Friday, February 02, 2007

Bastrop County : Redefining EMS Insanity

Well, it's that time again. Bastrop County and its contracted private EMS service are again parting ways.
Travis County, Williamson County, and even Fayette County made a committment years ago to fund a third-service EMS system in their respective counties, co-equal with fire and law enforcement.
Bastrop County, in an apparent moment of shortsightedness, made a decision to contract out for EMS service. This is all well and good, so long as there's adequate funding for the company.
Unfortunately, though, Bastrop County has never increased its subsidy to its various EMS contractors since the 1980s. While Bastrop County grows, its Commissioners' Court maintains a rural mentality, still believing they run a rural county whose main concerns are the county commissioners' road and bridge fiefdoms and the local extension agent.
Every few years, the local EMS provider will approach the Commissioner's Court and ask for an increased subsidy. The Commissioner's Court will claim poverty (Interesting for a county with several million in reserve funds to keep the Wall Street bond market happy!) and "reluctantly" let the contractor out of their contract. Then a new EMS company comes in and the same drama repeats in a few years. Bastrop County lost Rural/Metro less than 3 years ago. Now, they are getting ready to lose MetroCare. Sadly, MetroCare did the best it could with the resources that Bastrop County gave them, even sacrificing paid contractual obligations in it's Austin operation to send additional ambulances to Bastrop County to cover an excess of 911 calls.
I'm a fiscal conservative as much as the next person, but there comes a time when fiscal conservatism becomes a cult and strait-jacket. Bastrop County has reached that point. Bastrop County will get the kind of emergency medical care that less than $400,000 will buy. Sadly, consultants with EMS expertise told Bastrop County how to figure out a subsidy that would ensure quality EMS coverage. Claiming the cult mantra of fiscal conservatism, Bastrop County dismissed much of the advice and continued on its same path of a low subsidy. The Commissioners' Court again proved the maxim that insanity is defined as repeating the same pattern and expecting different results.
Texas state law allows a county to create a separate property taxing district called an "Emergency Services District" to provide tax funding for fire and EMS services. This would be a solution for Bastrop County, creating a countywide Emergency Services District (ESD) to fund EMS, but for one thing. The county acquiesced as several volunteer fire departments created a Bastrop County ESD #1 to fund their rural volunteer services. Thus, you have a small fire department in Bastrop County with its own portable trailer to replenish air tanks for firefighters, but a county where a 20+ minute response time for an ambulance is not unheard of. Who's being fiscally responsible now?
What will change things? There are two possible solutions I see:
1) A commissioner's family member will die and could've been saved by timely EMS response.
2) The voters will eventually recognize that an idyllic life in "rural" Bastrop County means being condemned to substandard medical response compared to their neighbors in Fayette, Travis, and Williamson Counties.

Call County Judge Ronnie McDonald, Commissioners David Goertz, Clara Beckett, John Klaus, and Lee Dildy. Demand that they enter the 21st century and fund an adequate EMS program for their constituents. Any public official's primary obligation is to protect the safety of the public. Bastrop County's "good ol' boys" have to hear from you. They need to hear that the constant switching of private ambulance services is unacceptable when every other surrounding county manages to fund an adequate county (and city) funded 911 EMS response.