The URL can be used to link to this page

Home My WebLink AboutIR 0740INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 23-0740 1875 To the Mayor and Members of the City Council August 29, 2023 Page 1 of 3 SUBJECT: MEDICAL DIRECTOR REPORTING STRUCTURE IN EMS AND FIRE OPERATIONS This informal report provides information on the role of a medical director in Emergency Medical Services ("EMS") and Fire operations and shows a comparison of the reporting structure for medical directors between the City of Fort Worth ("Fort Worth") and its peer cities in Texas and the United States. The following three tables compare Fort Worth to the top 5 DFW Metroplex cities by population, top 10 Texas cities by population, and top 20 US cities by population. Role of the Medical Director in EMS and Fire The role of an EMS medical director is to provide medical oversight, direction, and guidance to EMS providers and organizations. Texas is a delegated practice state which allows EMT's and Paramedics to work under the license of the EMS medical director. Texas Administrative Code 157.14 requires first responder organizations to have a written affiliation agreement with the primary licensed EMS provider, which includes a medical director. The medical director is responsible for ensuring that pre -hospital patient care is aligned with current medical practices and standards. Key responsibilities of an EMS medical director include medical oversight, protocol development, training and education, quality improvement, and research and evidence -based medicine. Chief Medical Director, Assistant Medical Directors and Staff The number of staff assigned to the medical director's office varies greatly across jurisdictions. It is not uncommon to find a chief medical director and a number of assistant medical directors (also physicians) working for large jurisdictions. Several fire -based EMS organizations also use staff completely comprised of members of the fire department. Nurses and ancillary civilian staff for quality assurance, research and infection control were also reported. Top 5 DFW Metroplex Cities by Population Analysis reveals 80% of the top 5 DFW Metroplex cities' medical directors report to the fire chief or city management. The City of Arlington ("Arlington") and Fort Worth are the only two jurisdictions that do not provide fire -based EMS, however, Arlington's medical director reports to the fire chief. Arlington contracts ambulance service through American Medical Response (AMR). DFW Metroplex Cities by Population City State Population EMS Delivery Model Reporting Structure (reports to) Dallas Texas 1,299,544 Fire -based Fire Chief and City Manager Fort Worth Texas 956,709 PUM Emergency Physician's Advisory Board Arlington Texas 400,316 Private EMS Assistant Chief and Fire Chief Plano Texas 285,537 Fire -based Fire Chief Irving Texas 254,715 Fire -based Fire Chief PUM — Public Utility Model Sources: https://www. census. gov/data/tables/time-series/dem o/popest/2020s-total-cities-and-towns. html ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 23-0740 1875 To the Mayor and Members of the City Council August 29, 2023 Page 2 of 3 SUBJECT: MEDICAL DIRECTOR REPORTING STRUCTURE IN EMS AND FIRE OPERATIONS Top 10 Texas Cities by Population Analysis reveals 80% of the top 10 Texas cities' medical directors report to the fire chief or city management. Only Fort Worth and Lubbock have medical directors that report to an outside board. Fort Worth, Lubbock and Arlington are the only jurisdictions that do not provide fire -based EMS. City State Population EMS Delivery Model Houston Texas 2,302,878 Fire -based San Antonio Texas 1,472,909 Fire -based Dallas Texas 1,299,544 Fire -based Austin Texas 974,447 Third City Service FFort Worth Wexasy 956,709 PU El Paso Texas 685,434 Fire -based Arlington Texas 400,316 Private Corpus Christi Texas 237,144 Fire -based Plano Texas 285,537 Fire -based Lubbock Texas 265,761 Private PUM — Public Utility Model Reporting Structure (reports to) Fire Chief Fire Chief Fire Chief and City Manager City Manager Emergency Physician's Advisory Board Fire Chief EMS Assistant Chief and Fire Chief EMS Assistant Chief and Fire Chief Fire Chief Board of County Commissioners Sources: https://www. census. gov/data/tables/time-series/dem o/popest/2020s-total-cities-and-towns. html ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 23-0740 1875 To the Mayor and Members of the City Council August 29, 2023 Page 3 of 3 SUBJECT: MEDICAL DIRECTOR REPORTING STRUCTURE IN EMS AND FIRE OPERATIONS Top 20 U.S. Cities by Population Analysis reveals 80% of the top 20 US cities' medical directors report to the fire chief or city management. All of the cities that do not follow this arrangement, Fort Worth, Charlotte, Denver, and Oklahoma City are structured as a unique Public Utility Model EMS System. For the majority of the largest US cities, the medical director reports directly to the fire chief/ fire commissioner through a fire -based EMS system. Approximately 90% of the population (30.7 million) are served by a centralized medical director in a fire -based EMS system, while only 10% of the population (3.2 million) are served by an outside public utility. City State Population EMS Delivery Model Reporting Structure (reports to) New York New York 8,335,897 Fire -based & Hospital Fire Commissioner Los Angeles California 3,822,238 Fire -based Fire Commissioner Chicago Illinois 2,665,039 Fire -based Fire Commissioner Houston Texas 2,302,878 Fire -based Fire Chief Phoenix Arizona 1,644,409 Fire -based Fire Chief Philadelphia Pennsylvania 1,567,258 Fire -based Fire Commissioner San Antonio Texas 1,472,909 Fire -based Fire Chief San Diego California 1,381,162 Fire -based & Private EMS Deputy Chief and Fire Chief Dallas Texas 1,299,544 Fire -based Fire Chief and City Manager Austin Texas 974,447 Third City Service City Manager Jacksonville Florida 971,319 Fire -based EMS Division Chief and Fire Chief San Jose California 971,233 Fire -based & Private EMS Deputy Chief and Fire Chief Fort Worth Ir TexasW 956,709 PUM Emergency Physician's Advisory W Board Columbus Ohio 907,971 Fire -based Fire Chief Charlotte North Carolina 897,720 PUM Medical Control Board Indianapolis Indiana 880,621 PUM Fire Chief San Francisco California 808,437 Fire -based Fire Chief Seattle Washington 749,256 Fire -based Fire Chief Denver Colorado 713,252 Hospital Medical Control Board Oklahoma City Oklahoma 694,800 PUM Medical Control Board PUM — Public Utility Model Sources: https:llwww. census. govldataltablesltime-series/demolpopestl202Os-total-cities-and-towns. html If you have questions concerning this information, please contact Assistant City Manager Valerie Washington, City Manager's Office, at 817-392-6192. David Cooke City Manager ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS