Thousand Islands Emergency Rescue Service Inc

What Thousand Islands Emergency Rescue Service Inc does

Thousand Islands Emergency Rescue Service Inc (TIERS) is a 501(c)(3) non-profit emergency medical services organization founded in 2001 and headquartered at 885 Graves Street in Clayton, New York. The company serves as the exclusive 911 ambulance service provider for the Towns of Clayton and Orleans in Jefferson County, NY, covering approximately 175 square miles of rural terrain along the US/Canadian border, including portions of the St. Lawrence River and its islands. TIERS operates four fully-equipped ambulances and staffs paramedic-level care 24 hours per day, 365 days per year, with capability for advanced procedures including narcotics administration, advanced airway management, and cardiac monitoring with real-time data transmission to receiving hospitals.

The organization's core technology stack consists of industry-standard EMS equipment: Lifepak 15 cardiac monitors (12-lead ECG, capnography, SpO2), LUCAS 3 automated CPR devices, video laryngoscopes for camera-guided intubation, Ferno INX and Stryker power stretchers rated to 700 lbs, and a paramedic fly-car for expanded geographic reach. TIERS maintains a regional first-mover position on multiple clinical capabilities and was recognized as the New York State Department of Health's 2008 EMS Agency of the Year.

Revenue is generated through a hybrid non-profit model combining government service contracts with Clayton and Orleans (primary recurring revenue), patient transport and treatment billing through MeD-Ex Billing Inc covering Medicare, Medicaid, and third-party payers, AHA-certified CPR/First Aid/BLS/ACLS/PALS training, private inter-facility hospital transport contracts, and a robust fundraising operation including the Friends of TIERS $1,000+/year membership program, annual galas, spaghetti dinners, and grants from regional foundations and Empire State Development. The 2024 annual operating budget is approximately $850,000, supporting 5 full-time staff plus roughly 60 part-time paramedics, EMTs, volunteer drivers, and administrative personnel.

Name

Thousand Islands Emergency Rescue Service Inc

Legal name

Thousand Islands Emergency Rescue Service Inc

Website

https://tirescue.org

Company type

Private

Founded year

2001

Operating status

Operating

Headcount range

1–10 employees

Short description

Thousand Islands Emergency Rescue Service Inc is a 501(c)(3) non-profit EMS organization providing 24/7 paramedic-level 911 ambulance response, inter-facility transport, and AHA-certified CPR/first-aid training to the Towns of Clayton and Orleans in Jefferson County, New York.

Ownership category

akta.pro rank

Product category

Emergency Medical Services

NAICS

Ambulance Services (621910)

SIC

Services-Misc Health & Allied Services, Nec (8090), Services-Health Services (8000)

akta.pro primary industry

911/Public EMS Agencies (Municipal/County/Fire-Based) (HLAFANAA)

akta.pro secondary industries

Private EMS Providers (Contract/Interfacility) (HLAFANAB), Medical Emergency Response & On-site First Aid/Paramedics (BPABANAG)

Keywords

• Emergency medical services
• Ambulance transport
• Paramedic services
• CPR first aid training
• 911 emergency response

Headquarters

HQ city

Clayton

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales, Others

Revenue model

1. Government Service Contracts: Primary revenue from service contracts with the Towns of Clayton and Orleans for 911 ambulance service provision
2. Patient Care Fees: Billing for ambulance treatment and transportation services billed through MeD-Ex Billing Inc; includes Medicare, Medicaid, and third-party insurance billing
3. Donations and Fundraising: Charitable donations through Lifesaver Program, Friends of TIERS program ($1,000+/year membership), annual galas, spaghetti dinners, and other fundraising events
4. First Aid/CPR Training: Revenue from American Heart Association CPR/First Aid courses, BLS, ACLS, and PALS training classes offered to the community
5. Private Service Contracts: Hospital-to-hospital ambulance transport services and other private contracts

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels6 records

Core offering

Thousand Islands Emergency Rescue Service Inc operates as the contracted 911 ambulance provider for the Towns of Clayton and Orleans in Jefferson County, New York, delivering Paramedic-level Advanced Life Support pre-hospital emergency care 24/7/365 across an approximately 175-square-mile rural district that includes portions of the St. Lawrence River along the US/Canada border. The agency supplements ambulance response with hospital-to-hospital inter-facility transport, American Heart Association-certified CPR/First Aid/BLS/ACLS/PALS training courses, a Junior EMS youth program, community health education (in-home visits, fall prevention, blood pressure clinics), and a reflective address sign program. Revenue is generated through government service contracts, patient billing via MeD-Ex Billing Inc, donations, fundraising, training fees, and grants.

Product overview

Thousand Islands Emergency Rescue Service Inc (TIERS) is a 501(c)(3) non-profit EMS organization that provides emergency medical services as its core offering. The organization operates four fully-equipped ambulances staffed 24/7 with Paramedics supplemented by paid and volunteer EMTs. TIERS' equipment portfolio includes LUCAS 3 CPR devices for mechanical chest compressions, video laryngoscopes for airway management, Lifepak 15 cardiac monitors for advanced cardiac care, and Ferno INX/Stryker electric stretchers for safe patient handling. Beyond emergency response, TIERS offers community health education services including American Heart Association CPR/First Aid training (Heartsaver, BLS, ACLS, PALS), a Junior Membership Program for teens ages 14-18, and serves as a clinical site for paramedic students. The organization also provides hospital-to-hospital ambulance transport and community outreach programs including blood pressure clinics and fall prevention education.

