Fire districts and special districts were incorporated and voted on by the citizens to pay for fire protection. As the EMS (Emergency Medical Services) and the healthcare system in the United States grew, someone was needed to absorb that service. In the 1970s fire departments began to take on that service. Fire districts, however, weren’t funded for that. Obviously, ambulances, training, hiring paramedics, etc., cost extra. The money raised by fire districts and special districts pays to keep personnel ready to respond, but when they go out on EMS tasks, it takes them away from their main job, which is fire protection. So fire districts charge extra for EMS service. This has been a common theme throughout the country since the inception of Emergency Medical Services.