Sedgwick County reviews EMS budget options as ambulance availability dips

Sedgwick County commissioners spent a morning briefing on emergency medical services (EMS) capacity, staffing and equipment as the department asked for a series of budget decision packages to reduce periods when ambulances are scarce.

Kevin, the EMS presentation lead, told the commission the department is near full staffing and now has 24-hour critical care capability, but faces rising call volume, an aging fleet and no integrated inventory system. He said staff captured data from April 1 through May 15 showing 1,192 minutes countywide when there were three or fewer ambulances available and 68 minutes when no ambulances were available — intervals the department said can harm patient outcomes for time-critical events such as stroke, heart attack or major trauma.

The department sought funding for several items, including a $178,000 equipment replacement package to refresh IV pumps, ventilators, monitors and other end‑of‑life gear; roughly $30,000 to stand up a basic inventory management module (with per-ambulance add‑ons) to replace manual spreadsheets; and larger staffing requests. The largest operational ask would add 27 full‑time EMS positions intended to enable six 12‑hour basic-life-support (BLS) ambulances on peak shifts (or equivalent coverage), plus a separate request for five full‑time paramedic “CRV” first‑responder positions for Clearwater and Cheney that the department says would largely offset current overtime costs.

Deputy Chief Angela Fuller said staffing, not just vehicles, drives availability: “Most of our accidents were hitting fixed objects,” she reported, and later the department confirmed 58 accidents in 2025. Fuller and other staff emphasized that vehicle choice affects patient comfort, provider safety and maintenance costs, and commissioners asked the department to study whether smaller or van‑style BLS units could reduce accident exposure and long‑term costs compared with the larger F550 ambulances now used on many calls.

The presenters described a possible tiered model in which dedicated BLS trucks (staffed by EMTs) handle low‑acuity calls and non‑emergency transfers while ALS (paramedic) units and quick‑response paramedic vehicles respond to higher‑acuity calls. Staff said custom ALS ambulances can take roughly 36 months to procure, while simpler BLS vehicles or van‑style designs may be available in 14–16 months and can be less expensive to equip and remount over time.

Commissioners pressed for detail on how the status‑event minutes break down (how long status‑zero events lasted, and whether interfacility transfers or non‑emergency work contributed to low availability). Staff answered that hospitals (Ascension and Wesley) have contractual windows for initiating transfers (90 minutes to get a unit on scene for non‑emergency transfers) and that holding certain transfers when system status is low is part of managing availability.

On revenue, staff reported a recent notice that Medicaid is exploring reimbursement for “treat‑in‑place” care; the department said Medicare is the federal baseline to watch and that more guidance is expected after July 1. Staff cautioned the commission the fiscal impact of treating‑in‑place reimbursements is not yet quantified and will depend on documentation and program rules.

Commissioners acknowledged the need to scale EMS and urged a phased approach that balances public‑safety gains with taxpayer capacity. One commissioner said a single $9 million increase in one year would be difficult to accept, recommending staging FTE increases and vehicle purchases so the county can begin to see results sooner without a single large budget spike. The session closed with commissioners thanking EMS staff and asking for follow‑up details on hiring timelines, vehicle‑type studies and the evolving reimbursement guidance.

The commission did not vote on any motions during the session; staff were asked to return with refined cost estimates, hiring timelines and a plan that stages investments to address the status‑event risk while limiting near‑term budget shocks.