Washington County approves EMS quarterly report after revenue surge, staffing near full

Washington County Commissioner's Court approved the Emergency Medical Services quarterly report at its meeting on Jan. 21, 2025, after a presentation that said the department’s revenue exceeded projections and staffing was close to full.

The quarterly presentation by Mister Grama, an EMS staff member, outlined service and financial trends the department says drove stronger revenue performance. "We had around 14,000 responses for the year," Mister Grama said, and later summarized that the department brought in about $8,300,000 for the year, an increase he described as roughly 28 percent higher than the prior year.

The court was shown operational details the department said explain the numbers: changes in billing performance, increased success billing air transports, and a modest rise in call acuity that requires more units or higher-level responses. Grama told the court the billing company’s improved work and a modest rate increase contributed to the revenue gains: "I do think that the billing company is getting good at doing it," he said.

The report also covered staffing and equipment. Grama said the department had three full-time openings out of 45 shift workers and expected to be at full staff in the first quarter of 2025. He described measures to reduce fuel use and improve safety, including idle-mitigation systems on some vehicles and vehicle-mounted cameras that detect distracted driving. Grama said three vehicles already have the idle-mitigation systems and that the county used American Rescue Plan Act (ARPA) dollars to fund at least some of those conversions.

Budget details presented to the court showed the department was over budget on both expenditures and revenue; Grama said that despite higher revenue the EMS operation was not yet fully self-funding. He noted some higher costs—about $400,000 tied to task-force staffing—and said timing of receipts and expenses affects year-end results. The presentation listed a roughly $700,000 additional ground-revenue figure compared with the pro forma projection and an approximately $400,000 gain from air revenue compared with projection.

Commissioners asked for clarifications about jail medical staffing, blood draws performed for law-enforcement uses, and clinical outcomes. Grama said some metrics—such as the number and timing of blood draws and clinical outcome measures—require more detailed tracking and follow-up. He also pointed to a $105,000 total in donations for the year, including one donor who the presenter said has contributed roughly $400,000 over time.

After the presentation, a commissioner moved to approve the quarterly report and the court approved the motion by voice vote.

The court’s approval was recorded as a voice vote; the clerk announced the motion carried.