* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.
          [00:00:05]
          TO A SPECIAL MEETING, AN EMERGENCY MEETING OF THE, UH, KAMAN COUNTY COMMISSIONER'S COURT. 
          TODAY'S FRIDAY, FEBRUARY THE 27TH. 
          IT'S 10 O'CLOCK, AND WE A LITTLE AFTER 10 ACCIDENT. 
          WE'LL BEGIN OUR MEETING NOW AND WE WILL, UH, PASS OVER THE, UH, OPENING CEREMONIES AND ENTER RIGHT INTO, UH, THE BUSINESS AT HAND. 
          I DO APPRECIATE EVERYBODY BEING HERE TODAY ON A SHORT, SHORT NOTICE. 
          AND, UH, THIS IS, UH, UH, AN IMPORTANT SUBJECT FOR US,  COUNTY TO, UH, TO HANDLE. 
          SO, UH, ITEM NUMBER ONE IS, UH, PURSUANT TO TEXAS GOVERNOR CODE 5 51 0 4 5 B ONE, REVIEW OF CONSIDERATION OF ANY PROPOSED CONTRACT, ASSIGNMENT OR LETTER AGREEMENT FOR AMBULANCE SERVICES FOR KAMAN COUNTY, UH, FOR EAST TEXAS MEDICAL CENTER CARE FLIGHT, OR ANY OTHER RELATED ENTITIES FOR THE REMAINDER OF THE 2015 AND OR FISCAL YEAR 2015. 
          THE COURT MAY DISCUSS ALL MATTERS RELATED TO THE AMBULANCE SERVICE PROGRAM WITH THIS TEXAS MEDICAL CENTER AND TYLER AS IT RELATES TO THE CANCELLATION OF THE EXISTING CONTRACT WITH CAIN COUNTY. 
          UH, THE COURT MAY ALSO REVIEW AND AUTHORIZE ONE OR MORE PERSONS TO FINALIZE SPECIFIC TERMS AND CONDITIONS OF ANY AGREEMENT FOR AMBULANCE SERVICE FOR THE REMAINDER OF 2015 AND OUR FISCAL YEAR 2015, THAT SERVE TO MINIMIZE THE IMMINENT THREAT TO THE HEALTH AND SAFETY TO THE CITIZENS OF CALTON COUNTY, TEXAS. 
          AND I BELIEVE JUST FOR HISTORY, THAT'S THE LONGEST ITEM I'VE EVER SEEN ON A AGENDA. 
          SO, AND, UH, COMPLIMENTS OF MR. LONG. 
          SO, UH, GENTLEMEN, WELL, I GUESS SO APPLE JUST LET, UH, OUR ATTORNEY, DISTRICT ATTORNEY FROM THE DISTRICT ATTORNEY'S OFFICE AND MAKE A PRESENTATION. 
          I APPRECIATE THAT. 
          I THINK THAT STEVE EY AS TO MAKE PRESENTATION. 
          HE HAS QUESTIONS OR COMMENTS ON THAT. 
          THANK YOU. 
          UM, JUDGE COMMISSIONERS, UH, SINCE ALL THIS OCCURRED, WHEN WE FIRST GOT THE NOTICE THAT EAST TEXAS WAS GOING TO WITHDRAW FROM THE COUNTY, UH, THERE, THEY WANTED TO ASSIGN THEIR CONTRACT TO CARE. 
          AND CORRECT ME IF I'M WRONG HERE, BUT JOHN SAID THAT THAT'S NOT IN THE CONTRACT. 
          SO WHAT, UH, I DID ALONG WITH SOME OTHERS IS WE HAVE TALKED WITH, WITH CARE PLAID AND COME UP WITH A SEPARATE COMPLETELY VOLUNTARY AGREEMENT WITH YOUR BLACK TO TAKE CARE OF THE INTERIM TIME PERIOD, UH, BETWEEN NOW AND THE END OF THE YEAR, SO THAT, UH, IT WILL ALLOW US TIME TO DO A PROPER RFP AND LOOK AT ALL OF OUR OPTIONS AND ALL OF THE PEOPLE THAT COULD SERVE US. 
          SO, AND, UH, EXCLUDING ANYTHING THAT, YOU KNOW, JOHN WANTS TO DO BECAUSE HE'S THE ATTORNEY AND I'M JUST AN OLD FORMER FIREMAN. 
          SO, UH, I WOULD RECOMMEND WE GO WITH CARE FLAT PURSUANT TO THE, UH, LANGUAGE AND EVERYTHING THAT JOHN AND CARE FLAT HAVE OR WILL AGREE. 
          I, I THINK THAT IN THE NEGOTIATIONS, JOHN MAY I DO, DO WE HAVE REPRESENTATIVE SHEER FROM CARE FLAT? I, I KNOW. 
          DO I THINK I SAW HAVE, UH, JIM SCHWARTZ, THE, UH, CHIEF PRESIDENT CEO PRESIDENT? IS ANYBODY HERE FROM, UH, EAST TEXAS MEDICAL? NO, SIR. 
          OKAY. 
          I DIDN'T WANTED TO PROCEED. 
          A COUPLE OF OBSERVATIONS. 
          THE FIRST OBSERVATION IS THAT, UH, BOTH THE EMERGENCY ITSELF AS WELL AS IN AGREEMENT ON WANTING TO REFLECT THAT THE EMERGENCY RULING ON BY THIS TEST MEDICAL CENTER IS NOT BY SOMETHING THAT'S WORKED IT OR FAIL TO DO. 
          YES. 
          AND, AND THE CAUSE OF THE EMERGENCY WAS COMPLETELY OUTSIDE OF THE COMMISSIONER'S COURT ITSELF AND, AND ANY, UH, ACTION THAT IT HAD TAKEN OR FAILED TO TAKE. 
          AND, AND THAT'S REFLECT TO BOTH IN THE NOTICE TODAY AND ALSO IN THE AGREEMENT. 
          THE SECOND THING I WANT TO TELL THE COURT IS THAT THE TERMS OF THE AGREEMENT HAVE REALLY BEEN HAMMERED OUT WITH STEVE. 
          AND SOMETHING I WOULD WANT THE COURT TO KNOW AS WELL AS THE PUBLIC TO KNOW IS THAT, UM, IT'S, IT'S CAUSED A REVIEW OF THE RESPONSE TIME AND OTHER PARTICULAR, SO A 20-YEAR-OLD AGREEMENT. 
          FRANKLY, IT'S BEEN VASTLY IMPROVED FROM WHAT WE HAD BEFORE TO WHAT WE HAVE TODAY. 
          AND SO, UH, IF, IF NOTHING ELSE IS A SERIOUS UPGRADE AND AND SERVICE THAT, THAT, 
          [00:05:01]
UH, SHOULD BE PROVIDED FOR THE CITIZENS. 
          UM, AND, AND THAT'S, UH, I GUESS THE GOOD NEWS TO COME OUT OF THE BAD NEWS IS, IS THAT, UH, BANK CARE PLAN HAS BEEN COOPERATIVE THROUGH THE NEGOTIATIONS. 
          WE HAD DIFFERENT REQUESTS THAT WE WANTED AS PART OF THE CONTRACT, AND I THINK THIS HAS BEEN ACCOMMODATED. 
          AND THE LAST ONE, UH, THAT I WAS AWARE OF WAS JUST A VENUE PROBATION, MAKE SURE VENUE FOR THE DISPUTES IS INMAN COUNTY. 
          SINCE IT'S REQUIRED UNDER STATE LAW, I THINK NOW'S GONNA GO THROUGH IT. 
          AND, UH, MR. SWARTZ IS HERE AND I THINK HE'S SEEN THE DIFFERENT REVISIONS THAT BEEN SUGGESTED, AND I THINK HE'S IN AGREEMENT. 
          UM, AND THAT WILL GIVE US A CHANCE TO LOOK AT CAREFULLY ALSO TO ALLOW US TO, UM, PUT THIS WHOLE PROCESS THROUGH AN RP, UM, THIS UPCOMING BUDGET CYCLE AND SEE WHAT WE WANNA DO AS A NEXT STEP. 
          OKAY. 
