HomeMy WebLinkAboutContract 63581CSC No. 63581
CITY OF FORT WORTH — MEDSTAR MOBILE HEALTHCARE
EMS INTERLOCAL AGREEMENT
This EMS Interlocal Agreement (the "Agreement") is entered into by and between the City of Fort
Worth, Texas, hereafter referred to as "Fort Worth", acting by and through its duly authorized
assistant city manager, and the Metropolitan Area EMS Authority d/b/a MedStar Mobile
Healthcare , an interlocal administrative agency, hereafter referred to as "MedStar." Fort Worth
and MedStar may collectively be referred to herein as the "Parties" or individually as a "Party."
WHEREAS, Fort Worth and other local jurisdictions ("Member Cities") were parties to a
Restated and Amended Interlocal Cooperative Agreement, effective July 23, 2020 (the "ILA"), for
the provision of out of hospital emergency medical services ("EMS"), non -emergency medical
services, unscheduled medical transportation and ambulance service, mobile integrated healthcare
("MIH")(collectively the "EMS System"), and scheduled interfacility medical transportation
("IFT");
WHEREAS, Fort Worth and the Member Cities executed a memorandum of
understanding and agreement (the "MOUA") and individual EMS Interlocal Agreements to jointly
withdraw from the ILA, dissolve MedStar, and designate Fort Worth as the exclusive provider of
EMS System Services;
WHEREAS, the MOUA authorizes MedStar to continue to operate and exist in a
transitional capacity and under the authority of Fort Worth until such time as EMS System services
may fully transition to Fort Worth;
WHEREAS, Fort Worth is a political subdivision of the State of Texas and participates in
the delivery of high -quality pre -hospital emergency medical services ("EMS") for the public
within its jurisdiction and the Member Cities' jurisdictions;
WHEREAS, MedStar is a licensed provider of high -quality EMS and holds a State of
Texas EMS Provider license and appropriate federal registrations;
WHEREAS, to facilitate the transition of EMS System services from MedStar to Fort
Worth, Fort Worth has obtained its own EMS Provider license and is actively adopting necessary
policies, hiring and training staff, acquiring property, contracting with necessary vendors, and
registering with necessary agencies to become the exclusive EMS System provider for Fort Worth
and the Member Cities;
WHEREAS, to ensure there is no lapse in service as EMS System services transition to
Fort Worth, and to protect the public health and safety of the people of Fort Worth and the Member
Cities' jurisdictions, there is a necessity for Fort Worth to subcontract with MedStar to temporarily
provide EMS during the transition period, using MedStar's licensing and registration number;
WHEREAS, pursuant to Chapter 791 of the Texas Government Code, the Texas Interlocal
Cooperation Act, and section 774.003 of the Texas Health and Safety Code, the Parties may agree
to regulate and provide governmental services for the public health and welfare, and such services
OFFICIAL RECORD
EMS Interlocal Agreement CITY SECRETARY page 1
FT. WORTH, TX
include those provided by the EMS System;
WHEREAS, MedStar will bill for services it is to provide pursuant to this Agreement;
WHEREAS, the Parties have notified the Texas Department of State Health Services
("DSHS") concerning this temporary delegation and arrangement; and
WHEREAS, pursuant to MedStar Board Resolution No. BC-1624, Fort Worth Resolution
No. 6037-12-2024, and the Member City MOUA, identified as City Secretary Contract No. 62555,
a Fort Worth Assistant City Manager is authorized to sign on behalf of MedStar.
NOW, THEREFORE, the Parties agree to the following:
Section 1: DEFINITIONS
The following index of definitions includes terms that may not appear in this Agreement but are
used in the MOUA, the Uniform EMS Ordinance, or in the ordinary course of describing the
services of the EMS System. Therefore, the full index is included herein for ease of reference by
the Parties.
1. Advanced Life Support (ALS). Out -of -hospital care that uses invasive medical
acts (as defined in Tex. Health and Safety Code § 773.003(1)).
2. Aeromedical Transportation Unit. Any rotary or fixed wing aircraft providing
basic or advanced life support services and Patient transportation that originates
within the Service Area.
3. Ambulance. A vehicle for transportation of sick or injured person to, from, or
between places of treatment for an illness or injury, and provide out of hospital
medical care to the Patient.
4. Ambulance Mutual Aid Agreement. A written contract between Fort Worth and
one or more entities whereby the signing parties agree to provide backup
ambulance service to one another under the terms and conditions specified therein.
5. Ambulance Service. The transportation of Patients by emergency or non -
emergency ambulance; for purposes of this Agreement, Ambulance Service does
not include IFT services as defined herein.
6. Associate Medical Director. A licensed physician who assists the Medical
Director in carrying out his or her duties under the EMS Interlocal Agreements,
the Uniform EMS Ordinance, and any Medical Director's agreement with Fort
Worth.
7. Basic Life Support (BLS). Out -of -hospital care that uses noninvasive medical
acts (as defined in § 773.003(2), Tex. Health and Safety Code).
8. Emergency Care Attendant (ECA). A person certified as an "emergency care
attendant" under § 773.046 of the Tex. Health and Safety Code.
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9. Emergency Medical Services (EMS). Services used to respond to an individual's
perceived need for immediate medical care and to prevent death or aggravation of
physiological or psychological illness or injury.
10. Emergency Medical Technician (EMT). A person certified as an "emergency
medical technician" under § 773.047 or an "advanced emergency medical
technician" under § 773.048 of the Tex. Health and Safety Code, and any other
class of EMT recognized by state law or regulation.
