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EMSA tells committee it met response standards while pursuing workforce training and preparing FY26 budget
Summary
Emergency Medical Services Authority leaders briefed the committee on accreditations, workforce development programs, MCare enrollment trends and FY26 budget pressures driven by Medicaid/Medicare payer mix and staffing costs.
Representatives of the Emergency Medical Services Authority (EMSA) presented a semiannual update to the Urban Economic Development Committee on June 11, outlining accreditation status, workforce programs, community outreach and the Eastern Division FY26 budget outlook.
EMSA President and CEO Jonna Easley said EMSA is one of the largest U.S. EMS organizations by transport volume and highlighted two external accreditations the agency holds: the CAAS accreditation (ambulance services accreditation) and designation as an International Academy of Emergency Dispatch (IAED) center of excellence for its communications center. ‘‘We are the largest EMS organization in The US, relative to transport volume,’’ Easley said.
Key operational points staff reported: - FY26 budgeted transports for the Eastern Division: just over 93,000 (a roughly 1.2% increase over FY25 trends). - Payer mix: roughly 70% of EMSA’s revenue comes from Medicare and Medicaid programs, which on average reimburse at or below cost. - MCare (the city’s utility‑based program that supports low‑income residents): open‑enrollment metrics improved and enrollment/retention rose; EMSA reported annual MCare funding shortfalls because write‑offs exceed MCare funds drawn. EMSA said the city’s rate‑stabilization fund is used only as needed and that the fund balance is roughly $8 million (staff figure).
Workforce initiatives: EMSA described two in‑house training paths it operates to address staffing shortages: the EMSA Advantage EMT program (an employer‑funded pathway to EMT certification with no out‑of‑pocket costs for trainees) and an in‑house paramedic program that pays trainees while they are in school. Program results cited by staff: more than 75 Advantage graduates and 38 paramedic graduates since mid‑2022; EMSA said Advantage graduates now compose more than half of its EMT workforce.
Staff also reported they have sustained priority‑1 response‑time compliance at or above the industry standard used by the agency (90% target), and they continue to monitor hospital bed‑delay issues that can hold ambulances at emergency departments and remove units from the field.
Budget and fees: Laura Conger, EMSA chief financial officer, told the committee EMSA expects pressure on reimbursement from federal and state changes and that roughly 86.7% of operating revenue is patient revenue. EMSA said it has not raised transport fees in more than a decade and will undertake a comprehensive fee review, noting there may be opportunities to bill for some on‑scene interventions not currently billed under the structure now in place. EMSA said overtime and frontline compensation are the largest expense drivers.
Why it matters: EMSA’s revenue depends heavily on public payers that reimburse below cost; workforce and fee decisions affect both service levels and the city’s support structures such as MCare. Committee members asked questions about bed delays, overtime and how fee changes might interact with MCare enrollment.
Ending: EMSA offered to meet with council members and district meetings to discuss MCare enrollment and said it will provide more detailed fee and budget information as it completes its FY26 planning.
