DLS warns Maryland EMS Operations Fund may be insolvent by 2026 without revenue changes

State analysts told the Public Safety, Transportation and Environment Subcommittee that the Maryland Emergency Medical Services Operations Fund (MEMSOF) faces a structural shortfall that could produce insolvency as soon as fiscal 2026 unless the legislature enacts revenue increases or provides continuing general fund support.

Madeline Miller, the DLS analyst for MEMSOF, said the fund is primarily financed by a $29 motor-vehicle registration surcharge and supports components of Maryland’s EMS system including the State Police Aviation Command, the Maryland Institute for Emergency Medical Services Systems (MIMS), the Maryland Fire and Rescue Institute, and the R. Adams Cowley Shock Trauma Center. DLS projects the fund will remain solvent through FY25 with an estimated closing balance of about $4 million largely because of prior general-fund infusions, but forecasts that the fund would be insolvent in FY26 without action and would need approximately $18.8 million in additional general funds that year; the gap would grow in later years, to about $38.9 million by FY2030 under current assumptions.

DLS recommended that the administration and the EMS board comment on assumptions used in the forecast, particularly how salary enhancements are split between general and special funds, and suggested the General Assembly consider fee increases or other revenue enhancements that would require separate legislation enacted no later than the 2025 session to affect FY26.

Stakeholders testifying for the EMS coalition emphasized the system’s statewide integration. Clay Stamp, chair of the EMS board, asked lawmakers to "put the money on the table" and to preserve the collaborative, regional structure that coordinates hospitals, counties and emergency responders. Dr. Ted (executive director of MIMS) and other witnesses noted a multi-year communications upgrade, helicopter maintenance needs (including an estimated roughly $1 million tower repair in Annapolis), and the Shock Trauma Center’s continuing standby costs. Major Michael Tagliaferri recounted a recent complex medevac where multiple aviation assets and the shock-trauma go team saved a patient’s life, illustrating the system’s cross-agency reliance on MEMSOF funding.

Lawmakers acknowledged a temporary infusion of $25 million in the prior fiscal year but said a long-term funding solution is the priority for the session. DLS and stakeholders agreed to continue technical discussions about forecasts and revenue options during the session; the subcommittee took no immediate vote.