PITTSBURGH -- It's a busy time at Ross/West View (Pa.) Emergency Medical Services Authority.
When the company's 20 paramedics and EMTs aren't running out to care for the sick in their 25-square-mile coverage area, they're focused on raising the money needed to keep the ambulances rolling with the annual subscription drive.
"A lot of people think only old people need an ambulance," said Jennifer Swab, a 17-year veteran paramedic with the company. "You think, 'It can never happen to me,' but it can. Anything can happen to anyone, anytime, anywhere."
One of the largest EMS companies in Allegheny County, Ross/West View is one of four municipal EMS groups and dozens of nonprofit companies struggling to find financial stability. Depending primarily on third-party billing, subscription services and capital campaigns, the majority of the 51 EMS companies in the county receive no tax money to cover increasing overhead.
The groups are looking to the state for help. The Legislature is considering three bills that would require municipalities to ensure paramedic services are provided. Only police and fire departments are on that list now.
"It would be a great stride for EMS organizations," said Jeff Kelly, an operations supervisor. "If we (fall) on hard times, it gives us something to fall back on."
Some EMS companies have survived through consolidation, said Tom McElree, executive director of the Emergency Medical Service Institute in Point Breeze, which regulates the EMS council for the state Department of Health in 10 counties.
There are definite advantages to having a larger EMS company, said Steve Shurgo, director of Eastern Area Prehospital Services in Turtle Creek. The nonprofit EMS company serves more than 40,000 residents in a 13.8 square-mile region of Edgewood, Swissvale, Turtle Creek, Wall, Wilkins and Wilkinsburg, and is the result of a merger of several smaller EMS companies. Shurgo said there have been very few changes since the merger.
"There aren't any difficulties just because we're larger," Shurgo said. "Money is always tight, but everyone has a charity they prefer to give to. Sometimes it's us, sometimes it's not."
The nonprofit receives some contributions from Edgewood and Swissvale, but mostly is funded by third-party billing. Meanwhile, Ross/West View is one of four municipal authorities that have the ability to tax residents but choose not to. The others are Valley, Medical Rescue Team South Authority and McCandless Franklin Park Ambulance Authority.
"There definitely is a perception that when you call, you get an ambulance no matter what," McElree said. "They expect that EMS is provided as part of their municipal services."
Many residents thought their EMS companies were receiving taxes several years ago, McElree said, when the state changed the $10 occupational tax to a $52 EMS tax -- Emergency Municipal Services tax, not Emergency Medical Services tax. Rather than supplying funds to local EMS companies, the tax funded municipal projects, McElree said.
"People said why buy a $40 subscription when they're taking $52 out of my pay?" McElree said.
While they aren't the backbone of a company's budget, subscription programs are integral to EMS funding. Still, residents aren't biting. At Eastern Area Prehospital Services, just 6 percent of the area's residents subscribe.
At the other end of the spectrum is Ross/West View, where 40 percent of the more than 52,000 residents living in the EMSA's service area are subscribers. While the service offers various plans for families and individuals, Kelly said not enough residents are taking advantage of the subscription, which represents 7 to 10 percent of the company's operational budget.
It costs more than $400,000 to have an ambulance parked 24 hours a day, 365 days a year without spinning a tire, McElree said."We're not just there waiting, this is our job. We are not a tax-based service; the money has to come from somewhere," Kelly said. "Taking people to the hospital is what we do."