County seeks clarity on EMS subsidy after Deaconess takeover; officials warn of rising costs

County officials reviewed updated ambulance finances and were told that a recent contract and operational change — moving EMS billing and administration to Deaconess Health — has increased the county’s projected subsidy for emergency medical services.

Why it matters: EMS is a core public safety service. Commissioners and councilors were told the new relationship with Deaconess changed the department’s cost structure: Deaconess requires the county to pay employee fringe benefit costs and pay a billing vendor fee, whereas the hospital that previously hosted EMS did not charge those separate line items. The county’s EMS director said the change, along with aging equipment and technology replacements, pushed the expected annual subsidy higher; staff estimated the subsidy could be in the $700,000–$820,000 range for the coming year, depending on final accounting.

Officials discussed service availability and calls for ambulances outside the county. The EMS director said crews still keep at least two ambulances available for 9‑1‑1 calls and that revenue from transfer runs into and out of the region has partially offset costs (he cited roughly $81,000 in revenue from some recent transfers). Commissioners raised service‑level concerns after members of the public reported longer response times at busy periods.

Options discussed included evaluating a modest patient fee for nontransport or “lift‑assist” calls (other services in the region sometimes bill callers for dispatches that do not result in transport), increasing fees for interfacility transfers, or amending the public‑safety funding model. No formal change was adopted at the meeting; EMS and finance staff were asked to provide a detailed fleet and depreciation schedule, expected vendor fees, and revenue projections.

Ending: County leaders asked EMS management to provide a vehicle/asset condition report and a clearer multi‑year projection for subsidy needs before the final budget vote.