In a broad sense, County leaders describe the current contract for EMS services as no longer being a good fit. They point to growing communities like Cedar Creek in the county’s western ‘ex urban’ area, which are becoming more city than country, as more people move in. Emergency providers they say, need to be able to keep up and not be constrained by dated contract clauses that for example, spell out maximum allowable EMS hours per week.

But since last summer, the county has also been working with an outside consultant on how to refine an EMS service where profit for the provider is part of the recipe. A final report is still weeks if not months away. County staff decided to move on the bid process now.

“It became pretty obvious early on, not only from the consultant, but among my colleagues, given the circumstances, it’s probably time to do another RFP,” said Mike Fisher, Bastrop County Emergency Management Coordinator.

Included in the new bid:

  • encouraging applicants to base revenue on patient transports alone; not the current subsidy arrangement. Guardian EMS receives nearly $383,000 dollars annually to provide service.
  • removing dispatch duty from the provider to the Sheriff’s Office
  • mandating third party oversight of reports including monthly response times.

A KXAN Investigation exposed some of the specific issues related to quality of service, including response times. We showed how the EMS company stays in compliance with response time goals, but provides its own monthly numbers to the county with no oversight.

“It’s uncommon. But it happens where there’s 45 minutes, an hour response time and as an EMT that’s not acceptable, said Liston Crim, a former fire chief in Elgin, TX the small city in Bastrop County’s north end.

Crim said he has worked 30 years as a first responder and that commissioners have long ignored EMS in Bastrop County compared to the budgets and oversight of fire and police. County officials say EMS companies Rural/Metro and Metro Care have each provided service to Bastrop in years’ past. And Crim said he does not blame the provider of the day.

“In my opinion, we have the same level of service we had 10 years ago. Even if we get a new provider,… my biggest fear is the level of service doesn’t improve,” he told KXAN.

KXAN’s Investigation also revealed Guardian paramedics getting lost on the way to emergency calls and using some trucks and equipment that failed state inspections. As well during one period last year, the provider frequently called on outside counties like Travis and Caldwell for back up.

Guardian CEO Ricky Powell told KXAN his company will apply for the new bid since he says he’s already meeting mandatory minimum operating and safety standards.

But he doesn’t like the sound of what county managers call added ‘desired conditions’ – more accountability for the response time reports and for the first time, letting the Sheriff’s Office handle dispatching ambulances.

Right now, Bastrop ambulances are dispatched out of Guardian’s head office in Columbus, TX. The actual ambulances and crews are stationed in population hubs around the county for the quickest possible response time.

But Sheriff’s Office staff told KXAN of problems with Guardian crews’ ability to locate some calls and dispatchers not offering callers critical pre-arrival instructions. That prompted the Sheriff’s call takers to stay on the line in some cases where Guardian staff would allegedly hang up.

Sources told KXAN moving dispatch to the Sheriff’s Office would mean hiring the equivalent of five full-time staff. But costs could be offset by another ‘desired condition’ -  ending the so-called annual subsidy (or fee for service) and having a company’s revenue stream come mainly from the cost of emergency and non-emergency patient transports.

Guardian’s current contract lists that cost between $550 and $825 depending on the urgency and distance involved.

Annually, Guardian’s subsidy shown in the 2008 contract is: $382,999.80. The county also pays the cost of maintaining four ambulance posts to the tune of $75,000 a year.

Guardian’s Ricky Powell did want to discuss what would or would not be in his company’s bid, but indicated Guardian EMS intends to stay in the game in Central Texas. The company also runs non-emergency transport services in the Travis County and Round Rock areas.

“It’s going to be the same service we’ve always provided and will continue to provide. (Our service) is outstanding,” said Powell noting Guardian has run 40,000 ambulance calls since the company’s contract in Bastrop started in May of 2008 for a first five-year term. A first of a three possible automatic two-year renewals kicked in at the end of April 2013.

That means Guardian’s contract next renews in May 2015. If the County wants to cancel the current deal, it has to give the company 120-days notice. That gives it until next January if commissioners decide to put a new EMS company in place under the new parameters.

Along with Guardian, representatives from at least two other ambulance providers were at Commissioners’ Court Monday. One told KXAN he has an emergency transition plan if Guardian decides to leave town unexpectedly.

That’s a move Powell says won’t happen. When Judge Paul Pape asked Powell if he would continue to provide good service for Bastrop during the bid process, he replied from the audience in court, “Absolutely, No problem.”

The county’s bidding process starts Saturday Jan. 18th and ambulance companies have until February 20th to apply.

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