Preliminary talks to explore a regional EMS solution are underway, says head of hospital district

ALPINE — With local EMS providers across the tri-county area in a state of tumult, the question of a consolidated, region-wide solution has been floating around for some time. In recent months, as North Brewster County scrambled to fill the gap in their emergency services after the death of Alpine EMS Director and Fire Chief Michael Scudder, talk of a regional approach became a routine part of discussions — time constraints prohibited any real entertainment of that idea, and private emergency services provider Emergent Air was chosen to take on the role for the Alpine area.

But J.D. Newsom, executive director of the Big Bend Regional Hospital District — which spans Presidio and Brewster counties — is looking to the future. On Tuesday night, at a regular Alpine City Council meeting, Newsom shared that he was initiating conversations with local entities about a prospective regional EMS solution and that everyone seemed to be on board. 

“There are six different agencies that provide EMS operations in the tri-counties, and all of them are struggling, and I think part of this exercise is really looking at: what is the vision for EMS ten years down the road?” said Newsom. “Where do you want to be? Do we want to be in another place where we’re hanging on by a thread and scrambling to find a solution, or can we have some discussion now to educate ourselves on what some options might be, not only for the benefit of all the residents in the tri-counties but also the benefit of the taxpayer.”

A consolidation could ultimately help save money, he explained. And though Alpine had been fortunate enough to lock down the services of Emergent Air, the long-term question of emergency services for tri-county residents loomed across the region. Jeff Davis County Emergency Services Director Vickie Fowler is set to retire this month after 13 years in the role, and Terlingua Fire and EMS Chief Greg Hennington is looking for a replacement. In short, longtime service providers are reaching retirement, and they are not being replaced — as folks reaching retirement age are aging out, Newsom told The Big Bend Sentinel, recruiting personnel has proven difficult. 

In the past, local entities had been more reluctant to relinquish local control, said Newsom, but as time has progressed, a regional approach has started to make more sense. “Everyone I’ve talked to is ready to have these conversations, which is great, because I think we need to be having these conversations so we can plan for our future, make data-driven solutions, and find a path forward that’s going to be not only for the benefit of the taxpayer but provide a well-trained, well-equipped, robust emergency medical service,” Newsom told The Big Bend Sentinel.

At Tuesday night’s meeting, Newsom explained that the initiative was in the early stages, and could take years to come to fruition, though he hopes to be equipped with some “initial recommendations” in the near future. In a conversation with The Big Bend Sentinel, Newsom said he hopes to have an initial roundtable discussion with all entities in late July to get a feel for the challenges facing each city and county. 

In the meantime, the hospital district board is working on collecting data to help them forge a path forward. A public health intern will devote 300 hours to research and analysis on the topic, said Newsom. The district will look at entities in the state that have implemented regional models and will conduct a budget analysis to determine how much a regional plan will cost.

There are challenges inherent in such an ambitious plan — mainly, geography and cost, said Newsom. A tri-county EMS solution would serve a geographically sprawling area, including small communities separated by vast space. Then there is the question of how it would be funded, and ensuring funding is equitable across the region. 

One prospective model would be the establishment of emergency services districts (ESD) — local government entities funded by sales tax or property taxes. Hypothetically, such districts could probably be established by county and united by an interlocal agreement to provide emergency services. Such a plan would require the approval of local voters, noted Newsom. There are also examples of hospital districts running regional EMS operations, and of such operations being run by nonprofits. “I think that’s part of the fact-finding mission, is looking at some of these potential solutions and looking at what might work well for us,” said Newsom.

Newsom also said he is in talks with Jeff Davis County grant coordinator Larry Francell to put together a grant proposal to help fund the undertaking.

“My guess is it’s going to be a long process,” said Newsom of the upcoming discussions and analysis. “But a worthy process that I think will in the long run help us make educated decisions moving forward.”