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TASER draft finds rising ambulance costs, recommends recurring equipment grants and training‑capacity changes
Summary
A draft TASER report finds county ambulance expenditures increasing, recommends converting equipment grants to recurring funding, and suggests removing or raising the statutory cap on ambulance training centers to address staffing shortages.
TASER staff presented a draft report on required ambulance services on June 22 that catalogued delivery models across Tennessee’s 95 counties, rising costs and potential policy options to stabilize services.
Research Associate Nathaniel Pettit told commissioners that counties are legally responsible for ensuring at least one licensed ambulance service operates locally; 63 counties provide services directly (including county hospitals and non‑hospital providers) while 32 rely on contractual arrangements. Excluding extreme values, average county expenditures on ambulance services increased from about $1.8 million (FY2020–21) to $2.7 million (FY2023–24).
Staff discouraged the originally filed bill language (Senate Bill 160/House Bill 83) that would have required municipalities that do not provide ambulance service to reimburse counties proportionally; stakeholders said cities already help fund county services via county taxes and that mandatory reimbursement could push cities to start their own services and raise overall county costs. Instead, staff recommended a set of alternatives: make ambulance equipment grants recurring rather than one‑time, consider removing or raising the statutory cap (30) on ambulance training centers to scale EMT/AEMT workforce training, and encourage ambulance services to explore third‑party billing, expanded non‑emergency transport, shared medical directors and increased use of the TNT2 program to capture reimbursement for alternative care pathways.
Members pressed staff on reimbursement shortfalls from TennCare and Medicare and on CMS rule changes that may affect state‑directed payment arrangements. Pettit said staff had received additional TennCare data that will be analyzed and added to the final report.
Why it matters: Ambulance services are essential to public health and rely on a mix of payer reimbursements and county funding. Rising labor and equipment costs and potential federal payment changes create fiscal pressure at the county level.
What’s next: Staff will integrate new TennCare data into the final report and may propose targeted policy options for the General Assembly and state agencies to consider.
