Lewiston approves new interagency ambulance agreement with Nez Perce County, adopts standardized fee formula

The Lewiston City Council on July 14 approved Resolution 2025-32 authorizing the mayor to sign a new interagency ambulance agreement with Nez Perce County that establishes an updated, audited formula for county payments and standardizes per-response charges.

The agreement replaces an older, hard-to-reconstruct payment approach that the city and fire chief said relied on undocumented historical calculations. “We sat down with the county commissioners … and we worked on putting together a new formula that wasn't based on things in the past,” Fire Chief Greg Reitmeier told the council, describing the new approach as “an objective standard that's verified and it's audited by a third party.”

Why it matters: city staff said the new formula is meant to better align county payments with the city’s actual costs for ambulance response and transport. Under the revised structure the city will retain ambulance transport revenue it bills (previously, portions had been returned to the county), and will charge a standardized per-trip fee to the county for county calls. Chief Reitmeier told councilors the change should bring in “about half a million dollars, annually” to help sustain current staffing and coverage levels.

What the agreement changes: chief staff outlined three components used to set the new rate: (1) an objectively audited transport cost based on the city’s Medicaid reimbursement (“GMT”) submissions; (2) a calculation for out-of-service or standby time that includes equipment depreciation (the chief used a $40,000 straight-line, 10-year example for a rescue tool); and (3) removal of special flat fees for jail transports and folding those trips into the standard per-response charge. The chief said the city also will stop remitting collected transport fees to the county and instead keep revenue it collects through ambulance billing.

Council debate focused on fairness and the dollar amounts. Councilor Spickelmeyer said the per-call numbers “seem very, very low” compared with the city’s broader fire budget. The chief acknowledged the figure is not a precise, consultant-level cost-center study but said the formula represents a significant improvement over the previous, undocumented method. He added that if calls grow substantially in the future the city would need to revisit coverage and staffing.

Jail transports: staff said the earlier flat fee paid by the jail worked out to roughly $94 per transport in 2024 for 52 jail transports, which the chief and mayor described as far below actual costs. The new agreement will charge the county the standard per-trip rate for jail transports rather than a reduced flat fee.

Vote: Councilor Schroeder moved to approve Resolution 2025-32; Councilor Wright seconded. The roll call was: Council President Klieberg — Aye; Councilor Wright — Aye; Councilor Forsman — Aye; Councilor Schroeder — Aye; Councilor Klein — Nay; Councilor Spickelmeyer — Nay. The motion carried 4-2.

Next steps and implications: the resolution authorizes the mayor to sign the interagency agreement. Chief Reitmeier and the mayor said the change should stabilize revenue used for the city’s EMS operations; they also said it should prompt county-level discussion about alternative local emergency-response options and cost-sharing. The council and chief noted that a future review could be needed if call volumes or response-time impacts change.

Excerpted council direction and staff notes: staff said the new contract sets year-by-year rates (not arrears), will be adjusted quarterly to actual runs, and will be audited. The chief said the city currently records several hundred county runs annually (665 county responses in fiscal 2024 were cited in staff remarks) and that the city’s EMS revenue mix is roughly $3.5 million, with the county contracts contributing a material portion of that funding.

Acknowledgments: the item was presented by Fire Chief Greg Reitmeier; legal review was completed by city attorneys before the contract was presented to county commissioners and then to the council.

Ending: The signed agreement will go into effect when executed by the mayor and county commissioners; staff indicated ongoing quarterly tracking and audits will follow to apply the new formula.