11. EMS Communications Center. The facility designated by Fort Worth as the
central communications center from which all EMS System services offered by
Fort Worth shall be dispatched and coordinated.
12. EMS Interlocal Agreement. The service level interlocal agreements executed by
Fort Worth and Member Cities to designate Fort Worth as the exclusively
contracted EMS Provider of the EMS System within the Service Area.
13. EMS Provider. The entity that has received a Texas EMS Provider License, as
required by relevant state law, to provide the EMS System services and is the
exclusively contracted provider of the EMS System services within the Service
Area. For purposes of this Agreement, the EMS Provider is Fort Worth.
14. EMS System. The regulated out -of -hospital EMS, non -emergency medical
services, unscheduled medical transportation and ambulance services, and mobile
integrated healthcare system provided by Fort Worth within the Service Area, not
including those first response services MedStar chooses to provide itself as a First
Responder.
15. First Responder. Any agency that, in cooperation with the EMS Provider,
provides initial response to requests for EMS and, on its own or in cooperation
with the EMS Provider, provides immediate on -scene care to ill or injured persons
but does not transport those persons to healthcare facilities.
16. FW EMS. The EMS division of the Fort Worth Fire Department responsible for
providing the EMS System services.
17. Interfacility Transportation (IFT). The provision of scheduled, or by
appointment, medical transportation services by a person or entity between
hospitals or medical facilities originating within the Service Area.
18. Medical Director. The licensed physician employed or contracted by Fort Worth
who is responsible for carrying out his or her duties under the terms of their
engagement with Fort Worth, the Uniform EMS Ordinance, and the EMS
Interlocal Agreements and for directing the Office of the Medical Director.
19. Medical Transportation. The transportation of Patients by ambulance,
Specialized Mobile Intensive Care Unit, Specialty Care Transport, or Aeromedical
Transportation Unit, including both emergency and low -acuity emergency
transports, where such transportation originates within the Service Area.
20. Mobile Integrated Healthcare (MIH). Services provided by Fort Worth, as
requested by MedStar, that are designed to enhance, coordinate, effectively
manage, and integrate out of hospital care, in order to improve outcomes, enhance
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the participating individual's experience of care, and improve the efficiency and
effectiveness of healthcare services provided to the enrolled individuals.
21. Office of Medical Director. The department or division through which the
Medical Director carries out his or her functions. The Office of the Medical
Director is comprised of the Medical Director, any Associate Medical Director(s),
and other individuals assigned to the Office to assist the Medical Director in
carrying out the Medical Director's functions.
22. Paramedic. A person qualified as a certified or licensed "paramedic" as defined
by Tex. Health and Safety Code Sections 773.049 and 773.0495.
23. Patient. A person: who requests EMS, or for whom EMS has been requested; and
who has any medical or psychological complaint, obvious injury/distress, or has a
significant mechanism of injury.
24. Service Area. That geographical area which is contained within the corporate
limits of the Parties and other local jurisdictions who have entered into an EMS
Interlocal Agreement with Fort Worth and adopted the Uniform EMS Ordinance.
25. Specialty Care Transport. The transportation of a critically injured or ill patient
requiring a level of service beyond the scope of an EMT or Paramedic due to the
patient's condition requiring ongoing specialized care that must be furnished by
one or more health professionals, such as emergency or critical care nursing,
emergency medicine, respiratory care, cardiovascular care, or a paramedic with
additional training.
26. Specialized Mobile Intensive Care Unit. A vehicle which is specially
constructed, equipped, staffed, and employed in the inter -facility transport of
patients whose requirements for en route medical support are likely to exceed the
clinical capabilities of an Advanced Life Support ambulance.
27. Uniform EMS Ordinance. The ordinance adopted by the Parties and other units
of local government to establish standards for the provision of the EMS System
services and designate Fort Worth as the EMS Provider for the EMS System.
28. Unscheduled Medical Transportation. The transportation of Patients by
ambulance service, Specialized Mobile Intensive Care Unit, Specialty Care
Transport, or Aeromedical Transportation Unit, including both emergency and
low -acuity emergency transports, where such transportation originates within the
Service Area and is not previously scheduled or made by appointment.
Section 2: COMPLIANCE
2.1 The parties will comply in all material respects with all applicable federal, state, and local
laws and regulations. Ambulances will conform to applicable state and local regulations for
medical equipment for ambulances and be duly licensed for the transportation of patients.
2.2 All EMS System services required hereunder, including but not limited to ALS and
emergency medical transport services, shall be provided in accordance with Texas law and rules
and prevailing industry standards of quality and care.
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Section 3: RESPONSIBILITIES OF MEDSTAR AND FORT WO TH
3.1 Pursuant to the licenses held by MedStar, MedStar will serve as the licensed EMS Provider
for Fort Worth and the Member Cities, and, pursuant to the terms of this Agreement, has contracted
with Fort Worth to lease from Fort Worth the necessary personnel, vehicles and equipment from
Fort Worth to enable MedStar to perform the EMS System services it is required to provide under
this Agreement.
3.2 MedStar authorizes Fort Worth to manage and staff MedStar's EMS System services by
and through MedStar's license and authorizes Fort Worth to bill , for EMS System services on
MedStar's behalf either directly or through a contracted third -party billing vendor. MedStar and
Fort Worth agree to ensure that MedStar's Medicare and Medicaid enrollment records are amended
within thirty (30) days of the effective date of this Agreement to add Forth Worth as an
organization with managing control of MedStar, to add Fort Worth's third party billing company
as the billing agent for MedStar, and to add all vehicles Fort Worth is leasing to MedStar.
