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Committee questions plan to buy ambulances for every rural county, asks who will sustain service
Summary
Lawmakers pressed administration officials over a proposal to fund new ambulances for rural counties and to expand community paramedicine, seeking clarity on costs, county ownership, use agreements with providers, and long‑term payer sustainability.
The committee spent a substantial portion of its time probing the administration's proposal to fund ambulance purchases and last‑mile teams for rural counties.
Chairman Watson pressed officials on cost and sustainability, noting that buying ambulances for 89 counties would consume a large portion of a $66.6 million line item and asking, "how do you make this realistic that you can actually support it over time?" Administration witnesses said the proposal pairs vehicle investment with training, community paramedicine and neonatal resuscitation programs, and that counties would receive grant funds and then contract via use agreements with whatever EMS provider serves that county.
To a direct question about unit costs, a department official said the plan includes roughly $30,000,000 dedicated to ambulance purchase and that a top‑of‑the‑line vehicle with a lift is expected to cost about $350,000–$360,000. "To answer your question specifically about ambulances...it's about 30,000,000 that's dedicated for purchase of new equipment. I think that's about 350 to 360,000," the official said.
Officials described the procurement model as grant‑to‑county: the county would receive funds and buy the vehicle through its procurement process, then enter a use agreement with the county's EMS provider (which might be hospital‑owned, county‑run, or a private vendor) so the ambulance is committed to county service and federal procurement rules are met.
Members, including Senator Hensley, warned that many rural systems operate on razor‑thin margins and that hospitals or private vendors often provide EMS across county lines. They asked whether counties would be required to create or expand agreements to ensure county access rather than private operator retention of new assets. Administration witnesses said use agreements and federal compliance steps would be built into grant terms and that procurement assistance would be provided.
The exchange underscored a recurring theme in the hearing: members support investments to expand rural care but repeatedly pressed officials about long‑term operations, payer reform and who will pay for ongoing service costs after initial capital purchases.
