Commissioners Grant Judge Authority To Negotiate Contract With EMS Consultant

By Kelly McChesney, Reporter

After an extended discussion, the commissioners voted Monday, Jan. 5, to approve providing the authority for the county judge to negotiate a contract to provide professional and technical guidance to ensure the timely replacement of emergency medical service (EMS) providers and ensure continued ambulance coverage for the citizens of Houston County.

All other action items on the agenda were tabled until a future Commissioner's Court meeting.
The Houston County Commissioner's Court met in a special called meeting to discuss ambulance service in the county.

According to Houston County Judge Erin Ford. ETMC EMS Vice President Ron Schwartz has notified Ford their ambulance service contract with Houston County will end on March 14.

Schwartz committed to the county to maintain consistent ambulance service during the transition period (between the end of December 2014 and March 14, 2015.

The agenda for Monday's meeting was to discuss and consider action providing authority for the County Judge to:
A) Negotiate a contract to provide professional and technical guidance to ensure the timely replacement of EMS service providers and ensure continued coverage for the citizens of Houston County.
B) Contact and negotiate with the current and replacement EMS providers should the need arise.
C) Contact and negotiate with other entities and agencies concerning optimization of the service.
D) Contact and negotiate with the Houston County Hospital District (HCHD), City of Crockett, Emergency Services District #2 to ensure cooperation,support and agreement on responsibility.

Ford met with members of the Houston County Hospital District (HCHD President Dr. John Stovall and Dr. Patrick Walker) to discuss options for providing ambulance service to Houston County residents.

Ford said he asked for the item to be placed on the agenda of the Hospital Board meeting on Tuesday Jan. 20.
Ford reported, "We've met tentatively with prospective consultants to the county. None of us are experts in EMS service. We need the benefit of their experience and their background in order to help us move forward expeditiously -- to conceivably select the best third party provider for Houston County and the City of Crockett."

Precinct 2 Commissioner Willie Kitchen asked Ford to inform the commissioners about the previous meetings with the City of Crockett and the hospital board. "Could you fill us in?" he asked.

Ford explained that on Dec. 11, Neil Franklin, general manager of ETMC EMS, met with Ford and informed him that they would be terminating their ambulance service contract effective in 90 days, which would be March 14, 2015.

"I requested a letter substantiating that," Ford said. Franklin sent the letter to Ford.

"I responded to that, indicating our contract with the county, calls for a one-year advance termination notice," Ford said.

"The city, however, has a 90-day contract," Ford explained. "We immediately set up a committee to review the options we have available, knowing that ETMC EMS would not be in contractual compliance." Ford said he wanted to make sure options were available to provide third party EMS service.

He said, "We met weekly with the City Administrator Shawn Hutchinson, County Auditor Melissa Mosley, Precinct 1 Commissioner Roger Dickey, Crockett Fire Chief John Angerstein and County Attorney Daphne Session."

"On the evening of the 11th, I met with ESD #2. Their charter only obligates them to provide emergency fire response. They specifically excluded EMS service in their charter, unlike ESD #1, which has fire response and ambulance service," Ford said.

As reported by Ford and Session during the Commissioners Court meeting on Dec.23, "Houston County may not impose taxes or issue bonds or other obligations for hospital purposes or to provide medical care for Houston County Hospital District (HCHD)."

Ford continued, explaining the Hospital District statute Special District Local Laws Code, Title 3, Health, Subtitle A, Hospital Districts, Chapter 1078 . The hospital district MAY operate or provide for the operation of a mobile emergency medical service. He also said the HCHD Board of Directors may contract with a political subdivision of the state to furnish a mobile emergency medical service. Houston County is a political subdivision of the state.

Ford said, "So we have ESD 2, they're out of it.We have the county that can't tax. We have the hospital board that may provide service and we've got the city that has the charter to provide service to its residents."
"We have to work out how it's going to be paid, how it's going to be administered and time line," Ford said.
He added, "It's important we meet with the hospital board on the 20th to find out their level of support."
Kitchen asked, "When you and Roger met with the hospital board (Stovall and Walker) last week, what feeling did you get?"

"I really shouldn't be speaking on behalf of the hospital board," Ford said, "but I think they are looking at a long term solution that doesn't necessarily include a third party provider."

"If the county is able to tax . . . how do we tax with the residents in ESD #1, fairly? Would they be taxed for a service they would not benefit from?" Ford asked.

"I really don't want to give the impression that we are trying to draw them into this," he said.
"If we want to tax for a third party service, how do we tax? As a county can you specifically exclude a section of the county from taxation?" Ford asked.

He said, "It's a foregone conclusion that we're going to have an ambulance provider and somebody will have to pay for it."

"I'm worried. If, worst case scenario, we lost ambulance service in March," Ford said, "we would be jumping through hoops. We haven't lost a thing by getting this consultant in place."

Kitchen said, "If we take this action today . . . I want to keep everybody on board . . . If we are going to cooperatively spend money, we will have to have an inter-local agreement to actually spend those funds."
He said he would rather have something in writing about who is going to pay for the consultant and what percentages each entity is going to pay.

Kitchen said he had talked to some hospital board members. "The hospital board is really not sure," he said. "We don't know at this point if the hospital board will be willing to fund it or administer it."
Mosley said, "Under 1078-115, the hospital district can issue general obligation bonds."

"There are so many loose ends right now. None of us are EMS experts," said Ford. "Somebody's got to take the lead on it."

Ford said the cost for a consultant will be about $20,000, possibly less, depending on the amount and scope of work he was asked to do.

"The fees could be as little as $2,500 to about $18,000," Ford said. "I'm concerned about making sure we have a seamless transition."

City of Crockett Fire Chief John Angerstein addressed the Commissioners Court saying, "We feel the moral obligation as well." He explained the sense of urgency to hire a consultant.

He said that the city and the county feel that one of the first moves of a third party advisor, who has negotiated EMS contracts as an expert, will be to negotiate or find a third party EMS provider for the interim (between the end of ETMC's service and contracting with another provider).

"It is on our agenda (City of Crockett) to vote for this consultant's fee," he said.

If the county stalls, waiting for the city's meeting, then the city might have to stall and wait for the county's decision, Angerstein said.

"We're already down time. The clock has been clicking," he warned.