          UH, COMMISSIONERS, Y'ALL HAVE ANY QUESTION OF, UH, STEVE OR, UH, JOHN? I, I'VE LOOKED THROUGH THIS CONTRACT PRETTY, PRETTY WELL, JOHN. 
          AND, UH, HAVE WE PAID, UH, EAST TEXAS MEDICAL FOR OUR COUNTY EMPLOYEE? I KNOW PAY CARE PLAN FOR STARTING IN MARCH, IS THAT NOT CORRECT? I CAN ANSWER THAT. 
          THE COUNTY HAS PAID EAST TEXAS. 
          THEY SAID THEY WILL REIMBURSE THE COUNTY IN A PRORATED SHARE. 
          UH, WHILE WE HAVE PAID THEM, UH, ON THE OTHER SIDE OF THAT CARE, FLAT HAS AGREED TO TAKE IN OUR COUNTY EMPLOYEES AT A RATE LOWER THAN WHAT WE WERE PAYING, UH, EAST TEXAS FOR. 
          SO BASED UPON THE NUMBERS, WHAT THEY GIVE US MEDICAL TO COVER, UH, WHAT WE WOULD NEED TO PAY TO, UH, CARE FLAT TO KEEP OUR EMPLOYEES COVERAGE. 
          UH, JUST TO BE CLEAR AND GENTLEMEN, IF ANY OF YOU HAVE QUESTIONS, PLEASE, PLEASE JUMP IN HERE. 
          JUST TO BE CLEAR, THE, THE NOTICE THAT WE RECEIVED FROM EAST TEXAS MEDICAL CENTER, UH, THEIR REQUEST OR ALMOST A DEMAND WAS IS THAT MAY BE RELEASED FROM THE CONTRACT ON FEBRUARY THE 28TH AT MIDNIGHT. 
          IS THAT WHEN THIS WILL TAKE EFFECT? IT WAS MARCH 1ST WAS SEVEN 7:00 AM MARCH 1ST AT 7:00 AM YES SIR. 
          THAT'S WHEN CARELY WOULD TAKE OVER THE SERVICES FROM ET. 
          YES, SIR. 
          OKAY. 
          JIM, UH, I HAD A DISCUSSION WITH MR. SCHWARTZ. 
          I WISH HE WOULD EXPLAIN THOSE OF US THAT HAVE A, UH, CONTRACT WITH THEM. 
          IN OTHER WORDS, MY OWN PERSONAL AGREEMENT, IF HE'D EXPLAINED HOW THAT, HOW THAT IS AND WHAT IT COSTS, WHAT WE'RE GONNA DO, WHAT HE'S GOING TO DO FOR US CITIZENS OUT THERE THAT, THAT HAVE THESE AGREEMENTS WITH THE EAST TEXAS. 
          I WAS GONNA ASK MR. SWARTZ TO COME UP AND GIVE US A, UH, WE MET YOU, SOME OF US SAT UP OVER THE PAST AND, UH, UH, I KNOW, UH, YOU'VE INDICATED YOU WOULD DO SOME THINGS TO MAKE THIS TRANSITION AS SMOOTH AS POSSIBLE, PERIOD. 
          SURE, CERTAINLY. 
          I, I APPRECIATE THAT. 
          AND I KNOW THE COURT DOES AS WELL, BUT THERE ARE QUESTIONS LIKE THAT THAT PEOPLE WILL HAVE QUESTIONS, YOU KNOW, WONDER, WONDER ABOUT. 
          OF COURSE. 
          WELL, I'M HONORED TO BE THE, UH, OBJECT OF THE LONGEST AGENDA ITEM HISTORY. 
          AND UH, I'M ALSO HONORED TO BE FIRST ON AGENDA BECAUSE WHEN YOU'RE A JOB LIKE MINE, YOU APPEAR BEFORE LOT FOUR ENTITIES. 
          YOU CAN ALWAYS TELL WHERE YOU STAND BY WHAT THEIR NUMBER IS ON THE AGENDA, ESPECIALLY AT NIGHT MEETINGS WHEN YOUR NUMBER 30, WELL, IT WAS KIND OF FORCED TO PAUSE, YOU KNOW, NOT BY US. 
          IT'S NOT BY US. 
          I UNDERSTAND. 
          UM, YOU KNOW, WE JUST STEPPED INTO THE BREACH. 
          WELL, THE ANSWER, THE SPECIFIC QUESTIONS ABOUT THE MEMBERS WHO ARE, UH, WHO ARE CURRENTLY ETM C MEMBERS, THEY'LL GIVE THEM A PROGRAM OF REFUND AND CARE FIGHT IS IF YOU'RE AN EAST TEXAS MEMBER, CURRENTLY WE'RE GONNA PERMIT PEOPLE TO JOIN OUR PROGRAM FOR $12 A YEAR, WHICH IS A HOUSEHOLD RATE. 
          WE ONLY SELL IT BY HOUSEHOLDS. 
          AND THAT'S REALLY TO COMPENSATE THEM FOR THE INCONVENIENCE. 
          THE TYPICAL PUBLIC RATE FOR US IS $49 A YEAR PER HOUSEHOLD, BUT WE'RE GONNA DO IT FOR 12 FOR ANY CITIZEN WHO'S AN EAST TEXAS MEMBER. 
          UM, BECAUSE I WOULD SAY THAT THE MORE INCONVENIENCE, I THINK THERE'S PROBABLY BEEN A LOT OF, UH, CONCERN ABOUT GM S ITSELF, BUT I THINK THAT'S PROBABLY MADE SOME PEOPLE NERVOUS, UH, WHICH WAS NOT OUR MAKING. 
          BUT, BUT WE STILL THINK THAT'S THE RIGHT THING TO DOS. 
          A NON , IT'S OVERSEEN BY, UM, TEXAS HEALTH, WHICH INCLUDES THE ATTORNEY HOSPITAL HERE, BAYER SCOTT FLIGHT, METHODIST HEALTH SYSTEM IN DALLAS, JPS, THE PUBLIC SYSTEM OF KE COUNTY AND PARK ON THE PUBLIC SYSTEM IN DALLAS COUNTY. 
          AND I WOULD SAY IF THERE'S ONE THING OPERATIONALLY THAT WILL MAKE THIS VERY DIFFERENT, UM, THIS IS OUR HOME. 
          WE'VE BEEN FLYING HERE FOR 36 YEARS IN THIS COUNTY AND WE HAVE A LOT 
          [00:10:01]
OF RESOURCES IN DALLAS COUNTY. 
          WE RUN THE 9 1 1 SYSTEM IN FALLS SPRINGS AND SOUTHEAST DALLAS COUNTY. 
          AND SO FOR US TO GIVE ADDITIONAL RESOURCES INTO THE COUNTY, WHETHER IT'S A BIG EMERGENCY, GOD FORBID, SUCH AS VACO OR SOMETHING LIKE THAT, WHERE WE HAVE MORE  RESOURCES THAN ANY OTHER ENTITY, WE JUST, JUST ON THE OTHER SIDE OF THE COUNTY LINE, WE HAVE A LOT OF RESOURCES. 
          AND WHAT THAT MEANS ON A DAY TO DAY BASIS IS GENERALLY SPEAKING, UH, WE WOULD NEVER PERMIT MORE THAN ONE OF OUR AMBULANCES IN THE COUNTY DO A HOSPITAL TRANSFER. 
          WE WOULD SEND AN AMBULANCE OUT FROM WAL SPRINGS TO GET THAT PATIENT AND TAKE HER BACK IN TOWN BECAUSE DEFENDING THE 9 1 1 AND, AND MEETING THE RESPONSE TIME COMPLIANCE IS THE SINGLE MOST IMPORTANT PART OF THESE AGREEMENTS. 
          YOU KNOW, GETTING TO THE PATIENT'S 90% OF THE TIME ON THE STANDARDS. 
          UM, YOU KNOW, I'VE READ ALL THE OTHER AGREEMENTS AND THE AGREEMENTS THEMSELVES ARE CONFUSING, FIRST OF ALL. 
          AND SECOND OF ALL, ONLY CARE IF I CAN SCOTT CARE. 
