Shelby County Today

January 1, 2015 - The Joaquin Volunteer Fire Department was dispatched to a single-vehicle rollover on FM 699, approximately 1 mile south of U.S. 84 at 1:24 am on Thursday, January 1st, 2015.

Units arrived to find a white Ford F-150 laying on its passenger side, wedged in a small thicket of cedar trees, with the driver still in the driver's seat. Using the Jaws of Life, firefighters assisted ACE EMS personnel in removing the driver from the vehicle.

He was transported to Nacogdoches Medical Center's Center ER with non-life threatening injuries. Fire department units returned to the station at 2:15 am.

December 22, 2014 - During Commissioners' Court Monday morning, a long discussion time was held before Commissioners approved a request from ACE EMS for a $15,000 monthly temporary subsidy on December 22, 2014.

Dale Alexander, ACE EMS owner, was the first to address the court concerning the subsidy request. "Since the close of the hospital last July 11th, [ACE EMS] has run 3,845 calls. We average about 226 calls a month. You are looking at about 98% of all these calls that are 9-1-1 which goes back to our contract, we agreed to cover all these, as many as possible with the terms of the contract, the two 24-hour trucks with a call-in truck."

Alexander addressed self pay patients who have no medicaid/medicare, insurance, or no way to pay. When a 9-1-1 call comes in, they can't discriminate as to whether or not the patient can pay. Alexander said, "Now these people have totaled up a bill, they can't or don't pay, for whatever reason, of $615,025.80. Over each month that averages out currently up to this point during the year, averages to just a little over $51,000 a month that we absorb our self."

"Bottom line is with that is, covering the contract, it still costs us more than what it brings in. It's hard to cover that, but the county has to have it. There is no way we can cut back. I just, I don't believe we can cut back on the service we offer, so that Shelby County takes care of all the people the way they need to be taken care of and that's the reason we started it, was to take care of Shelby County," explained Alexander.

To summarize the situation, Alexander said, "In the end it comes down to you need a certain amount every year to operate." He continued, "At the end of this year right now we expect to collect approximately $1.5 million. Well, what we actually collect is about $1,030,000 at this point, that is just kind of a rough number of what we've collected. But it costs $1.25 [million] to $1.3 million just to operate, just to break even, to cover the county with the service we are giving right now."

ACE EMS owner, David Chandler said, "Just like Dale said, we don't have a choice, we get called 9-1-1 we go knowing that it is going to cost us $1,200 to $1,500. A person gets out of the hospital two days later, the exact same person calls for an ambulance 9-1-1, guess what, we lose another $1,200 to $1,500 but we have not choice, we've got to go. Kind of stings sometimes."

Discussion was held about the opening of the new Center Emergency Department (CED) and if it would help with the expense burdens the ambulance service is having to absorb. Alexander explained with the assistance of Jesse Griffin, ACE EMS manager, some patients will be able to be taken to the new ER; however, the CED informed ACE during a previous meeting, there are certain calls which will still need to be taken to other hospitals depending on the call type including broken bones because there is no ortho, anything requiring emergency surgery such as appendicitis, cardiac care, and anything ICU.

Judge Rick Campbell asked, "Are you asking for a subsidy, do you think the subsidy is something that you need every month from now on."

Alexander replied, "I believe it is or at least, at the very least, through one year of the new hospital being open to see if that's going to be what it takes to change everything. At this point we don't know that, we can't guarantee that, that will change very much."

Judge Campbell asked, "Year to date since y'all have been in service, have you shown a profit?" Alexander replied, "No. Not yet. We have been in business since August of 2012 and not one penny of profit yet. We've actually shown a loss every time."

Alexander addressed recent questions from people about their new recent purchase of two brand new trucks by explaining it was cheaper to replace the two diesel trucks needing repairs with two new trucks with gasoline engine in the long run partly because the reduced cost of maintenance over the diesel engines.

Roscoe McSwain, Precinct 1 Commissioner stated, "Don't forget the fact that any service you go into like this, you know there is always going to be an amount of goodwill." In response Alexander said, "Like you said there is a certain amount of goodwill that is going to be involved in it. But where is your breaking point. We are presenting you with our breaking point," and Chandler added, "I'm afraid we are about there."

Rodgers asked the two owners of ACE EMS if the service could survive without the county helping. Alexander replied, "At this point, it can't survive without the county helping because I've watched the last two months, our last month that we received subsidy was in October, that's when our original agreement was up. And then we've had November and we are almost done with December, I already see a difference and its not a good difference."

McSwain expressed his desire to hold off on approving the subsidy and having the ambulance service run three to six months without the subsidy and then return to the Commissioners' Court and show the court if the subsidy is still needed considering the opening of the new Center Emergency Department.

Commissioner Jimmy Lout made a motion to give ACE EMS a temporary subsidy of $15,000 per month with requirement of the company providing a financial statement to the court prior to any continuance of the subsidy in the future. The motion carried with votes of approval from Jimmy Lout, Travis Rodgers, Bradley Allen, and Judge Rick Campbell and a negative vote from Roscoe McSwain.

