The landscape of emergency medical services (EMS) in northern Dauphin County is on the brink of significant change. As local ambulance providers face mounting financial pressures, a group of municipalities is considering the formation of a joint authority to oversee and fund these critical services. This innovative approach aims to address the growing challenges of funding and staffing that have plagued EMS providers across Pennsylvania.
The proposed authority would bring together five boroughs—Elizabethville, Gratz, Halifax, Millersburg, and Pillow—and four townships, including Halifax, Mifflin, Reed, and Upper Paxton. A joint special meeting is scheduled for Tuesday, July 28, to vote on the incorporation of this new authority, which would develop a long-term plan to administer EMS services in the region.
Financial Struggles and the Need for Change
The Millersburg Area Ambulance Association one of three nonprofits operating in the area, has been grappling with significant financial burdens. The transition from volunteer emergency medical technicians (EMTs) to paid employees, coupled with increased call volumes and the cost of advanced equipment, has strained the organization’s resources. Staff expenses, equipment, supplies, and insurance have really created a financial burden for all ambulance associations throughout Pennsylvania said John Orr, a board member at large for the association. Each year it gets a little more critical.
The nonprofit relies on insurance billing, memberships, and a local tax for funding. However, the current tax revenue is insufficient, and only one sixth of residents contribute through an annual $50 membership. This financial gap has left the association seeking alternative solutions to sustain its operations.
The Role of the Proposed Authority
The Upper Dauphin Council of Governments EMS Stakeholder Committee is leading the effort to establish the new authority. The committee hired Robb consulting to conduct a study in 2026, which revealed a structural deficit in the funding model of local ambulance companies. There’s a structural deficit in the amount of money that local ambulance companies retrieve or are able to cover from each call that they make explained Chris Dietz, project manager for the committee. Part of that is that they only get reimbursed if they have to transport the patient to the hospital. They go on a lot of calls that they may not have to transfer the person to the hospital. They don’t get any reimbursement for that.
The proposed authority would likely impose a fee per household to maintain EMS services. However, the exact amount and structure of this fee have not yet been determined. Whenever we come up with that structure, there’s going to be another hearing Dietz noted. And that’s when the exact number that we’re planning for is going to be shared and discussed, and the structure of how it’s going to operate is going to be shared and discussed with the municipalities that have joined the incorporation ordinance and the public.
Lessons from Lancaster County
The Municipal Emergency Services Authority of Lancaster County (MESA) offers a compelling case study for the proposed authority in northern Dauphin County. Formed in 2026 due to funding issues and the need for a sustainable solution, MESA has since garnered community support. Debra Dupler, chair of MESA’s board, shared that initial pushback from residents has given way to widespread appreciation for the service. If you’ve never used an ambulance, you don’t really understand how important it is to have it available she said. People now are like, ‘This is fantastic because we know you’re there’.
As northern Dauphin County moves forward with its proposal, the experiences of MESA and other similar authorities could provide valuable insights into the potential benefits and challenges of this new funding model. The upcoming vote on July 28 will be a crucial step in determining the future of EMS services in the region.
