FAQs
What is the Alle-Kiski Emergency Services Authority (AKESA)?
The Alle-Kiski Emergency Services Authority (AKESA) is a public municipal authority created by Brackenridge Borough, Harrison Township, and Tarentum Borough under Pennsylvania’s Municipality Authorities Act.
AKESA was created to provide reliable, professional, and financially sustainable emergency medical services through a unified regional system. Its purpose is straightforward: to make sure our communities have a professional EMS system that is staffed, equipped, and ready to respond when an emergency occurs.
Why was AKESA created?
The traditional EMS model has become increasingly difficult to sustain. Local EMS providers face rising operating costs, workforce shortages, declining subscription and donation revenue, and insurance reimbursement that does not fully support the cost of maintaining a 24/7 emergency response system.
AKESA provides a regional structure to address those challenges together, rather than expecting individual EMS agencies or municipalities to solve them independently.
How long has this been in development?
The process began approximately two years before the Authority was created. EMS leaders and municipal officials from the participating communities formed a working group to examine the long-term sustainability of local EMS. The group reviewed financial and operational information, considered different options, worked with professional consultants, and ultimately developed the regional Authority model.
The group also held a public community presentation at Highlands High School on December 4, 2025, to explain the proposal and receive public feedback.
Were professionals involved in developing AKESA?
Yes.
The participating municipalities and EMS agencies worked with professional consultants experienced in Pennsylvania municipal authorities and regional EMS systems.
The planning process also included the people who understand the local system firsthand: EMS chiefs, emergency medical professionals, municipal managers, elected officials, financial professionals, legal counsel, and other local stakeholders. This combination of professional expertise and local operational experience helped shape the Authority.
Has AKESA officially been created?
Yes.
On March 25, 2026, Brackenridge Borough, Harrison Township, and Tarentum Borough each approved the creation of the Alle-Kiski Emergency Services Authority and authorized its incorporation.
The Authority has since been legally incorporated, its Board has been appointed, and AKESA is now working through the implementation process necessary to begin full regional EMS operations.
Who runs AKESA?
AKESA is governed by a seven-member Board of Directors.
Each participating municipality appoints two members, and the participating municipalities jointly appoint one additional at-large member. The Board sets policy, oversees the Authority’s finances and operations, and develops the regional EMS system.
AKESA is a separate public authority. No single municipality controls it.
Are AKESA Board meetings open to the public?
Yes.
AKESA is a public authority, and its Board meetings are conducted in accordance with Pennsylvania’s Sunshine Act. Meeting dates, agendas, minutes, and other public information are posted on the AKESA website.
What is the Pennsylvania Sunshine Act?
The Pennsylvania Sunshine Act is the state law governing public meetings of government agencies. It generally requires official deliberations and actions to occur at properly advertised public meetings where members of the public can observe the decision-making process and provide comment, subject to limited exceptions established by law.
How will AKESA be funded?
AKESA is expected to use several sources of revenue, including:
- Insurance reimbursement for EMS services;
- An annual EMS readiness fee;
- Grants and other available funding; and
- Other revenues legally available to the Authority.
The readiness fee is important because insurance reimbursement primarily pays for individual patient services. It does not adequately fund the entire system that must remain available before an emergency occurs.
What is an EMS readiness fee?
The readiness fee helps pay for the 24/7 availability of the EMS system itself.
That includes expenses such as personnel, ambulances, medical equipment, training, insurance, communications, facilities, vehicle maintenance, and other costs necessary to keep an ambulance service prepared to respond. Those costs exist whether an ambulance responds to a call or sits ready for the next emergency.
The readiness fee supports that standing capability, while insurance billing helps pay for services provided to individual patients.
Why can’t insurance reimbursement pay for EMS?
Insurance reimbursement is an important part of EMS funding, but it does not pay for everything required to maintain an emergency medical system.
EMS must have trained personnel, ambulances, medical equipment, facilities, and other resources available around the clock regardless of how many billable transports occur.
Additionally, some EMS responses do not result in transportation to a hospital and may produce little or no reimbursement even though personnel, equipment, and an ambulance were still required to respond. AKESA’s funding structure is intended to address that gap.
