Damascus EMS Report Increase in Emergency Calls as Volunteer Pool Shrinks, Medicaid Reimbursement Threats

Inside the large white ambulance, there’s a radio system, oxygen tanks, and other life-saving equipment. It’s one of two medical vehicles that Damascus Volunteer Ambulance Corps uses to serve people in case of an emergency.

“It’s basic life support. We are here to expeditiously get you to major medical care,” said John Tucci, president of the Damascus Township Volunteer Ambulance Corps, the volunteer-led emergency service organization serving Damascus and other townships in Wayne County in Pennsylvania and Sullivan County in New York.

But Tucci says the number of calls to the Damascus Volunteer EMS Corps is far beyond the Corps’ capacity. EMS providers have seen a 14 percent increase in emergency calls from 331 calls in 2024 to 382 calls in 2025 to date.

Mike Bruce, a volunteer EMT with Damascus EMS, says that the region’s growing population coupled with a declining volunteer base has added growing pressure to the mostly volunteer-led organization.

“We have a lot of new residents that moved out of the urban areas and moved north,” said Bruce. Many newer residents, he says, are moving from Philadelphia and New York City where there are more healthcare options and services for residents.

Plus, Damascus EMS volunteers respond to mutual aid calls, or calls outside of their immediate service area if another township or village needs additional support.

Their biggest challenge remains not having enough volunteers to respond to emergencies, especially young volunteers.

“We don’t have a lot of 18, 19, 20 year olds volunteering,” said Bruce. “Our average age is… forties to fifties.”

In smaller, rural communities around the country, emergency volunteer responders are struggling to attract and keep volunteers. While some volunteer ambulance organizations have decided to pay some members, Tucci says that it still doesn’t solve for the high costs of training and equipment. EMT training programs in Pennsylvania can cost anywhere from $500 to $2,000.

“A volunteer organization is not gonna have the wherewithal of a commercial entity like Penn Med or Cottage Ambulance,” said Tucci.

Another challenge that’s increasingly an issue for Damascus EMS is having enough funds to sustain operations. Like other volunteer EMS providers, Damascus EMS is funded by several revenue streams, including insurance billing, donations, tax revenue, and grants. But Bruce worries that it may not be enough for the coming years.

“ How can an organization that’s doing 400 calls a year [continue]…. like most agencies, we’re only getting 50 percent of what we bill out because Medicare rates are about 50 to 55 percent billable, that we’re agreeing to accept,” said Bruce.

With looming federal Medicaid cuts, there is growing concern amongst EMS providers about the future of how rural volunteer ambulance providers will continue.

“We don’t know where we’re gonna be in two to three years. If we can get through the year with still money in our bank and people to ride in the seat, we’re gonna say, that’s a good year,” said Bruce.

Image: Emergency ambulance vehicles in front of the Damascus Township Volunteer Ambulance Corps station in Damascus, P.A. (Photo Credit: Damascus Township Volunteer Ambulance Corps)