Staff Writer
PRESQUE ISLE – The future of the city’s ambulance service was discussed at a special City Council meeting held Sept. 15 at City Hall.
Earlier in the year, councilors expressed concern over the rising costs involved in operating various city departments, including the fire department.
Staff photo/Kathy McCarty
DUANE WALTON, of NMDC, prepared a business plan for the city detailing what it would involve for the Presque Isle Fire Department to provide ambulance service to the community. Pictured at the table, from left: Walton; Fire Chief Darrell White; and Tom Stevens, city manager. Beyond Walton seated in the audience are officials from The Aroostook Medical Center and Crown Ambulance Service. Not pictured but present were members of the PIFD.
While others had ways to bring in revenue, it was determined the fire department lacked the ability to do so, relying on taxpayer dollars to cover its budget. City Council began discussing ways the department could begin bringing in revenue, including the possibility of taking on ambulance service a way to make money to offset budget expenses.
At the Sept. 15 meeting, all councilors, expect G. Melvin Hovey, were present to discuss the city’s option. Also on hand for the discussion were: City Manager Tom Stevens; Fire Chief Darrell White; and Duane Walter, of the Northern Maine Development Commission’s Business Finance Office, who assisted in preparing a business plan for the city of Presque Isle’s emergency medical services.
“This is just a fact-finding mission on our part on whether the city will pursue getting into the ambulance service. The city has been looking into this for some time now – looking for ways to reduce costs and increase revenue,” said Council Chair Walt Elish. “Due to fuel costs, etc., we have issues with the budget. Tom has asked the departments to look for ways to increase revenues.”
Stevens stressed that the issue was “financial” in nature, not based on “quality of care.”
“We have four options, basically. One is to do nothing. The city has had a contract with The Aroostook Medical Center for a number of years. We could continue with that,” said Stevens.
Option two, according to Stevens, would stop or reduce payment to TAMC.
“Option three we would arrange with TAMC to have their ambulance housed at the fire department, staffed by PIFD personnel, which would mean a savings to TAMC but an expense to the community,” said Stevens.
Stevens said option four would have the city operating a full-service ambulance with no attachment to TAMC.
Walton gave an overview of the business plan he worked to create for the city, noting ways an ambulance service could help create revenue for the city. He indicated by having a service of its own and not having to pay another agency would, once equipment and staff were operational, save the city from the contract payments it now has.
White said training wouldn’t be an issue, since several of his staff are either already qualified paramedics – who also work for Crown Ambulance when not at the department – while others are only a few courses shy of such certification.
“Our goal for the project is to bring our intermediates – one is only a few classes away – to have two paramedics per shift,” said White.
Walton advised Council if the city went into the ambulance business, it would need to have more than one unit to make money.
“One ambulance just won’t work. If one ambulance is out and another call came in, (with just one unit) you’d have to call Caribou or Crown for backup. That won’t earn you money and defeats the purpose,” said Walton.
A new ambulance, fully equipped, Walton told councilors would cost approximately $414,580 – a figure the city obtain through fees paid to the ambulance service as well as through the annual budget. Up to 70 percent of salary cost could be absorbed through ambulance calls, according to the plan.
“The city could use the $100,000 a year they’re using now (toward paying Crown) toward the $400,000 startup,” Walton told the Council.
Councilor Ron McPherson questioned how the department would pick up calls. He noted marketing was one possibility but wondered what other options were available.
“Through 9-1-1,” said White. “When folks pick up the phone and dial 9-1-1, the call goes to the barracks in Houlton and we’d pick up on them. The city would pick up a large portion of calls,” said White, since 9-1-1 calls are automatically routed to municipalities.
Currently, 9-1-1 calls come in to the local fire and police departments. From there, calls go out to Crown Ambulance for mutual aid.
Firefighters and TAMC officials were just some of those who attended the meeting. TAMC and Crown personnel met with city officials earlier this year to discuss the same topic.
“I understand the need to provide municipal services while trying to keep from raising taxes. This is the wrong way of going about it,” said Dave Peterson, president and CEO of TAMC, during an interview Sept. 19.
Peterson was joined by Jim McKenney, senior manager of Crown Ambulance Service.
Peterson and McKenney expressed concern over staffing and qualifications.
“For 20 years Crown has provided well-documented, qualified service. We’ve been recognized for our qualified care. We’re already there – up to speed,” said Peterson. “Their (fire department staff) ability to get up to speed is questionable.”
Crown has nine ambulances, with two personnel per run, according to McKenney. Crown serves about 16 communities, ranging from Caswell all the way down to Monticello, and from the Ashland line to Fort Fairfield.
“We’re licensed at the paramedic level. One (paramedic) has to do each run,” said McKenney.
The men questioned the fire department’s ability to adequately staff ambulances and fire trucks when calls came in.
“They talk about having people on call – paying them to be on call – but how long would it take them to get to the station? We have people with the ambulances at all times,” said Peterson.
Hospital officials indicated the city’s proposed plan to house and man one of Crown’s ambulances was perhaps the most workable option at this point.
“They would man with a paramedic and respond to our calls. That would save us around $90,000 annually,” said McKenney, noting this option would provide a quicker response time from the fire station for calls to the north of town, since it eliminates the travel time from Crown’s Academy St. facility.
McKenney continued, adding Crown is capable of responding with several ambulances to multiple calls all at once, while the fire department would have a more difficult time handling multiple calls due in large part to staffing and having to call people in.
Peterson said another issue was medical in nature.
“We have an obligation to provide medical directives to the ambulance service. Once a call comes in, that’s our patient. Our physicians have confidence in Crown’s staff now. Our concern is they may not have the same confidence with a new business,” said Peterson.
Peterson said much still needs to be discussed before the city makes such an important decision.
“The plan’s not fleshed out enough. There’s a lot that needs to be worked out,” said Peterson.
Stevens agreed that more discussion is necessary.
“We’re just considering our options. We’re trying to find ways to maintain department budgets in light of rising costs. An ambulance service being run by the city is just one idea being considered. Council will continue to discuss the matter in October,” said Stevens.
