FINANCIAL MODEL 07

EMS Funding Scenario Dashboard

This dashboard models how different combinations of funding sources affect the financial sustainability of a rural EMS agency. The funding levers modeled are Highway User Tax Fund (HUTF) allocations, local mill levy revenue, billing collections, and subsidy contributions from local governments. Adjust any input to see how changes in one source affect the overall picture.

HUTF is the primary state-level EMS funding source in Colorado. RETAC base funding from HUTF has not increased since 2000. The dashboard contextualizes that stagnation by showing how the gap between HUTF and actual operating costs has grown over time, and what combinations of local revenue would be required to close it at different agency sizes.

Designed for agency administrators, county officials, and RETAC planners building funding arguments or evaluating mill levy scenarios. For background on how Colorado EMS funding works, see How EMS Is Funded.

HUTF data from CDPHE. Model developed by NCRETAC.

Model 07: EMS Funding Scenario Dashboard | NCRETAC Colorado EMS

← All Models Model 07: Funding Scenario Dashboard Scenario Analysis v3.2

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.

Agencies merged 0 / 46

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%.

Savings realized 0%

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

Rate per $100 $0.05

→ $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

Rate per night $0.50

→ $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

Fee per vehicle/yr $2.00

→ $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)

Additional mills 0 mills

→ $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

Projected savings $0M/yr

→ $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

Sales tax revenue

Visitor night surcharge

HUTF vehicle fee

County levy (50% TABOR passage)

TIP & TAD value-based savings

Residual Gap $96M

Gap coverage by mechanism

Consol.

Sales

Tourist

HUTF

Levy

TIP/TAD

Unfunded

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.

Structural gap: $95.5M baseline (current ops) · $432.8M desert remediation (CCECBI v1.0 underfunded mandates)

CO population: 5,877,610 (Census 2024)

CO vehicles: 5.8M (CDOT)

Taxable sales: $152.2B (CDOR Form DR 0100, 2024)

Lodging nights: ~75M commercial paid (OEDIT/Dean Runyan 2024)

HUTF base: $2.00/vehicle = $11.6M current

Assessed value: ~$130B local gov base (DOLA DPT, est.)

Mill levy TABOR: 50% passage rate assumed

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.