How Sullivan County used a strong base of resident support to build the case for expanded EMS coverage
The Challenge
Sullivan County covers roughly 1,000 square miles, much of it served by a thin network of volunteer ambulance crews that oftentimes are not able to arrive to the scene fast enough. To help address the emergency medical services shortage, in 2024 the County launched a Fly Car service. As a result, fly cars cut emergency response times by an average of 15 minutes for rapid-response emergency medical services.
Based on the success of the program and as Sullivan County leaders weighed a countywide EMS expansion, they faced a real decision point: was there enough resident support to justify a property-tax-funded system — and how would they know before committing?
How They Used Zencity
Instead of only hearing from the “Same Ten People,” the County built this question directly into its first Zencity Community Survey to bring in defensible data for the community voice. A representative sample of Sullivan County residents were asked whether they’d support a property tax increase to create a countywide EMS system, building on the County’s existing “fly car” rapid-response program with 24/7/365 ambulance service.
The department needed to understand two things: how residents perceive the health department and its services, and what residents themselves define as the priorities that would improve their health, with a more flexible timeline and structure.
Since the breakdown of responses mirror Sullivan County’s Census makeup for Race/Ethnicity, Age and Gender, as well as reported Income and Education level for respondents, the County gained visibility into specific demographics that were more likely to support the property tax increase. For example, residents aged 55+ were more opposed than 18-34 year olds (68% opposed compared to 44% , respectively). More importantly, by understanding which demographics were less inclined, the County was able to inform communications and outreach about the program and its benefits accordingly.
What the Data Showed
According to the data, 40% of residents backed the tax increase to fund expanded EMS coverage- a meaningful base of support to start with, even though it fell short of a majority. Knowing that the County had not yet launched a communications campaign or focused on expanding the EMS system, this 40% was a meaningful validation right off the bat with significant opportunity to grow support.
Combined with the fact that the successful launch of the fly cars effectively reduced emergency response times by roughly 15 minutes, these two data points gave county leaders something more useful than either alone: direct evidence of resident appetite for expansion, paired with proof that the underlying program already worked.
The Outcome
The findings helped build the case for expanded EMS and Sullivan County moved forward with a countywide ambulance system, now funded at roughly $4M per year, all locally funded.
“The ability to have a survey that is representative and based on a scientifically-validated research based model is a powerful tool for sharing with internal stakeholders as part of the decision-making process.”
– Dan Hust, Director of Communications
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