Austin-Travis County EMS 2023 Annual Report

Austin-Travis County EMS Annual Report


Austin-travis county emergency medical services would like to thank our elected officials for their continued support.


TABLE OF CONTENTS Message from the Chief

3 4 5 7 9



Strategic Plan Field Operations

Emergency Communications

11 13 15 17 18 19 21 22 23 25 26 27 28 29 30 31 32 33 34

Special Events




Operations Support Community Education

Honor Guard

HR & Recruiting




Employee Development


Billing & Finance Integrated Services

Airport Medic Explorer Post

Clinical Performance


Words from the chief 2023 marked a year of significant growth for Austin-Travis County EMS. We completed our Strategic Plan, and made great strides toward our newly updated mission: ‘Fostering our community’s health and safety through inspired solutions.’ With that mission in mind, ATCEMS established and grew industry-leading initiatives and renewed our commitment to innovation and outside-of-the-box thinking. As you’ll see throughout this report, our commitment spans well beyond our daily ambulance operations. This includes Finance and Human Resources, Support and Logistics, Integrated Services, and Employee Well-being to name a few. With costs continuing to grow, our finance team worked to increase our revenue by more than 25%, adding more than $10M to the General Fund. Our new Airport Paramedic program is improving healthcare equity in the community, ensuring resources are available for local residents by reducing ambulance responses to the airport by more than 50%. Emergency Medical Services is a community effort. Bystander education prior to EMS arrival is proven to save lives, and in 2023, ATCEMS increased its commitment to empower the community. We launched a Stop the Bleed educational campaign that has trained over 800 civilians in bleeding control to date, taught nearly 1,500 residents in CPR, and distributed over 500 Narcan overdose kits in the community. Despite all of these achievements, we are not without our challenges. While our recruiting has stabilized, the exponential growth of Austin and Travis County in the past few years makes it difficult to keep up with the need for expansion. As our providers work harder, it becomes even more important to put a renewed emphasis on provider health and wellbeing. Likewise, maintaining our top-notch equipment, fleet, and facilities are critical, albeit challenging in the era of significant cost increases and supply chain shortages. Ultimately, however, the thing about ATCEMS that makes me most proud is the people. We continue to have some of the highest caliber individuals working every single day to keep the residents and visitors of Austin and Travis County safe and healthy. Their penchant for innovation and dedication to the profession is unmatched, and I am blessed to have the opportunity to work with them. The City of Austin and Travis County are incredibly lucky to have this group of passionate and dedicated pre-hospital providers, and I am consistently in awe of the work they do day in and day out. I want to thank and recognize the Mayor and City Council of the City of Austin, the Travis County Judge and Commissioner’s Court, and all of the officials and public safety partners that support the Austin-Travis County EMS System and its efforts to be a pioneer in the EMS industry. We would not be here today without your support.

Robert Luckritz Chief of Emergency Medical Services


Austin has the largest urban bat colony in North America

OUR MissIon

Austin-Travis County EMS (ATCEMS) was founded in 1976 as a third service EMS agency serving the City of Austin and Travis County. ATCEMS provides 911 communications and emergency medical response to residents and visitors of Austin and Travis County. In 1998, ATCEMS began providing services to Travis County through an interlocal agreement that continues to exist today. In 1997 ATCEMS transitioned from the Advanced Life Support (ALS) and Basic Life Support (BLS) tiered system to an all ALS dual paramedic deployment model. In 2012, ATCEMS became the first third service EMS system to be included under State Civil Service law, which previously only included fire and law enforcement. In addition to managing day-to-day emergencies in Austin and Travis County, ATCEMS provides medical coverage for hundreds of special events each year. ATCEMS is implementing its new Strategic Plan that will guide the Department’s goals for the next five years aligning with the City’s Strategic Direction 2028. The next few years will see extraordinary growth and opportunity for the Department. TO FOSTER OUR COMMUNITY'S HEALTH AND SAFETY THROUGH INSPIRED SOLUTIONS Overview and vision

1.4 million People

we have the honor of serving over 1,100 square miles to keep our residents safe


























station Locations





























M28 M12 DC01




strategic Plan Mission TO FOSTER OUR COMMUNITY'S HEALTH AND SAFETY THROUGH INSPIRED SOLUTIONS Values TRUST & INTEGRITY The belief and confidence in the strong ethical or moral principles of a person. ADAPTABILITY & RESILIENCE The ability to adjust and recover from difficult experiences and setbacks. INNOVATION Increasing knowledge and transforming existing processes and business models to better serve changing needs and expectations. SERVICE Taking action to create value for someone else. RESPECT & EMPATHY A positive feeling or action shown towards someone, and having the skill to understand their experiences.

