A quarter of a century ago, we wrote about the passion Kenneth Mackey had for helping his fellow townspeople when they needed it most.

He knows what it is like to need an ambulance. Mackey has walked with a steel bar in his leg for over 40 years.

“I was in a real serious auto accident when I was 18 years old, due to a drunk driver,” he said then. “I was seven months in the hospital...I’ve never forgotten what it is like to need an ambulance.”

Back then, in 1988, twenty-four volunteers were on the roster of the Westerlo squad that Mackey captained; they answered 168 calls. The next year, there were four fewer volunteers and many more calls.

“Although 20 members are on the roster only seven or eight ride continuously,” said Mackey; that year, he estimated he rode on 90 percent of the calls. “I’m getting burned out, but I’ve got to be there,” he said.

Fast forward to current times. Typically there are 300 calls answered annually by Westerlo. How many volunteers? Eight.

And, yes, Mackey is still one of them. So is his wife, Deborah Theiss-Mackey. They should be beyond burned out; they should be incinerated. But no, their constant care continues.

This month, at the Westerlo town board meeting, Brian Wood, Albany County’s emergency medical services coordinator, made a proposal meant to ease the burden for Hilltown volunteer ambulance squads. The rural squads have held their own far longer than in urban and suburban areas, which long ago started hiring paid emergency medical technicians and paramedics years ago.

We give great credit to the Mackeys and volunteers like them who put the needs of others in the community above their own.  Wood calculates that, of the 700 emergency medical services calls, in the Hilltowns annually, about 300 are handled by the Westerlo squad. Each squad provides 17,520 hours of EMS coverage to its residents, and that is not even counting the monthly meetings and drills or the continuing education and recertification, which total 100 hours more for each member every year.

This time-consuming lifesaving service is being provided by just three one-thousandth of the population in Westerlo.

And Mackey is not alone. All three of the squads have one member who answers more than half the calls. Wood points out, if any one of them were hurt or sick, there would be a major gap in the coverage.

The county looked at several options and presented the least expensive one: $94,700 to be split among the three participating Hilltowns — Westerlo, Berne, and Rensselaerville — based on population.

Commenting on a “drastic decline” in volunteerism statewide, Sheriff Craig Apple said, “When the economy bottomed out, everybody just had to go out and get second jobs, third jobs; spouses had to work...We’re looking to try to fill the void.”

The plan is to have a paid county emergency medical technician serve the Hilltowns 12 hours each day.

Theiss-Mackey raised a variety of concerns, ranging from county workers not taking proper care of squad equipment to the current practice of having the county go ahead of the local squad when a second tone goes out Theiss-Mackey spoke with great passion that welled to anger. We have no criticism of the swearing or yelling that came with that passion.

We understand what it is like to pour your life — your brain, your brawn, and your heart — into something you care about and do well. To have to relinquish any control is excruciating.

Yet the time has come to face reality. More help is needed. Every one of the Mackeys’ concerns must be heard and answered. But including the county as part of the plan is essential if lives are to continue to be saved.

In 2012, Albany County stepped in with the Voorheesville squad when the number of volunteers lagged; the sheriff’s department workers covered Voorheesville ambulance calls from 6 a.m. to 6 p.m. every weekday. That pilot program was at no cost to the town of New Scotland or the village of Voorheesville, which both support the squad financially. The Voorheesville volunteers continued to cover nights and weekends; they were pleased with the plan and have seen an uptick in their membership.

It would make no sense to cut off dedicated volunteers. The annual salary for a single emergency medical technician is in the neighborhood of $55,000. But besides the financial benefit, there’s a community benefit to be served by those who know you.

Any plan to centralize or consolidate has to be considered carefully, with the pros and cons investigated and weighed. Often, a cost savings isn’t great enough to cancel a lost identity. Right now, for example, after a consultant came up with scenarios for efficiency, many in the village of Altamont are eager to see their elementary school stay open. The school board will have to carefully consider what would be lost educationally by closing a small community school and also investigate what, if any, the savings would be. The board also needs to cast a wide net in finding other options for using space efficiently as enrollment in the district declines.

The situation with the Hilltown ambulance squads is very different. No one is advocating shutting down the squads; rather, this plan is meant to be an aid to help them continue, to still harness the worthwhile volunteer services while cost effectively providing essential life-preserving coverage.

Who knows? Maybe the economy will improve. Americans once thought after decreasing the workday from 12 hours to 10 and then eight, that four was in sight. With more leisure time, more might volunteer. But that doesn’t look realistic any time soon. Also, the ranks are graying as fewer young people volunteer for the squad.

We learned from one of our elders this week as we sat on her front porch, to interview her for a story about her 95th birthday. She came of age in the Great Depression, part of a hardworking Hilltown family of nine that didn’t see itself as poor.

Helen Quay Coulter first learned to sew from her mother, a practical skill in hard times. After she left the one-room schoolhouse in Knox to attend the central school in Berne, she had to make a skirt in her home economics class.

“The teacher was telling us to mark the pattern a certain way. I said, ‘It’s using way too much material.’ I didn’t have any more material,” she told us.

Coulter didn’t need to follow the established pattern; she used what she had. She made a fine skirt and wore it with pride.

Now is the time to use that same frugal Hilltown spirit. Stitch together what we have; make it work. Maybe the established pattern won’t work. We can’t make something out of material we don’t have. If there aren’t enough volunteers, a county EMT can make the new plan work.

Twenty-five years ago, Ken Mackey told us, “When I got my first save, you couldn’t get me off the clouds.” He had, at that point, brought back two patients with cardiopulmonary resuscitation.  We’re sure there are many more in the Hilltowns who literally owe their lives to the Mackeys and others like them.

We need to respect these volunteers and answer their concerns but, at the same time, we need to embrace a plan that will keep on saving lives.

As Mackey said, “Nothing makes you feel better than helping someone who needs it.”

— Melissa Hale-Spencer