Fort Worth outlines July transfer of MedStar EMS to fire department, plans 9‑1‑1 consolidation and tech upgrades

Fire Chief Jim Davis said the city is preparing for an anticipated July 1 transfer of MedStar emergency medical services into the Fort Worth Fire Department as part of a multi‑year effort to improve response times and system reliability.

The move follows a 2023 review by outside consultants and an EMS ad hoc committee that recommended a single‑role EMS civil service position, consolidation of dispatch for fire and EMS, and creation of two advisory boards. “MedStar has operated as the single service provider for the city of Fort Worth in 13 member cities for the last 30 years,” Davis said, describing a months‑long implementation effort that will change how ambulances, billing and communications are managed.

Why it matters: City leaders said the reorganization aims to reduce unit‑hour utilization, improve response times and place clinical oversight with a newly formed medical director’s office. The city projects a net fiscal impact as it absorbs pension and benefit costs and hires additional operational staff.

Budget and staffing: Davis said the fiscal impact of the transition could reach about $21 million, with roughly $16 million of that tied to pension and health care costs. The plan includes about 75 additional positions to meet demand identified in the Fitch study. Davis also said the city expects continued transport revenue and will contract with an outside vendor to manage billing and collections. “An EMS system billing is never a profit center,” Davis told council, adding that billing offsets but does not fully eliminate operating costs.

Member cities and governance: City staff reported that interlocal agreements (ILAs) are in place (13 member cities at the time of the study; Richland Hills subsequently asked to join) that allocate costs to member jurisdictions based on unit‑hour consumption. The city will present member allocations in June so partner cities can budget; staff said they will “true up” those allocations annually against actual use.

9‑1‑1 consolidation and technology: Bruce Mueller of Fitch & Associates summarized findings from a recent 9‑1‑1 assessment that recommended reducing call transfers, consolidating radio channels and, as a future state, unifying call intake so a single call taker can route requests to police, fire or EMS without repeat questioning. Aubrey Zinsko, the city’s 9‑1‑1 administrator, said the city is already taking phased steps: co‑locating fire alarm staff with MedStar at the MedStar (Altamir) facility as a near‑term consolidation and assessing a longer‑term plan to remodel the Zipper building into a single unified emergency communications center.

Technology pilots: The city trialed a platform called Prepare 9‑1‑1 (text/transcription/translation, live video streaming and media exchange) in February and April. Zinsko said the pilot showed promise for real‑time translation and transcription as well as live video streaming in complex incidents. She said the trial ends in late April and the city is seeking funding to continue a one‑year extension. Zinsko also said prepared text exchange can shift non‑emergency workloads away from trained 9‑1‑1 staff, freeing them to answer emergent calls.

Operational timeline and next steps: Staff described a phased implementation. Phase 1: co‑locate fire and MedStar dispatch at MedStar’s Altamir facility ahead of the July transfer and complete required equipment and vehicle modifications. Phase 2: longer‑term consolidation of all three public‑safety dispatch centers into a single purpose‑built operations center (Zipper building). Budget requests for FY26 will reflect personnel and technology needs; the city will seek a regional inspection to convert licenses and finalize licensing changes.

Questions and concerns: Council members asked about billing mix (chief said roughly 60% of payer mix is Medicare/Medicaid, with private insurance representing 10–15%), payroll onboarding challenges and retention. Chief Davis said nearly 1,000 people registered for the first single‑role EMT exam and about 425 took it; he described a robust hiring pipeline if additional staffing is required. Staff acknowledged payroll contractor issues that prompted a short pivot in integration plans but said contingencies are in place to protect employee pay and data.

Context and limits: Staff repeatedly framed projections as contingent on reimbursement rates and national billing trends. Councilmembers and staff emphasized monitoring KPIs for any external billing vendor (turnaround time, charity care policy and maximal lawful recovery) and using incremental, measured changes when adjusting staffing or consolidation to validate performance against targets.

Ending: City staff said they will return to council with ordinance updates, FY26 budget requests and follow‑up reports on the ILAs, billing vendor KPIs and the 9‑1‑1 consolidation timeline.