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Fort Worth fire chief Jim Davis had strong words for his fellow MedStar board members at their Nov. 2 meeting.

“A 90-day extension is built on a hope and a prayer that things work out,” he said. 

Davis was referencing plans to pass a stopgap budget for the EMS provider through January, the second such mini-budget the organization has passed since the start of the 2024 fiscal year. Months after the cities it serves passed their annual budgets, MedStar has delayed passing a yearlong budget of its own. 

The EMS provider’s hesitancy is fueled by a fluctuating financial situation without a clear endpoint. At their last meeting in September, MedStar leaders approved an October budget that would hold the organization steady while Fort Worth, its largest member city, prepared to transfer set-aside funds

But that process has been complicated by discussions with JPS Health Network and the county about potential reimbursements for millions of dollars in emergency jail transports. A Fort Worth Report investigation showed those transports have gone unpaid for years — if MedStar can secure those payments, its subsidy needs would be cut in half. 

MedStar also received verbal confirmation that the city of Fort Worth will reimburse it for services to the city jail last year. While those services cost the organization far less than emergency transports from the county’s jails, they still represent more than $500,000 in potential revenue. 

A car drives past the jail at 350 W. Belknap St. (Cristian ArguetaSoto | Fort Worth Report)

JPS and MedStar have another meeting set for Nov. 10. The city pushed back its plans to vote on subsidizing MedStar from October to December, giving the provider more time to negotiate payment of the jail bills. 

“We want to make sure we’re using tax dollars appropriately, and that we’ve exhausted all other possible avenues before we start utilizing tax dollars to help supplement the system,” MedStar CEO Ken Simpson said.

MedStar board members ultimately approved the 90-day budget in a split vote. Fort Worth has indicated its intention to vote on the subsidy in mid-December. 

Davis said he was concerned that the organization hasn’t had enough hard conversations about possible cuts if that subsidy plan fails. Ensuring that crews continue to provide service to residents is essential, he said, but cuts to everything else should be on the table.

“I’m not sure we’ve had those conversations to the level we need to have them,” he said.

Saginaw fire chief Doug Spears echoed those sentiments. 

“Are we living up to what our responsibility is as a board?” he asked. 

But board members Janice Knebl, Brad Commons and Susan Alanis expressed confidence in the temporary plan. Simpson said plans are in place for passing a balanced budget in the new year whether or not the funding is secured.

Commons, an emergency physician, said pursuing stiff budget cuts could hurt paramedic crews that have worked longer-than-expected hours this year due to high call volumes.

District 2 Councilman Carlos Flores, who represents Fort Worth on the board, said he approved passing the smaller budget and understands the necessity of moving forward. While he can’t speak for the county and JPS Health Network, he said, he knows from discussions with county officials that the jail reimbursement issue is at the forefront of their minds. 

“It’s not anyone’s fault, it’s just the way things have been done historically,” Simpson said of the jail transport bills. “And everyone realizes that’s changed, and we all need to contribute and figure out how to move forward.”

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 emily.wolf@fortworthreport.org 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...