Interview with Brent Smith of Hopkins County EMS

Brent Smith is the current EMS Director for Hopkins County EMS and has been in the position for six years. Hopkins County EMS is a 911 hospital-based ambulance provider in Sulphur Springs, Texas that operates four ambulances daily between Hopkins and Delta Counties.

Along with his duties, Brent also plays an active part in the State of Texas Emergency Medical Task Force (EMTF) Program as a Task Force Leader for EMTF-4. Since 1993, his EMS work has included roles with a for-profit private ambulance service in Dallas and large hospital-based EMS service provider in the East Texas area. During these roles, Brent received industry-specific education and management experience through the American Ambulance Association, Texas Ambulance Association, and TEEX.

He is a dynamic and diverse leader in EMS Management with multiple expertise in EMS operations, billing, fleet maintenance, customer service, disaster preparedness, and education. Brent has received numerous awards for clinical paramedicine and EMS operations.

A resident of Sulphur Springs, Texas, Brent and his wife Brynn have four children. Brent was elected to the TEMSA Board of Directors in August 2015.

The following is an interview with him.

TEMSA: Why did you want to get involved with TEMSA as a board member?

BS:I wanted to get involved with TEMSA because I truly believe that the mission and foundation that the founding board established has led to the best principles and vision for our industry in Texas. In every aspect of the EMS industry in which I get involved, I want to see succeed including making Texas EMS agencies superior than other parts of the country. I want Texas EMS agencies to set the bar for standards and quality in our industry and make other states take notice that Texas is the best place to work in EMS and provides the best care for our communities.

I would like to see TEMSA continue to push legislation to combat fraud and abuse, which includes higher standards for owners, operators, and team members in the field. I feel this can be done without a financial burden upon the EMS providers. We have to have an association that can make positive change with a united voice from all types of providers and find the best solutions to prosper in our ever-changing health care environment.

TEMSA: We have witnessed a rapid transformation of the entire health care industry over the past few years due to a number of reasons, including the Affordable Care Act, industry consolidation, and declining commercial insurance reimbursement rates. How do you see the Texas EMS industry fitting into this changing environment?

BS: With a dynamic shift in the health care environment, I feel the EMS industry has to stay on point and look ahead of what trends are happening to our partners in health care. Hospital acquisitions and mergers are an almost daily occurrence.

Community paramedicine is happening: how does that fit into rural EMS providers where there is not a means for reimbursement? What solutions should be questioned and some things work for one provider type or geographical area and not for the others? These are complex and trying times for some providers that face significant challenges, and I feel the TEMSA is in the best position to be a resource either through networking or another type of vetting to help providers through change.

While going through change alone is difficult and taxing, having TEMSA as a partner from a member standpoint makes things not as cumbersome. TEMSA staying in tune with the legislation and members is the key to helping the EMS industry in Texas during a paradigm shift is essential.

TEMSA: You operate an EMS system in a rural community. What types of challenges are you witnessing in the rural area?

BS: Operating EMS in a rural area has significant challenges that not all providers face. I also feel that what provider type you are leads to different variables. Being a hospitalbased rural provider and looking at how to make community paramedicine work is challenging; the hospital already owns the EMS and pumping more money into the organization to reduce readmissions may not be the answer.

Readmissions may not be a significant issue financially for the organization, which in turn means no reimbursement avenue for the program. This is just an example of what a rural provider may face. Financial acumen is essential for rural providers, and making every dime count from the collections you do make on EMS calls is a must. Some rural providers have a huge amount of self-pay, and balancing capital purchases on equipment at times can be extremely difficult.

TEMSA: What do you think your EMS program will look like in five years?

BS: As a hospital-based EMS provider, it can be difficult to envision what our agency will look like in five years. What I would like to see in the next five years for our agency is some growth of market along with financial stability in our industry. I foresee some type of community paramedicine program along with more community outreach initiatives. We will most adamantly look for the newest clinical practices and standards and continue to strive for the best technology that matters to patient care.