EMS LEVY RENEWAL SUMMARY:
On the ballot: Tuesday, November 3, 2026 General Election
Mon EMS is asking the voters of Monongalia County to renew the EMS levy first approved in 2022. The levy supports our mission to ensure readiness, preparedness, and the provision of Emergency Medical Services (EMS) throughout Monongalia County.
The renewal keeps the current levy rate. There is no rate increase.
Every person who lives, works, and plays in Monongalia County deserves access to efficient, effective, high-quality EMS care.
WHAT ARE WE ASKING FOR?
Mon EMS is asking the voters to renew a four (4) year EMS levy that will provide approximately $5,345,131 per year to help support the provision of EMS services.
The estimated total of the four (4) year levy is $21,380,524.
If renewed, the levy would continue at its current rate through June 30, 2031. Like all excess levies in West Virginia, it must be approved by at least 60% of voters.
IF THE RATE ISN’T GOING UP, WHY IS THE TOTAL HIGHER THAN IN 2022?
The levy rate stays the same. The dollar amount is higher because Monongalia County’s tax base has grown since 2022, with new homes and businesses added to the county. The actual amount collected will vary slightly over the life of the levy as the tax base changes.
WHAT IS THE IMPACT TO YOU?
Your property’s assessed value is 60% of its appraised value. The levy rate is applied to the assessed value. For example, a home appraised at $100,000 has an assessed value of $60,000.
For owner-occupied homes and personal property (Class II), the levy rate is 4.8 cents per $100 of assessed value, or $48.00 per year for every $100,000 of assessed value. Commercial and rental property (Class III and IV) is assessed the same way, but at twice the rate: 9.6 cents per $100 of assessed value.
| Appraised Value | Assessed Value | Annual Cost: Owner-Occupied (Class II) | Annual Cost: Commercial/Rental (Class III & IV) |
|---|---|---|---|
| $100,000 | $60,000 | $28.80 | $57.60 |
| $166,667 | $100,000 | $48.00 | $96.00 |
| $250,000 | $150,000 | $72.00 | $144.00 |
| $333,334 | $200,000 | $96.00 | $192.00 |
HERE IS AN EXAMPLE:
An average Monongalia County home is valued at about $270,000, and the average household has two vehicles valued at $30,000 each. Together, the home and vehicles have an assessed value of $198,000.
| Cost to This Household | Amount |
|---|---|
| Annual | $112.32 per year |
| Monthly | $9.36 per month |
| Weekly | $2.16 per week |
| Daily | $0.31 per day |
WHY DOES MON EMS NEED THIS LEVY?
- EMS is your safety net. EMS, along with Police and Fire, is here when all others cannot be. But unlike Police and Fire, EMS isn’t funded through regular government budgets.
- Readiness has a cost. No matter how efficient an EMS service becomes, there will always be a cost of readiness to ensure an ambulance is ready for you in your time of need.
- Insurance doesn’t cover readiness. The cost to provide EMS readiness is not covered by insurance reimbursement alone.
- EMS is mainly paid for transports. EMS is mainly reimbursed for patients who are transported to the hospital. No reimbursement exists for patients or calls that don’t end with a transport.
- Disasters and complex events aren’t reimbursed. Disaster response, readiness, and complex events are not included in the EMS reimbursement model and must be funded elsewhere.
WHAT HAS THE LEVY ACCOMPLISHED?
Since voters approved the EMS levy in 2022, Mon EMS has:
- Responded to more than 84,000 calls over four years, ranging from heart attacks to car accidents.
- Hosted free community CPR classes across the county, because bystander CPR is a key part of survival.
- Launched the four-week Citizens Academy, where residents earn CPR and AED certification and see firsthand what EMS professionals do every day.
- Relied on the levy for about 37% of our annual budget, supporting the readiness that keeps ambulances available across the county.
A renewal allows Mon EMS to continue this work and keep building a safe, sustainable EMS system for Monongalia County.
QUESTIONS
In an effort to promote transparency, Mon EMS provides answers to frequently asked questions here. If you have other questions, please contact Mon EMS at info@monems.org.
Tell me a little about Mon EMS.
Mon EMS was officially formed on July 1, 2019, from two previous agencies: Mon Health EMS (affiliated with Mon Health System) and the Morgantown operation of WVU HealthTeam (affiliated with WVU Medicine). After issues were identified in 2017 and 2018, the Monongalia County Commission, Mon Health, and WVU Medicine worked together to bring the two competing agencies into one, eliminating duplicated services and inefficiencies to better serve Monongalia County.
What is Mon EMS’s corporate status?
Mon EMS is a 501(c)(3) nonprofit corporation.
How is Mon EMS governed?
Mon EMS is governed by a seven (7) member Board of Directors, made up of the following representatives:
- County Representative
- WVU Medicine Representative
- WVU Medicine Physician
- Mon Health Representative
- Mon Health Physician
- Community Representative
- Community Representative
You can read more about our Board Members at the link below.
