Title
Consider a memorandum/resolution approving an Emergency Medical Services Interlocal Agreement between Bell County and Killeen Fire Department.
Body
DATE: October 8, 2026
TO: Kent Cagle, Interim City Manager
FROM: Jim Kubinski, Fire Chief
SUBJECT: Bell County and Killeen Fire Department EMS ILA
BACKGROUND AND FINDINGS:
An Interlocal Agreement for Emergency Medical Services (EMS) establishes a formal partnership between the City of Killeen and Bell County that authorizes Killeen Fire Department EMS to provide emergency ambulance services in the unincorporated areas of Bell County. The agreement is intended to define each party’s responsibilities and provide a clear framework for EMS response, billing, reimbursement and accountability. The findings are that Killeen Fire Department has the personnel and equipment necessary to provide EMS outside the city under ordinary circumstances, while Bell County has identified a public health and safety need for emergency ambulance services in the county that requires assistance from the Killeen Fire Department. Under the agreement, Bell County will pay a base surcharge of $750 for each transported patient response, 50% of the base cost for qualifying no-transport calls, and no surcharge for false alarms, cancellations before arrival on scene, or calls with no patient contact. The base cost may increase annually based on the CMS Ambulance Inflation Factor, capped at 3%. The agreement also allows the City of Killeen to bill patients and insurers for allowable EMS services, while maintaining the fire department’s priority to respond to emergencies within the city limits
A previous MOU with Bell County for Emergency Medical Services that was presented more than twenty years ago has not been addressed or updated since initial presentation of the item. This Interlocal Agreement will be put in place for a five-year period and auto-renew annually.
THE ALTERNATIVES CONSIDERED:
N/A
Which alternative is recommended? Why?
N.A
CONFORMITY TO CITY POLICY:
Conforms to City Policy
FINANCIAL IMPACT:
What is the amount of the revenue/expenditure in the current fiscal year? For future years?
The amount of revenue anticipated in FY 2027 is unknown at this time. Under the agreement, Bell County will pay the City a base surcharge of $750 for each transported patient response and 50% of the base cost for qualifying no-transport calls. Actual revenue will depend on the number and type of eligible responses provided by the Killeen Fire Department. Revenue activity will be monitored during FY 2027 to inform future-year budget projections.
Is this a one-time or recurring revenue/expenditure?
Recurring revenue.
Is this revenue/expenditure budgeted?
No. Revenue associated with the new Interlocal Agreement was not included in the adopted FY 2027 budget. Actual collections will be monitored during FY 2027 and incorporated into future budget projections as sufficient historical data becomes available.
If not, where will the money come from?
Revenue will be generated from payments made by Bell County in accordance with the Interlocal Agreement.
Is there a sufficient amount in the budgeted line-item for this revenue/expenditure?
N/A - No additional City appropriation is required as a result of this agreement.
RECOMMENDATION:
Staff recommends that City Council authorizes the City Manager or his designee to enter into an Emergency Medical Services Interlocal Agreement between Bell County and Killeen Fire Department
DEPARTMENTAL CLEARANCES:
Fire
Legal
Purchasing
Finance
ATTACHED SUPPORTING DOCUMENTS:
Interlocal Agreement (ILA)
Presentation