Often the paramedic would ride in the back of a town ambulance to provide advanced medical care to the patient en route to the hospital.

This is accomplished by establishing national standards which not only address the delivery of patient care, but also the ambulance service's total operation and its relationships with other agencies, the general public, and the medical community.

[2] The application was the first step in the regulatory process toward creating an organization which was aimed at better serving the Hudson Valley community in providing emergency and ambulance services.

Health Quest and Northern Dutchess Paramedics anticipated that the regulatory process would take approximately six to twelve months; however as of December 31, 2008 the merger was not completed and is now abandoned.

In January 2009 Health Quest began allocating additional funding to Alamo to aid their goal of covering most of the towns in Dutchess County.

Up until its demise in 2009, Alamo EMS was the only community-owned ambulance service[1] and was governed by an all-volunteer board of trustees composed of community leaders, and under the guidance the umbrella organization Health Quest.