Yankton County ambulance service reports operating loss, staff changes and a planned administrator search

The Yankton County ambulance service reported a first-quarter operating gap of $114,190.49 and presented staffing and billing updates to the County Commission, which approved the quarterly report.

The ambulance presentation, given by Troy (acting ambulance administrator), said the service recorded 541 patient care records in the first quarter, including 387 billable patient transports and 54 non-transport responses such as refusals or lift assists. Revenue for the quarter was $261,058.23 against expenses of $375,248.72, yielding the reported shortfall. Troy said the service’s cost per county resident for the quarter was $4.86, using a county population figure of 23,509.

The nut graf: The report shows the ambulance service remains an essential county function but is not currently self-sustaining; commissioners approved the report while staff recommended short-term staffing approaches and a search for a permanent administrator to address operations and revenue.

Troy outlined workforce changes: the service currently lists 32 employees (five full-time medics, five part-time medics, a mix of EMTs and billing staff). He said one full-time paramedic recently resigned to take a job in Kansas and another full-time EMT expects to leave for medical school in July; several part-time paramedics also resigned. Troy said a full-time EMT in training is expected to graduate by summer and help fill certified staffing needs.

On billing, Troy reported 451 payment claims were sent to the clearinghouse Waystar during the quarter; 93.4% of those required no adjustment. He said ambulance billing staff recently earned billing certifications, and the service had strong lien collections ($63,187) compared with prior periods.

Public commenter Bob Gleick, a Yankton County resident, urged the commission to rescind a recent motion to advertise for a new ambulance director and instead explore selling the ambulance service to a private operator, saying advertising would cost money and “if a year goes by and no one has picked that up, I think the county commission should vote to absolve the ambulance system and shut it down.” His remarks were made during the meeting’s public comment period and were not a formal action.

Commissioners and Troy discussed rate reviews. Commissioners asked Troy to review lift-assist fees, airport transfer fees and other rates that have not been updated since about 2018; Troy said a rate review is a high priority and he would present proposed adjustments later.

Troy also said he will sit on the hiring committee for the new ambulance administrator search and that the Yankton Fire Chief has requested to assist on the committee. Troy asked that the county continue to fill part-time positions to maintain adequate weekend and night coverage.

The commission voted to approve the ambulance first-quarter report. Motion by Wanda, second by Don; vote: motion carries.

Ending: Commissioners directed staff to continue short-term coverage strategies, begin a formal rate review and proceed with the advertised search process for a permanent ambulance administrator with local EMS representation on the hiring committee.