Last year, both the Gloversville-based Ambulance Service of Fulton County and the Johnstown Area Volunteer Ambulance Corps shut down due to financial hardship, leaving greater Amsterdam volunteer ambulance services to pick up the slack. 

Democratic Assemblyman Angelo Santabarbara is pushing for more support for rural ambulance services by introducing legislation to create a task force to study the specific challenges rural ambulance services face. Ambulance travel times in rural communities are often quite long, meaning the care received by responding paramedics is critical. 

Financial stress is putting a strain on rural ambulance services and their ability to stay open. Santabarbara wants to create a task force to study the unique challenges they face. 

"You're looking at longer travel times, you're looking at weather challenges; rural roads are a lot different than what you would see, say, in the city of Schenectady. This task force is meant to bring challenges to light," Santabarbara said.

Dean Romano is the executive director of Rotterdam EMS. It's an unfunded operation that survives on 'fee for service.'

"When they call 911, an ambulance has to respond. We do because that's the right thing to do, but if the patient can't pay or the patient's insurance can only pay a portion of the bill, that's what we have to accept... It's always been about taking great care of sick people but when you don't get paid for the service you provide or get paid so little, you can't continue on," Romano said.

Rotterdam EMS has faced its share of instability. In 2013, Rotterdam's ambulance services operated basic life support and transportation while paramedics were employed by the police. The town terminated the paramedics program to save money and sought to contract Mohawk Ambulance — which would, in turn, put Rotterdam Ambulance out of business. 

"We rallied together and brought the ambulance service to an advanced life support level, we hired all the paramedics that were with the town of Rotterdam — so nobody lost their job and the town board decided to give the contract back to Rotterdam EMS," Romano said.

But Rotterdam EMS, like many other ambulance services, still struggle to stay afloat on their lean budgets. Santabarbara and Romano are hoping this task force could help come up with dedicated state funding.

"This would hopefully stabilize our funding stream and hopefully make it a little more robust," Romano said.