Camden First Aid selling assets; working to continue 'expected service'
Camden — Property in the northern Maine town of St. Agatha valued at $83,000 remains in the name of Camden First Aid Association, according to real estate tax records.
However, the association's Service Chief Julia Libby said the property has been for sale for two years and will likely be auctioned in coming months.
Libby said the property, which was purchased in 2006, was used “as security for something” purchased by Camden First Aid. At the time, Chris Knight was service chief of the emergency medical service.
Knight was ousted in 2011 following more than a month of administrative leave after it was discovered that between $6,000 and $8,000 in contributions to employee retirement plans had been diverted to pay for company insurance and fuel bills.
Libby said several items, including a pick-up truck and dock at the St. Agatha property, have already been sold.
"We've liquidated some of the assets," she said, adding the nonprofit organization has been negotiating costs with vendors such as phone, internet and cable companies as well. "It's really just nickle-and-diming us."
Libby said other measures, such as "working with area nursing homes and emergency rooms to educate them," have been put into action recently. She said Medicare is billed the standard cost of an emergency call when nursing home staff dials 911. The problem, Libby said, is when the patient is cleared from the hospital and ready to return to the nursing home. She said a return trip to a nursing home "has to be medically necessary" to allow billing of Medicare for reimbursement.
In recent months, the association has called for increased private donations and requested hundreds of thousands of additional municipal dollars, citing a projected budget shortfall of more than $350,000 in the 2013-2014 budget. Since the initial appeal by Camden First Aid Board President Steve Corson in November, Libby said the organization has received about $35,000 in private donations.
Libby said the association lost approximately $92,000 last year and the board of directors “decided to [ask for additional municipal funding] all at once” rather than spread it over several years. She used Camden as an example and said funding requested has remained static at $10,000 per year until last year when the association requested — and received — $20,000.
“It should have been going up over the past 20 years,” Libby said.
Rockport has seen its contribution increase from $19,000 to $24,000 last year, to a request of $129,000 this year. Lincolnville went from $7,500 to $10,000 last year and was asked for $77,000. Hope, for years paying $2,000, was asked to increase the contribution to $27,000. Camden residents could see the largest increase — from last year's $20,000 to $174,000.
Each municipality currently has a one-year contract, according to town officials. Libby said she did not request an increase in funding from Hope last year due to turmoil in that town surrounding emergency medical services. She said keeping the request the same likely contributed to receipt of a contract with Hope.
Compounding financial problems is the loss of more than $230,000 in patient billed services because “time had run out to collect appeals,” Libby said, adding patients without insurance are directly billed for services. Addressing that shortfall, she explained there was a shortage of manpower at the billing company that is part of the association, which at the time was handling billing for more than a dozen EMS provider agencies. Libby said concerns about inadequate staffing fell on deaf ears despite the topic being brought up numerous times to Knight.
“The billing company was so inundated with work, they didn't pay attention to CFAA,” Libby said. “We're not losing money other than people not paying bills.”
Currently, Camden First Aid only manages billing services for Belfast, Clinton and itself, she said. According to a presentation Libby made to area select board members Feb. 27, the billing company is projected to bring in $40,000 income during the next fiscal year.
In addition to lost compensation for emergency calls, Libby said she added full-time staff to the night shift. The largest budget line included in Camden First Aid's proposed budget is payroll, at an estimated $477,500. Libby said there are 10 full-time employees — one of whom is not an EMS provider; she is a billing clerk and receptionist — as well as a slate of per diem personnel. She said most of the full-time employees work in dual roles, some in billing. There are two crews available during the day and one at night, she said.
“I can't go any less,” Libby said, adding relying on volunteers at night does not provide adequate coverage for the four towns.
On occasion, all available personnel are out of the station and Camden First Aid calls Rockland for mutual aid, Libby said, adding Rockland charges for the service. Currently, Camden First Aid does not bill other towns — most often Union and Warren — when they are called for mutual aid or a paramedic intercept, Libby said. She currently is exploring options to begin billing for those services.
Libby said she is concerned about the potential impact on employees, some of whom are left wondering if they will continue to have jobs after June town meeting when each of the four municipalities is expected to vote on funding for Camden First Aid.
“It's tough on the employees,” she said, adding employees also have gone without raises for the past four years, despite positive evaluations. “All I tell them is you've done a great job. And you can't spend that in the grocery store.”
Libby said she's received estimates from Camden and Rockport regarding the potential impact on taxpayers in those towns. If Camden voters approve $100,000 for Camden FIrst Aid, the average homeowner with a property valued at $225,000 would see an increase of $20.25; with voter approval of $174,000, that same homeowner would see an increase of $38.25, she said. Rockport officials estimate an increase of $10 per $100,000 of valuation, she said.
Libby said she feels she can “work with what [municipalities] give us as long as we can keep the doors open.” She said the loss of funding from Hope — currently $2,000 but requested to increase by $25,000 to $27,000 — would not be devastating to the service; however, awarding a contract to another provider would be.
“If we didn't get the full funding, we can still stay here but if they choose another service...” Libby said, trailing off. “If another service got the contract, there wouldn't be any competition.”
She addressed the possibility of a merger or cooperation with North East Mobile Health Services and said she and Corson met with representatives of the for-profit service based in Rockport before approaching municipalities.
“They offered to take over financially,” Libby said. “[But] I'm not ready to give up the ship.”
She said the option of merging with another service has “not been cut off as an option” but said the agency wanted to give municipalities a chance to consider the increased funding before making that type of a decision.
A number of proposed budget lines are more than $100,000 each, including capital equipment, operation expense and payroll.
Citing her figures for the upcoming fiscal year, Libby said loan interest — projected at $60,000 — is being paid on the Camden First Aid building on John Street as well as one ambulance unit that was purchased used.
Camden First Aid has four ambulances, Libby said, ranging in age from 1997 to 2004. She said the lifespan of the vehicles is generally based on mileage as well as age.
“I should replace probably all four of them,” she said, adding a goal this year is to replace one of the larger unit with a smaller ambulance for transfers.
Libby said there has not previously been a replacement cycle in place for ambulances but she'd like to establish one in the future, should the EMS provider receive requested municipal funding.
“I think 911 service, like fire, police, is expected,” she said.
Libby said Camden First Aid is permitted at the paramedic level. She said the service is not required to be staffed 24/7 by paramedics but the public has come to expect that level of service.
Associate Editor Stephanie Grinnell can be reached at 236-8511 or firstname.lastname@example.org.