Ambulance fleet aging and billing lag flagged as budget concerns

Staff provided an update on the town’s ambulance (PSA) operations, noting call volumes tied to senior housing and a substantial share of revenue coming from Medicare and Medicaid reimbursements that do not fully cover costs. Evergreen Healthcare (a staffed facility) accounts for about 21% of call volume for the PSA, staff said.

Billing lags were described as averaging about 60 days, though the exact timing can vary. Staff said they accrue outstanding revenue for roughly two months and then carry anything older into the next fiscal year. Reimbursement mixes were described as roughly 83–84% Medicare/Medicaid, about 7% self-pay at the time referenced, with the remainder covered by the town’s self-insurance.

On fleet replacement, staff listed vehicle ages and mileage: two trucks about 10 years old, one 13–14 years, and the newest at seven years with roughly 70,000 miles. Officials said the typical useful life is about 10 years and that the town plans to pursue a replacement once the new fiscal year begins; options include lease or purchase depending on availability and financing.

Board members discussed state mandates that could require vehicle retirement in the future and the practical challenge of acquiring new vehicles. The town budget includes a payment schedule that the staff said will allow searching for a replacement starting July 1, with an eye to replacing the oldest vehicle first.