          I, UH, THE FIRST RESPONDERS WHO WE RELY ON, WHICH, WHICH WE SHOULD DO AND, AND IT'S APPROPRIATE TO, AND THEY DON'T STOP OUR COUGH ONLY WE STOP OUR COUGH WHEN WE GET TO THAT PATIENT. 
          AND, AND THERE'LL BE MONTHLY REPORTS GIVEN TO STEVE THAT WILL SHOW EVERY SINGLE RESPONSE THAT WE MADE AND HOW WE PERFORMED UNDER THE SYSTEM. 
          AND, UH, FROM MY PERSPECTIVE, WE TREAT THIS AND THIS IS WHAT I BELIEVE IT COULD BE MY KID WHEN I'M ON THE SIDE OF THE ROAD AND THAT WHAT IS IT THAT I WOULD WANT? THAT'S WHAT THE STANDARD, VERY SERIOUSLY, WE TAKE THIS RESPONSIBILITY VERY SERIOUSLY BECAUSE IT STANDS TERRIBLE, TERRIBLE, TERRIBLE CIRCUMSTANCES. 
          IT'S UNIQUE TO HAVE FIVE SYSTEMS, UM, OPERATE ENTITY LIKE THIS OVER A FEW OF THESE IN THE UNITED STATES. 
          THIS IS THE OLDEST ONE FACTOR, WHICH MULTIPLE HOSPITAL SYSTEMS GOT TOGETHER BECAUSE THEY DIDN'T WANT TO BE COMPETITORS. 
          THEY WANTED TO DO THIS AS AN OVERALL COMMUNITY PROJECT. 
          NOW WE ONLY OPERATED OVER TEXAS. 
          UM, AND UNLIKE YOUR PREVIOUS UH, ENTITY, I'M NOT THE REGIONAL MANAGER. 
          SO I DON'T HAVE ALL THE TECHNICAL KNOWLEDGE, BUT I HAVE THE AUTHORITY TO COMMIT CARE, FIGHT TO THINGS. 
          AND PEOPLE WHO KNOW ME WILL TELL YOU AND TURN UP AT THE MEETINGS AND I'M ACCESSIBLE. 
          WE ALL HAVE MY CARD AND IT INCLUDES MY CELL PHONE NUMBER. 
          AND IF IT'S IMPORTANT ENOUGH TO A CONSTITUENT TO CALL YOU AT 10 O'CLOCK AT NIGHT, YOU BETTER BE CALLING ME. 
          I'LL PROBABLY BE ASLEEP, BUT I'LL PICK THE PHONE OUT AND I'D PROBABLY NOT BE TOO LITERATE AT 10 O'CLOCK AT NIGHT. 
          BUT IT'S IMPORTANT ENOUGH TO THAT CONSTITUENTS THAT THEY HAVE CONCERN, I WANT TO KNOW ABOUT IT RIGHT NOW. 
          I'M OVER HERE THREE WEEKS LATER, SO-AND-SO WAS UPSET ABOUT THIS OR THAT. 
          SO, UH, I THINK WE HAVE A GREAT RAPPORT WITH YOUR FIRST RESPONDER COMMUNITIES. 
          ALL THE FIRE DEPARTMENTS, UH, YOU KNOW, SPEND PLENTY TIME WITH US, KNOW OUR CAPABILITIES, PROVIDING MEDICAL DIRECTION FOR THOSE FIRST RESPONDERS. 
          I I COULD TALK ABOUT CARE ALL DAY, BUT I'LL STOP AND LET YOU ASK ME ANY QUESTIONS WHERE THE DAMAGES GONNA BE STATIONED, UH, EXACTLY WHERE THEY ARE NOW. 
          ANY SAME QUESTION THEY ARE NOW, AND I'M NOT GONNA SAY THEY MIGHT NOT ULTIMATELY ADJUST THE LOCATION TO FACILITATE THE BEST POSSIBLE RESPONSE SOMETIMES, UM, 'CAUSE THAT'S BE SOMETHING WE STUDY EVERY MONTH TO SEE, UM, IN HERE IN THE CITY OF KAUFMAN. 
          UM, AT THE MOMENT, BOTH TRUCKS ARE ONE STATION AND WE HAVE TENDED TO WANT TO SEPARATE THOSE AS A MAP BECAUSE IT'S EASIER TO GET A BIGGER AREA WITHIN THE TIMEFRAMES REQUIRED. 
          BUT, YOU KNOW, WE'LL HAVE TO STUDY THIS MONTH OR SO TO SEE HOW THAT'S WORKING OUT. 
          SO WE'RE STAYING FROM THE SAME, SAME NUMBER OF THAT. 
          YES. 
          BUT CAREFULLY, CARELY WILL PROVIDE WHATEVER RESOURCES ARE REQUIRED TO MAINTAIN THE, THE MINIMUM, THE COMPLIANCE. 
          SO IN JOHNSON COUNTY IS AN EXAMPLE WHERE WE'RE IN OUR 11TH YEAR, WE STARTED OUT WITH THREE 20 FOURS AND A 12 HOUR TRUCK. 
          CAN YOU SPEAK UP JUST A, I'M SORRY. 
          WHAT, WHAT, UH, SOME OF US AROUND THIS TABLE ARE A LITTLE, I'VE BEEN AROUND AVIATION ALL MY LIFE AND I DON'T, I DON'T HEAR SO WELL EITHER. 
          AT LEAST MY WIFE FITS IT IN, UH, , UH, JOHNSON COUNTY 11 YEARS AGO WE STARTED WITH 3 24 HOUR TRUCKS IN A 12 HOUR TRUCK. 
          TODAY I PEAK A POINT WITH THIS EIGHT AND, AND THAT IT HAS NOTHING. 
          YOU'RE NOT, YOU ARE NOT CONTRACTING WITH US FOR THE NUMBER OF AMBULANCES YOU ARE CONTRACTING WITH US TO MEET THE COMPLIANCE AND GET TO THE PATIENTS IN THE TIME OF THE TRIALS. 
          NOW THIS HAPPENED VERY QUICKLY AND STEVE AND I WORKED VERY HARD ON THE LANGUAGE THAT'S IN THE CONTRACT. 
          AND YOU 
          [00:15:01]
WILL, YOU ARE GONNA SEE THAT IN THE FIRST 90 DAYS, THERE AREN'T GONNA BE ANY PENALTIES BECAUSE WE HAVE TO BE ABSOLUTELY CERTAIN THAT THE RESPONSE TIMES ARE REASONABLE. 
          AND THE STANDARD IN THE CONTRACT IS THAT NO RESPONSE TIME CAN BE FASTER THAN THE TWO MINUTES FROM THE DISPATCH THAT WE HAVE TO GET OUT OF THE STATION. 
          PLUS DRIVING TO THE LOCATION AT THE SPEED LIMIT. 
          UM, MOST PEOPLE DON'T KNOW THIS, BUT THE AMBULANCE, AMBULANCE BUSINESS IS ONE OF THE MOST HAZARDOUS PROFESSIONS IN THE COUNTRY. 
          AND, AND WORKERS AND PATIENTS AND PUBLIC GET KILLED FROM INTERSECTION CRASHES PREDOMINANTLY. 
          AND SO WE SPENT A LOT OF TIME AND ENERGY, WON A LOT OF AWARDS AND PAID VERY CLOSE ATTENTION TO SAFETY ASPECTS OF THIS OPERATION. 
          SO, UM, YOU MAY SEE THAT YOU, THERE MAY BE SOME ADJUSTMENTS, UM, AT, IN THE THIRD MONTH IF THERE ARE PLACES THAT WE, WE CAN'T PHYSICALLY GET TO WITHOUT SPEEDING. 
          'CAUSE SPEEDING LEADS TO CRASHES AND CRASHES LEAD TO, TO, AND THE FIRST RULE IN OUR BUSINESS, WHICH IS A MEDICAL BUSINESS, ULTIMATELY IS TO DO NO HARM. 
          AND WE, WHAT WE DON'T WANT TO DO IS HURT ANYBODY WHILE WE'RE TRYING TO PROVIDE THE SERVICE. 
          AND UH, SO I JUST POINT THAT OUT TO YOU SO EVERYBODY'S COGNIZANT OF THAT. 
          SO, UM, WE'RE GONNA SEE HOW IT'S GONNA WORK. 
