Towns to seek emergency medical provider options

By Stephanie Grinnell and Bane Okholm | Mar 13, 2013

In the wake of substantially increased funding requests from Camden First Aid Association, the four towns the emergency medical service covers — Camden, Rockport, Lincolnville and Hope — are considering all available options.

One of those options currently in progress is creation of a Request for Proposals for emergency medical services. Camden, Rockport and Lincolnville select boards each have authorized their respective town managers to collaborate on creation of the RFP.

“There are other ambulance services that could be available, ” said Camden Town Manager Patricia Finnigan. She said Camden wants to work with the other four towns but also is open to emergency services other than Camden First Aid.

“Switching the provider doesn't necessarily make the problem go away,” she said.

Town managers are in the process of researching wording and requirements.

“I got lost very quickly in terms of my ability to interpret that stuff...what we intend to do is develop a general RFP,” Rockport Interim Town Manager Roger Moody said March 11.

He said there is a lot to learn and he has been researching what other municipalities seek in an emergency provider agency.

“I'll share that document when I get it,” Moody told Rockport Select Board members.

Rockport Select Board member Tracy Lee Murphy asked if one RFP would be issued for all towns that wish to participate and if provider agencies will be allowed to bid for one or two towns rather than as a package. Moody noted there is often a benefit in the “economy of scale” but said each town will have to decide how to proceed when the RFP responses are received.

“This is smart. We don't have any options [for comparison],” Murphy said.

Moody said another option being considered by the town managers, who meet regularly, is creation of an EMS district, with municipalities serving as managers.

“There is no requirement for towns to provide EMS service,” Rockport Select Board member Ken McKinley pointed out, adding there may be assistance in developing the RFP available through the state emergency medical services office in Augusta.

“This RFP is quite interesting,” Rockport Select Board member Geoffrey Parker said, adding he feels Camden First Aid Association should be urged “to be as brilliant as possible in their response.”

Parker suggested participating towns include in the RFP what type of service is expected, without being too technical. Rockport Select Board Chairman William Chapman noted the town has never had to seek an EMS provider before, having relied in the past only on nonprofit organization Camden First Aid.

“It's incredibly poor timing,” Parker said of the increased funding request.

Rockport Select Board Vice Chairman Charlton Ames said, “We certainly need choices.”

McKinley noted that even if Camden First Aid submitted a proposal accepted by Rockport, the organization should be required to show change in how things are done.

“The service they provide is excellent, top notch,” he said.

“That may be why we are seeing the increase in costs," Moody speculated, adding he intends to have a draft RPF to present to Rockport officials at the next regular meeting March 20.

Hope Town Administrator Jon Duke previously said Union Ambulance already has given an estimate to provide emergency services in that town. He said the cost of Union Ambulance is much less than Camden First Aid's request and said Hope likely will switch providers.

"I don't believe that any long-term solution is going to be prepared that could be presented to any town meeting in June, so it's an attempt, at this point, to stomp on the brush fire and make sure it doesn't spread," Lincolnville Town Administrator David Kinney told the board of selectmen March 11.

The goal of the RFP, Kinney said, is to "create a long-range, viable solution that will be supportable by the communities."

Kinney said Lincolnville will participate in the joint search with Camden, Rockport, and Hope and the town "may be looking to some of our other regional partners to partner with, or asking them to respond to the request for proposal."

Kinney gave the example of Belfast, "because that one's immediately known. They have an ambulance, and they have an ambulance service. They service other communities. They may also be willing to service Lincolnville, Hope, Camden, Rockport, or anybody else."

"I think one way of looking at this [is] we got away with it for a heck of a lot of years, we just got caught and now we've gotta pay what we should have been paying for the last 10 years," Lincolnville Select Board Chairman David Barrows said.

Barrows said he has seen "a lot of figures" regarding emergency services, including a purportedly cheaper option, but said he doesn't know "if some of that isn't being supported by other budgets that we don't have access to at this time."

CFAA Service Director Julia Libby confirmed March 12 that CFAA would respond to any RFP issued for emergency medical services. North East Mobile Health Services chief and chief executive officer Kevin McGinnis previously said his agency is not interested in taking business away from existing services but also would respond to an RFP.

Comments (2)
Posted by: Barry King | Mar 15, 2013 10:53

I serve with Union Ambulance and Appleton Fire. The relationship between these two entities is excellent. Having seen a little bit of the discussion in my area as to how best serve the 4 community's wishes for EMS and Fire protection it strikes me that there is a delicate financial balance between a not-for-profit model and a for-profit model of EMS. They are not mutually exclusive but in my humble opinion a "volunteer" service has some virtues in the way of public scrutiny that a for-profit service need not provide. Arguments can be made for both models of operation but once a volunteer service is abandoned the chances of communities changing their minds later becomes challenging. The beauty (and curse) of Camden First Aid and Union Ambulance is the transparency with which they serve the community. If you don't like something you have a chance to change things, perhaps even volunteer your time and energy to make the change you want to see happen.

 

There are basic rules which every EMS provider must follow. So some costs are not really all that negotiable. There is the argument for economy of scale. Perhaps a group like Northeast can operate more efficiently due to its scale but profits go where? That is not something communities have a right to control. Communities can control the level of care and response time with both models so each town needs to come to that basic decision first. Do you expect or want a paramedic available at all hours. Are towns people willing to pay for that level of care. Do folks want crews sleeping at stations to accelerate response time? There is a price tag for that as well. In Union we have paid per diem staff with on-call volunteers between 5PM and 5AM. Sometimes it takes us longer to get to a call at night and we don't always have a paramedic available. The Union Select Board have determined based on public input the best way to operate the ambulance service for the 4 towns served. The financial balance is not always easy but it would be hard to argue that the ambulance service is wasting taxpayers money for the level of care provided at the price it is delivered.

Will a for-profit service provide fire fighter rehab when volunteer firefighters are on a scene? As a volunteer fire fighter I would hope so. It is the least a town could do to take care of its volunteers. Do folks want to retire ambulance rigs after 5, 7 or 10 years? Or wait until they break down on the side of the road? Are all ambulance miles the same? Rural unpaved roads vs. highway travel? Should a not-for-profit service provide patient transports between facilities? The Union Select board has chosen not to giving up a potential revenue source in favor of keeping the demands on the service simpler. Every community can have a different set of needs and allowing some control over the cost of the service they desire beyond the baseline costs associated with having service available.

There are no perfect answers but there are some virtues to a not-for-profit ambulance that allow the participating communities to have a long term stake in the service provided with the financial responsibilities that come with that. The price tag is not simple and requires tremendous volunteer efforts and creativity. But that is the price of transparency and control over what kind of EMS and Fire service each town desires. Once towns chose a for-profit service all of the headaches of running a not-for-profit service go away. But at what price? We towns people don't know and won't know until the private services tell us how much they want.



Posted by: Fred W Adams | Mar 13, 2013 19:48

When they didn't need help you didn't see them untill they were needed. Now they need help and some of you still don't see them untill you need them! You towns need to suck it up and start giving your fair share to CFAA they have served you for many years! Emg.Serv. seems to get crappy end of the stick when it comes to needing help. Been there!

             

 



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