Nottoway supervisors weigh EMS funding, town request and billing options
January 10, 2026 | Nottoway County, Virginia
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Supervisors spent an extended portion of the meeting on emergency medical services funding, operational responsibilities and revenue options for EMS and fire responses.
Speaker 1 told the board the town of Burkeville approved last night to pay five paid EMS employees and that the town may submit a request to the county for $44,500 per month to support its EMS staffing. Board members said they had heard the request but had not taken action and asked staff to include the item in budgeting discussions and provide financial detail.
Members debated how to address repetitive, non-emergency or 'nuisance' calls without deterring people from requesting help in true emergencies. Speaker 3 recommended legal review to define abuse versus legitimate medical calls and explored whether a blight or nuisance ordinance could be used to reduce repeat non-emergency dispatches, but other supervisors warned that dispatchers are not medical experts and diverting responses carries liability risks.
An invited presenter summarized regional experience with third-party billing and "at-fault" billing practices, explaining departments often bill multiple parties and insurers or courts later sort fault. The presenter said third-party billing firms typically retain a portion of collections (commonly in the single digits for EMS and higher for fire responses) and that insurance policy design and state-level rules limit what ultimately reaches local departments. He noted an existing ordinance was provided in the packet (transcript reference: "30 38 2 21 30") that constrains recoverable amounts and billing practices.
Board members asked staff to include detailed call-volume and financial reports for calendar-year 2025 in the upcoming budget package (including counts of refusals/treat-and-release and breakdowns by call type) so members can assess realistic revenue projections from billing versus reliance on stable government funding.
No new county billing ordinance or immediate revenue policy change was adopted; supervisors directed staff and legal counsel to provide clarifying documents for future discussion.
Speaker 1 told the board the town of Burkeville approved last night to pay five paid EMS employees and that the town may submit a request to the county for $44,500 per month to support its EMS staffing. Board members said they had heard the request but had not taken action and asked staff to include the item in budgeting discussions and provide financial detail.
Members debated how to address repetitive, non-emergency or 'nuisance' calls without deterring people from requesting help in true emergencies. Speaker 3 recommended legal review to define abuse versus legitimate medical calls and explored whether a blight or nuisance ordinance could be used to reduce repeat non-emergency dispatches, but other supervisors warned that dispatchers are not medical experts and diverting responses carries liability risks.
An invited presenter summarized regional experience with third-party billing and "at-fault" billing practices, explaining departments often bill multiple parties and insurers or courts later sort fault. The presenter said third-party billing firms typically retain a portion of collections (commonly in the single digits for EMS and higher for fire responses) and that insurance policy design and state-level rules limit what ultimately reaches local departments. He noted an existing ordinance was provided in the packet (transcript reference: "30 38 2 21 30") that constrains recoverable amounts and billing practices.
Board members asked staff to include detailed call-volume and financial reports for calendar-year 2025 in the upcoming budget package (including counts of refusals/treat-and-release and breakdowns by call type) so members can assess realistic revenue projections from billing versus reliance on stable government funding.
No new county billing ordinance or immediate revenue policy change was adopted; supervisors directed staff and legal counsel to provide clarifying documents for future discussion.
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