AGENDA CAPTION:
Title
Report on the San Marcos Emergency Medical Services (EMS) transition efforts, and provide direction to the City Manager.
Body
Meeting date: April 7, 2026
Department: City Manager’s Office
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Background Information:
The presentation outlines the City of San Marcos’s evaluation and planned transition toward establishing a standalone, city-operated Emergency Medical Services (EMS) department. This shift is driven by broader regional changes in EMS delivery across Hays County, including multiple jurisdictions moving away from a shared regional model to independent service structures. At the same time, rapid population growth and increasing call volumes within San Marcos have placed additional demand on existing EMS services, prompting the City to assess long-term sustainability, service quality, and operational control.
In response, the City Council directed further analysis of a municipal EMS model, emphasizing key priorities such as workforce transition, labor considerations, quality of care, and implementation planning. The City has initiated a structured approach to stand-up EMS as a third public safety service alongside police and fire. Central to this strategy is the early recruitment of an EMS Chief to lead operational design, guide hiring decisions, and ensure readiness. A phased hiring process will follow, prioritizing current San Marcos Hays County EMS personnel to maintain workforce stability and continuity of care, while also opening opportunities to external candidates to ensure adequate staffing levels.
The City is also carefully evaluating workforce integration and compensation to align with municipal policies while remaining competitive in recruiting and retaining qualified paramedics. This includes ensuring internal equity across departments, integrating EMS into the City’s organizational and human resources framework, and maintaining consistent pay structures, benefits, and career progression opportunities. The goal is to create a sustainable and well-integrated EMS department that supports both employee stability and long-term operational success.
A comprehensive legal review of labor frameworks indicates that EMS personnel in a standalone municipal department would become City employees, subject to existing municipal policies. However, state law limits certain labor mechanisms, such as collective bargaining and civil service protections, which do not apply to EMS under current statutory criteria. While employees may present concerns, binding collective bargaining agreements are not authorized. These constraints shape the City’s approach to workforce relations and employment protections.
Importantly, the transition to a City-operated EMS model is designed to maintain full continuity of patient care and clinical quality. The existing medical director, clinical operating guidelines, credentialing processes, and quality assurance systems will remain unchanged. Current paramedics and EMTs will continue providing care under the same physician oversight and performance standards, ensuring no disruption to emergency response or clinical outcomes. The structure of governance may change, but the clinical system and standards of care will remain consistent.
Also attached is a short video session with the Medical Director reinforcing continuity of care . Here is the link. <https://url.us.m.mimecastprotect.com/s/oPGSC2kQrLU8kprVIBiXS5INSq?domain=youtu.be>
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