Probably a combination of the two along with the high training requirements. I believe Chesapeake does not have volunteers any longer.
Here in the Beach, the EMS system used to be all-volunteer. Currently, there's about 30-40 single role career Paramedics that work for the EMS Department. The EMS system remains predominantly volunteer however, things are slowly changing towards a more career type system. More often, the changes to the system are very subtle and unnoticeable by most of the members. A large portion of our members in the Fire Dept. are patiently waiting for the day we start staffing ambulances. Most of us have accepted that one day it will happen so, we welcome it.