At a recent meeting, Carlisle Fire Company asked Milford City Council for an increase in funding from $250,000 last year to $300,000 this year. The department explained that the growth of Milford is making it difficult for them to keep up with EMS and fire services.
“With the growth of the city, what we were five years ago, what we were ten years ago and what it will be in the future, we just keep growing and growing,” Lewis Sacks, President of the fire company, said. “People are relocating as we heard from the organizations that preceded us. People are moving here, some are of an older age, causing the ambulance to increase how much they are running.”
In addition, Sacks explained that with Bayhealth Sussex Campus relocating to the edge of city limits and the old hospital becoming multiple medical facilities, ambulance needs have grown considerably. Banyan, PACE Your Life, La Red and the assisted living area in Milford Wellness Village have added to the burden of EMS services.
“We are running to Banyan five or ten times a week and it is becoming a lot, plus new facilities have grown by the new hospital with PAM rehab and other future plans,” Sacks said. “Nemours and PAM are right across the parking lot but they cannot transport, they have to call an ambulance, so we run out there to carry a patient across the parking lot.”
Sacks explained that there was a plan to construct a substation on the east side of Rehoboth Boulevard to provide better coverage, but this was somewhat down the road as they negotiate with the landowner. Sacks also pointed out that there are now three buildings on their property on Northwest Front Street which meant additional water, sewer and electric usage.
“In 2024, we had 5,069 ambulance requests and out of those 3,942 were within city limits, that’s 78 percent of our call volume,” Sacks said. “As of now for 2025, just starting in January, we are already over 900 calls. I don’t have the breakdown about whether they are in city limits or not, but we are possibly going to go over 6,000 calls this year, just with the ambulance.”
Sacks pointed out that the number of ambulances available were not enough for the calls and Carlisle had to rely on other companies, including Greenwood, Frederica and even Georgetown. The cost of a new ambulance is now between $300,000 to $400,000 and Milford had one on order but there is a delay. Sacks pointed out that he had not even gotten to the fire service and the need for fire trucks.
“The cost factors we see in our everyday lives are hitting us in the fire service,” Sacks said. “The vehicles, insurance, vehicle replacement, our last ambulance cost $200,000 and now they are up to $300,000 to $400,000. A tower ladder that was bought at one time was just over a million. Now they are $2.1 million and higher. Equipment costs are up with costs of $50,000 to $60,000 for minor things. We also have healthcare insurance, overtime, dental, payroll taxes, all of that adds up.”
Councilman Jason James asked how long it takes for another company to cover runs in Milford. Sacks explained that he did not have the details down to the very minute, but that it would depend on the location of the run and which company responded. He pointed out that if the run was to Bayhealth in the summer, it could take ten minutes or longer.
“We have what we call the golden hour which if you have a distressed patient, you have one hour from the time of the call to get them into the hospital for the best outcome,’ Sacks said. “After that, it dramatically increases the chances of morbidity.”
Councilman Dan Marabello pointed out that he needed an ambulance a few years ago and it was half an hour before the ambulance arrived, stating “that half hour is everything.”
“Recently, my family has been going through some medical conditions as well and had to call the ambulance a couple of times,” Sacks said. “What really hurts is that the ambulance charged $900 but the insurance company only paid $100 of that bill. There are also, unfortunately, a lot of homeless people that we are serving and not getting reimbursed, so that makes it hard as well.”
