Ambulance district warns of $200k-plus shortfall, asks commissioners to approve early release of special-district funds

Ambulance leaders told Madison County commissioners during the budget workshop on June 7 that rising calls and low reimbursement rates are producing a growing operating deficit for the district.

Dana, identified in the transcript as the ambulance district representative, said the district’s gross charges rose from about $403,000 in 2025 to a projected $630,000 for the current fiscal year. “We usually only collect about 38 to 40% of those charges,” Dana said, explaining that Medicare and other payers typically reimburse a fraction of billed ambulance rates. That combination of higher utilization and low collection rates leaves the district with a projected operating shortfall and depreciation that together exceed $242,000.

Why it matters: Ambulance services are typically low‑margin operations but are often relied on as a public-good emergency service. The district’s shortfall, if not addressed, risks cutting capacity or requiring larger tax or levy support from residents in future years. Officials said tax-allotment dollars collected for the ambulance special district are intended to backstop these losses but require timely distribution.

What commissioners heard: The district asked the board to accept a simple letter from the ambulance district requesting release of available special-district funds this month, so allocations can be split and paid before the end of June. Dana told commissioners a letter, together with the county’s approval, would serve as the “equivalent of an invoice” for the two-county split that funds the service. County staff said once second-half tax receipts are posted in June they can calculate the cash balance and release funds accordingly.

Context and next steps: District officials said utilization had climbed about 25% year-over-year and that payers’ low reimbursement practices make ambulance billing structurally difficult to close to break-even. Commissioners asked staff to accept a formal written request from the ambulance districts, approve the letter at the next routine action, and authorize finance to process a split payment once receipts and the county cash balance are confirmed.

Outcome: Commissioners signaled willingness to process a timely request and asked staff to prepare a paper trail and a formal letter for their approval so the funds can be released before month-end.