          I THINK THE EMPLOYEES ARE, 9% OF THE EMPLOYEES WHO, WHO ARE HERE TODAY FOR EAST TEXAS HAVE COME TO WORK FOR PARA FIGHT. 
          WE'VE BEEN RUNNING CLASSES FOR THE LAST TWO WEEKS, UH, GIVING THEM 40 HOURS. 
          NOT HOW BE A MEDIC, BUT HOW DOES CARE FIGHT DO IT? HOW DOES OUR DOCUMENTATION SYSTEM WORK? AND I THINK, AND I'VE MET EVERY SINGLE EMPLOYEE AND I THINK THAT THEY, UM, ARE PLEASED WITH THE FACT THAT THEY'RE GONNA HAVE A LOT MORE SUPPORT IN DOING THEIR JOBS BECAUSE WE HAVE SO MANY MORE ASSETS AVAILABLE. 
          UM, WHICH IS, WHICH IS AN IMPORTANT, YOU KNOW, KEY ELEMENT WHY THIS WORK. 
          AND YOU'LL RUN YOUR RFP AND THEN YOU'LL PICK US BECAUSE TO KNOW US IS THE LOVE US. 
          AND, AND, AND 'CAUSE WE DO THE JOB. 
          THAT'S THE REPUTATION THAT WE HAVE. 
          WE'RE TRANSPARENT, WE RESPOND. 
          I'M NOT SAYING WE WON'T MAKE MISTAKES, I'M SURE WE'LL, IT'S A HUMAN ORGANIZATION. 
          ANY OF 'EM WE KNOW ABOUT, WE'LL FIX. 
          AND WE WON'T MAKE THE SAME ONE TWICE. 
          WE'LL MAKE NEW ONES. 
          WE'RE NOT, WE'RE NOT GONNA MAKE THE SAME EXACT STATEMENTS TWICE. 
          AND UH, THIS HAS BEEN, UH, THE MOST INTERESTING MONTH WE BE HERE, BUT THE 10 YEARS I'VE BEEN CAREFUL BY PARTICULARLY WITH ALL THE TECHNICAL REQUIREMENTS TO GET THE CALLS TRANSFERRED FROM ALL THE DISPATCH CENTERS AND TO GET AGREEMENTS WITH THE, THE TWO CITIES THAT ARE SEPARATELY CONTRACTING, BOTH OF WHICH HAVE ALREADY APPROVED THEIR, THEIR SITUATION AS THEY SEE IT. 
          SO, AND I BELIEVE YOU DO HAVE THE TWO SEPARATE CONTRACTS, THE CITY OF TERRELL AND THE CITY OF COLLEGE. 
          YES SIR. 
          WE DO. 
          YES SIR. 
          WE DO. 
          UH, AND THIS MAY BE IN, IN HERE AND I MAY HAVE OVERLOOKED IT OR YOU MAY HAVE UH, SAID IT WHEN I WASN'T LISTENING AS CLOSELY AS MAYBE I SHOULD HAVE BEEN, BUT AT ONE TIME THERE WAS DISCUSSION ABOUT HAVING SOME TRANSFER AMBULANCES. 
          IF WE HAD, UH, AN ISSUE WITH A, SOMEBODY NEEDED TO BE TRANSFERRED FROM A NURSING HOME RIGHT. 
          TO A HOSPITAL, WHATEVER. 
          IS THAT STILL A HOSPITAL? SURE. 
          WELL LOOK, AS MANY RESOURCES OUR ARE NEEDED TO MAKE THE COMPLIANCE, WE NEED MORE, WE'LL PUT MORE. 
          UM, IF WE FIND THAT, I MEAN, NORMALLY IF A NURSING HOME CALLS 9 1 1, IT'S TREATED AS A NINE ONE ONE CALL IF IT'S, UH, A SCHEDULED DOCTOR'S APPOINTMENT AND IT'S NOT A 9 1 1 CALL. 
          AND SO FROM THE NURSING HOMES AS WELL AS THE HOSPITAL, THE ONLY WAY THAT WE'RE GONNA TAKE A 9 1 1 TRUCK OUTTA OF SERVICE TO DO A TRANSFER OUT OF THE COMMUNITY, IN OTHER WORDS, TO GO TO THE PL, IS WE'D HAVE TO BE AT FULL. 
          WE'D HAVE TO BE AT FULL STRENGTH AND HAVE NO CALLS RUNNING AT THAT MOMENT. 
          OTHERWISE, WE'RE GONNA SEND TRUCKS OUT TO DO THOSE. 
          AND THE NURSING HOMES, IF IT'S A DOCTOR'S APPOINTMENT, TYPICALLY WILL HAVE TOLD US ONCE FOUR HOURS ADVANCE THAT THEY'VE GOT SOMEBODY'S GOTTA GO TO SCHEDULE APPOINTMENTS. 
          SO WE'LL BRING EXTRA RESOURCES IN TO DEAL WITH THAT. 
          'CAUSE I, I'M NOT INTERESTED OTHER THAN WHAT MAY HAPPEN IN THE FIRST 90 DAYS UNTIL WE MAKE SURE WE UNDERSTAND HOW THIS WORKS. 
          UM, I'M NOT INTERESTED IN COMING UP TO MEETINGS AND TRYING TO EXPLAIN WHY WE NEED TO MAKE THE COMPLIANCE. 
          I I DON'T, THAT'S THE NUMBER ONE THING THAT WE HAVE TO DO. 
          WE HAVE TO GO TO THESE PATIENTS. 
          OF COURSE WE HAVE AIR RESOURCES TOO, AND WE'LL USE THEM AS NECESSARY AS THIS BEST FOR THE PATIENT. 
          SO, UH, WELL THAT WAS GOING TO BE MY NEXT QUESTION. 
          AND THE OTHER MEETING THAT I ATTENDED, WHEN YOU WERE THERE WITH SOME OF THE FIRE DEPARTMENTS CHIEFS AND RIGHT OTHER FIRST RESPONDERS, YOU'D INDICATED THAT YOU WERE THINKING ABOUT PUTTING, UH, A HELICOPTER IN COLTON COUNTY. 
          AND I UNDERSTAND THAT'S NOT IN THIS PROPOSAL. 
          WELL, NO, IT'S NOT BECAUSE, UH, THE AIR SIDE IS FEDERALLY REGULATED. 
          AND SO, UM, UH, UM, WE HAVE 
          [00:20:01]
HELICOPTERS IN PLACES WHERE WE DO 9 1 1 SERVICE, BUT MANY PLACES. 
          BUT, UH, IT'S NOT REALLY, IT'S NOT A CONTRACTED DEAL EXCEPT THE MEMBERSHIP COVERS ALL ABOVE IT. 
          RIGHT. 
          UM, BECAUSE THE, THE STATES ARE PREEMPTED THE MM-HMM . 
          THE STATES ARE PREEMPTED FROM THE REGULATION OF, OF AIR TRANSPORTATION, WHICH IS WHAT THAT IS. 
          UM, BUT WE'RE STUDYING IT VERY SERIOUSLY. 
          AND I'M GUESS BY THE END OF 90 DAYS I'LL HAVE A REALLY CLEAR IDEA OF, OF UH, WHAT I THINK IS REQUIRED, HOW WE GO ABOUT IT. 
          SO YOU HAVE NO DOUBT IN YOUR ABILITY TO, WHEN WE WAKE UP SUNDAY MORNING AT SEVEN O'CLOCK, THAT WE CAN CALL 9 1 1 AND GET IN. 
          YES, SIR. 
          I HAVE ABSOLUTELY NO. 
          UM, AND I CAN ASSURE YOU WE WON'T BE RESPONDING FROM RED OAK, NOR WILL WE BE GOING TO RED OAK OR ENLI FROM KAUFMAN. 
          I CAN ASSURE YOU OF THAT. 
          AND THE REASON IS, WE HAVE THE RESOURCES. 
          DALLAS COUNTY HAVE THE BIGGEST NUMBER OF RESOURCES IN OUR WHOLE SYSTEM RIGHT THERE. 
          AND WE OPERATE BY MANEUVER ALL THE TIME. 
