HILLTOWNS — The Town of Westerlo’s senior judge and a welder, Kenneth Mackey responds to almost two-thirds of the calls the local ambulance answers in the town of 3,360.

That, for Brian Wood, the county’s emergency medical services coordinator, illustrated the need for a shared ambulance service in the Hilltowns as he and Sheriff Craig Apple spoke to the Westerlo Town Board on Aug. 5. They told the town board the volunteers are working hard, but they’re stretched too thin.

Mackey and his wife, Deborah Theiss-Mackey, who serves on the Westerlo Rescue Squad’s board of directors, are now in their fifties. Theiss-Mackey acknowledged the squad, like others in the Hilltowns and across the country, might need help as its ranks aren’t being replenished by younger volunteers. She said squad members are split in how they feel about the idea.

The proposal for the three local squads — Westerlo, Rensselaerville, and Helderberg Ambulance — would use tax money and revenue from transportation billing. Twelve hours a day, seven days a week, a paid emergency medical technician from the Albany County Sheriff’s Office would be the first responder in the county’s own van ambulance. Wood said the county’s ambulance would serve as support, and a local volunteer could still respond to a daytime call.

“It’s a Band-Aid, but it seems to be what will work for now and what will be most affordable for the towns as we move forward,” Wood said during the meeting. He stressed to The Enterprise that he is willing to work out a different logistical plan once he gets agreement from the three towns, which he likened to the three legs of a tripod.

Apple and Wood said Westerlo was the remaining town board to agree to the shared service. Town and ambulance leaders have given verbal approval to go ahead. The fourth Hilltown, Knox, has not been included in the discussion. It has no squad of its own, but is served by Helderberg Ambulance, Altamont Rescue Squad, and Guilderland paramedics.

The current plan would cost $94,700, to be split based on population among the three participating towns. Almost $40,000 of it would come from Westerlo, where the 2-percent cap on levy increases equals about $25,000. 

Theiss-Mackey warned during the board meeting that the squad’s future is uncertain, saying the county should be helping it plan as the Hilltown volunteer squads may eventually not exist. She said that a mutual-aid plan the Westerlo and Helderberg ambulance boards of directors set out in a letter to the county years ago wasn’t acknowledged and should be revisited.

“The communication has to start and it needs townspeople’s input as well. They don’t want to volunteer,” said Theiss-Mackey, who has worked on the squad as an assistant captain, secretary, treasurer, and training officer.

In other areas of Albany County and surrounding counties, squads have dealt with weak volunteerism by creating staff with some or all paid members. The nationwide trend is blamed on a lack of community service in a younger generation in the face of more stringent training requirements and the economic pressure to work more. Theiss-Mackey said young volunteers have taken the training they received working with the Westerlo squad and gone to paying jobs.

“I’ve seen every agency that’s gone paid,” said Eve Aragona, who works with the paid Mowhawk Ambulance service in Rensselaer County and a volunteer for Westerlo Rescue. “The volunteers just stop responding after a while.”

“Ma’am, that’s my biggest fear,” Apple responded.

Wood told the The Enterprise he faced hesitation from Westerlo and Helderberg ambulance squads when the sheriff’s office first started its county-wide ambulance service in 2009. At the time, Wood said, Westerlo didn’t give its support for the county’s certificate of need, the authority to operate in the county, preferring to focus on a mutual-aid plan.

“Mutual aid means exactly what it is: ‘You help us; we’ll help you,” Wood told The Enterprise. “If you can’t do your work and you require somebody else to come help you, then how is it mutual? Because you can’t help them.”

The county ambulance leaves to respond as soon as the first call is made, but it is considered the second responder and may stand off if a local volunteer handles the call first. In some cases, the county aggressively pursues response, Theiss-Mackey said, assuming a local squad won’t arrive first because it didn’t acknowledge the call on the first tone.

 “I like that system that we can help each other out as neighbors,” Gerald Cross, the longest serving member of Helderberg Ambulance, told The Enterprise of mutual aid. “We all know that probably there will be a time, whether its in the near future or later on, that you won’t be able to get enough volunteers to provide ample care for the needs of the town.”

The county service is funded through town budgets and billing patients for transportation. Westerlo budgeted $84,500 for the county ambulance this year, up from $50,000 the year before. The Westerlo Rescue Squad’s budget is $100,000, which has remained steady for the past several years, despite its recent purchase of a new ambulance, following large increases since it first incorporated.

Westerlo, unlike the other Hilltown squads, does not bill any of the patients it transports.

Wood and Apple fended off suggestions from residents during the Aug. 5 meeting that the county was smothering the volunteer squads.

“Everybody says we’re trying to come in and take over your ambulance,” Apple said, responding to a resident. “The last thing we want to do is see the volunteer ambulance squads go by the wayside, because we cannot survive without” them.

Wood noted the county has a certificate of need, but said becoming the main ambulance service in the Hilltowns is “not realistic.” By his calculation, running a basic life support ambulance 24-7 would cost almost $380,000, not including the cost of housing.

Cross, a director for the Helderberg Ambulance, which covers Berne and about half of Knox, said he is OK with the back-up service the county ambulance currently provides, but he’s reluctant to have a paid service that he considers destructive to the volunteer squads until the squad is unable to meet patients’ needs.

“I walk into the house and people call me by name,” said Cross. “The confidence and comfort of knowing somebody that’s there puts them more at ease and I think a lot of times with a paid service you don’t have that.”