Bradley County weighs buying two transport vans and new ambulance as ERs open

Bradley County commissioners on the dais reviewed a budget request from county EMS that would add two convalescent transport vans and complete a planned ambulance purchase as two new standalone emergency rooms open in the county.

The county was told Bradley Medical Center plans a 10-bed standalone ER at the old Community Hospital campus this fall, and a state-approved Parkridge ER is expected in January, creating additional transfer and ambulance demand, Director Lewis said. "Each additional facility will increase call volume," Director Lewis said, adding the supplier told staff it could have one van "potentially by this fall, if not both by the 1st of the year." He said vehicles can be equipped and authorized by the state within a couple of weeks after delivery.

Why it matters: Commissioners framed the proposed purchases as a way to meet rising transport demand without asking taxpayers for new revenue. County staff said the EMS revenue forecast for the current year was about $5.5 million and that the department used conservative figures for the 2026–27 budget. "A very conservative estimate is $383,000 a year" for the revenue one additional convalescent van could generate, Director Lewis said. He also provided a one-time outfitting cost estimate of about $305,000 per van.

Staffing and costs: Adding two vans would likely require four additional EMTs. Commissioners and staff discussed pay scales: a basic EMT-B starting figure cited in the meeting was about $39,993; benefits and employer taxes raise the county cost of an entry-level hire substantially above base pay. Commissioners noted that the department is "fully staffed" relative to budgeted positions but that some positions remain frozen and are not available as unspent savings.

Funding options and accounting: Commissioners weighed options to pay for the vans, including using one-time reserve funds referenced in the discussion as fund 172 or fund 189 with a plan to repay those sums from future transport revenue. One commissioner recommended adding a separate revenue line to make tracking and repayment clearer. Mayor Davis and commissioners agreed the intent was to avoid a tax increase and to structure any front-loaded purchase so it would be reimbursed by generated revenue over time.

Operational effect: Several commissioners emphasized that dedicated convalescent vans would free ALS ambulances from non-emergency transports and reduce wear and tear on higher-cost vehicles, allowing ambulances to focus on 911 emergency responses. Staff clarified clinical limits: interfacility transfers that require cardiac monitoring or IV medications typically need a paramedic on the transport, while basic discharges can be handled by EMT-B–staffed vans.

Revenue timing and caveats: Director Lewis warned that although billing starts once vans are in service, insurance and billing cycles mean the county may not see cash receipts for three to four months after services are rendered. Commissioners also noted that revenue from a previously approved memorandum of understanding with the hospital had not yet been received.

Next steps: No formal vote or motion was recorded during this discussion. Commissioners directed staff and the finance committee to continue refining the budget language, examine fund-172/189 repayment plans, and present a funding/repayment proposal before budget adoption.