Local officials across the Big Bend are rushing to apply for a sizable pot of new state funding that could pump more than $1 million into the region’s emergency medical service operations.
Last year, Texas lawmakers approved House Bill 3000, a measure that created a new state grant program designed to bolster ground ambulance services in rural areas. Under the law, counties with fewer than 10,000 residents are eligible to receive up to $500,000 to buy new ambulances and associated equipment.
Presidio, Jeff Davis and Brewster counties are all applying for the grant. The Texas Comptroller’s Office, which oversees the program, plans to announce grant awards in February.
The opportunity comes at a critical time for Brewster County, the state’s largest county by size, where local officials recently announced that the private ambulance company servicing Alpine, Marathon and outlying areas in the county’s northern half would be leaving the region later this year. (Terlingua Fire & EMS continues to operate in the county’s southern half, which includes Big Bend National Park.)
Greg Henington, the county’s top elected official and former Terlingua Fire & EMS chief, said at a meeting this week that Emergent Air’s contract will expire at the end of May, though the company has agreed to continue operating ground ambulances for an unknown period of time after that.
“I think they want us to be working for a solution, but they’re not just going to run off and abandon the northern part of the county,” he said. “I think we’re going to be okay.”
Brewster County and the City of Alpine have launched a joint task force to explore options for replacing the company. Options include hiring another private company, launching a purely government-run service or creating an “emergency services district” (ESD) that would collect taxes to fund an EMS operation. Terlingua Fire & EMS has long operated as an independent non-profit funded by an ESD.
Henington said in an interview Thursday he’s urging officials to “look at all solutions.”
“I’m cautious about getting too far out on the ESD thing,” he said. “I’m trying to keep the task force from getting myopic on this.”
Officials have scheduled three town halls this month to gather input from locals: Jan. 21 at the Alpine Civic Center, Jan. 26 at Sul Ross State University and Jan. 31 at the Marathon Community Center.
While the new funding wouldn’t fix the county’s EMS quandary overnight, Henington suggested at this week’s commissioners court meeting it could give officials a head start on the issue.
“If you order an ambulance today, depending on the kind of ambulance you’re getting, it can take 18 months to two years to get one,” he said. “The backlog is that bad.”
In neighboring Presidio County, officials are trying to figure out whether the state would allow them to split up a $500,000 grant between the region’s two city-run EMS entities in Presidio and Marfa.
County Commissioner Deirdre Hisler said this week that if the county was awarded a grant, Presidio and Marfa’s EMS crews had each drafted $250,000 plans for ambulance upgrades or purchases that could be put into action, if the state allows the split.
“It’s very nebulous, but the committee that gave this bill language to the legislative member that put it forward, they said please recognize that some counties have more than one provider,” Hisler told Marfa Public Radio.
Still, Hisler said officials could be forced to choose which EMS entity receives the full $500,000, a difficult task given that both services in Presidio and Marfa are facing financial challenges.
“I don’t think they’re very sustainable at all,” she said. “I think they struggle with being able to get enough crews to keep the services running.”
Presidio County officials hope to get more answers after a meeting with grant program coordinators on Jan. 21.
In recent years, officials across the Big Bend have discussed the prospect of a more regionalized approach to EMS operations, but the talks haven’t yet led to anything concrete. That could change thanks to a sweeping $1.4 billion pot of rural health care funding Texas is set to receive from the federal government over the next five years, according to Presidio County Judge Jose Portillo.
Portillo said at a Wednesday commissioners court meeting that he’s been in talks with top elected officials in neighboring counties about asking the state for a share of the funding to invest in health care infrastructure across the region, including EMS operations. County judges in Brewster, Jeff Davis, Terrell, Hudspeth and Culberson counties are on board, he said.
“We suspect that with our demographics, our geography, that we’re going to have a hell of an opportunity to go and seek about $30 million in funding for five years,” Portillo said. “It’s going to be in lockstep with our EMS.”
Gov. Greg Abbott’s office said in December the Texas Health and Human Services Commission would “use a competitive process to allocate funds” for initiatives that improve rural health care according to certain criteria.
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