Council reviews proposed exclusive EMS agreement with CareFlight, asks about costs and flexibility

The Terrell City Council reviewed a proposed agreement with CareFlight on March 25 that would make CareFlight the city's exclusive provider of emergency medical services under a five-year contract with automatic one-year renewals.

Fire Chief Shane Lacroix and CareFlight representatives summarized the draft terms and definitions the city requested. The agreement defines advanced life-support (ALS) and MICU standards, sets response-time expectations for different call types, requires a quality assurance program and monthly reporting, and allows CareFlight to bill for transports. The draft also includes an optional, state-approved household membership program of $1 per month collected on the utility bill, with an opt-out available to residents.

Council members sought details on several items: - Exclusivity and backup: Council asked what would happen if CareFlight resources were unavailable. CareFlight representatives said the company maintains a broad regional response capacity and arranges backup resources; the city's dispatch may use a list of approved mutual-aid providers such as CHRISTUS or UT Health when needed. - Term and termination: The contract contains a 180-day notice of nonrenewal and performance provisions tied to meeting the contract's standard of care and response-time metrics. - Cost and sustainability: Councilors asked whether the city could absorb ongoing costs if grant or subsidy funding declines; CareFlight said the $1-per-household membership and existing subscription model reduce direct out-of-pocket costs for many residents, and the company indicated it currently provides service without a city subsidy in Terrell. Staff noted a five-year term would allow the city to transition later to in-house EMS if elected officials decide to pursue that option.

The council did not take a final vote on an agreement at this meeting. Chief Lacroix recommended authorizing the city manager to negotiate and execute the contract with CareFlight and said staff would return with final documents for council consideration.

Why it matters: The agreement would formalize service standards and response metrics, expand quality assurance expectations, and lock in a five-year exclusivity arrangement that councilors said should be balanced with the city's longer-term consideration of establishing in-house ambulance service.

Next steps: Staff will return with a final contract for council approval and suggested performance reporting; members requested quarterly metric reports if the agreement is executed.