Town staff recommended transferring Apex EMS to the county by June 29. But the council forwarded the question to its finance committee, hoping to gain a tighter grasp of a complicated, shifting medical system.

The town's service is projected to hit a $170,000 deficit this year, and the county's proposed budget would end the county subsidy that has patched budget gaps for Apex EMS in recent years. The county has offered to take over the service and spare the town the expense.

"I'm torn. I recognize that the numbers are what they are - it doesn't make sense for Apex to hold on to it," said Councilman Gene Schulze. "But, long term, I don't think it's the right decision."

County and town staffs say that residents wouldn't notice any difference in the service besides the new logos on the ambulances. The county would offer jobs to all six full-time Apex emergency medical technicians. But a handover would change the culture and leadership of the Apex squad.

The county also is planning to assume more influence in the operations of the nonprofit Cary Area EMS. Starting this year, the county will hold greater authority over the nonprofit's budget.

Last year, the county took control of the town-operated Holly Springs EMS and the nonprofit Garner emergency squad, and earlier this year merged with the Six Forks units.

Apex EMS uncertain

Now the Apex council will decide the fate of its emergency squad. The council could make a final vote at its next meeting June 7, said Mayor Keith Weatherly.

Apex EMS has run deficits since it joined the town, but the county covered the losses.

Council and staff hoped when they acquired the squad in 2009 that the service would sustain itself.

This year, insurance and administrative costs unbalanced the EMS budget and the town fell back on the county's financial safety net.

The county said it won't bail Apex out next year. The county is instituting sweeping, systemic changes so it can run emergency services more efficiently and gain greater oversight of its money, said Brent Myers, medical director for Wake County EMS.

"We, just like you, ... are under a budget crisis," he told the Apex council. "I don't think the county's going to go back into the benevolent business of giving medical equipment away."

Myers promised the county would continue to carefully track and manage ambulance service across western Wake.

Myers and the Apex chief also noted that the county's EMS groups already share infrastructure and jointly decide placement of squads.

The town only controls the employees that staff the trucks, said Mark Haraway, Apex's fire and EMS chief.

Weatherly thinks the town is likely to give up Apex EMS.

"We do have a fiduciary duty to the taxpayers to make the most cost effective decision," the mayor said.

The town's finance committee is set to weigh the issue this week.