Beaufort County commissioners are talking EMS — in this case, consolidating all EMS squads under a county EMS umbrella.

County Manager Brian Alligood initiated the discussion at the Board of Commissioners’ annual retreat Wednesday, in advance of county staff putting together recommendations for the 2016-17 budget.

“We’ve got to stick with the status quo or we’ve got to pull the trigger in this new budget,” Alligood told commissioners.

Currently, residents pay a tax for EMS, one that varies across the tax districts and ranges from 1.3 cents per $100 valuation in Bath to 5 cents per $100 in Pantego. Residents of municipalities, with the exception of Chocowinity, receive EMS service but do not pay an EMS tax, while Washington’s EMS is funded through the city’s general fund. Each department does its own billing for EMS services.

Wednesday’s discussion centered around the county taking over the roll of billing, initiating a 3.5–3.9 cents tax per $100 valuation for all county residents and essentially subcontracting out services to all existing EMS squads. According to Alligood, there would be no change in individual squads’ budgets — each would continue to receive money it accrued through its billing while also receiving supplemental income from the county general fund.

“The county acts as billing agent,” Alligood said. “That’s not us wanting to be in control and taking over everything. … It’s simply economies of scale.”

“By the county doing the billing, that opens us up so we can receive the Medicaid reimbursement,” Flemming said.

The combination of volunteer EMS squads, subcontractors White Oak EMS serving Belhaven and the eastern part of the county, and the newly established Beaufort County EMS, which covers gaps in service areas in and around Pinetown, Bath and Blounts Creek, means that all residents have equal access to paramedic-level service, Flemming said.

Alligood posed the question: should the cost of that service, to be effective in billing, as well as standardizing equipment for each department, be shared?

“We’re looking at EMS as a county system, a whole system,” Alligood said.

In addition to the uniform tax, one of the key elements of squads operating under a county EMS umbrella is that all would have to bill for their services. Currently, the residents of Pinetown pay a voluntary fee of $5 per individual or $20 per family, per year, for EMS service, but Pinetown EMS does not bill for that service.