Goals Leverage resources to be an adaptive, innovative, and solution-oriented public safety department Provide collaborative, service-oriented, and comprehensive care to the community

Attract, develop, and retain a thriving, empowered, and resilient workforce

Thriving, Empowered, Resilient Workforce

Adaptive, Innovative, Solution-Oriented

Collaborative, Service-Oriented, Community Focused




Pursue new procedures, innovative technology, and other system-wide improvements to advance patient care solutions and improve service outcomes Simulation Lab Advanced Practice Providers

Develop comprehensive financial strategies to maintain the necessary resources to operate a reliable and trustworthy emergency medical service Telemedicine Central Health Partnership

Provide increasingly effective and comprehensive prevention and care in our communities through public outreach and education programs Stop The Bleed Strategic Communications

Improve patient outcomes by providing the right resource to the right patient at the right time focusing on equity

CHP/C4 Expansion Airport Medics

Become the employer of choice by developing innovative recruiting and retention strategies and training initiatives

Optimize the quality of life for our workforce by empowering them with effective tools, programs, and opportunities to increase resilience at home and at work Safety Program Station Renovations

Direct to hire Paramedics Expanded Recruiting Team


PLAYING WELL WITH OTHERS Creating cohesive and professional relationships with allied agencies is imperative to a successful mission.

100 personnel 48 Ambulances per day every day



Austin-Travis County EMS (ATCEMS) Operations Division is the primary response entity for the department and is dedicated to delivering the highest level of out-of-hospital medical care to a population of over 1.4 million residents and visitors within Austin, Travis County, and parts of Hays and Williamson Counties. Our service area covers 1,110 square miles.

Every day over 100 personnel work in four shifts, operating up to 41 24 Hr. Field ambulances (37 Field Operations ambulances, two Rescue ambulances, and one Tactical ambulance), seven 12 Hr. Field Operations ambulances, two LakeMed Paramedics (APD boats), with oversight from seven District Commanders and one Shift Chief. Additionally, there are two Rescue Task Force Special Response Units working weekends in the

Austin Entertainment District in partnership with other public safety agencies. The last year saw a significant increase in incident responses and ATCEMS Operations was forced to expand. The trendline shows the incident response volume continuing to increase as our community grows.


Incident Response Volume 2022-2023 annual call volume

9,500 10,000 10,500 11,000 11,500 12,000 12,500 13,000





first point of contact

Your emergency is our priority

Inside CTECC

Ready to answer your call. Ready to respond with intention.

In FY2023, Austin-Travis County EMS Communications began transferring low acuity 9-1-1 calls identified through triage of the OMEGA MPD (Medical Priority Dispatch) protocol to the Collaborative Care Communications Center (C4) to address patient needs without sending a 9-1-1 ambulance. The Communications Technology Team began a multi-year project aimed at redesigning the Computer Aided Dispatch (CAD) system to allow for more complex response plans as well as the ability to be readily adaptable to future changes.

Austin-Travis County EMS Communications continues to expand its dispatch footprint outside the traditional communications center environment. In FY23, EMS Communications provided on-site medical dispatch at multiple large scale special events including Austin City Limits Music Festival, SXSW music and film festival, Formula 1 and NASCAR racing, Moto GP motorcycle racing, UT Football, and Austin FC soccer.

Communications Medics answered over 158,690 requests for service with 96% of all calls being answered within 40 seconds or less.


emergency Communications

Our Communications Medics are EMTs and Paramedics skilled in both their medical knowledge and technical capabilities. All Communications Medics obtain an Emergency Medical Dispatcher (EMD) certification through the International Academies of Emergency Dispatch (IAED).

REQUESTS FOR SERVICE Receiving over 158,690

PRIORITY 1 CALLS City Response 7:40 County Response 10:29

911 CALL PICKUP TIMES 96% of calls answered within 40 seconds

DISPOSITIONS Sorting through over 36 call types to send the right resource to the right calls


Cardiac Arrest: 2,069 Stroke: 2,952

Medical: 64,368 Trauma: 24,664

Penetrating Trauma: 832 Overdose: 4,564

Behavioral: 5,922 Rescues: 368

Environmental: 968 Traffic Accident: 11,586

Over 158K Requests for Service



The Communications Division is the first point of contact for all patients entering the EMS system. Communications Medics accurately triage 9-1-1 calls, ensure the correct response is sent, and begin patient care through Pre-Arrival Instructions (PAIs) before field responders arrive on scene. We take pride in our role as the voice of calm in what is often a chaotic and emotional situation for the citizens we serve.

The Emergency Communications Division is based out of the Combined Transportation, Emergency & Communications Center (CTECC) in Austin, Texas. The Division has 54 full time employees who are responsible for managing all incoming 9-1-1 requests for EMS response in the City of Austin and Travis County jurisdictions.

Finding patients in their homes and on the trail

Connecting patients and providers



Covering Austin and the surrounding ESDs

MPD protocols identify what is needed


Special Events

200,000+ additional people surge Austin during the larger events

From music festivals and racing to sports and parades, we're there.

