Cole County commissioners approved the county’s State Fiscal Year 2025 GMT cost report for EMS reimbursement at the Nov. 26 meeting.

County consultants compiled the report and staff summarized key figures: the county expects $427,632 in reimbursement for 2025, must pay a nonfederal share of $147,668, leaving a net county effect of $279,964. Staff said operating costs rose by about $900,000 last year, while reimbursements from CMS were lower than expected during the year; those factors explain the larger reimbursement number. Auditors will reconcile and staff said the nonfederal share will be shifted across departmental budgets in the audit process.

Staff requested signatures on the general information certificate and an administration-fee agreement with MoHealthNet, noting time is of the essence and asking that signatures be completed by the end of the day. Commissioners approved and signed the documents by voice vote.

Staff said the county’s consultants have a conservative track record and that recent process changes mean the numbers are now audited before payment issuance, reducing the risk of a later-clawback. No additional policy action was requested at the meeting beyond approval and signature of the report and related documents.