FAQ – Frequently Asked Questions

Sand Lake Ambulance is a combination of a volunteer and paid agency. SLA is run exclusively by volunteer members. To raise our level of services and improve response times, we supplement our volunteer staff who cover nights and weekends by hiring paid paramedics to be in-house 24 hours a day, 7 days a week. We also hire an emergency medical technician (EMTs) to be on duty between the hours of 6 AM and 6PM seven days a week and sometimes on weekends. We have volunteer day time drivers to assist the paramedic and EMT during the day as well as volunteer drivers in the evening.  This has allowed us to keep our response times and level of care among the best in the county.

Volunteers typically are on-call one night per week (6PM to 6AM) and one weekend every five or six weeks, and also attend monthly member meetings and periodic drills. Training to become an EMT is usually a 14-week class offered two or three nights per week. Training to become an Emergency Vehicle Operator (EVO) is on-the-job and the duration of training depends upon call volume and the progress shown by the EVO trainee. Most longtime volunteers eventually serve in some office (e.g. Secretary, Treasurer, Board Member), which entails additional responsibilities. People who want to support us with their time, but do not want to ride on a crew are also welcome to donate services (e.g. clerical skills, accounting, fundraising, etc.). Call us at 518-674-2221 or stop by one of our meetings (7:00, the first Wednesday of every month) for more details.

A small number of our volunteer members are trained as paramedics, but in order for our agency to be certified to provide ALS services, we are required by the NYS Department of Health to have ALS staffing 24 hours a day, 7 days a week. Our volunteers generally work full-time and have families and other personal obligations. Many of our volunteers also serve in our local fire departments and/or in the National Guard or military reserves. It has become increasingly difficult in recent years to recruit and retain reliable volunteers. Other small local ambulance services face similar challenges and sometimes are not able to complete a crew to get their ambulance out of the garage. This results in an ambulance having to be dispatched from a neighboring agency, which delays services. Our paid paramedics (and paid EMTs) enable us to generally avoid this situation to ensure that town residents receive advanced life support emergency medical services as quickly as possible.

Not all ambulance services are staffed with paramedics. Sand Lake Ambulance was not staffed with paramedics until the middle of 2005. Before Sand Lake Ambulance became an ALS agency, it took 15-45 minutes for a paramedic from outside the town (often Troy or Cohoes) to reach our patients. In situations where transport could not be delayed, the paramedic would 'intercept' the ambulance en-route to the hospital.

Currently, our fully equipped paramedic arrives on scene within minutes (depending on location of course) of a call being dispatched and sometimes 5-10 minutes before the volunteer-staffed ambulance arrives. This is far better for our patients than having to pull over on the way to the hospital so that a paramedic from outside the town can board our ambulance. Clearly, the sooner a seriously ill or injured patient receives ALS care the better the outcome.

We do not receive any County or State funding. We also do not receive any funding from or through the fire departments. We do have a contract with the Town of Sand Lake to serve the Town. Partly due to having some paid staff, but for many other reasons as well, it is estimated that it cost well over half a million dollars a year to operate SLA. SLA leadership estimates that 50% of income will be realized from billing insurance recovery, about $30,000 from its annual fund drive, and a small about from interest earned. The Town contract is for slightly less than 50% operating costs.

Based on information obtained from the assessor’s office, the average taxable parcel in the Town of Sand Lake is assessed at $189,419. The taxpayer impact due to our contract to operate SLA is less than $75 on the average parcel per year for paramedic level ambulance coverage.

There are many operating expenses related to running an ambulance service. The vehicles and building must be paid for and maintained, fuel must be purchased in large quantities, and medical equipment and supplies must be paid for. Medical supplies are becoming progressively more expensive and expiring supplies means they must be discarded if not used by the end date. We may have to throw away supplies that cost hundreds of dollars to purchase. Maintaining a paid paramedic in-house and weekday EMT staffing when most volunteers are at work is also a very significant expense. Although we would like to operate based only on donations from the community, this is not even remotely possible. While we have a contract with the Town of Sand Lake to provide service, that contract barely covers half the cost of operation. One of our goals is to keep the cost of the Town contract as low as possible. Billing insurance companies and other health care insurers helps reduce significantly the size of the contract the Town needs to sign. The time our volunteers contribute is the equivalent of over a quarter of a million dollars a year compared to a paid agency.

EMTs are trained to provide Basic Life Support (BLS), which includes basic first aid for illness and injury, cardiopulmonary resuscitation (CPR), and basic airway management.  Paramedics bring the emergency room into your living room or the scene of an emergency. Paramedics are trained to provide Advanced Life Support (ALS), which includes all BLS skills, plus advanced airway management protocols, interpretation of hospital grade 12 Lead ECGs, and the administration of life-saving medications by injection or IV lines. About two-thirds of our calls require a paramedic. Our paramedic staff is paid and daytime EMT’s are paid but most nights and week-end are covered by volunteer EMT’s.