Audit Objective
Did the Town of Cohocton (Town) Town Board (Board) adequately oversee and manage the Town’s ambulance service?
Audit Period
January 1, 2023 – April 4, 2025
We extended the audit period back to January 1, 2021 to analyze budget trends and back to August 1, 2013 to provide historical background of the ambulance district’s (District’s) formation.
Understanding the Audit Area
Towns are authorized, pursuant to the New York State Town Law (Town Law), to provide an emergency medical service, a general ambulance service, or a combination of such services, for the purpose of providing pre-hospital emergency medical treatment or transporting sick or injured persons found within the boundaries of a town to a hospital, clinic, sanatorium or other place for treatment of such illness or injury. Town Law authorizes towns to provide this service by, among other methods, establishing an ambulance district. Once established, the ambulance district may provide ambulance services to the town by acquiring, supplying and equipping vehicles and operating, maintaining and repairing the vehicles directly, or by contracting with third parties for the operation and maintenance of the vehicles. An ambulance district is governed by a town board (board).
The District, which is an administrative unit of the Town, is governed by the Board. Therefore, it is essential that the Board oversee and monitor the District’s operations and finances. The District is town-wide (i.e., includes the Village of Cohocton [Village]) and is funded primarily with real property taxes and user charges. The District’s 2024 budgeted appropriations totaled $218,100.
Audit Summary
The Board did not adequately oversee or manage the Town’s ambulance service. The Board’s general lack of oversight of and policy development for the District resulted in excessive fund balance and unnecessary tax increases. Additionally, a loss of revenue or fraudulent activity could occur. The Board did not:
- Adequately oversee the billing, collecting and enforcement of fees for ambulance services totaling $562,675 and allowed unauthorized billing write-offs and adjustments totaling $248,163 to occur.
- Effectively audit 27 District claims totaling $13,146 of 25 claims totaling $14,234 and 16 credit card claims totaling $5,0991 that we reviewed. Without an adequate claims audit process, the Board cannot ensure that all claims paid for the District are for a valid purpose.
- Approve two of the six emergency medical technician (EMT) appointments or pay rates for all six EMTs. Additionally, the Town did not use required civil service procedures, such as selecting individuals through a civil service list, prior to hiring all six EMTs. Without using a civil service list for hiring, the town’s hiring processes are susceptible to biases such as favoritism and nepotism.
- Ensure there was a current (unexpired) contract with the third-party billing service vendor (vendor). Without updated written contracts with the vendor detailing the type and timeframe of services to be provided and for what compensation, the Town may not receive all agreed-upon services or could be paying for services not authorized or delivered.
The report includes 19 recommendations that, if implemented, will improve the Board’s oversight of the Town’s ambulance service. Town officials disagreed with certain aspects of our findings but indicated they planned to initiate corrective action. Appendix C includes our comments on issues raised in the Town’s response letter.
We conducted this audit pursuant to Article V, Section 1 of the State Constitution and the State Comptroller’s authority as set forth in Article 3 of the New York State General Municipal Law. Our methodology and standards are included in Appendix D.
The Board has the responsibility to initiate corrective action. A written corrective action plan (CAP) that addresses the findings and recommendations in this report should be prepared and provided to our office within 90 days, pursuant to Section 35 of the New York State General Municipal Law. For more information on preparing and filing your CAP, please refer to our brochure, Responding to an OSC Audit Report, which you received with the draft audit report. We encourage the Board to make the CAP available for public review in the Town Clerk’s office.
1 One credit card claim totaling $975 was included in our original sample of 25 claims reviewed.