Iowa County ambulance director warns equipment, staffing and revenue variability strain FY26 budget

Adam, the county ambulance director, told the Iowa County Board of Supervisors during a budget work session that the ambulance department’s FY26 budget rests on uncertain revenue and several near-term capital and staffing pressures.

At the meeting Adam said two of the department’s four cardiac monitors/defibrillators are approaching a 10-year life and bids to replace them “came in at $48,000 a piece,” while he had budgeted $40,000 each. He described the department’s regular vehicle and equipment replacement practice — budgeting for an ambulance every other year and carrying money forward so a single purchase does not unduly spike any one year’s expenses.

Adam warned revenue from transports is variable and can move the budget “a hundred thousand” or more. He reviewed recent multi‑year transport and revenue patterns and said he had budgeted conservatively for FY26: “I budgeted 1,100,000… but I’m aware on averages it’s been higher.” He said call volumes and payer mixes (Medicare, commercial payers) fluctuate, and that historically the service has experienced multi‑year drops in transports that reduced revenue by tens of thousands.

On staffing, Adam outlined how overtime and vacancies affect wages: he budgets for one full‑time turnover yearly and about 16 weeks of overtime to cover orientation and vacancies; unexpected parental leave this year will add roughly $20,000 to costs. He also noted recent hiring of paramedic students at lower pay where certified paramedics were not available, which has reduced wage costs relative to prior budget assumptions.

Supervisors and staff discussed small, practical adjustments rather than immediate large programmatic changes. On the revenue side, participants proposed modest increases to commercial billing projections; Adam said adding $50,000 to projected revenue would reduce the property‑tax ask and that shifting a commercial line to $400,000 (from the $225,000–$350,000 figures in various reports) was an option under consideration. Supervisors directed staff to update the ambulance revenue and equipment lines and return revised numbers.

Adam described vehicle maintenance variability (tires, transmissions, accidents) and said ambulances log about 100,000 miles per year across the fleet, creating uncertain repair costs. He also reviewed a potential long‑term vehicle strategy — remounting ambulance boxes on new chassis as a cost‑saving alternative when appropriate — but said timing and prices remain uncertain.

Asked about alternatives to buying equipment outright, Adam and supervisors discussed grants and fundraising for capital items such as monitors; Adam said some items might be pursued through grants or casino‑fund money but that such sources would not fully cover needs and might require multi‑year planning.

Supervisors instructed Adam to revise and resubmit the FY26 ambulance budget with updated revenue projections and with the $48,000 monitor quotes reflected, and to provide clear options that would change the property‑tax ask if adopted.

Ending: Supervisors did not adopt final funding levels at the session; they directed the ambulance director and budget staff to return revised numbers before final levy decisions are made.