Historically, fire protection and EMS provided by fire departments have been funded as part of the municipal budget; only ambulance companies billed for their services. Pressured by the tax revolts of the 1970s and 80s and the fiscal crises of the early 1990s and late 2000s, EMS and fire administrators are thinking like entrepreneurs, increasing organizational efficiency, and seeking out new revenue streams. Changes in health-care financing and new legislation are challenging, traditional approaches to managing EMS. These pressures are particularly difficult for EMS and fire providers as they come at a time when there are increased demands for the services they provide and a need to add capacity in order to prepare for emerging threats to public health and safety, such as terrorism and pandemic.

Public safety providers need to know the range of possible funding alternatives available to them, especially those that have proven effective. This manual describes alternative sources of funding and revenue-producing opportunities that may be used to finance EMS and fire protection systems.