Fitch & Associates will take the lead on examining Fort Worth’s EMS services, after the City Council unanimously approved a $182,500 contract with the public safety consultant. 

It’s the first time in more than a decade that Fort Worth has commissioned a comprehensive study of its EMS system, which MedStar currently manages. Fort Worth has relied on MedStar for emergency medical services since 1986. But several times throughout the EMS provider’s tenure, it has run into financial problems. 

Over the past several years, those problems reared their heads again — and this summer, MedStar officials told city leaders that they’d need a significant subsidy to continue serving Fort Worth residents at the current level. 

Since that announcement, Fort Worth has taken several steps to stabilize the provider and scrutinize its future. Mayor Mattie Parker created a council committee dedicated to examining emergency services in the city, whose members will work with Fitch & Associates in the coming months. Council members also approved a budget with $4.2 million carved out for potential allocation to MedStar, to help the provider stay afloat while the study is ongoing. 

What’s next

  • Fitch & Associates will begin meeting with the council committee Nov. 7. The consultant will provide updates on 45-, 90- and 120-day intervals, and give a final report by April 30, 2024.
  • City staff will make a recommendation to council members Dec. 5. on how much of the $4.2 million set aside should be given to MedStar. Council members will officially vote on the allocation Dec. 12

The process the city used to select the contractor was a good one, Matt Zavadsky, MedStar’s chief transformation officer, said. 

“Fitch is a very well-respected public safety consultant that has done many similar projects across the country,” he said. 

This isn’t the first time Fort Worth has tapped Fitch & Associates to examine EMS services. In 2008, the company was commissioned to identify problems with MedStar, assess its financial model and offer recommendations for improvement. 

Among those recommendations: increasing the subsidies per capita that MedStar collected from each member city it served. MedStar serves 14 cities across Tarrant County.

“Failure to increase funding to levels of required performance will ultimately result in patients being harmed,” the contractor wrote in the 2008 report.

At the time, Fort Worth wasn’t keen on increasing funding to the provider over the long term. The following year, a different consultant group recommended doing away with the subsidy entirely. In response, MedStar sought to become completely financially independent from the cities in its coverage area. 

Fifteen years later, both organizations are back at the drawing board. 

Michael Glynn, president of Fort Worth’s fire department union IAFF 440, said it’s high time for a review of the system. The union, which itself hired Fitch & Associates for a separate study last year, has criticized MedStar for its response policies and financial management

“I’m looking forward to an outside entity or agency coming in and taking a look at the system,” Glynn said. “Someone with experience in that industry and someone who has a pretty good understanding already of what the system looks like.”

IAFF 440 has pushed council members to consider a switch to fire-based EMS, which would make the Fort Worth Fire Department the primary EMS provider in the city. In the 2008 study, Fitch & Associates cautioned leaders against moving in that direction — but now, more than a decade later, council members have indicated all options are on the table.

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 or via Twitter.

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Emily Wolf is a local government accountability reporter for the Fort Worth Report. Originally from Round Rock, Texas, she spent several years at the University of Missouri-Columbia majoring in investigative...