3.3 MedStar hereby agrees to provide ambulance transport and EMS System services for Fort
Worth and the Member Cities until October 1, 2025, with Fort Worth leasing to MedStar all
vehicles, personnel, and equipment MedStar requires in order for MedStar to provide the EMS
System services.
3.4 During the Term of this Agreement, MedStar retains full regulatory responsibility for
compliance with Texas Health and Safety Code Chapter 773 and 25 TAC Chapter 157, including
reporting, vehicle inspections, equipment, patient care standards, and data submissions required of
the license holder. Fort Worth will manage MedStar's operations in accordance with these
requirements and under MedStar's direction for all regulatory purposes.
Section 4: RESPONSIBILITIES FOR THE PROVISION OF EMS SYSTEM SERVICES
4.1 Fort Worth agrees to lease the personnel and equipment of Fort Worth to MedStar for the
purpose of MedStar providing the EMS System services for each receiving jurisdiction including
coordinating with MedStar to create a mechanism for dispatch services and transferring 911 calls
requesting medical assistance as necessary. The equipment and personnel of Fort Worth shall be
under the control and supervision of Fort Worth employees in their capacity as having managing
control and authority over MedStar during an emergency medical response pursuant to this
Agreement and the MOUA.
4.2 MedStar, under the managing direction of Fort Worth, will provide the EMS System
services within the Service Area. It is recognized and understood that neither MedStar nor Fort
Worth assumes responsibility for the provision of the EMS System services in any jurisdictions
extraterritorial jurisdiction or other areas outside of the Service Area.
4.3 MedStar's EMS System services will be provided in accordance with the procedures and
protocols of Fort Worth, the Fort Worth Fire Chief, MedStar, and the Medical Director for the
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EMS System and under the direction of the Fort Worth Fire Chief.
4.4 Fort Worth agrees to:
4.4.1 Set System Performance standards for the Service Area in compliance with the
clinical and medical protocols and standards established by the Medical Director and adopted by
Fort Worth and MedStar.
4.4.2 Ensure that MedStar provides the Member Cities with EMS System services
including: out -of -hospital emergency medical services, non -emergency medical services, life, or
limb, threatening emergency, low acuity emergency, and Advanced Life Support ("ALS") and
Basic Life Support ("BLS") Unscheduled Medical Transportation and Ambulance Service, and
MIH with such service to comply with all applicable laws, rules, and regulations, and with the
clinical standards, credentialing requirements and medical policies that may be promulgated from
time to time by the Medical Director, including the following commitments:
4.4.2.1: MedStar shall provide, on a 24-hour daily basis, a mobile intensive care
unit ("MICU")-capable EMS response and medical transportation service with a
minimum staffing as required by relevant state law, which may be amended from
time to time, for a BLS Ambulance and an ALS ambulance;
4.4.2.2: MedStar shall respond to incidents in the Service Area through FW EMS
dispatch, using the same algorithms in place for responses within Fort Worth.
MedStar will respond to calls for EMS System services throughout the entire
Service Area in less than or equal to 8:00 total travel time 90% of the time for high
acuity incidents, as defined by the Medical Director, measured from the time EMS
System resources are en route until the time a unit arrives on scene. MedStar will
respond to calls for EMS System services throughout the entire Service Area in less
than or equal to 11:00 total travel time 90% of the time for low acuity incidents, as
defined by the Medical Director, measured from the time EMS System resources
are en route until the time a unit arrives on scene.
4.4.2.3: MedStar will transport patients to the closest or most appropriate receiving
health care facility as determined by the ambulance crew. If the patient is
incapacitated, otherwise unable to make a choice known, or unable to go to the
chosen facility due to diversion status, the ambulance crew will transport the patient
to the facility best able to meet the patient's needs;
4.4.2.4: FW EMS, in its capacity as managing MedStar under this Agreement, will
keep the EMS System resources stocked at all times in accordance with normal FW
EMS operating procedures and local, state, and federal requirements, as applicable,
and ensure its ambulances are properly inspected and approved by DSHS;
4.4.2.5: FW EMS will maintain third -party or self -insured vehicle liability
insurance on the ambulances and EMS personnel it is leasing to MedStar, naming
MedStar as an additional insured on all such policies;
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4.4.2.6: FW EMS will provide all maintenance for the ambulances and assume all
operational costs of the ambulances, including fuel;
4.4.2.7: FW EMS shall equip the ambulances it leases to MedStar at all times with
current technological advancements in emergency equipment, whether portable or
fixed in place on or about the vehicle, as are adopted throughout the FW EMS
ambulance fleet and leased to MedStar.
Section 5: TERM AND TERMINATION
5.1 This Agreement will be effective beginning July 1, 2025 and will continue for a term of
three months, unless earlier terminated in accordance with the terms of this Agreement, and expire
on October 1, 2025.
5.2 Termination by Fort Worth: Fort Worth may terminate this Agreement for convenience at
any time with at least 30 days' written notice.
5.3 Upon the effective date of termination of this Agreement, Fort Worth will cease managing
MedStar's operations and leasing vehicles and personnel to MedStar, and MedStar will cease
being the EMS Provider to Fort Worth and the Member Cities and Fort Worth's operation of the
EMS System will transition to Fort Worth's EMS Provider license and applicable credentials and
registrations. The Parties will each ensure DSHS is notified and the Medicare, Medicaid, and
private payors are appropriately informed. The parties understand and agree that Medicare and
Medicaid must be notified of the effective date upon which Forth Worth ceased being an
organization with managing control over MedStar within thirty (30) days of the effective date of
this change, and they will also remove Fort Worth's third party billing agent as the billing agent
for MedStar as well as all vehicles leased to MedStar and reported to Medicare and Medicaid at
this same time.
