Henry County officials briefed on Newcastle EMS preliminary $915,000 ask; commissioners weigh alternatives

Commissioners and county officials discussed a preliminary budget from Newcastle EMS that would raise the county’s share of emergency medical services to a figure materially higher than current payments, asking officials to prepare options before the April budget season.

The meeting heard that Newcastle EMS’s total proposed budget is roughly $4,550,000, of which the service attributed about $210,000 to grant‑funded community paramedicine programs; Newcastle’s stated breakdown of runs showed 61% of calls as city and 39% county. Using Newcastle’s numbers, county staff reported a calculated county receivables figure of about $780,000 and a preliminary “incremental expense” to the county of roughly $915,000.

Why this matters: county leaders said the figure is substantially higher than the roughly $300,000 the county currently pays and would force decisions in upcoming budget sessions as state revenue pressures intensify.

County Commissioner Chad (Commissioner) summarized the briefing: “They presented us with a budget, not actual expenditures,” and warned, “no matter where we settle here, I'm sure it's gonna be more than the 300,000.” He and other commissioners urged further review rather than accepting the preliminary total at face value.

Key numbers and sources discussed in the meeting - Newcastle EMS budget presented: about $4,550,000 (presented budget figure). - Grant funding (community paramedic program) included in that budget: about $210,000 (presented as grants, removed from net calculation). - Newcastle stated run-share: 61% city / 39% county (presented by Newcastle representatives). - Newcastle‑reported county receivables (runs billed in county): ~ $780,000 (presented figure). - Preliminary county incremental expense based on Newcastle’s approach: about $915,000 (presented figure). - Equipment/service contract referenced (ZOLL): roughly $200,000 a year; commissioners said getting out of that contract could reduce Newcastle’s budget by about $100,000 and reduce the county’s share by the 39% proportion if that occurred (presented by meeting participants). - Balance‑billing pilot estimate mentioned: collection impact potentially “50,000 plus” (presented, collection history noted that $32,000 had been charged originally in one reported instance but not fully collected).

Options and constraints discussed - Audit and data verification: multiple commissioners asked for actual expenditures and run‑by‑run data rather than a top‑line budget divided by 39%. “I just wanna make sure it's an accurate number,” one commissioner said, urging line‑item and run‑level review. - Quarterly vs. annual review: Newcastle reportedly requested the county pay a quarterly‑reviewable amount so the parties could revisit costs every three months; county leaders noted quarterly adjustments complicate annual budgeting. - Balance billing: commissioners discussed pursuing balanced billing as a modest revenue source but noted legal limits (Medicare and Medicaid cannot be balance‑billed) and uncertain collection yields. - Henry County EMS capacity: participants described Henry County EMS as able to perform ALS transports and to back up the city when Newcastle is busy but not yet staffed to be the sole 9‑1‑1 ALS provider. Commissioners asked staff to quantify what ramping Henry County EMS to provide more 9‑1‑1 ALS responses would require (staffing, training, equipment). - Third‑party/hospital partners: commissioners discussed asking hospitals that receive transported patients or private ambulance companies for cost‑sharing or contracts; participants said some neighboring counties contract with hospitals or private vendors, but arrangements vary widely.

Concerns and context Commissioners placed the Newcastle figure in a larger fiscal picture: several cited looming reductions in state revenue, falling interest income, and other pressures that will shrink the county’s general fund in the next two to three budget cycles. “We don't have $600,000,” one commissioner said bluntly about the ability to absorb such an increase. At the same time, participants recognized that ambulance services operate on narrow margins because Medicare and Medicaid reimbursements are low and insurance negotiated rates vary.

Next steps recorded in discussion - Commissioners requested more detailed documentation from Newcastle: actual expenditures, run counts and classifications (ALS vs. BLS), payroll detail (paramedic staffing levels), and receivables/collection history. - County staff were asked to obtain comparative quotes from private providers and to analyze options for Henry County EMS to cover more BLS runs while contracting ALS responses when needed. - Commissioners agreed to reconvene with Newcastle and city representatives after legislative changes and the next round of budget information (proposed meeting in April) to discuss a negotiated price or alternative service arrangements.

Ending note No formal vote or contract amendment occurred at the work session; the briefing functioned as an initial fact‑gathering and planning step. Commissioners emphasized that any payment increases will need documented justification and that the county will explore multiple service and funding options before committing funds.