The Perfects are not happy with Tucker County.

Ski resort suing Tucker County over ambulance fee - August 14, 2025, WBOY

" . . .

Timberline Mountain is suing the Tucker County Commission over an ambulance fee on all recreational activities and entertainment in the county that it says is “fundamentally unfair.”

The Special Emergency Ambulance Service Fee, which went into effect at the start of 2025, is 2% on things like ski rentals, lodging, bicycle rentals and other indoor and outdoor activities. The ordinance from the commission says the fee is meant to help pay for the EMS services for people visiting from outside of the county and don’t pay taxes there; about 40% of EMS calls in the county are from non-resident visitors, Tucker County Commission President Mike Rosenau told 12 News when the ordinance passed.

. . ."

Scott wrote:

Interesting. Don’t most ambulance services (county or private) bill the patient (and/or their insurance company) for transport and services?  Is that not the case in Tucker County?  Or does that not provide enough revenue to fund the service 24/7, requiring subsidization via taxes?

 Based on a ST Post from a friend - who I think posts here - that may not always be the case. At least for Taos NM.

I see both sides of this argument. I do think some sort of tax or fee should be imposed, not necessarily the amount or the precise recipient. Search and rescue and EMS do impose costs, who should pay them is TBD. What about the legal costs to process claims against uninsured and/or those who can’t pay? And the upfront costs to provide capacity for non-residents. From what I understand, Tucker County doesn’t have a lot of resources, or much of a tax base to tax. A lot different than DC area.

EMS in general, and in rural areas especially, is in a severe financial crisis across the country. Reimbursements from insurance are very poor and do not reflect actual costs. The reimbursement model simply does not work. EMS is not recognized as a core public safety element such as fire and police in many areas, and often does not get nearly the same level of support from government, if any at all. My understanding is that the state of WV has also failed to address this.

Tucker County EMS was on the verge of closing the station in Davis due to funding shortfalls. The service fee was a result of the county pulling back other funding from them a few years ago. Frankly, I don't understand the opposition to this fee, it is basically a pass through that ultimately will get charged to the customer. I don't like paying more for staff as much as anyone, but 43 years in EMS has taught me that this is, or needs to be, the reality to keep service levels reasonable.

Pennsylvania is in just as bad of shape, maybe worse. 

JohnL wrote:

Scott wrote:

Interesting. Don’t most ambulance services (county or private) bill the patient (and/or their insurance company) for transport and services?  Is that not the case in Tucker County?  Or does that not provide enough revenue to fund the service 24/7, requiring subsidization via taxes?

 Based on a ST Post from a friend - who I think posts here - that may not always be the case. At least for Taos NM.

I see both sides of this argument. I do think some sort of tax or fee should be imposed, not necessarily the amount or the precise recipient. Search and rescue and EMS do impose costs, who should pay them is TBD. What about the legal costs to process claims against uninsured and/or those who can’t pay? And the upfront costs to provide capacity for non-residents. From what I understand, Tucker County doesn’t have a lot of resources, or much of a tax base to tax. A lot different than DC area.

Seems to be that way in Maryland.  I know AA and Baltimore counties cover ambulance thru taxes for residents.

PA was a different story.  Ambulance had to take my son to the hospital for an allergic reaction.  It was semi-rural - only about 13 miles to the hospital. It was a private ambulance service and they billed my insurance. Unfortunately at they were out of network at the time (joined a month later :rolleyes:) and we got a huge bill. Total bill was over $2000.  Insurance paid about $1100 or so, and we were stuck with the rest.  If the ambulance provider was in network, copay was $250 on our plan.  Had it happened at my folks, their service would have been in network.

We recently moved to York and I haven't checked to see if they're in network on my new plan.  The ambulance company is private, so I'd likely have to pay something similar.  However, these ambulance services offer memberships for a year.  My local one is like $100 for a family for a year, and they'll waive a certain amount of the bill. I don't remember the exact amount, but it was several hundred.  My guess is that they get enough people to buy into it, knowing that most won't need it and it helps spread the cost out to make it more affordable.