Five Greene County mountaintop towns are seeking to combine their ambulance services into one district, hoping to recruit more emergency workers, improve response times, and share rising costs.

Ashland, Jewett, Lexington, Prattsville, and Windham plan to apply for a $1.25 million grant through the state Department of State’s Local Government Efficiency program, Windham Supervisor Tom Hoyt said. If the towns receive the funding, he expects the district could be in place by mid-2027.

The five towns would jointly oversee the district, but how they would divide expenses and whether residents would face a new or changed tax haven’t been determined, Hoyt said. Working out those details would be part of the planning supported by the grant.

The proposal follows years of discussions among mountaintop supervisors about how to sustain emergency medical services in their rural communities.

“In that conversation, it’s always been what are we doing with our EMTs, what are we doing with our paramedics, how can we make it easier, better, a better response time,” Hoyt said. “We’ve been talking for years about how we can work with each other and make a better system.”

The towns already rely on overlapping coverage. Ashland provides ambulance service to Lexington and Prattsville, while Windham covers Jewett. Agencies regularly cross municipal boundaries to help one another, and all five towns also work with Greene County Paramedics.

That reliance on mutual aid is part of the reason for the proposed merger, Lexington Supervisor Robert Riccardella said.

“We’ll be able to stabilize that, give everybody one good pay scale, benefits and everything,” he said. “They’ll be working for a town organization, so they’ll be in the pension system.”

Recruitment is one of the biggest challenges facing Windham’s ambulance service, said Davia Montie, the town’s ambulance administrator.

“People look at what we have to do, and they’re like, ‘Why don’t I just become a nurse and I’ll make double what you’re making and I’ll be in a controlled setting,’” Montie said. “A lot of people come to this and use it as a stepping stone.”

Windham has four full-time staff members and two ambulances at its joint ambulance and senior center on South Street, near the Ashland town line. Built in 2023, the center has a kitchen, sleeping quarters, and training areas. At least two crew members are on duty at all times, Hoyt said.

A larger district could support more full-time positions with benefits, making emergency medical services a more attractive career, he said.

“If we do a merger, we’ll have more full-time employees,” Hoyt said. “You’ll get a health plan, vacation time, personal time. You’re getting a career out of it.”

The towns are already proposing higher spending on ambulance services for next year.

Windham’s tentative 2027 budget would increase emergency medical services spending 21.4%, to about $1.07 million from $884,513 this year. The town plans to raise hourly pay to $25 from $23 for emergency medical technicians and to $30 from $28 for paramedics. Hoyt is also seeking to hire another full-time paramedic.

Ashland’s tentative budget would increase ambulance spending 14.4%, to $825,080 from $720,939. The town also plans to raise its pay rates to match Windham’s.

A combined district could purchase supplies together. Montie pointed to the expense of medications that crews don’t always use.

“There’s medications that are just through the roof,” she said. “We don’t use them all, we end up throwing them away.”

Hoyt also wants to standardize billing practices across the towns.

“If someone refuses medical attention, and we charge $75, is Ashland charging $75, or are they charging $250?” he said. “We want to keep parity on what the industry standards are.”

Combining insurance coverage could offer another opportunity to save, he said.

“We each have our insurance companies,” Hoyt said. “If we were to combine it, we could shop for a better rate.”

Two of the seven mountaintop towns, Hunter and Halcott, aren’t participating in the initial proposal. Hunter is the only mountaintop town besides Ashland and Windham with its own ambulances.

Hunter Supervisor Sean Mahoney said his town would likely join later, after Windham and Ashland work through the initial consolidation.

“We wanted to let Windham and Ashland, which are two big systems, merge first,” Mahoney said.

He said Hunter supports the effort but wants to give the other towns time to resolve the challenges of combining their services.

“Our intention would be to really, strongly jump into that at a later date and have a true mountaintop district,” he said. “It’s not that we disagree with it in any way.”

Halcott has no paved road connection to the rest of Greene County and receives ambulance service from Margaretville Hospital in neighboring Delaware County, Supervisor Samantha Wickham said.

The five participating towns plan to use the grant to help cover the planning and legal work needed to establish the district, Hoyt said. Applications are due at the end of the year, he said, and the towns would contribute a local match equal to 10% of the grant award, or $125,000 if they receive the full amount sought.

Creating the district would also require coordination with state health officials.

“There’s going to be the element to legally make a district, but we’re also going to have to work with the state Department of Health on a certificate of need,” Hoyt said.

Equipment would need to be brought into alignment. Ashland’s ambulances provide basic life support, while Windham’s provide advanced life support, Hoyt said. Windham’s ambulances, for example, carry ventilators; Ashland’s don’t.

“If we were to merge, we’d want to standardize the rigs in Ashland with our rigs,” he said.

Those differences would be among the challenges the towns would have to resolve before combining their services.

“It’s going to be a lot of work, but I think it’s a good direction for the people that get the service,” Hoyt said.

Connor Greco is a staff reporter for The Overlook covering Windham, Hunter, and surrounding Greene County communities. Send correspondence to connor@theoverlooknews.com.