Northern Dauphin County municipalities consider regional EMS authority amid funding challenges

The proposed authority would create a new way to fund and manage EMS services as local ambulance providers face financial pressures.

• Haley O'Brien/WITF
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  Haley O'Brien joined WITF in 2026. A native of Scranton, she enjoys exploring Pennsylvania's diverse communities. Haley previously worked at NPR/PBS stations in Northeast Pennsylvania and the Lehigh Valley, and has won awards for video storytelling and beat reporting.

A group of municipalities in northern Dauphin County is considering forming a joint authority to oversee emergency services as communities across the state struggle with rising costs and staffing shortages. 

Officials from five boroughs and four townships will hold a joint special meeting Tuesday, July 28, to vote on incorporating an authority that would develop a long-term plan to administer services.  

If approved, the authority would include Elizabethville, Gratz, Halifax, Millersburg and Pillow boroughs and Halifax, Mifflin, Reed and Upper Paxton townships. 

Members of the board of the Millersburg Area Ambulance Association, one of three nonprofits operating in the area, say funding issues have come from the transition of EMTs from volunteers to paid employees, more calls and costly equipment. 

“Staff expenses, equipment, supplies and insurance have really created a financial burden for all ambulance associations throughout Pennsylvania,” board member at large John Orr said. “Each year it gets a little more critical.”   

The nonprofit is funded through insurance billing, memberships and a local tax. Board members say the tax isn’t enough, and only one sixth of residents have a $50 per year membership to support the ambulance association. 

Orr says the association is not opposed to the idea of forming an authority. But they still have questions.  

Chris Dietz is project manager for the Upper Dauphin Council of Governments EMS Stakeholder Committee, which is leading the effort. The organization hired Robb consulting to conduct a study in 2025. 

“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… part of that is that they only get reimbursed if they have to transport the patient to the hospital,” he said. “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.”  

Dietz says the authority would likely impose a fee per household to maintain EMS services, but that has not been determined yet. 

“Whenever we come up with that structure, there’s going to be another hearing,” he said. “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.” 

The Municipal Emergency Services Authority of Lancaster County (MESA) formed in 2023 because of funding issues and the need for a sustainable solution. 

Debra Dupler, chair of MESA’s board, says not everyone liked the idea at first, but now has community support. 

“We did have some pushback at first from some residents,” she said. 

“If you’ve never used an ambulance you don’t really understand how important it is to have it available,” she continued. “People now are like, ‘This is fantastic because we know you’re there.’”