Breckenridge Texan

By Tony Pilkington/Breckenridge Texan

Beginning April 1, Sacred Cross Emergency Medical Services, Inc., will return as the emergency ambulance service for the City of Breckenridge and Stephens County.

According to Stephens Memorial Hospital CEO Brian Roland, at their Nov. 29 meeting, the Stephens County Hospital Board approved a three-year contract with Sacred Cross and the company is  scheduled to begin providing emergency services locally on April 1. Sacred Cross was the ambulance service provider for the city and the county from 2017 until April 1, 2020 when American Medical Response Ambulance Service, Inc. (AMR) took over after winning the bid for the services.

“With the beginning of 2023 comes great news for The Cross Nation! Effective April 1st 2023 SCEMS is going back home to our first 911 contract in Stephens County!” the company said in a Facebook post this week. “After 3 long years we could not be more excited to bring the Cross Nation back to the wonderful citizens of Stephens County! Sacred Cross EMS ownership and Management are very grateful to Stephens Memorial Hospital, Stephens County, Texas, and the City of Breckenridge for their trust in the service we provide.”

Roland said when the current contract came up for renewal, AMR withdrew their bid and Sacred Cross was the only provider that submitted a bid.

According to Roland, local officials were told by AMR representatives that since the company had been providing the services in Stephens County they had lost $700,000 a year, even after being paid a yearly combined subsidy of close to $300,000 by the City of Breckenridge, Stephens County and Stephens Memorial Hospital.

“(The AMR Representative) said AMR basically wanted the full cost of the losses. So their bid – if they bid– would have been close to a million dollars,” Roland said. “So, when they first came in, they basically said your subsidy, based on utilization, should be $275,000 a year. Okay, now, all of a sudden, they’re saying that the cost of non-covered, or the money they’re losing, is a million dollars. So they wanted each of us to pay the equal portion of that.”

That would have meant that the City, County and Hospital Board would each have had to pay over $300,000 a year each to cover the cost of what AMR said they were losing.

Roland said when he, County Judge Michael Roach and Breckenridge City Manager Cynthia Northrop originally met with AMR, the company had presented them with a specific amount of funding that they needed and the local officials were going to stick with AMR. “And then they basically came back and said they couldn’t do that,” he said. “It was now going to be almost three times as much. So yeah, we didn’t have much of a choice.”

Under the new contract with Sacred Cross, Roland said, the provider will be paid a $300,000 per year subsidy, which will be split by the Stephens Memorial Hospital District, Stephens County and the City of Breckenridge.

“So what it does is, we (the hospital) signed the contract with the ambulance service,” Roland explained. “And then there’s an agreement between the hospital and the city and the county to help cover that cost.”

Any other income Sacred Cross receives will be from revenue earned from payments by patients and their insurance companies for the ambulance services.

Roland said the decision to switch from AMR was strictly a cost-related decision and that the hospital has had no issues or problems with the service provided by AMR.

“It’s bottom line,” he said. “It was a dollar thing. We looked at the quality reports every month. We kept in contact with them. We had quarterly meetings with AMR. We didn’t have any issues with them. It was bottom line.”

The contract with Sacred Cross is a three-year contract with up to three annual renewals after the initial three-year contract.

“So what it is, is instead of having to do a brand new contract after three years, these are set up to auto renew. If you don’t let them know 60 days prior to each contract year date, it just automatically renews at the current rate,” Roland said. “That’s it for four to five to six, but then after six years, you have to have a new contract.”

Using the same ambulance facilities

Roland said he would like to see Sacred Cross locate their ambulances in the same facilities on West Walker Street where AMR currently houses their ambulances and crews.

“Our goal right now is mid January; I’m going to do a walk-through of that building with AMR because they actually lease that. And then I’m going to bring Sacred Cross in and see if it will work for them starting April 1. Our goal is to continue that lease on that property,” he said.

The cost of leasing the facilities, Roland said, would be divided between the City, County and Hospital Board. “But that will be minimal cost,” he said.

According to Roland, Sacred Cross will have the same ambulance setup and services that AMR currently provides. He said the way the contract is structured basically follows the same exact level of care as what AMR provides the hospital. He said a benefit for SMH using Sacred Cross is they are also located in Palo Pinto County, which means they have other ambulances that are close by if they need them.

“If we have a transfer to Abilene or to Dallas, rather than being in the middle by ourselves with no partnering ambulances around us, we’re basically backed up to a county that also has Sacred Cross,” he said.

Interlocal Agreements

Although the contract between the Stephens Memorial Hospital District and Sacred Cross has been approved and signed, the interlocal agreements between the Hospital District and the City of Breckenridge and Stephens County for providing their share of subsidies have not been approved yet. Those contracts are expected to be voted on during each of their February meetings.

However, during a Commissioners Court meeting on Dec. 12, there was an action item on the agenda and discussions among commissioners about the county’s part in approving subsidies to Sacred Cross.

Although the actual contract will not be voted on until February or March, the commissioners voted 3-2 on a motion to agree to pay the County’s one-third of the contract with Sacred Cross. County Judge Michael Roach and Precinct 3 Commissioner Will Warren voted against it after expressing concerns they had about some issues with Sacred Cross near the end of their contract in March 2020.

Roland said one of the things they are doing differently this time with the Sacred Cross contract is that every month a Sacred Cross representative will attend the Hospital District Board meeting and give a quality report.

“The goal with that is to ensure that nothing falls through the cracks. And everyone is aware of what’s going on. And also if the city wants them (to attend), or the county wants them to show up, they’ll show up for those meetings also,” Roland said.

He said as far as paying the subsidies, it would be just like with AMR and he’d ask for the year-end financials, just to ensure that the local entities are not paying for something that they don’t need to be paying for.

“But, realistically, if you look at the cost of ambulance services now and the losses that these entities are seeing in rural areas, I doubt we’ll ever see a place where the subsidy is not needed,” he said.

Option for the county to provide the services

Roland said the county could create its own ambulance service for residents in the county, but the cost is so high and the liability of so high it would not be something he would want to try to get set up here right now.

“I mean, the judge and the city manager and I talked about that, because I’ve done EMR services before. But the cost of getting it implemented, if you could find ambulances and if you can find staff, still would cost the county a million dollars a year, minimum. Here, you’re talking $300,000,” he said. “And I don’t have to worry about the ambulances; I don’t have to worry about the staff. They’re a separate entity. And the only thing we do is manage the quality and make sure that they’re hitting their numbers.”

Roland said he is very comfortable choosing Sacred Cross as the emergency ambulance service provider for the city and county.

“I’ve also had the benefit of working with Sacred Cross in other entities. So I worked with them when I was up in Cook County. They assisted the hospital and certain stuff…so yeah, I’ve worked with them before, so I feel real comfortable,” Roland said.

(Photo courtesy of Sacred Cross EMS, Inc.)