Rockland Paramedic Service units are paged at the same time the BLS service is for all calls and responds using non-transporting units (suburbans). Since the VACs and the RPS units are on the same channel, they can talk directly to each other for coordination (best access, patient status updates, etc.). Transport, with or without the paramedic - depending on the patient's condition, is handled by the volunteer corps. See http://www.rocklandparamedics.org/ for details.
Regional EMS, in Rockland, is a service that provides interfacility transfers, routine transports, and other non-emergent services (i.e.: ambulettes). See http://www.rocklandmobilecare.com/ for details.
In Orange County there are two ALS providers (main ones) Mobile Life and Regional EMS. Mobile Life handles most of Orange County, Regional has Warwick, Minisink, Mt. Hope, Deerpark and those areas.
They are dispatched on any call that WAU718 feels paramedics may be needed for. Once on scene, they either transport the patient themselves, have the VAC transport them, or go "Medic Aboard" which means one Paramedic riding with the VAC.
In Orange County, as said before, Orange 911 (as it was called 718) codes the call at BLS or ALS. If the call is coded ALS, the agencies ALS service is dispatched at the same time as the vollys. The vollys may also request ALS and make an ALS intercept with the unit.
The three main ALS units are Regional EMS, Mobile Life Support Serivces and Transcare.
Regional EMS (REMS) covers: Greenwood Lake VAC, Warwick VAC, Pine Island VAC, Florida VAC, Lenape VAC, Greenville VAC, Port Jervis VAC, Chester VAC
Mobile Life (MLSS) covers: Monroe VAC, Woodbury VAC, Highlands VAC, Newburgh VAC, Montgomery VAC, Goshen VAC, Walkill VAC, Pine Bush VAC. They also are primary for the cities of Middletown and Newburgh and for the town of Otisville.
Transcare covers Cornwall VAC.
Blooming Grove VAC and New Windsor VAC have their own paramedics.
Tuxedo VAC is covered by Rockland Paramedic Medic 31.