Town of Houlton significantly raises ambulance rates for contract towns

HOULTON, Maine — Communities that contract with the town of Houlton for ambulance services will see a sharp increase for that service in 2021. 

The town is changing its fee structure for the 12 communities that Houlton provides ambulance services for, Houlton Town Manager Marian Anderson said on Monday, Jan. 11. Those communities include Amity, Cary, Dyer Brook, Hammond, Hodgdon, Linneus, Littleton, Ludlow, Merrill, Monticello, New Limerick, Oakfield and Smyrna.

“Since August of 2019, when Crown Ambulance notified County towns of service being discontinued, Aroostook town leaders met to discuss ambulance service in The County,” Anderson said. “The meetings included managers, administrators, fire chiefs and ambulance service chiefs throughout Aroostook County. Costs and reimbursements were analyzed and discussed at great length. We all recognized that the taxpayers in the service communities could no longer continue to subsidize all of the service costs.”

Historically, the town has charged these communities $16.47 per capita for ambulance services. That fee will now be $74 per capita. In comparison, the city of Caribou raised its rate to $100 per capita, while Presque Isle is currently in the process of reviewing its fee structure.

The increase varies for each of the communities, depending on their populations. For example, Hammond, with a population of 113, will see an increase of $6,568, while Hodgdon (population 1,285) will see the largest spike of $73,613.

A complete breakdown of the new fee schedule is as follows, as provided by the town: Amity, $32,468 (up $13,359); Cary Plantation, $28,535 (up $12,547); Dyer Brook, $15,466 (up $11,974); Hammond, $12,746 (up $6,548); Hodgdon, $95,090 (up $73,613); Linneus, $68,820 (up $52,795); Littleton, $77,108 (up $59,666); Ludlow, $49,822 (up $22,169); Merrill, $19,462 (up $15,130); Monticello, $55,056 (up $42,539); New Limerick, $139,751 (up $28,831); Oakfield, $50,690 (up $38,914); and Smyrna, $31,450 (up $24,326).

Houlton is just the latest service community to raise its ambulance rates for surrounding towns. In January, 2020, the city of Caribou raised its contract fees as a way to balance its budget.

“These conversations took place during the budget workshops,” Anderson said. “There was not a formal adoption process until the budget was adopted. A lot of the towns knew last year informally that there was going to be an increase. The town of Houlton acknowledges that this is a significant increase.”

Notices were mailed to each of the 12 communities on Jan. 5.

Oakfield Town Manager Dale Morris confirmed Friday, Jan. 8, that he had received the new proposal and would be taking it to his board of selectmen for  discussion. “It’s quite the increase,” Morris said. “I expect this will be a topic of discussion.”

Monticello Town Manager Ginger Pryor confirmed that she too had received the proposal, but said it had not gone before her board. “I am working on our budget now and that was on my list to do,” she said.

Littleton Town Manager Lori Schools said the hike caught both her and her board of selectmen off guard.

“We received our ambulance contract in the mail Friday afternoon with absolutely no explanation of the substantial increase,” Schools said. “The selectmen were only made aware of it Friday afternoon after I received the contract. Needless to say we are looking at our options.  Our fiscal year begins March 1 and we have not had our budget meeting yet. I am sure it will be the topic of discussion.”

County Administrator Ryan Pelletier said Monday that the rate for Cary Plantation was substantial.

“The new rate reflects a 355 percent increase in that contract and we will have to absorb that through the existing budget as our budgets are adopted in November typically for the ensuing year,” he said. “We plan to bring the contract for ratification at the Feb. 17 meeting. While I am sure this rate is shocking for many of the smaller communities that will be affected by this, it doesn’t really come to a surprise to us as we have been dealing with significant increases in our ambulance contracts throughout The County.”

He added The County currently has about nine contracts with different ambulance services covering north to south.

With the increase, Houlton expects to see its revenue increase from $117,810 for ambulance contracts in 2020 to $517,112 in 2021. Much of that revenue will be allocated to paying for four new ambulances, purchased on Nov. 4 to replace vehicles ranging in age from 2015 to 2004.

“The decision to upgrade the rescue units in Houlton was made after feedback from patients, meetings with the Houlton EMS Director Milton Cone and staff,” Anderson said. “The old equipment presented many challenges in providing patient care while maintaining the safety of our patients and paramedics.”

The new contract rates are based on service communities covering 50 percent of the ambulance budget, as well as helping to pay a portion of the five-year debt of purchasing the new vehicles. The town will review the 2021 revenues and review the contracts annually, Anderson added.

“We recognize that the 2021 increase to our service communities is significant,” she said. “We have been discussing this since 2019, so while it’s difficult it is not unexpected.”

In addition to aiding with the vehicle payments, the increased revenue will also assist the town with paying its bills from non-payment of services with some patients.

Anderson said any of the 12 contract communities have the option of creating their own ambulance service. The communities of Fort Fairfield and Mars Hill/Blaine/Bridgewater both pursued this option in January, 2020, when their respective contracts increased.

“We respect that other towns have to do what is right for them,” Anderson said. “Nothing is getting any cheaper.”

The town is not imposing a strict deadline to accept the new fee structure and will work with those communities that have March town meetings or who may use a fiscal budget cycle rather than a calendar year cycle. Towns will have 30 days from the date of their town meeting to pay their fees without incurring interest.

“We appreciate all of our neighboring towns, but the taxpayers of Houlton cannot continue to subsidize the ambulance department,” Anderson said. “This is why everyone wants to live outside of Houlton. We just can’t do it anymore.”

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