On May 5, Gov. Jared Polis administratively signed House Bill 26-1238, which declares emergency medical services (EMS) are an essential service in the state and an integral part of the state’s health care infrastructure.
The signing of the bill came on the heels of the Upper San Juan Health Service District Board of Directors, which oversees Pagosa Springs Medical Center (PSMC), hearing a report about PSMC EMS at its April 28 meeting.
That report was presented by Jason Webb — who serves as chief/director of PSMC EMS, hospital environmental services and community liaison — and focused on what PSMC EMS does, how funding for EMS works, a statewide funding gap for EMS, the status of EMS facilities and vehicles, and more.
Webb explained PSMC EMS provides 911 response services; interfacility transport; serves at community events; and helps at PSMC with things like emergency response, Emergency Department backup resources and as a backup plan when medical flights are grounded.
He added that EMS was a core service when the district formed in 1981 and provides service over 1,800 square miles, spanning Archuleta County and parts of Hinsdale and Mineral counties.
While EMS has an obligation to respond to 100 percent of calls, Webb explained, approximately 50 percent are billable, and PSMC collects on about half of those.
Right now, he told the board, EMS is only able to bill when it transports a patient.
He explained that the EMS service line operated at a loss of $2,225,661.60 in 2025 because expenses outweigh revenue.
He noted that, to make up the shortfall, EMS relies on grants for capital, the current mill levy of 3.884 that helps support all of PSMC’s services and PSMC’s overall bottom line or reserve funds.
He indicated PSMC EMS is in line with the state in terms of the funding gap.
“We’re pretty much on par with everyone around the state,” he said, noting there’s an estimated 40 percent funding gap for all EMS service providers in Colorado and PSMC is at about 37 percent.
But, he indicated to the board, it is expensive to be ready every hour of every day.
He added they are expected to be quick and competent in their responses.
Webb then discussed PSMC EMS’s buildings, including its newest facility, the San Juan building, in downtown Pagosa Springs.
The San Juan building, Webb told the board, has improved response times by 10 to 15 minutes for some areas.
He added that location will allow lives to be saved over and over again and saves EMS vehicles from having to go into the oncoming lane on Put Hill during responses.
It was noted later in the meeting during reports that the Colorado Department of Local Affairs recently awarded $100,000 for renovations at the recently acquired facility, with plans still being prepared for work to make the building a facility that can house EMS personnel 24/7.
The organization’s uptown building is located on the Pagosa Fire Protection District (PFPD) campus.
Webb explained there are 10 years left on the land lease for that facility and that the building needs “significant maintenance” and doesn’t have an adequate generator.
In later conversation on the matter, Webb noted he’d had discussions about the lease with the PFPD’s previous chief, but not the current one.
Webb further explained PSMC EMS currently has five ambulances, but, ideally, it would have six ambulances and a second quick-response vehicle.
He explained ambulances should be replaced at 200,000 to 250,000 miles, need four-wheel-drive capability and come with a two-year build time.
He noted new ambulances costs in excess of $300,000, but remounting the box portion is 50 to 60 percent the cost of a new build. He noted PSMC has three ambulances that are remount capable and two that are not.
Funding, he told the board, is not as available as in years past.
He indicated the mileage on the five ambulances ranges from 25,000 on its 2023 ambulance to 208,000 on a 2012 ambulance.
In terms of staffing, Webb explained PSMC has three full-time crews and a lieutenant, with additional staff scheduled as needed; administrative staff, which includes the chief, deputy chief, assistant chief and the medical director (an Emergency Department doctor).
He noted there’s an estimated 35 percent shortage in the EMS workforce in Colorado and, to help combat that, PSMC did a 2026 wage increase for EMS staff.
He noted that EMS staff must be highly trained due to it being an autonomous role that includes clinical decision making, is stressful in nature and requires continuous training.
He added there’s a minimum of six months of training after someone is hired.
Webb then discussed state licensure and data requirements, including that all charts must be completed and submitted with 48 hours, with a potential of up to 585 data points reported, and that that work is not able to be performed in PSMC’s electronic health record system.
Webb then discussed pending legislation, including HB26-1238.
Webb highlighted that the bill would open additional funding from the state, which would include county-level dispersal and the transfer of funds for governor-declared disasters.
For more on HB26-1238, visit https://leg.colorado.gov/bills/HB26-1238.
Webb also highlighted HB26-1069, which would, among other provisions, require Medicaid to pay for treatment provided at a scene without ambulance transport.
As of Wednesday morning, May 6, that bill was still under consideration.
For more on HB26-1069, visit https://leg.colorado.gov/bills/HB26-1069.
Webb noted that there are unknowns with pending legislation, including whether or not they will be approved and if funding will be available.
Following Webb’s report, board member Matt Mees asked if EMS will be changing its staffing when the San Juan building renovation is complete, with Webb explaining staffing is looked at with each year’s budget.
He further indicated they will also be looking at things like the upcoming airport project, which will mean five months without medical flights and more ambulance transports.
randi@pagosasun.com
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