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MedAct proposes fee increase to 2× Medicare and hires to expand impact‑ambulance hours
Summary
County Emergency Services proposed increasing MEDAC user fees to twice the Medicare allowable rate, hiring nine EMTs/paramedics and expanding an impact ambulance schedule to 12 hours a day, seven days a week, funded initially by a $1.2 million draw from general‑fund reserves for FY2026.
Johnson County Emergency Services and MedAct leadership presented a proposal to expand impact ambulance coverage and adjust user fees to stabilize operations amid sharply rising call volumes and workforce pressures.
Paul Davis, Director of Emergency Services, said MedAct call volume has risen roughly 67% since 2010 while county population grew about 13.5%. In 2025 MedAct averaged 156 calls per day with peaks to 236; the system is designed for about 130 calls per day. Unit availability and response performance have declined, and the county experiences frequent system stress events during evening hours when current impact unit shifts end.
To address those strains, staff proposed increasing user fees to 2× the Medicare allowable rate (affecting commercial third‑party payers while Medicare/Medicaid reimburse according to their schedules), hiring nine EMTs/paramedics to expand an existing impact unit from 8×5 to 12×7, and authorizing a one‑time use of $1,200,000 in general‑fund reserves for FY2026 to provide initial budget authority. Staff said the proposal is cost neutral over the year because new fee revenue is projected to offset personnel and operating costs and that the county’s billing vendor fee will rise modestly (estimated $50,000) with increased collections.
Deputy Chief Sayer and MedAct leadership explained the operational rationale: extended impact‑unit coverage would add roughly 13,104 annual coverage hours and could absorb an estimated 7,300 additional calls per year (equivalent to two 24‑hour trucks), reduce system stress and improve response times. Commissioners expressed strong support for a stop‑gap solution while noting long‑term needs: additional 24‑hour units, more stations and sustained investments as demographic trends increase demand. Commissioners asked for additional metrics and background on fee benchmarking; staff provided regional comparisons showing current MedAct rates are about 39% below Midwest averages and said the proposed rates would remain below some national norms.
The item was left on action for formal consideration; staff will return with any additional requested metrics and documentation ahead of the next meeting.
