Lake County BCC approves countywide EMS expansion, dedicates first two new ambulances to Clermont area

The Lake County Board of County Commissioners on Oct. 14 approved a plan to expand the county ambulance fleet and directed that the first two newly funded ambulances be deployed to the Clermont/ISBA area as staffing allows.

The move follows months of talks between county managers, fire-rescue leadership and Clermont officials over how the city could address strained local EMS response times. Assistant County Manager Thomas Carpenter outlined several options the county and Clermont had discussed; commissioners voted to accept “option 4,” under which the county brings ambulances into the county EMS system and covers the operational costs while continuing county oversight of day-to-day EMS operations. Clermont officials said they would supply personnel and infrastructure as they are able.

County representatives said they secured budget authority this year to hire 45 new EMS positions and intend to staff additional ambulances in phases: two in the first quarter after hires/onboarding and three more in the second quarter, with a longer-term goal of expanding to about 30 ambulances countywide over several years. Chief John Simpson of Lake County Fire Rescue said the county currently operates 20 24-hour ambulances and that unit-hour utilization and response-time data show a need to add units to reduce workload and improve readiness.

Clermont Fire Chief David Ezell and City Manager Rick Van Wagner told commissioners the city plans to buy at least one ambulance and to add personnel and station space incrementally; they said the city is willing to invest its own funds in vehicles, facilities and local staffing to speed response in the city and ISBA. Ezell said analysis using deployment modeling showed the Clermont area would need roughly six ambulances to reliably reach a 10-minute first-response goal; county staff said adding ambulances across the system, and not fragmenting service, is the most efficient model to meet countywide needs.

County staff described the ambulance MSTU (special tax) funding and billing model used to operate EMS. Fiscal year 2024 MSTU revenue for ambulance operations was about $8.9 million countywide; dividing that amount by total ambulance calls in 2024 produced an operational subsidy estimate of approximately $141.81 per call. County staff also reported that about 72% of ambulance responses result in a transport, and that average net patient-billing revenue per transport in FY24 was about $423.58 (net collection rate about 77%). Carpenter said those figures informed the county’s suggested per-call subsidy when partnering with municipalities.

Following debate, Commissioner Campion moved, and Commissioner Morris seconded, a motion to approve option 4 with the specific direction that the first two newly added ambulances be assigned to the Clermont area; the motion passed unanimously. Commissioners asked staff to return with updated utilization and response-time data after the initial ambulances go into service and to continue cooperative planning with Clermont, including efforts to identify temporary or permanent ambulance hubs where space is available.

The board also directed county staff to continue recruiting and onboarding paramedics and EMTs; county leaders said hiring classes and a paramedic academy have increased the pool of qualified staff and made the immediate ambulance hires feasible.

Commissioners emphasized that the countywide, coordinated EMS model will continue to be used for dispatch, medical direction and clinical standards; units added under the county system will operate under county protocols and shared medical oversight.

The board asked staff to report back on a six-month timeline to evaluate the effect of the new ambulances on workload and response times and to continue working with Clermont leadership on stationing and operational details.