Audit Objective
Did the Town of Macedon (Town) Town Board (Board) and Town officials (officials) adequately oversee and manage the Town's ambulance service’s financial operations?
Audit Period
January 1, 2024 – April 15, 2026
Understanding the Audit Area
A town board is responsible for the general management and control of the town’s ambulance service’s financial operations and should provide adequate oversight of the financial operations to ensure revenues are properly billed, collected, recorded and safeguarded and expenditures are authorized, supported and for appropriate town purposes. Effective financial oversight also provides officials with reliable information to monitor operating results, evaluate the cost of providing ambulance services and make informed decisions regarding rates, funding and operations. These practices help safeguard public resources, support continued delivery of ambulance services and promote accountability, transparency and public trust.
The ambulance service is funded primarily with real property taxes and ambulance service charges. The 2026 Board-adopted budget includes $500,000 in revenue from ambulance service charges and appropriations totaling $891,104.
Audit Summary
The Board and officials did not adequately oversee and manage the Town’s ambulance service’s financial operations. The Board did not ensure ambulance service charges were properly billed, collected and reconciled; authorize billing write-offs; adopt realistic budgets; develop long-term financial or capital plans; ensure only authorized claims were paid; and ensure emergency medical technicians (EMTs) were paid at Board-approved rates. Officials also did not maintain complete and up-to-date financial and inventory records or comply with certain procurement requirements. These deficiencies diminished accountability over ambulance service financial operations and increased the risk that Town resources could be lost, misused or improperly spent. For example:
The Board did not:
- Ensure the accurate billing, collection and enforcement of ambulance service charges totaling $235,902. This resulted in billing write-offs totaling $17,320 that were not approved by the Board and possible mileage billing errors totaling $575.
- Adopt realistic budgets or develop long-term written capital or financial plans for the ambulance service.
- Ensure sufficient appropriations were available before approving expenditures.
- Effectively audit 17 claims totaling $13,552.
Officials did not:
- Maintain an up-to-date accounting of all ambulance service financial transactions.
- Ensure that all ambulance services were billed and charges were collected, enforced and reconciled with third-party billing reports.
- Seek competition by obtaining verbal or written quotes for 14 purchases totaling $59,674, as required by the procurement policy.
- Ensure that a contract let by a group purchasing organization (GPO) used to purchase an ambulance for $173,000 met each prerequisite for using the piggybacking exception, according to New York State (NYS) General Municipal Law (GML) Section 103(16).
- Maintain written ambulance service inventory records.
- Ensure one EMT’s pay rate increase was Board-approved, resulting in a payment of $2,114 in excess of the Board-approved pay rate.
The report includes 15 recommendations that, if implemented, will improve the Town’s oversight and management of ambulance service’s financial operations and help safeguard Town resources. Officials generally agreed with our recommendations, and their response is included in Appendix B.
We conducted this audit pursuant to Article V, Section 1 of the State Constitution and the Office of the New York State Comptroller’s (OSC) authority as set forth in Article 3 of GML. The audit’s methodology and standards are included in Appendix C.
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 GML. 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.