Officials in Camden and Rockland are talking about combining forces to create a regional emergency ambulance service for multiple towns.

Rockland City Manager Tom Luttrell and Rockland Fire and Emergency Management Services Chief Chris Whytock were invited to the Feb. 26 Camden Select Board meeting for the first public discussion of the plan.

Camden Town Manager Audra Caler-Bell said she and Camden Fire Chief Chris Farley had previously met informally with Lutrell and Whytock.

Caler-Bell said the talks are at the investigatory stage, and that she thought the board meeting in Camden was a good opportunity to discuss this publicly and hear the reactions of board and community members.

Select Board Chair Bob Falciani characterized the discussions as part of the responsibility of Camden's elected officials to look at every option, and "under every stone" for the benefit of the community.

The recent history of Camden's ambulance service was brought up by multiple speakers during the discussion, particularly the change from the local nonprofit Camden First Aid Service to privately-owned North East Mobile Health Services, as well as massive price fluctuations over the years.

Currently, Camden, Rockport, Hope and Lincolnville are in a one-year, performance-based $300,000 contract with North East, which provides the four towns with 911 emergency ambulance services. Prior to that, the four towns had a three-year contract with North East for $79,000. North East also provides Pen Bay Medical Center with inter-facility transfer services between hospitals, nursing homes and other health care facilities.

At the Feb. 26 meeting, Farley said the talks about whether the fire department would be interested in providing an ambulance service "created some excitement for me, and to others in the room sitting behind me," referring to several rows of firefighters attending the meeting.

Farley started his work in the fire service in a department that provided ambulance services, and has been on many ambulance calls. Talking about the new proposal, he said, "What appealed to me is that it would be a collaborative effort with several communities." He expressed hope that "we can get some of our neighbors involved" and said the city of Rockland would be a good partner to work with.

He has researched the inception of the Camden Fire Department, and talking about it with town historian Barbara Dyer, found that Fire Chief Alan Payson started the first ambulance service in Camden about a hundred years ago.

Lutrell said the city of Rockland is also excited to be starting talks with Camden and the other three towns on regionalization of EMS services, and anything else down the road.

He said the regional emergency service would be set up as a special revenue account. Revenues would go into a special account, with the expenses coming out of it. "Any revenue left in the account would go towards equipment. It would not be going back into the city coffers," he said.

Whytock said the Rockland Fire Department has 18 full-time firefighters and EMS personnel. They are all cross-trained for fire and EMS, except for two who are EMS only, he said.

"Many towns find that is the biggest bang for your buck, to have cross-trained personnel in the station," Whytock said. "Typically when a call comes in, whoever is in the station can answer that call. Last year we did just over 2,000 runs."

Whytock said the fire department is a highly skilled, highly trained workforce, and takes pride in that. "If you talk to the local hospital or community members, people are pretty happy with the service we provide," he said.

Whytock explained his view of the difference between the regional plan linking Rockland, Camden and the other towns, which supply funding through taxes, and what the four towns have now.

"We're not like a private company, where if they're not making money, they're losing money and going to be out of business," he said. "We have the benefit of combining revenue with the tax base. That gives us a leg up on the competition." He said costs would be higher for the regional EMS, but consistent over time. Costs would be driven by union-negotiated increases, he explained.

Whytock said regionalization of EMS services is a natural fit for the towns. The plan to extend services to the four additional towns would not neglect or delay service in Rockland or affect its staffing, he said.

Julia Libby, who spent 30 years with Camden First Aid, the last two years as service chief, asked Select Board members "to listen to these individuals who have put a lot of thought and work into this."

She said there were good reasons the fire departments were interested in a regional EMS service. One reason is to focus solely on emergency calls, the practice and training for those calls, and the experience of using the training and practice in the field. Another reason is that the staff would be drawn from the surrounding communities.

"We need people who live in the community. They are caring for your neighbors, friends, family, coworkers," she said. “There's a difference if you live in the communities, of how you treat your people. There's connection."

Libby emphasized that the firefighter and EMS staff would "need to make a living. They can't do this for $8 an hour."  While Camden First Aid was basically volunteers many years ago, she acknowledged that today, "there are no more volunteers."

Libby said local EMS was needed, not because North East was not doing its job, but because the nature of its business is based on inter-facility transfer. Their EMTs and paramedics love to do the emergencies, but that's not what they do most of the time, she said. She said she has been told that they also do not do as much training for emergencies.

State Rep. Vicki Doudera, D-Camden, said she was speaking as a private citizen. She was a member of Camden First Aid for many years. That started with her taking the first responder class, and then going out on emergency calls. "It wrapped me into this town, and that set me on a course to want to do more for the town," she said."It was helping your friends and neighbors at a vulnerable time." She believes that the regional EMS model could "perhaps be a tool to increase volunteerism in the town."

