Commissioners in Brown County heard a lengthy update from Duke Topridge, director of Town and Country Ambulance, about staffing, call volumes, billing and the county stipend that supports the private service.

Topridge told the board the service’s roster was updated after a Dec. 3 state inspection and that “OB nurses and providers are now on our roster,” allowing the company to accept obstetric transfers. He said the service handles roughly 290–300 calls per quarter and “over 1,300 a year” overall. Topridge described ongoing efforts to recruit more paramedics and additional full‑time staff to reduce reliance on part‑time responders.

Commissioners pressed for financial detail. The chair noted the county’s regular payment to the private provider in the transcript as “602,000 or 6,000 a year” and asked for clearer accounting so taxpayers can judge value for money. Topridge described billing practices and payer mix: a basic life support (BLS) call was cited in the discussion at about $525 and an advanced life support (ALS) call about $700, and he said recoveries from Medicare and other insurers substantially reduce collections.

Topridge also described collection attempts and limitations: letters and small‑claims filings produced limited recoveries and insurer write‑offs often reduce billed amounts. He offered to try producing a quarterly report showing payer mix (private insurance, Medicare, Medicaid and uninsured) and counts of transports that result in no payment, to help the board evaluate subsidy needs.

The board and Topridge discussed operational pressures: vehicle mileage and replacement timelines, remounting ambulance boxes, and the practical effects of a recent state policy allowing some rural crews to operate with fewer on‑board staff, which Topridge said “was not received well” by EMS organizations.

Commissioners said they want regular forecasting and data to inform the 2026 budget and asked staff to pursue options to stretch county dollars — including exploring memoranda of understanding for loaned equipment or other partnerships, and to pursue grants or intergovernmental funding where available. No formal motions or changes to the contract were made during the meeting; commissioners asked Topridge to provide clearer quarterly financial and utilization reports and to return with follow‑up information.