Around here a community usually selects a private EMS service for a three year term. 99% of the time the company's only compensation comes from charging from transports.
Around here, the municipalities have the right to designate their emergency service providers... usually, they choose the closest department, taking into account the status of the department - are they all volunteer, and have a 6-7 minute dispatch-enroute time? Do they get out in less than 4 minutes? Are they partially paid, and the ambulance gets out almost immediatly?
In my area, most EMS agencies have a paid presence on station, at least daytime. Many agencies have staff on station 24x7.
That being said... all the township/borough/city does in name the provider. There is also usually an expectation that some amount of the tax money goes to the FD/EMS every year... this is often based on population and tax #'s... and is NEVER enough.
I know one EMS agency approched a township and offered to locate a 24x7 911 truck in the township if the township gave them the WHOLE township (instead of the 40% they had)... If the township provides anything, it is just a "station"
