When Grapevine, Texas, voted to replace Engine 1 with a two-firefighter squad to address rising EMS demand, the decision exposed a familiar divide. City leaders pointed to a workload that is 71% EMS and said the change would help put a fourth ambulance in service. Firefighters and residents warned that decommissioning the engine would weaken fire protection and compound long-standing staffing concerns.
I do not have insider knowledge of this particular battle or the discussions that led to this decision. However, as a retired fire chief, union member and former volunteer, I understand most, if not all, of the issues and positions associated with this story. Whether it is the union stance opposing reallocation and/or the reduction of firefighters, the chief’s position about more efficiently using available funding to improve EMS delivery, or EMS professionals sharing this as reason to separate EMS, I can see all sides.
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The dispute is bigger than one apparatus assignment. I believe in unified 911 response for fire and EMS. Call it what you want — EMS, fire-based EMS or even EMS-based fire — as the name-trigger is not the focus of this article. Our focus is the delivery and quality of service.
Fire and medical incidents often require overlapping personnel, training and logistics, and most do not involve a law enforcement function. That makes unified delivery a practical fit.
The more difficult question is how prehospital care fits into the broader U.S. healthcare system. Fire departments cannot solve the healthcare crisis, but they operate squarely in the gap between a person’s call for help and definitive care. Any serious discussion of staffing, apparatus or deployment has to account for that reality.
What’s in a name — fire
How did fire departments become the agency that people call for everything from a trench collapse to a pet stuck in a tree? I believe the reason is rooted in the altruism that most people associate with Ben Franklin’s 1736 assemblance of the first fire department in the colonies. Neighbors organized, acquired basic equipment and trained together to limit their collective losses from fire.
By the 1800s, fire departments evolved into paid and unpaid gangs, mostly affiliated with political parties that fought often violent turf battles for control of fire hydrants. These groups fought their rival fire companies for the first-arriving status over actually saving property.
The service eventually professionalized, but competition, politics and local identity have not disappeared entirely and in fact exist across the fire service today.
I’d like to think that we have progressed past all that in the 2000s, although we still struggle in some communities to focus on our original and primary mission — fighting fires.
We need to focus on the basics before we agree to be everything to everyone. Our focus is out-of-focus. If firefighting is the mission, then we must ensure there is sufficient staffing — at least four firefighters on every unit that will do interior firefighting. That does not mean the volunteer model can’t work. It simply means we must accept that it’s not 1736. As long as a person is capable, properly trained and can be personally trusted (background check and personally responsible), I don’t believe that Grandma Jones cares one iota whether you are paid or volunteer. They care that you show up at the right place, at the right time, with the right people and stuff, to do the right things.
What’s in a name — EMS
Emergency Medical Service (EMS) by definition would theoretically mean medical care for something that was emergent or that could become emergent without immediate intervention. Similar to the fire service example, a little history helps paint the picture.
EMS as a service was born out of military conflict — the need to transport injured soldiers to hospital-based care. After military care, EMS became associated with funeral home transports, not from the perspective of inevitable death but out of a matter of convenience. Funeral homes had vehicles to transport bodies, which translated into transporting patients to hospitals.
With the advent of more motorized vehicles and the westward expansion of Americans, tow companies got into the act, transporting patients from roadway crash scenes. Highway officials saw faster patient removal as a way to reopen roads — and secure budget funds in the process.
That history helps explain why EMS at the federal level is nested in the Department of Transportation’s National Highway Traffic Safety Administration. NHTSA’s Office of EMS is supposed to coordinate EMS across the country, specifically stated as coordinating “community leadership and data analysis.” Additionally, the Federal Interagency Committee on EMS is intended to coordinate work across the departments of Health and Human Services, Homeland Security and Transportation.
In my 45 years of fire and EMS experience, much of it near Washington, D.C., beyond roadway incident management training, I never worked with anyone from NHTSA on an EMS issue. While I’m sure some will be able to demonstrate some non-roadway coordination somewhere, my observation is that EMS is a cash-cow for NHTSA and that we the first responders have been left to fend for ourselves.
