The towns of Camden, Rockport, Hope and Lincolnville are facing increased costs for ambulance services as the June 30 end of a three-year contract with North East Mobile Health Services nears.

Currently the annual contract is $79,000, which is split unevenly between the four towns. Beginning July 1, annual costs are projected to increase two to three-fold, depending on service level options. The annual cost proposals range from $214,000, for less service than currently provided, to $315,532 to maintain the current level of service.

North East Chief Executive Officer Butch Russell explained Jan. 8 the reason for the increase is that the services provided cost more than the towns are currently paying.

Russell based the current contract on the belief that the volume of ambulance transports, from 911 calls and from local health facilities, would pay for three ambulances during the day and two at night, all staffed by paramedics. However, he has seen a drop in the number of ambulance transports each year.

The company had budgeted for 2,800 transports each year based on actual numbers from 2015, but transports dropped to 2,400 each year for 2016 and 2017.

At a rate of $560 per call, the decrease in calls resulted in a loss of $439,000 over the two-year period.

Payment for ambulance transportation comes primarily from Mainecare and Medicare, he said. The contract with the four towns provides a subsidy, and some revenues come from private insurance and individuals with no insurance. He said about 80 percent of patients transported are covered by Mainecare and Medicare. He also explained that only about 10 percent of the cost of ambulance trips billed to individuals with no insurance is paid for.

North East has provided ambulance services to the four towns for about five years.

Emergency ambulance transportation, when 911 is called, makes up just under half of the transports in the four towns. The remainder of transports involve patients from area health care facilities.

Russell met on Jan. 3 with local representatives from all four towns, who sit on the Emergency Medical Services Review Committee. The Lincolnville Board of Selectmen discussed ambulance service Jan. 8, and Camden and Hope Select Boards held discussions Jan. 9. On Jan. 8, Russell spoke at the Rockport Select Board meeting, though the issue was not on the agenda.

Camden Select Board Chairman John French is a member of the EMS Review Committee. In an interview Jan. 9, he pointed out that even at a cost of $315,000 a year, the four towns would not be paying the full cost of ambulance services. He spoke about how expensive it would be for the town of Camden to start up its own ambulance service, with the cost of buying two ambulances, the required medical equipment, and the cost of salaries and benefits for two paramedics as well as support staff. He estimated that would cost anywhere from $600,000 to $1 million dollars.

French feels that paramedic level staffing is important, especially in cases of an emergency call for a heart attack or a stroke.

He pointed out that if the towns provide the service, it will be all emergency 911 calls, and will cost much more than what North East is proposing to charge the four towns. He figures North East costs the towns less, because of the revenues coming in from the transports for medical facilities.

Proposed costs

Russell presented the EMS Review Committee with several options Jan. 3. The cost for the current level of service in a future contract would be $315,532. While he believes that the current number of ambulance transports does not require that level of staffing, he said it is up to the four towns to decide what service level they desire.

A proposed contract with the annual cost of $240,000 would provide two paramedic ambulances during the weekend, daytime, instead of current three. During weekday, daytime hours, three ambulances would be staffed. On one of the weekday, daytime ambulances, the license level would be reduced from paramedic staffing to Advanced Emergency Medical Technician (AEMT). Russell thinks this is a good match for the needs of the area.

Russel has also proposed a contract with an annual cost of $217,180, with further reductions in paramedic services, but does not recommend this option.

The Emergency Medical Services Review Committee meets again Jan. 11, at 5:30 p.m., in the meeting room at the Rockport Opera House. The meeting is livestreamed and recorded so it can also be watched at a later time.