          I MEAN, IN THE WEST EXPLOSION, WE HAVE MORE AIR GROUNDING ASSETS IN THAT EXPLOSION THAN ANY OTHER ENTITY. 
          AND, AND WE, WE HAVE THE RESOURCES AND WE DON'T HESITATE TO USE THEM. 
          AND, UM, WE PUT THE PATIENTS FIRST IN ALL CIRCUMSTANCES, WHATEVER IS BEST FOR THAT PATIENT AT THAT MOMENT IN TIME, AND WE JUST SEND THE RESOURCES AND WE NEED MORE TRUCKS, WE'LL PUT IT. 
          WE WON'T ASK YOU FOR YOUR PERMISSION 'CAUSE HAVEN DON'T NEED IT, AND B YOU KNOW, WE, WE'LL JUST DO, WE DO WHATEVER IS REQUIRED. 
          YOU NEED TO BE ABLE TO RELY UPON US TO TAKE CARE OF THESE PEOPLE. 
          THIS IS ALMOST LIKE NATIONAL DEFENSE IN WAY FOR A, FOR A, A LOCAL ENTITY LIKE THIS. 
          SO YOU CAN RELY UPON US AND IF THERE'S A PROBLEM, PICK UP THE PHONE AND CALL, YOU KNOW, 'CAUSE WE'LL FIX IT. 
          THERE'S A PROBLEM. 
          SOMEONE BRINGS IT. 
          WE WANT TO KNOW ABOUT IT. 
          WE'RE NOT HIDING. 
          COMMISSIONER, I HAVE SOMETHING I I NEED JIM TO, TO ADDRESS. 
          UH, AND I NEED Y'ALL TO BE AWARE OF. 
          FOR THE LAST 20 YEARS OR SO, EAST TEXAS WAS TRANSFERRING OR TRANSPORTING OUR INMATES THAT NEEDED MEDICAL ATTENTION AT NO COST. 
          NOW FROM, FROM OUR JAIL, FROM OUR JAIL TO KAUFMAN PRESBYTERIAN. 
          AND IN MY CONVERSATIONS WITH JIM, UH, THEY PROBABLY SHOULD NOT HAVE BEEN DOING THAT. 
          AND I WOULD LIKE FOR HIM TO ADDRESS THAT ISSUE. 
          IF Y ALSO YOU HAVE A CLEAR UNDERSTANDING. 
          SO A CONTRACT REQUIRES THAT WE COMPLY WITH ALL FEDERAL STATUTES, REGULATIONS AND ALL STATE STATUTES AND REGULATIONS AND THE TERMS OF THE AGREEMENT. 
          20 YEARS AGO IN RURAL AREAS, YOU KNOW, IF A FIRST RESPONDER WAS TRANSPORTED, YOU JUST DIDN'T SEND THE BILL. 
          WE FLEW A, YOU KNOW, IF WE FLEW A FARMER 20 YEARS AGO, WE JUST DIDN'T SEND A BILL. 
          AND, YOU KNOW, AS AN ACCOMMODATION IN THOSE DAYS, WE WOULD TRANSPORT PRISONERS AT NO CHARGE. 
          BUT IN THIS DAY AND AGE, UM, THE COUNTY IS REFERRING PATIENTS TO CARE FLIGHT BY VIRTUE OF THE FACT THAT YOU RUN AN 9 1 1 SYSTEM AND YOU TRANSFER THAT CALL AND REQUEST FOR SERVICE TO US, WHICH IS HOW IT WORKS. 
          IF WE PROVIDE AN ACCOMMODATION AT A RATE MORE THAN THE MEDICARE ALLOWABLE RATE, WHICH IS THE FEDERAL RATE, UM, OUR COMPLIANCE COUNSEL TELLS US THAT WE ARE IN VIOLATION OF THE MEDICARE ANTI-KICKBACK STATUTE. 
          SO CARE FLIGHT CARE FLIGHT'S ALWAYS GREAT, EVEN TO THE HOSPITALS THAT OWN IT IS THE MEDICARE ALLOWABLE RATE BECAUSE I HAVE NO INTEREST IN TAKING A VACATION IN A PLACE WITH HIGH WALLS AND BARBED WIRE ON TOP OF IT. 
          AND, AND SO THAT IS A CHANGE, UH, THAT'S THE LOWEST RATE THAT WE BELIEVE WE'RE ALLOWED TO CHARGE WITHOUT PUTTING EVERYBODY IN JEOPARDY. 
          AND IT WOULDN'T JUST BE THE AMBULANCE PROVIDER UNDER PART B UNDER THESE RULES, IT WOULD BE THE ENTITY WITH WHOM YOU'RE DEALING. 
          AND THESE THINGS DO CARRY CRIMINAL, POTENTIALLY CRIMINAL, UH, SANCTIONS. 
          AND IT, SO, UM, THE CONTRACT INCLUDES A PROVISION THAT, THAT ALL THE ENTITIES THAT, THAT ARE COVERED THROUGH THIS CONTRACT. 
          UM, WE BILL A MEDICARE ALLOWABLE RATE. 
          AND THAT'S JUST A, IT'S A PROTECTION FOR BOTH OF US TO MAKE SURE, I'M JUST NOT INTERESTED IN HAVING DISCUSSIONS WITH THE US ATTORNEY AS TO WELL YOU GAVE THEM THAT, YOU KNOW, THAT'S THE INDUCEMENT. 
          WE'RE GIVING YOU THIS FOR NOTHING, WHICH IS LESS THAN, THAN THE FEDERAL GOVERNMENT PAYS. 
          AND IN RETURN, YOU'VE GIVEN US ALL THESE PATIENTS. 
          THAT IS THE CLASSIC DEFINITION OF AN INDUCIBLE. 
          AND WE JUST CAN'T, WE JUST, WE JUST CAN'T GO THERE. 
          WE JUST CAN'T. 
          THAT'S JUST, WE CAN'T DO THAT. 
          THAT'S JUST TOO DANGEROUS FOR EVERYBODY IN THE COUNTY. 
          US AND THOSE OF US INDIVIDUALLY WHO ARE ASSIGNERS AND AUTHORIZERS, WERE 
          [00:25:01]
INDIVIDUALLY SUBJECT TO THIS. 
          AND, UH, YOU GUYS ARE INVOLVED IN PUBLIC SERVICE AND IN A WAY WE ARE TOO, EXCEPT WE'RE NOT ELECTED AND WE JUST, WE JUST HAVE TO DO WHAT'S RIGHT WHEN WE RULES. 
          WHAT IS THAT RIGHT? OH, UH, OR DO WE KNOW WHAT IT'D BE FOR PRISONER? UH, IT IT, DEPENDING ON THE LEVEL OF CARE THEY'VE GOTTA GIVE, DOESN'T, IT COULD BE ANYWHERE FROM PROBABLY 300 UP TO 900. 
          UH, YEAH, I WOULD, MY GUESS IS THAT IT'S MOSTLY GONNA BE THE AAL S VERSION BREAK. 
          AND I DON'T HAVE A SHEET RECOLLECTION IS THAT'S 300, 3 50, SOMEWHERE AROUND THERE. 
          YOU WON'T HAVE, YOU WON'T HAVE TOO MUCH MILEAGE. 
          YOUR JAILS ARE AROUND HERE SOMEWHERE, RIGHT? YES. 
          AND SO THE, THERE'S A BASE RATE, WE'RE LIKE A TAXI CABOT THING PUTS IT DOWN LIKE A, THAT'S CALLED OUR BASE RATE. 
          THAT'S THE SAME DEPENDING ON THE LEVEL OF CARE AND THEN THERE'S MILEAGE. 
          UM, AND YOU DON'T HAVE VERY MANY MILES. 
          SO, UM, HOW MUCH DO THE MEMBERSHIPS COST? SO, UM, FOR, WELL, FOR OUR EMPLOYEES AS WELL. 
          IS ANYBODY SITTING OUT THERE COST? OKAY, SO THE HIGHEST PUBLIC RATE IS $49 A YEAR PER HOUSEHOLD. 
          THE RATE IN THE CONTRACT, THREE WALL IS $12 PER EMPLOYEE PER YEAR. 
