Fort Worth wants to improve emergency medical services within the city’s boundaries. The starting point is a study — and a new council committee to oversee it.
Mayor Mattie Parker assembled a five-member ad hoc committee on Aug. 8. Parker, as mayor, has the authority to convene ad hoc committees on any issue she believes requires additional attention. She said she reserves the designation for some of the highest priority items in Fort Worth.
Council members Carlos Flores, Elizabeth Beck, Macy Hill, Charles Lauersdorf and Jared Williams will advise and support city staff and consultants during a third-party study of existing EMS structures and potential alternatives. The committee members will provide a final report to the full City Council by April 30, 2024, with recommendations on the best EMS service system for Fort Worth.
The focus of the study overseen by the committee is wide-ranging. The plan is to compare Fort Worth’s situation with national EMS trends and challenges; evaluate different EMS models and their governance structures; review patient outcomes compared to other systems; and analyze cost and revenues of the current system compared to others.
The move follows concerns from firefighters and council members about the financial viability and effectiveness of the city’s current emergency medical services provider, MedStar.
Parker said the committee will also act as a more neutral party in the discussions. She pointed toward past disagreements between city management and the fire department’s union, IAFF 440, about emergency services.
“I was afraid that if we let all of the discussion and work with the new consultant go through the city management office, it would be shrouded in doubt or controversy of some sort,” she said. “I think this committee overseeing that process will hopefully defuse any consternation, and we can work together to really get to the right result.”
District 2 council member Flores will serve as the committee’s chair. Flores previously chaired the ad hoc committee on firefighter staffing, and currently serves on MedStar’s board of directors.
Fort Worth is one of 15 area municipalities served by MedStar, an emergency medical services provider created in 1986. It is a public utility model, meaning government entities entered an agreement to create MedStar and its board; the EMS provider, in turn, is responsible for hiring workers, financing infrastructure and providing services.
MedStar previously received some subsidies from its member municipalities, but that practice ended in the early 2010s. Since then, the provider has sought to be financially independent and sustain its services without funding from Fort Worth or other cities.
This year, however, a variety of issues came together to make that impossible. Declining reimbursements from Medicare and Medicaid, rising costs and higher call volumes over the years have all played a part in MedStar’s financial issues. In response, MedStar asked for a several million dollar subsidy from Fort Worth over the next year to remain stable and continue providing services while the EMS study is ongoing. In his 2024 proposed budget, City Manager David Cooke recommended giving the provider $4.2 million.
Parker said the final amount Fort Worth will give to MedStar during the study’s duration isn’t set in stone. Council members may decide they want to change the amount, or give it out on a quarterly basis. In July, council members told the Fort Worth Report they were willing to help MedStar next year, but it needed to be paired with concrete, long-term solutions to the financial crisis.
“They’ve been good partners for the city of Fort Worth, and for other jurisdictions, and they’ve been very transparent in this process,” Parker said. “I’m less concerned about the total amount than how we communicate that to residents moving forward.”
The application period for companies seeking to conduct the third-party study closed Aug. 3. Once the city chooses the proposal it wants to move forward with and signs an agreement, initial findings are due within 90 days, according to request for proposal documents reviewed by the Report. Final recommendations are due 30 days after the initial findings are submitted.
“When you call 911, you need someone to answer the phone and dispatch the best life-saving care that you need,” Parker said. “And that will not stop, that will absolutely continue throughout this process.”
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