Trackside at COTA


The goal of the Austin-Travis County EMS Special Events Division is to provide the highest standard of medical care to the participants and workers at large mass gatherings, outdoor events, and celebrations. We manage these events without degrading our quality of service and successfully minimizing the impact on our 9-1-1 resources keeping them available for our community. ATCEMS Special Events provides medical coverage for Austin City Limits Music Festival, SXSW film and music festival, Formula 1 racing, Moto GP racing, NASCAR racing, UT Football, Austin FC soccer, and a variety of community festivals and parades. All of the event coverage relies on volunteers from Field Medics to not interfere with 9-1-1 system resources. At these events, depending on the size and complexity, we deploy Command

structure, Motorcycle Medics, Special Response Units, Logistics support, Foot Teams, and Ambulances.

15,862+ Total for spec

FY2023 Event Numbers: •

We staffed over 200 unique events, and when broken out per event day, ATCEMS worked over 400 event days. This illustrates the number of times we staff multiple events in a single day, some of those are three and four events in one day. Not including Formula 1, NASCAR, and MotoGP, we staffed over 200 separate track rental days. From all of these events, we ran over 1,000 medical incidents from dedicated ATCEMS resources, keeping those 9-1-1 resources in the community.


Dedicated to keeping you in the festivities ATCEMS is commited to your health, while you are commited to enjoying what Austin has to offer.

+ HOURS WORKED cial events FY2023

special events worked

Unique events worked VS event days worked by crews. This illustrated that there are sometimes as many as four events working on a single day.
















Unique Events

Days Worked

1st Qtr

2nd Qtr

3rd Qtr

4th Qtr

Gear prep for SXSW


Homeland Security emergency management

FIRE LINES TO HAZMAT ZONES The Austin–Travis County EMS Homeland Security and Emergency Management division consists of four field Commanders, one administrative Commander, and one Division Chief. The division also oversees a Disaster Medical Response team with approximately 60 members. ATCEMS continues to support regional and state partners through various deployments and training. The department mainly deploys with the Texas Emergency Medical Task Force and Texas A&M Task Force One. Most of the deployments this year were centered on wildland fire support.

ATCEMS had four lengthy deployments to support state wildland fires, including six personnel. These deployments are normally two weeks or longer. Medics were deployed as Medical Unit Leaders and Wildland Paramedic Units to multiple areas around the state. These deployments better prepare ATCEMS personnel for large fires that may happen in Austin and Travis County. The Ambus continues to be an important deployment asset for the department. A new driver program was implemented this year allowing EMS personnel to gain additional

experience driving a large, mass casualty response vehicle. Also, this year, ATCEMS DMR team members, for the first time, were placed on standby for events outside of Texas with TX EMTF (Texas Emergency Medical Task Force). Once for wildland fire support in Louisiana and once for a hurricane response in Florida. ATCEMS will continue to support the deployment of personnel to disasters and gain valuable knowledge and experience while helping our neighbors.



Wildland deployment

ATCEMS EMTF Deployments

Solar Park Fire West Branch – Wildland Fire Support – February 2023 Severe Weather – Ambus – March 2023 Severe Weather – MIST – June 2023 Central Branch Fire – Wildland Fire Support – August 2023 Central Branch Fire – Wildland Fire Support – September 2023 State Coordinating Office – Wildland Fire Support – September 2023

EMTF Texas A&M Task Force One Deployments

Hurricane Ian - September / November 2022 Severe Weather Event - January 2023 Severe Weather Event - March 2023 Severe Weather Event - May 2023 TS/HC Idalia - July 2023

AMBUS staged for EMTF


Special Operations tactical We bring medicine where it is needed the most, at your side.

Special Operations Tactical Total Deployments Hours on Deployments Training Exercises Team Training Hours Patients Treated Always on the ready

Tac Medics with SWAT

The Tactical team supports an increasing number of agencies beyond our primary Law Enforcement Officers (LEO) partners. This year the team made operations with six different law enforcement agencies. Our team is becoming widely known for its tactical operations and is routinely requested by federal and regional agencies. Beyond meeting our operational mission, the team’s responsibility includes initiating and preparing our training. We have created a whole new process to plan

and track our training hours based on national tactical competencies and guidelines from the National Tactical Officers Associations. Training plans are developed with intention and evidence-based guidance from lessons learned during our operations. The team still prides itself on its culture and accountability. We have ALWAYS had two Tactical Medics on our truck providing 24/7 coverage to all of our LEO partners.

FY2023 provided the opportunity to fill our ranks and improve our onboarding process remaining the rest of the year at 11 members. Our culture and internal standards keep us in good standing with our peers and chain of command. We work hard to hold ourselves accountable to physical fitness standards and medical capabilities concerning national guidelines through organizations like NTOA (National Tactical Officers Association) and SOMA (Special Operations Medical Association).

