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EMS director outlines possible federal/state ambulance funding, insurer reimbursement changes and asks for staffing increases
Summary
Robertson County EMS Director Brent N. Dyer told commissioners the county may qualify for up to $300,000 in state-distributed rural-ambulance funds tied to a larger federal package, described proposed state insurer-payment reforms and requested three full-time paramedic positions to improve daily staffing.
Brent N. Dyer, director of Robertson County EMS, briefed the commission on March 23 about pending state and federal measures that could affect ambulance procurement and reimbursement and described staffing and budget requests he plans to bring to the EMS Committee.
Dyer said federal rural-healthcare funding included in an omnibus proposal could result in a Tennessee allocation that would allow counties to receive up to $300,000 "per County that qualifies" to go toward purchase of an ambulance. He told commissioners Robertson County is expected to qualify and noted the department already has one ambulance on order for the FY 2026-27 plan; the transcripted cost figure in the packet is unclear and the exact unit price was not specified in the meeting materials. Dyer said any county share would reduce local capital need for additional units.
Dyer also described two state-level bills under consideration: an "Ambulance Transport Balanced Billing" measure that, according to his briefing, would require commercial insurers to pay roughly 400—25% of Medicare-allowable rates; and a TennCare change that would reimburse certain nonemergency transports at 100% of Medicare-allowable rates. "If this bill passes, it would enhance our revenues some, I expect at least $100K or so, maybe more," Dyer said, describing the insurer-payment proposal's potential effect on local EMS revenues. He said approximately 30% of Robertson County ambulance transports are billed to commercial/private insurance and estimated current nonemergency transport revenue in the $150,000—100,000-per-year range.
On staffing and budget planning for FY 2026-27, Dyer told commissioners he will seek funding for three full-time paramedic "floater" positions (one per shift) to stabilize daily staffing, and asked the commission to consider cost-of-living adjustments and pay-plan step increases tied to certifications (AEMT to paramedic, critical-care paramedic, etc.). He invited commissioners to the EMS Committee meeting the following Monday at 5 p.m. at EMS Station 1 to review the departmentbudget and proposals.
What to watch: whether the federal omnibus or state bills are enacted and how the Tennessee distribution of rural-healthcare funds is allocated; whether the county's EMS budget committee funds the requested paramedic positions and how procurement and staffing are phased if external funds are realized.
Quote: "If this bill passes, it would enhance our revenues some, I expect at least $100K or so, maybe more," Brent N. Dyer said of the proposed insurer-payment changes.
Note: the EMS packet included a line-item cost for an ambulance on order but the transcript contains a garbled numeric string; the county packet or vendor quote should be consulted for exact capital costs before assuming a funding shortfall or replacement schedule.