Why not simply fund EMS through municipal taxes?
Brackenridge, Harrison, and Tarentum have different tax bases, budgets, and financial structures, while EMS operates as a regional service across municipal boundaries.
Using a regional funding structure allows the Authority to determine the cost of maintaining the EMS system and distribute those costs using one consistent methodology throughout the service area.
It also makes EMS funding more visible. Residents can see what is being charged specifically to maintain emergency medical services rather than having the expense incorporated into a municipality’s broader general tax structure.
Has the EMS readiness fee been finalized?
The Authority has been evaluating a proposed fee structure as part of its financial and operational planning. The Board must complete the required public process before the fee structure is finalized and implemented.
Information regarding the proposed fee, service plan, and public hearing will be provided before final action is taken.
Will there be a public hearing before the fee is implemented?
Yes.
AKESA will conduct a public hearing on the proposed service and fee structure before implementation.
Property owners will receive the required notice, and members of the public will have an opportunity to review the proposal, ask questions, and provide public comment before the Authority Board takes final action.
Who will receive the EMS readiness fee bill?
Under the proposed structure, the readiness fee will be billed to property owners within the participating communities.
Residential and commercial properties will be addressed through the fee structure adopted by the Authority.
Renters will not receive a separate AKESA property fee bill directly from the Authority. Any arrangements between landlords and tenants regarding property operating costs are separate from AKESA.
Does paying the readiness fee mean I will never receive an ambulance bill?
Not necessarily. The readiness fee and patient billing serve different purposes.
The readiness fee helps maintain the EMS system so personnel, ambulances, and equipment are available when an emergency occurs.
AKESA will also continue to bill insurance for medical treatment and transportation when appropriate. Any amount that may ultimately be the responsibility of an individual patient will depend upon the Authority’s adopted billing policies, the service provided, and the patient’s insurance coverage.
The goal of the readiness fee is to provide stable funding for EMS—not to replace insurance.
Do I still need health insurance because I am paying an EMS fee?
Yes.
The readiness fee is not health insurance and does not replace Medicare, Medicaid, private insurance, or other medical coverage.
It supports the availability of the regional EMS system.
What happens when someone calls 911?
Residents should continue to call 911 for medical emergencies.
The emergency communications system will dispatch the appropriate available EMS resources based upon the nature and location of the emergency.
The transition to AKESA is intended to strengthen the system behind that response, not change how residents request emergency assistance.
What happens if an AKESA ambulance is already responding to another emergency?
Mutual aid is a normal and important part of emergency services.
AKESA will coordinate with neighboring EMS organizations so additional resources can be requested when Authority units are committed to other calls, when multiple emergencies occur at the same time, or when specialized assistance is needed.
Regional cooperation helps provide additional capacity during periods of high call volume.
Is AKESA another municipality or another layer of local government?
No. AKESA is a municipal authority, which is a separate public entity created for a specific public purpose.
Pennsylvania communities have long used authorities to operate services and infrastructure that cross municipal boundaries or benefit from specialized regional management.
AKESA exists specifically to provide and support emergency medical services. It does not have the general governmental responsibilities of a borough or township.
When will AKESA begin full EMS operations?
AKESA is currently in the implementation phase.
During this period, the Authority is establishing its staffing structure, operational policies, financial systems, equipment and facility plans, service agreements, billing procedures, and other components necessary to transition to regional operations.
The current goal is for AKESA to begin full operations in January 2027, subject to completion of the necessary operational and financial transition work.
Will there be opportunities for the public to follow the process?
Yes.
AKESA Board meetings are public, and residents are encouraged to follow the Authority’s work as the transition moves forward.
Meeting schedules, agendas, minutes, public hearing information, financial information, announcements, and other documents will continue to be posted on this website.
Where can I find the latest information?
This website is the official source for AKESA updates.
Residents can use it to find:
- Board meeting schedules;
- Meeting agendas and minutes;
- Public hearing information;
- Authority documents;
- Fee and service information;
- Employment opportunities; and
- News regarding the transition to regional EMS operations.
As major implementation decisions are made, additional information will be posted here.