What does the future of Fort Worth’s EMS system look like? Council committee nears decision

dfwnewsa | March 19, 2024 | 0 | Fort Worth , Fort Worth News

What does the future of Fort Worth’s EMS system look like? Council committee nears decision

A MedStar ambulance sits off Lancaster Avenue July 25, 2023. (Sandra Sadek | Fort Worth Report)
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Fort Worth’s EMS committee will make a recommendation on the future of emergency care in the city come April — and its decision could have ripple effects across the county.

Committee members received a draft of the complete EMS evaluation report from Fitch & Associates March 19, after nearly five months of research, analysis and discussion. The members are tasked with considering four different options:


Keeping the current MedStar system, with changes to its governance structure.

Creating a fire-based EMS model, with either civilian or sworn positions.

Establishing a third-service model alongside police and fire within the city.

Switching to a private contractor model.

“These are all viable options,” Hilary Shine, a consultant working with the city, said. “So in their professional estimation, none of these are options that would not work and could not be successful, depending on the policy decision that’s made.” 

Among the options, maintaining the current system would be cheapest, while establishing a fire-based EMS system staffed by sworn firefighters would cost the most. 

This is the first time in more than a decade that Fort Worth has taken a comprehensive look at its EMS system, which MedStar currently manages. Fort Worth has relied on MedStar for emergency medical services since 1986, and the EMS provider also services more than a dozen smaller communities. But as the public utility struggles with rising costs and declining reimbursements, council members chose to explore what alternative models would look like. 

The EMS committee will meet twice more, on April 16 and April 30, before making a recommendation to the entire City Council. 

Some of Fitch’s recommendations are applicable to all of the four options. These include consolidating existing 911 communication centers; making Fort Worth City Council the governing authority of the EMS system; and separating 911 calls and interfacility transports.

District 2 council member Carlos Flores, who chairs the EMS committee, said interfacility transports have become a topic of conversation with local hospitals, who have suggested it as an area of improvement within the current system. Currently, MedStar is responsible for both responding to emergency calls and transporting patients from one care facility to another. 

“Right now, MedStar is the sole provider of (interfacility transports),” Flores said. “And so from a market standpoint, they’re interested in seeing if perhaps, from a price standpoint, could there be other options?” 

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Fitch also presented cost estimates for each of the four models for the other cities who rely on MedStar, should they choose to participate. Assistant city manager Valerie Washington said discussions with those cities revealed anxieties about what Fort Worth’s decision would mean for them financially. 

“I do think there is some general concern that the city of Fort Worth isn’t going to take their interests in mind, even though we keep reassuring them that we are,” she said. “And we mean that.” 

The estimates outline what it would cost each city to participate in each model, based on either population and incident distribution or unit hour cost. Fort Worth, which accounts for the majority of 911 calls handled by MedStar, would bear the brunt of the cost.

“Everyone would pay their fair share, proportional to what they’re using,” Washington said.

The cost allocation estimate for retaining MedStar.

The cost allocation estimate for establishing a fire-based EMS system.

The cost allocation estimate for establishing a third-service.

The cost allocation estimate for entering a private contract.
Click to review the cost allocation estimates for member cities under each model.

After the EMS committee meeting, MedStar CEO Ken Simpson said he’s confident in the EMS system his organization has created, and pointed toward the national recognition MedStar has received for its services.

Fort Worth Fire Chief Jim Davis said the consultant process has been fair, open and collaborative. The sooner the council can provide direction moving forward, he said, the more peace of mind those affected will have.

“Over the next couple of weeks, our council is going to have to make some decisions on the direction that they want to go,” he said. “And once they set that policy, I think the fire department will be in the position to help execute that policy at a high level. Whichever direction they go we’ll support.”

At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here. Emily Wolf is a government accountability reporter for the Fort Worth Report. Contact her at emily.wolf@fortworthreport.org or via Twitter.

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