Llano County Ambulance Service Update

From: Peter Jones <commpct1@co.llano.tx.us>
Date: Tue, May 9, 2017 at 11:42 AM
Subject: Llano County Ambulance Service Update

When you or a loved one is not feeling well and you call 911 for emergency help, most of us do not think of the organization behind the emergency response other than how quickly will they arrive. This update provides the background on the structure of the organizations of these medical emergency first responders.

Llano County has two Emergency Medical Services (EMS) that dispatch ambulances to respond to 911 emergency medical calls. The EMS service that responds depends on the location of the medical emergency. One is Emergency Medical Service #1 and the other is Baylor Scott and White.

Emergency Service District #1

Medical emergencies that take place in the City of Horseshoe Bay (HSB), Oak Ridge Estates, Blue Lake, Deerhaven, The Trails, Sandy Harbor and any location in Llano County from the Llano/Burnet County line to Sandy Creek on Hwy 71 are responded by Emergency Medical Service (EMS) ambulances from Horseshoe Bay that are located at the Horseshoe Bay Fire Department.  When a medical emergency call is received both the EMS ambulance and the Horseshoe Bay Fire Department respond. Either one may be on the scene first. All fire fighters are qualified Emergency Medical Technicians. If the fire truck arrives prior to the ambulance, those firefighters begin the initial patient assessment and treatment.  One ambulance is located at the City of HSB Fire Department with 24/7 service staffed by one Paramedic and one Emergency Medical Technician at all times. If this ambulance is in service, it is backed up by three ambulances in Marble Falls and one in Granite Shoals. These are also supported by an on duty captain in the service area of Burnet County and South East Llano County. If the HSB ambulance is in service a Marble Falls ambulance is moved to HSB to cover for any potential emergency calls, if it is available.

The response time from when the 911 call is received to when the first responder arrives at the scene is targeted to be no more than 8 minutes. In the 6 months from October 2016 to March 2017, 259 calls were received with 222 responded within the 8 minute goal or 85.7% of the time. The other 37 calls had a response time of greater than 8 minutes for various reasons with the main reason being the distance from the ambulance hall. Of these calls 190 were transported to hospitals with 120 transported to the Baylor Scott & White Hospital in Marble Falls on Hwy 71.

This service is provided under the direction of the Llano County Emergency Service District #1 (ESD #1) which is a taxing entity that charges property tax to property owners in the service area. The current tax rate is 1.837 cents per $100 of taxable property value. That is $18.37 for every $100,000 of taxable property value. The Llano County ESD #1 operating budget for the 2017 fiscal year is $491,840 which includes an allowance to pay $300 to the City of HSB for each response by the fire department to medical calls in areas without fire department support contracts with the City of HSB.

The Llano County ESD #1 is managed by a board of commissioners appointed by the Llano County Commissioner's Court. They are currently Rhett Ruiz (President); Jerry Clinesmith (Vice President), Fred Thurman (Treasurer), Jarrett Bates (Secretary) and Paul White (Assistant Treasurer). All reside in the ESD #1 service area. Since the service area of HSB includes part of Burnet County, a Burnet County ESD #1 board is also in place whose commissioners are Kirk Robinson, Susie Keiser, Frank Sanders, Neil Younker and Jeffrey Guy. These board members are all volunteer positions and both boards meet jointly on the 4th Wednesday of the month at the Horseshoe Bay City Hall at 9 am. The public are welcome to attend these meetings.

Each board is separate from the other but work together to provide EMS service to the area. The boards have contracted the EMS service to Marble Falls Area Emergency Medical Service under the direction of Executive Director, Johnny Campbell. Response times and financials are reviewed at each board meeting and these boards set the budget and property tax rate each year. Financials are audited each year and presented to the Llano County Commissioner's Court for acceptance. As Llano County Commissioner I recommend appointments to the Llano County ESD #1 board to the Commissioner's Court for approval, but the board operates automatously without approval on its actions by the Commissioner's Court.    

As County Commissioner I attend the ESD #1 board meetings and am pleased to advise that both the ESD #1 boards and the contracted EMS service are doing an excellent job with a high concern for service and response times as well as being fiscally responsible in managing financials and setting property tax rates.

Baylor Scott and White EMS

Medical emergencies that take place in other locations in Llano County are responded by Baylor Scott & White EMS located in the City of Llano, Kingsland and Buchanan Dam. This service is contracted to Baylor Scott & White by the Llano County to provide this EMS service. Three ambulances respond to calls 24/7 in this service area with one Paramedic and one Emergency Medical Technician on each ambulance. One ambulance is located in the City of Llano, one in Kingsland and one in Buchanan Dam. There are no paid fire departments in this service area so Volunteer Fire Departments provide back-up response when requested. This EMS service provides response to most of the rural areas of Llano County covering about 972 square miles. The response rate target of 9  minutes for the City of Llano and Kingsland ambulances is met 76% and 84% of the time respectfully. The Buchanan Dam ambulance response target is 12 minutes which is met 84% of the time. This EMS service responds to almost 300 calls per month with about 50% to Kingsland, 35% to the City of Llano and 15% to Buchanan Dam.  

In addition to responding to medical emergency calls this EMS service follows up each month with past patients to help guide and advise with preventative care, such as heart patient care and to protect against falls to avoid emergency situations in the future if possible.

The fee for this service is $150,000 per year that is paid by Llano County from property tax revenue. This fee is paid to the State of Texas under what is called the "1115 Waiver" program. This program was established in 2013  and is currently in place to the end of 2018. Under this program Baylor Scott and White bill the state for expenses incurred and could receive as much as 2.5 times the amount the county paid if they meet certain service requirements. This helps keep the county costs low for this service and Baylor Scott and White receives reasonable compensation. This program is currently under review by the state and may or may not continue long term.

Llano County is proud to support these Emergency Medical Services to provide good quality emergency medical help to the residents of Llano County.


Peter Jones
Llano County Commissioner Pct 1
P.O. Box 8759
101 Ferguson Rd.
Email: commpct1@co.llano.tx.us
Bus phn: 830-598-2296
Cell: 830-385-3292
Fax: 830-598-5231