Section 6: PAYMENT
6.1 Fort Worth shall be responsible for billing patients and third parties for services on
MedStar's behalf All payments shall be deposited into an account in MedStar's name. MedStar
is responsible for remitting payment to Fort Worth for the management, billing, staffing, leasing
and other services in the amount of all funds deposited in MedStar's account for services provided
during the term of this Agreement.
6.2 This Agreement does not obligate the payment of funds to MedStar.
Section 7: MEDICAL DIRECTOR
7.1 The Medical Director for the EMS System has been retained by Fort Worth for MedStar
and his associated credentials have been provided to DSHS. The Medical Director must be a
licensed physician in the State of Texas who is board -certified in EMS and emergency medicine
and meets all state requirements.
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7.2 The Medical Director is the Chief Medical Officer of the EMS System, will report to the
City Manager of Fort Worth or their designee, and will have the powers and duties afforded and
required of EMS medical directors under Texas State law. The Medical Director will provide all
independent medical direction and clinical oversight for the EMS System. The Medical Director's
powers and duties concerning the EMS System will be established by agreement between Fort
Worth and the Medical Director, which shall include those afforded and required under Texas
State law with the resources necessary to fulfill such requirements.
Section 8: FORCE MAJEURE
8.1 It is expressly understood and agreed by the Parties to this Agreement that if the
performance of any obligations hereunder is delayed by reason of war; civil commotion; acts of
God; inclement weather; epidemics or pandemics; governmental restrictions, regulations, or
interferences; fires; strikes; lockouts, national disasters; riots; material or labor restrictions;
transportation problems; or any other circumstances which are reasonably beyond the control of
the Party obligated or permitted under the terms of this Agreement to do or perform the same,
regardless of whether any such circumstance is similar to any of those enumerated or not (each, a
"Force Majeure Event"), the Party so obligated or permitted shall be excused from doing or
performing the same during such period of delay, so that the time period applicable to such
requirement shall be extended for a period of time equal to the period such Party was delayed. To
invoke this section, a Party must provide written notice of the alleged Force Majeure Event to the
impacted Parties within a reasonable time after the occurrence of a Force Majeure Event,
explaining the Force Majeure Event and the extent to which the Party's performance of obligations
are hindered.
Section 9: RIGHT TO AUDIT
9.1 The Parties will have the right to audit each other's financial and business records that
relate to the services provided (collectively "Records") at any time during the Term of this
Agreement and for three (3) years thereafter in order to determine compliance with this Agreement.
Throughout the Term of this Agreement and for three (3) years thereafter, each Party shall make
all relevant records available following reasonable advance notice by the other and shall otherwise
cooperate fully with each other during any audit. Notwithstanding anything to the contrary herein,
this Section 9 shall survive expiration or earlier termination of this Agreement.
Section 10: STANDBY EMS, INTERFACILITY TRANSPORT (IFT), AND MUTUAL
AID AGREEMENTS
10.1 This Agreement is not intended to designate Fort Worth as the exclusive, sole, or single
provider of standby EMS for MedStar.
10.2 This Agreement is not intended to designate Fort Worth as the exclusive, sole, or single
provider of IFT services for any hospital or medical facility. Nothing herein prohibits any hospital
or medical facility from privately contracting for interfacility transport services as deemed
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necessary by that facility. Provided, however, each IFT provider must meet the requirements
provided by the Uniform EMS Ordinance.
Section 11: GOVERNMENTAL POWERS
11.1 It is understood and agreed that by execution of this Agreement, the Parties do not waive
or surrender any of their governmental powers or immunities.
Section 12: ELECTRONIC SIGNATURES
12.1 This Agreement may be executed by electronic signature, which will be considered as an
original signature for all purposes and have the same force and effect as an original signature. For
these purposes, "electronic signature" means electronically scanned and transmitted versions (e.g.
via pdf file or facsimile transmission) of an original signature, or signatures electronically inserted
via software such as Adobe Sign.
Section 13: COUNTERPARTS
13.1 This Agreement may be executed in one or more counterparts and each counterpart will,
for all purposes, be deemed an original, but all such counterparts will together constitute one and
the same instrument.
Section 14: LIABILITY
14.1 Each Party agrees to be solely liable for the actions, omissions, and negligent acts of its
own employees, agents, and representatives engaged in the provision of services through the EMS
System under this Agreement. Except as expressly provided herein, neither Party shall be liable to
the other for any indirect, incidental, consequential, special, punitive, or exemplary damages
arising out of or in connection with this Agreement, regardless of the form of action, whether in
contract, tort, strict liability, or otherwise, even if advised of the possibility of such damages.
14.2 The above notwithstanding, Fort Worth agrees defend and indemnify MedStar concerning
its operation under this Agreement and in the event such operation results in a claim during the
term of this Agreement.
Section 15: INSURANCE
15.1 Fort Worth may, at its discretion, elect to self -insure against claims arising from the
provision of EMS or its indemnity obligations, provided that such self-insurance meets the
applicable statutory requirements and guidelines set forth by state law, including but not limited
to Chapter 2259 of the Texas Government Code.
Section 16: GOVERNING LAW AND VENUE
16.1 This Agreement shall be construed in accordance with the laws of the State of Texas. If
any action, whether real or asserted, at law or in equity, is brought on the basis of this Agreement,
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venue for such action shall lie in state courts located in Tarrant County, Texas or the United States
District Court for the Northern District of Texas, Fort Worth Division.
