Burleson transitions from MedStar to fire department-based ambulance service
Burleson has launched its own in-house fire-based ambulance service after 35 years with MedStar as the city’s sole hospital transport provider.
The switch from MedStar to the Burleson Fire Department took place at midnight Oct. 1. Burleson City Manager Tommy Ludwig described the transition as “seamless,” and said the first call for ambulance service came in at 9 a.m. the same day.
“It’s been many, many months in the making,” Ludwig said. “And there’s lots of challenges that go along with bringing those services in house, from, you know, getting your equipment, supply chain issues, to all the licensing and everything that goes along with it.”
Burleson’s new ambulance fleet consists of four units — one for each of the city’s three fire stations and a fourth to be deployed as needed.
The Burleson Public Safety Communications Department will continue to answer all 911 calls, and can now dispatch ambulances without transferring the call to MedStar. Burleson has also hired a medical director to oversee the system.
The switch to in-house ambulance service will allow Burleson be strategic about where to place its ambulances and maximize response times, according to Ludwig.
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For years, the fire department was only equipped to provide first responder EMS services and relied on MedStar to transport patients to the hospital. Burleson joined the MedStar Mobile Healthcare system in 1988, two years after Fort Worth.
Fire Chief K.T. Freeman said the city has been building its own fire-based EMS system since at least 2017, and that investment put Burleson in the perfect position to take over the ambulance side as well.
“It was just an organic, natural process of evolution of how we were growing this system,” Freeman said.
Fire departments are taking on more and more EMS services even as fire calls have decreased. According to the U.S. Fire Administration, in 2020 less than 4% of calls to fire departments across the country had to do with actual fires.
Freeman said about 70% of calls received by the Burleson Fire Department are EMS related, and that is consistent nationwide.
Freeman, who served as deputy fire chief in Fort Worth, took over the role of Burleson fire chief in 2016. The department was significantly under-resourced and understaffed, he said.
As a strategy to maximize resources, Freeman implemented a squad system — a two-person team in a Ford F-250 outfitted with lights, sirens and medical supplies — to respond to EMS calls.
The squad responded to about 40% of the department’s calls and proved such an effective model, according to Freeman, that the city council approved a second one. The squads run on three shifts, so every new squad required hiring six or seven firefighters to cover the shifts.
When a third squad became necessary, Freeman approached the city council with the idea of contracting an outside company to analyze the fire department’s EMS system and see if it would be feasible to take on ambulance services.
“I told the council at that time, I believe that ... the best service I can do for the community is to at least ask ourselves the question, since we’re staffing up and we’re responding to the EMS side, we need to be able to legitimately and analytically show the community and our policymakers why or why we would not at least consider going to the transport side.”
The consulting firm conducted an in-depth analysis of both MedStar and the Burleson Fire Department, and in November 2021 recommended to the city council that Burleson take on ambulance service. The city was in a good position to do so, the consultant said, and providing transport might help the city recapture some of the money already invested in the EMS system.
In January 2022 the council voted 7-0 to move ahead with the fire-based EMS and gave notice to MedStar of their intentions.
Ludwig said that when they got the green light from the council to proceed, they got all the key players together to create a specific timeline of what needed to be done. Oct. 1 was chosen as the start date.
“That was, again, a mutually agreeable date, and it was one that was realistic to meet,” Ludwig said. “And so it made sense from a lot of different perspectives.”
Freeman said the transition allows the city to have an ambulance service “specifically centric to Burleson” and designed with the city’s growing population in mind. Burleson’s population stood at just over 48,000 in the 2020 census, and has since grown to nearly 60,000, according to the World Population Review.
Even though MedStar posted ambulances in Burleson, it was not the same as having an ambulance dedicated only to that community, Freeman said. Burleson is on the outlying edge of the MedStar service area, and when the MedStar ambulance in Burleson was responding to a call, the replacement ambulance might have to come from another city.
“Where are they coming from?” Freeman said. “Or when a unit is not available here and you get a unit responding on a cardiac arrest (coming) from Haltom City — that’s the closest location — that’s problematic.”
MedStar provides ambulance service for 14 Tarrant County cities. To cover its 436-square-mile service area, it utilizes the Dynamic Resource Management system to position ambulances where the greatest call volume is projected to be based on a predictive modeling system. When an ambulance is dispatched, another one is sent to take its place.
Under MedStar, all EMS related calls from Burleson were answered by the Public Safety Communications Department. The caller would explain their emergency and be transferred to MedStar, where they would explain their emergency a second time. Freeman believes cutting out that transfer will save valuable time.
“Seconds count,” Freeman said. “They (the delays) can be from a minute to two, they can be however long, and then they have to repeat that same information to somebody else. We found it to be unacceptable and not providing the highest level of service to our citizens.”
Although Fort Worth plans to study long-term options for its EMS services, MedStar spokesperson Matt Zavadsky said Burleson is the first city to pull out of the MedStar system.
“We wish them well,” Zavadsky said.
MedStar will back Burleson Fire up if the city’s ambulance service gets overwhelmed in an emergency. Burleson also has mutual-aid agreements with Crowley and CareFlite, according to Ludwig.
The city will receive revenue from insurance and and other ambulance-related fees, but the transport service won’t pay for itself, Ludwig said. What it will do is add another stream of revenue to fire department funding. The Burleson Fire Department has always been funded through property and sales tax, and Ludwig said they don’t anticipate any tax increases as a result of the new service.
A schedule of Burleson Fire/EMS ambulance service fees is posted on the city’s website.
Freeman said offering transport was never about making money.
“That was never at all really part of the discussion or our goal,” Freeman said. “We will recover some of our cost, but it was again just about enhancing the services.”
By the afternoon of Oct. 6, the Burleson fire department had transported 71 people to local hospitals, Freeman said.
