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Medic II proposal: regional EMS group seeks large rate increase; Cibolo to consider options
Summary
The regional EMS organization that provides ambulance service to Cibolo and nearby jurisdictions presented a proposed amendment asking member cities to accept increased per-capita charges to cover rising staffing and capital costs.
Representatives from the regional EMS provider briefed the Cibolo City Council on a proposed first amendment to the interlocal agreement that would increase participating cities' per-capita contributions to close a projected cash shortfall.
Medic Department leadership said the service covers eight cities and Guadalupe County and is experiencing rapid growth in call volumes, rising staffing costs and equipment inflation. The provider presented two increase options: an initially proposed 35% increase followed by smaller increases, and an alternative phased approach of 20% in year one, 20% in year two and 5% thereafter. The provider said the larger initial increase would return the enterprise fund to a positive cash position sooner; the smaller phased approach would delay the recovery by one year but be easier for municipal budgets.
EMS director (presenting) described staffing changes that increased payroll costs (shift model changes from 24 to 12 hours, higher paramedic pay after a classification study), rising ambulance procurement costs (quoted at about $340,000 for a 2025 ambulance), reduced transport revenue caused by changes in state reimbursement and limits on balance billing under Senate Bill 2476, and declines or variability in federal/state supplemental reimbursements. He also described actions the service has taken to control costs, including teaching EMT classes in-house, reusing ambulance boxes and buying new chassis to reduce cost, instituting volunteer programs, and launching internal supply and billing efficiencies.
Council members asked about timing. The EMS director said he could return to council in July with more detailed numbers and that the participating cities' managers are coordinating budget timing. Councilman Hicks asked whether the council had considered a smaller spread such as 15/15/15; the EMS director said the group had not recommended three even steps because that would extend the recovery and require another multi-year contract negotiation. Several council members said they needed the proposal to be presented to their own budget processes and asked staff to put the item on a future agenda.
Ending: Staff and the EMS provider agreed to return to a future meeting with firm budget figures and options. No council action was taken; council members asked staff to schedule the topic for follow-up in July so each city can complete budget deliberations.
