Town officials and select board members from Camden, Rockport, Lincolnville and Hope convened at Camden First Aid Association headquarters Feb. 27 for a presentation of the organization's proposed fiscal year 2014 budget.

The four towns are serviced — or partially serviced — by the non-profit, Camden-based ambulance service which has recently been grappling with financial challenges.

For fiscal year 2013 CFAA received a total of $56,000 from the four towns, with Camden contributing $20,000, Lincolnville contributing $10,000, Hope contributing $2,000 and Rockport contributing $24,000.

Now, CFAA is requesting a total of $407,000 — or $37 per capita — from the towns, according to a presentation shown at the Feb. 27 meeting, which also was attended by members of the public.

Phone calls to CFAA and CFAA Service Chief Julia Libby's home seeking comment were not immediately returned, nor were several electronic communications sent to Libby between Feb. 27 and March 1.

CFAA service history


In 2009, CFAA responded to 2,485 calls for assistance.

In 2010, CFAA responded to 2,476 calls for assistance.

In 2011, CFAA responded to 2,081 calls for assistance.

In 2012, CFAA responded to 1,965 calls for assistance.

In 2012, of the 1,965 calls — an average of 38 calls per week, or five calls per day — 300 were transfers between facilities; 1,208 were emergency calls; and 457 were non-transports.

Non-transports in 2012, broken down by town:

Camden, 223

Rockport, 151

Lincolnville, 58

Hope, 10

According to information presented at the meeting, CFAA is not reimbursed for non-transport calls. 

Source: Feb. 27, 2013, presentation to town officials by CFAA

Camden's requested contribution could increase by $154,000 for a total of $174,000, said Camden Town Manager Patricia Finnigan. She said CFAA is expected to present the request to the town's budget committee Thursday, March 7, at 7 p.m. in the Washington Street conference room. Currently, Camden has a three-year contract for emergency medical services with CFAA, though the rate of $20,000 paid this year is the only rate Camden has previously committed to, Finnigan said. Prior to the contract, which was created last year, CFAA money was considered part of the charitable contributions budget, she said.

“Camden First Aid is an essential part of our overall public safety response,” Finnigan said. “They deliver a great service…there's also a limit to how much municipalities can support.”

She noted the final decision regarding CFAA funding will be made at the annual town meeting, as whatever amount of money town officials recommend will appear as part of the budget.

"Ultimately, this is going to be a town meeting vote," Finnigan said.

Rockport residents could be asked to contribute an additional $105,000 to CFAA — for a total of $129,000 — according to numbers provided by Camden First Aid.

"It's an enormous increase," Rockport Interim Town Manager Roger Moody said March 4.

He said he anticipates the request by CFAA will be included in the budget and addressed during budget meetings next week.

"There are a lot of options," Moody said, adding he's been researching how municipalities across the county handle emergency services. "There is a lot of understanding that needs to be developed."

Lincolnville Town Administrator David Kinney said the group meeting was "informative." He added town managers and town administrators have been working with CFAA since last fall. Lincolnville residents would see an increase of $67,000 for a total request of $77,000, according to information provided by CFAA.

Kinney said municipalities are not "statutorily required to provide ambulance service" to residents, but that he doesn't see that as a solution for Lincolnville.

"There's no one silver bullet for the problems that CFAA is facing…It was good to have all the policy setters in the same room hearing the same message," he said.

Hope Town Administrator Jon Duke said the proposed cost increase to the town — which amounts to an additional $25,000 — is not likely to gain traction. In 2013 Hope paid $4,900 to Union Ambulance for service to South Hope, in addition to the $2,000 paid to CFAA for service to North Hope.

Duke said Hope Selectmen are scheduled to review the ambulance portion of the budget in a March 12 meeting.

"I suspect there won't be any support for paying $27,000," said Duke.

He added options may include working with CFAA to see if there is a more agreeable number, or going to Union Ambulance for expanded coverage.

Duke said the two sides of Hope are comparable in the number of "address points" — meaning businesses and residences — that could potentially require ambulance service.

He said Feb. 28 a current estimate from Union Ambulance to cover the entire town is $8,700.

"We also realize that [figure] is not realistic for CFAA, we're part of this community organization and we want to see it succeed…but the jump is big for us," he said of the hike in the CFAA budget request.

Duke added that residents are happy with present ambulance service in the town.

