By Stephen T. Watson
The Buffalo News
TONAWANDA, N.Y. — The Town of Tonawanda says it expects to clear just over $250,000 annually from its new ambulance service, with program revenue far exceeding expenses.
Reimbursement from private and public insurers will outpace the town’s cost for its ambulances, medical equipment, gasoline and the EMTs who will provide this service, Tonawanda Supervisor Joseph Emminger said in an interview.
| HOT TOPIC: Cincinnati proposal would charge nursing homes up to $1,000 per non-emergency lift assist call
Emminger shared the updated financial projections with The Buffalo News shortly before he planned to present them at Monday evening’s Town Board meeting.
“This is a moneymaker,” he said.
This comes two months after Tonawanda officials announced they were scaling back their ambitious plan, revealed in October 2024, to launch a municipal ambulance service that would replace the town’s existing private provider, Twin City Ambulance.
After a year of delays in winning state approval for the service and struggles to hire enough people to staff the ambulances, the town now is moving ahead with a program that will have fewer town ambulances and EMTs and more help from Twin City.
Emminger said the downsized program, now expected to launch in January, still will offer improved service to Tonawanda and Kenmore residents in a way that makes financial sense to the town and to Twin City.
“We have a balance in this arrangement that I think will give them what they’re looking for, as well as making sure that we have enough call volume that we can actually support our operation,” Twin City President Terrence Clark told The News.
The town unveiled its ambulance plans at a news conference 14 months ago.
Emminger said then that concerns raised by town officials over delays in ambulances responding to emergencies in Tonawanda and Kenmore prompted them to investigate whether to start their own service. After receiving a consultant’s analysis, the town made plans to purchase four ambulances and hire 20 EMTs to support a 24-hour, seven-day-a-week municipal program.
Officials from Twin City, the town’s ambulance provider, said they were blindsided by Tonawanda’s announcement. Clark at the time said the town never brought up problems with the company’s service record and questioned the conclusions reached by the consultant, Fitch & Associates.
The town originally said it anticipated starting the service in early 2025 but the launch was delayed for months as Tonawanda officials waited for required approvals from the State Health Department and as they ran into unexpected difficulty in hiring EMTs.
By late summer and fall, as the proposal came under criticism from town Republicans, Tonawanda officials were negotiating with Twin City executives on a public-private partnership model for ambulance service in the town.
Under the two-year agreement approved by the all- Democratic Town Board in October, the town will use two of its four ambulances to cover eight-hour shifts − 10 a.m. to 6 p.m. − seven days a week, with one ambulance in use and one available as a backup.
Twin City will respond whenever the town’s ambulance is unavailable during this shift and will provide full coverage the rest of each day, officials said.
“We’re enhancing our emergency medical service,” Emminger said.
Two of the four ambulances are ready for use and two remain in storage, Emminger said. The town borrowed $1 million to purchase and equip the ambulances but received a $250,000 state grant through the office of Assembly Member Bill Conrad, D- Town of Tonawanda, to cover the cost of one of them.
The town has hired four full-time EMTs and two part-time EMTs who are ready to start work. The last remaining obstacle is obtaining a certificate of need from state health regulators, an approval that could come any day now, town officials said.
The service should launch sometime in January, though Emminger was reluctant to be more specific given that previously predicted start dates have come and gone.
The town’s cost to pay for EMT salaries and benefits, debt service on three ambulances, fuel, space to house the two ambulances in service, the third-party company that will handle billing, medical supplies and EMT uniforms and other expenses is expected to reach $816,000 annually.
The town estimates it will handle about three basic or advanced life support calls per day, or 1,100 per year, as well as 675 calls where town paramedics will accompany transports made by Twin City Ambulance.
Reimbursement rates vary. Generally speaking, private insurers reimburse at a higher rate for an ambulance ride than public payers such as Medicaid or Medicare, and the town predicts close to a 50-50 split for its transports.
The town assumes a blended rate of $653 per advanced transport and $564 per basic transport, or $664,000 annually.
Combined with new, increased revenue from Twin City “intercept” transports that require the presence of a town paramedic, the town expects to take in $1.07 million in revenue each year.
This would leave the town with a net gain of about $253,000 annually through its ambulance service, if the calculations hold. Emminger said the town was conservative in its estimates and is confident the scaled-back service will still be a revenue-generator for Tonawanda.
“If we did all this work and found out that we couldn’t make it work with the one shift, we would have sold off the four ambulances. We wouldn’t be moving forward,” he said.
Any revenue collected by the town is payment for an ambulance transport now handled by Twin City.
Clark said the company still takes issue with some of the town’s previous claims about Twin City’s service, and the way the municipal ambulance corps was announced.
But he joined Emminger in saying the relationship is better today and the deal protects the financial interests of both parties.
“We have a good agreement in place that, ultimately, will allow them to actually make money, and provide enough call volume for us that we can maintain a presence in the community and continue to operate pretty much the way we have been,” Clark said.
© 2025 The Buffalo News (Buffalo, N.Y.).
Visit www.buffalonews.com.
Distributed by Tribune Content Agency, LLC.
