Texas counties seek state EMS funding as costs rise

AUSTIN (KXAN) — Counties across Texas are using part of their budget to pay for their own fleet of ambulance services or they're contracting them out.

These services require large portions of county budgets and, as costs for emergency services continue to rise, leaders are turning to the state for help.

Terri Langford, the health and human services reporter at The Texas Tribune, joined KXAN's Will DuPree to discuss the reasons behind these rising costs and why there’s a growing need for these services in areas outside of major cities in Texas.

Watch the full interview in the video player above or read an edited transcription of the conversation below.

Will DuPree: Right now, counties are not required to provide EMS services, because that is the duty of the cities. Why are county leaders, though, getting involved?

Terri Langford: County leaders are having to get involved. They've been involved for quite a while. They've done a variety of things, relying on volunteer fire departments, but those volunteers are aging out. They're having a tough time recruiting more of them and more people are coming into counties. As housing costs rise, more people are willing to eat a commute and and live 15, 30 minutes, 45 minutes from where they work. So you're seeing an influx of new housing, new residents, and as soon as they close on that house, they're thinking about 'Oh, what happens if I have an emergency and I need to get to a hospital quick' So counties are having to pony up, as they have been for several years. It's just getting more expensive for them to do so. 

Will DuPree: You just talked a little bit more about that, but if you could just maybe talk about the need for an ambulance service outside of a major community, and how that's rising right now?

Terri Langford: A lot of new developments are going in outside city limits and counties. Johnson County is a good example. It's 30 minutes south of Fort Worth. It's seen a lot of growth in the last few years, as more and more people are moving in and new houses are being built. But that EMS service, which had been sort of confined to Burleson, Keene, and Cleburne, is now needed out in the unincorporated areas where this new housing is going. 

Will DuPree: EMS, as many of us could guess, is not cheap. The service can cost millions of dollars. What exactly makes it so costly and the challenges facing county leaders to try to pay for those?

Terri Langford: You want somebody on call when another ambulance is out, taking someone maybe, you know, 30 miles to a hospital. So you can't just rely on one or two extra ambulances in a county, you're going to have to have three and four, or you're going to have to shore up and coordinate more with your cities, to contract with them, maybe to pick up people in the unincorporated areas. So it's a lot of coordination, a lot of money, like everything else, the costs are rising for counties. Private ambulance companies are able to raise their prices. It's very expensive to man an ambulance with all the required equipment, the required training. I mean, we're not talking about just putting someone in the back of a pickup truck, as we did probably 40 years ago, and taking them to hospital. You've got life-saving equipment on there, you've got drugs, you've got highly trained professionals. So it's costly. 

Will DuPree: We're approaching another regular legislative session coming up in January, and county leaders, some of them, are calling on the state for additional support. What kinds of things do they want from the state?

Terri Langford: They just want a little help. I mean, they don't want to raise their own taxes, their property taxes, and they can't, because they're restricted with a 3.5% cap that's been imposed. You can't raise your taxes more than that without going to the voters and they don't want to do that, but what they'd like to do is have a grant program similar to what we saw with rural law enforcement a year ago. A $330 million fund was set up to help with rural law enforcement. They’re not asking probably for the same amount, but they'd like to see a grant program to help subsidize this growing need.