Day or night, the tactical team has you covered

Deployment Types Hostage Rescue Barricaded subjects


28 47

search/arrest warrants

Night Ops training


castmed When seconds count, we are already there. s


81 649 41 816.5 11

Austin-Travis County EMS Special Operations CASTMED Paramedics in partnership with the Austin Police Departments Counter Assault Strike Team or APD CAST operate together in the City of Austin Joint Agency Rescue Task Force. The integration of these specialized units deliver hands-on resuscitation within 90 seconds from time of dispatch to direct point of injury in violent environments typically non permissible for traditional EMS units. The City of Austin attracts 30,000,000 visitors annually. In addition to supporting the Downtown Area Command (DTAC), CASTMED has directly supported high profile events.

High Profile Events •

City of Austin New Year's Celebrations

• • • • • • •


City of Austin 4th of July Celebrations Austin City Limits Music Festical (ACL)

University of Texas Football Department of Public Safety Executive Protetcion Detail

Political Rallies

Civil Unrest Events

FY2023 saw 135 deployments resulting in 248 responses and treating 150 patients most with life threating traumatic injuries .

CASTMED extrication



Statio stand a joint em distric county demand

KEEPING OUR CREWS SAFE AND OUR FLEET RELIABLE ATCEMS Operations Support Division is comprised of multiple areas with one overarching goal: “To provide our Uniformed and Civilian staff the best equipment, vehicles, supplies, facilities, uniforms, and protective gear in a timely, fiscally responsible, and efficient manner so they can care for our patients and the public”. Operations Support consists of the following sections:

significantly delayed the delivery of dozens of new or remounted ambulances. The three uniformed and one civilian employee dedicated to the EMS Fleet section have worked tirelessly with the City of Austin Fleet Services team to keep our ever-aging fleet of over 90+ ambulances on the road. Additionally, a once-in-a-century, summer period of over thirty-five plus 100F days tested the EMS Fleet team’s resolve, which passed with flying colors. EMS Fleet always had a sufficient number of reserve ambulances available for operations during the excessive heat period. Facilities “Exciting” is the word that comes up when describing the last fiscal year for EMS Facilities. Facility staff (in conjunction with several City of Austin Departments and contractors) have seen the beginning of nine Field Station renovation projects; the opening of one new joint EMS/Fire station; the construction start on a second, new joint EMS/Fire station, and the design of a third new facility. Additionally, the Facilities section has planned and overseen the movement of Field ambulances to five temporary facilities as well as numerous other small projects. This monumental amount of work is handled by two civilian staff and one uniformed supervisor.

Fleet Facilities Logistics Honor Guard Unit

Fleet “Defying the odds” sums up the situation for the EMS Fleet section over the last fiscal year. While the first quarter saw the delivery of a few new Road Rescue Dodge ambulances, production and supply chain issues with all the major vehicle chassis manufacturers have

Goodnight Ranch Station


on Types alone EMS

12 27

ms & fire

ct command y stations d stations

7 9 8

Logistics “Innovation” is the goal of EMS Logistics. Working in partnership with the Inventory, Materials Management, and Purchasing civilian areas of ATCEMS, EMS Logistics strives to locate, assess, purchase, and deploy equipment, uniforms, and supplies to the Department. In the first Quarter of FY22-23, EMS Logistics introduced the Operative IQ ® Asset Management Software service ticket portal and tracking system for all Fleet and Facility repairs and requests. The system has provided a “one-stop-shop” for critical need requests throughout many areas of the Department. The software assists Fleet, Facility, and EMS Comm Technology in tracking and prioritizing operational and administrative needs in a timely and fiscal manner while offering the end-user a simplified means of tracking their requests. The fourth Quarter of FY22-23 saw the roll-out of Operative IQ to Materials Management and Purchasing by placing all medical supplies, equipment, and other capital goods into the asset management system. An additional highlight was the sourcing and arrival of Level III Ballistic plate armor sets for all on-duty Operations ambulances.

Final layout for production


Multi-Station Unveiling

Our community education efforts shifted in FY2023 to focus on the increased community demand for hands-on bleeding control and emergency preparedness training. STOP THE BLEED community education

The City of Austin Stop The Bleed Project was created in December 2022 after a mass shooting in a Colorado LGBTQIA+ nightclub. Stop The Bleed is a nationally recognized training program that provides hands-on practice of applying direct pressure, packing a wound, and using a tourniquet to stop bleeding. The project is a collaboration between Austin-Travis County EMS and the Austin Fire Department (AFD). Our ATCEMS Regional Training Center provides AHA (American Heart Association) certified courses for Basic Life Support (BLS) CPR and First Aid with an AED.

