SERVICE QUESTIONS

• Are we looking for air and ground transport services? We are looking for 911 ground ambulance services only. These emergency services do not include air or ground transport from the local hospital to another facility. Air transport is controlled and contracted through the Hospital.

• When Emergent Air was awarded the contract for EMS, there were two other bidders. Can we use one of them now? We cannot contract with one of the previous bidders without issuing a new bid. The original bid for these services was conducted 3 1/2 years ago. The County/City are subject to purchasing laws that would require a new bid for these services.

• Can we share services between counties? We currently have mutual aid agreements with other counties and assistance is provided when needed. Sharing of all services, at all times, would require formation of a regional entity and approval of all member counties/cities.

• Are there any other communities in our similar situation? If so, what successful solutions have they implemented and how can we borrow from their success? We are gathering information from other communities on how they handle 911 ambulance services. This information should be forthcoming at future Town Hall meetings.

• Can we use EMS volunteers for the “backup” service? (similar to a volunteer firefighter scenario) There may be opportunities to use EMS volunteers for some services; however, all volunteers would have to meet the appropriate criteria before serving in such a position.

• Have we received any bids/quotes from private vendors? We have received one informal quote and are waiting for a second quote.

   

• How would dispatch services be handled? There are no plans to change dispatch services. These services are currently provided by the Sheriff’s Office and the Alpine Police Department.

COST QUESTIONS

• Is it possible to get an ambulance for less than the amount stated during the town hall? At this time, we believe the current state grant will cover the cost of ambulances for our operation.

• How much are we currently paying Emergent Air? The County and City currently pay Emergent Air about $350,000 in total for 911 ambulance services.

• What is the gap between the anticipated cost of service and collections? We estimate a “worst case” shortfall of approximately $1,300,000 between the cost of service and collections. These preliminary costs are based on what we know now and include 24/7 coverage (in Alpine and Marathon), second-shift backup coverage, full benefits for full-time staff, training and other operational costs such as liability/property insurance, supplies, fuel and vehicle maintenance.

FUNDING QUESTIONS

• Can the new federal rural health care bill be used to offset the funding needed for EMS? There is some provision in this bill for emergency management services but its main focus is primary care in rural areas. It does not fund operating costs for 911 ambulance services. It would however offer opportunities for the purchase of capital equipment such as heart monitors, stretchers, training devices, etc.

• Can EMS accept donations from corporations and individuals as a way to build a surplus? Donations can be accepted by the County, City and/or an ESD.

• Can we use sales tax and/or property taxes to fund EMS? Both sales tax and property tax can be used to fund 911 ambulance services; however, north Brewster County, is already at the maximum rate for sales tax. We do not have the ability to raise the sales tax other than in the Marathon area.

• Can hotel/motel taxes be used to fund EMS? Hotel/motel taxes cannot be used to fund 911 ambulance services. These funds are restricted by state law to tourism related projects and cannot be used for general County/City operations. 

• How are transport rates set for ambulances? We can set our own transport rates; however, Medicare, Medicaid and private insurers make their own determinations on what amount is reimbursable.

• Instead of an ESD, can we combine with the Hospital District to help reduce costs and/or taxes? The Hospital District and an ESD serve two different purposes. Currently, the Hospital District provides indigent health care support for residents in Brewster and Presidio County. An ESD would provide 911 ambulance services for any North Brewster County resident that needed it. Although the Hospital District is allowed to provide 911 ambulance services, there would be little cost reduction available since they do not currently provide these services. In addition, since it is a bi-county district, they may be required to provide the same service in Presidio County, increasing the costs.

• How much would an ESD tax raise? Based on the projected taxable value of properties within the district boundaries, a tax of $0.10 per $100 would raise $1.5 million if fully collected. We do not have firm taxable values at this time.

   

• Do we have any tax abatements? Yes, we have one that ends January 2027.

OTHER QUESTIONS

• Will information from this town hall be in the newspaper? Yes, we will be providing information to the newspaper.