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Board approves higher ambulance user fees after questions about collection rates and resident pricing
Summary
The board approved an increase in EMS user fees; staff said Medicare and Medicaid adjustments mean the county cannot collect all billed revenue and described payment‑plan and collections practices. Supervisors asked about resident vs nonresident rates and transfer impacts with Door County Medical Center.
Supervisor Gunlixson moved to adopt updated user fees for emergency medical/ambulance services, citing a multiyear committee review. Director Aaron explained the county does not collect all billed charges because a large share of patients are covered by Medicare ("that's over 65% of our patients") and Medicaid, both of which require mandatory adjustments; the department uses payment plans and collections efforts to recover what is collectible.
Supervisors asked whether fees are actually collected, how payment plans are offered, and whether nonresident rates (noted in the fee schedule) are common elsewhere. Aaron said the office will work with individuals (including interest‑free payment plans from $5 per month) and will pursue collections when necessary, including tax intercept and other options coordinated with the county administrator's office. Board discussion noted potential transfer cost effects with Door County Medical Center and the possibility of higher nonresident fees used in some tourist areas; staff said some counties apply a roughly $100 nonresident surcharge and that in other jurisdictions differences can be much larger.
The board approved Resolution 2025‑50 to increase ambulance user fees by voice vote. The packet includes the recommended fee schedule and background provided by the EMS committee; staff noted this was the first comprehensive update in about five years. The change will be implemented by the department per the approved schedule and county administration's billing practices.
Next step: Department to implement new fee schedule and continue collection and payment‑plan practices; supervisors requested follow‑up in public safety or budget discussions on mitigation and transfer program impacts.