          AND THAT INCLUDES ALL MEMBERS OF THEIR HOUSEHOLD EXCEPT ANYBODY COVERED BY MEDICAID, WHICH IS EXCLUDED BY WALL. 
          SO $12 PER YEAR, IF YOU'RE AN EAST TEXAS MEMBER AND YOU'RE HAVING TO GET A REFUND FROM THEM, IT'S $12 A YEAR. 
          I SUSPECT THERE'LL BE SOME AMOUNT OF, UH, ROOT AND UH, WATER SYSTEM AGREEMENTS IN A SHORT PERIOD OF TIME. 
          AND THOSE RATES, AGAIN, 12 TO 12 HOURS. 
          THAT'S VERY INTRIGUING THING TO ME THAT, UH, THE WATER SYSTEM. 
          RIGHT. 
          THAT SOUNDS LIKE IT HAD LOT OF POSSIBILITY. 
          YEAH. 
          THE WAY THAT ONE WORKS IS IT'S A, SO DO YOU HAVE AN INMATE, UH, UH, PRISONER, I MEAN AN INMATE, UH, MEMBERSHIP ? WELL WE HAVE, WE HAVE HAD AGREEMENTS WITH JAIL AND I'M, I'M HAPPY TO DISCUSS THAT. 
          I'D WANT TO KNOW THAT, YOU KNOW, THE AVERAGE POPULATION, ONE HOUSE 12, THEY ALL COUNTY FEASIBLE, BUT WE LOOK AT IT. 
          YEAH, JUST, JUST TO KIND OF LET YOU KNOW, THAT'S WHY I WANNA MAKE SURE STEVE BROUGHT THAT UP. 
          'CAUSE WE UH, CALLED AMBULANCES LAST YEAR, UH, ABOUT 46, 47 TIMES LAST YEAR WAS WE CALLED 43 TIMES BETWEEN 44 40. 
          SO THAT'S YOU'RE LOOK, WE'RE LOOKING AT SOME MONEY SIR. 
          I JUST WANNA MAKE SURE YOU'RE AWARE OF THAT. 
          MOST THE TIME WE TRY TO TRANSPORT OURSELVES, WE'LL TRY, THEY CALL 43 TIMES AND TRANSPORT FROM, FROM THE JAIL FROM 2014 I THOUGHT SAID FOUR WEEK. 
          SO I MEAN, YOU KNOW, AT $300 THAT'S 12,000. 
          SO I THINK THE RANGE IS 12 TO 15,000 IS KIND OF A RANGE OF FALL OUT. 
          AND I'M SURE IT DIDN'T HAVE IN YOUR BUDGET AND IN PLAN. 
          BUT THE SCHEME OF THINGS, IT'S UH, A VERY SMALL NUMBER TO KEEP US ALL COMPLIANT WITH FEDERAL STATUTES. 
          OKAY. 
          MR O RAISE YOUR HAND. 
          OH, I WAS JUST ASKING MR. HUEY, DID HE KNOW THE STATISTICS ON HOW MANY OF THOSE TRANSPORTS WENT TO THE KAUFMAN PRESBYTERIAN HOSPITAL AND HOW MANY MIGHT HAVE INCURRED ADDITIONAL MILE CHARGES? SO YOU WERE JUST WORKING NUMBERS IN MY MIND THAT, YOU KNOW, IT LOOKS LIKE ABOUT A $12,000 POTENTIAL BUDGET. 
          JUDGE ALL WENT HERE. 
          THERE WAS A BAND A COUPLE TIMES WE'VE HAD TO TRANSPORT HIM TO DALLAS. 
          UH, JUST OFF THE TOP, TOP OF MY HEAD, I REMEMBER ABOUT THREE OR FOUR LAST YEAR THAT VERY FEW. 
          VERY FEW, VERY FEW. 
          AND THEN YOU'VE GOTTA REMEMBER ALSO, WE'VE GOT ONE PROBABLY GONNA COME UP PRETTY SOON WHEN HE SENT THE P IT'S GONNA WIND UP GONNA PC. 
          WE'RE GONNA HAVE AGAIN, WE HAVE TO AMAZON. 
          YES, YOU HAVE TRANSPORT. 
          OH YEAH, WE PROBABLY A BETTER RATE SOCIAL SECURITY. 
          ALRIGHT. 
          IN THIS CONTEXT PROVIDE THE COMMISSIONER'S COURT. 
          SO THIS WILL HELP US A LOT WITH UH RIGHT, RIGHT. 
          YOU'RE GONNA GIVE UP TO STEVE AND THEN, AND AND STEVE WILL LET ME KNOW AS WE ALL WISH US TO APPEAR. 
          UH, I WOULD TELL YOU THAT PROBABLY IN THE THREE AND A HALF MONTHS FROM NOW, AFTER WE'VE DONE ALL THIS ANALYSIS WOULD 
          [00:30:01]
PROBABLY BE A  FOR US TO COME OUT AND SHOW YOU. 
          EXACTLY. 
          THESE ARE ALL RUNS. 
          THIS IS, THIS IS WHAT WE JOINT, THIS IS WHAT WE JOINTLY AGREED TO BASED ON. 
          IT WAS 12 MILES. 
          THE SPEED LIMIT IS 60, THAT MEANS IT'S BASICALLY 12 MINUTES PLUS OR WHATEVER IT IS. 
          WHATEVER IT COMES OUT TO. 
          I THINK THAT WOULD BE INCLUDED. 
          AND YOU'RE ENTERING INTO BASICALLY THE SAME CONTRACT WITH ELLIS COUNTY. 
          IS THAT CORRECT? OR HAVE YOU BASICALLY ELLIS COUNTY, THEIR COMMISSIONERS, UM, APPROVED A SIMPLE TRANSFER OF THE AGREE. 
          AND I KNOW THIS IS HARD FOR ANYBODY TO IMAGINE, BUT LAWYERS HAVE DIFFERENT VIEWS OF THINGS IN MY EXPERIENCE. 
          AND THEY, THEIR VIEW WAS WE CAN JUST ACCEPT THE ASSIGNMENT. 
          SO THAT'S WHAT THEY DID. 
          SO WE TRY TO MAKE THINGS HARDER AROUND HERE. 
          I EVEN HARDER OF IT. 
          THAT'S WHAT TEST ONE ISN'T IT? PARDON ME? THAT'S THE TEST ONE. 
          THAT'S ATTACHMENT ONE. 
          THAT'S THE PART OF THE CONTRACT THAT STEVE AND I SIGNED WILL PREPARE FOR THE TWO ENTITIES. 
          AND THEN WHEN WE, IF WE DECIDE THAT JOINTLY THAT ON A REASONABLE BASIS THAT THESE NUMBERS HAVE TO BE ADJUSTED AND WE'RE GONNA START WORKING ON THAT AFTER, UH, EARLY IN APRIL ONCE WE HAVE ONE MONTH'S WORTH OF DATA. 
          UM, 'CAUSE I HAVE, WE WE'RE VERY CONCERNED ABOUT A COUPLE PLACES THAT, UH, THERE'S NO SURPRISE TO US. 
          THERE'S SOME PLACES HERE THAT AREN'T SO EASY TO GET TO AND THE POPULATIONS ARE THIN. 
          AND SO WE'RE, YOU KNOW, WORKING WE'LL WORK TOGETHER TO TRY TO FIGURE OUT WHAT HAS TO BE DONE THERE. 
          WE, WE JUST DON'T WANT TO BE, WE JUST CAN'T BE IN THE SITUATION WHERE THE REQUIREMENT TO RESPOND IS FASTER THAN IT CAN BE DONE WITH THE SPEED LIMIT. 
          THAT IS WE JUST, WE HAVE ABSOLUTE RULES OF CARE FLIGHT TO PREVENT DEATH AND MAYHEM. 
          THAT THE SPEED LIMIT IS THE MAXIMUM SPEED THAT WE GO AT. 
          THERE'S A LOT REGARDING THE STATE, BUT THE DUE REGARD ENDS AT THE MOMENT OF IMPACT IN THE CRASH. 
          AND, AND WE JUST, WE JUST, WE'RE NOT UP BURIED TO COWORKERS SINCE I'VE BEEN TERRIFIED. 
