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Council hears paramedic program concept; funding tied to proposed fire sales-tax expansion and state billing rules
Summary
Councilors and staff discussed creating a community paramedic program but said reimbursement rules for Medicare/Medicaid do not yet support billing; the administration and staff described a proposal to expand the city's fire sales tax on the November 2026 ballot to buy apparatus and potentially support a paramedic program if state/federal billing changes allow reimbursement.
University City public-safety leaders and staff described a two-track approach to improving emergency response: pursue a local revenue measure to fund fire apparatus and related needs, and continue to press the state for a billing mechanism that would make a community paramedic program financially sustainable.
Deputy Chief Wilmouth summarized the core technical constraint: "The short answer is you can have the program right now. It's just not funded through any insurance base," he said, explaining that existing Medicare/Medicaid billing codes and reimbursement structures do not currently support community paramedic mobile-integrated-health services.
Council and staff sketched how local and state action would interact. City staff described deliberations about expanding the city's quarter-cent fire sales tax to a half-cent and placing that measure on the November 2026 ballot to fund replacement apparatus, equipment and potentially a paramedic service if the legislature or federal regulators create the needed billing pathways. Council members repeatedly urged clarity in ballot materials and asked staff to avoid promising services on which implementation depends on external legislative action.
Council Member McMahon urged specificity for voters: his "only suggestion would be to be clear that it's for programs that are in existence at the time the votes taken and not some program that we're working on that may or may not ever come to pass." Other councilors discussed communications and the risk of litigation or public skepticism if the ballot language leaves room for perceived 'wiggle room.'
Staff said the two paths can proceed in parallel: the sales-tax measure could be advanced to replace aging fire apparatus and increase department capacity, while advocacy and legislative work would continue to seek billing changes that make community paramedic services reimbursable.
What happens next: staff will refine the ballot language and financial projections for the proposed sales-tax change, plan public messaging about how funds would be spent if approved, and continue outreach to state-level health and EMS regulators about reimbursement mechanisms. No formal decision or ballot language was adopted during the session.