Section 17: NOTICES
17.1 Notices required pursuant to the provisions of this Agreement shall be conclusively
determined to have been delivered when (1) hand -delivered to the other party, its agents,
employees, servants or representatives, or (2) received by the other party by United States Mail,
registered, return receipt requested, addressed as follows:
TO FORT WORTH:
City of Fort Worth
Attn: Assistant City Manager
100 Fort Worth Trail
Fort Worth TX 76102
With Copy to the City Attorney
at same address
TO MEDSTAR
MedStar Mobile Healthcare
2900 Alta Mere Dr.
Fort Worth, Texas 76116
Section 48: CONFIDENTIALITY AND HIPAA BUSINESS ASSOCIATE ASSURANCES
18.1 Fort Worth and MedStar shall comply with all applicable federal and state laws and
regulations regarding the privacy and confidentiality of patient records, including the federal
Health Insurance Portability and Accountability Act of 1996 (HIPAA). MedStar, in providing the
EMS System servicesng, will be considered a "covered entity" under the HIPAA Privacy Rule and
the Texas Medical Privacy Act. 45 C.F.R. § 160.103; Tex. Health & Safety Code § 181.001(b)(2).
18.2 Each party shall comply with the privacy and security provisions of the Health Insurance
Portability and Accountability Act of 1996 and the regulations thereunder ("HIPAA"), if
applicable. All Patient medical records shall be treated as confidential so as to comply with all
state and federal laws.
18.3 Privacv Rule.
18.3.1. Fort Worth, in its capacity as a Business Associate, shall carry out its obligations
under this Agreement in compliance with the privacy regulations pursuant to Public Law 104-
191 of August 21, 1996, known as the Health Insurance Portability and Accountability Act of
1996, Subtitle F — Administrative Simplification, Sections 261, et seq., as amended ("HIPAA"),
to protect the privacy of any personally identifiable protected health information ("PHI") that is
collected, processed or learned as a result of the services provided hereunder. In conformity
therewith, Fort Worth agrees that it will:
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18.3.1.1 Not use or further disclose PHI except as permitted under this
Agreement or required by law;
18.3.1.2 Use appropriate safeguards to prevent use or disclosure of PHI
except as permitted by this Agreement;
18.3.1.3 Mitigate, to the extent practicable, any harmful effect that is known
to Fort Worth of a use or disclosure of PHI by Fort Worth in violation of this Agreement.
18.3.1.4 Report to MedStar any use or disclosure of PHI not provided for
by this Agreement of which Fort Worth becomes aware;
18.3.1.5 Ensure that any agents or subcontractors to whom Fort Worth
provides PHI, or who have access to PHI, agree to the same restrictions and conditions that apply
to Fort Worth with respect to such PHI;
18.3.1.6 Make PHI available to MedStar and to the individual who has a
right of access as required under HIPAA within the thirty (30) days of the request by MedStar
regarding the individual (or such shorter time as may be required by law);
18.3.1.7 Incorporate any amendments to PHI when notified to do so by
MedStar;
18.3.1.8 Provide an accounting of all uses or disclosures of PHI made by
Fort Worth as required under the HIPAA privacy rule within sixty (60) days (or such shorter
time as may be required by law);
18.3.1.9 Make its internal practices, books and records relating to the use
and disclosure of PHI available to the Secretary of the Department of Health and Human
Services for purposes of determining MedStar's compliance with HIPAA; and
18.3.1.10 At the termination of this Agreement, return or destroy all PHI
received from, or created or received by Fort Worth on behalf of MedStar, and if return is
infeasible, the protections of this Agreement will extend to such PHI.
18.3.2 The specific uses and disclosures of PHI that may be made by Fort Worth include
any disclosures pertaining to those services enumerated within this Agreement, and those
disclosures that Fort Worth is permitted or required by law to make.
18.4 Security Rule.
18.4.1. Fort Worth, in its capacity as a Business Associate, shall carry out its obligations
under this Agreement in compliance with the security regulations pursuant to Public Law 104-
191 of August 21, 1996, known as the Health Insurance Portability and Accountability Act of
1996, Subtitle F — Administrative Simplification, Sections 261, et seq., as amended ("HIPAA"),
regarding the security of electronic protected health information ("e-PHI") that is received as a
result of the services provided hereunder. In conformity therewith, Fort Worth agrees that it
will:
18.4.1.1 Implement administrative, physical, and technical safeguards that
reasonably and appropriately protect the confidentiality, integrity, and availability of the
electronic protected health information that it creates, receives, maintains, or transmits on behalf
of the covered entity as required in the regulations;
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18.4.1.2 Ensure that any agent of Fort Worth, including a subcontractor, to
whom it provides such information, agrees to implement reasonable and appropriate safeguards
to protect protected health information; and
18.4.1.3 Report to MedStar any security incident of which it becomes
aware.
18.4.1 Notwithstanding any other provisions of this Agreement, this Agreement may be
terminated by MedStar, in its sole discretion, if MedStar determines that Fort Worth has violated
a term or provision of these Paragraphs 18.3 and 18.4 pertaining to its obligations as a Business
Associate of MedStar, or if Fort Worth engages in conduct which would, if committed by
MedStar, result in a violation of the HIPAA Privacy Rule or HIPAA Security Rule by MedStar.
