Washington County approves 27% increase to emergency transport rates, 4-1

The Washington County Board of Commissioners voted 4-1 on Oct. 21 to raise the county's emergency medical services emergency-transportation rate by 27% effective Jan. 1, 2026.

The increase, presented by Mira Samantha, director of Health and Human Services, and Adrian Donner, public health program supervisor, is intended to shore up the county's fee-for-service 9-1-1 ambulance system while county staff pursue operational efficiencies. Samantha told the board the rate change is being proposed alongside ongoing projects to reduce ambulance patient offload time at hospitals and to limit unnecessary overlap of multiple ambulances on the same call.

The staff presentation noted that roughly 73% of Washington County ambulance transports are for Medicare or Medicaid patients and therefore paid at lower federal reimbursement rates that are not affected by a local rate increase. About 17% are covered by private insurance and roughly 11% are self-pay, the presentation said.

Commissioner Snyder urged the EMS team and contractor partners to achieve efficiencies by July 2027, saying future increases would depend on progress. Commissioner Willie said he would not support the increase and criticized rate hikes as masking deeper system problems involving hospitals and market-wide ambulance staffing issues, saying, "I cannot support this." Commissioner Treece (Treese) and Commissioner Fye expressed support for continued collaboration on efficiencies and for advocacy on federal reimbursement policy.

Board members and staff said AMR, the county ambulance contractor, has committed to examine its budgets and rates while county staff continue the efficiency initiatives. The board noted the next routine rate adjustment under county formula would not occur before July 1, 2027.

The motion to approve the 27% increase passed by a 4-to-1 vote. No additional implementation date beyond Jan. 1, 2026, was specified in the staff report; billing and administrative steps were described as operational details to be handled by AMR and county staff.

Staff and commissioners emphasized ongoing work on offload times and other operational improvements and several members urged simultaneous advocacy to increase federal Medicare and Medicaid reimbursement rates.

The board did not attach further conditions to the approval at the meeting.