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Richland County finance director warns ambulance fund near break-even; billing gaps and write-offs cited
Summary
Finance director Leanna Pick told the executive and finance committee the Richland County ambulance service ran a $27,000 pre-audit deficit for 2025 and showed a pre-audit fund balance of about $81,000; large accounts-receivable write-offs and billing delays from the county's vendor drove much of the shortfall. Staff also reported $6,162.50 in county expenses related to an ambulance union petition.
Leanna Pick, Richland County finance director, told the executive and finance committee that unaudited financial statements for the county ambulance service show a $27,000 operating deficit for 2025 and a pre-audit fund balance of $81,004.26.
"These are unaudited financial statements," Pick said as she reviewed the balance sheet and income statement, noting accounts receivable of $489,317 and a $200,000 allowance for bad debt. She warned auditors’ year-end adjustments and recent grant receipts could push the fund balance lower or negative after audit adjustments.
Why it matters: the ambulance service is largely reimbursed by Medicare and Medicaid, and Pick and several supervisors said reimbursement shortfalls, billing delays and large write-offs are driving the service’s weakness. Pick said the county expects another sizeable audit entry and that historically an allowance for uncollectible accounts has been about 40 percent.
Pick highlighted a cluster of operational drivers. Monthly revenue for 2025 totaled about $1.292 million while expenses were about $1.319 million, producing the reported $27,000 deficit. The report also showed a large December bump after the billing vendor provided previously unsubmitted collections dating back to 2024.
"When we finished December 2024 Unified had taken over, but never sent us reports," Pick said, explaining a roughly $60,960 adjustment that was booked into December revenues and a set of write-offs Unified reported. She told the committee that December included collections and write-offs from prior months that made the month appear unusually large.
Supervisors pressed for more detail on the composition and age of write-offs. One supervisor asked, "What would be the typical age of those write-offs? How far back would they be before you finally decide to write them off?" Pick said the write-off detail is provided by the billing vendor and that auditors are aware the county uses a hybrid method of direct monthly write-offs and an allowance for receivables.
Several supervisors and staff said the county is switching billing companies and that a new vendor’s collections and a collections department might recover some previously uncollected balances. "I am hopeful the new billing company... are gonna go after the old debt, which is something Unified never did," public commenter Barb Scott said during the meeting’s public-comment period.
Staff and supervisors also discussed structural drivers: rising payroll and overtime after the service expanded paid staffing; limits on what Medicare and Medicaid will reimburse; and whether contracting with a larger not-for-profit or private provider could spread costs differently.
In a related item, staff told the committee the county has spent $6,162.50 through January 2026 on matters related to an ambulance staff petition for union election and said ongoing legal costs are anticipated. "I would say yes" to a question whether legal costs will continue, staff advised, noting negotiating creation of contracts can be costly.
What’s next: staff agreed to request more detailed write-off and billing historic data from the former vendor and said they will return with additional detail as the county evaluates options for billing, collections and potential operational changes. The committee did not take a final action on the ambulance budget at this meeting.