Section 19: ACCESS TO RECORDS
19.1 The Parties agree that until the expiration of six years after the last date of furnishing of
services provided under this Agreement, the Parties will make available to the Secretary of the
United States Department of Health and Human Services ("the Secretary") and the United States
Comptroller General, and their duly authorized representatives, this Agreement and all books,
documents, and records necessary to certify the nature and extent of the costs of those services. If
a Party carries out the duties of this Agreement through a subcontract worth $10,000 or more over
a twelve-month period, the subcontract will also contain an access clause to permit access by the
Secretary, the United States Comptroller General and their representatives to the related
organization's books and records.
19.2 The Parties shall make records related to the EMS System services available to DSHS upon
request or as may be necessary.
Section 20: NO WAIVER
20.1 No course of conduct or verbal waiver or consent shall be deemed a waiver by a Party of
its rights under this Agreement. The waiver by a Party of a breach or violation of any provision
of this Agreement shall not operate as, or be construed to be, a waiver of any subsequent breach
of the same or other provision of this Agreement
Section 21: ASSIGNMENT AND DELEGATION
21.1 The Agreement shall be binding upon and inure to the benefit of the Parties and their
respective successors and permitted assigns. No Party may assign or transfer any of its rights or
obligations under this Agreement without prior written consent of the other Party.
Section 22: ENTIRE AGREEMENT
22.1 This Agreement, including any exhibits attached hereto and any documents incorporated
herein by reference, contains the entire understanding and agreement between the Parties, their
assigns and successors in interest, as to the matters contained herein. Any prior or
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contemporaneous oral or written agreement is hereby declared null and void to the extent in
conflict with any provision of this Agreement.
(signature page follows)
IN WITNESS WHEREOF, the Parties hereto have executed this Agreement in multiples.
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City of Fort Worth:
By:
Name: William Johnson
Title: Assistant City Manager
Date: 07/02/2025
Metropolitan Area EMS Authority d/b/a
MedStar Mobile Healthcare
By: Valerie Washington (Jul 2. 2025 11:28 CDT)
Name: Valerie Washington
Title: Assistant City Manager
Date: 07/02/2025
Authorization: Resolution No. 6037-12-2024;
and BC-1624
CITY OF FORT WORTH INTERNAL ROUTING PROCESS:
Approved as to Form and Legality:
By:
Name: Taylor C. Paris
Title: Assistant City Attorney
Contract Authorization:
Resolution No. 6037-12-2024; M&C 25-
0571
City Secretary:
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By: /Cll
Name: Jannette S. Goodall
Title: City Secretary
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
EMS Interlocal Agreement Page 14
City of Fort Worth, Texas
Mayor and Council Communication
DATE: 06/24/25 M&C FILE NUMBER: M&C 25-0571
LOG NAME: 13EMERGENCY MEDICAL SERVICE INTERLOCAL AGREEMENT
SUBJECT
(ALL) Authorize Execution of an Emergency Medical Service Interlocal Agreement with the Metropolitan Area EMS Authority d/b/a MedStar Mobile
Healthcare for the Temporary Provision of Emergency Medical Services Using City of Fort Worth Staff and Equipment
RECOMMENDATION:
It is recommended that the City Council authorize the execution of an Emergency Medical Service Interlocal Agreement with the Metropolitan Area
EMS Authority d/b/a MedStar Mobile Healthcare for the temporary provision of Emergency Medical Services using City of Fort Worth staff and
equipment.
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In accordance with the directives of the Fort Worth City Council, and the recommendations of the Emergency Services Ad Hoc Committee, the
City of Fort Worth (Fort Worth) executed a Memorandum of Understanding and Agreement (MOUA), identified as City Secretary Contract No.
62555, with the Metropolitan Area EMS Authority d/b/a MedStar Mobile Healthcare (MedStar) member cities (the Member Cities). Fort Worth and
the Member Cities anticipated that during the period between execution of the MOUA, the transition of EMS System services to Fort Worth as the
licensed emergency medical services (EMS) Provider, and the complete dissolution of MedStar there may be some operational and practical
complications for the EMS System. Therefore, Fort Worth and the Member Cities agreed that MedStar would maintain its legal status as a
governmental administrative agency and continue to operate under the direct management and oversight of Fort Worth during a transition period.
During this transition period, the MOUA authorized MedStar to operate certain temporary functions under the management of Fort Worth to ensure
continuity in billing, collections, and other operational areas as needed, and further authorized Fort Worth to take all necessary actions to ensure
the continued operation and administration of the EMS System services to all parties, such as maintaining or renewing any required licenses,
permits, or registrations for the EMS System services.
The purpose of this Mayor and Council Communication (M&C) is to authorize the execution of an EMS Interlocal Agreement (ILA) that formalizes a
temporary transitional arrangement in which MedStar, as the licensed EMS provider, will continue EMS operations from July 1, 2025 through
September 30, 2025, using personnel and equipment leased from Fort Worth and under Fort Worth's operational management and oversight, in
order to ensure uninterrupted EMS services during Fort Worth's transition to full licensed EMS Provider status. The ILA authorizes MedStar to
operate the EMS System, with Fort Worth providing operational management, staffing, and equipment support, using MedStar's state EMS
Provider license and credentials and leased Fort Worth assets and personnel while completing the final stages of transitioning to Fort Worth's own
EMS Provider license and associated registration numbers.
Agreement Overview:
Structure:
• MedStar remains the licensed EMS provider for the term of the agreement.
• Fort Worth provides and leases personnel, ambulances, and equipment to MedStar for EMS System operation.
- Fort Worth manages daily EMS operations, dispatch, and staffing.
MedStar authorizes Fort Worth to bill for services and oversee all operational functions.
Medicare/Medicaid Administration:
MedStar will update federal registrations to reflect Fort Worth's managing control, billing agent, and leased assets.
