Port Arthur reviews EMS operations, response-time metrics and contract options

Port Arthur City Council on Aug. 7 heard a detailed workshop on emergency medical services that described how the city’s call-handling process and data systems affect published response-time figures and examined contract options ahead of the current provider’s November contract expiration.

The discussion, led by Marcin Nasoor, the assigned EMS battalion chief, and a representative of the current EMS provider, centered on three points: how the city’s public safety answering point (PSAP) and private ambulance dispatch processes start and record response-time clocks; whether response time alone is a sufficient measure of system performance; and operational options the council could consider, including colocating ambulances in fire stations and asking the city to run dispatch.

Nasoor told the council the Port Arthur Fire Department is a “first responder” organization with cross-trained personnel who begin care at many medical scenes before a transporting EMS unit assumes custody. He said more than half of the department’s call volume is EMS-related and urged the council to consider outcomes and clinical quality alongside response-time numbers. “Response time can be a useful tool,” Nasoor said. “It is not the whole picture.”

Why it matters: Council members said they want reliable, auditable data to measure contractor performance and to avoid incentivizing unsafe driving or other undesirable behaviors that can accompany an exclusive focus on clocks. The council also must address the expiring EMS contract while balancing cost, liability and patient access.

Key technical points raised

- Call start times and data ownership: Nasoor explained that 100% of 911 calls enter the city’s PSAP and the fire department’s response clock begins when the call is received there. The private transporting EMS provider receives the call after that transfer; because their dispatch clock begins when they receive the call, their reported response times can appear shorter or inconsistent compared with the fire department’s internal record. Nasoor described this as a “flaw” in how records are compared.

- NFPA standard and metrics: Nasoor referenced the nationally recognized standard NFPA 1710 (noting the transcript as NFPA 17 10) for response and turnout time obligations and said the city also uses ordinance benchmarks for turnout and response times. He argued for measuring patient outcomes, crew competency, protocol compliance and scene care quality in addition to raw travel times.

- Operational options and data merging: Council members asked whether the city could merge dispatch and ambulance CAD data or run dispatch directly. Nasoor and fire staff said technical and contractual work would be required and the ambulance provider would have to agree to some operational changes. Council members repeatedly requested a measurable timeline (30/90/180 days) for remedies.

Provider remarks and insurance

Andre, identified in the meeting as a representative of the city’s current EMS provider, told council the company accepts all insurance; whether a patient’s insurer treats the provider as in-network or out-of-network affects co-pay amounts. “We accept all insurance,” he said, and offered to discuss network status and billing issues in a sidebar with council members. Andre also said his organization supplies monthly CAD reports that include timestamps and that his organization can and has placed ambulances at fire stations if the city wishes such an arrangement.

Council concerns and next steps

Council members pressed several operational and policy points: that the city can adopt an ordinance to set local standards (so long as it does not conflict with state or federal law), that colocating ambulances at fire stations may reduce the apparent data gap, and that any change involving stationing ambulances at fire facilities raises insurance and liability questions that require further review. Chief Mitchell (Fire Department) confirmed that liability and insurance issues would need discussion and suggested an executive-session review with legal and risk staff.

Council directed staff to pursue follow-up work: produce an auditable timeline for potential fixes to data and dispatch integration, report options (including the feasibility and cost of the city running dispatch or colocating ambulances), and bring contract-extension/renewal options back to council. The city manager and city attorney were asked to advise on whether and how the current contract could be extended; meeting discussion indicated the current agreement cannot be extended past Nov. 30 without a procurement process.

Quotes

- “Response time can be a useful tool. It is not the whole picture,” Marcin Nasoor, assigned EMS battalion chief, said about measuring EMS performance.

- “We accept all insurance,” Andre, representative of the city’s current EMS provider, told council when asked about patients’ billing and network concerns.

- “We have to do better,” Councilmember Kinlaw said, describing constituent complaints that prompted prior policy changes.

Ending

Council did not take a contract vote at the workshop. The governing body asked staff to return with technical options, timelines and legal guidance, and it placed related items — including liability review for any stationing of provider ambulances in city facilities — on the agenda for further consideration and executive-session review.