Austin to provide oversight of EMS in Pflugerville amid concerns about quality of care

PFLUGERVILLE — After hearing concerns about the medical care provided to Pflugerville residents by Allegiance Mobile Health, the City Council last week approved an agreement with the city of Austin to supervise the private ambulance company.

During the council meeting Tuesday night, officials from Travis County Emergency Services District No. 2, also known as the Pflugerville Fire Department, expressed concerns about the quality of care provided by Allegiance medics, saying the death of one patient in January was because of negligence.

ESD No. 2 Chief Nick Perkins said oversight is needed as Fire Department paramedics often have had to intervene to provide the high-level care that Allegiance medics have not.

“It’s not uncommon that we do intervene, either preventing unnecessary actions or we help with procedures where an individual provider is not able to do that,” Perkins said during the council meeting. "It breaks my heart. I am concerned about the residents in this city and the care that is being delivered.”

During a council workshop meeting earlier Tuesday, Amanda Baum, Allegiance's regional vice president, said she could not comment on the fatal incident in January.

“(Baum) is not able to comment on a patient dying of a result from care of Allegiance; however, I am not under those limitations, and that did in fact occur," Perkins said later during the council meeting. "That patient did die as the result of the care provided by Allegiance."

Perkins told the Statesman that Allegiance representatives told ESD No. 2 that the employee would be fired. Perkins said he knows that the Texas Department of State Health Services suspended the medic's medical license.

During the workshop meeting, Council Member Ceasar Ruiz said he has heard from residents about ESD No. 2 paramedics taking over at incidents because Allegiance medics did not know how to respond, and that an ESD No. 2 medic received a shock while helping with a defibrillator because of negligence by an Allegiance worker. Ruiz said he is worried that Allegiance responders do not have the proper equipment and training.

Baum said she is aware of only two incidents in which an ESD No. 2 medic was shocked, one due to human error and the other due to a technical failure.

Perkins told the American-Statesman the incidents happened in January and July. He said one was because Allegiance medics did not follow standard procedure, such as calling "clear" to ensure no one is still touching the patient.

"It's an incredibly rare thing that's happened twice in a year," Perkins said. "Obviously, it's concerning for us because, you know, it's our people, our firefighters. We don't want anything to happen to them. We want them to be able to do their jobs. It's just part of a larger issue with the profit model that doesn't have the investment that are needed to ensure high-quality performance from the providers."

Under the agreement approved by the council, an Austin emergency medical services commander will oversee Allegiance's operations in Pflugerville and report to its city manager. The agreement will begin Oct. 1 and end Sept. 20, 2024. Pflugerville officials have the option to extend the agreement four additional times for one-year terms, according to city documents.

Allegiance officials did not return calls for comment after the vote.

The agreement with the city of Austin comes a year after Pflugerville approved a contract with Allegiance to provide the city with ambulance and emergency medical services.

The city of Pflugerville has been wrestling with its ambulance services for years. ESD No. 2 used to provide EMS services to the city until it said it could no longer afford to because of increased call volume. In November 2021, voters in the area outside the city limits approved creating ESD No. 17 to handle ambulance calls in the ESD No. 2 service area. City officials said the district's stipend of about $2.8 million for EMS calls was unsubstantiated and did not put the creation of ESD No. 17 on the ballot. Instead, the city hired hired Acadian Ambulance Services on Jan. 1, 2022, to provide service in Pflugerville.

The city ended its contract with Acadian after only two months, citing dissatisfaction with its quality of service, including inadequate response times. In May 2022, the City Council voted to begin contract negotiations with ESD No. 2 to again provide EMS services, but later that month it also opened negotiations with Allegiance after a few council members said the ESD price tag would be much more than they had been led to believe.

Allegiance began providing services to the city on July 1, 2022. Under the contract, Allegiance has to provide a minimum of four mobile intensive care unit ambulances at no cost to the city. Allegiance has committed to having each ambulance arrive at an emergency scene within eight minutes at least 90% of the time.

More: Allegiance to provide EMS services in Pflugerville

During the workshop Tuesday, city officials received an update from Allegiance on its performance.

Since the contract was approved, Allegiance has installed three stations in the city at 1317 Piccadilly Drive, 1601 E. Pflugerville Parkway and 201 N. Heatherwilde Blvd., Baum said, based on the volume of services needed near those locations. She said the company also moved its nonemergency units closer to the city to a station at 1421 Wells Branch Parkway.

For the past year, Baum said, the company has responded to 5,135 incidents, including 96 possible overdoses and 692 traffic incidents. She said the company also has taken 3,583 patients to a hospital and had 1,089 patients who refused transport.

The average response time for Allegiance during the past year is 6 minutes, 45 seconds, while the national average is 7 minutes, Baum said.

The City Council took no other action but met in executive session to discuss the agency's performance and the agreement between the two parties. The agreement with Allegiance will end June 30, 2024.

This article originally appeared on Austin American-Statesman: Austin to supervise private EMS company in Pflugerville amid concerns