Upon termination, MedStar will remove Fort Worth from federal records and return full responsibility to Fort Worth's permanent EMS
license.
Operational Expectations:
• EMS responses must meet strict performance standards:
- High -acuity incidents: <_ 8 minutes (90% of the time)
Low -acuity incidents: <_ 11 minutes (90% of the time)
• MedStar must provide 24/7 ALS/BLS services, consistent with Fort Worth protocols and medical oversight.
• EMS operations will be directed by the Fort Worth Fire Chief and Medical Director, who will also oversee clinical standards.
• Fort Worth maintains vehicles, insurance, medical equipment, and third -party billing operations.
Financial and Compliance Provisions:
• Payments: All patient and third -party reimbursements are deposited into MedStar's account; MedStar remits full amounts to Fort Worth for
services provided.
• No additional compensation is owed by Fort Worth to MedStar.
HIPAA Compliance: Fort Worth is designated as a Business Associate under federal regulations and must safeguard all patient
information.
Audit & Records: Both parties retain audit rights for three years post -agreement and must comply with federal and state access
requirements.
Indemnification & Liability: Each party is liable for its own staff and actions; Fort Worth agrees to defend and indemnify MedStar during
the transition.
The term of the Agreement will be effective July 1, 2025 and expire September 30, 2025, unless otherwise extended by the parties. The
Agreement does not obligate Fort Worth to pay funds to MedStar and specifies that any payments required for governmental functions or services
under the Agreement will be made from current revenues available to each party, as required by Chapter 791 of the Texas Government Code.
Chapter 791 of the Texas Government Code authorizes Fort Worth and MedStar to execute an interlocal agreement for the provision of
governmental functions and services, including EMS, and is exempt from competitive procurement requirements.
A Form 1295 is not required because: This M&C does not request approval of a contract with a business entity.
FISCAL INFORMATION / CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendation and execution of the agreement, funds will be deposited into the
Emergeny Medical Services Fund. The Fire Department (and Financial Management Services) is responsible for the collection and deposit of
funds due to the City.
Submitted for Citv Manaaer's Office bv: Reginald Zeno 8517
Oriainatina Business Unit Head: Reginald Zeno 8517
Additional Information Contact: Anthony Rousseau 8338
A Resolution
NO. 6037-12-2024
DELEGATING MANAGERIAL CONTROL OF THE METROPOLITAN AREA EMS
AUTHORITY TO THE FORT WORTH CITY MANAGER'S OFFICE AND
REQUIRING THE METROPOLITAN AREA EMS AUTHORITY TO FOLLOW
CERTAIN CITY OF FORT WORTH PROCUREMENT STANDARDS AND
POLICIES
WHEREAS, in 1988, the City of Fort Worth (the "City") and certain other Tarrant
County municipalities came together to create a regional ambulance and emergency medical
services ("EMS") agency known as the Area Metropolitan Ambulance Authority, d/b/a
Medstar, (the "Authority") through the adoption of a uniform EMS ordinance and interlocal
cooperative agreement under the provisions of Section 773.051 of the Texas Health and Safety
Code and pursuant to Ordinance Number 10094;
WHEREAS, now known as the Metropolitan Area EMS Authority and operating under
the trade name MedStar Mobile Healthcare, the Authority operates under the Restated and
Amended Interlocal Cooperative Agreement executed in 2020 (Fort Worth City Secretary
Contract No. 54348; hereinafter, the "Agreement") and an updated uniform EMS ordinance;
WHEREAS, the Agreement provides for the creation of a Board of Directors (the
"Board") that administers all operations of the Authority;
WHEREAS, the Board is advised by two advisory boards, the First Responder
Advisory Board (the "FRAB") and the Emergency Physicians Advisory Board (the "EPAB"),
which were created by the updated uniform EMS ordinance and receive their directives from
the Agreement;
WHEREAS, the Agreement further provides that the Authority shall continue in
existence until all units of governments that are party to the Agreement (the "Member Cities")
withdraw from the Agreement;
WHEREAS, the Member Cities have, pursuant to the Memorandum of Understanding
and Agreement ("MOUA") executed by each Member City agreed to: withdraw from and
terminate the Agreement; dissolve the Authority; and designate the City as the licensed
EMS Provider for the Member Cities' jurisdictions;
WHEREAS, the MOUA further provides for the transition of all EMS related services,
operations, assets, and responsibilities to the City, to be administered by the City of Fort
Worth Fire Department with independent medical direction provided by a Medical Director
through the new City of Fort Worth Department Office of the Medical Director;
WHEREAS, the MOUA requires the City to create two new City advisory boards,
the Emergency Services Advisory Board (the "EAB") and the Medical Control Advisory
Board (the "MCAB"), composed of relevant stakeholders and medical experts to ensure
medical best practices; robust Member City representation, and to facilitate community
engagement;
WHEREAS, pursuant to the MOUA, the Authority will continue to exist, operate
and serve as the EMS Provider for the Member Cities in a transitional capacity until at
Ieast July I, 2025 (the "Transition Period") under the management and control of the City;
WHEREAS, by withdrawing from and terminating the Agreement, the Member Cities
also dissolved the Board;
WHEREAS, prior to its dissolution, by and through Resolution No. BC-1624, the
Board authorized: the Authority to continue its operations under the management of the City;
the City to act as the Authority to take all actions it deems prudent and necessary to
manage all day-to-day operations of the Authority and facilitate the transition of EMS to
the City; the transfer and conveyance of all Authority assets to the City; and the Interim
Chief Executive Officer of the Authority to execute any documents and take any further
actions necessary to implement the provisions of the resolution during the Transition Period;
