The town is reevaluating if should have more paid medics to service the community, which has many elderly housing units and assisted living and elderly day care centers.
But few EMTs are willing to hold paid positions in Trumbull because the pay is not enough for the amount of work, TEMS officials told the Trumbull Board of Finance recently.
"Our community doesn't offer a big benefit [for paid workers]. We have nursing home after nursing home. We have a lot of special needs here that are taxing our resources," said EMT and Director of Training Michael DelVecchio.
He added that many doctor offices in town also use TEMS' services.
In comparison, Trumbull gets twice as many calls as Monroe EMS, officials said.
For the year ending April 30, TEMS finished $111,276 in the red, according an audit by James Henderson, Trumbull's Financial/Accounting Control analyst, who revealed his findings to the Board of Finance recently.
First Selectman Tim Herbst said the finance board should ask more questions so TEMS can bring back answers and perhaps request additional funding.
While the service effectively handles the calls it takes, it only makes money when it responds. But often it can only staff one ambulance and additional calls go to paid services.
Volunteer services across the United States are suffering the same problem, TEMS officials and Henderson added.
Also, TEMS is not collecting on all of its bills, and mainly deals with Medicare because of the town's senior population. The paid services make money because they can transport seniors from facility to facility, but TEMS cannot restrict itself like that, officials said.
Meanwhile, many people who take EMT classes in Trumbull are not staying afterward. According to Henderson's analysis, between June and August 2011, the most EMS calls came in between 6 a.m. and 6 p.m., when volunteers are working.
EMS officials said they could staff two ambulances with two EMTs in one and an EMT and a paramedic in another. But right now, Henderson's report found that only one ambulance was staffed during the day in the time period he studied.
Some solutions were to replace the third-party billing agency; go to an all-paid service; rent out space in the TEMS office to paid services; and regionalizing service.
John Butkus, a member of the Trumbull Emergency Medical Service Commission, concluded, "In essence we are covering 95 percent" of the service costs.
No one wanted to see TEMS as a source of revenue for the town. Finance Board Chairwoman Elaine Hammers said, "I want to break even. I just don't want to lose money."