MedStar provides advanced life support ambulance service to 436 square miles and more than 1 million residents in Fort Worth and 13 surrounding cities. Responding to 190,000 calls a year, MedStar operates with a fleet of 65 ambulances.

When someone calls 911, there must be, and will be, high-quality patient care sent to help, at all times. In the past year, the issue at hand has been about sustainable funding and continuing to deliver a high-quality Emergency Medical Services (EMS) system to the City of Fort Worth and surrounding areas. In December 2024, a Memorandum of Understanding and Agreement (MOU) was executed by all member cities to withdraw from and terminate the existing agreement and designate the City as the licensed EMS provider through the Fort Worth Fire Department (FWFD). Fort Worth City Council adopted a revised Emergency Medical Services (EMS) ordinance effective July 1, designating itself as the licensed EMS provider for participating member cities. This change aims to centralize EMS operations across multiple jurisdictions, improving service delivery and efficiency. The EMS Interlocal Agreements will govern the relationship between the City of Fort Worth and each member city, authorizing the City to serve as the licensed EMS provider. In addition to serving as the licensed provider for each city, the EMS Interlocal Agreement requires each city to set performance standards under protocols established by the medical director. Executed interlocal agreements include the member service area below.