Liberty County commissioners hold workshop to discuss EMS options

By Vanesa Brashier, editor@bluebonnetnews.com

Liberty County is considering the possibility of managing its own ambulance service, though it likely will be a few weeks before a decision is made. On Thursday, county commissioners held a workshop to hear a presentation from current and former staff members of now-defunct Liberty County EMS about the costs of the County taking over the service, which until recently served all of the unincorporated parts of the county.

Liberty County EMS is offering the County all of its ambulances and equipment for approximately $500,000, which would be used to pay all of the organization’s remaining debts. As Liberty County EMS operated as a non-profit, the rules require that assets be transferred to another non-profit service or business, or a government entity. Liberty County is being given the first option.

To help navigate them through this process, commissioners created a committee, headed by Klint Bush, with Pct. 2 Commissioner Greg Arthur, Pct. 1 Commissioner Bruce Karbowski and Fire Marshal Bill Hergemueller serving as members. It was previously reported that Liberty County EMS Director Mike Koen served on this committee, but Koen said that is a misunderstanding. Recently, the committee did a walkthrough of Liberty County EMS’s operations in order to report their findings at the meeting Thursday.

“As you will see here, I have listed all of the assets we have and the current value. Where it says new value, that’s what you would have to pay for brand new items,” said Koen. “I have two of my board members here – Dana Pittman and Don Neyland. We had a meeting after that group did a walkthrough. We talked about whether we could throw the building in, too, and we were in agreement to do that. The amount we sell for must go toward debt. It can’t go in our back pockets.”

Koen said the board was very passionate about Liberty County EMS becoming a county entity.

“The fact is when we changed the name when I took over 24 years ago, we thought then we would be able to do that. We decided not to do it at the time because we were doing well financially,” Koen told commissioners. In recent years, the Affordable Care Act set limits on what would be paid for an ambulance call. More recently, Liberty County EMS was dealt a second blow during the COVID-19 pandemic because of fewer calls for service.

The plan that was prepared for commissioners was presented three options to commissioners with annual operating costs ranging from $1.2 to $2.4 million. Option 1, the most expensive at $2.4 million, would include six advanced life support ambulances staged at strategic points throughout the county. Option 2, at $1.6 million, is for four advanced life support ambulances, and Option 3, at $1.2 million, would include three advanced life support ambulances. All three would include a highly-trained captain, following in a chaser vehicle, to assist in medical emergencies.

Ron Nichols, EMS director for Chambers County, was asked to sit in on the discussion and offer his take on the proposals. Chambers County, which is about half the population of Liberty County, took over operations of its ambulance service in 2019. Prior to that time, the unincorporated sections of Chambers County were served by three non-profit ambulance services.

Commissioners learned that the cost of operating Chambers County EMS is about $2.7 million annually. One advantage to the county operating its own service is grant money, Nichols said.

“The State will reimburse you for some of the uncompensated care costs for non-insured. If we get back what we are anticipating, it will be another $470,000 from the State,” Nichols said. “You open yourselves up to additional state and federal grants that are not available to EMS services.”

After the meeting, Liberty County Judge Jay Knight said he is still weighing the options. He first wants to review the bids that were submitted to the county through a recent Request for Proposals.

“I have gotten so many different numbers regarding Liberty County EMS. One thing we must do first is find out how much it is going to cost down to the penny,” Knight said.

Knight said three things are “staring him in the face” as this decision lingers. First, the County just took over the jail. While he and commissioners have a good idea of how much it will cost to operate the jail, there are situations that could arise. Secondly, Liberty County is growing at a rapid pace, which is causing a strain on manpower at the sheriff’s office. Additional manpower and equipment will be needed in order to adequately serve county residents, he said. Thirdly, a new federal administration is now in place, which has created some uncertainty in the economy, Knight said.

“I do not know where the economy is going to go. Why would we want to step off in a dark hole without knowing what the economy is going to do?” he said.

At the end of the meeting, commissioners asked the committee to continue working on a more detailed budget should the County take over Liberty County EMS.

“We have the RFPs from the other companies but we still have to evaluate them. We won’t put a decision on the agenda for next Tuesday. It will be the first meeting in February at the earliest before we make a move in any direction. That gives us time for those young men to get us good numbers that we believe are accurate,” Knight said.

Currently, Liberty County has a month-to-month contract for $70,000 per month with Allegiance Mobile Health for ambulance service in the unincorporated areas of the County. Cleveland, Dayton and Liberty have their own ambulance services in place.

4 COMMENTS

  1. The taxpayers do not need to pay private debt. I do not know how many ambulances they are trying to sell for $500k, but the City of Cleveland sold Liberty County EMS two ambulances for $13,500 in 2014. Liberty County needs to do it right if they are going to step up and take over EMS. Start from scratch rather than buying used ambulances. Why would you bring the head of the failed business into your team? Look to the successful public ambulances services for advice – Montgomery County, Fort Bend County, Williamson County, etc. Stop basing our success on where we’ve been and where we are. That only works for personal growth – not government.

  2. I am not a fan of the ALS idea and a Paramedic chase vehicle. The citizens of this county deserve to have a Paramedic on EVERY truck. This county is to vast to get definitive care prehospital (a Paramedic) to a citizen based on where that chase vehicle may be when the call comes in. So is the thought process going to be that if the chase vehicle is to far away, that ALS truck should load and leave. Then the patient doesn’t get the care they need but by golly, they have IV access. The other option is to sit on a scene and wait for a Paramedic wasting crucial time to get the patient to definitive care (a hospital). In the meantime, let’s say you have them transport to one of these county hospitals which has ZERO capabilities to stabilize or get the pt the treatment they need, just to turn around and have to send them to an appropriate facility for any intervention. Kingwood, Conroe, Baytown, Beaumont are definitive care. Another issue is having these ambulances out of county to transport to an appropriate facility. How quick is that turn around? What if the chase vehicle Paramedic rides on one of these trucks to an appropriate facility and another call comes in that requires a Paramedic. Oh wait, your chase truck Paramedic is gone!!!! The call volume is only going to increase upon completion of the Grand Parkway. The expansion along the finished 99 is insane. Did you plan for that? If you’re starting over from scratch, my expectation as a tax payer is to get the best service to the citizens. Meaning a EMS Director that is experienced with a thriving service, knows how to budget, and knows how to grant write. Then, bring in an educator who is experienced educating to get the staff up to snuff. Supervisors with extensive background in prehospital critical care to QA/QI and said educator to reteach if needed. A Medical Director with expansive protocols (its rural and no definitive care here). The Medical Director should also have insight and be a functioning part of this new agency. Rural EMS needs to have the best most educated Paramedics out there. Not a patch and a pulse or even worse ALS who cannot legally interpret an EKG. My example for understanding is getting a call for chest pain. At the ALS level most providers cannot determine whether it’s anxiety, a cardiac event, or pleural pain because they have had a cough. They all present with chest pain. With that said, they treat down a chest pain protocol because if it looks like a duck, quacks like a duck, it’s a duck! A Paramedic can at least hook them to an EKG and figure out through assessment whether it’s a duck or a zebra! If the Zebra is present, then transport to definitive care! The ALS idea is dumb! As a tax payer my taxes haven’t increased but my property value was at $78,000 6 years ago and is now $110,000! The citizens deserve more than ALS and a patch and a pulse on an ambulance.

  3. I vant believe anyone thinks lcems with 45 min eta to scenes was appropriate or with in national standards, or the fact of poor management for many years were providing a good service to the tax payers

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