Ambulance Prices Have Tripled. Princeton’s Rescue Squad Wants Help

PRINCETON, NJ — The Princeton First Aid & Rescue Squad is asking the town to start buying its ambulances. The squad says the trucks now cost about $500,000 each, and donations and insurance payments can't keep up.

Ari Meisel, the squad's executive director, presented the proposal to Mayor Mark Freda and the council on Monday. Council members praised the squad's work but did not make a decision.

Subscribe

"We are not going to provide a reply tonight," Councilman Brian McDonald said. He added that the governing body would ask for more information if needed and then have "a bit of an internal process to talk about how we want to move forward."

What the squad is asking for

Under the plan, the town would buy ambulances through the state contract and purchasing cooperatives it already uses. The squad would write the specifications.

The town would own each vehicle for its first three years, then transfer the title to the squad. When an ambulance is retired, it would go back to the town, and any resale money would return to taxpayers. Meisel said South Brunswick and other towns use a similar setup.

The squad would still handle staffing, training, dispatch, insurance and maintenance.

"Residents see no change in who shows up or how fast," Meisel said.

The squad estimates the cost at $200,000 to $250,000 a year, averaged over the ambulance replacement cycle. That would come on top of the $125,000 the town already gives the squad each year, which is the most state law allows for operating support.

Meisel said the vendors don't currently require deposits, so on today's terms the town's first payment would come in 2028. The squad's schedule calls for new ambulances in 2028, 2030, 2032 and 2036.

According to the squad's presentation, the program would cost about $3 million over 13 years.

The squad has answered Princeton's 911 medical calls for 87 years. It responded to 3,573 calls in 2025, with an average response time of 5.6 minutes. Meisel said that compares with an average of eight minutes in New Jersey and 10 minutes nationally.

Call volume is up 21 percent from the last year before the pandemic and has grown about 7 percent a year since 2021. Meisel pointed to more residents, an older population, new housing and a busy downtown.

Operating costs have nearly doubled over a decade, mostly because the squad has shifted from volunteers to paid EMTs. The squad runs five ambulances on a 20-year cycle and used to buy them with donations and reserves.

"That worked at $160,000," Meisel said. "It does not work at $500,000, with two to three years from order to delivery."

He added that New Jersey doesn't classify EMS as an essential service the way it does police and fire, so no state funding is set aside for it.

"The question in front of Princeton is not whether the town will have EMS," Meisel said. "It's whether Princeton keeps the independent, locally accountable service that, on average, last year responded in less than six minutes."

According to Meisel, the squad is one of only three fully independent EMS providers left in Mercer County, along with Trenton and Hopewell.

Councilman David Cohen asked how the squad's recent rate increase was affecting its finances. The base rate went from $900 to $1,200 a transport in March.

Meisel said the squad ended last year with a structural deficit of about $300,000 but is "on track to end up in the black" this year.

Cohen also suggested asking Penn Medicine Princeton Medical Center to contribute, since the hospital doesn't run ambulances of its own in Princeton.

"I really would like to see them kick in, you know, in the same way that we and the university already are," Cohen said.

Meisel said the hospital already supports the squad. It recently sponsored the squad's golf event, and the two are discussing a training center for new EMTs at the squad's building that the hospital would run at no cost to the squad.

Councilman Leighton Newlin asked whether the town should also plan for more staff as Princeton grows. Meisel said the squad has 55 volunteers in the pipeline and more than 100 members, the most in many years as far as he knows. He added that the squad recently moved its fifth ambulance out of reserve and into regular service.

Councilwoman Mia Sacks described the care her aging relatives received from the squad as "incredibly professional" and "prompt."

"If we had to prioritize anything, I think this is ... something that I think we should prioritize," Sacks said.

Council President Michelle Pirone Lambros said she would support moving forward. She asked whether the ambulance money would come from the capital or operating budget.

Freda said the money would likely come from the operating budget. Interim CFO Joseph Monzo has said an ambulance's useful life is too short for the town to count it as a capital expense. Freda added that the early plan was to put the money in a reserve fund and draw on it whenever an ambulance purchase comes due.

Freda said the squad's next steps would go through the town's finance committee. He also noted that the squad bills the university and the schools for event standbys, and it bills out-of-town patients the same as Princeton patients.

The squad's full presentation, including seven appendices, is in the agenda packet for the Oct. 26 meeting.

Have a correction or news tip? Email sarah.salvadore@patch.com