Nicholas County EMS reports steady call volume, seeks part-time hire and weighs Medicaid supplement, building amendment

Nicholas County EMS gave the court its monthly departmental report, requested approval to hire a part-time EMT and outlined several funding and contract matters the department is tracking.

During the March meeting of the Nicholas County Fiscal Court, an EMS representative said February run volume was about in line with recent months and that equipment is operating normally. The representative asked the court to approve hiring Christian Warner as a part-time EMT with an intended start date of March 1, 2025. “He did very well during his ride time,” the EMS speaker said. The court approved the hire by voice vote (motion made, seconded; motion carried).

The EMS presenter also told the court the county will soon need to reopen negotiations on an intercounty response contract with Robeson County. Court members asked staff to calculate the average cost per run, including labor, mileage and equipment wear, before further talks so the court can determine whether the current reimbursement covers expenses; a precise per-run calculation was requested but not provided at the meeting.

Members discussed House Bill 152, described in the meeting as a bill creating a new Medicaid supplemental payment program for public ground ambulance providers and special districts. The EMS presenter said the bill would go into effect Jan. 1, 2026, if enacted and that participation would be voluntary and require a local pay-in. “It’s supposed to increase your payout,” the speaker said, but added staff had only received informational materials the prior day and had not completed a review. Several court members asked staff to examine the bill’s requirements and estimated financial impact before the court takes a position.

The EMS report also noted that if the county chooses to participate in a supplemental Medicaid program, the county’s billing agent and a regional association (identified in the meeting as MCA) could handle required monthly reporting. Staff said they would review how participation would change billing operations and revenue flows before recommending whether to opt in.

Separately, the court considered an amendment to the professional services contract for the new EMS building. The amendment would incorporate a change to the design and to the helipad location and would add extra compensation for the architect/engineer. The transcript includes two differing dollar figures when the fee change was discussed — the amendment was described once as adding $25,000 in architectural fees and later as adding $45,000 to the contract. The court asked staff to clarify the correct figure; despite the discrepancy, the court approved amending the contract so the helipad design and lighting could be included in the project schedule to keep the existing pad available until the new facility is online. A court member said the amendment was recommended so the new helipad would be ready before the old pad is taken out of service.

Why it matters: The hire and building amendment address near-term operational capacity for EMS response. The bill staff is monitoring (House Bill 152) could materially change how Medicaid reimbursements flow to public ambulance providers and requires a local cost-benefit review before the court decides whether to participate.

The court directed staff to prepare cost analyses: an average per-run cost for Robeson County transports, a review of House Bill 152 and its financial implications, and a clarified amendment with an explicit, reconciled fee amount for the EMS building contractor. The court approved the part-time hire and approved the contract amendment as presented pending clarification of the fee amount.