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EMS budget holds steady; council hears concerns about ambulance fees and enterprise fund deficits
Summary
Kevin Giussulo, EMS administrator, presented a neutral FY26 EMS budget (2.48% proposed increase described as a net wash) and discussed ambulance fees, Medicaid reimbursement uncertainty and the enterprise fund deficit and recovery plans.
Kevin Giussulo, administrator of EMS, told the council the fiscal 2026 EMS budget is effectively neutral with a proposed 2.48% increase and referred members to page 64 of the budget workbook.
Giussulo summarized 2024 operational highlights: Stratford EMS responded to 8,369 medical calls in calendar 2024, saw reduced mutual-aid reliance, and moved toward full staffing by making offers to additional full-time positions. He said per diem personnel remain an important staffing source and that the University of New Haven has been a steady pipeline of EMTs.
Why it matters: the EMS enterprise fund finances ambulance operations and has run deficits in recent years; councilors asked about how the department sets ambulance service fees, the town contribution to EMS, and contingency planning if federal or state Medicaid reimbursement changes.
Giussulo explained ambulance service fees are set through an annual request process to the Connecticut Department of Public Health. Departments may use a short-form process (typically yielding ~2% increases) or a long-form process (used less frequently, sometimes producing larger increases). He said the department applied the long-form process last year and received about a 3.7% increase. Giussulo said the federal continuing resolution extended ambulance-rate funding through September and that state and federal decisions remain uncertain; director Luis (not present) sits on the Connecticut EMS Advisory Board and is tracking developments with the legislative delegation.
Councilor questions focused on the town contribution (Giussulo said the town contributes $450,000 to EMS) and whether the department has contingency plans if federal or state reimbursement falls short. Giussulo said the department would not change operations immediately and would wait to see state/federal rule changes before proposing specific adjustments; he also noted the FY26 budget does not assume a planned January 1 rate increase because that amount is unknown, so the revenue projection is conservative.
On the enterprise fund and long-term finances, Giussulo and other staff explained the enterprise model historically funded roughly 85–90% of EMS costs, leaving a town subsidy; they said the fund has been challenged by structural changes since the model began (2003), including higher full-time staffing levels and integration of fringe-benefit costs that the town previously absorbed. The department is targeting a $175,000 paydown of the fund balance deficit in the proposed budget and reported improved audit-year results (roughly a $500,000 improvement from 2023 to 2024 audit figures).
Councilors asked for follow-up data on miscellaneous revenue, ambulance billing receivables, and precise current-year receipts; Giussulo offered to provide exact numbers offline through finance staff. He also detailed non-revenue items in the EMS budget (disposal fees and hazardous waste costs tied to regulated medical waste and an underground oil/wash tank at the station).
Ending: The council heard that EMS staffing is stabilizing (Giussulo said full-time offers were accepted to reach full staff for the first time since COVID) and that the department will continue monitoring state and federal reimbursement developments and report implications to the council.