Explain your budget and how EMS is funded.
The Mon EMS budget is approved by the Board of Directors before each fiscal year. Total annual expenses are approximately $13–14 million.
To meet those expenses, Mon EMS currently receives the following income:
- Patient revenue (billing a patient’s insurance): approximately 48%
- EMS levy: approximately 37%
- Mon Health and WVU Medicine: approximately 13%
- Other sources: approximately 2%
Can you help me understand EMS billing? What is a “contractual allowance”?
We are required by law to bill everyone under the same rate structure. The chart below shows how our different payers handle the same sample bill of $1,028.31.
First, the red bar on the far left (first column) represents patients who do not have insurance, which we call “self pay.” They make up about 14% of our calls. They receive the same bill as anyone else, but very few are able to pay it.
Second, the next column (Commercial Insurance) is the insurance you typically get through your employer, such as Blue Cross, Aetna, or Highmark. Most people with commercial insurance have some sort of co-pay, like at a dentist or doctor’s office. Commercial insurance accounts for only about 16% of our calls.
Lastly, the two columns on the right are Medicare and Medicaid, which make up approximately 67% of the patients we transport. These payers set fixed amounts they will pay for each service, shown in dark green. To receive payment from them, we must agree to write off the rest of the bill. That write-off is called a contractual allowance and is shown in yellow. Any patient co-pay is shown in blue.
Exact amounts will vary on a case-by-case basis. There are many different insurance plans, so no single call can be expected to pay an exact amount.
Why don’t you just raise your rates?
Mon EMS re-evaluates its charge rates every year, just like any other business, and usually adjusts them based on a realistic market percentage. However, raising rates has a limited effect:
Federal Payers (Medicare and Medicaid): These payers reimburse a set dollar amount, not a percentage of the bill. Unless they increase their reimbursement rates, raising our rates does not change what they pay.
Commercial Payers: These are the only payers truly affected by a rate change, since they pay a portion of the bill. Even so, the result is not guaranteed. Commercial payers decide how much of the total bill they pay, and many variables affect that decision.
Does this levy fund WVU and other special events in the county?
No. WVU pays for dedicated service when it requests it for events like football, basketball, baseball, track and field, graduation, and Fall Fest. Other events that request dedicated service must pay or make arrangements for that service.
Is Mon EMS facing the same staffing challenges as other services?
Yes. EMS agencies across Monongalia County, West Virginia, and the nation continue to face a workforce shortage. EMS professionals are the “tip of the spear” in healthcare. They usually make first contact with patients and handle difficult situations in every kind of setting and weather.
Is it feasible for EMS to be government (taxpayer) supported?
Yes, and Monongalia County has shown it works. Since the levy passed in 2022, the county has been able to help with readiness and infrastructure costs, while patients who are transported continue to be billed through the normal insurance process. The health systems partner with Mon EMS to make sure non-emergency transports are coordinated and completed efficiently. Everyone pays a little, and the result is a strong, cost-effective EMS system for everyone.
What happens if the levy is not renewed?
The current levy expires on June 30, 2027. Without a renewal, Mon EMS would lose approximately $5.3 million per year in funding, about 37% of our revenue. The Mon EMS Board of Directors, the Monongalia County Commission, and Mon EMS would have to have a conversation about the level of service we would be able to provide if our revenue is cut by 37%. We hope that is not the outcome. Either way, we are committed to an open, transparent conversation with the community about next steps.
What can be done to keep EMS services stable?
The levy has been a critical step toward stability, but the work continues. We must keep innovating, as WVU Medicine, Mon Health, and Monongalia County did in creating Mon EMS, and keep looking for ways to improve how EMS is delivered. We will continue to pursue better reimbursement rates where we can, but reimbursement alone will not solve the EMS funding problem.
Governments, health systems, communities, and the public all have to recognize the problem, make a plan, and follow through. We are fortunate to have a County Commission that cares about its constituents and worked to put a plan in place. Together, we share a vision to ensure the county’s safety net is here when we need it.
The healthcare environment is not getting any easier, and people are not getting any healthier. Mon EMS is doing its part to provide a strong safety net, but like any good net, it needs a little support.
What do you want people to know about the EMS levy?
We cannot thank the citizens of Monongalia County enough. The voters who approved the levy in 2022 made it possible to build a strong, reliable EMS system for our county. We are also grateful to Mon Health and WVU Medicine, and to the Monongalia County Commission. Together, they built a true public/private partnership and a model for EMS delivery that many counties can only hope for.
EMS is not something you should have to think about. We want every resident to have peace of mind that in an emergency, a professional, well-trained crew will arrive quickly, whenever they are needed. Renewing the levy keeps that promise in place.