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Ambulance district budget shows revenue growth; commissioners keep contingency while exploring separate EMS insurance
Summary
The ambulance district’s draft budget projects higher revenues and a reserve buildup; commissioners agreed to prioritize contingency building and noted a January option to explore separating EMS health coverage to a First-Responder plan, pending stop-loss and timing constraints.
Bonner County’s ambulance-district presentation showed revenue growth driven by current EMS billings and expected grant money, but commissioners emphasized rebuilding contingency reserves rather than using draft funds to pay EMS employee premiums this fiscal year.
Revenue and reserves: EMS staff increased the ambulance district’s EMS-billing revenue line by $100,000 in the draft after year-to-date collections exceeded expectations; combined with an anticipated $200,000–$400,000 in GMT (grant/other) money, staff projected roughly $5.45 million in total revenues for the ambulance district. To start rebuilding reserves, the draft also includes a contingency line of about $474,000.
Insurance and benefits discussion: EMS leaders asked whether the ambulance district could pay employee premiums on its plan. Commissioners and staff said segregating EMS from the county medical pool might yield a lower-cost, first-responder-focused option (discussed in the meeting as a quote: “I triple a” as one vendor being considered), but disentangling EMS from the county’s self-insured arrangement will take additional administrative work and might be feasible in January rather than immediately. Commissioners were concerned that using contingency or current-year funds to cover premiums would undermine the goal of rebuilding reserves and reducing reliance on short-term financing.
Operational staffing concerns: EMS leadership warned they are at minimum staffing levels and that losing additional staff would require new hires — a greater long-term cost. Commissioners acknowledged the recruitment pressures and signaled willingness to consider insurance segregation in the near term, provided staff can present a clear fiscal comparison and implementation plan.
Decision and next steps: commissioners directed staff to prioritize building contingency for the ambulance district in the draft budget and to ask the insurance broker to model the fiscal impact of separating EMS coverage in January, after open enrollment closes and stop-loss constraints are clearer. The board did not direct immediate payment of employee premiums from EMS draft funds.
Ending note: EMS and county staff agreed to pursue modeling and to revisit the question once open enrollment closes and the insurer/broker can provide reliable cost and claims comparisons for a potential separate EMS plan.
