Selectmen in Warren have set a public hearing to go over several options for providing ambulance service, including paying emergency responders per diem during the work week and possibly hiring an outside agency to take over the ambulance service for the town.

Among the options on the table is replacing the town’s ambulance service entirely with a contracted outside entity and turning over the town’s ambulances to such an entity, according to Town Manager Grant Watmough.

“Do I think that will happen?” Watmough said. “No.”

Other issues include whether contracted outside ambulance workers will work out of Warren or come from headquarters outside the town.

The public hearing will be held Friday, Feb. 19 at 7 p.m. at the town office with a snow date of Feb. 24. Selectmen set the date at the Feb. 10 selectmen’s meeting.

After they have had a chance to listen to the views of the public on the matter, the selectmen will draft a warrant article dealing with the ambulance department that will go before the voters at town meeting in March.

“Ambulance service to the town of Warren is having a problem covering emergency calls during the day during the weekdays,” Watmough wrote in a document he released Feb. 10. “Selectmen have asked for several proposals to solve this problem.”

The Warren Ambulance Service has offered two proposals for per diem from 6 a.m. to 6 p.m. Monday through Friday. The service could have two people at the station 60 hours per week at a proposed cost of $84,710 per year or one person at the station and a standby driver for $58,520.

This would be added to the present budget for the volunteer ambulance service.

“Keep in mind that if approved this year, we would be looking at about half a year by the time it was set up and this is the only option where money received from these calls would stay in our budget,” Watmough wrote.

Waldoboro’s Emergency Medical Service has proposed two plans. One plan would provide two people at the Warren station during the daytime, one driver and one EMT or paramedic. It is also noted that if a medic is needed, he or she would respond from the Waldoboro station. The proposal also includes a nighttime stipend with shifts covered by Waldoboro personnel living in Warren from their homes at $2 per hour on-call pay. Advanced life support and paramedic service would be provided from the Waldoboro station as needed. This option would cost $217,079.

Waldoboro also offered a plan that would only provide one EMT or paramedic during the daytime. “That person would respond with the ambulance and appropriate personnel would intercept on scene to transport,” Watmough wrote. The night time plan would be the same as in the other Waldoboro plan. This would cost $153,326.

“Keep in mind that these plans would mean that payments for calls would go to Waldoboro,” Watmough said.

Sterling Ambulance Service out of Union has proposed two plans as well. Under the first plan, Sterling would provide emergency coverage Monday through Friday from 6 a.m. to 6 p.m. from Union at a cost of $28,000 per year.

Sterling has also offered to provide 24/7 coverage, responding from Union, for $72,000 per year.

“Warren will relinquish their current ambulance and all related equipment to Sterling Ambulance to be used as necessary,” Watmough’s document states. “Response will be from Union.”

Payments from patients for ambulance runs would go to Sterling Ambulance.

The town has also asked for proposals from North East and Delta, but had not received any at the time of this report.

In the summer of 2009, selectmen and Watmough met with members of the Warren Ambulance Service to discuss options for the future. The issue came to light after the town received bills from ambulance services in Rockland and Thomaston for providing backup service in Warren.

One of the big challenges is that volunteer ambulance staff members have commitments to full-time jobs during the week, making them unavailable for ambulance calls.

Watmough said last year that it was the first time the town had received bills from outside agencies. The town has seen a significant increase in its demand for ambulance service driven by an increase in population, moving the prison from Thomaston to Warren and an increase in traffic through the town. Meanwhile, the volunteer ambulance service is the same size at it was when it handled a smaller demand.

In the past, the Warren Ambulance Service has been able to cover the town’s needs, but the bills show that Thomaston and Rockland have had to fill in at a cost of $225 to $250 per ambulance run.

The ambulance service favors changing from the present stipends for volunteers to a per diem system in which paramedics and emergency medical technicians would be paid to be available for a certain number of hours.

Warren Ambulance Director Polly Wood and Assistant Director Robert Wood said other local towns are going through the same thing and have solved their problems by going to per diem status.

“Per diem is what the surrounding communities have so they can keep their own ambulance service,” Polly Wood said.

Wood explained that in the past, Warren had a mutual aid agreement with Rockland and Thomaston and other towns that provided free service in Warren when Warren’s department couldn’t cover a call.

She said that in 2009, other towns started charging $250 fees per run for this service.

Meanwhile, Warren’s call volume is way up. She said the town department received 349 calls in 2009. It missed 49 calls because it didn’t have a day crew to cover them.

The Woods also point out that if the town hires an outside firm, that entity will also be doing transfers or nonemergency calls moving patients from one hospital or nursing facility to another. They said some of Warren’s existing volunteers have stated they do not want to do transfer work.

Polly Wood made it clear that the town ambulance volunteers went to the selectmen with the per diem plan and the selectmen came up with the other options now on the table.

“It’s not going to be cheap,” Wood said. “There is no cheap way.”

Wood said the other firms being considered are going to make a sales pitch to the town, but that doesn’t mean the costs won’t go up over time. In the long run, the ambulance directors argue the town can either pay an outside agency or pay to staff its own ambulance department, but either way it’s going to pay more.

“We want to do what the public wants us to do,” Watmough said Feb. 10.

At the moment, the budget for the Warren Ambulance Service is $64,200, up $1,000 from last year. The budget change reflects a $6,000 cut in volunteer wages (from $26,000 to $20,000) and a $7,000 increase in funds for advanced life support backup (from $8,000 to $15,000). Watmough said in his notes to the budget committee that Thomaston, Rockland and Waldoboro advanced life support backup rates have increased.

The county dispatch fee is up $10,385 for the town, and Watmough said any outside agency hired by the town is likely to expect the town to continue to pay that fee. Sterling has specifically noted that in its proposal.

The town election will be held Monday, March 22 from 10 a.m. to 8 p.m. at the town office.

The town meeting will be held Tuesday, March 23 at 7 p.m. at the Warren Community School.