Four towns are working together to find alternatives for emergency medical services following drastically increased funding requests from Camden First Aid Association, which currently provides emergency care.

Camden, Hope, Lincolnville and Rockport issued a joint Request for Proposal early this week. It can be found on Camden and Lincolnville's websites. Questions regarding the form should be asked via email no later than April 8 and proposals are due April 23.

Respondents will be allowed to submit bids for one town, a combination of towns or all four towns.

In recent months, each of the four towns has received a funding request from Camden First Aid many times higher than years past. Camden First Aid Service Chief Julia Libby said there are a number of factors that led to the higher requests and said the agency has been taking steps to decrease costs.

Libby said several items, including a pick-up truck and dock at a St. Agatha property currently owned by Camden First Aid, have already been sold. The St. Agatha property also has been for sale for two years, according to Libby.

"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 $77,000 has been requested this year. 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.

“There are other ambulance services that could be available,” Camden Town Manager Patricia Finnigan previously said. 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.

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.

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 — with a base in Rockport — is not interested in taking business away from existing services but also would respond to an RFP.

Courier Publications Associate Editor Stephanie Grinnell can be reached at 236-8511 or by email at