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Sheriff reports higher-than-budgeted ambulance billing, urges reserve for ambulance replacement
Summary
Sheriff told the legislature ambulance billing is exceeding the budgeted amount and proposed creating an equipment reserve (suggested $100,000 yearly) to prepare for costly ambulance replacement; he also asked the legislature to invite billers to explain collections and consider leasing as an option.
Montgomery County's sheriff reported that ambulance billing revenue has exceeded the department's budgeted projection and proposed creating a dedicated equipment reserve to build toward future ambulance replacement.
At the budget workshop the sheriff said EMS calls since Jan. 1 include 1,622 instances where "we either had no ambulances in the county or an extended response time of 45 minutes or more or not the level of care that the call required." He said the department budgeted $500,000 in revenue for 2025 but has realized about $797,008.70 year-to-date and has approximately $691,004.80 in billed but not yet received revenue, a large portion of which staff told legislators is more than 180 days old.
The sheriff told legislators his billers expect to ultimately collect about 50% of the built-out receivables as a norm; legislators asked to schedule the billers to present to committee about collections and older receivables. The sheriff proposed establishing an "equipment line" or reserve and begin depositing $100,000 annually to prepare to replace ambulances, which he said can cost $250,000 to $300,000 each. He also raised leasing as an alternative, describing a prior local practice of leasing ambulances to swap units every few years.
Legislators and the treasurer advised that a dedicated reserve would require a resolution to authorize creation of the account; the treasurer offered to work with staff to draft appropriate language. Committee members moved to invite billing staff to a future committee meeting for a deeper dive on collections and to consider reserve-account language for a later resolution.
No formal budget action was taken on the reserve during the workshop; the sheriff said discussions could occur in committee or at a future meeting and that any implementation would likely not begin before January 2026 if the legislature supported it.