1,468 Students trained in cpr


When local community members expressed their fears of going into LGBTQIA+ identifying establishments, ATCEMS and AFD employees assembled a team to address their concerns, and what started as a hallway conversation became a thriving community education program. The program was designed to be deployable and scalable for any group or establishment in the city. We have taken this training into businesses all over the City of Austin so that they can train in the environment that they are most familiar with and comfortable in. Since its inception, we have taught just over 400 community members including City Council members and over 200 Entertainment District staff members. The program has supplied the community with 200 Stop The Bleed Kits provided by the Capital Area of Texas Regional Advisory Council (CATRAC) and built 12 at-cost hemorrhage control kits dispersed throughout the 4th Street District. Program instructors have plans to train 150 team members of the SXSW Event Staff and

an additional 50 stage managers and security guards in time for SXSW 2024. The program recently combined forces with the Austin Police Department to teach a condensed Civilian Response to Active Shooter Event class alongside Stop The Bleed. In addition, ATCEMS participates in Emergency Preparedness training throughout the City of Austin by attending monthly events hosted by the City of Austin Homeland Security and Emergency Management Department (HSEM) and local Austin Public Library neighborhood branches. We are proud of this joint agency effort to train our city in hemorrhage control and Emergency Preparedness techniques to continue towards our goal of making this the most well equipped, safest city in the country. We strongly believe that through this type of community outreach and training, we can decrease the number of preventable deaths due to traumatic injuries and unforeseen emergencies in the City of Austin.

connecting people with ideas, resources and hope.



respecting & Representing

Respecting and representing sums up the dedication of the 16 volunteer uniformed members of the ATCEMS Honor Guard Team. This group continued to represent in the highest manner Austin-Travis County Emergency Medical Services and our employees at multiple large-scale events and national ceremonies over the last year. The Team was also privileged to provide “final honors” at several funerals in respect to our deceased retirees and those who died in the line of duty.


Fiscal 2023 was the year of change for EMS Recruiting. We are now under the direction of the Academy Operations staff division. Through strategic planning to fill our vacant positions, we increased the number of hiring processes and academies from three to four per year. In addition, our application intake system is always open to potential candidates. EMS Recruiting was instrumental in implementing the new lateral Direct Hire process for the Clinical Specialist positions within our department. Through these efforts, we opened a total of 12 hiring processes and four Academies in FY23.

HR & Recruiting bringing in today's best for tomorrow's success


EMS HR was instrumental in administering the promotion process for sworn employees from new exams and existing eligibility lists. This resulted in a total of sixty-eight promoted employees HR onboarded 101 Sworn 16 Civilian Medic Field: 33% were female applicants 43% were diverse applicants Communications: 52% were female applicants 58% were diverse applicants Lateral- Clinical Specialist: 20% were female applicants 36% were diverse applicants 261 Hispanic 53 Black or African American 513 White 8 American Indian & Alaskan Native 35 Asian 3 Native Hawaiian & Pacific Islander 30 Two or more diverse backgrounds Diversity Stats

Cadets at water training

Finding and hiring for the future of care

EMS Recruiting continues to increase the number of applications projected for each fiscal year and improve our overall diversity within our applications and hires. Recruiting strives to be out in our community to recruit top talent for

our department. With the newly budgeted increase to the Recruiting staff, we will continue to excel in our outreach activities and create new and innovative ways to reach potential applicants.

Projected Applications 760 Actual 938 Projected Hires 112 Hired 115 FY 22/23 Performance Measures

Job fairs, college/high school visits, community events, and military career fairs. Virtual events: 66 (from Oct 22-Sep 23) In-Person events: 63 (from Oct 22-Sep 23) 129 Outreach Events


Spec OPS Rescue finding all the best views in all the weird places

Industrial Rope tech

The rescue section of the Special Operations Division delivers advanced, comprehensive, life-saving patient care to the sick and injured in austere and hazardous environments anytime, anyplace. To accomplish this mission, the Rescue team is made up of skilled paramedics who are trained in multiple rescue disciplines such as still-water, swift-water, technical/rope, confined spaces, and wilderness rescue. The Rescue team also supports HAZMAT operations and most recently has added Infectious Disease Response to its mission. Rescue added eight new members to the team. This included three

rescuers that will complete their ALS credentialing while partnering with a Rescue System Qualified trainer (Captain or FTO). Over the course of the year, over 2,000 hours of training were completed through additional monthly training scenarios and evolutions to cover each of the modalities. The rescue team co-led training with Austin Fire Department Special Operations Battalions to multiply efforts and streamline mission goals when dispatched on complicated scenes together. This training is attended by the members when on duty which makes it a challenge due to the high call volume of the system.

Often times, team members attend training courses or competitions out of town. Sometimes these are financially supported by the Department but often times team members attend at their own expense. In 2023, a team comprised of one Rescue Captain and two Rescue Clinical Specialists, travelled to New York City to attend the FDNY Search & Rescue Field Medicine Symposium and compete in the Rescue Competition. This event provided professional growth and networking opportunities.

