ESD board cancels plans for tax election
San Jacinto Newstimes - March 2008

COLDSPRING – San Jacinto County Emergency Services District (ESD) board members voted Monday to cancel their plans for adopting a one-half percent sales tax election in May since the county announced their intentions for the same tax last week. “I’m not advising you to cancel the election but since the county has announced they are going to have an election for the one-half cent tax you might want to discuss all options,” the ESD attorney told board members. “If the county and the ESD both have an election for the same onehalf cents and taxpayers pass both elections the county would get the tax and not the ESD,” the attorney said. “The only way you could get it is if your election passed and the county’s failed,” he added. “If you cancel the election and the county moves forward with theirs in May and it fails, the county will be locked out of another election for one year. That would give you time to have your election in November during the general election,” he said. The attorney said he is looking into issues about how the county did its notice of election. “Your notice was done in two languages – English and Spanish. There’s a chance the county is not required to be bi-lingual. We are still working with the election administrator just as though you are going forward with the election,” he said.

Last week San Jacinto County Commissioners’ Court voted to call a public election on adopting a onehalf percent sales and use tax during the May 10 city and school board elections. The county already collects a onehalf cent sales tax which is used to alleviate ad valorem taxes. If adopted by voters, the election will give the county an additional one-half cent sales tax for a total one percent. If passed, the sales and use tax would affect everyone in the county with the exception of the City of Shepherd where the sales tax is already 2 percent.

The county must use the sales tax revenues to perform functions of the district such as the construction, maintenance or improvement of roads or highways; the provision of law enforcement and detention services; the maintenance or improvement of libraries, museums, parks or other recreational facilities; the provision of services that benefi t the public welfare, including the provision of fi refi ghting and fi re prevention services; or to promotion of economic development and tourism. In other business, ESD board members heard a presentation from Allen Sims with Montgomery County Hospital District on providing dispatching for the district.

No action was taken on the presentation. Sims told board members that his service would not remove whoever is dispatching ESD calls today, but would provide additional help for better outcome for patients. “It would give the sheriff’s department, who currently dispatches calls for the ESD, another resource to turn to for calls and gathering more information,” Sims said. Sim’s pilot program is underwritten by the University of Texas Medical Branch with support from Montgomery County Hospital District – EMS; City of Gatesville (Coryell County) Police Department; City of Lufkin (Angelina County) Emergency Communication Center and Faith Memorial Hospital (Jack County) EMS. Giving an overview of the pilot program, Sims said Senate Bill 523, passed by the 79th Legislature, directed the Area Health Education Center (AHEC) of the University of Texas Medical Branch (UTMB), to establish a pilot program to test the efficacy of using emergency medical dispatchers located in a regional dispatch resource center to provide life saving and other emergency medical instructions to persons who need guidance while awaiting the arrival of emergency medical personnel.

The East Texas Area Health Education Center undertook planning, development, implementation and evaluation of the emergency medical services dispatch resource center pilot program. An advisory group con-sisting of a representative of the EMS Advisory Council and leaders from the Texas EMS field were convened to participate in planning. A project team was composed of AHEC and EMS field staff from the participating sites. The Emergency Medical Dispatch Resource Center Pilot was activated once planning; technical accommodations and training were completed. The actual pilot ran from late June 2006, into September 2006, and ended with 400 transferred calls handled at the pilot dispatch resource center site operated by the Montgomery County Hospital District EMS Dispatch Center. Local 911 public safety answering points in Lufkin, Gatesville, and Jacksboro participated. The pilot was evaluated with internationally adopted, standardized quality improvement guidelines commonly used by state-of-the-art technology- supported dispatch centers, as well as by review of the project team and advisory group.

According to Sims, Rural EMS services are a vital part of the rural health care infrastructure that serves not just those living in the rural area, but also those who travel through, visit in, and seek recreation in rural Texas. EMS dispatch systems of today offer the trained dispatcher a sophisticated computer-based algorithm that enables the dispatcher to analyze the nature of the call, the condition of the victim, and the necessity of an emergency response that can be dispatched instantaneously. Additionally, the call may meet criteria for additional prearrival instructions to assist the caller with management of the victim in anticipation of the arrival of trained EMS personnel. Technology-based dispatch systems also incorporate quality assurance measures which are routinely reviewed for quality assessment and quality improvement interventions for dispatchers, responders, and the system itself. These intelligent technology-based dispatch systems support the dispatcher with a set of well-researched scripted questions and responses (protocols) that assist the on-the-scene caller with life-saving instructions. Dispatcher training is critical to effectiveness, and includes training in the use of communications equipment and protocols. To ensure that on-going training is effective, the advanced technology-based dispatch systems include quality improvement (QI) assessment measures with statistically significant benchmarks and markers that guide improvement of performance.

To foster maximum effectiveness, the QI elements identify dispatcher behavior that results in underutilization of resources that can negatively impact patient outcomes and over-utilization of resources that are not cost-effective and do not impact patient outcomes. Furthermore, the QI elements meet the National Association of Emergency Medical Service Providers and the National Institute of Health positions on standards for scripted dispatch instructions for the on-the-scene caller and specialized dispatch training. These reliable dispatch systems are recognized nationally and internationally by the industry to be effective strategies for improving pre-hospitalization emergency care. Texas’ EMS infrastructure, and especially the rural EMS infrastructure, is a complex patchwork quilt. Urban settings usually have well-developed technology-based dispatch systems staffed by trained dispatchers.

Rural EMS infrastructure usually results from the well-intentioned efforts of dedicated local individuals who are compelled to work with a wide range of conditions to create a response system defined by availability of local resources, including personnel, equipment, training, administrative hierarchy and leadership interest. This engenders a wide range of technical sophistication, administrative proficiency, and basic service effectiveness. Rural EMS systems range from the use of a minimally trained individual who answers the phone and dispatches a first responder for any request, to fully trained dispatchers who use computer-based algorithms and patient care protocols to assess the call and specifically dispatch emergency care providers. Rural EMS and 9-1-1 program systems are funded through mechanisms that combine local, state, and federal dollars.

They are somewhat dependent upon local agency proficiency in defining and representing their needs, according to Sims. “The system is not designed to be on forever,” Sims said, “only until quality improvements are initiated.” The ESD’s cost for the program would be about $30,000 to $40,000 annually, according to Sims who added that there would be no cost associated with training.