Bangor Daily News

PENOBSCOT COUNTY, Maine — An unexpected change from Northern Light Health threatens to leave multiple rural Penobscot County towns without their long-standing ambulance service unless they can come up with tens of thousands of dollars on short notice.

Seven towns will have to pay Northern Light Health for ambulance services — a change the towns said they didn’t expect — while insurance and patients also continue paying the healthcare giant.

Eddington, Etna, Dedham, Dixmont, Glenburn, Kenduskeag and Newburgh received letters in June about the changes, said Andrea McGraw, associate vice president of Emergency Medical Services, Northern Light Medical Transport and Emergency Care. Other towns have heard they’ll also be affected, but Northern Light said it’s “premature” to talk about other regions as those contracts have not been reviewed.

These contract disputes are just the latest example of rural Maine towns struggling to maintain ambulance services amid rising costs. Other towns have had to contract with neighboring towns, hire private ambulance companies or even purchase their own ambulances to continue providing services to their residents.

For years, Northern Light paid the towns to provide emergency medical services before an ambulance from the health care system arrived.

Dixmont received about $2,500 a year for those services, the town’s First Selectman David Bright said. The money went to the town’s volunteer fire and rescue department.

The Dedham Fire Department received a “small stipend” for the medical services it provided before the ambulance arrived to transport patients, Dedham Fire Chief Craig Shane said.

Contracts between those towns and Northern Light end this year. Now Northern Light will charge the towns a yearly fee of $17 a resident, McGraw said.

Reimbursement for ambulance services are at an all-time low, which means Northern Light carries the cost of whatever insurance and patients do not pay, McGraw said. Paying people who work in emergency medical services, as well as the upkeep of ambulances and equipment is expensive, she said.

“In order to continue to care for our Maine communities for generations to come, we have to make some changes,” McGraw said.

The per capita charge model is used across the country, with fees ranging in price from $3.50 per capita in Palmyra, Pennsylvania, to $55.95 per capita in 2018 in Vermont.

“The cost of municipal-based EMS is high, and we can no longer avoid making this change,” McGraw said. “Our rates are at the low end of providing this service.”

Towns are required to have a contract for medical transport of people, so an agreement will have to be reached to ensure ambulance services continue, Shane said.

Even with a new contract, there is no guarantee that an ambulance will respond to a call, something Shane said he wants to address in the new contract. Northern Light was unable to send an ambulance to 28 percent of his department’s calls last year, he said.

“Sign a contract to do what?” Shane asked. “Have an ambulance service that struck out 28 percent of the time? That’s disheartening.”

Dixmont’s contract in which it’s paid by Northern Light ends Dec. 31 . The town will have to pay $20,587 a year to continue receiving ambulance services. But the town cannot spend that money until residents vote on a budget at its next annual town meeting on March 15, 2025.

The new contract is not yet finalized, so it’s unclear what will happen to the ambulance service in the three-month gap from the end of the old contract to the town meeting.

Dixmont doesn’t know where it will find the money, as it hasn’t started budget preparations, Bright said.

“We have an obligation to provide health and safety to our occupants so if that’s what we’ve got to do, we’ll do it,” Bright said.

Dedham learned about the changes days after the town finalized its budget July 1, Shane said. For years the towns have had it good with the way the contract works, and a change made sense at the business level, especially with staffing issues. It’s the way the change was presented and the amount requested that is the problem, he said.

“It’s painful,” Shane said, referring to how the town learned about the change just after finalizing its budget.

Dedham will pay $30,000 for the ambulance service. Shane said he’s thankful the per capita charge is based on permanent residents and not seasonal residents.

“It’s going to be pinching pennies for the next 11 months to scrimp and save on a budget that’s already tight.”

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