The money for the subsidy will come out of the contingency fund starting January 1, 2014.

Following approval of all items on the agenda and prior to adjournment, Clint Porterfield, County Auditor, stood up and addressed the court. He said, "I believe scripture tells us that we're supposed to give praises in the good times and the bad. So, in light of that, I would like to thank Judge Campbell, since this is your last court meeting, and give you the praises for the job you have done. You've been with us through the good and the bad. We've had to do a lot of tough decisions and we've had some easy times, so I just want to acknowledge the fact that we do appreciate your service and wish you the best of luck." Campbell replied, "Thank you, it's been an honor. I've enjoyed it."

Following the words from Porterfield and Campbell, the audiance and the commissioners all stood and applauded Judge Campbell for his service.

Agenda items receiving approval include:
1) Approved monthly expenses and to amend budget line items.
2) Approved bonds for newly elected officials
3) Approved subsidy to ACE EMS.
6) Approved moving County Attorney's office and Justice of the Peace, Pct. 1 to an office space located on Loop 500 near the intersection of Hwy 7 East. Mike Kyle, Area Manager of Azure, offered the office space on Loop 500 free to the county for a term of 5 years.
7) Approved incoming Justice of the Peace, Pct. 1, Mike Crouch to rent a new office space in downtown Timpson for $400 per month.
9) Approved Commissioners McSwain, Lout and Rodgers to each purchase a John Deere tractor and brush cutter for their precinct through the Buy Board. The motion was made with $150,000 coming out of Right-of-way fund and $59,000 out of each of the three commissioners cash carry over. Pct. 1 and 2 will receive their brush cutters first, Pct 3 will have to wait for the 3rd brush cutter to be built.
10) Approved Commissioner Rodgers to advertise for bids to sell a Ranch 2 door belly dump, a 1975 Chevy Silverado flatbed truck and a Fiat 175 maintainer.
11) Approved increasing the County mileage rate from 55.5 cents to 57.5 cents which is the new approved IRS published rate.
12) Approved closing the Courthouse on Friday, December 26, 2014 with all employees agreeing to take a vacation day for the extra day off.

Items reported to the court

4) Recorded the creation of Fund 83 - District Attorney Non-Traffic Forfeiture Fund and Fund 84 - District Attorney Traffic Forfeiture Fund.
5) Recorded the establishment of Forfeiture Budgets for District Attorney Forfeiture Funds (Non traffic and Traffic).
8) Reported mandatory hours of training for Tax Assessor, Debora Riley, a requirement under Texas Property Tax Code Section 6.231 (d). Riley has received 50 hours of training, only 20 hours were mandatory. 10 hours of the 50 can carry over to the next year.

December 22, 2014 - An open house for emergency personnel was held on Friday, December 19, 2014 at Nacogdoches Medical Center's new Center Emergency Department's emergency and diagnostic imaging facility.

Representatives from several entities including the Texas Department of Public Safety, Texas Game Wardens, Center Fire Department, Shelby County Probation Office, ACE EMS, Shelby County Sheriff's Department, Center Police Department, Timpson Volunteer Fire Department, West Shelby County Volunteer Fire Department and Life-Air Rescue took the tour.

Tammy Hanson, the manager of the facility, and Don Radcliff, RN BSN, escorted the representatives through the new facility and introduced them to the different areas of the building.

"This is a fully functioning, freestanding emergency room," said Hanson. She went on to explain there is no difference between the ER and one that is in a hospital, "the difference in the big hospital is what happens after the ER."

Hanson spoke with the officers about such things as legal blood draws and the facility employees look forward to working with them. She said if there are any issues, she has an open door policy toward the emergency personnel.

When the visitors entered, Hanson explained where each side of entrance takes them. The left side is for emergencies and the right side is the diagnostic and imaging center which will be open Monday through Friday. This side will provide CT scan, ultrasound, x-rays, and lab work.

The facility is well staffed and Hanson described how some of the registered nurse schedules, "By daytime this building will be staffed by five RN's and one nurse technician that is an EMT basic. At nighttime it drops one staff member and me I''l drop off, so it will actually have four RN's and one EMT basic. So, we've worked really, really hard to be very adequately staffed," said Hanson.

Hanson told the visitors the hospital is staffed by experienced medical professionals, "The nurses here are very experienced, there is not a brand new nurse in this building, there is not a brand new ER nurse in this building so we can help you. We can help you with anything you need."

The facility is located on Loop 500 in Center and once the facility is open calls to the facility may be directed to 936-657-3030.

Hanson (blue scrubs) speaking with Shelby County Sheriff's Department, Game Wardens, and Shelby County Probation

December 19, 2014 - Nacogdoches Medical Center (NMC) announced the doors to the Center Emergency Department will be open to the public starting at 8am, Monday, December 22, 2014 which is 528 days since the closure of Shelby Regional Medical Center (SRMC).

