Last updated: July 2026
A town of 400 people got a $16,967.73 ambulance bill last year. They had budgeted $7,500.
When the Town of Hill board opened the invoice from Taylor County at their June 16, 2025 meeting, the numbers didn’t add up. The bill was $9,467.73 over what they planned for. That’s a 126% overrun on a single line item for a municipality with roughly 400 residents.
The board’s response was unusual for a small town: they refused to pay it.
According to the meeting minutes, the board voted to hold off on payment and requested that Bob Kirkley attend their next meeting to explain the increase. That’s not how things usually go in rural Wisconsin, where towns often just absorb the cost and move on. Hill decided to push back.
One Bill, Then Another
The Taylor County invoice wasn’t the first shock. At their October 28, 2024 meeting, the Hill board reviewed an Aspirus MedEvac invoice for $7,407.18. They had budgeted $5,000 for it. Was a 48% overrun.
A year later, the same line item ballooned to $16,967.73. That’s roughly a 240% increase over two years for ambulance and MedEvac service.
The board didn’t get a clear explanation at first. At the July 21, 2025 meeting, Robert Kirkley appeared to answer questions about the sharp increase in the Aspirus invoice. According to the minutes, he attributed the jump to staff changes and a reorganization of the service. He said the changes contributed to both the confusion and the increase in Hill’s allocation.
The board wasn’t satisfied. They asked Kirkley to go back to his board, relay their concerns, and bring back information on call performance and a resolution on the invoice amount. In other words, they wanted proof the service was actually worth what they were being charged.
The Math Doesn’t Work
Hill’s budget is built for a town of 400. When a single invoice eats through more than double its allocated budget, something has to give.
And the ambulance costs are just one piece of it.
At that same October 2024 meeting, the board learned that Taylor County’s ambulance service was short over $100,000 for a new ambulance they had ordered. A loan would be taken out to cover it. The fire district wasn’t in much better shape. New turnout gear was ordered for two members, and a loan for a new fire truck would cost $33,000 per year for seven years. That’s $231,000 over the life of the loan.
Then there’s the backfill problem. In the last year prior to that meeting, Taylor County had paid $45,000 to the city of Phillips for calls they were not able to cover. So Hill and its neighbors are paying Taylor County for ambulance service, and Taylor County is paying Phillips to actually handle the calls Taylor County can’t make.
The chain is expensive and fragile. Each layer adds cost without necessarily adding capacity.
A Rural Problem, Not Just a Hill Problem
What’s happening in Hill is playing out across rural Wisconsin and rural America. Small towns rely on regional ambulance services that cover large geographic areas with thin staffing and tight budgets. When those services raise their allocation rates, the towns pay because there’s no alternative.
The Wisconsin Towns Association flagged this at their October 2024 meeting, where the main topic was combining fire and ambulance services. Grants are available for towns that want to evaluate consolidation and startup costs. But consolidation is complicated. It requires agreements between municipalities, shifts in governance, and often political will that doesn’t exist.
In the meantime, the costs keep climbing.
Even insurance is spiraling
At their March 18, 2026 meeting, the Hill board discussed health insurance for the Roads Supervisor. Nothing comparable to their current plan was available for under $1,500 per month. The board noted that switching to America First Healthcare would mean losing access to many specialists and current doctors.
Their recommendation was to consider adjusting the monthly amount on payroll rather than switching plans. Even for a single employee, healthcare costs were becoming a budget problem.
For a town of 400, every line item matters. When ambulance costs jump 240%, fire truck loans run $33,000 a year, and a single employee’s insurance tops $1,500 a month, the cumulative pressure is enormous.
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The Pushback
What makes Hill’s story worth watching is that the board didn’t just pay the bill and complain later. They used the only use they had: they withheld payment and demanded an explanation.
It’s a small thing. But in rural government, where relationships matter and everyone knows everyone, refusing to pay a regional service provider is a meaningful act. The board wanted call performance data. They wanted to know if the service they were paying more for was actually delivering more.
The minutes from July 2025 don’t record whether Kirkley returned with that information. The invoice resolution isn’t noted either. What is clear is that Hill put the issue on the table and forced a conversation about value, not just cost. conversation is long overdue in rural Wisconsin. When a town of 400 pays $17,000 for ambulance service from a provider that pays another city $45,000 to cover its gaps, the system isn’t working. The question is whether more towns will follow Hill’s lead and demand answers before they sign the check.
For now, the invoice sits. The math doesn’t. And the next bill is already on its way.