As Fort Worth鈥檚 July 1 takeover of MedStar draws closer, details are falling into place.
Last May, the city voted to dissolve longtime EMS provider MedStar after the entity acknowledged were making it difficult to operate independently while meeting response time goals.
Instead of subsidizing MedStar, Fort Worth pivoted to create its own EMS system within the fire department 鈥� a decision guided by recommendations from a committee made up of several council members who spent six months .
Officials updated Fort Worth City Council on the status of the transition at an April 15 work session, detailing budget projections, staffing changes and infrastructure preparation.
About 617 full-time and 40 part-time employees are expected to transition from MedStar to the city, and Fort Worth has seen more than 400 applicants take exams for its 75 open EMT positions, said Fort Worth Fire Chief Jim Davis.
All EMS employees will be part of the fire department and represented by Fort Worth Firefighters Association Local 440.
鈥淲e鈥檙e set up really nicely in the event that some folks that have been offered (jobs) decide to go in different directions,鈥� Davis said.
The EMS operations have a projected annual budget of $85 million 鈥� a cost that will be mostly offset by more than $65 million in anticipated annual revenue, according to city documents. The $20 million gap is largely due to the staffing costs, pensions and health care benefits the city will now take on, Davis said.
For the initial transition, officials need to replace about 26 ambulances. In subsequent years, about nine ambulance replacements and retrofits are expected annually.
MedStar鈥檚 local operations generated revenue of about $60 million a year 鈥� roughly the amount Fort Worth officials expect to continue receiving through the city鈥檚 operations. Around 60% of this revenue was from Medicare or Medicaid reimbursements; 10% to 20% was private insurance; and up to 22% was from out-of-pocket payments, Davis said.
He noted that revenue could be impacted by cuts to federal welfare programs and grants 鈥� something that has shaken across the country, including Tarrant County鈥檚.
鈥淲e鈥檙e not exactly sure where that鈥檚 all going to sit. We鈥檙e watching that very closely,鈥� Davis said.
Around $2 million of the projected revenue will come from 14 partnering cities that have previously relied on MedStar. They will pay for Fort Worth鈥檚 EMS services by the unit hour.
Fort Worth鈥檚 forecast for funds from partner cities is based on the cities鈥� average ambulance use, multiplied by the cost of about $141 per unit hour to operate an ambulance. Haltom City, for instance, is expected to use about 4,800 hours of EMS services over the 2026 fiscal year, paying Fort Worth about $677,000 鈥� the most of any partner, according to city graphics.
鈥淲e owe this information to (partner cities) in June every year, so that when they do their budget, we will true up with them based on what the actual usage is versus what their preexisting usage was,鈥� Davis said.
To streamline fire and EMS operations, the city will combine fire and EMS 911 communications and dispatch services at 2900 Alta Mere Drive, the current MedStar headquarters, in June.
Officials have to the state to designate the Fort Worth Fire Department as a licensed EMS transport provider 鈥� an essential step in moving to assume MedStar鈥檚 operations. The department is already a licensed EMS provider, but hasn鈥檛 had the authority to transport patients, which traditionally fell to MedStar crews. Officials expect the application to be approved by June.
These updates continue the city鈥檚 11-month, bit-by-bit takeover of MedStar. Previously, officials have new terms with the union representing firefighters; taken ; revealed a ; and purchased new technology necessary to make the transition possible.
Officials also have created a new city department, the , and two new advisory boards 鈥� the , which is expected to meet for the first time in May, and the Medical Control Advisory Board, which on March 27.
Care facilities will need to find some services previously provided by MedStar through contracts with private providers. Those services include interfacility transports, which generally involve moving a patient from one care facility to another.
The ultimate goal of the transition is to bring in new transport revenue and improve response times and system reliability, Davis said.
The city鈥檚 next steps are to continue finalizing EMS budgets, intercity agreements, transition costs and staffing.
Drew Shaw is a government accountability reporter for the Fort Worth Report. Contact him at drew.shaw@fortworthreport.org or .
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