          WE'RE INVOLVED IN AN ACCIDENT THAT IS A CATASTROPHIC FAILURE OF A PART DUE TO A MISTAKE IN ITS MANUFACTURER MANUFACTURING. 
          NOTHING THEY DID WRONG, NOTHING WAS MR. MCCREE FLIGHT. 
          THE PART FAILED WITHIN ITS LIFE LIMIT. 
          THAT'S AN ACCIDENT. 
          A CRASH IS YOU GO 80 ON A ROAD THAT'S GOT A 50 MILE AN HOUR SPEED ON THAT. 
          IT'S REASONABLE TO BELIEVE YOU CAN FORESEE THAT SOMETHING BAD CAN HAPPEN IF YOUR FRONT TIRE GOES OUT OR WHATEVER HAPPENS. 
          AND WE'RE JUST NOT, WE'RE IN THE BUSINESS OF SAVING LIVES, NOT TAKING THEM. 
          AND THAT MEANS THAT WE ABSOLUTELY MUST OPERATE CONSISTENT WITH THE TRAFFIC STANDARDS AND, AND WE'RE A LITTLE UNUSUAL ON THAT, BUT I'M, I'M NOT INTERESTED IN IT'S GONNA BE THE SAME TIME EXCEPT FOR YOU'RE GONNA IMPROVE ON THE YES. 
          EXAM AND, AND AND WE'RE GONNA CUT OUT THE FREE DEAL. 
          RIGHT. 
          AND, AND THIS IS A REALLY IMPORTANT FACTOR ONLY CARE. 
          FLIGHT STOPS CARE FLIGHTS TIME CLOCK. 
          YOUR PRIOR CONTRACT SAID THAT ETM C'S CAUGHT STOP WHEN THE FIRST RESPONDERS SHOWED UP, WHICH I APPRECIATE THAT. 
          AND MANY TIMES THE FIRST RESPONDERS WILL GET THERE FIRST, BUT OUR RESPONSIBILITY IS OUR RESPONSIBILITY. 
          IF WE'RE NOT, WE DON'T TAUNT IT OFF ON SOMEBODY ELSE. 
          I MEAN THAT TO ME WAS THE, I MEAN YOU WOULD SEE PLACES WHERE THEY HAD AN AMBULANCE 15 MILES AWAY AND THE RESPONSE TIME WAS 10 MINUTES. 
          I'M THINKING THEY MUST HAVE SOME JET POWERED VEHICLE THAT'S THOUSAND WINGS OR SOMETHING IN THE CITY OF FLORIDA RECENTLY THEY GOT ON THE SCENE AND IT, AND NOT CORRECT ME IF I'M WRONG, CHIEF TOWNSEND, IT WAS 45 MINUTES BEFORE THE AMBULANCE EVER SHOWED UP AND YOU WOUND UP HAVING TO GET SOMEBODY OUTTA MESQUITE. 
          WE'VE HAD, WE'VE HAD TWO INSTANCES OF THAT. 
          YES SIR. 
          SO THAT'S GONNA HELP A LOT BECAUSE EVEN THOUGH FIRST RESPONDERS GET THERE AND CAN ADMINISTER CARE, A LOT OF TIMES THAT PATIENT'S ULTIMATE CONCLUSION RESTS IN THEM GETTING TO A HOSPITAL AS QUICKLY AS POSSIBLE. 
          AS QUICKLY AS POSSIBLE. 
          SO IF IT TAKES 45 MINUTES FOR AN AMBULANCE TO GET THERE, THEN EVEN THOUGH THEY'VE CARED FOR ME IN THE SHORT TERM, IT DOESN'T HELP THEM LONG. 
          AND IN A SITUATION LIKE THAT WE'RE, WE'RE HERE LIKELY TO SEND A HELICOPTER AND SOMETIMES WE'LL SEND A HELP OUT FROM CHARGE OF GROUND RATE IF WE DO IT FOR OUR OWN BUSINESS REASONS. 
          THE PATIENT ISN'T REALLY A TERRIBLE TRAUMA, BUT WE WANT TO MAKE THE COMPLIANCE AND THE SYSTEM IS COMPLETELY, YOU KNOW, I MEAN WE CAN'T HELP IF THERE'S SIX CALLS GOING AT ONE TIME IN THE COUNTY, WHICH THEN WE'RE GONNA DO WHATEVER WE HAVE TO DO TO GET TO THESE PATIENTS AS FAST AS POSSIBLE. 
          I MEAN, BELIEVE ME, WE'D GET A HELICOPTER HERE, EVEN EVEN FROM DALLAS AND YOU KNOW, IN HORNY 10, 12 MINUTES, SOMETHING LIKE THAT. 
          SO, UH, YOU KNOW, IT'S A SENTINEL EVENT. 
          [00:35:01]
IF IT TAKES US 45 MINUTES TO GET AN AMBULANCE TO A A, AN EMERGENCY PATIENT, A SENTINEL EVENT THAT WILL BE, WOULD BE REPORTABLE WITHIN OUR SYSTEM AS COMPUTER. 
          SEVERAL. 
          WHERE ARE YOUR HELICOPTERS CURRENTLY BASED FOR OUR AREA. 
          AND WHO HAS THE AUTHORITY TO REQUEST IT? UH, ANYBODY WHO'S THE FIRST RESPONDER ASK FOR A HELICOPTER. 
          THEY'RE GONNA GET IT. 
          THEY'RE GONNA GET IT. 
          RIGHT NOW WE'RE NOT. 
          THERE'S NO WELL NO OR NO. 
          THE AMBULANCE HAS TO COME AND LOOK FIRST. 
          NO, NO, NO. 
          OUR OUR SORT OF INTERNAL SAYING IS YOU CALL WE HALL AND WE'LL TALK ABOUT AFTER THE FACT YOU REALLY CALLED US FOR A BROKEN ANKLE. 
          REALLY? YOU KNOW, PROBABLY, BUT EXACTLY THAT'S NOT GONNA HAPPEN. 
          YOU GUYS KNOW WHAT THE DEAL IS. 
          SO, UH, YOU, YOU CALL AND IT'S THE SAME FREQUENCY, IT'S THE SAME RADIO AND THAT OIL FIELDS YOU USE THE CELL PHONE ON THE TRUCK ABOUT. 
          AND THEY'RE GONNA, THEY'RE GONNA DISPATCH IT 'CAUSE WE WILL NEED, YOU ALL KNOW WHAT THE STANDARDS ARE AS YOU'RE OPERATING WITH THEM. 
          A MAN WE'RE GONNA SEND YOU THE HELICOPTER AND WE'RE GONNA SEND IT RIGHT NOW. 
          AND COULD BE THE GROUND AMBULANCE GETS THERE BEFORE AND SAYS WE REALLY DON'T NEED THIS HELP. 
          THIS IS JUST A BROKEN LEG, WE'RE REFINED AND THE HELICOPTER JUST GOES BACK. 
          BUT WHAT WE'RE NOT GONNA DO IS WAIT, BECAUSE THE GOLDEN HOUR IS THE STANDARD INTO THE TRAUMA CENTER, WHICH IS 60 MINUTES. 
          THE 30 IS BETTER THAN 60. 
          YOU KNOW, I'M NOT MUCH ON MATT, BUT THAT MUCH I KNOW HALF HOUR IS BETTER THAN THE WHOLE HOUR. 
          AND THE ONLY WAY TO DO THAT IS TO DISPATCH THESE HELICOPTERS. 
          AND IF YOU HAVE A SYSTEM, A LOGISTICAL BREAKDOWN, YOU HAVE TO REMEMBER THAT THIS AMBULANCE IS 50% LOGISTICS AND 50% MEDICAL CARE. 
          EITHER AREA CAN EITHER INCREASE THE LIKELIHOOD OF A GOOD OUTCOME OR DECREASE IT. 
          YOU CAN HAVE THE BEST MEDICAL CARE, YOU HAVE A WRECK IN THE INTERSECTION AND THE AMBULANCE GOES ON ITS SIDE. 
          YOU CAN HAVE THE BEST MEDICAL CARE PATIENTS ON THERE FOR A CARDIAC AND NOW THEY HAVE A CARDIAC KIND OF TRAUMA DOES NOT MAKE IT MORE LIKELY THEY'RE GONNA SUCCEED. 
