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EMS leaders present pay, overtime and vehicle plans as commissioners weigh trade-offs
Summary
Ouray County EMS leaders outlined pay adjustments, a proposed community paramedic program, vehicle needs and overtime trends as the county evaluates how to close the preliminary budget gap.
Nate and other EMS leaders described multiple budget items in the county’s 2026 preliminary requests: compensation adjustments for supervisory staff, staffing-level questions, vehicle lease and upfit timing, and two new service ideas intended to reduce long-term costs.
Nate summarized recent hiring and pay pressures: the county raised starting paramedic pay to fill vacancies and now proposes bringing longer-tenured medics closer to that new starting rate to avoid internal compression. He said the county set a new starting hourly rate that equates to roughly $71,280 per year for new paramedics and proposed internal adjustments so newer hires are not paid more than incumbent medics.
Nate and EMS staff also proposed launching a community paramedic program intended to provide in-home care, medication reconciliation and other non-transport services. Nate described the model as “like a remote clinic” and said comparable programs statewide net participating counties roughly $50,000–$60,000 annually while improving care delivery and reducing unnecessary transports. He said the service is intended to break even or net revenue after initial startup and billing arrangements are in place.
On vehicles, commissioners and staff discussed the county’s enterprise leasing program and the timing of payments for four new vehicles. Nate and Vicky (the enterprise representative) confirmed the county has four vehicles at an upfitter; some payments and upfitting costs remain pending. Vicky told commissioners those quoted rates were locked in and that the county pre-pays some enterprise invoices to avoid interest. Commissioners and staff expressed concern about administrative fees and imputed interest on long enterprise leases and asked for a detailed breakout of interest, admin fees and upfit costs to compare alternatives.
Commissioners also questioned large overtime projections and encouraged EMS leaders to continue identifying ways to reduce overtime through PRN staffing, volunteer recruitment and operational changes. One commissioner said any compensation increases should be paired with measurable reductions in overtime rather than adding both costs without offsetting savings.
No formal board action was taken; EMS leaders were told their proposals and supporting data should be refined for the next work session.
