Columbia County reserves $3 million to order ambulances as EMS shortfalls mount

Columbia County commissioners on Friday moved to reserve $3 million from contingency funds to order ambulances after hearing that the county's contracted ambulance provider has not consistently met response-time targets.

David, the county's budget officer, told commissioners the special meeting was called to give the board and the public information ahead of an 18th vote on potential funding options, including an EMS municipal service taxing unit (MSTU), a sales tax (not eligible this year), or funding service within the current budget. He presented charts showing taxable values and modeled homeowner impacts for different MSTU scenarios.

Staff and the county's fire department reported that the advertised price of an ambulance does not include the cost to staff and operate it. Jeff, the county fire chief, said the county budgeters used a conservative, high-end annual figure of roughly $800,000 to $900,000 per staffed ambulance to account for salaries, benefits, fuel, equipment and overtime; he said his MSTU study line items estimate about $3.5 million for the existing contract plus personnel to run supplemental county units.

The board also discussed a conditional offer from Lakeshore Hospital Authority to buy ambulances. David said the authority would consider purchasing units only after the county provided a finalized staffing and sustainable funding plan and signed an interlocal agreement.

Commissioners debated short-term fixes and longer-term strategy. Lance, the county contract administrator, presented early June compliance data showing the contractor's urban-area compliance at roughly 69.6 percent and said the contractor had not reached the 90 percent threshold called for in the contract. Commissioners noted the contract contains a three-major-failures clause that can lead to termination, but staff cautioned that building a county-run EMS or replacing a large private contractor would take months to years and would require emergency procurement if termination becomes necessary.

On the motion to act now, a commissioner moved to set aside money in contingency and order ambulances immediately while staff develops a plan to staff two to three county units. The motion as clarified requested $3 million be reserved to purchase ambulances and to fund early implementation costs; commissioners debated whether to wait for contractor performance in the coming weeks or to move ahead. A voice vote resulted in commissioners vocalizing approval; at least one commissioner (Commissioner Parnell) registered opposition. Commissioners asked staff to return at the next meeting with a line-item operating budget for proposed county ambulances, options for PRN staffing, and contingency plans should the contractor fail to improve.

Public commenters urged long-term planning: Ben Lawren said the county should begin preparing now to bring EMS in-house if private providers cannot deliver required coverage; Katherine Ashworth cautioned that rural calls generate less revenue than urban runs and suggested tourist/resort fees or other targeted revenue sources as possible funding mechanisms.

Next steps: staff will produce a detailed, line-item budget for the proposed two-ambulance supplementation (personnel and operating costs), provide audited billing and receivable figures used in collection estimates, and host the contractor at the June 18 meeting to explain how it will meet contractual response-time requirements. The board's reserve authorization clears the way to order ambulances, but budget and recurring operating funding remain to be finalized.