WHEREAS, the Fort Worth City Council (the "Council") believes it is prudent to
delegate the responsibility of managing the operations of the Authority during the Transition
Period to the Fort Worth City Manager's Office ("CMO");
WHEREAS, the Council also believes it is prudent to require the Authority to follow
certain policies and procurement standards typical of Texas governmental entities during the
Transition Period for transactions initiated by the Authority while under the management and
control of the City;
WHEREAS, the CMO will be required to report directly to the Emergency Services
Committee concerning its management of the Authority during the Transition Period;
WHEREAS, during the Transition Period, the EAB and MCAB will advise the City
in place of the FRAB and the EPAB; and
WHEREAS, this Resolution shall be effective as of the date of its adoption by the
Council.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF FORT WORTH, TEXAS, THAT:
1. The CMO is hereby granted the responsibility to manage the day-to-day operations
of the Authority during the Transition Period and to make necessary decisions,
including directing the interim Chief Executive Officer of the Authority, to
facilitate the transition of services from the Authority to the City as reflected in
the MOUA;
2. The CMO shall: (1) require the Authority to follow certain procurement
standards required of Texas units of local government; and (2) implement a
procurement policy promulgated by the Purchasing Division of the City's Financial
Management Services Department during the Transition Period. The procurement
policy must comply with Texas Law and be substantially similar to the City's
existing Purchasing Administrative Regulation;
3. The CMO shall approve all new contracts or amendments to existing contracts that
exceed $100,000.00 and the Council specifically waives any requirement, if any,
for those contracts to be presented to or approved by the Council;
4. The EAB and MCAB will advise the City concerning the operations of the Authority
during the Transition Period in place of the FRAB and EPAB;
5. The CMO shall report to, and provide periodic and regular updates to, the
Emergency Services Committee concerning its management of the Authority and
other matters related to EMS and the Authority that the CMO deems appropriate
and necessary.
Adopted this 10'h day of December 2024.
ATTEST:
By:
Jannette S. GoodaIl, City Secretary
Docusign Envelope ID: BD6EBD97-7179-4AD2-8F67-29CAODED36D1
A Resolution
NO. BC-1624
AUTHORIZING ALL NECESSARY ACTIONS ASSOCIATED WITH THE
TRANSFER OF OPERATIONS AND ASSETS TO THE CITY OF FORT
WORTH
WHEREAS, in 1988, the City of Fort Worth (the "City") and certain other
local municipalities came together to create a regional ambulance and emergency
medical services ("EMS") agency known as the Area Metropolitan Ambulance
Authority, d/b/a Medstar, (the "Authority") through the adoption of a uniform EMS
ordinance and interlocal cooperative agreement under the provisions of Section
773.051 of the Texas Health and Safety Code and pursuant to Ordinance Number
10094;
WHEREAS, now known as the Metropolitan Area EMS Authority and
operating under the trade name MedStar Mobile Healthcare, the Authority operates
under the Restated and Amended Interlocal Cooperative Agreement executed in
2020 (Fort Worth City Secretary Contract No. 54348; hereinafter, the "Agreement")
and an updated uniform EMS ordinance;
WHEREAS, the Agreement provides for the creation of a Board of Directors
(the "Board") that administer all operations of the Authority;
WHEREAS, the Agreement further provides that the Authority shall continue
in existence until all local governments that are party to the Agreement (the
"Member Cities") withdraw from the Agreement;
WHEREAS, all Member Cities have expressed their intent to terminate and
withdraw from the Agreement, as documented in the Memorandum of Understanding
and Agreement (the "MOUA");
WHEREAS, the MOUA further provides for the dissolution of the Authority
and the transition of all EMS services, operations, assets, and responsibilities to the
City, to be administered by the City of Fort Worth Fire Department;
WHEREAS, during the transition period and pursuant to the MOUA, the City
is authorized to manage the Authority's operations in a temporary capacity until the
Authority is fully dissolved;
WHEREAS, acknowledging the likely termination of the Agreement and
dissolution of the Authority, the Board of Directors deems it necessary and
appropriate to authorize all actions required (i) to continue operation of Medstar
assets by the City to the extent required during the transition period to ensure
continued provision of emergency medical services and (ii) to effect the conveyance
of the Authority's assets and liabilities to the City and the transition of services to
the City in accordance with the MOUA.
Docusign Envelope ID: BD6EBD97-7179-4AD2-8F67-29CAODED36D1
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF
DIRECTORS OF THE METROPOLITAN AREA EMS AUTHORITY:
1. Authorization for Interim Operations: The Board authorizes the Authority to
continue its operations on a temporary basis during the transition period, under the
management of the City as provided in the MOUA.
2. Designation of Transition Authoritv: The Board authorizes the City to act `as' the
Authority and take all actions as it deems prudent and necessary to manage all day-to-
day operations, make necessary decisions, and facilitate the transition of services, as
set forth in the MOUA.
3. Asset Transfer Authorization: The Board approves the transfer and conveyance of all
Authority assets, including but not limited to property, equipment, and land, to the
City as part of the dissolution process.
4. Administrative Formalities: The Board authorizes the Interim Chief Executive Officer,
Frank Gresh, to execute any documents and take any further actions necessary to
implement the provisions of this resolution.
5. Effectiveness: This resolution shall take effect immediately upon its adoption and
remain in force until the final dissolution of the Authority and termination of the
Agreement, as provided in the MOUA.
Adopted this 23 day of October 2024.
ATTEST:
By: ��._
Carlose Flores, MAEMSA Board Chairman