Sandoval County to assume EMS operations in Cuba, northwest areas; agreement with Presbyterian Medical Services approved

On June 25, 2025, the Sandoval County Board of County Commissioners approved a service agreement with Presbyterian Medical Services that begins a 12-month transition of EMS operations in the Cuba and northwest areas to county control. The vote was unanimous.

County Manager Wayne Johnson told commissioners that under the agreement the county will assume ownership of vehicles and become the fiscal agent for EMS billing starting July 1. "What we will do come July 1 is we take ownership the county takes ownerships of the vehicles which are being inspected. The vehicles, we become the fiscal agent for both the EMS billing," Johnson said. The contract also provides that a portion of billing revenues will be returned to PMS to support its personnel for the next 12 months while the transition proceeds.

The county manager and county staff said the long-term funding plan relies on a Medicaid reimbursement program that county staff estimate will provide roughly $1,200,000 annually to fund the positions and operations. County staff said the first tranche of Medicaid-related payments should begin arriving in August and that the program requires an annual application and cost report submitted January–March each year. "This is an annual application that we work through," the county manager said, describing the cost-reporting cycle.

Commissioner questions during the discussion focused on contingency planning if Medicaid payments decline. Commissioner Jones asked, "And then, you know, say year 3, year 4, we don't get the grant. What's our what's gonna be our contingency?" County staff responded that losing the funding would present a difficult choice — either find general-fund support or reduce service levels — and described that outcome as a worst-case scenario while saying they will "move heaven and earth to find a solution." The county said it will pursue multiple funding sources, including EMS transport billing revenue and intergovernmental partnerships with neighboring counties.

County staff described operational details that the commission approved: the county will take ownership of inspected vehicles on July 1; the county will begin EMS billing and manage state EMS funds for medications, equipment and vehicle maintenance; PMS personnel will continue to be employed by PMS during the transition but staff will be invited to join county service where appropriate. The commission was told that preliminary FY26 budget proposals include positions to support the change.

Officials said facility options are under review for housing personnel and assets; staff have considered the AMI Kids building and county fairground property as possibilities but said a more functional facility is preferred. County staff said the existing PMS facility would be usable if necessary but is small and not ideal for the planned staffing levels.

The motion to approve the service agreement passed on a roll-call vote; the commission recorded unanimous approval 5–0.

The county flagged next steps as vehicle inspections and contract close-out paperwork before July 1, onboarding of billing and finance staff for EMS revenue, and continued coordination with PMS and the state's Medicaid office to implement the reimbursement program.