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County manager outlines budget 'reengineering'; in-house EMS billing expected to boost revenue

2140805 · January 22, 2025
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Summary

County manager Brian Eppley briefed commissioners on budget reengineering strategies including shifting EMS billing in-house (trending to $6.9 million revenue), solid-waste cost avoidance estimated at over $1 million, radio purchase savings of about $1.2 million and pharmacy plan savings of about $1 million; board accepted the report 5-0.

Brian Eppley, Burke County manager, presented a budget "reengineering" briefing to the Board of Commissioners on Jan. 21 as the county begins its 2025–26 budget process.

Eppley said the county faces slower property-tax growth (about 1.7–1.8 percent projected) and a moderate decline in sales tax collections, which together make reengineering—repurposing existing revenue and reducing fixed costs—an important focus for the coming year. "Sometimes it's how do you redistribute in the highest and best use way resources that you already have," Eppley said.

He described several workstreams and preliminary results. In solid waste, the county shifted hauling in-house and expects to save "over $1,000,000" this year by eliminating a transport contract. The county also ended a cardboard-hauling contract that had cost about $160,000 per year and now compacts cardboard at three of six sites to retain market revenue.

On public-safety communications, Eppley said a bulk purchase of Motorola radios, aided by a technology credit and legislative funds, produced a roughly 29 percent discount and reduced costs by about $1,200,000. He said the county expects a phased replacement over five years for radios that have reached end-of-life and that older units will be used until they break or for lower-priority assignments.

Health-plan changes are expected to produce roughly $1,000,000 in pharmacy savings through formulary redesign and contract renegotiation; Eppley said pharmacy costs previously represented about 41 percent of plan claims. The county will also start a biometric program in March to identify employees with multiple risk factors and steer them toward health coaching.

Eppley described a major reengineering effort in EMS billing. The county moved billing in-house in May after previously contracting with a third-party firm that kept 6–8 percent of collections; Eppley said in-house billing allows additional collection tools (debt setoff, wage garnishment) and closer payer negotiation. The county is "trending towards what we think is gonna be about a $6,900,000 revenue source," he said, and reported average revenue per transport trending at about $370—above regional comparators that averaged just over $300. He also noted that in 2024 the EMS department ran more than 20,000 calls for the first time in county history.

Eppley said the county is commissioning an AIA study (Willis Engineering) and doing smoke testing to identify unbilled water use and sewer flows that create cost exposure. He said those findings will be presented in March.

Commissioners asked clarifying questions about the radios and the disposition of older units; Eppley said used-equipment resale values are minimal and that parts for very old units are no longer available. After discussion the board voted 5-0 to accept the manager’s report as presented.

Ending: Eppley said staff will bring more detailed briefings on other reengineering strategies during the budget season; the board directed staff to continue work on the initiatives described.