Service & staffing

More money and more staff didn’t buy faster ambulances

The real test of “we need more funding” is whether more funding made the service better. ESD 2 roughly tripled its budgeted staff and doubled its spending, yet its EMS response times never met the standard, and in some years they got worse.

The core test

ESD 2 never hit the 8-minute standard

The common benchmark for a career department is an advanced-life-support ambulance on scene within 8 minutes, 90% of the time. That’s the standard the City adopted. In its own reports, ESD 2 missed it every year, in every area.

ESD 2 never hit the 8-minute standard, and got slower EMS response times (90th percentile) by year and area, in minutes:seconds, against the 8:00 standard the City adopted (dashed line). Lower is better.
0:004:108:2012:3016:4020:50 2020, Urban: 12:1812:182020, Suburban: 12:0212:022021, Urban: 12:1012:102021, Suburban: 12:1512:152022, Urban: 13:5713:572022, Suburban: 16:0716:072023, Urban: 12:4812:482023, Suburban: 13:5613:56 8:00 standard2020202120222023
View the data
CategoryUrbanSuburban
202012:1812:02
202112:1012:15
202213:5716:07
202312:4813:56

Source: ESD 2 headcount reports, budget and Fire & EMS response reports.

When the City asked each potential provider to show it could meet the 8-minute standard, ESD 2 said it could not. The private provider that replaced it committed in writing to arriving within 7:59 on 90% of calls.

Staffing

Staffing tripled while calls stayed flat

Staffing tripled while call volume held flat Budgeted full-time-equivalent (FTE) positions by fiscal year.
0100200300400 FY2016, Budgeted FTE positions: 110FY2017, Budgeted FTE positions: 127FY2018, Budgeted FTE positions: 152FY2019, Budgeted FTE positions: 175FY2020, Budgeted FTE positions: 192FY2021, Budgeted FTE positions: 194FY2022, Budgeted FTE positions: 289FY2023, Budgeted FTE positions: 330FY2024 est., Budgeted FTE positions: 338FY2025 prop., Budgeted FTE positions: 351FY2016FY2017FY2018FY2019FY2020FY2021FY2022FY2023FY2024 est.FY2025 prop.
View the data
CategoryBudgeted FTE positions
FY2016110
FY2017127
FY2018152
FY2019175
FY2020192
FY2021194
FY2022289
FY2023330
FY2024 est.338
FY2025 prop.351

Source: ESD 2 adopted and proposed budgets.

ESD 2’s budgeted positions went from 110 in FY2016 to 351 for FY2025. Over the same stretch, total calls for service barely moved, and EMS calls fell by about half after it stopped running ambulances in 2022.

There’s a catch under that headline number. A lot of the staffing was budgeted but never hired. In March 2024, ESD 2 reported about 246 actual personnel against a budget of 338, roughly 92 funded-but-vacant positions.

That matters, because those empty positions were later used to argue that reclaiming tax money would force “layoffs.” You can’t lay off people who were never hired.

Spending vs. workload

Spending climbed; the workload didn’t

Both lines are set to 2017 = 100 so they share one honest scale. Budgeted expenses more than doubled while total calls for service barely moved.

Spending climbed; calls didn't Everything indexed to 2017 = 100 so the two trends share one scale. Budgeted expenses more than doubled while total calls for service stayed roughly flat.
0100200300 2017201820192020202120222023Budgeted expenses (index)Total calls for service (index)2017 baseline
View the data
YearBudgeted expenses (index)Total calls for service (index)2017 baseline
2017100100100
2018119105100
2019144117100
202017599100
2021169123100
2022181121100
2023256124100

Source: ESD 2 budgets and Fire & EMS operational statistics.

A fully paid (“career”) fire department costs money by design, and only about 9% of U.S. fire departments are all-career like ESD 2, so a bigger budget than a volunteer department is expected. The issue isn’t that ESD 2 costs money. It’s that its costs grew far faster than the community, the calls, or the service it delivered.

What the job actually is

97% of the calls are medical, not fires

97% of ESD 2's calls are medical, not fires TCESD 2's own 2023 reporting: of 10,885 total service calls, 10,553 were medical and 332 were fires.
Medical emergencies: 10,553 (96.9%)Fires: 332 (3.1%)97%medical Medical emergencies, 96.9% Fires, 3.1%
View the data
CategoryValueShare
Medical emergencies10,55396.9%
Fires3323.1%

Source: TCESD 2 2023 Annual Report.

By ESD 2’s own 2023 reporting, of 10,885 total service calls, 10,553 were medical and just 332 were fires. Almost all of the work is emergency medical care, the exact service ESD 2 stopped transporting patients for in 2022.

That’s not unusual. Nationally, actual fires make up only about 4% of all fire-department calls, and the rest is mostly EMS and rescue. But it does reframe the debate. A “fire department” that is 97% medical is really an EMS agency that also fights the occasional fire, which is what made walking away from ambulance transport such a strange move.

Underused equipment

Most fire trucks sit idle almost all the time

“Unit Hour Utilization” measures how much of the time a unit is actually working a call. The independent study found most of ESD 2’s fire apparatus were used a tiny fraction of the time, well below the 25 to 31% range used to justify putting a unit in service at all.

