⚠ PRELIMINARY: NOT FOR PUBLIC USE: These models are unfinished and calculations have not been verified or finalized. They are intended solely for internal discussion purposes. Data and outputs may be inaccurate or incomplete. These models do not represent a policy position, recommendation, or official stance of NCRETAC, its board members, volunteers, or staff.
EMS Sustainability Task Force — Phase IV | Funding Workgroup
Colorado EMS Funding Scenario Dashboard
Model the combined effect of consolidation, revenue mechanisms, and value-based care. Baseline: $774.3M system cost · $95.5M gap (APCD) · $12M HUTF at $2/vehicle default.
Revenue estimates:
APCD — Colorado-specific actual rates · $95.5M gap at current ops (used in calculations)
|
GADCS — national avg rates · $107M surplus at current ops
01
Consolidation Scenarios
select one
Status Quo
Baseline
209 licensed agencies operating independently. No structural changes — establishes the funding gap all other scenarios seek to reduce.
Sets expenditure gap
$432.8M total (ops + future support programs)
Very Small Agency Consolidation (Model 05)
Admin savings
Merge agencies with fewer than 1,000 calls/year into larger entities. 46 qualifying agencies statewide. Use the slider to set how many are merged — selecting this scenario defaults to 23 agencies.
Estimated administrative savings
$0
County-Level Consolidation (Model 06)
Admin savings
One primary transporting agency per county. Model 06 data: up to $12M savings statewide (county-level admin consolidation). Use the slider to set the percentage of savings realized — selecting this scenario defaults to 50%.
Estimated administrative savings
$0
Ambulance Desert Prevention
Investment required
The minimum state investment required to prevent coverage gaps in 51 geography-bound counties. Consolidation cannot reduce this floor — number of required units is set by the 25-minute coverage map, not call volume.
Frontier
$250M
24 counties
Rural
$162M
28 counties
Urban
$52M
12 counties
Administrative savings possible
$0 — no consolidation savings
02
Revenue Mechanisms
mix & match
Statewide Sales Tax
→ $0 — not currently enacted
Requires TABOR ballot approval. Applied to $152.2B Colorado state net taxable sales (CDOR Form DR 0100, 2024). Does not include food for home consumption, medical, or other statutory exemptions.
Per CO resident: $0 at current rate
Visitor Night Surcharge
→ $0 — not currently enacted
Applied to hotel, motel, STR, and campground stays. Base: ~75M commercial paid lodging nights (OEDIT/Dean Runyan 2024). Visitors generate ~30% of rural EMS calls. May be structured as a state fee (no TABOR vote) or a tax.
Per lodging night: $0 at current rate
HUTF Vehicle Registration Fee
→ $11.6M/yr current — no change at $2.00 baseline
Current HUTF EMS fee: $2.00/vehicle = $11.6M/yr (5.8M registered vehicles, CDOT). Does not require TABOR vote — set by legislature. Each $1.00 increase = ~$5.8M additional. Slider $0–$5/vehicle.
Per vehicle: $2.00/yr current | vs baseline: no change
County Mill Levy (Additional)
→ $0/yr
Additional EMS-dedicated mill levy on ~$130B statewide assessed value (DOLA DPT, local gov non-school base). 1 mill = ~$130M theoretical max. Revenue shown at 50% TABOR passage — each county requires a separate voter-approved ballot.
⚖ TABOR: Each county mill levy requires separate voter approval. Frontier counties, with highest EMS need, face the most constrained tax base and smallest voter pools.
TIP & TAD Value-Based Savings
→ $0 — no value-based contracts active
TIP (treat without transport) and TAD (transport to alternative destination) reduce downstream ED costs. Under current fee-for-service rules, diverted calls generate zero billing revenue. Value-based contracts pay a per-encounter fee based on insurer savings. Enter your projected net annual savings from active or anticipated VBC agreements. Range: $0–$100M.
⚠ Legislative gap: Colorado HB26-1069 (2026) would authorize Medicaid reimbursement for TIP/TAD but has not yet passed both houses and is not yet law. No state payment structure currently exists. This estimate requires active value-based contracts — projected savings should reflect actual or negotiated agreements, not theoretical potential.
LIVE GAP CALCULATION
Updates as you adjust scenarios and levers
Residual Funding Gap
$96M
No mechanisms applied. Includes $12M HUTF-funded support programs (nets $0 at baseline). Future scenarios add $11M unfunded support program gap.
Expense (system cost)
$774M
Local EMS agencies
$762M
Statewide EMS infrastructure
$9.5M
CDPHE operations
$2.5M
Structural gap before mechanisms
$95.5M
/
−$107M
Consolidation savings
$0
Sales tax revenue
$0
Visitor night surcharge
$0
HUTF vehicle fee
$0
County levy (50% TABOR passage)
$0
TIP & TAD value-based savings
$0
Residual Gap
$96M
Gap coverage by mechanism
Consolidation
Sales tax
Tourist
HUTF
County levy
TIP & TAD
Per CO Resident
$83
contributed · residual gap
5.88M residents
Per Household
$215
contributed · residual gap
2.28M households
HUTF Rate
$84
residual gap per unit
per vehicle registration
Tourist Surcharge Rate
$6.53
residual gap per unit
75M commercial lodging nights
Gap Remaining vs. Consolidation Scenario at Current Revenue Settings
How to read this chart
What you seeEach bar shows how much of the structural funding gap remains after applying the selected combination of consolidation and revenue mechanisms. Shorter bars mean less remaining gap. The dashed line marks the current gap with no new funding.
What it meansNo single mechanism closes the gap. The bars show which combinations get closest and how much more would be needed. Scenarios using multiple mechanisms simultaneously — consolidation plus a sales tax plus a HUTF increase — come closest to closing the gap under the GADCS method, but still leave a residual under the APCD method.
What this means for policy: Legislators can use this chart to understand the trade-offs between different funding approaches. A statewide sales tax gets there faster but requires a ballot. A HUTF increase does not require a ballot but yields less. The combination panel on the left lets you model any mix in real time.
Consolidation Notes
Model 05 (Very Small) savings are administrative: shared dispatch, overhead, administration. Geographic coverage obligations do not change. Max ~$55M if all 46 agencies merge.
Model 06 (County-level) savings ($12M max) assume one primary transporting entity per county with full tier-progression cost reduction. Home rule preserved.
The Desert Prevention scenario ($250M frontier, $162M rural, $52M urban) is irreducible regardless of consolidation scenario. It must be funded through revenue mechanisms.
Revenue Mechanism Notes
Sales tax: $152.2B CDOR 2024 taxable sales base. Requires TABOR statewide ballot. Rural counties generate less taxable sales per capita.
Visitor night: ~75M commercial paid lodging nights (OEDIT/Dean Runyan 2024). May be a state fee (no TABOR) or tax (TABOR required).
HUTF: Set by legislature, no TABOR vote. Current $2.00/vehicle. Each $1 increase = $5.8M. Slider shows $0–$5/vehicle range.
County mill levy: 50% TABOR passage assumed. 1 mill = ~$130M theoretical max, ~$65M TABOR-adjusted.
Key Constraints
TABOR: Sales tax requires statewide ballot. County mill levies require a separate ballot in each of Colorado’s 64 counties.
Consolidation and funding are complementary, not substitutes. Even maximum county consolidation (Model 06, $12M) leaves $83MM unfunded depending on the gap method used.
The $250M frontier desert-prevention floor is irreducible by consolidation and must be funded through revenue mechanisms. See Model 02 (CCECBI) for county-level scores.