The problem was that the City of Hood River was uncertain whether existing fire-based ambulance transport services enhance or diminish fire protection services which were funded by tax revenues. The purpose of the research was to determine if fire-based ambulance transport services either enhance or diminish the provision of fire protection services which were supported by tax revenues in Hood River, OR.By conducting a thorough literature review of current publications and a local survey, industry professional interviews, and an analysis of data and budget reports, the results of descriptive research answered the following three questions: (a) what are the base costs of providing emergency services in Hood River, without providing transport EMS, (b) what are the incremental operational risks and benefits of providing fire-based EMS transport in Hood River, and (c) what are the incremental financial requirements and revenues of providing fire-based EMS transport in Hood River? The results of the research indicated that the fire-based EMS transport system in Hood River, OR. enhanced the provision of fire protection services. Literature review and original research of existing budget and call volume data indicated that operational benefits out-weigh the risks.Also, even though medical services are expensive, the revenue model that was in place in Hood River was sufficient to cover EMS-related expenses. EMS revenue was found to subsidize fire protection capabilities at Hood River Fire and EMS. Recommendations were made to continue the fire-based EMS transport service that was in place in Hood River, OR. Finally, Hood Fire and EMS should monitor staff for signs of burn-out and fatigue to ensure the safety of the responders and community.