August 9, 2023 818 PM
JEFF DAVIS COUNTY — A year after appointing Peggy Fonseca as director, Jeff Davis County EMS, long a primarily volunteer-run entity, is well on its way to becoming a bonafide paid service, with 90% of its EMTs and paramedics now on payroll.
The county also recently broke ground on a new bunkhouse for first responders, which will be connected to the existing EMS and fire facility. As EMS operations continue to rely less on volunteer labor and more on paid on-call staff — a change longtime EMS Director Vickie Fowler, who retired a year ago, advocated for as call volumes continued to increase and volunteers age out — a bunkhouse for those staff to utilize will be integral, said Fonseca.
“It’s going to transition us into more of a paid service,” said Fonseca. “Because paid departments, they don’t get to go home and come back, they’re committed to that.”
The bunkhouse, which will be insulated and fireproof with a stucco exterior, will sleep 12 or more individuals, and will include a kitchen and a living room. It is located in the back of the existing facility and the two will be connected via a walkway. Construction is expected to last four to five months.
The cost of the project, which has been in the works for many years, totals $435,000, and is being funded by grants from the FMH Foundation, Permian Basin Area, and Yarborough Foundations as well as local grant contributions, according to county grants coordinator Larry Francell.
Fonseca said in addition to providing lodging for local first responders and those brought in to help in emergency situations, like Texas A&M Forest Service firefighters, the bunkhouse will shorten response times by housing emergency personnel closer to trucks and equipment. It will also result in some cost savings, as the county currently rents a trailer for $1,000 a month for first responders to utilize as needed.
The interior of a Jeff Davis County EMS ambulance. Photo by Mary Cantrell.
County Judge Curtis Evans said the bunkhouse and transition to a paid service will be beneficial for the future if the tri-county area adopts a regional EMS model — a concept years down the road that is still a discussion among area leaders and the Big Bend Regional Hospital District, but one made possible by the passage of a bill this legislative session. The orderliness created by a paid staff and more formal schedule will allow a smoother transition into a cohesive regional model, said Evans.
“The volunteers, they have other jobs, and they’ve done a bang up job to this to this time, but we’re getting more calls, we’re having more people,” said Evans. “It is more beneficial to have a paid service. Because they’re here. They’re on staff.”
While the feasibility and structure of a regional EMS model is still being assessed, Jeff Davis County EMS will continue to offer 24-hour, 365-day coverage, and when the bunkhouse is complete, the emergency services facility will always be staffed –– with medical care providers there to help locals or tourists who may show up seeking help, said Fonseca.
“We’re hoping that when people do show up [to the emergency services facility] in need that there’ll be somebody here when they bang on the door or honk the horn,” said Fonseca.
Since last July, Jeff Davis County EMS has grown to include four full-time paramedics, two part-time paramedics, two part-time advanced EMTs and two part-time EMTs in addition to volunteers — a significant number of new employees considering the region’s past struggles to recruit qualified healthcare workers.
Paid staff are coming from Alpine, Balmorhea, Midland, Pecos and San Antonio. Full-time staff are receiving medical insurance and retirement, and pay is $15 an hour across the board, including travel pay, said Fonseca, who emphasized the service’s supportive, evolving culture as an attractor for job candidates.
“I would say our biggest recruitment is our personnel that work here. We have great equipment. We have a very supportive community. We have a supportive commissioners court. We’re growing education-wise,” said Fonseca.
In order to increase revenue to pay for the new positions, Jeff Davis County EMS is upping its collections, changing billing companies to one that allows patients to pay with credit cards and updating their fee structures in order to better comply with Medicare and Medicaid reimbursements.
A Jeff Davis County EMS ambulance. Photo by Mary Cantrell.
The service is funded, in part, by a half-cent sales tax. For now, the county primarily contributes to the operation by paying Fonseca’s salary, as well as for some accounting, facility and utilities costs. Over time the county will absorb more of the costs to run EMS, said Fonseca. Judge Evans said in addition to ad valorem, or property taxes, supporting the entity, they are seeking other creative ways to lessen the burden for local taxpayers through grant funding or charging those who want EMTs present at their events an hourly rate.
“We’re looking at some different avenues in order to cover those expenses without going too strictly ad valorem. Because it’s an expense that comes to our taxpayers, but if we can keep it off of them and get it covered in another way, that’s what we’re looking for,” said Evans.
Both Fonseca and Evans emphasized a departmental focus on preventative healthcare and community paramedicine moving forward. Fonseca said Mountain Medics will work closely with patients, particularly the local elderly population, considering the absence of home healthcare in the area. In addition to performing wellness checks at no costs, EMTs will help patients manage medications, understand how to use medical equipment, keep up with doctor’s visits and more, she said.
“We are the middleman broker between the patient and their provider. The challenge is here, there’s more patients than there are providers [and] a lot of miles in between,” said Fonseca.
“In Houston, San Antonio and Austin, there’s urgent care centers, there’s hospitals, there’s doctor’s clinics, there’s specialty clinics. Here, you turn, no matter which way you go, there’s nothing,” she added. “Let’s focus on the things that mean the most to us, our population is very elderly.”
Judge Evans said he wants to ensure the county can keep up with the healthcare needs of its citizens, including its aging population, and exploration into how to improve care within a vast region will continue.
“We’re doing a lot of research in moving to better our healthcare in the community,” said Evans. “You eat an elephant just one bite at a time, and this is a big elephant.”
