Operating an ambulance service is an expensive enterprise, even for volunteer rescue services affiliated with volunteer fire departments.

"There's nothing in the fire or medical service that's inexpensive," said Chuck Lewis, commander of Saxonburg Ambulance, which is part of the Saxonburg Volunteer Fire Department.

A new ambulance costs between $75,000 and $120,000, just for the vehicle, Lewis said.

There are three kinds of vehicles, Lewis explained. A Type I van is the smallest, and easiest to maneuver, Lewis said. A Type II is a critical care unit, with a box style body in back and a pickup truck style front end. A Type III is the largest, also a box style truck, equipped with the most advanced medical equipment on board.

Ambulances are licensed either as BLS, for basic life support, or ALS, for advanced life support. In most of Southwestern Pennsylvania, they are licensed by the Emergency Medical Services Institute, a regional department for the state Department of Health.

A BLS ambulance carries less equipment than an ALS ambulance.

"You could probably outfit one of those for $20,000," Lewis said.

Equipping an ALS ambulance costs about $60,000, Lewis said.

A BLS ambulance is for non-life threatening situations, Lewis said. However, it may be the first to respond, and can meet with an ALS ambulance as soon as possible.

The two types of ambulances are also staffed differently.

A BLS ambulance is staffed with a driver and emergency medical technician, commonly referred to as an EMT.

An ALS ambulance must be staffed with a paramedic, who has more advanced training than an EMT.

"Having paramedics on staff is more expensive," Lewis said.

Saxonburg has three ALS ambulances, Lewis said.

EMTs cannot do invasive procedures, but can give basic aid, give certain medications such as a nitroglycerin pill for a heart attack victim, an antihistamine shot for someone with a severe allergic reaction, or oxygen to someone having trouble breathing.

A paramedic can start an IV, give medication, do more invasive procedures such as opening airways, and resuscitate pediatric and trauma patients.

There are about two dozen ambulance services in Butler County, most affiliated with volunteer fire departments.

The largest in the county, privately owned Butler Ambulance Service has about 10 ALS ambulances.

In addition to the basic life support equipment a BLS ambulance would carry, an ALS ambulance would have a heart monitor ($20,000), defibrillator ($2,500), other advanced equipment plus about $2,000 worth of drugs.

"We have enough spare equipment for another truck," Lewis said.

Lewis said Saxonburg Ambulance has a paid staff on duty from 8 a.m. to midnight, and volunteers through the rest of the night.

"We've got an annual payroll running about $250,000," he said. Benefits total another $60,000, he said.

Utilities and equipment repairs cost about $100,000, he said. Supplies cost about $35,000 a year.

Professional services, such as billing cost an additional $35,000 a year.

Insurance costs about $20,000 a year, he said.

Training costs are only about $10,000 a year, he said, thanks to the low tuition fees for staff and volunteer members at the Public Safety Training Facility at Butler County Community College.

Tuition for an EMT amounts to just $75. Paramedic training costs $500. However, neither figure includes textbooks.

Although some costs continue to increase, such as the cost of fuel and vehicles, some advanced technological equipment has actually decreased in price, Lewis said.

Regarding the cost of charges for an ambulance call, Lewis said fees for a basic life-support call range between about $200 and $300. An advanced life-support call can cost as much as $1,000.

"As a volunteer service, we try to be as inexpensive as we can," he said.

Lewis said that, like other ambulance services in the county, Saxonburg offers area residents annual subscriptions that can reduce the cost. He said the Saxonburg service also offers subscriptions to people in outlying areas not served by ALS ambulances.

"We try and help them out, Lewis said, "and include them in our subscriptions."

He said Saxonburg has mutual aid agreements with Buffalo and Winfield townships and Sarver. First responders from those areas help by getting to a location as soon as possible to give basic aid until an ambulance arrives.

"There are places it takes 15 minutes to drive to," he said. "If they can get oxygen to a patient earlier," it could make a big difference, he said.

"Subscriptions run between $20 and $40 for a family, annually," Lewis said.

The ambulance company would lower the cost for subscribers.

"We'll forgive any cost insurance doesn't pay," Lewis said.

"Check with your local ambulance company for how their subscription service works," he suggested.