The Wilmington Volunteer Fire Department is in between a rock and a hard place - or more precisely, a state property tax cap and state regulations.
Town Supervisor Randy Preston, said Wilmington raised its budget this year for a part-time emergency medical technician to work on the weekends.
"The discussion was, that isn't going to be enough," he said.
Right now the town has emergency medical services Monday through Friday from 8 a.m. to 5 p.m. There is one paid EMT who works the weekdays and eight volunteers. Because there is not enough emergency call volume in Wilmington, it's hard for the department to recover costs from insurance companies for ambulance runs.
"There is no place else for the fire district to come up with the money besides property taxes," Preston said.
Travis Howe is executive director of the Mountain Lakes Regional EMS Council, an agency that oversees and supports EMS providers in the counties of Essex, Franklin, Warren, Washington and Clinton counties. He said there is currently a paradigm shift in how ambulances are staffed.
"Advancements in technology and pre-hospital care has led to an increase in training hours and regulations." Howe wrote. "People now expect a highly trained and equipped ambulance crew to show up when they need help. Volunteers have been the backbone of our system for many years, and many people can no longer afford to help."
Howe said volunteers are having a hard time with the costs, travel and hours of training involved in attending EMS classes several nights a week.
"Fire Department based EMS can still work in many places but unfortunately those agencies cannot bill for services like separate EMS organizations." Howe wrote. "Revenue recovery has created staffing opportunities and can ease the burden of taxation but the law currently does not allow fire departments to utilize this avenue of funding."
Preston said state regulations for emergency medical services were leading less people to volunteer.
"A basic EMT used to be an 80-hour course," Preston said. "Now it's 140-plus hours. There is no such thing as a volunteer Advanced Life Support technician because of the commitment."
He added he was a firm believer in training, but the state had to take into consideration the outcome of rigorous regulations.
Preston questioned if the regulations are worth it for places like Wilmington.
"Some of the doctors I've spoken to locally said we are not changing the (patient's) outcome with all this burden."
The idea of consolidating services into one larger ambulance district is an idea being tossed around by some to solve the bind Wilmington faces. Preston said if a consolidation occurred, it could possibly be between Wilmington, AuSable Forks, Keene and Lake Placid.
However, Preston doesn't think the idea is feasible for Wilmington. If an ambulance had to drive from Lake Placid to Wilmington to pick up a patient, it would take too long and cost too much, he said.
"I don't know how consolidating saves the costs," he said.