The revenue from Jefferson County’s per-property ambulance fee is covering a shrinking share of a growing emergency services budget, which could force the County Commission to make difficult choices about service levels and funding in future budget cycle.
The Jefferson County Emergency Services Agency (JCESA) currently operates 5 ambulances with two-person crews 24×7 and an additional two-person ambulance crew during a 12-hour daytime shift.
The budget for the JCESA has increased from $4 million in fiscal year 2022 to $6.5 million in the current budget (fiscal year 2026). Since 2014, the County has billed an “ambulance fee” for all residential and commercial structures in the county to help cover the costs of operating the ambulance service.
In contrast to the significant increase in the JCESA operating budget, the amount billed for the fees has remained level over the past five years: In FY 2022, the county billed $1.1 million for the fee and in FY 2026 the county mailed out invoices totalling $1.2 million for the bills that were due last month.
In FY 2022 the ambulance fee covered 30 percent of the JCESA budget. In the current fiscal year, the ambulance fee covered only 18 percent of the total JCESA budget (chart below).
Fee Set Low From The Start
The Jefferson County Commission has been holding town hall meetings at all of the volunteer fire companies in recent weeks. During these sessions, several volunteer fire chiefs recounted their memories of how the Commission set the “ambulance fee” in 2014. According to the chiefs, when the Commission was working on drafting the ordinance authorizing the ambulance fee, they considered a high, medium, and low fee option. The Commission ultimately opted to set the fees below the “low” option when they adopted the ordinance in 2014. In 2019, the Commission further reduced the fee for owner-occupied residences to its present level of $39 per year. For residents who are 65 or older and qualify for the property tax “homestead exemption,” the ambulance fee is only $20 per year.
For comparison, Berkeley County’s ambulance fee for owner-occupied residences is $110 per year, reduced to $85 for properties with a homestead exemption. In Morgan County, the fee for residences is $150 per year.
What this means for services and taxpayers
A static fee amid rising operating costs is likely to force choices: the County can absorb the shortfall from other revenues, cut services or staffing, or raise the fee. Each option carries trade-offs:
- Absorbing costs shifts the burden to the general fund, potentially competing with other county priorities.
- Cutting or scaling back ambulance coverage could increase response times or reduce spare capacity during peak demand.
- Raising the fee would provide an increase to the dedicated funding for ambulance services, but may prompt concerns from some taxpayers.
Ordinance Requires Annual Public Hearing
The ambulance fee ordinance specifies that the JCESA must conduct a public hearing on the ambulance services every year (no later than December) and make recommendations to the County Commission about any changes to the fee amount.
When the County Commission reorganized the JCESA two years ago from an independent agency into a county department, it did not update the ordinance, but it made it clear that all of the JCESA duties and obligations were absorbed by the Commission itself — so presumably the County Commission will conduct the public hearing this year and make recommendations to itself.
Published 2025 Oct 16 in the Observer Weekly.
By Steve Pearson