Some municipalities in Berks are wrestling with imposing a tax or fee dedicated to emergency medical services as they put together budgets for 2026 and try to preserve a system in crisis.
By Amanda Fries, Spotlight PA
Pictured above: Western Berks Ambulance Association this year asked each of its serviced municipalities to help fund a feasibility study to determine the best way to raise money for new ambulances and equipment. Photo courtesy of Jason Hugg / Berks Weekly
This story was produced by the Berks County Bureau of Spotlight PA, an independent, nonpartisan newsroom. Sign up for Good Day, Berks, a daily dose of essential local stories at spotlightpa.org/newsletters/gooddayberks.
As municipal leaders in Pennsylvania hold budget workshops for 2026, some have proposed or are considering a tax or other monetary payment to preserve emergency medical services in their communities.
Across the commonwealth, ambulance companies have folded or adjusted coverage areas to stay solvent, increasing response times and stoking fear over the future of EMS.
The crisis has been called out by EMS providers and highlighted in a study released last year that recommended more funding for Berks County’s EMS. Still, local and state officials have been slow to fully address the problem.
By law, Pennsylvania municipalities need only ensure EMS is available. They aren’t required to fund it.
Instead, services are paid through insurance, whether public or private. But that doesn’t cover the entirety of the cost, which is why providers want communities to help pay.
Less than half of the commonwealth’s over 2,500 municipalities pay for EMS. Elected municipal officials can pay for these costs out of their locality’s main account, typically called the general fund, or they can set money aside using a special real estate tax and restrict that income to EMS or fire services.
Only about a dozen of Berks County’s 72 municipalities have a designated EMS tax. Another 30 communities, the EMS study estimated, pay providers an annual “membership” fee that ranges from $100,000 to $250,000.
The study by Albright College’s Center for Excellence in Local Government recommended myriad service efficiencies and improvements, like creating regional EMS authorities to pool resources and funding, as well as educating the community on funding needs and establishing adequate EMS tax rates in municipalities.
These findings came as little surprise to Western Berks Ambulance Association CEO Anthony Tucci, who has gotten about 10 municipalities to pay the org for services in its coverage area in recent years (some of which will take effect next year). But the report has driven home the need for all municipalities to pay, he said.
“It’s educating the public to where they need to understand that public safety needs to be funded 100%,” Tucci said. “While the voluntary ambulance offered Cadillac service for so long — municipalities were given great service — now it’s come to the point where you’ve got to pay for it.”
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The borough of Wyomissing established a membership fee in 2024 with Western Berks.
“Council made the decision to fund resident memberships, understanding the consequence of not doing so,” Wyomissing Borough Manager Michele Bare said. “I personally can think of few things scarier than calling 911 for fire, police, or EMS and there being a delayed response or no response.”
The borough of Leesport proposed a 0.5 mil tax in its 2026 budget to fund emergency services for the first time. This would add $50 to the property tax bill of a home assessed at $100,000. Elsewhere in the county, Washington Township officials are also considering an EMS tax, while Exeter Township officials are looking at shifting to that model from an existing membership fee.
“The staff is currently putting together some options for the Board of Supervisors, and implementing an EMS tax is among the considerations we’ll be tasking the board with,” Exeter Township Manager William Heim said.
Emergency medical services were historically staffed by volunteers, who chose to help their neighbors and community without compensation.
The field began with police officers and volunteers staffing horse-drawn wagons to carry the injured and ill to the hospital or a doctor. That morphed into local organizations like fire companies, service clubs, or funeral directors, providing ambulance services.
But it wasn’t until the formation of Freedom House, an ambulance service that operated from 1968 to 1975 in an impoverished section of Pittsburgh, that the modern EMS system in America took shape.
Freedom House was staffed by young Black men and women who volunteered as medics in Black Pittsburgh communities like the Hill District. The medics were the first to treat cardiac arrest with chest compressions, rescue breathing, and intubation outside of a hospital. They traveled with EKG machines and various medications to use on the scene.
Those services have become more specialized and advanced, necessitating more training for staff, updated equipment, and higher compensation. But funding didn’t keep up.
Ambulance services in Pennsylvania today are mostly paid, Tucci said, but “they’re not funded by the municipalities the way they should be.”
EMS is paid through insurance coverage, whether that’s private health insurance, Medicaid, or Medicare, but those payments don’t cover the entire cost of the service.
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Private insurers pay an EMS agency directly only when there is an existing contract in place. In other cases, insurers remit payment to the patient, and the EMS agency must pursue the individual for reimbursement.
Meanwhile, the federal Centers for Medicare and Medicaid Services sets payouts for those programs, and if the services are denied for a patient, the EMS agency is left with no way to collect payment.
EMS agencies may have endowments that can assist with operating revenue or acquiring facilities. They also host drives and fundraising events to cover special capital projects or general expenses.
Western Berks Ambulance Association this year asked each of its serviced municipalities to help fund a $27,000 feasibility study to determine the best way to raise money for new ambulances and equipment. The study is moving forward, Tucci confirmed.
That leaves taxes — direct payments from municipalities to agencies — as the final mechanism of raising funds.
To assist in that endeavor, Pennsylvania lawmakers last year approved Act 54, raising the fire tax limit to 10 mills and the EMS tax cap to 5 mills for about 150 boroughs and townships in Bucks, Delaware, and Montgomery Counties. A bill approved earlier this year in the state House would expand that opportunity to more than 1,400 additional municipalities, like Washington and Exeter Townships in Berks County. The legislation has yet to be considered by the state Senate.
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