Most fire trucks are used a tiny fraction of the time Unit Hour Utilization is the share of time each fire unit is actually on a call (2018 to 2020 average). The industry starting range for putting a unit in service is 25 to 31%. Most units fall far below it.
industry deployment range (25–31%)ENG221 (Engine)ENG221 (Engine): 12.8%12.8%ENG211 (Engine)ENG211 (Engine): 12.5%12.5%ENG231 (Engine)ENG231 (Engine): 9.3%9.3%QNT251 (Quint)QNT251 (Quint): 9.1%9.1%ENG241 (Engine)ENG241 (Engine): 8.0%8.0%QNT221 (Quint)QNT221 (Quint): 5.4%5.4%BAT201 (Battalion)BAT201 (Battalion): 2.8%2.8%SAFE201SAFE201: 2.3%2.3%BT211 (Brush)BT211 (Brush): 0.4%0.4%BT231 (Brush)BT231 (Brush): 0.3%0.3%BT241 (Brush)BT241 (Brush): 0.2%0.2%ENG280 (Engine)ENG280 (Engine): 0.1%0.1%ENG290 (Engine)ENG290 (Engine): 0.1%0.1%
View the data
UnitValue
ENG221 (Engine)12.8%
ENG211 (Engine)12.5%
ENG231 (Engine)9.3%
QNT251 (Quint)9.1%
ENG241 (Engine)8.0%
QNT221 (Quint)5.4%
BAT201 (Battalion)2.8%
SAFE2012.3%
BT211 (Brush)0.4%
BT231 (Brush)0.3%
BT241 (Brush)0.2%
ENG280 (Engine)0.1%
ENG290 (Engine)0.1%

Source: AP Triton Fire & EMS Assessment, Figure 67.

Idle equipment isn’t automatically waste. You keep a fire engine ready even if it rarely rolls. But it does cut against the claim that the district is stretched thin and needs more of everything. The study’s wording was blunt: existing facilities and equipment are underutilized.

The billing angle

The ambulance system was underpriced, not unfundable

Who pays for ambulance transports Share of ambulance transports by payer (Oct 2019 to Sep 2020). ESD 2 collected just under 38 cents per dollar billed, which points to rates set too low rather than a service that couldn't be funded.
Medicare: 2,204 (41.5%)Commercial insurance: 1,356 (25.6%)Private pay (uninsured): 1,153 (21.7%)Medicaid: 593 (11.2%)5,306transports Medicare, 41.5% Commercial insurance, 25.6% Private pay (uninsured), 21.7% Medicaid, 11.2%
View the data
CategoryValueShare
Medicare2,20441.5%
Commercial insurance1,35625.6%
Private pay (uninsured)1,15321.7%
Medicaid59311.2%

Source: AP Triton EMS System Valuation Study (billing data from Emergicon).

When ESD 2 ran ambulances, it collected just under 38 cents on every dollar it billed. That points to transport rates set too low, not to a service that inherently loses money.

The independent valuation found that just moving to a single base rate (around $1,600, in line with a national survey of comparable cities) would raise transport revenue to about $3 million a year. Add a subscription program, treat-no-transport billing, and a state supplemental program, and the system’s value reached about $3.6 million, all without any new taxes.

Put another way, the ambulance service the district said it couldn’t afford could have mostly paid for itself.

The big picture

Fire departments are mostly EMS agencies now

ESD 2 being 97% medical isn’t a fluke. Across the country, the fire service has shifted from fighting fires to answering medical calls. Federal data makes the change hard to miss:

  • Nationally, fires are about 4% of all fire-department runs; EMS and rescue are about 64%.
  • The number of U.S. fires has fallen roughly 45% since the 1980s, and structure fires about 42%.
  • Over the same decades, total fire-department calls climbed from about 20 million a year to more than 36 million, almost entirely from medical calls.

That’s the backdrop for Pflugerville: a “fire department” whose real job is emergency medicine chose to stop transporting patients. The national picture makes that decision stand out even more.

Nationally, fires are a small share of what departments do Breakdown of all U.S. fire-department responses. Medical and rescue calls dominate; actual fires are about 4%.
EMS & rescue: 64% (66.7%)Good intent: 12% (12.5%)False alarms: 8% (8.3%)Service calls: 8% (8.3%)Fires: 4% (4.2%) EMS & rescue, 66.7% Good intent, 12.5% False alarms, 8.3% Service calls, 8.3% Fires, 4.2%
View the data
CategoryValueShare
EMS & rescue64%66.7%
Good intent12%12.5%
False alarms8%8.3%
Service calls8%8.3%
Fires4%4.2%

Source: NFPA, U.S. fire department call breakdown (2020, ~27M responses).

Head to head

How ESD 2 compares to U.S. fire departments

MeasureTypical U.S. department / standardTravis County ESD 2
Share of calls that are fires~4% (USFA, 2020)~3%
EMS response standard (ALS, 90th pct.)8:00 (NFPA 1710)~12:00–16:00 — missed every year
Typical suburban EMS response~6:00 average (JAMA, 2017)Above the 8:00 standard every year
Staffing modelOnly ~9% of U.S. departments are all-careerAll-career
Fire spending per resident~$100–$200 for a typical city (rough, Census-derived)At the high end
Healthy operating reserve~3 months (25–30%)~18 months held

Sources: USFA/FEMA fire department run profile (2020); NFPA U.S. Fire Department Profile; NFPA 1710; Mell et al., JAMA Surgery 2017; U.S. Census-derived spending data; AP Triton studies; ESD 2 financials. Full citations on Sources. National figures are averages and standards for context, not legal requirements, and a large all-career combined fire+EMS budget is expected to run higher than a volunteer department.