Simsbury volunteer ambulance warns state-set rates leave service short of operating costs

The Simsbury Volunteer Ambulance Association told the Board of Finance on June 16 that state-set ambulance transport rates and inconsistent collection levels leave the service unable to cover operating costs. Chief Karin Stewart and EMT Russell Regenauer said SVAA’s operating budget is about $1.6 million, reserves are roughly $50,000 and the group seeks a reserve target near $300,000 to ensure preparedness.

"The rates are set by the State of CT," Chief Karin Stewart said, and the association’s billing typically yields amounts that are uncollectable. EMT Russell Regenauer told the board the association projects about 1,850 transports in 2026, plus or minus 100, and that roughly half of transports are private pay or uninsured. He said staffing is roughly 80 percent of SVAA’s costs and that the organization currently employs 22 people, six of them full‑time.

SVAA described using a revenue forecasting model that accounts for dispatch volume growth, response rate, percentage of calls transported and collections. "If we could collect on everything that we are permitted to by the state, we would be in a position of making a profit," Regenauer said, while noting the service has little control over reimbursement levels. He added that Medicare historically reimburses only for transports and that "treat in place" billing has only recently become possible and is difficult to enforce.

Board members asked for more precise cost and coverage metrics. Regina Pynn and Art Wallace questioned whether costs could be made more variable; Regenauer said wages are largely fixed given staffing needs and that SVAA effectively staffs roughly one and a half ambulances per day as a sunk labor commitment. He said mutual aid accounted for about 9 percent of call volume and that removing the second ambulance would increase mutual aid requirements by about 700 calls per year.

SVAA outlined a multi‑year town funding need presented as approximate amounts: about $360,000 in 2027–2028, and about $200,000 in each of the 2028–2029 and 2029–2030 fiscal years, plus contribution for ambulance replacement. Regenauer said the second ambulance would reach break‑even only with roughly six or seven additional transports per day.

Town staff and SVAA also discussed short‑term cash options. Heavner suggested exploring a loan; Regenauer said SVAA could consider a bank loan and noted they used federal COVID relief funds in 2025 for payroll retention. Chris Kelly, SVAA vice president, said preliminary cost‑per‑capita research places Simsbury at about $6.53 per capita compared with a state range that staff reported runs from $2.35 to $85.

The board did not take formal action at the meeting; members asked staff to return with clarifying data, including mutual aid details, updated per‑capita comparisons and options for reserve funding or town support.