The Tri-Town Ambulance Service agreement will get a complete overhaul for the first time in 33 years, up-Island selectmen and ambulance committee members decided this week.

The rural ambulance service serves Aquinnah, West Tisbury and Chilmark. The original agreement for the service was written in 1978. In 1991 a large governance committee was established for the service, which some feel is too unwieldy.

“I think there’s a general consensus [for a new agreement] and the only question is when, not if,” West Tisbury selectman Cynthia Mitchell said at the monthly tri-town meeting Tuesday night. “If it’s the committee’s model to try to support the service similarly to a police department, it seems to me that seven representatives is overkill,” Mrs. Mitchell added.

Also at the meeting Aquinnah selectmen said they intend to ask voters at a special town meeting on July 7 to restore the $26,000 slashed from the annual budget for the ambulance service. At the annual town meeting in May, voters backed the selectmen’s recommendation only to fund $134,000 of the $160,000 requested for the budget.

The decisions come amid growing tension in the three rural towns over how the ambulance service is managed and financed. Last week the Chilmark selectmen, who are the fiscal administrators for the service, voted to appoint Paul (Zeke) Wilkins as the new chief of the service, over the objections of the hospital emergency room director. Dr. Jeffrey Zack expressed concerns that Mr. Wilkins does not have enough experience as a paramedic to lead and train other paramedics on the squad. State rules now require all the town ambulance services to provide paramedic-level service.

When the ambulance service was first formed in 1978 the three towns shared one ambulance; today each town owns an ambulance as well as two so-called interceptor vehicles (retired police cruisers used for early response).

On Tuesday night the group agreed to hand the task for writing a new agreement to West Tisbury selectman Richard Knabel, who was not present. The consensus was to restructure the seven-member committee by making it smaller, to rewrite guidelines and examine the possibility of a new assessment formula for the tri-town budget.

Reached by telephone after the meeting, Mr. Knabel said he hoped to have a first draft circulating to the other selectmen by the end of the month.

“There’s going to be some give and take and out of it will come a revised agreement that reflects the realities of 2011 rather than 1978,” Mr. Knabel said. “I think the structure of the new governance and the rules of operation are going to have to be a part of it,” he added.

On Tuesday Bruce Haynes, squad representative to the committee, said the current agreement has two key deficiencies: There are no rules for the committee, and having the police chiefs serve on the committee potentially chills the ambulance chief’s ability to speak up.

“If you guys define what the committee’s job is it would make it a whole lot easier,” Mr. Haynes said. “If you take those three [chiefs] out of there and have a representative from each selectmen’s board you will see a chief flourish and grow in a different direction.”

The current agreement also penalizes a town that does not pay its share of the cost by terminating service to the defaulting town 60 days after notification, something that appeared to be a possibility for Aquinnah until this week.

Mr. Knabel said language in the agreement is vague and will be clarified in the new draft.