Virginia Beach chief proposes compassionate EMS billing to fund ambulances, squad support

Chief Jason Stroud, director of Virginia Beach Emergency Medical Services, told the City Council on May 6 that the city should adopt a “compassionate EMS billing” program to provide a sustainable funding stream for ambulance staffing, equipment and volunteer rescue squads.

Stroud said the city’s consultant estimated $14.7 million in annual revenue and that the proposal would return more than $4 million to volunteer rescue squads, add 29 uniformed EMS positions (33.5 FTE total including administrative staff), centralize medical supplies and cover pharmacy startup and operating costs. “A compassionate EMS billing program . . . can provide the much needed funding in order to help sustain the Virginia Beach EMS system,” he said.

Why it matters: Virginia Beach relies on a hybrid system of career personnel and 10 independent volunteer rescue squads that operate as 501(c)(3) corporations. The chief and rescue-squad leaders say rising vehicle and supply costs, plus longer ambulance lead times, threaten squad sustainability. Stroud and rescue-council leaders presented the billing study and said the revenue would stay restricted to EMS and squad operating expenses.

Stroud described protections built into the plan: ability-to-pay would not affect care, the city would create financial-hardship policies that avoid burdening patients or sending accounts to collections, and residency could be used to avoid balance billing residents for uncovered portions. “Compassionate being that ability to pay is never a factor of care,” Stroud said.

Volunteer rescue-squad support: Stroud said the rescue council — an advisory body in city code representing the 10 squads — voted to endorse moving forward, conditioned on funds being used only for EMS/rescue-squad expenses, full transparency and a city-led communications campaign. Stroud said squads would retain ownership and continued ability to raise funds locally; the billing program would provide either direct contributions or a pathway to repay interest-free city loans used to buy ambulances.

Operational detail and timeline: Stroud said staff already negotiated a vendor and have started prework (credentialing, documentation, training). He said credentialing is typically a 60–90 day process, and if council approves the budget to implement billing July 1 the city can submit credentialing and hold runs for back-billing so revenue is not lost during the approval window.

Costs and capacity: Stroud noted new ambulance costs and lead time: recent ambulances cost $350,000–$375,000 to purchase and, when fully outfitted, exceed $500,000–$550,000; lead times have been 12–24 months. The proposed program includes a fund to replace ambulances and distribute funds equitably to squads based on membership size and fleet.

Questions and concerns: Councilmembers asked about readiness, impact on insurance premiums and how funds would be distributed. Stroud reiterated that ambulance transport accounts for less than 1% of national health-care costs and that the program’s protections and residency policy would reduce out-of-pocket burdens for residents.

Next steps: Stroud’s presentation was part of the city-manager budget package; council will consider the full budget and related ordinance language during May budget votes. The rescue council’s written position and the consultant study are available as part of the budget materials.

Ending: Stroud closed by noting a public outreach effort and printed talking points prepared with the communications office; he invited public questions and referenced an informational QR code on staff handouts.