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.