Richland County moves three ambulance proposals to full board after heated hour of public pleas and budget debate

Rachel Ward, an advanced emergency medical technician with Richland County Ambulance, told the committee on May 20 that the county’s procurement discussion was about more than cost: “The people of Richland County don’t deserve to wait an hour for an ambulance,” she said, urging supervisors to keep the county-run service in place and retain local staff.

The committee spent more than two hours on the future of local emergency medical services, hearing public commenters, a hospital chief, the county’s interim ambulance director and representatives from two private providers before voting to forward three proposals to the full county board for consideration. The motion — moved by Supervisor Sandy Green and seconded by Mark (staff) — passed 8–1.

Why it matters: Supervisors must choose between continuing a county-run ambulance with upfront capital costs and operating subsidies, or contracting with an outside provider at a lower annual price but with uncertain local staffing and response-time consequences. Advocates for the county service argued that local crews know county roads and preserve local jobs; supporters of private contractors emphasized experience, scale, and alternate revenue streams that lower their bids.

What presenters said: Barb Scott, the interim Richland County service director, reviewed the county’s proposal and comparison sheet and warned that switching providers could affect PAP grant funding and the county’s role in emergency medical dispatch for neighboring municipalities. Scott raised several technical points about required training-officer coverage, how the county would handle dispatch fees, and whether staff had accurately budgeted ambulance replacement costs.

Representatives of Gunderson Health System Ambulance — which submitted the lowest annual bid the committee could read from the packet — told the panel they would provide a dedicated 24/7 911 ambulance, upgrade to paramedic-level care over time and supply emergency medical dispatch countywide at no charge. Gunderson’s bid was presented at $215,000 per year in the packet. LifeStar Ambulance said its proposal emphasized local governance flexibility and reliable service; staff read LifeStar’s proposal at about $404,000 per year. A third bid listed in staff materials (Ryan Brothers) was noted in the packet at a higher figure (reported in staff summary as approximately $952,000). The county’s internal proposed-service scenarios contained a larger range of modeled costs and capital options; staff reported an interpreted first-year number of roughly $500,000 in the comparison sheet but said many details (annual cost-of-living adjustments and Medicare/Medicaid write-offs) were not specified in the county proposal packet.

Staff analysis and budget scenarios: County staff presented an equalized-value levy model and three capital scenarios: (1) buy two new ambulances up front, (2) buy one and lease one, and (3) lease two refurbished units on a rolling replacement. The staff models included estimated dispatch and radio-tower cost-sharing, reimbursement of municipalities’ current payments if the county levies countywide, and a built-in five-year replacement schedule. Staff flagged an ongoing revenue shortfall in the county’s ambulance operating line (on the order of roughly $300,000) driven largely by reimbursement write-offs and uncertainty in cost-of-living escalators.

Public and elected officials’ concerns: Speakers and supervisors repeatedly returned to three central questions: response times (and whether the lowest bidder had reliable performance in nearby towns), the long-term fiscal impact on taxpayers, and fairness across municipalities if the county levies for a countywide service. Multiple supervisors asked staff to quantify the mill-rate impact per household for each scenario and to show how funds paid today by municipalities would be treated under a countywide levy.

Claims and responses: Several public commenters alleged that private bidders had produced longer response times in neighboring towns; an online commenter said Sparta’s experience with a private provider showed increased call times. Gunderson representatives countered that CAD/state EMS reports are available and that out-the-door times reported from their system are typically low, and they noted eligibility for state funding programs that can materially reduce net cost.

Outcome and next steps: The committee voted to advance three proposals — Gunderson, LifeStar, and a modified county-run proposal — to the full county board with direction to staff to resolve outstanding items (ambulance replacement timing, inclusion of Medicare/Medicaid write-offs in the county model, precise annual escalation assumptions, and response-time reports from each provider). The full county board will review the three proposals and make a final decision.

What to watch next: Supervisors asked staff to prepare precise response-time reports (from CAD/state EMS data), a reconciled five-year budget for the county proposal that includes Medicare/Medicaid write-offs, clear capital purchase timing options, and a more detailed levy-impact schedule for each municipality. The county board is scheduled to consider the proposals at a forthcoming meeting; staff noted that public grant programs (PAP grants, innovation grants, Medicaid assessment mechanisms) may change the fiscal picture but are not guaranteed.