Middlesex County amends 2025 budget, substitutes $5 million in hospital revenue with surplus

Middlesex County commissioners on Feb. 20 adopted an amendment to the county's 2025 operating budget that reduces an anticipated hospital revenue line by $5,000,000 and increases surplus anticipated by $5,000,000, a swap that county officials said leaves the overall budget unchanged.

"We're essentially reducing the revenue type of hospital ... and increasing surplus anticipated by $5,000,000," said a county official during the public hearing, describing the change as a substitution between two revenue sources and a net-zero effect on the budget. The amendment was approved after a public comment period and a motion to close the hearing.

The measure amends Resolution 25-377 (listed in the clerk's readout as Resolution 25-377-R), which updates multiple line items across general revenues. The amendment increases the county's surplus anticipated from $0 to $5,000,000 and adjusts several miscellaneous revenue categories. The clerk read changes that included increases in interest on investments and certain local revenues and reductions in a category described as "special items of general revenue anticipated." The board moved the amendment to a vote and the motion passed.

Why it matters: County finance leaders framed the amendment as a precaution. A county…