In 2023 special operations rescue responded to 264 events

From ropes to boats, ATCEMS spec ops teams are ready

Flood Water training


EMS Spartan unmanned aerial Systems


As response types evolve, so does our deployment of new technology. Deploying these assets provide vital intelligence on larger or more complex scenes.

Other Flights

The SPARTAN Team is the Department’s Unmanned Aerial System (UAS) or drone team. SPARTAN pilots are assigned across the department and are available for deployment 24 hours a day. SPARTAN pilots respond to a wide range of incidents including:


SXSW 2023

• Wilderness Rescues • High Angle Rescues • Swiftwater/Stillwater Rescues • HazMat Incidents • MCIs (Mass Casualty Incident) • Active Shooter/Attacker incidents


General Flights


Emergency Operations

Upon request, the team is also available for:

• EOC/LE (Law Enforcement) support • Fire Mission


ACL 2022

• Overhead/Traffic Support • Special Event Overwatch

The SPARTAN Team had a busy year logging nearly 240 hours of live mission flight time supporting Emergency Operations as well as Event Overwatch (not incluting auxiliary training hours).


Training Flights


public information office Bringing the story to the community

+80,000 FOLLOWERS over multiple platforms

The Public Information Office (PIO) is a 24/7/365 operation and responds to media inquiries, open records requests, and legal requests and acts as the legal liaison for EMS employees. Its primary function is to serve as a conduit for the release of accurate and timely information from credible and accountable sources to the media, as well as visitors and residents of Travis County. Other Responsibilities Include: • Respond to major/high profile incidents; on-scene department spokesperson Crisis management message mitigation Collaborate with Community Relations and Injury Prevention to increase awareness Design, produce, and deliver department presentations Generate press releases and talking points for executive staff and subject matter experts (SME) Create and delivery of safety messaging Manage and operate all department social media activity • • • • • •

Our Facebook page is a tool to share information with the Austin-Travis County community. We post pictures, videos, stories, and links daily to keep our community and the media informed and engaged. Our Twitter feed, @ATCEMS, is our breaking news, incident reporting, weather, and safety messaging channel and is considered a “must-follow” channel by local media and residents. The ATCEMS YouTube and Vimeo channels are the primary medium for media and department-produced videos, including Public Service Announcements (PSAs), promotional videos, training videos, and news stories. Instagram is structured to tell the story of the work lives of our medics through pictures and videos. Our LinkedIn channel allows us to reach out to prospective applicants and others within our industry by posting about daily activities, medical advances, and procedures. We also share medical success stories as a result of our cutting-edge programs.

INITIATIVES & ACCOMPLISHMENTS • Coordinated and conducted 274 media interviews • Coordinated and tabled at 11 (one in each council district) Emergency Preparedness Pop-up presentations • Broadcasted four academy graduations live on Facebook • Participated in the TxDOT Share the Road Campaign (Motorcycle safety & awareness) • Participated in the TxDOT Click it or Ticket or Worse Campaign (Driver safety & awareness) • Participated in the TxDOT Work Zone Safety Awareness campaign • Presented a general introduction to the ATCEMS Public Information Office at all ATCEMS Cadet Academies


employee development

EDucating. growing. building. supporting.

The Austin Travis County EMS Employee Development and Wellness Division (EDWD) supports both the department and individual providers. The division facilitates primary and continuing education, new hire and promotional Academies, clinical oversight, safety, wellness, recruiting, and community outreach. EDWD is uniquely invested in the long-term success of every employee and is committed to lifelong learning, physical and psychological wellness, and safe learning environments. We aim to foster the employee's professional growth through education, mentorship, and innovation. In turn, this ensures patients cared for by our providers receive the highest quality and compassionate care.

PARAMEDIC SCHOOL & Continuing education (CE)

• 19,926 Hours of CE awarded • 21 Students

• 15,529 Student contact hours • 6,584 Student clinical hours • Developed programing to meet the needs and address the concerns from the employees • Reassigned the employees enrolled in the paramedic program to accommodate the paramedic school schedule for better work life balance. In 2023, ATCEMS began hiring qualified applicants directly into the Clinical Specialist position in an effort to streamline experienced paramedics into the ALS position. The Direct Hire program reduced the amount of time from hire to initial credential by over 75%. In FY2023, 19 Clinical Specialists have been hired into this accelerated program.


