See my post #30.
It’s the same here and they are busy busy round the clock. All our firefighters are emt’s. Then they turn them over to the paramedics of the ambulance company. Firefighters are always first on scene here.
Contract ambulances work okay, if you get one of the better managed companies, and if you hold them to a quality standard. In situations where the city fathers go for low bidder, they can be a nightmare. I once dispatched for a company that was so underfunded that we only had one of the pieces of equipment we were supposed to have on each rig. Om pre-inspection nights, we’d move everything into the rig that was going to be inspected (and sometimes swap tires too), then spread it around again after that rig passed.
I remember one night when we had a run, my closest station’s rig was out of gas, and we’d just discovered the gas credit card had been cancelled for non-payment. They made a code 3 to me, I dashed out and handed them my last 5 bucks, they hit the gas station across the street, then went on their run. The company finally got shut down when the Highway Patrol pulled a surprise inspection on all the rigs at once.
The economics of the ambulance business are very marginal. They’re at their worst running 911 calls, because collection rates are low, and community supplementation rates are always being squeezed. The best company in my town back in the day was run by a guy who had a real commitment to the community, and a tow company. The tow company subsidized the ambulance business.