FORNEY, Texas — The City of Forney is seeking to expand emergency medical services provided under a county contract with CareFlite and, among changes sought in the contract, the removal of response time exceptions which skew reporting to the general lay public.
The City of Forney is currently an end user to a Kaufman County contract with CareFlite which began in March 2015 after East Texas Medical Center (ETMC) withdrew from the county, citing changes in Medicaid, Medicare, and private insurance funding. The City of Terrell and City of Kaufman negotiated their own, standalone contracts at the time, as they have for over 40 years with EMS providers.
With the departure of ETMC, CareFlite assumed 90% of their workforce already servicing Kaufman County, including 10 ETMC ambulances. As CareFlite began replacing those outdated ambulances with newer models, and in accordance with the new Kaufman County contract, six ambulances were assigned to Kaufman County.
Since then, the number of ambulances has increased to eight assigned to Kaufman County. City of Forney officials and council members say that isn't enough — especially considering Forney is the fastest growing city in the fastest growing county in the nation.
An effort was made to discuss changes to the contract with outgoing Kaufman County Judge Hal Richards and, ultimately, in a letter dated November 7, 2022, Forney Fire Department Chief Briggs told Richards the City of Forney and Emergency Services District No. 6 sought to be removed from the CareFlite contract, effective June 1, 2023. The City of Forney received no response from Richards.
Without legal action, however, the City of Forney must first work with county officials to take such action.
Following an oft-heated special-called meeting and closed-door executive session on Tuesday, the Forney City Council decided to engage with recently seated Kaufman County Judge Jakie Allen.
"We would like to engage in a conversation with the current county judge and give Judge Allen an opportunity to have a conversation with us to see, and understand that we have the intent to still have those conversations to see what CareFlite and the county can do on behalf of the city," stated Forney Mayor Amanda Lewis. "And then, if that does not receive any attention, then we ourselves will be addressing commissioners court."
"The contract, they are meeting the needs of the county-wide contract but not meeting the demands of the city based on our current population needs and call volumes," she said.
Major talking points Tuesday night focused on the fact the original 2015 contract remained unchanged when it was renewed in 2020, despite the county's explosive growth; response times and exclusions to the reporting data under the terms of the contract; and communication between the parties of the contract and their absence from the meeting.
While the original 2015 contract remained unchanged, CareFlite has since added two new ambulances to Kaufman County to meet response time requirements under the contract. The city and council, however, would like to see allowed exceptions to the reporting under the contract terms to be removed.
In its current state, the contract allows CareFlite to not record response times for any ambulatory call after a third consecutive call. For instance, if three ambulances are dispatched and on call, response times for any consecutive ambulance are not required to be reported. While the first three call-outs for ambulances may be made by ambulances at a station or on stand-by, the consecutive calls may require resources from other areas of the county or other jurisdictions with CareFlite contracts, such as those in southeast Dallas County.
And, while the first three response may be considered adequate, or within the parameters of the contract, subsequent calls often fall outside of those contract parameters but are not required to be recorded — giving a false representation of the data when presented to the lay public.
"The numbers being publicly reported by CareFlite are not a true representation of the data," one source tells inForney.com on background.
A flier being distributed by CareFlite boasting its response times includes only those times required to be reported and does not include response times which are allowed to be excluded under the contract terms.
And while the response times may be disputed, city officials and council members admit CareFlite is in compliance of the contract terms.
"The contract as written for 2015, should have been suitable for the situation that we faced in Kaufman County, specifically Forney and the northern/northwest of Kaufman County," stated Briggs. "2022, I wasn't here at that point but, based on what I got when I got here in June, I would say that the contract was not sufficient to meet the need at that time much less where we are today or where we are projected to go in the future.
"So, CareFlite has been operating under the same set of rules, or performance indicators and benchmarks that the contract was looking for, since 2015," he continued. "In their defense, they're doing what the contract asks them to do. Does that mean it meets the needs of the citizens, no."
"We're here because we are beholden to a contract that we didn't write, that is operated by the county, that is delivering poor service to our residents," stated Councilmember Sarah Salgado. "They might be contractually meeting the terms of the contract but the terms of the contract are not what is good for our citizens."
"I would prefer for us to have different language in the contract that helps measure the accuracy of system performance and we work together to provide better service and transparency to the community on what the system's true performance is instead of standing behind a set of exclusions that allow you to not count things," stated Briggs. "I would rather come up here and tell you our response times are slower than they should be and provide you with some options on how we can make them better than to say, 'well I don't have to count this run, or this run, or this run because we were too busy.'"
"We can't stop. I would be all in favor of trying this again and see if we have at least part of the group show up," stated City Manager Charles Daniels in reference to other parties of the contract not attending the meeting. "There is another portion of this whole equation that I'm hopeful there are people watching this because once the public realizes that they're not receiving the type of service that they deserve and require, I think that they can move some things that we possibly cant and we just need to keep trying to move forward with this."
To view to discussion portion of the meeting, see below: