Ulster County seeks an evaluation of its existing EMS system and training. Recommendations will inform County efforts to ensure the long-term success, viability, sustainability, stability, and improved efficiency and safety of EMS services over the next 10 years with a focus on patient-centered solutions. The study should provide a comprehensive review of the EMS system described above. This will include, but is not limited to, each agency’s service area and demographics; deployment of EMS resources compared to call locations; strengths and opportunities for improvement identified through a combination of on-site assessment, focus groups, case studies and interviews; analysis of data on call volumes, transports and response times; agency staffing, organizational structures and finances; mutual aid impacts; an overview of hospital capabilities and capacities; EMS training levels and availability; and 911 policies and procedures. The final report should identify at least three options to improve service and enhance program sustainability, quality, efficiency and affordability. This should include consideration of public, private or regional consolidations, or establishment of new services. Options should include potential costs, governance structures and other considerations for implementation. The selected consultant will present findings in a public forum to be designated by the County Office of Emergency Services, Office of the County Executive, and the County Legislature.