As Fort Worth launched its in-house emergency medical services at midnight July 1, there wasn’t much dramatic fanfare.
There were no ball drops, parades or fireworks — at least not legal ones.
By that time, the city had practically already realized its transition to a Fort Worth Fire Department-operated EMS. The main changes at midnight were on paper, as Fort Worth hit its deadline to absorb the functions and assets of MedStar, the city’s longtime, third-party EMS provider.
The transition officially started in May 2024, when City Council voted to create Fort Worth’s own EMS branch at the guidance of a consulting firm hired to study the sustainability of MedStar.
The decision gave the city the large logistical undertaking of creating an all-new branch of first responders that merged MedStar and fire department workers — two teams that historically saw tension.
But as the deadline drew near, city and MedStar officials grew more optimistic about the transition. The fire department swore in over 600 former MedStar employees over May to build out its EMT staff, the two teams — now one — switched to operating on the same radio system, Fort Worth received its state EMS transport license and absorbed all of MedStar’s financial and physical assets.
“While I appreciate everybody and everybody’s efforts … it is about the end user of the product, and it is about the folks that are my customers,” said Fire Chief Jim Davis at a June 25 press conference about the launch. “My customers are those employees that are serving the end user of our product, which is our ultimate customer, and that is the public.”
City officials attributed the smooth transition to months of hard work as both involved parties navigated the transition with respect and focus on their shared mission of public service.
“Today, the city of Fort Worth does begin a new chapter in high-quality emergency services and patient-centered care that we have a virtually established EMS system within the city of Fort Worth Fire Department,” said Mayor Mattie Parker at the press conference.
How much will EMS cost the city?
The city’s EMS branch has an estimated annual budget of around $87 million, Davis told the Report. About $65 million will be covered by anticipated revenue from billing insurance and patients, according to estimates based on MedStar’s historical revenue.
Another estimated $2.5 million will be drawn from 14 surrounding, smaller cities that will pay Fort Worth to use its EMS services. That means about $19.5 million of new city money will be going to the services.
In June, City Council approved a budget amendment to cover EMS expenses during the last three months of fiscal year 2025. Most was covered by $17.6 million received from MedStar, and another $5.5 million was drawn from nondepartmental general funds.
In May 2024, Fort Worth approved the absorption of MedStar after deeming the third-party EMS contractor wasn’t financially stable.
After decades of MedStar operating financially independently, taking no money from the city budget, it came to Fort Worth officials to ask for financial subsidies to help offset its own budget deficits.
“MedStar hit a financial headwind and came to the city and said, ‘Listen, we are really in trouble financially,’ where they were spending $400,000 a month out of their reserve to try and make ends meet,” Davis told the report. “The first ask was a big ask, and that’s what made the city go, ‘No, we need to pay more attention to this, we need to have more eyes on it, and we need to bring it into the city.’”
Fort Worth’s third-party EMS agreement was unique for a city of its size, Davis said. In most major U.S. cities, EMS is housed within the fire department, while a few such as Austin have a city-operated independent EMS department.
City officials promise faster response times, streamlined service
The central goals of the EMS transition are to speed up call-response time by up to 5.5 minutes, leading more coordinated efforts in emergency situations and ensuring financial stability, officials said at the press conference.
“The city has made substantial investments in improving technology, improving our communications, all in an effort to (save) time and saving lives,” said Assistant City Manager William Johnson, who oversees the fire department, at the press conference.
Now, calls for EMS and firefighters are answered in the former MedStar building. EMTs are deployed out of fire stations, and firefighters are working on the same radio as EMS responders.
The merging of the teams has already led to better coordinated emergency responses, Davis said.
On June 23, as a fire at The Cooper apartments in Near Southside demanded a historic six-alarm response, EMTs were able to work as one with firefighters and talk to each other from the radios inside their vehicles, rather than walking up and down the street to talk in person.
“I am so grateful that the trust has been bestowed upon the Fort Worth Fire Department to take on this mission. I am very humbled by that opportunity,” Davis said, adding that the firefighters and EMTs on the streets are the “force behind” him. “We are here as a circle, and I am also very humbled that 14 member cities in the Fort Worth area have agreed to come along with us on this journey, and they are true partners, and I am proud to work with them.”
Drew Shaw is a government accountability reporter for the Fort Worth Report. Contact him at drew.shaw@fortworthreport.org or @shawlings601.
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