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County EMS to pursue paid agreement with correctional facility after transport and billing pressures
Summary
Williams County EMS reported growing transport volume to a local correctional facility and said Medicaid/Medicare reimbursements do not fully cover operational readiness. Commissioners asked staff to draft a compensation proposal for the facility and to coordinate with Ohio Billing before the board's March meeting.
County EMS staff presented four-year statistics for transports requested by a local correctional facility and the juvenile detention center, and recommended the county seek a formal compensation agreement to cover readiness and out-of-county transports.
Kyle and Jesse (EMS) told commissioners the jail (CCNO) averaged about 68 EMS requests per year from 2022 to 2025. Historically the majority of those patients were transported to Bryan-area hospitals; in 2025 the county increasingly transported people to Defiance at the facility's request to preserve chain-of-custody for certain federal inmates. EMS reported average on-scene-to-in-service times of roughly 1 hour 15 minutes when transporting to Bryan and about 1 hour 30 minutes for Defiance runs.
Staff and commissioners discussed the economics. EMS told the board that payer mixes (Medicaid/Medicare) frequently yield modest reimbursement — Medicaid-rate payments near the low hundreds — while the county's full cost-per-run, when readiness, overhead and vehicle availability are included, is closer to $500. Because recurring transports remove squads from county coverage for extended periods, the county is proposing a negotiated compensation model with CCNO that could be a guaranteed annual payment or an activity-based invoice. Vond (county staff) agreed to draft a proposal and work with Ohio Billing to refine billing and contract language; commissioners asked for a draft for review ahead of the board meeting at the end of March.
Commissioner discussion emphasized fairness and continuity: commissioners noted the county has provided the transports as a service but that the financial burden falls on county taxpayers if the facility's residents or agency do not contribute to cost recovery.
Next steps: Vond will prepare a draft contract or proposal for CCNO and coordinate with Ohio Billing; staff aims to present a finalized recommendation to the board in late March.
