When Crisis Leads to Collaboration: A Case Study on Lansdowne Fire Co., Lansdowne Borough & Narberth Ambulance

Via Narberth Ambulance

Under the looming threat of an EMS service crisis, Narberth Ambulance, Lansdowne Fire Company, and Lansdowne Borough formed an innovative, thriving partnership that has secured reliable, around-the-clock prehospital emergency care and medical transport for Lansdowne residents.

This case study details the origin and evolution of this partnership, which began in September 2023, and serves as a framework for other municipalities in Pennsylvania and beyond seeking a solution to their own struggle to provide citizens with 24/7 EMS support.

Lansdowne Fire Company, which serves 11,000 residents in Delaware County, PA, is licensed to operate the ambulance it owns and houses, but it does not have its own EMTs. For many years, Lansdowne used EMS staffing provided through Trinity Health. However, there were days when Trinity failed to assign ambulance staff to Lansdowne due to a shortage in staffing.

The gaps in staffing grew more frequent by 2022. Residents were never without care, but when there was no one staffing Lansdowne’s ambulance, help took longer to arrive. Under Delaware County’s emergency services guidelines, the closest available ambulance responded. But traveling from another town could add minutes to response time and in an emergency, every second counts. Additionally, the ambulance the fire company paid to maintain sat idle while payment for ambulance services went to the responding agency, costing the fire company revenue that helps cover the cost of operations.

Concerned Lansdowne Fire leaders started researching other options, leading them to Narberth Ambulance.

“We had been meeting, sharing information, and building trust with each other, since 2022,” said Narberth Ambulance Executive Director Albert Davey. Those talks were still in progress when Trinity sent the fire company notice in 2023 that it would stop providing EMS staffing to the one-square-mile, working-class borough entirely unless Lansdowne agreed to surrender its basic life support (BLS) ambulance license and accept that Trinity Health would only guarantee 75% staffing. Fire company leadership could not accept that staffing lapse risk, and finding a new arrangement became more urgent. Other Delaware County first response agencies who relied on Trinity staffing received similar notices and Delaware County officials began pressuring EMS leaders to ensure proper coverage in a time of uncertainty, but Lansdowne Fire had a head start since it was already considering Narberth Ambulance as a potential service provider.

Lansdowne fire company and nonprofit Narberth Ambulance built an agreement that assured Lansdowne’s residents would have the 24/7 ambulance service they deserved, every day of the year. A borough communique called it “the most responsible choice going forward,” and the Borough Council agreed to cover the cost — most of which is recouped through reimbursement for ambulance services provided to nearby communities through the county’s emergency services guidelines. Service launched in September 2023.

A Winning Collaboration: Lansdowne’s Ambulance, Narberth Ambulance’s Skilled Staff

Narberth Ambulance is no stranger to stepping in to provide EMS coverage and staffing in unserved communities. It became the EMS provider for Haverford Township in 2016, began providing advanced life saving (ALS) services in Conshohocken and West Conshohocken in 1999 and has been saving lives in Lower Merion Township and Narberth since 1944.

Davey said each relationship is different, custom-built to a community’s needs. In Lansdowne Borough’s case, the fire company “hosts us,” he said. Lansdowne Fire Company still owns the ambulance, which bears its insignia. The fire company owns the station, the office space, and the bunk rooms where on-duty ambulance personnel stay.

While the partnership is funded by (and has the full support of) Lansdowne Borough, the agreement is between Narberth Ambulance and Lansdowne Fire Company.

“We report to President (Mike) Boyce and are managed fully by the fire company, not the municipality,” Davey said. In other municipalities where Narberth Ambulance provides staffing, it reports to an emergency management coordinator, a township manager or a chief financial officer.

The six full-time and six rotating part-time EMTs who staff Lansdowne’s ambulance are Narberth Ambulance employees who were hired or assigned with the Lansdowne community’s needs in mind.

“They had people who they already knew and trusted, and we also assigned some of our members who live in Delaware County,” Davey said.

Narberth’s contract called for providing the BLS ambulance staffing, as Lansdowne’s previous provider did, but Narberth Ambulance is an ALS agency and always brings that mindset with them, adding EpiPens, albuterol breathing systems, CPAP machines, glucometers and Narcan treatments to the ambulance, expanding the BLS care the ambulance can provide. Narberth Ambulance also brings its focus on clinical excellence, which The American Heart Association recognized with Mission: Lifeline Gold status, a benchmark for cardiac arrest reporting and survival.

