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Town officials urged to budget $240,000 for ambulance contract as calls surge
Summary
The fire/EMS leadership told selectmen that ambulance costs have jumped and recommended budgeting $240,000 next year, citing a $50,000 retainer plus per-call fees, low insurance collections and a year-to-date spike to 589 incidents in Ashland.
The Ashland fire chief recommended that selectmen and the budget committee set aside $240,000 for next year’s ambulance contract, warning that the town’s costs have risen because of increased call volume and low returns on billing. “So I’m recommending that you budget $240,000 strictly for the ambulance contract to stay where we are safely,” the fire chief said.
The chief explained the current contract structure: a $50,000 retainer and a per-call fee of $1,373 that began in July. Using incident counts through mid-September, he said the contractor provided a figure of roughly $141,419 for transports; with continuing call volume—he reported 589 incidents in Ashland year-to-date—he proposed a routinely rounded $240,000 for the town to avoid shortfalls. He added that the contractor’s collections from insurers are returned to the town only when recovered, and that the national average return on billing is about 62% while Ashland’s range is nearer 49–51%.
Budget committee members pressed on drivers of the spike. Committee member Kendall Hughes asked whether older demographics or falling reimbursement rates explained increased transports; the chief said the town’s per-capita demand has grown and that some transports result from residents lacking other transportation. “A lot of these people have no driver's license, have no cars, have no way to get there, but they wanna be seen,” the chief said, noting this is “a nationwide” pattern.
The department also moved EMS training and supply lines into the ambulance line to reflect the full cost of providing ambulance transports, the chief said, and asked the committee to consider the salary offsets that will show up elsewhere in the fire budget when transports and per‑diem staffing are reallocated.
The committee discussed whether alternative transport options could reduce expensive ambulance use; the chief and others said ride-hailing services are not reliably available in town and that using nonmedical transport raises safety and liability concerns. They also noted pending reimbursement-rate changes tied to state or federal rules that could change revenues for the next two years.
Next steps: the chief urged budgeting the higher figure so the town does not under-fund ambulance service; the recommendation will be incorporated into the draft budget the selectmen forward to the budget committee.
