San Juan County EMS asks Bluff council to back 1% rural‑health sales tax to stabilize ambulance service

Jeremy Hogarth, a representative of San Juan County EMS, told the Bluff Town Council on May 5 that county ambulance operations face mounting costs and a new state requirement that municipalities ensure ground ambulance availability.

Hogarth said San Juan County’s 2026 budget target for EMS is about $1,060,000 and that his agency responded to 591 calls last year and transported 449 patients. He said about 37% of those calls come from visitors or people outside served ZIP codes, creating a mismatch between fixed costs and billable revenue.

“Last year we ran 591 calls, we transported 449 patients, and about 142 were non‑billable,” Hogarth said. He described low Medicare/Medicaid reimbursement rates—collecting roughly 30–40% on those claims—and said payroll and staffing are the largest cost drivers.

Hogarth described three broad options to address the shortfall: reduce services, raise property taxes, or adopt a rural‑healthcare sales tax shared across the county. He said the county commission supports a sales‑tax option and recommended a 1% measure, noting that a dedicated sales tax is not applied to nonprepared food, fuel or prescription medications. The county’s estimate for a 1% dedicated sales tax was about $1.2 million annually.

“We think it’s the most fair way to try to fund EMS into the future,” Hogarth said, adding that the revenue could be used to hire additional full‑time staff, establish a replacement fund for ambulances (the county’s oldest ambulance dates to 2002), and make modest station improvements to support out‑of‑area personnel.

Hogarth cited Utah Senate Bill 215 (2024) as a catalyst for the county’s effort: the law, he said, makes municipalities and counties responsible for assuring minimum ground ambulance services. He also listed peer counties (Wayne, Wasatch, Summit, Grand, Garfield) that have implemented similar sales‑tax measures.

During council questions, Hogarth said the county had provided verbal confirmation of its plan and expected to take the measure through the formal process so it can appear on the fall ballot. He described efforts to keep the county’s existing tourism‑related TRT (resort tax) receipts for municipalities while shifting general‑fund supplements away from EMS if a dedicated sales tax passes.

Local public commenter Gary Lichtenstein, a Bluff volunteer firefighter, told the council he supported funding emergency services but urged the town to be clear about outcomes and costs before approving tax increases. “My figures show a minimum cost of $230,000 a year” to run a sustainable fire department in a small town, Lichtenstein said, and he urged the council to clarify staffing and administrative structures.

Hogarth asked the council to serve as local champions for the county’s outreach and said the county will run a campaign separate from using county funds for ballot promotion: “We will not use county funds to run the ballot campaign,” he said, noting the need to organize a grassroots group to print signs and distribute materials.

Next steps: Hogarth said the county will finalize a proposition number with elections officials, continues to coordinate with municipalities, and plans to place a measure on the fall ballot pending the formal approval process. He offered to answer council questions after the meeting and asked Bluff leaders to help educate residents about the proposed measure.

For more information, Hogarth said county staff will provide outreach materials; Aaron Nelson, Bluff’s town manager, is the local staff contact for follow‑up.