Middletown is served by four fire departments organized as the Skyline Fire District Association (S.F.D.A.). The SFDA is comprised of the:
The Parkland Fire Company is the only Township fire company. Although all fire departments are volunteer organizations, the Second Class Township code allows elected officials of the Township certain supervisory duties over "Township" fire company officers, equipment, and operations
The Township is divided into four primary fire districts. Therefore, the three other SFDA fire companies are located in the boroughs geographically situated within the borders of Middletown Township and are contracted to provide fire protection. Borough codes also allow their elected officials certain supervisory duties over fire company operations. However, borough officials generally do not get involved in the operations of the fire company.
There are also two other fire companies that provide fire protection to Middletown Township. The Newtown Fire Association provides fire protection to the area of northern Middletown. The Levittown Fire Company #2 provides fire protection to the Quincy Hollow section of Levittown.
In 1951, the fire companies organized into the Skyline Fire District Association (S.F.D.A) in order to resolve disputes that arise from time to time. Four fire districts were established and each company assigned an area for primary service and (in 1961 via contract) were compensated by the Township. This has since evolved into various contracts with the Township such as an annual operating contract, vehicle agreement, and distribution of the 2% Foreign Fire Insurance funds.
The SFDA is the sole negotiator with the Township for all service-related issues that come before the Board of Supervisors in accordance with the by-laws of the SFDA and Township operating contract. There are several sub- committees within the SFDA. The Chief's Committee has a primary responsibility to establish tactical operations, response and equipment needs, while the President's Committee addresses all administrative issues. In addition, the Emergency Prevention and Education Division (EPED) operates under the Chiefs' sub-committee. It provides all fire safety programs, handouts, and displays in conjunction with the Fire Marshals' Office.
The Penndel-Middletown Emergency Squad (Squad 168) is the emergency health care provider for Middletown Township and surrounding communities. The squad provides Advanced Life Support (ALS) units staffed with paramedics who can administer cardiac measures such as defibrillation and medicines. Basic Life Support (BLS) units staffed with Emergency Medial Technicians (EMT) respond to minor medical emergencies.
In addition to the volunteer crews, the squad employs full time paid personnel on a 24-hour basis to meet the State mandated goals outlined in Act 45.