Former Select Board member John French, who was a member of the four-town ambulance service committee that helped to negotiate the current contract with North East, spoke about how North East's services were sought when the locally based Camden First Aid Service met its demise nearly six years ago. The town issued a request for proposals, and received three: a $550,000 proposal from Delta, $450,000 from Camden First Aid, and North East was under $30,000. French mentioned that North East was depending on revenues from other sources, but he could not recall all of the details.

He said that even at $300,000 current costs are low compared to what it will cost the towns to buy and staff ambulances. He praised North East's work in the community, and commented that he did not like hearing the "North East bashing" that was going on in the room.

" These people do great work. We're getting a contract that we negotiated," he said. "They've done a great job and they've done what we asked them to do."

Select Board member Mark Ratner, current chairman of the four-town ambulance service committee, also helped negotiate the current contract with North East. Before Ratner moved to Camden, he spent 20 years with the Los Angeles Sheriff's Department as an emergency medical technician specializing in search-and-rescue services. He defended North East's services.

"It's not fair to compare this as a public-versus-private situation. He said he had yet to meet any EMT or paramedic, whether public or private, who wasn't giving 100 percent and doing the best they could for the patient.

At the same time, he said, the plan to regionalize EMS, drawing on cross-trained local firefighters and working together to provide better services, "is how we move forward."

He cited the difficulty Maine law enforcement and fire departments have in attracting people for the jobs. He said staffing is also a key difficulty for private providers, like North East, while acknowledging the company has done a good job with staffing.

Ratner sees that municipal services, with staff who live in the communities, will draw committed people, and become more of a career than a job. '"Providing fire and police services so our citizens feel safe and can depend on us when they need us is more important than anything else we do," he said.

Select Board member Taylor Benzie works as a professional firefighter, and started out in his career working in the Knox County communications center on 911 calls. He said the issue being discussed "is near and dear to my heart."

"A municipal service and regionalization similar to what we're talking about now, particularly if it gives our fire departments the opportunity to work more closely together, is a significant benefit," he said. Benzie had questions regarding costs and how regionalization might affect service levels and mutual aid.

Select Board member Alison McKellar expressed support of the regionalization of emergency ambulance services, and said she deferred to her more knowledgeable colleagues, who are showing support. She agreed she had seen good ambulance service from North East, but said she had also heard complaints. She described North East's entry into the area with a low price as an example of how the privately owned company "lured the business away," and has now established itself as a monopoly and engaged in price gouging.

Butch Russell, chief executive officer of North East Mobile, was also present at the meeting. He added to the history, saying that, "when we first moved into the area, Pen Bay Hospital reached out to us. They said they were not being serviced the way they needed to be, and needed help."

He said he was not involved in negotiating the original contract with the four towns, when Camden First Aid was having problems, and did not know the factors behind the low price initially offered.

Last year, during negotiations for the current one-year contract, he had explained the reason for the jump in price from $79,000 to $300,000. North East had projected a higher number of emergency calls for the prior three-year contract, and there were actually fewer emergency calls. The towns only pay North East for the actual emergency calls, and the company was losing money.

On Feb. 26, Russell said everyone in the room could take out their phones and do a quick calculation of how much ambulance staffing costs. He said the hourly rate for staff is $20, which rises to $26 if benefits are included.

Multiplying the hourly rate by 24 hours times 365 days a year is around $225,000 in payroll just for one person, he said. Staffing two people per ambulance is $500,000. He said the cost of salaries alone for the towns to add two ambulances for regional service could be as high as $1.2 million. Russell mentioned that North East uses per-diem employees to fill in when staff are sick or on vacation. He said most fire departments do not use per-diems, but pay overtime to employees filling in for others. He mentioned the practice of paying double-time for "forced time," where someone does not show up to work, and another firefighter is called in.

Russell said the revenue from the four towns is only $400,000, and the rest would have to be paid by taxpayers.

Caler-Bell wrapped up, saying that this discussion to gauge opinion was not the place to work out details, such as whether a regionalized fire and EMS service would try to do the interfacility transfers, or to ask North East if it would continue to do that service without the emergency calls. She indicated there would be further talks where details would be discussed.

Farley said in a  Feb. 27 interview that Camden's fire department has "a decent-sized group of young people." He is a chief who works outside of his regular job description to help keep his firefighters by helping them find a job in town, or housing. The days are over when the Knox Mill was open and part-time firefighters and volunteers could leave work and jump on the fire trucks, he said.

He sees the new model in its place as the cross-training in EMS and regionalization, and wants to build on the excitement he sees from his firefighters. "It creates a challenge and opportunity to help keep our young people here," he said.