SRMC closed its doors at noon on Thursday, July 11, 2013 by orders of Dr. Tariq Mahmood, the owner. Just over a week later Nacogdoches Medical Center announced July 19, 2013 its intentions to build a free standing ER and Imaging Center in Shelby County at the intersection of Hwy. 96 and Loop 500.

Thursday, December 18, 2014 invited guests attended a press conference and meet and greet in front of the new emergency and imaging center. Clay Ferrell, the Operating Officer at Nacogdoches Medical Center, said, "Welcome everyone to the Center Emergency Department" and recognized several people for their support and assistance over the past year. Those recognized included Pam Phelps, Executive Director of the Shelby County Chamber of Commerce; Rick Campbell, Shelby County Judge; David Chadwick, Mayor of the City of Center; Chad Nehring, Manager of the City of Center and then members of Nacogdoches Medical Center Governing Board who were present at the event.

Francis Spruiell, Nacogdoches Medical Center Governing Board Chairman and a Shelby County resident, took to the podium saying, "I cannot think of a better Christmas gift for this community than this facility right here." She thanked the staff and management at Nacogdoches Medical Center in Nacogdoches and at the new facility in Center. Spruiell finished saying, "My only wish is that the staff here treats the clients, the patients, with the kindness we do in Medical Center in Nacogdoches. So, Merry Christmas everyone and congratulations."

Clay Ferrell spoke again saying, "Where do I begin; we've had a great journey over the last year and a half. The construction effort has lasted for 11 months. I stood here, I think in January or February, and said our goal was to open this facility by the end of the year. We have a lot of work left to do, it's going to be a long weekend, but this facility will open Monday morning at 8 o'clock on the 22nd." Ferrell continued, "Everything is going to be ready for patient care beginning Monday, morning, so we are very excited about that."

Ferrell then expounded on partnerships the new facility will have with other emergency care providers, "We have very important and key partnerships to make this emergency center operate." Ferrell then listed the emergency partnerships to be with ACE EMS out of Center, Flight for Life out of Tyler, PHI from Lufkin, and Life Air Rescue from Shreveport.

"We also have relationships with a company called EmCare who is the group affiliated with our physicians that will man the emergency room on a 24 hour basis beginning Monday morning," explained Ferrell. EmCare is a leading emergency department staffing and management provider and has more than 750 practices serving nearly 600 hospitals, hospital systems and other healthcare facilities nationwide.

 "The most important relationship, obviously over the last 12 months has been with (J.E.) Kingham Construction," mentioned Ferrell. He continued expressing appreciation of Kingham saying, "It is very, very uncommon for a contractor to allow his customer in six weeks before he turns it over. And we have been stepping all over Daniel (Garcia, onsite supervisor,) and his crew so that we would be able to begin operations just a few days after we receive our certificate of occupancy. But it was important to us and I know it was important to the community to be open as quickly a possible. And I commend Kingham for a very good job, well done."

As a final report of the Center Emergency Department, Ferrell described, "In the final analysis we have hired more than 40 employees for this facility from laboratory all the way to imaging, nursing, patient access registration, security, pharmacy, and house keeping. We have invested about 4 million dollars in the land acquisition and the construction of the building and over 3 million dollars in technology, equipment, and furnishings. We have strewn 5 miles of data cable through this building. We have 28 computers, 5 laboratory machines, 4 imaging modalities, and 200 pieces of medical equipment. We are expecting to see anywhere from 15 to 20 patients a day in our emergency room to begin with which translates to 5,000 to 8,000 in a year. And on the imaging side, anywhere from 20 to 30 exams per day. We are anxious to see how the reality shakes up with what we've estimated. We feel very confident that this is going to be a very well used facility."

As a final announcement, Clay Ferrell introduced the manager of the new facility to be Tammy Hanson, "Tammy lives in Timpson with her husband (Mike Hanson) and two kids. She is an LVN by training and also an RN since 1999, certified in basic life support and advance cardiac life support. She has a strong background in emergency nursing. She was a trauma nursing instructor and pediatric emergency nurse instructor. For a long time she has been the trauma coordinator at Nacogdoches Memorial Hospital. So you can imagine it was very exciting for us to be able to recruit Tammy to be our onsite manager here and I know its going to be exciting for her to run this operation."

Hanson expressed her appreciation for her new position, "I would like to first extend a thank you for allowing us to serve Shelby County. This is going to be a great endeavor and we welcome you on the journey with us." Hanson continued, "I'm home. I'm a native Shelby Countian and I have not been employed in Shelby County for over 20 years and it feels great to be back."

Hanson then had the employees of the hospital stand and introduce themselves saying, "I want you to meet the faces of those who are going to make this building successful and great to serve Shelby County."

Following the announcements, all attending were invited to tour the new facility and to meet with staff and visit with them about the new facility and its equipment.