Do you have money or investors lined up? If no, kill your dream now.
Do you have political friends? If no, kill your dream now and bury it 6 feet under.
If the answer is yes to both, continue.
How are you going to meet your overhead? County contract (facing opposition) or private?
Overhead is going to include:
-EMT-B / AEMT / Paramedic salary + benefits + health plan + whatever else
-Ambulances (are they going to be new or used? How much will you pay in gas?)
-Company building (factor in maintenance, gas, water, electricity, phone, etc.)
-Equipment
-Drugs
-Human resources
-PR
-Your salary
-Maintenance on ambulances
What makes you a different (and better) employer of EMTs/Paramedics than others? Who's going to act as medical control and write protocols? What are you going to do when you don't meet overhead? What's your short term plan? Long term? Do you know your state's certification requirements? How many ambulances will you need? What makes your company better than others? Can you get a loan? What if your company goes under? Do you have a plan to meet final paychecks? Do you know your state's employment laws? OSHA's?
Answer those and you might have a company. It's far better to be realistic now than throw money at a doomed concept.