Salem's Emergency Services Fund has ballooned to more than five times its prior-year size since the city took over ambulance transport, but a complete accounting of whether the program pays for itself is still months away.
Fire Chief David Gerboth briefed the Salem City Council on Monday, Aug. 10, one year after the Salem Fire Department replaced private provider Falck Ambulance Northwest as the city's sole ambulance operator. Through March 31, the fund reported roughly $40.3 million in resources and $27.9 million in expenditures, according to the Salem Business Journal.
Those numbers don't equal profit. The fund includes a beginning balance and an internal startup loan from the Building and Safety Fund alongside ambulance revenue and expenses.
Through June, gross charges for ambulance transports totaled $51.1 million, according to a Statesman Journal report on Gerboth's staff briefing. But what the city actually collects will be shaped heavily by its payer mix: Medicare patients account for 54% of transports, Medicaid about 24% and private insurance roughly 11%. Government payers reimburse at lower rates than commercial insurers.
The city has not published complete first-year financial results, including actual transport collections, reimbursement levels, overtime costs and total operating expenses. No public timeline for that report has been announced.
More calls, more staff
Operationally, the system is handling more volume than planners expected. In a January 2026 operational update, the city reported averaging 55.77 transports per day during the first six months, about 3.3% above the original projection of 54. Response-time compliance stayed above 90% in both Marion and Polk counties.
The higher demand led the City Council to approve four new full-time EMS positions at an estimated $643,984 per year, converting a peak-hours ambulance unit to round-the-clock service. The city said additional transport revenue and reduced overtime should offset that cost.
Staffing hours rose from 1,030 per week under the Falck contract to 1,168 per week under city operation. In a staff report covered by the Statesman Journal on Aug. 9, Gerboth said staffing is "stable and consistent, exceeding previous contracted unit-hour requirements from 1,030 hours per week to 1,168 hours per week."
Mutual aid calls to neighboring agencies dropped from more than 500 per month under Falck to an average of 27.
Why the city made the switch
Salem ended roughly two decades with a private ambulance contractor on July 1, 2025, citing Falck's inability to meet required service hours. The city reported spending about $3.3 million in overtime from 2021 through the transition to cover gaps left by the private provider.
Officials also expected a publicly run system to unlock federal Ground Emergency Medical Transport funding, a revenue stream unavailable to private operators.
As we reported Aug. 9, the transition cut daily ambulance downtime from 391 minutes to 24 minutes.
What's next
In the same staff report, Gerboth wrote that the department plans to focus on alternative response models, reducing reliance on overtime, supporting career advancement and ensuring efficient staffing. The city has not announced when it will release complete collection and reimbursement data for the ambulance program's first year. Residents can track updates through Salem City Council meeting agendas posted on the city's website.
