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FKAG committee warns Fremont County ambulance system may cost up to $3.8 million; committee seeks regional or joint-powers solutions
Summary
Mick Crier, chair of an FKAG solutions committee, told commissioners the county’s contracted ambulance system likely costs between $3.5 million and $3.8 million a year and that current county payments cover roughly half; the committee will deliver recommendations on governance, finance and regionalization by Nov. 13.
Mick Crier, chair of the Fremont County Association of Governments solutions committee, told the county commission that the committee’s initial assessment shows the county’s contracted ambulance system likely costs “between $3.5 million and $3.8 million” a year while the county’s current expenditure toward the service is about “$1.6 or $1.8 million,” a figure Crier said he could not state with absolute precision.
The committee has been meeting weekly to “understand the ambulance problem,” Crier said, and has focused on three deliverables: suggestions for structure, governance and financing. He said the county lacks a clear picture of revenue collected by Frontier, the private contractor that provides ambulance service under the county contract, calling transparency around contractor-collected patient revenues “the real black box.”
Crier described one revenue opportunity that is not being captured locally: intra-hospital ground transfers to larger medical centers. A county official told the commission that a prior program—created as part of a Department of Health grant and involving county-purchased ambulances—expected the hospital to perform many nonemergent ground transfers and thereby save the county roughly $400,000 a year. According to staff, the hospital has not consistently honored that arrangement, and the county has seen only a fraction of the expected transfers.
Commissioners and committee members discussed options the FKAG committee is preparing, including shared funding under a joint-powers agreement, folding ambulance oversight into a regional transportation/management authority such as WRTA, or other regionalization models. Crier said the committee is collecting data from state health officials, Park County EMS and people who have worked inside Frontier to refine costs and identify gaps in current operations.
Several commissioners emphasized the county’s limited legal authority and the importance of including the hospital and tribal partners in future conversations. Commissioner Mike Jones urged inviting hospital officials and ambulance leadership to committee meetings so the group can resolve operational gaps and better quantify cost and revenue streams.
The committee expects to meet weekly through its Nov. 13 deadline and will deliver a report with tangible recommendations on finance and governance. “We will provide those recommendations to FKAG,” Crier said, and requested the county consider acting on them if the options are feasible.
What happens next: the committee will continue to seek documents and clarifications on Frontier’s revenue collection, pursue discussions with the hospital about ground-transport commitments, and explore joint-powers or regional funding models. The commission requested that the committee invite hospital and ambulance leadership to future meetings and directed staff to share any existing memoranda of understanding or agreements related to the earlier ground-transport program.