Programs and initiatives: • Respiratory Protection Program • Driver Safety Program •

The ATCEMS Safety Program is dedicated to providing a safe work environment for our employees. Our goal is to prevent injuries and accidents involving our employees and the citizens we serve, enhance the health and well-being of our personnel, and create a safe experience for our patients. The team also conducts safety reviews of fleet accidents, on-the-job injuries, near misses, and assaults on providers. Collaborated with our public safety partners to create a workgroup dedicated to addressing workplace violence and assaults on first responders. Updated and extended the ATCEMS Cadet Driver Training Program curriculum based on relevant data and employee feedback. This comprehensive, 4-day emergency vehicle operations course is provided to new employees during their Cadet Academy. • •

Injury and Illness Prevention

• • •

Infection Control

Patient Safety

Facility Safety and Ergonomics

Cleaning and disinfecting of fleet and facilities


Continued conducting high level reviews of Incidents and Safety Concerns, identifying trends and patterns that guide strategic and operational planning. Performed a Health and Safety Audit for 100% of EMS Facilities. Through proactive efforts with Facilities and Command Staff, these audits continue to successfully provide a safe work environment and improve working conditions.

Water Safety Awareness


total numer of PPe items keeping our providers safe each day


wellness & peer support

The Public Safety Wellness Center is an occupational medical clinic that provides holistic, specialized, work-related wellness services to the City of Austin first responders. Programs and initiatives: • Conducts abbreviated and full medical exams • Annual physicals • New hire exams • Return to work • On-the-job injury exams • Behavioral health, fitness, and vaccination services Wellness fitness team, a team of exercise physiologists, conducts station visits for EMS crews. These visits include a menu option of injury mitigations, a resiliency course focused on health topics, or a lifting course. The fitness team also provides individual fitness consults when requested. Peer Support Team Mission: Our mission is to provide Emergency Service Personnel, both sworn and non sworn, psychological and emotional support through pre-incident education, spousal/family support, on-scene support and demobilization intervention, post-incident diffusion or one-on-one interaction. Purpose The purpose of the Peer Support Program is to prevent or lessen the potential negative impact of stress upon employees by providing emotional support, information and assistance. The program provides employees psychological and emotional support through one-on-one discussions, pre FOSTERING THE PHYSICAL, EMOTIONAL AND SOCIAL HEALTH OF EMPLOYEES

Cadet PT before class

Wellness eval for physicals

incident education, education on stress management, spousal/significant other support, on-scene support and demobilization intervention and diffusion. Team Members will work in conjunction with designated mental health professionals. Goals • To provide a system of trusted support that will aid employees in resolving situations affecting their personal and professional environments

Be a liaison between the employee and resources available to them To work in conjunction with the Peer Support Teams of APD, AFD and Victim Services (COA) to promote cross-agency support system


business technology


ANALYSIS, RESEARCH & TECH The Knowledge Management Division consists of two sections: Business Analysis and Research (BAR) and Business Technology Services. This dynamic team gathers and analyzes data, produces internal and external reports, performs predictive analysis, manages patient care records and billing systems, IT contract management and purchasing processes. Other functions include management of SharePoint Online for ATCEMS and IT project management. Both sections aim to improve performance through data collection, analysis, and process improvement. ATCEMS continues to find new and innovative ways to incorporate M365 products into business processes, report on trends, and share these achievements on the ATCEMS Online SharePoint page. The adoption of M365 products and features has flourished into several heavily used custom applications. The ATCEMS Whole Blood Program, Everbridge, and Daily Shift Report are a handful of applications that provide department staff and external partners with information instrumental to their line of business.


• Implemented the full version of Optima Predict software which includes the Resource Location Optimizer. Optima Predict is a powerful analytical software that allows management to ask complex questions regarding our ambulance locations, call volume, strategic planning, and response time compliance. This software allows ATCEMS to run simulations on what-if scenarios. • Configured and transitioned the ATCEMS ePCR program to the new National EMS Information System (NEMSIS) version 3.5. • Created the ESO Change Review group; change requests to ESO/ePCR are now reviewed and approved by a committee of ATCEMS stakeholders, greatly increasing insight into ESO/ePCR changes.


billing & finance

$ 115.5 MILLION Department Budget

Austin-Travis County EMS Billing is an in-house program to recover the costs of emergency medical services associated with transporting a patient to the hospital by ambulance. The Billing program bills insurance companies, government medical coverage plans, and patients for ambulance transport. Our team implemented an online form system to allow customers to submit updated demographic and insurance information when it is not obtained at the time of service, as well as submit authorizations to file claims to their insurance. The system allows customers to provide their information electronically without being limited to office hours or utilizing mail services for submissions. The ATCEMS Financial unit supports the department in a variety of ways such as creating the annual budget to ACCURATE MEDICINE WITH ACCURATE NUMBERS

provide the funding for EMS operations and monitors spending to ensure fiduciary responsibility. EMS Finance is responsible for all accounts payable and works to ensure all payments go out promptly. EMS Finance is also accountable for all revenue collection and accounting entries and reconciliations for the accurate posting of financial data.


