Home Services Fire Fire Investigations Smoke Detectors Disposal of Fireworks Contractor Information EMS For Facilities For Patients Ambulance Demos Membership StarSaver EMS Standby for special events Programs Education Site Visit Requests Contact About Fire & EMS Department Leadership Board of Directors Service Area Office of Medical Director Permits & Acknowledgments Interfacility Transport Permitting Process Ambulance Permitting Application S6927 NEW Interfacility Transportaton Permitting SOP Final Alarm Medstar Foundation Office of Medical Director Surveys & Forms Fire Department Contact Form EMT Recruitment Form EMS Record Request FWFD Event Inquiry Form Reports City Secretary City Records Open Records RFP, Agendas & Board Metropolitan Area EMS Authority Apply to Serve Upcoming Board & Commission Cases Agenda & Public Notices Calendar How Do I Reporting - Fire or EMS Fire: 817-392-3000Ambulance: 817-927-9620 or dial 911 for emergencies Non-Emergency Reporting made easy on MyFW APP Ways to report Fire code violations Request Report Prevention, Education & FAQs Contact & Request Fill out a online form to contact us Media line or read current news Request a fire truck or an event Fire Department Special Request Jobs & Recruitment View open job listings Firefighter/EMS trainee information EMT Interest Form Fire Recruitment Form Location for Training Find more about My neighborhood fire department Volunteering Fire & EMS Services Fire & EMS Operations Report illegal fireworks Home Services All Fire/EMS Services Fire Fire Investigations Smoke Detectors Disposal of Fireworks Contractor Information EMS For Facilities For Patients Ambulance Demos Special Programs Membership Starsaver Services Fees EMS Standby for special events Programs Education Site Visit RequestsMIH-CP Outcome Measures Project--> Contact Contact About Fire & EMS Department Leadership Board of Directors Service Area Office of Medical Director Permits & Acknowledgments Interfacility Transport Permitting Process Ambulance Permitting Application S6927 NEW Interfacility Transportaton Permitting SOP Final Alarm Medstar Foundation Office of Medical Director Surveys & Forms Fire Department Contact Form EMT Recruitment Form EMS Record Request FWFD Event Inquiry Form Observer Interest Form Reports City Secretary City Records Open Records RFP, Agendas & Board Metropolitan Area EMS Authority Apply to Serve Upcoming Board & Commission Cases Agenda & Public Notices Calendar How Do I Reporting - Fire or EMS Fire: 817-392-3000Ambulance: 817-927-9620 or dial 911 for emergencies Non-Emergency Reporting made easy on MyFW APP Ways to report Fire code violations Request Report Prevention, Education & FAQs Contact & Request Fill out a online form to contact us Media line or read current news Request a fire truck or an event Fire Department Special Request Jobs & Recruitment View open job listings Firefighter/EMS trainee information EMT Interest Form Fire Recruitment Form Location for Training Find more about My neighborhood fire department Volunteering Fire & EMS Services Fire & EMS Operations Report illegal fireworks
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When someone calls 911, there must be, and will be, high-quality patient care sent to help, at all times. In the past year, the issue at hand has been about sustainable funding and continuing to deliver a high-quality Emergency Medical Services (EMS) system to the City of Fort Worth and surrounding areas.
In May 2024, the Fort Worth City Council approved the EMS Ad Hoc Committees recommendations, which include establishing an EMS system within the Fort Worth Fire Department. This will ensure that the EMS system for residents and visitors is financially sustainable, responsive, timely and focused on high-quality patient care.The Fort Worth City Council, by separate resolution, agreed to create two advisory boards in support of the EMS system, including an EMS Advisory Board and Medical Control Board.
Most recently, the Memorandum of Understanding (MOU) between the City of Fort Worth and the Fort Worth Professional Firefighters Association, International Association of the Fire Fighters Local 440, was approved by Fort Worth City Council. This agreement will amend certain provisions of the current Collective Bargaining Agreement (CBA) between the City and the Local 440 for incoming Emergency Medical Services (EMS) positions joining the Fort Worth Fire Department (FWFD) in July 2025. Through the collective bargaining process, the City and Local 440 negotiated revisions to the CBA, providing civil service status to former employees of MedStar. Their primary duties will be emergency medical services as emergency medical technicians (EMTs), paramedics and telecommunicators. The CBA approved today expires Sept. 30, 2026.
Background
In 2023, the City recognized the rising costs of EMS delivery and the stagnant revenues affecting the MedStar EMS delivery model.
In December 2024, the Local 440 membership ratified the MOU by majority vote.
The Study
Success is a long-term, financially sustainable EMS model that provides quality care for patients for years to come.
Since 1986, the Fort Worth Fire Department and MedStar have shared the common mission of providing the highest level of care that is in patients' best interests. The Fire Department regularly works with MedStar and remains committed to providing a high level of service to the community. Their crews work closely together daily.
Since 2019, MedStar’s leadership team, in collaboration with their Board of Directors, took steps to prevent, or at least delay, the opportunity for expenses to exceed revenue. At the time, the financial challenges MedStar faced were anticipated to take place further in the future, and MedStar leadership and the Board of Directors kept member cities aware of the challenges that seemed to lie ahead.
Since 2009, the City of Fort Worth, along with other MedStar member cities, has not needed to contribute any financial support to MedStar. MedStar has supported itself through fees from health insurance and government programs like Medicare and Medicaid. The COVID-19 pandemic caused extreme decreases in MedStar revenue and other health care organizations such as hospitals and clinical practices. In 2020 and 2021, MedStar requested federal CARES Act funding through its member cities. The City of Fort Worth allocated a one-time payment of $606,400 in federal CARES Act dollars to MedStar in addition to other member cities collectively providing $20,000 of additional CARES Act funding.
MedStar utilized reimbursement from private and government insurers, like Medicare and Medicaid, for the services provided. Because of that third-party funding, member public agencies had not supported MedStar financially since 2009. A third-party cost reporting firm confirmed that MedStar had been the lowest cost provider in Texas from 2012 through the most recent cost report in 2022.
No. The City of Fort Worth and its member cities created MedStar as a public utility model, under the direction of the Metropolitan Area Emergency Medical Services Authority. As the Authority’s largest customer, Fort Worth accounts for 90 percent of the Authority’s call volume and is represented by five of nine seats on its board of directors.
The declining financial status of EMS systems is an issue across the country, forcing many municipalities to evaluate their models. According to themunicipal.com, “The EMS system is under pressure from various sources and faces significant change in the coming years. EMS agencies face financial pressure from increasing costs coupled with flat or decreasing reimbursement; difficulties in recruiting and retaining personnel to staff ambulances, all coupled with an aging population and increasing number of calls.”
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