EMS that once was a standalone entity remains that way in some agencies but has been partially or wholly absorbed into fire departments in many locales across the country. Is it the same cash-cow effect that many fire departments saw? In some cases, yes. In other, I’ll call them more progressive, departments, EMS has become the natural extension of public safety service.
Along the way, EMS moved from emergency transport to a much broader safety net. Crews now handle many calls that do not require emergency department care, feeding the frustration behind the phrase “you call, we haul.”
Why transport became the default
This “you call, we haul” mentality has been perpetuated by multiple forces, two of which I’ll cover here:
- Risk-averse legal guidance has conditioned departments to avoid saying no. Departments’ internal legal advice tells providers, “just take them to the hospital if they want to go and let the hospital sort them out.” Early-adopters of paramedicine found that many doctors did not trust prehospital care providers’ quality of care, so the doctors’ propensity to just say “bring them here so I can figure it out” was real. This became the way of doing business for many, simply transferring liability from the ambulance crew to the doctor.
- Some chiefs and union/volunteer officials encourage the EMS volume to justify increased staffing and funding at the expense of both (or either of the) services. I have seen many fire and EMS departments obtain grant funding to buy beautiful ambulances with loads of shiny EMS equipment. Many of the purchases are made without regard for the staffing and training needs of the providers using the equipment. Many departments make investments in the EMS arena without a thought of financial sustainability. Making the investment and saying you’re providing the service is great, but are you really providing the service and will you be able to keep it going when your tax dollars start getting absorbed?
Where do we go from here?
Departments need to define their core capabilities, match resources to community risk and stop measuring success by the name on an apparatus or building. Two steps can move that work forward:
- Stop trying to be everything to everybody: You have likely heard the phrase “Jack of all trades, master of none.” Is that what your fire or EMS department has become? We must focus on the basic trades first before we claim to be experts in anything else.
- Incorporate EMS into community risk reduction (CRR): While some may espouse that CRR goes too far, I submit that fire safety and prevention was at the heart of Franklin’s fire department vision in 1736. Why do we have to reinvent wheels all the time? It feels like both fire and EMS are constantly trying to chisel the perfect wheel in an imperfect society. Bring the concepts of reducing 911-call recidivism together in one fire and EMS mantra, that focuses on three notions:
- A safer less emergent environment;
- Educating the communities we serve about fire and EMS issues; and
- Coordinating with affiliate agencies to route those non-emergent issues to a more appropriate party — the concepts of Mobile Integrated Health.
Service over politics
This discussion quickly becomes political, so let me be clear: My goal is better, more professional service, not allegiance to a party or faction. My position on this topic is generally considered to be more progressive, but I assure you I temper these notions with two words — disciplined leadership. Don’t we have the responsibility as public safety servants to rise above the fray and make sure we are providing the emergency services and striving for safer environments for those we serve? I say yes.
That responsibility also supports my previous call for a single federal parent for fire and EMS. The federal government has started to consolidate one of the seven entities with responsibility for fire, EMS or 911. Department of Agriculture wildland firefighters have moved to the Department of the Interior, and the January 2026 creation of the U.S. Wildland Fire Service is another step. That reduces the number of federal parents from seven to six. It is only a start.
As tired as I am about hearing how fires burn differently in your community (they don’t), I am equally tired of hearing that a federal organization — let’s say modeled after the National Guard model — won’t be better for the fire and EMS service as a whole.
Federal priorities will continue to shift as political leadership changes. I do not care which party is in power or how its leaders identify. I care that the service we provide is of the highest quality and that we are professional in our actions, whether paid or volunteer, at all times.
When the final analysis is written, we should not be concerned about the name on the door. We should be concerned that we will have left our communities safer and better off from a fire and EMS perspective than when those communities were when we started.
Yes, that’s easier said than done, but it starts with the difficult conversations. While all of the sides with the Grapevine Fire Department do not agree, they are having those discussions now. More departments should have it before the next budget or staffing crisis forces the issue.
