Debate on Ambulance Service Set-up in West Texas

April 29--If Lubbock elects to be a dual-EMS city, it will be the only one in the region.

Most major cities in West Texas rely on one main ambulance service for emergencies, with some communities opting to contract with private companies while others rely on the public sector.

A-J Media reached out to Amarillo, Wichita Falls, Abilene, San Angelo, Midland and El Paso to see how EMS operates within those cities. All except El Paso responded.

Of the five cities that responded, two of the EMS systems are run by the local fire department and three are contracted to third parties.

Amarillo

Only one EMS service provider operates in Amarillo.

Amarillo Medical Service is owned and operated by American Medical Response, the same corporation that owns the EMS service in Wichita Falls and Abilene.

In an email to A-J Media, Lauren Christie of AMS said there are two main hospitals in Amarillo -- Amarillo Northwest Texas Healthcare and BSA Hospital.

"The needs of the patient drive the decision," Christie wrote. "For example, a patient suffering from a trauma will be transported to a trauma center. If things are equal regarding hospital capabilities, then patient choice will drive the decision followed by distance. In cases where the patient is unable to choose, the paramedics will make the decision based on the patient's best interests."

The average response time is six minutes, Christie wrote.

"AMS is the exclusive 911 provider for the city," Christie wrote. "There are very few communities that exist that have dual services performing EMS. What you won't find is communities converting to a dual-EMS system, for obvious reasons such as duplicate costs. It is really difficult to rationalize the creation of a dual system from a taxpayer perspective."

San Angelo

The city of just under 100,000 people in West-Central Texas has two level-three trauma centers, San Angelo Community Hospital and Shannon Medical Center, said Eddie Martin, chairman of the Concho Valley Regional Advisor Council (RAC) for EMS & Trauma Systems through the Department of State Health Services.

Where a patient is taken is up to patient preference, he said.

The EMS system in San Angelo is run by the San Angelo Fire Department, said Fire Chief Brian Dunn.

"The fire department operates all ambulances inside Tom Green County," he said. "We're the only ones that get dispatched."

The average response time is about five minutes, Dunn said.

Both hospitals excel in care, Martin said, but major trauma is generally directed to Shannon Medical Center.

If a patient can't verbally relay his or her decision, they are taken to the nearest one, Martin said.

Midland

The Midland Fire Department responds to 911 calls and takes patients to Midland Memorial Hospital, which is the only major hospital in that region, Chip Balzer, assistant fire chief for Midland, said in an email. Midland's population is about 125,000.

"All 911 calls for service within Midland County are answered by the city of Midland Fire Department, except for a few service area pockets which overlap with our entities from Ector and Martin counties," Balzer wrote. "Some coordination does have to take place with these nearby agencies to make certain the responsible entity is notified. All of our patients are transferred to Midland Memorial Hospital unless we find ourselves closer to, or in need of specialized services offered at Odessa's Medical Center Hospital in neighboring Ector County."

The average response time is six minutes and 43 seconds.

"As all of our stations are within the corporate city limits, calls for service within town will be shorter while county responses will take longer," Balzer wrote.

Wichita Falls

Kim Stringfellow, chair of the North Texas RAC for EMS & Trauma Systems through DSHS, also responded through email.

The medical hub for the North Texas region is Wichita Falls and the city of about 105,000 people has a contract with American Medical Response -- the same corporation that owns the EMS system operating in Abilene.

"United Regional is the lead level-two trauma center for the region," Stringfellow wrote. "Within the city limits, UR is the only leveled trauma facility. We do have a private hospital, Kell West, within the city and patients can go there by request, except trauma. EMS does not take trauma to an undesignated facility. They will be bypassed to get to the trauma center."

Stringfellow said AMR takes all 911 calls but calls are occasionally rolled to Trans Star, which is a private EMS service in the Wichita Falls area.

Calls are rolled according to patient volume, according to her email.

"Patients can call Trans Star direct for transport, even for emergency calls," Stringfellow wrote. "However, if 911 is called, the call will go to AMR. There is no confusion."

Stringfellow was unsure about the average response time.

Abilene

Homer "H.T." Fillingim, chair of the Big Country RAC for EMS & Trauma Systems through DSHS, said ambulance services in Abilene are done by Metro Care, which is owned by AMR.

"They are the primary ambulance service," he said.

Fillingim said there are two major hospitals in the city of 120,000, including Abilene Regional Medical Center and Hendrick Health System.

Neil White, director of operations for Metro Care, said transports are based on patient preference.

"After patient preference, everything is protocol driven," he said. If a patient does not or cannot express a preference, other factors considered for transport include proximity to the nearest hospital and what services are needed.

In January and February, response times averaged four minutes, White said.

ellysa.gonzalez@lubbockonline.com

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