By Stephen Smoot
The past three years in the world of West Virginia EMS have created significant frustration from a funding standpoint.
In 2023, the West Virginia State Legislature passed a salary enhancement program that helped to boost the salaries and stipends of personnel. Services had wide leeway with which to use the funds provided. Volunteer EMS organizations using the funds to enhance the stipend per call got the best results from its use.
In 2024, the fund worked as projected in the bill. Then in 2025, the administration of incoming Governor Patrick Morrisey sounded the tocsin on state revenues, projecting a revenue shortage. Though established by statute, the salary enhancement fund did not receive the designated funds from the State, leaving local governments and cashstrapped EMS services in difficult straits.
By fall of that year, Governor Morrisey promised new legislation to replace the salary enhancement fund. It created a multi-tiered system where all counties, regardless of whether they had a levy or fee, received a share. A second fund would be divided among counties that had passed a levy or imposed a fee.
That legislation was interpreted to exclude counties such as Pendleton whose county commission voted to simply backfill in 2024 what the state had promised in the 2023 legislation, rather than impose a fee or try to pass a levy.
Charleston’s message was clear. Counties whose populations allowed themselves to be taxed by levy or have an ambulance fee imposed upon them would receive extra help.
Last month, the Hardy County Commission released a draft proposal for an ambulance fee that would affect residential and business owners alike. State code grants the authority to the County to “impose a special ambulance fee dedicated to the reasonable and necessary costs of providing ambulance services and supporting the ambulance authority.”
The fee would support operations of both the Hardy County Emergency Ambulance Authority and the Hardy County Ambulance Service. Monies collected would be deposited into a special ambulance fund and used to pay for normal expenses.
The proposal contained a description of the fee structure for both residences and businesses that the Commission “feels . . . is reasonable and equitable.” The structure is designed to put the most burden of payment on those who have the most potential to use the service, specifically larger employers in the County.
The residential fee is applied to each “living unit,” which means almost any place of residence, occupied or unoccupied with a few exceptions. These include primary residences, second and vacation homes, rentals of any kind, recreational camp structures for hunting, fishing, or other activities, mobile homes, and anything else that can be lived in even if it lacks water, sewer, or septic.
Landlords with a significant number of rental units will have a monthly payment option available.
A few exemptions for residential structures are listed. Should a single owner have two or more living units, but have non-renters living in them, they will not be charged for the structure. Similarly, structures that are unable to be inhabited or occupied for residential purposes can receive a waiver as well.
Fees, if passed, will be charged per living unit, not per person.
Annual fees will start at $120 for the first year billed, $135 in the second, $150 for the third, and $165 in the fourth. Starting in the fifth year, the “residential living fee then in effect shall be subject to the annual adjustment mechanism.”
Those who qualify under tax law for a homestead exemption on their property will pay $75. Non residents who need to use emergency services will be directly billed.
Businesses will also pay the fee. Those with multiple locations must pay a separate fee for each facility.
Those with between one and seven employees will pay the residential unit fee, while for those with more than seven “the annual fee shall be the then-current residential living unit fee plus $25 for each employee in excess of seven, rounded to the nearest cent.” The County Commission reserved the right to request annual reports of the number of employees.
Additionally, the County Commission can “Negotiate and enter into written agreements with a specific business, employer, institution, or organization” to “establish a special rate or payment agreement. The “Covered Entity” paying the fee must show cause why the “schedule is not reasonably cost-effective.” Agreements under this category are “not intended as a waiver or preferential exemption unrated to cost.”
Any special arrangement must provide for an additional cost based payment or provide an alternative cost-based payment in lieu of the otherwise applicable fee.” It must more accurately reflect costs “and does not materially shift costs to other payers.”
Incorporated cities that establish their own EMS service would have their residences and businesses exempt from the ordinance, but none have their own at this time.
Once the proposal is passed, the public has 30 days in which to comment before final passage.
