Ambulance Chassis: Wait Times Soar, Costs Skyrocket

June 20, 2022
James Philips tells of the challenging marketplace that fire departments face when it comes to acquiring ambulances, whether new, remounted or used.

It isn’t a 9-1-1 emergency, but another quiet crisis is well under way—namely, the greatly curtailed ability for EMS providers to purchase replacement ambulances. An unprecedented storm of economic events has choked off the supply of new, remounted and used ambulances and has sent prices soaring.


The problem starts with an ambulance prep package that’s built—or not built—built by Ford, Freightliner, General Motors, International or RAM. Furthermore, the global shortage of microchips has curtailed all automotive production sharply, and the production of the chassis that are used for ambulances has been hit particularly hard. Diesel, gasoline, 4x2, 4x4, all brands: The supply is remarkably short right now.

Ford’s E-Series, Transit and F-Super Duty (F-450, F-550) chassis cabs are sold out for the 2022 model year, and many that are on order just won’t be built.

Freightliner and International are sold out until the 2024 model year, mostly because of higher demand for commercial trucks for other segments.

“I’ve never had so little information on what will be built and when,” Marc McEver of Olathe Ford, which has been a major supplier of ambulance chassis to EMS body builders for 30 years, tells Firehouse Magazine. Of the crisis, he adds “I don’t think things will normalize for at least a year or more.”

The lack of clear or definitive information on chassis supply is trickling down to frustrated buyers through ambulance manufacturers and their local dealers.

Dealers across the major ambulance brands are telling surprised fire and EMS agencies that lead times are 14–24 months for built-to-order Type I and Type III ambulances. This compares with historical norms of 3–6-month lead times for the same vehicles.

The new lengthy timelines are upending customary specification, budgeting, procurement and replacement cycles.

“These are extremely difficult times for buyers, dealers and the manufacturers,” Bob Reilly, who is owner of North Eastern Rescue Vehicles, which is one of the largest ambulance dealers in the United States and offers five brands, says. “We’re doing all we can to support those agencies already waiting for delivery and also preparing those actively buying for the current timelines.”

Reilly also notes that the situation is driving costly maintenance challenges to keeping older units viable. So is a national shortage of repair parts and qualified mechanics.

Help Wanted

Even if the flow of new chassis were to return to “normal,” skilled labor shortages at many popular ambulance builders are evident from increased recruiting and advertising for new staff. This means that the industry’s ambulance manufacturers, which are sitting on a record backlog of orders, won’t be able to accelerate their production rate much even if material shortages ease.


It’s no secret that the United States is in a steep inflationary cycle. Nevertheless, sticker shock is a common reaction when agencies learn that their new ambulance—to the same specification as last year—jumped 25 percent–30 percent in cost. It’s a never-before-seen stacking increase, one that’s the result of material and labor increases being passed on by chassis manufacturers, ambulance builders, ambulance dealers and suppliers of key EMS equipment, including Ferno, Stryker, and other medical device and radio technology specialists.

Reflective striping and graphics, inspection trip travel and freight/delivery costs are up, too.

Ford and others also scaled back or eliminated incentives and rebates.


All remounts require a new chassis and most of the material and labor that goes into a new unit. Because the cost of aluminum has increased so much, the value of a body for reuse toward a remount is on the rise.

A bit of a ray of hope: Ambulance remounters and dealers that remount in-house might have stock remounts finished and available or already in-process (with remounter-supplied bodies and/or earlier 2022 production slots ahead to remount an existing unit). This potentially can save both time and money versus waiting for a new unit.

That said, consider the fact that stock remounts often put what’s available ahead of what’s desired by EMS agencies. The configuration of the exterior and interior is set, which means that if going that route is possible for your organization, these units likely will be inconsistent with others that are in your existing fleet. That lends itself to both operational and maintenance concerns.

It’s a local judgement call as to whether pursuing this option is worthwhile.

Some nonfactory remounters also have stock remounts (with bodies) and/or production slots ahead.


A collision or blown engine can result in an urgent, unplanned ambulance replacement. Previously, quick delivery of a dealer demo vehicle or a factory stock unit filled this immediate void nicely, but today, next to nothing is available right away. Unsurprisingly, the shortage of new ambulances has slimmed the supply of used ambulances, too.

Used ambulance prices, like that of other used automobiles, are up as much as 60 percent for units that are in excellent condition.

The supply of any new or used ambulance for immediate delivery is so scarce that agencies that are seeking to buy are encouraged to gain full procurement authority and approval of funds in advance of finding the actual vehicle. This allows same-day buying power.

The current situation is similar to a tight real estate market in a given area, where folks are paying more than asking price for the home that they want and making same-day payments to lock it in.

Fiscal stability

Given the circumstances, there’s significant financial pressure on dealers and manufacturers as a result of their delivery of many fewer units per month. This likely will continue for a year or more.

Most dealers and manufacturers are seeking advance deposits from buyers to lock in particular chassis or production slots.

Given the length of time from order date to delivery date, buyers should exercise good business practice, using binding documentation and elevated diligence to ensure that their funds are secure.

Waiting on answers

Uncertainty reigns across the ambulance chassis industry. It still is in everyone’s best interests to build and deliver as quickly as possible, but people who are accustomed to furnishing answers just don’t have them.

“It’s frustrating to not be able to provide accurate information to our valued customers,” Steve Apgar, who for decades has specialized in supplying new 4x4 ambulances in northwestern states, including Idaho, Montana, Oregon and Washington, says.

In sync with market conditions, Apgar’s used ambulance marketplace has seen a marked drop in units that are available for sale.

Although your ambulance dealer or manufacturer should provide more information as it becomes available, be sure to use multiple sources to verify what you’re told. It’s important to stay aware of these market conditions to make the most informed decisions for your next ambulance.

About the Author

James Philips

James Philips is a former EMS chief who has 35 years of leadership experience in the fire/rescue/EMS fleet community on behalf of manufacturers, dealers and remounters. As a vice president of fleet resources for Rural/Metro Fire, which is a private fire department that operates under contracts in numerous states, and for American Medical Response (AMR), he led national vehicle procurement, maintenance and remounting for 8,000 fire-EMS units that operate 200 million miles annually. Philips can be reached at [email protected]

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