They’re banding together providing pre-hospital emergency medical care.

But the United New York Ambulance Network says that care could be at risk under the 2019-2020 state budget proposal.

"In Onondaga County, when you call 911, you'll get an advanced life support paramedic ambulance," said Onondaga Ambulance Directors Association Jim Hogan.

Responders say the proposal cuts payments to providers by eliminating the 20-percent coinsurance Medicaid covers on behalf of patients with Medicare, known as crossover payment. Secondly, doing away with the Medicaid supplemental funds for ambulance providers

"This could lead to fewer ambulances on the road...likely EMT and paramedic layoffs and the very real possibility of ambulance services closing their doors," said Hogan.

"This really is an unsustainable situation in order for us to keep going. It doesn't matter large or small,” said AMR-CNY Operations manager Ken Case. “It's going to affect everybody."

Workers say they're already facing certain challenges without the cut such as staffing and long wait times.

"We'll bring a patient from the street into a hospital and there's sometimes a two-hour wait time to get them off of our stretchers into a hospital stretcher,” said TLC Medical Transport Service and United NY Ambulance Network Chairman David Butler. “That ties up an ambulance. Trying to find qualified staff is very difficult."

Which they say trickles down to current responders

"You have dedicated people behind me that work 24-hours a day providing healthcare,” said Butler. “They're getting burned out."

So for the state, they have a clear message.

"The state has charged ambulances to be there for the sick and injured New Yorkers regardless of the patient's ability to pay,” said Hogan. “Now the state must be there for ambulance by not skipping out on their portion of the bill.”