SAN MARCOS — EMS leadership has now responded after contract changes have been made between two agencies that serve Hays County.
On Nov. 19, the North Hays County Emergency Services District No. 1 (ESD 1) Board of Commissioners came to the decision to terminate its contract with San Marcos Hays County Emergency Medical Services (SMHCEMS), which will be effective 180 days from the legal notification in May 2025. Following this, the current leadership of SMHCEMS has responded previously stated to concerns.
As previously reported by the News-Dispatch, ESD 1 is the emergency medical services provider for the northern portion of Hays County, including Dripping Springs, Driftwood and Henly, servicing 244 square miles. As for SMHCEMS, a private nonprofit company, it has provided ambulance services to areas, such as Kyle, San Marcos, Dripping Springs and more, in Hays County since 1983.
“Since this organization's inception in 1983, the city of San Marcos, the city of Kyle [and] Hays County, as far as outside of Buda and Wimberley, to date, have never utilized another service outside of San Marcos Hays County EMS,” said SMHCEMS Interim Assistant Chief Scott Robinson. “North Hays came on board in 2004, I believe it was, and for 20 years, we had been the provider for that area. So, they’ve never had a reason to seek any other EMS services.”
SMHCEMS Interim Chief Jill Rosales stated, in response, that the process for taxing entities to be able to spend money is that they have to do a request for proposal, or RFP; in doing that, Rosales explained, SMHCEMS has had to rebid the contract, sometimes annually and sometimes up to a five-year term.
“For the last 20 years, {ESD 1 has] not been able to beat the service we provide or the price we provided at,” she said. “We have stood tall in our consistency with them for at least 20 years.”
In October, “SMHCEMS attempted to increase the cost of services to ESD 1 by more than $800,000 a year without explanation. This increase was not reflected in ESD 1’s contract with SMHCEMS and SMHCEMS made no attempt to amend the contract to reflect an increase in the cost of service, as is stipulated in the contract,” acording to ESD 1 Chief Bob Luddy.
In response, Rosales said that the ESD 1 board president sits on the SMHCEMS Board of Directors, as every ESD that it provides services to has a representative on the board of directors.
“They are in charge of approving our annual budget. So, for them to not understand where that money is coming from leads me to believe either our president is not passing information along to their chief or district administrator,” Rosales said. “They are very well aware of where that budget money is to be allocated and their responsibility for the portion of our increased budget for the operating year.”
Rosales also responded that part of the $800,000 was to make one of the 12-hour ambulances a 24hour ambulance, which was something that had been requested by a previous district administrator who was employed by ESD 1. She also explained that operational costs have increased following the formation of the labor union — Hays County EMS Association — that represents the field staff of SMHCEMS.
“The association forming has encouraged us to give our employees some more benefits and more opportunities, which is increasing our operational cost. A portion of that, and I say a portion, because it is spread equally amongst all of our providers, is allocated to ESD 1, which was part of the cost increase,” Rosales explained, “And then, taking a 12hour ambulance and making it a 24-hour ambulance, paying for the additional man hours, the additional assumed supplies and those sorts of operational costs, was the other portion of that $800,000. That is something that was discussed at length at our board meeting, when the board president for ESD 1 was either present or had the information made available to her to note how that was going to impact their partnership with us.”
Additionally, ESD 1 previously claimed that there have been several instances in 2024 where SMHCEMS has not been able to staff the ambulances or provide event coverage to Dripping Springs High School football games.
Rosales stated, in response, that this is akin to the staffing issues that the “entire medical field is still suffering [from] post-COVID. So, I mean, it's not untrue and it’s an unfortunate circumstance of the medical field currently.”
ESD 1 will retain the battalion chief, while hiring approximately 32 EMS personnel and adding an additional battalion chief over education, a deputy chief over operations and a chief of the department, who are all paramedics and will have the ability to act as first responders, as previously reported by the News-Dispatch. In response, Rosales said, “I'm not 100% sure how they're retaining one of our battalion chiefs. I know that some of our staff will absolutely move over to the employees of that organization. That's part of the reason we're trying to continue our training process as diligently as [we can] because when those employees leave our company and go work for ESD 1, we want to make sure that they're getting the best trained and fully-equipped employees that they have been receiving service in their service area with … I think it's imperative to note that the same care that they have received is the care they will be receiving going forward, which is nothing short of amazing. I mean, our employees are held to a higher standard than most agencies in the state of Texas and that's what ESD 1 will be receiving by obtaining some of the employees who are moving from one agency together.”
While there is some concern on a potential downgrade of care, as previously reported by the News-Dispatch, Robinson responded, “That’s what we are actually not allowing to happen by sharing the same physician as far as the medical direction is concerned. The concept of North Hays [Emergency Services District No. 1] starting up their own EMS system is not one that has been tumultuous or created any new type of animosity.”
Rosales agreed, stating that she wants the community who will continue to do business with SMHCEMS to know that “we're not falling apart. We're not unstable and our people are still going to provide amazing care,” she said.
Also previously reported by the News-Dispatch, ESD 1 has a concern about the stability of the leadership of SMHCEMS, as this year, the following occurred: two assistant chiefs left the department; a large percentage of the employee body presented the SMHCEMS Board of Directors with a vote of no confidence against the department chief; and the chief resigned.
“While we are both in interim positions together, we have just shy of 39 years of experience within this company and over 40 years of experience in EMS service delivery. So, while we are in interim positions, we're capable … And the previous assistant, she mentioned the lab working environment and that is being actively rectified as we speak and while we need to learn from our past, we're not going to continue to look backwards in the things that we have done,” Rosales responded. “We're going to continue to look to the future and providing the stability that our employees need going forward because they inevitably are the ones responsible for patient care and the happier we can keep our employees and the more stable into their working environment, the better care they tend to provide to all of the members of our communities. So, it's kind of one of those snowballs that rolls downhill. We take care of our people and our people take care of the people who are out in our communities.”
“We do have the trust and confidence of all of our employees right now. We're going to take care of them and even with ESD 1 starting up their own endeavor,” Robinson added, “We're still going to have 10 ambulances on the road every day … There won't be any kind of downgrades.”
Rosales said that ultimately, she wants to ensure the communities understand that SMHCEMS has been active for 40 years and will continue to evolve: “We're still actively pursuing protocols that provide for better patient care.
We're still training our people at a higher level than most EMS agencies in the state and we're doing so these days with a bigger smile on our face than we've had in a very long time,” she concluded.
More information about SMHCEMS can be found at www. smhcems.com.