The very first week that Narberth Ambulance EMTs staffed Lansdowne Fire Company’s ambulance included a major 9-1-1 call — a gas-leak at Grace Court senior apartments in nearby Yeadon. The team delivered 23 senior citizens, including many who use wheelchairs, to safety. Things have not slowed down since then.

“We estimated there would be 1,500 to 1,800 calls per year,” Davey said. “The surprise of our relationship is it’s been double that.” In 2024, the team responded to 3,133 calls, averaging nine calls for EMS assistance per day.

A Greater Need Than Expected

Just 1,048 of those calls were in Lansdowne. The majority of calls came from elsewhere in Delaware County, including Upper Darby, Yeadon, East Lansdowne, and Drexel Hill as directed by county mutual aid agreement. Lansdowne Fire Department bills for these services and the revenue generated have largely offset the cost of their Narberth Ambulance contract.

Lansdowne is an “aging medical community” and many residents have cardiac and respiratory issues, Davey said. Calls from across the ambulance service area run the gamut from cardiac arrest to trauma, including gunshot wounds. In response, Narberth upstaffed Lansdowne’s ambulance in June 2025 to include a mix of EMTs and paramedics, who have additional medical training and can provide additional emergency care. This level of care is possible thanks to Narberth’s ALS license, yet Lansdowne Fire’s BLS license remains intact.

“We are so fortunate that Borough Council made a commitment to the residents of Lansdowne to allow the fire company to bring Narberth Ambulance into our community,” said Lansdowne Fire Company President Michael Boyce.

Foresight in 2023 Spares Lansdowne from a 2025 Countywide Calamity

Planning ahead could not have worked out better for Lansdowne Borough.

Less than two years later, in May 2025, Crozer EMS and other Crozer Health entities — including Crozer-Chester Medical Center and Taylor Hospital — ceased operations. The collapse placed a strain on the Delaware County system so significant that several stop gap measures were taken to buy both county and EMS providers to meet the increased demand. Delaware County declared a state of emergency and agreed to pay for paramedics for 90 days, giving municipalities three months to find solutions. Lansdowne’s early planning meant this situation had no impact on their response and with the reduction of ALS units systemwide, on June 22, 2025 the Fire Company elevated its status to a paramedic staffed ambulance and the Lansdowne unit has significantly increased in both volume and acuity.

Ridley Township has followed its lead and contracted with Narberth Ambulance in April of 2025. Under this contract, Narberth has provided a paramedic intercept vehicle staffed with one paramedic. Housed at Ridley Township’s Holmes Fire Company, the Narberth team responds in conjunction with ambulances from the Holmes and Woodlyn fire companies.

Securing Beneficial EMS Outsourcing Requires Homework

Outsourcing EMS services can be very beneficial if the provider is willing to take the time to understand your community’s specific needs, Davey said.

“Residents of every municipality expect their leaders to provide prehospital healthcare and transport, but that doesn’t mean the municipality or a first response organization within it has to run an ambulance company,” he said. “It can be a business service that you purchase, but you need to identify a provider committed to partnership with you to develop the best product you can for your residents.”

Municipalities interested in the contract model should thoroughly research every EMS provider on their short-list, Davey said.

Davey also advised that municipal leaders speak with leaders from neighboring communities, who may also be struggling. “Pennsylvania has many small municipalities, and one ambulance service could provide excellent coverage to a group of them. That means the costs would also be shared,” he said.

EMS Outsourcing Quality Checklist

Outsourcing EMS staffing can greatly benefit any municipality, provided leaders carefully vet every provider they consider. Davey offers this checklist:

• Can you trust this provider to deliver when you need them?
  • Ask the county or 9-1-1 center and/or the provider themselves to provide response metrics to help gauge operational readiness.
• Assess clinical excellence
  • Has the provider achieved American Heart Association Gold or Platinum Certification?
  • What equipment do they carry on their ambulances, and what medicines will they bring on calls? Look for advanced airway tools and assess the assortment of pharmaceuticals, as not all ambulances carry all medications.
• Is the provider fiscally responsible?
  • Meet with the billing team to assess the solvency of the ambulance company.
  • Ask for three years of financial statements and tax forms. Look for debts and liabilities.
• Are they a good employer?
  • Do they have a human resources program?
  • What is their average staff tenure?
• Do they enjoy long-term commitments?
  • Look at the duration of their current provider partnerships.