Cooke County EMS requests new ambulance, replacement cots and two community paramedics as call volume rises

At the FY2027 department budget hearing, Cooke County EMS outlined equipment and staffing needs tied to rising call volumes and long procurement lead times for ambulances and medical hardware.

EMS leadership said remounts and new-ambulance deliveries are delayed (lead times of 11–31 months), forcing older ambulances with high mileage into extended service and higher maintenance. "Our oldest ambulance has 185,000 mi on it... maintenance costs our older ambulances are running on an average of about 14, 15,000 dollars a year in maintenance and upkeep," the presenter said, noting a recent quote for a new ambulance that the department said rose to $334,751.

Equipment replacements factored heavily in the presentation. EMS staff described cots and cradle systems that are pricey and incompatible with older chargers and rail systems; they said a cot-and-cradle package and required chargers drive substantial capital cost increases when a new ambulance is purchased. Stair chairs and some stretchers are reaching or exceeding their manufacturer service life, risking liability if failures occur. The department noted some capital items were categorized under different line numbers and asked commissioners to confirm the correct coding for procurement and trade-ins.

To reduce recurring call volume the EMS leader proposed a community paramedic program: two paramedic positions to proactively visit high-frequency callers, assess barriers (transportation, medication access, literacy) and connect residents to services, with the goal of reducing repeat ambulance calls. The program would require paramedic-level staff and additional training; the department plans to phase-in the roles once identified and budgeted. "What this program does is after this we have persons identified as a repeat customer... the community paramedic will go out and sit down with them and try to find out why they keep calling an ambulance," the presenter said.

The commissioners did not vote on the EMS requests during the session. Staff noted capital lead times and procurement timing will affect when ambulances and large equipment can be taken into service; the EMS presentation asked the court to consider the near-term capital request and the phased staffing to reduce operational strain.

Next steps: EMS will provide formal line-item costs and procurement timing; commissioners’ staff will confirm capital vs. operating classification and identify potential grant or trade-in offsets.