Fort Worth Prepares to Dissolve MedStar Board of Directors and Establish New Governance Structure

As the end of the year approaches, Fort Worth is making steady progress on its plan to dissolve longtime EMS provider MedStar.

At a MedStar board meeting on Oct. 23, Assistant City Manager Valerie Washington announced that nine area cities have submitted agreements to end MedStar’s current structure and instead rely on an upcoming EMS division within the Fort Worth Fire Department.

MedStar was created through an interlocal agreement in 1986, after the poor performance of private EMS providers throughout Tarrant County. But MedStar itself has come under increasing scrutiny in recent years, drawing criticism from both members of the firefighters union and local council for their emergency response times and budget problems.

In May, the Fort Worth City Council unanimously approved a plan to Establish the city’s own fire EMS. and begin the process of dissolving MedStar. That’s where the city-by-city agreements come in: To completely dissolve the entity, Fort Worth negotiated with the other cities currently receiving MedStar services through the interlocal agreement.

Each individual agreement announces that city’s intention to enter into a new interlocal agreement with Fort Worth. The rate they pay for EMS services will depend on how much time Fort Worth EMS workers spend responding to calls in the city’s jurisdiction.

Haslet, for example, projected an annual cost of $51,969. Haltom City, the second largest city behind Fort Worth that is entering the interlocal agreement, It is estimated that he will pay $500,000 next fiscal year.

Fort Worth is finalizing agreements with four other cities that have traditionally received MedStar services, Washington said.

Some cities previously expressed concerns about how transitioning to a fire-based EMS system would affect its financial prospects; Member cities have not subsidized MedStar since the early 2010s. That means payments to Fort Worth will represent a new cost in their budgets. Fort Worth staff have emphasized that they are committed to reaching fair and beneficial agreements.

City leaders anticipate all agreements will be submitted in November, at which time Fort Worth will submit its own agreement and replace MedStar’s current governance structure.

Frank Gresh, interim CEO of MedStar, said its current board of directors will be dissolved and management will be left to the Fort Worth city administration and City Council members on the emergency services committee. Existing advisory boards, including the Emergency Physician Advisory Board and First Responder Advisory Board, will continue to operate.

That change in governance structure does not mean that MedStar will immediately cease operations. The regional EMS provider will continue to manage ambulances and handle emergency medical calls through July 2025, at which time Fort Worth intends to transition to its fire-based EMS system.

The city has set aside $3.5 million in funding for the system in its 2025 budget, which represents the final three months of that fiscal year. Starting in September 2025, the City Council will make new and increased general fund allocations for fire-based EMS in its 2026 budget, in addition to the fees it collects from neighboring cities that signed agreements.

In preparation for that transition, MedStar board members also approved spending $6.7 million from the entity’s cash reserves to purchase nine new ambulances, hundreds of Motorola portable radios and new mobile data computers. Those assets will be transferred to the incoming fire-based EMS system.

Gresh told board members that $13 million in additional capital expenditures are being contemplated before the July transition, which would also be paid for through cash reserves. These include ambulance reassembly, vehicle lease purchases and computer-aided dispatch transition costs.

This article first appeared in Fort Worth Report and is republished here under a Creative Commons license.