Updated: August 11, 2025

0545, July 4th, 2025. The RMOC San Antonio MEDCOM received the call for regional mutual aid and notified the RMOC San Antonio and EMTF 8 teams via Active911. The Regional MCI plan was initiated and regional ambulances, AMBUSs, Medical Incident Support Team members, and the RMOC all began to send support to Kerrville, Texas.

0621, July 4th, 2025, less than 40 minutes later, The TX EMTF State Coordination Office (SCO) was notified that a severe flooding event in the Hill Country and Central Texas was evolving from a local /regional MCI response to a full state response. A SCO representative immediately deployed to the State Operations Center (SOC) as requested, and began rostering and activating EMTF personnel and equipment from across Texas. Initially, 3 Severe Weather Packages (SWX PKG) were activated immediately that morning. Each SWX PKG consists of a Task Force Leader (TFL), two Medical Incident Support Team (MIST) specialists, an AMBUS, and a five-ambulance strike team (AST) with an Ambulance Strike Team Leader (ASTL). This was to augment the local and regional assets already active in Kerr County under mutual aid protocols and the STRAC Regional Mass Casualty Incident (MCI) Alarm Response, as well as those not yet involved in the response. 3 additional SWX PKGs were rostered and placed on Standby, ready to be activated at a moment’s notice.

The EMTF SCO arrived at the SOC by 0830 that first morning and immediately began working with the Texas Division of Emergency Management (TDEM) and the Department of State Health Services (DSHS) to determine the scope of events and the appropriate distribution of activated resources. By mid-morning, TDEM requested the 3 Standby SWX PKGs be activated, one package to be prepositioned in Llano County to provide response capabilities in the northern Hill Country and two packages staged in San Antonio in preparation for the expanding incident in multiple counties across central Texas. MIST personnel, AMBUSs and ASTs that had already responded to Kerr County under regional mutual aid (MCI Alarm) were folded into the activated state EMTF umbrella to enhance coordination of the emergency medical response. Work continued throughout the day and night of the 4th, as personnel on the ground were fully involved in rescue operations and the EMTF SCO, TDEM, and DSHS marshalled assets to the affected areas. By the end of day one, 169 EMTF personnel and 78 assets were deployed to the affected areas, with another 63 personnel and 33 assets on Standby.

The following days saw further expansion of the EMTF response on a daily basis for a week as we were called to support the ongoing the subsequent flooding incidents. The SWX PKGs staged in San Antonio were deployed to Williamson County to aid in the emergency response to widespread flooding in Leander and Georgetown. The Llano County SWX PKG expanded operations into Burnet County, supporting rescue operations in Burnet and Marble Falls. Six members of the Texas Mortuary Operations Response Team (TMORT) were also sent to the Kerr area to begin support operations to the Justices of the Peace (JPs) which are the Authority Having Jurisdiction (AHJ). And of course, work continued in Kerr, Kendall, and Comal Counties across the full spectrum of emergency response. In all operational areas, EMTF assets were mission tasked to support rescue operations, first responder medical force protection, local EMS and FD 911 support, hospital interfacility transfers, responder vaccine clinics, and cooling and rehabilitation support of responder and community recovery efforts, ensuring that patient load was balanced across regional hospitals. Mobile Medical Units (MMUs) were activated and brought into Kerr County to enhance responder force protection capabilities for the thousands of resources inbound from across the country to aid in the massive search and rescue effort as they were distributed across central Texas. Peer Support Team members were also brought into the affected areas, providing Critical Incident Stress Management resources to responders coping with the tragic aftermath of the historic Hill Country flooding. Additional ambulance strike teams were activated, supplementing 911 response in local jurisdictions as well as aiding in search and rescue and recovery operations.

At the height of the response, Texas EMTF had 232 personnel and 136 assets from 87 different agencies deployed across the affected area, fully integrated in all aspects of medical care and response.