YOUNGSTOWN — A study determined that a city-run ambulance service may be feasible at least five years from now — costing more than $5.6 million in just its first year — and it would be best for Youngstown to renew its contract with an outside entity to handle that for the foreseeable future.

The Vindicator obtained a copy Monday of the 136-page study by Public Consulting Group LLC of Boston, which was paid for $44,500 for the work.

The study states the city “is at a pivotal moment in shaping the future of its EMS system. Based on the findings and the current landscape, PCG believes that while the city may eventually be able to own and operate its own ambulance service in the distant future – five years or more – the most viable option for the near future is to continue utilizing a private EMS provider.”

It adds: “By prioritizing contract renewal, exploring a hybrid rescue ambulance model and developing a sustainable funding strategy, Youngstown can ensure continuity and operational efficiency while providing reliable, high-quality services to the community. Long-term investments in staffing, infrastructure and community education will further strengthen the EMS system’s resilience, enabling it to meet growing demand and serve the city well into the future.”

The city signed a three-year agreement in December 2022 to pay $3.968 million in total to Emergency Medical Transport for ambulance service using American Rescue Plan money with a two-year renewal option.

That contract, which expires Dec. 31, states the city must decide by Friday whether to get out of the deal or it automatically rolls over for the next two years, with EMT getting a 3% increase in 2026 to $1,403,061 and another 3% increase in 2027 to $1,445,153 in 2027. The city will have to fund the ambulance expenses through its general fund.

Mayor Jamael Tito Brown said Monday the city plans to let the contract automatically renew for two years.

Brown said he hasn’t reviewed the study and plans to hold a meeting in July, August or September with the consultants, city council members and others to discuss it and future options for the city.

“We haven’t done anything with the study yet,” he said. “We’re waiting for the consultants to get back to us and discuss the recommendations. We’ll share all that information. I don’t want to piecemeal it.”

The study quotes Brown as saying citizens wouldn’t support a city-run ambulance service, through its fire department, because it “would be perceived as a reduction of service, and though he understands how the changes could make the EMS system more efficient, he does not believe this is the best time to attempt” it.

Brown said Monday that his statements in the study need further context and he would explain that when a meeting takes place.

The study states it would cost the city $5,612,678 to create its own ambulance service, with $1.44 million going toward the purchase of six ambulances, $2,574,060 to hire 36 employees with the rest of the expenses for ambulance and communications equipment and training.

With salaries and benefits making up a large part of the expense of future years, operating a city-run ambulance service the year after buying the vehicles would cost $2,899,058 and increase to $3,424,909 by the fifth year, according to the study.

That is more than double the amount the city will pay EMT next year.

The study points out that of the seven fire stations, only four have space to house an ambulance and five of the stations “appear to be in a deteriorated state from deferred preventative maintenance, age and lack of repairs.”

Chris Weaver, president of the city’s firefighters union, said an ambulance service out of the fire department is definitely feasible and a majority of the firefighters support it. But it has to be negotiated with the union.

“It’s a lot of logistics,” he said. “It’s been talked about for several years. It’s at least two years out and it’s all got to be negotiated. If we don’t negotiate, it’s not going to happen.”

The study recommends the city eventually create a “hybrid rescue ambulance model” at the downtown station that would dispatch firefighters with EMS credentials “to fill service gaps when EMT units are delayed or unavailable.”

That would cost $1,079,253 over a five-year period though it doesn’t include the purchase of an ambulance.

“This cost-effective model expands EMS capabilities without overburdening YFD firefighters, allowing them to maintain focus on fire suppression during peak times,” the study reads.

The study also urged the city to replace its aging fire department fleet, hire additional firefighters who are either EMTs or paramedics when current firefighters leave, and look for financial sources to create an EMS fund.

The study states: “For now, the most viable option is for the city to continue utilizing a private provider as this would provide the most cost-effective solution. The least expensive city-owned model would involve hiring civilians and integrating EMS management under the fire department, but this could lead to personnel issues due to differences in culture and workload distribution between firefighters and EMS personnel.”

PCG wrote in the study that the Youngstown firefighters they spoke to favor a city-run ambulance, but most of them had a lack of confidence or trust in the city’s ability to handle EMS.

There’s been a lengthy list of disputes between the union and fire Chief Barry Finley since his February 2018 appointment as chief, including about 50 grievances, a December 2019 vote of no-confidence, a number of unfair labor practices against the city and multiple lawsuits.

The study states a city-run ambulance service “would provide a comprehensive and integrated model of emergency medical services, offering the city better control over service quality, cost-effectiveness and long-term sustainability. By transition to this model, Youngstown could improve response times, generate revenue through EMS transport billing and enhance its fire-based EMS system. However, significant investments in staffing, equipment and infrastructure would be necessary to establish and maintain the system. The city would also need to address the challenges of funding, labor negotiations and staff recruitment to ensure the success of this transition.”

Getting the PCG contract finalized proved to be challenging and time-consuming.

Council voted in November 2023 to move ahead with the study after postponing or rejecting the proposal at six other meetings dating back to February 2023.

It took the administration until April 2024 to select Public Consulting after getting two proposals.

Finley had initially proposed hiring Public Consulting in February 2023. Some council members were critical after Finley said he found the company while doing a Google search. Council members insisted that an open search be done — and the administration selected Public Consulting after that.

Finley said at a June 2023 council safety committee meeting that it is not financially feasible for the city to operate its own ambulance service, but would abide by the study’s results.