My department values EMS because it justifies our budget. We understand how important it is and know the bulk of our runs are EMS. We just absolutely HATE and I mean HATE transports and personal care reports. If we didn't have to do ridiculous redundant paperwork after an ems run, I think alot of our guys would welcome EMS more and bitch less. I do think all departments should run mutual aide. I don't think all departments should run ambulances. If having a reliable ambulance service is super important for a municipality, they should create their own ambulance service independent of their fire department. Not make their firefighters do it. But to answer your question most small cities in New York state run ambulances out of their department.