The story starts decades ago, when the old all-volunteer fire departments started a volunteer ambulance corps to handle the job of bringing dairy farmers and other local people to the hospital. Generally, the ambulance corps grew from those roots, and so they cover areas that are not contiguous with their towns and townships.

The Pine Bush Volunteer Ambulance Corps is caught up in a tangle that derives from exactly this kind of history. The corps is headquartered at 131 Center Street in Pine Bush and serves both the Pine Bush Fire District and also the Walker Valley Fire District in the Town of Shawangunk — and there's the rub.

Historically, Walker Valley didn't have that many residents, so the Town of Shawangunk only contributed a small amount of money into the pot to cover the co-payments for ambulance patients transported by the Pine Bush Volunteer Ambulance Corps.

That has lead Supervisor Charles Carnes of the Town of Crawford to raise the obvious fairness issue. The Town of Crawford has been paying $45,000 a year to the fund for the Ambulance Corps, and the Town of Shawangunk has been paying about $5,000 a year. However, it appears that as many as a third of the Ambulance Corps' calls are to Walker Valley residents. That means, in Charlie Carnes's words, "the Town of Crawford is paying for Town of Shawangunk services, and I can't do that."

Anna Lyons, President of the ambulance corps, puts it in perspective.

"We've been going fifty years. We're strictly volunteer, so nobody is paid anything for this. We raise money though the 5K Race, and we're funded by the towns and donations. The issue is that we have this old way of doing things, but with new houses going up all the time and the population growing, the call volume rises and then we have a problem. We found that donations were depleting and we were running old rigs. We have to update our equipment, for obvious reasons. Now, we don't want to burden taxpayers with the ambulance corps, but if we weren't here, if Mobile Life, for instance came in to replace us, it would effectively cost something like $340,000 a year, plus they would bill the patients."

Bradley Pinsky, a lawyer who specializes in ambulance service issues and has been brought in by the Pine Bush Volunteer Ambulance Corps to help resolve this issue, summarizes the legal situation.

"The ambulance service bills the patient for the 20% or so that is called the co-payment, which is not paid by the insurance company. Federal Regulations require that the ambulance corps collect that co-pay from the patient, unless the town assumes the co-pay obligation. However, if the town stops paying monies to the ambulance service, then the ambulance service must collect payment from the patients it serves.

"Clearly, if the Pine Bush Volunteer Ambulance Corps did go after the patients for payment, they could collect many tens of thousands of dollars, probably a lot more than they are receiving now.

"The Town of Shawangunk is in an interesting position here. They need to, at the least, triple their payment, to equal about 25% of the patients' insurance bill total. The $5,000 they pay now isn't anywhere near that."

John Valk, Supervisor of the Town of Shawangunk, has a plan, but it will take time to implement.

"The correct way to pursue the solution here would be to form an ambulance district in Walker Valley to cover that side of the town, where the Pine Bush Ambulance Corps operates. We can't have a general tax on the whole town, because that would penalize taxpayers who rely on our other two ambulance services, based on the eastern side of the town. However, it can't get done by January, so we're looking at January 2010 for this at the earliest."

Pinsky says the ambulance corps can wait that long, while corps president Lyons says she hopes something can be done soon.

"The volunteer spirit is what keeps us going," she says. "In other towns, the volunteer services have gone and been replaced by for-profit services, and the costs have gone up a lot. We want to try and avoid that if we can."

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