Board adopts updated EMS billing rates tied to Medicare allowable; staff says safe‑harbor protects county residents

Gary Wendle, chief for County Fire Rescue, told the board that rising equipment and supply costs — some items up 20%–56% in two years — required fee adjustments for transports billed to insurers. Wendle proposed aligning billed rates to 1.5 times the Medicare allowable so the county remains comparable to neighboring jurisdictions and can recoup increased operating costs. He explained a proposed BLS transport rate of $6.75, an ALS1 transport adjusted to approximately $8.01.91 (revising an earlier advertised $8.50), ALS2 at $11.60 and a new specialty‑care transport fee of $13.25.

Wendle emphasized a safe‑harbor policy for county residents that prevents additional out‑of‑pocket charges: "Safe Harbor ensures no additional out of pocket money is required assessed to residents of the county," he said. Board members questioned whether raising billed rates would indirectly drive insurance premiums; supporters said the proposed 1.5× Medicare methodology is defensible and consistent with neighboring localities and that only about 6% of bills go to private insurers (the rest to Medicare/Medicaid), limiting direct household impact.

After brief discussion about indexing future changes via ordinance or budget adoption, a supervisor moved to approve the EMS fee‑schedule amendment as presented (with the ALS1 rate adjusted to the Medicare‑based figure discussed). The motion passed on recorded roll‑call affirmatives.

The fee schedule will be incorporated into the FY25‑26 county fee schedule and staff indicated a follow‑up amendment will include the mileage change that was omitted from the advertised hearing.