Youngstown is facing the very real possibility of having no ambulance service come the first of next year.

Some city officials say they aren’t willing to subsidize the service, but without the subsidy the only company currently proving emergency medical service says it likely won’t stay put.

American Medical Response, or AMR, the company providing ambulance service within city limits, took the first step Wednesday to halting that service when it sent a letter notifying Youngstown officials it would cease service within 90 days without a financial subsidy.

Some council members have spoken out against AMR’s request for financial assistance, but until now, they have done little to nothing to serve their constituency by shopping around or comparing prices and services. We are most disappointed that no one in the city has taken ownership of this issue. For quite some time, communications from AMR went without response, and until very recently there was no interest in seeking Requests for Quotes (RFQs) or seeking other providers for comparison.

It’s essentially too late to do that now in earnest.

City officials’ lack of aggressiveness on this critically important issue now has backed them into a corner.

In Wednesday’s letter to Youngstown leaders, Edward B. Van Horne, AMR’s chief operating officer, said the ambulance company’s “decision comes after a three-year effort to find a solution for a sustainable and operationally effective system to extend this relationship.”

Still, he said the company remains prepared and willing to meet and negotiate with city officials.

It’s past time for that to occur.

Last month, AMR officials told The Vindicator that without an annual city subsidy of at least $750,000, the company could be forced to close its Youngstown operations. AMR’s existing contract doesn’t include a subsidy, and an effort to add one was rejected in April by city council.

For many months after that, AMR officials told us their attempts to talk were met with silence.

Finally, after Vindicator reporter David Skolnick pursued the matter in recent weeks, some talks occurred.

An AMR official told us he met last week with Councilwoman Lauren McNally, D-5th Ward, and Councilman Mike Ray, D-4th Ward, has reached out to schedule a meeting.

Good.

AMR tells us its funding request was made because an average ambulance run costs about $300 and Medicaid reimburses about $130, so AMR is losing a significant amount of money. About 54 percent of all ambulance calls in the city are for Medicaid recipients.

Earlier, the company sought a $62,500 monthly subsidy retroactive to March 1 for a total amount of $625,000 for this year. The payment was recommended by the administration, but council rejected it 6-1 on April 25.

Now, Van Horne says, “More recently, inflationary pressures and rising fuel costs have dramatically increased the cost to provide our life-sustaining services. Any incoming private provider will have the same pressures and any insourcing by the city with the fire department will likely increase citizen taxes and greatly exceed private industry costs.”

Without help from Youngstown, it’s unlikely any private company will provide service in the city. But we don’t know that for certain because until now, city leaders really haven’t explored their options.

Suggestions that the city should consider creating its own ambulance service also do not seem feasible because of even higher costs for setup, equipment, maintenance, staffing and training. To be clear, we generally oppose government-run services that compete with private enterprise.

Mayor Jamael Tito Brown said he supports negotiating a subsidy if that’s what it takes to keep ambulance service in the city.

“It’s not an ideal situation, but it’s my goal to make the citizens of Youngstown safe,” he said. “I’m willing to spend the funds to make the subsidy happen. It’s up to council.”

We agree.

This is not about just dollars and cents. Ambulance service is a safety issue, and it’s a social issue. If it is not resolved, then it also will become a political issue. It never should get to that point. Frankly, it never should have gotten to this point.

Government exists for the sole purpose of providing essential services to residents. Emergency response is at the top of that list.

Youngstown’s elected leaders owe it to city residents to ensure they have uninterrupted ambulance service. They must immediately head to the table with AMR and find a way to resolve this issue so their residents are not left in a lurch.