San Marcos staff urged to plan city‑run EMS as council presses for worker protections and timeline

A consultant who reviewed San Marcos’s emergency medical services (EMS) delivery told the City Council on Jan. 20 that a stand‑alone, city‑operated EMS would be the most cost‑effective, and council members signaled they are inclined to begin planning for a city‑run EMS — provided staff resolve labor protections, the hiring transition and timing with partner agencies.

Matrix Consulting Group Vice President Robert Finn summarized the study’s findings and recommendations, telling the council the analysis compared three models: continuing the current regional nonprofit contract; integrating EMS into the fire department; and creating a standalone city EMS department. "We'd recommend that you begin planning for city‑based EMS," Finn said, arguing the model offers direct local control, dedicated EMS leadership and better financial transparency.

The report found San Marcos currently faces rising call volumes (about 9,400 calls a year under current projections, rising toward 21,700 by 2040), performance measures that are close to but in some measures above suburban benchmarks, and patient‑transport revenue that offsets roughly $2 million of operating costs. Finn’s cost comparisons showed status‑quo contract costs near $9.46 million today (rising to about $11.1 million by FY31); a fire‑based model slightly higher; and a city EMS option roughly $9.2 million today and $10.8 million by FY31 — a projected $300,000–$400,000 annual savings over the long term but with overlap and startup costs during the transition.

City staff said the choice is time‑sensitive because partner agencies are already reducing contributions. Chief Les Stevens of the Fire Department told council that ESD 9 will begin taking ambulances out of service starting in April and will scale down its financial support through late 2026. "Their transition is already fully underway," he said, noting that the agency will phase out contributions as ambulances go offline.

Labor protections, employee retention and hiring were central concerns. Zach Phillips, president of the Hays County EMS Association (CWA Local 6115), had urged caution during public comment, saying the existing nonprofit has provided consistent care for decades and urging the council to prioritize workforce continuity. Council members pressed staff for options that would allow existing EMS personnel to apply for city jobs with preferential treatment, preserve seniority where possible, and address whether employees would have comparable benefits and legal protections if they become city staff.

Staff and the consultant said that the city would use standard hiring processes but explore procedures to give current employees early access and that some benefits (TMRS retirement eligibility, city health plans) would be available if employees join the city. On liability, Chief Stevens noted the service already carries malpractice insurance and said, "we currently pay $4,500 a year for malpractice insurance," stressing it as a known cost while warning that future liability remains an uncertainty.

Council members did not take a final vote to create a new department but several said they were leaning toward the city‑based model while conditioning support on concrete plans to protect employees and guarantee patient‑care quality. Assistant City Manager Lonzo Anderson told the council staff would assemble a transition team immediately to develop the hiring and labor plan, a timeline, a 10‑year service plan and proposals for quality oversight and billing; he said staff would return with written summaries and updates within a few months.

The city manager’s office and the consultant emphasized the phased timeline: authorization and planning, legal and financial setup and asset transfers, hiring and onboarding, then operational readiness — a sequence that Matrix estimated could take up to 21 months, with some council members urging staff to compress that timeframe where possible.

Next steps: Council directed staff to pursue planning on a city EMS path while working through labor‑protection options and a transition plan, to report back with a written timeline and to coordinate with partner agencies about assets and mutual‑aid agreements. No ordinance or appropriation was approved at the meeting; the council scheduled follow‑up briefings and said it expected to receive more detailed implementation materials in coming months.