Mission council hears EMS operations review as city nears break-even for ambulance service

Tim Brown, chair of Mission’s EMS oversight, told the City Council on Oct. 14 that the city-operated ambulance service “is doing extremely well.” The quarter- and year-long financial and operations review presented to the council showed Mission EMS billed about $9 million over the year, collected roughly $2.5 million (about 27 percent), and ran a deficit of about $24,815 for the period analyzed.

The presentation included both an operations summary from Tim Brown and a separate management cost and labor analysis by a consultant, who reviewed payroll, operating costs and responder hours. The consultant reported that total EMS expenses were about $2.4 million and payroll and fringe benefits accounted for roughly 80–83 percent of EMS costs. “If we didn’t transport anyone, we would already incur $361,099” in fixed costs, the consultant said when explaining the breakeven analysis. The consultant added that Mission recorded 50,215 responder hours during the fiscal year and calculated a break-even point of about 53,895 responder hours.

Why it matters: council members and staff said the near‑break even result contrasts with prior estimates that running an EMS system in-house would be substantially costlier than contracting out. The report identified two primary operational limits: unit downtime for maintenance and constrained staffing. The consultant said the division’s minimum staffing (two medics per unit) and equipment availability influenced both the hours on the street and the revenue collection window.

Key financial and operational details presented to council: - Billed revenue: about $9,000,000 (charges for service). - Cash collections: approximately $2,500,000 (about 27% of billed). - Average billed per trip: $1,906; average collected per trip: about $521. - Total EMS expenses (including payroll, supplies, other operating): roughly $2,400,000. - Net deficit for the year analyzed: ~$24,815. - Fixed costs (annual): $361,099. - Responder hours recorded: 50,215; breakeven hours estimated at 53,895. - Current estimated full‑time equivalent (FTE) responders: ~17.2; ideal 24 FTEs to sustain 24/7 coverage at four medic units (70,080 hours/year).

On collection practices and vendor support, Brown and city staff described the city’s third‑party collections partner, Emergicon, as an active collaborator on claims and aging accounts. The council discussed potential gains from modest improvements in collection percentages: council members noted that even a 10 percent increase in collections on outstanding balances could meaningfully increase revenues.

Council members and staff also discussed operational milestones and service performance. Brown noted Mission EMS “consistently beats the national time on arrival” and emphasized that fire engines often arrive prior to ambulances in many 911 responses. The Fire Department highlighted a recent on-scene delivery: an Engine and Medic crew assisted a woman in childbirth on Sept. 28, 2025; paramedic Noe Carrion cut the umbilical cord and both mother and baby were transported in stable condition.

Grants and equipment authorized at this meeting - The council accepted an Office of the Governor border zone fire department grant for $234,604.98 that the fire department will use to acquire three all‑terrain vehicles, a tilt trailer and office equipment (motion approved unanimously). - The council accepted a FY26 First Responder Mental Health Program grant for $70,000 with an in‑kind match of $17,500 to support trauma‑informed services for first responders (motion approved unanimously).

What the council decided and next steps: Council members voted to accept the grants noted above. Staff said new medic units (Medic 5 arrived and Medic 6 is forthcoming) will reduce unit downtime and overlapping-call exposure and should increase responder hours and revenue generation in future quarters. The consultant recommended continuing to refine coding and billing practices, working with the collections partner to target aged receivables, and increasing on‑road hours by improving unit availability.

The presentation closed with council praise for staff and operations. Mayor Pro Tem Ruben Plata and other members thanked staff for the documentation and results. The council did not vote on a change of service model during this meeting; no policy change was adopted.

Ending: Staff said a mid‑year budget amendment will be brought forward if additional grant awards or spending adjustments are required; the city will monitor arrival times, responder hours and collections as the new medics enter service.