On a Tuesday evening earlier this month, outside Ralls City Hall, nearly two dozen residents waited in the 90-degree heat of Texas. For two hours, they eagerly awaited a word from their city leaders on whether they would retain their emergency medical service (EMS) – the city’s latest lifeline after a series of budget cuts.
The rural town is at a stalemate that has become a common reality in other rural Texas communities where access to health care has been crippled. Crosbyton Clinical Hospital is approximately 9 miles with just two beds, and Ralls is between Crosbyton and Lubbock. The clinic is primarily used to stabilize patients before transferring them to Lubbock, which is an additional 30 miles, and a return trip via Ralls, further away.
Crosby County has less than six thousand residents and, according to data from the American Public Media Research Lab, 19% of their residents are uninsured. The 2019 census shows that 19% of the county’s residents are 65 or older.
Recently, Ralls City Council considered shutting down the EMS service as it was operating over budget, with little revenue. At a town hall meeting last month, residents expressed how important the service was to their community. Suddenly, without notice, the EMS was temporarily closed last week.
Residents have already seen the effects of this choice.
“The day after our ambulance was suspended my mother fell,” said Kathylynn Sedgwick, from Ralls who is caring for her 80-year-old mother. She described the situation in detail during a public hearing this week.
“She cut her head off enough to get seven staples,” Sedgwick said. “It broke my heart, as a person who has been here all my life. So I loaded her up and we went to Lubbock ER.
Sedgwick was one of eight residents who voiced concerns at the hearing, and although some acknowledged the lack of funds, no one spoke in favor of closing the station. About 20 minutes after the start of the event, the council broke into a two-hour executive session, shutting the doors to the public.
Sarah Jamerson was the director of Ralls EMS, but resigned last month. She grew up in Ralls and her grandmother started the service, so she jumped at the chance to come back and help keep the station open last year.
But the budget is tight – the town of Ralls operates the EMS service and Jamerson said $ 40,000 is allocated to the station by city council, but that is not enough to run the station.
“The health and well-being of the citizens of this city is worth more than the $ 40,000 that is currently in our budget,” Jamerson said at the meeting.
“I feel betrayed,” Jamerson said. “I did all I could to save him, but at the end of the day I couldn’t do it on my own and I certainly couldn’t do it with some advice that is going to stab me in the back while I try to. “
Texas Tech Public Media spoke to Jamerson on several occasions while working on a project with Texas Newsroom and the PBS FRONTLINE series that focuses on rural health care in the state.
In May, she explained that the EMS service was operating in the red due to a lack of income and growing expenses for equipment and training.
“The problem with EMS, as it grows as an industry, it inherently becomes more expensive to do,” Jamerson explained, “and the revenue stream doesn’t follow and evolve not as fast as spending. “
Jamerson added, “Training and personnel are getting more expensive, equipment and requirements are getting more expensive, and ambulances are more expensive. And gasoline is also getting more expensive, but not the reimbursement rates.
It doesn’t help, Jamerson said, that the salary offered to potential employees is lower than in neighboring towns, like Idalou, where they offer paramedics and advanced paramedics more than $ 3 per hour than in Ralls. In Ralls, the salary varies between $ 8 and $ 10 an hour and taxes are not withheld.
After his resignation, four other EMS employees left the station. Chris Pickering has been appointed interim director of the EMS, but the funding issues have not gone away. He resigned on July 9.
“When the last four people who quit said it was about pay and taxes,” Jamerson said at the meeting, “and we say you have to set the pay and the answer is a flat no , it has absolutely nothing to do with me or with Chris [Pickering]. It has to do with the people who make budget decisions in this room. “
Mayor Don Hamilton reminded everyone at the start of the meeting that city council was under no obligation to respond or respond to comments made that evening, so little was said by council that evening.
With the closure of Ralls EMS, Crosbyton EMS is the county’s only ambulance service. He only has two trucks. Pickering has addressed its main concern to city officials. “Crosbyton has no obligation to answer 911 calls from Ralls and Lorenzo.”
“They cannot function with the budget they have and continue to manage this whole county,” he continued. “They are doing all they can because they love the citizens of this community, but the day is fast approaching when you can all call 911 and no one will answer.
Pickering said he is “banging his head against the wall” trying to find a way to attract new employees and resolve the staffing issue. The only solution he could offer is to offer a better salary, which would require reallocating funds from other areas of the budget.
“If Ralls bends, he bends the whole system,” Pickering said. “And the ultimate suffering is for everyone in this room.”
Steve Beck, CEO of Crosbyton Clinic Hospital, said Crosbyton EMS faces the same staffing issue and also serves as a transport service for patients from Crosbyton to Lubbock, so it is not always available at all times.
“If you have a team that transfers a patient to Lubbock, you have 30 to 45 minutes to travel and then go through the process to transfer that patient,” Beck explained. “Then they have to turn around and go back to Crosbyton, so you’re talking about a two hour lapse.” When that happens, this county is now without this service. “
“What is more important: the budget or our citizens? Jamerson asked. “My wife and I have already had serious conversation about [whether or not] we can feel safe in a community that does not have EMS.
She comes from a long line of residents of Ralls – seven generations in total. As her family have dedicated their lives to the health and safety of her hometown through EMS, she now finds herself thinking, “I don’t know if it’s safer for us to be here.
When the city hall gates reopened two hours later, Mayor Don Hamilton and council accepted Chris Pickering’s resignation as interim EMS director and voted for Bobby Beene as his replacement. Less than two minutes after being called back to session, the meeting was adjourned. The inhabitants remained perplexed.
“So are the [EMS] open doors ? Jamerson asked. One board member shrugged, while others provided unclear answers.
Almost two weeks after the meeting, Kim Perez, the administrator for the town of Ralls, said Beene had put together a new team for the station and it was currently reopened.
– Edited by Kaysie Ellingson
This story is part of a collaboration with The Texas Newsroom through the FRONTLINE Local Journalism Initiative, which is funded by the John S. and James L. Knight Foundation and the Corporation for Public Broadcasting.