Cleared the billing backlog Collected $35M of revenue for transport fees Filled all Billing vacancies Stayed within our operating budget

• •

$ 10+ MILLION Exceeded year-end estimated transport fee recovery

Transport Fees



20m GOAL

25m GOAL

FY 2022 FY 2023


integrated services collaborative care and community health programs for alternative responses

finding unique solutions to common problems

The C4 provides access to clinically appropriate and efficient care through referral to the right resource, focusing on the best interests of the patient while reducing unnecessary EMS responses and transports. C4 Clinical Navigators complete expanded triage and assessment of low-acuity 9-1-1 EMS calls and identify needs that are better addressed outside of the traditional ambulance to emergency department pathway. Navigators connect patients with alternate resources including primary, urgent, and specialty care, as well as insurance, prescriptions, telehealth, and treatment in place. In addition to coordinating Physicians Assistants (PA) and CHPR responses, the C4 staffs a Paramedic Response Unit (PRU) to replace Field ambulance responses and provide direct patient care and follow-up. Highlights: • Engaged with 8,142 EMS incidents and contributed to emergency department transport diversions in 4,199 of them— respective increases of 93% and 151% over FY2022. Coordinated access to care for over 1,600 uninsured and underinsured patients within our community. Supported cold-weather disaster operations by providing access to essential medical equipment and transportation to shelter for hundreds of residents. works to preserve the ready state of ATCEMS to respond to life-threatening emergencies. The mission of the C4 is to bring the right resource to the right patient at the right time. • • The Collaborative Care Communication Center (C4) was developed to handle low acuity calls that address patient needs without the use of an ambulance or an emergency department. This program

Substance Use Disorders (SUD) take care of persons experiencing problems with addiction and provides immediate treatment and long-term solutions for opiate dependency, further reducing demand on primary system units. Working collectively with local programs and non-profit agencies allows ATCEMS to provide targeted and fiscally responsible attention to community members with complicated medical needs that cannot be properly addressed by an ambulance response and an emergency room (ER) visit. Highlights: •Community Health Paramedics worked 2,426 Mental health crisis calls; 87% (2,108) of those calls did not involve law enforcement. •SUD program successfully enrolled 191 clients into a Medical Assisted Treatment program. 69% of those clients completed the program. •CHP program diverted 1,045 clients from being transported to an ER. •SUD program handled 840 opioid alerts. •CHP program conducted nine pop up resource clinics that served 315 persons experiencing homelessness and provided them with 1,053 interventions.

CHP pop-up resource

Austin-Travis County EMS Community Health Paramedic (CHP) program provides citizens of Travis County with unique pre-hospital care. CHP Responders (CHPR) are ATCEMS paramedics who have additional training and credentialing with an emphasis on mental health crisis care. CHPRs are auto dispatched to specific psychiatric calls to assist a field ambulance and provide alternative dispositions to connect patients in crisis with an appropriate resource. CHP case managers oversee a variety of community programs. Their proactive approach is meant to provide appropriate care to clients within the community who may otherwise be forced into utilizing the 9-1-1 system and emergency rooms for non-emergent care. CHP Case Management and community awareness


C4 Engaged with 8,142 EMs incidents and diverted over half of that call volume

to more appropriate resources diversions



Coordinated access to care for uninsured and underinsured patients within our community 1,600


The Austin-Travis County EMS Airport Medic Program (AUSMed) went live on March 1st, 2023. Initially, a Council-directed pilot program funded in collaboration with Austin-Bergstrom International Airport (AUS), the program places two paramedics in the airport during the busiest 12 hours of the day. Crews are based inside the Barbara Jordan Terminal and respond to incidents throughout the AUS campus. They provide care for as many as 30,000 daily travelers and over 6,000 employees. Basing medics on the secure side of TSA eliminates delays associated with responding to the airport events and significantly reduces the time to patient side. The AUSMed Team improves patient care system-wide by reducing unnecessary ambulance responses to the airport and keeping those units available in the community. Medics respond to every EMS call within the AUS campus and only request an ambulance when transport is confirmed to be necessary. Highlights: • Responded to 964 calls for service • Accumulated over 4 million steps and 1,700 miles walked by providers • Supported AUS operations during their record-setting busiest travel year ever, including 9 of the 10 busiest travel days ever

reduction of system resources responding to the airport 50%

AUSMED gearing up

C4 reallocating calls

Explorer post


POST 247 With the unwavering guidance of Austin Medics, Post 247 continues to flourish, providing unparalleled opportunities for young adults aged 14-20 in the Greater Austin Area. These opportunities allow them to explore the world of EMS, develop leadership skills, and closely collaborate with healthcare professionals. In 2023, the post reached a milestone with 40 full-time members and a record-breaking 4,632 hours of explorers dedicated to ambulance ride-outs. This hands-on experience plays an instrumental role in shaping their understanding and proficiency in emergency medical services, which is a rare opportunity for today's youth.

ATCEMS award ceremony


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