After death of EMS director, Brewster County looks to fill service gap

The Big Bend Regional Medical Center in Alpine. Photo by Stephen Paulsen.

TRI-COUNTY — The City of Alpine and parts of Brewster County are unexpectedly facing the task of establishing a new emergency medical services provider after Michael Scudder, who operated the area’s ambulances since 1985, died at the age 61 in early December. 

Brewster County Judge Eleazar Cano recently appointed a task force, consisting of Emergency Coordinator Stephanie Elmore, Chief of Terlingua Fire and EMS Greg Henington, county commissioners Sara Allen Colando and Jim Westermann, County Treasurer Julie Morton as well as representatives from the Big Bend Regional Hospital District and City of Alpine. The brain trust has met three times to date and is working on writing up a recommendation for the county regarding the future of their EMS services. The aim is to present their findings and recommendations to the county sometime in March. 

Terlingua Fire and EMS agreed to lend a hand in the meantime to ensure services are not interrupted for area residents. They agreed to 120 days of assistance, which will end on April 30. 

“We were simply being good neighbors,” said Henington. “We would hope that if our EMS went down, somebody would come help us.”

Scudder’s company, West Texas Ambulance Service, served the area for over 35 years. His daughter, the heir to his company, chose not to continue to operate the business. Scudder also ran the volunteer fire department after his twin brother, who served as the station’s fire chief, died in 2019. Andrew Pierce now holds the role of Alpine Fire Chief. 

The monthly subsidies Scudder was receiving from the county and city to operate EMS are now being allocated to Terlingua EMS to pay for salaries, fuel and supplies. Terlingua Fire and EMS is operating under their license and got approval from the state to serve a larger area for the time being, said Henington. The EMS crew currently consists of Terlingua EMS staffers and professionals from other nearby towns. Of the three EMTs and paramedics that worked under Scudder only one remains. Henginton said of his six available EMTs, he typically has two people on duty. His main concern is burning out existing employees, he said, but luckily they have not seen an increase in COVID-19-related calls, and for the most part the temporary solution is working out.

“I’m not gonna say it’s going absolutely perfect. There’s always a challenge here and there,” said Henington. “We’re keeping things pretty much the same, because there’s no sense in changing it and changing it again.” 

They are currently operating out of the county fire station and renting two of Scudder’s ambulances from his daughter. It’s been a community effort, said Henington. The Alpine Police Department has stepped in to act as ambulance drivers when needed, and Oasis Tire has been assisting with the ambulance’s mechanical problems. 

The task force is considering three major options for the new EMS, said Judge Cano in a Brewster County Comissioner’s Court Meeting January 18. The county could opt to put out request for proposals (RFPs) in order to recruit a private contractor — this would likely involve the county, city and/or hospital district subsidising the cost to make it more profitable for the business owner. Henington said Alpine averages around 400 to 500 911 calls a year, which is not a large enough volume to attract a private company without additional assistance. 

“I don’t want to do some low bid deal where two years from now they’re broke and they’re out of business and we can’t run anymore, and now we’re doing this all over again,” said Henington. “Here, now is the time to do it right the first time.”

Another option is for the county to take over EMS, which Judge Cano said is estimated to cost $1.3 million dollars, making that option unideal, if not entirely out of reach. 

The third option is for the Big Bend Regional Hospital District to take charge of running EMS. “The hospital district, the City of Alpine and Brewster County, we [would] put money into the pot to try to continue to build on basically what the Scudders left behind,” said Judge Cano. “But that would be a whole different entity that would be led by the hospital district.”

One of the major advantages to this option, said Henington, who also serves on the board of the hospital district, is that they are already a taxing entity and could raise property taxes — which partially funnel into the district — to help fund the services. Grant funding through the hospital is another option. The Big Bend Regional Hospital District had not met concerning this matter at press time, but plans to meet in the near future to discuss the option, said Henington. Regional hospital districts do operate EMS in other parts of the state. 

Henington said rural healthcare, like water, will be one of the major challenges facing our region in the future, and it will be important to raise pay rates for EMTs and paramedics to attract quality candidates. Offering competitive salaries is something the taskforce can plan for now while they are reorganizing the structure of EMS for the area. 

“We’re going to have to be competitive in salaries and benefits or we’ll have a great organization, we just won’t have any people,” said Henington. “That’s the problem everywhere — everybody’s shorthanded.” 

South Brewster County became an established emergency services district (ESD) in 2004, meaning their EMS and fire services are partially funded by sales tax collected in the area. Hennington said it provides a couple hundred thousand dollars a year and helps them pay for supplies and salaries. The benefit of the ESD is tourists pay sales tax and in turn are helping pay for EMS services they may utilize. 

“The plans that we’re drafting are going to include everything north of the ESD service area,” said Judge Cano.

If Brewster County decides to operate EMS out of the hospital district, there is a possibility Presidio County will enter into the deal, since they are also covered by the hospital district. Presidio County Judge Cinderela Guevara attended the last task force meeting, said Judge Cano, and is processing information and assessing Presidio County’s EMS demands. Marfa EMS Director Bert Lagarde said an upcoming meeting has been scheduled with him, the mayor, city manager and the hospital district to discuss the possibility. Marfa’s EMS currently operates on funding from the city, county and grant funds. In addition to funding from the Texas Regional Advisory Council, they also received funding from the Big Big Regional Hospital District. 

Lagarde said they recently received $75,000 from the hospital district to spend on a new $250,000 to $300,000 ambulance, and four or five years ago the hospital district helped fund the entire cost of an ambulance for Marfa EMS. 

Marfa EMS covers a wide range, including parts of Jeff Davis County. They have a mutual aid agreement with Fort Davis to cover areas west of Marfa up to the Culberson County line. Jeff Davis County EMS is a volunteer service. 

“We are covering parts of Jeff Davis County on a day to day basis,” said Lagarde.

The taskforce will meet again in late January and is currently working on getting numbers together, said Judge Cano. 

“Everybody’s already burned out because of the pandemic. Everyone stepped up — the EMTs and Greg, and all the volunteers and the county officials,” said Brewster County Commissioner Sara Colando, who is on the EMS task force. “Everybody has really put this at the forefront of everybody’s to-do list about finding a solution.”