Slow response and financial issues are among the reasons Travis County residents have pushed to sever ties with Austin/Travis County EMS and opt for a private ambulance service.
The first quarter of this fiscal year, only three-fourths of rural calls had an ambulance on site within 12 minutes.
"People were talking about change because they were uncomfortable with the results, but they didn't really know what the outcome was that they wanted," David Williams, a consultant with True Simple Improvement, said.
Williams published an article this week in the Journal of Emergency Medical Services, showcasing Austin's issues on the national stage.
ATEMS Chief Ernesto Rodriguez says the agency is working through a pile of issues.
"We are doing what we are supposed to do. We are having those discussions,” Rodriguez said. “We've asked the county to add additional resources to help us improve response times, and they are stepping up and they are doing that."
This year alone, EMS moved to civil service, renegotiated its union contract and gained dual accreditation—the first agency to do so in Texas.
Rodriguez says that's more change than most agencies experience in a half decade. Now, the focus is on keeping up with rapid growth in and out of the city.
"We need to learn how to work smarter in the things that we do," Rodriguez said
That means looking at ways to control the agency's growth and still provide the level of service that's expected, according to Rodriguez.
"The system itself is sustainable, it is well funded,” Williams said. “It has all the right parts and pieces. It has wonderful people who are trying to do good work. There are opportunities always for improving the efficiency, reliability and the quality of the system."
The EMS department has dozens of job openings right now, but Chief Rodriguez says that's typical this time of year.
Austin's Public Safety Commission has called for a top to bottom audit of the EMS department, but the request still needs to be approved by City Council.