Differentiator

Problem solved

Functional benefit

Products and services

• 911 Emergency Medical Services (EMS) and Advanced Life Support Ambulance Transport
• Community CPR and First Aid Training
• Hospital-to-Hospital Ambulance Transport
• Junior EMS Membership Program
• Community Health Education Programs
• EMT Training and Certification (Off-Site Training Center)
• Paramedic Student Clinical Site Program
• Reflective Address Sign Program
• Island and Water-Based Emergency Response

Quantifiable outcome

• Over 1,000 calls annually averaging over 20,000 total calls since inception
• +3 more outcomes

Named customers7 records

Segments5 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature7 records

Partnerships

Ten partnerships are on record, tiered core and minor.

• Town of Clayton Fire DepartmentcoreStrategic or Co-development PartnerWorking in tandem with Clayton Fire Department for medical emergency response on islands within the two townships. Fire department provides fireboat (Last Chance) for water-based transport of TIERS personnel and equipment to island locations.
• LifeNet 7-10coreStrategic or Co-development PartnerAir medical transport service flying out of Watertown International Airport. Coordinates with TIERS for helicopter transport of critical patients to trauma centers including Upstate Medical University Hospital in Syracuse.
• Upstate Medical University HospitalcoreStrategic or Co-development PartnerLevel 1 Trauma Center in Syracuse, NY - primary destination for air medical transports of critical patients from TIERS response area.
• New York State Volunteer Ambulance & Rescue Association (NYSVARA)minorOthersTIERS Executive Director Michael Bennett serves as Director for NYSVARA District 21 (North Country) and Chair of Rural EMS and Youth Education Committees.
• United New York Ambulance Network (UNYAN)minorOthersTIERS is an associate member of UNYAN, a professional association that advocates for EMS in NYS.
• Jefferson Community CollegeminorStrategic or Co-development PartnerCreated first off-site EMT training center with Jefferson Community College for emergency medical technician education.
• River HospitalminorStrategic or Co-development PartnerTIERS Paramedic Christopher Erdman serves as Disaster Preparedness Coordinator at River Hospital.
• North Country EMS Program AgencyminorStrategic or Co-development PartnerCritical Incident Stress Debriefing Team available through NCEMS for mental health support of EMS providers.
• PIVOT of Jefferson CountyminorStrategic or Co-development PartnerMental health, alcohol, and substance abuse counseling partnership for TIERS employees and members.
• Priority Wellness CampaignminorStrategic or Co-development PartnerLocal first responder mental health initiative promoting confidential positive mental health resources and removing stigma.

Scale indicators11 records

Recent moves8 records

Expansion highlights6 records

Direct peers

• Empress EMS: New York-based private ambulance and EMS provider offering 911 response, ALS, BLS, and special event coverage across the Hudson Valley and lower NY. Comparable as a New York EMS provider serving contracted municipalities with ALS service.
• MedStar Mobile Healthcare: Public utility-model EMS agency providing 911 response and mobile healthcare in Fort Worth and 14 surrounding communities. Comparable as a contracted 911 ALS provider with subscription/contract revenue model, though serving a much larger population.
• Richmond Ambulance Authority (RAA): Independent authority providing 911 EMS service to the City of Richmond, VA under a public-private hybrid model. Comparable as a contracted paramedic-level 911 provider with community health programs analogous to TIERS' training and follow-up services.
• Mobile Medical Response: Non-profit 911 ambulance and ALS provider serving 14 counties in central/eastern Michigan. Most directly comparable to TIERS as a non-profit, paramedic-staffed, contract-based 911 EMS agency in a rural geography.

Broad incumbents

• Mecklenburg EMS Agency (Medic): Public-utility-model EMS agency serving Charlotte/Mecklenburg County, NC. Comparable as a publicly-accountable 911 EMS provider delivering paramedic-level care under contract, but on a metropolitan rather than rural scale.
• American Medical Response (AMR): Largest private ambulance and EMS provider in the United States, operating 911 and interfacility contracts across 40+ states. Comparable as an EMS provider serving municipal contracts, though vastly larger and for-profit versus TIERS' non-profit model.
• Falck USA: Global EMS and ambulance services provider with significant US operations in California and Georgia. Comparable as a contracted 911/interfacility ALS provider, though operating at much greater scale than TIERS.
• Acadian Ambulance Service: Large private EMS and air medical provider covering Louisiana, Texas, Mississippi, and Tennessee with 911 response, interfacility transport, and training services. Comparable in providing contracted 911 ALS service and community training in rural/semi-rural geographies.

Emerging players

• Priority Ambulance: Privately-held, growing EMS company operating 911 and interfacility services across the Southeast and Midwest. Comparable as a multi-state ALS ambulance operator competing for municipal contracts in non-urban markets.
• ProTransport-1: Private ambulance company specializing in interfacility and critical care transport across California and the Western US. Comparable in offering ALS ambulance transport and CPR/training programs, though oriented to interfacility rather than 911 911 response.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/thousandislandsrescue
• LinkedInlinkedin.com/company/thousand-islands-emergency-rescue-service-inc

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Thousand Islands Emergency Rescue Service Inc