          SO WE SPEND A LOT OF TIME TRYING TO MAKE SURE THE LOGISTICS AS WELL AS THE MEDICAL CARE ARE THE HIGHEST QUALITY IN THE COUNTRY. 
          AND THAT'S SOMETHING THAT A LOT OF PEOPLE, UM, JUST HAVEN'T RECOGNIZED. 
          'CAUSE YOU HAVE TO REALIZE AMBULANCES, SCHOOL BUSES AND HEARSTS ARE EXEMPT FROM ALL THE SAFETY REGULATIONS OF MANUFACTURING VEHICLES IN THE UNITED STATES. 
          THIS IS THE ONLY DEVELOPED COUNTRY THAT HAS NO SAFETY STANDARDS FOR A MANUFACTURER OF AMBULANCES. 
          THIS IS A SERIOUS PROBLEM WHICH WILL NEVER GET FIXED 'CAUSE CONGRESS WOULD HAVE TO CHANGE IT. 
          THERE ARE NO STANDARDS FOR THESE THREE TONS OF VEHICLES. 
          AND IT'S OFFENSIVE TO ME THAT WE'RE LUMPED IN WITH THE UNDERTAKERS, EVEN IF THEY'RE ANY IN THE ROOM. 
          IT'S OFFENSIVE TO ME BECAUSE WHAT WE DO IS THE OPPOSITE OF THAT. 
          AND NOT ONLY BEEN ON ONE AMBULANCE RIDE IN MY WIFE, WHICH WAS 51 YEARS AGO, I FELL OFF A HORSE AND A FARM WHERE WE LIVED AND PARENTS WEREN'T INVOLVED WITH THE DOCTOR CALLED FOR THE AMBULANCE, WHICH IN THOSE DAYS WAS THE UNDERTAKER. 
          'CAUSE THEY HAD A CONVERTIBLE, SOME OF YOU AREN'T OLD ENOUGH TO REMEMBER THIS, BUT THEY HAD WHAT WAS CALLED A CADILLAC CONVERTIBLE. 
          SO IT WASN'T A CONVERTIBLE TOPIC THEN EITHER THE COFFIN WENT THERE OR THE PATIENT WENT THERE. 
          SO THE AMBULANCE TOOK 30 MINUTES TO GET THERE. 
          1 45 MINUTES TO 30 MILES ON TWO LAKE ROAD. 
          AND THE DOCTOR PUTS ME IN THERE WITH THE UNDERTAKER AND I LOOK UP AND I GO, NOW WE'RE GOING TO THE HOSPITAL, NOT THE BOARD. 
          RIGHT. 
          AND HE LEFT THE GUY DRIVING IN THE BLACK SUIT. 
          HE, HE, HE HE VERY MUCH SO. 
          UM, THAT'S WHY THEY'RE ALL EXEMPT AND IT'S A TERRIBLE THING. 
          BUT IT'S, THAT'S HOW IT'S, I'M GONNA GIVE EVERY COMMISSIONER IF YOU HAVE ANY OTHER QUESTIONS. 
          STEVE, DID YOU HAVE SOMETHING? NO, I KNOW. 
          POINT BACK, ONE OF THE THINGS WE DID, Y'ALL CAME AND PICKED SOMEBODY UP JUST BECAUSE THE TRAFFIC WAS A SIX. 
          IT DIDN'T HAPPEN NECESSARILY THAT IT WAS, BUT THEY WANTED TO MAKE SURE THE YOUNG MAN THAT HEARD TRAUMA SO HIM UP STRAIGHT. 
          RIGHT. 
          SO, SO I I KNOW YOU WORKING IN A TIMELY FASHION. 
          EVERYTHING'S IMPORTANT. 
          YEAH. 
          AND, AND IN THE METRO EFFECTS DURING RUSH HOUR SOMETIMES WE FLY PATIENTS WHO WOULDN'T FLY OTHERWISE BECAUSE YOU JUST CAN'T GET 'EM. 
          YOU JUST CAN'T GET 'EM. 
          THEY HAVE TO GO THE TRAFFIC. 
          SO BECAUSE THEY DIDN'T KNOW HOW BAD IT WAS, THEY NEEDED, WE ALWAYS FAULT, FAULT TO THE CONSERVATIVE SIDE, WHICH IS WE'D RATHER FIND SOMEBODY WHO DIDN'T NEED IT THAN NOT FIND SOMEBODY AND TURNS OUT THEY DID NEED IT AND YOU HAVE A BAD OUTCOME AS A RESULT. 
          I AGREE. 
          JIMMY, DO YOU HAVE ANY? NO, NO. 
          I THINK IT'S WELL COVERED. 
          AGAIN. 
          I HEARD PRESENTATION LAST NIGHT AT CITY COUNCIL MEETING. 
          ALRIGHT, UH, JACK, I'M GOING TO ASK YOU A QUESTION AS WE WIND THIS THING DOWN UNLESS WE HAVE OTHER QUESTIONS. 
          UH, AFTER WE, IF ASSUMING WE SIGN THIS CONTRACT, UH, WHAT WILL BE THE NEXT STEP THAT WE WILL NEED TO TAKE AS FAR AS YOUR SHOP IS CONCERNED? , THEY, THEY SHOULD, THEY'VE BEEN INCLUDED IN, SO YOU WILL START IT, I GUESS 
          [00:40:01]
MORE, MORE OR LESS. 
          IT'LL START FAIRLY SOON. 
          UH, JUST SO WE HAVE SOME CERTAINTY WITH THIS ON DOWN THE WAY. 
          WE DON'T, WE DEFINITELY DON'T WANNA WAIT THE LAST MINUTE. 
          WE, WE START DOWN AND WE GIVE OURSELVES PLENTY TIME. 
          OKAY. 
          I JUST, YOU KNOW, I THINK WE SHOULD MOVE AS NOT JUST FOR THE SAKE OF SPEED, BUT I MEAN WE, AS SOONER WE GET THIS FINALLY RESOLVED, I THINK IT'D BE GOOD. 
          MR. . 
          THANK YOU JUDGE. 
          DO WE HAVE ANY PURCHASE ORDER REQUIREMENT TO, FOR THE JAIL TO BE ABLE TO CALL ON THE THIRD AND GET SERVICE, I GUESS FOR AN AMBULANCE, RIGHT? RIGHT. 
          IN OTHER, SO AGAIN, WAS THERE ANYTHING WE NEED TO DO THAT'S TO AUTHORIZE? NOT FOR US. 
          WE'LL WORK OUT. 
          NOT FOR US. 
          I MEAN, YOU CALLED ME HALL, RIGHT? YEAH. 
          AND I, I WAS JUST THINKING YEAH, THAT ALSO FALLS UNDERNEATH THE BARGAIN SEAT. 
          SO I MEAN, WE'LL DIRECT THAT WE WANT THIS LITTLE PAPERWORK AS IS NECESSARY BECAUSE WE DON'T WANNA MAKE ANYBODY'S JOB MORE COMPLICATED. 
          SO YOU, YOU, YOU CALL US, WE'RE GONNA HAUL AND WE'RE GONNA SEND YOU A BILL FROM MEDICARE. 
          WE'LL RATE, YOU PAY IT. 
          WE COULD GIVE YOU ONE BILL FOR THE WHOLE, GONNA APPROVE. 
          ALRIGHT. 
          DOES ANYBODY HAVE ANY OTHER QUESTIONS? I'LL MAKE A MOTION. 
          OKAY. 
          WE HAVE A MOTION FROM COMMISSIONER SHANE. 
          WE AGREED TO THE CONTRACT THAT HAS BEEN PRESENTED. 
          I, AFTER HEARING FROM, UH, MR. SWARTZ, UH, DO I HAVE A SECOND? UH, MR. PHILLIPS, UH, SECOND A MOTION. 
          ANY OTHER DISCUSSION? ALL IN FAVOR SAY AYE. 
          AYE. 
          THOSE, DO YOU HAVE A MOTION TO ADJOURN? SECOND, MR. ALLEN MAY 2ND MOTION.
* This transcript was created by voice-to-text technology. The transcript has not been edited for errors or omissions, it is for reference only and is not the official minutes of the meeting.