"People are happy with both [CFAA and Union Ambulance] services, everyone feels positive about the service," he said.

Finnigan agreed and said, “I think everyone is with them, wanting them to succeed.”

Duke said certain issues contributing to the financial strain on CFAA — including refusals or "non-transports" for which the organization does not receive compensation — are not largely coming from Hope. Of 457 non-transport calls, 10 were from Hope, Duke pointed out.

“It comes down to the level of service the community expects,” Finnigan said. “They're trying to provide the best service they can.”

However, Camden might be willing to consider other options. According to an agenda for the March 5 select board meeting, selectmen could “authorize the town manager to work with regional town managers including Rockport, Lincolnville and Hope, to provide a range of options and recommendations to ensure Midcoast residents continue to have to reliable, high quality emergency medical services available to them. At a minimum, the manager should provide both short term and long-terms options that include the following:

• Immediate, near-term steps that can be taken to help Camden First Aid Association CFAA reach financial stability;

• Analysis of the impact of funding CFAA at the proposed level on this year’s budget and future years;

• Issue a request for proposals for Emergency Medical Services;

• Develop a different organizational structure for CFAA;

• Create a regional or individual Town-owned/operated EMS service.”

March 1, Finnigan said “there are other ambulance services that could be available.” She said Camden wants to work with the other four towns but also is open to emergency services other than CFAA.

“Switching the provider doesn't neccessarily make the problem go away,” she cautioned.

A possible option is NorthEast Mobile Health Services, which has a base in Rockport currently housing two ambulances, said chief and chief executive officer Kevin McGinnis. He said the for-profit service based in Scarborough has been in communication with CFAA officials for several months but little has been accomplished.

“We were very disappointed to have our division commander told by the CFAA chief that the meeting the other night was not a public meeting,” McGinnis said, adding NorthEast personnel wished to attend the meeting to extend an offer of help and listen to the presentation.

McGinnis said at least three meetings have taken place between to the two services. There was discussion of NorthEast assisting CFAA with an application for the Community Paramedicine Program — a new program that trains first responders to administer primary care, public health, prevention and wellness, disease management, mental health and dental care, according to communityparamedic.org — a program NorthEast has successfully begun, he said. Another meeting discussed improving heart attack patient transfers.

“Thirdly, knowing about Camden First Aid's financial issues, we met with the board president and chief to offer a way to maintain Camden First Aid as a viable presence,” McGinnis said. “We had cordial meetings…we offered them a Plan B.”

While there currently are two ambulances based in Rockport, he said NorthEast “could overnight put six ambulances in there,” though he said that number of rescue vehicles is likely too many for the needs of the four communities. He said there are bases in Scarborough, Biddeford, Sanford, Dresden, Topsham and Rockport. McGinnis said NorthEast has about 30 ambulances in the state based at those locations.

McGinnis said an appropriate level of emergency service could be provided at the current rate charged by CFAA. He said NorthEast is not interested in taking business away from existing services but would respond to a request for proposal.

“We just think it's unfortunate they're in this situation,” McGinnis said.

During the Feb. 27 presentation, CFAA service chief Julia Libby cited “bad decisions” from the past as a factor in the current financial situation, in addition to other factors. Former director Chris Knight was terminated from his position in March 2011 after a month of administrative leave, according to previously published reports. Knight admitted “cash flow issues” prompted the organization to divert contributions for nine months to employee 403b accounts, according to previously published reports. At the time of Knight's termination, then-board of directors chairman Frank Morong stated, “All our loans are current and our bills are paid. We don't have as much money as we'd like but we're in reasonably good shape.”

Libby — who was assistant chief under Knight — was named the new director in March 2012, according to previously published reports. The largest portion of CFAA's upcoming 2013-2014 budget is payroll, quoted at nearly $480,000 in the Feb. 27 presentation. Between October 2011 and March 2012, Libby added three full-time staff members to CFAA, according to previously published reports. The organization is staffed by 10 full-time employees making an average of $19 per hour, Libby previously said.

In March 2012, she said “the financial situation has improved for the organization” and the goal of paying off the ambulances was within the organization's sights.

Six months later, in November 2012, CFAA began calling for donations via a letter authored by board of directors chairman Steve Corson, according to previously published reports.

Courier Publications reporter Jenna Lookner contributed to this report. Associate Editor Stephanie Grinnell can be reached at 236-8511 or sgrinnell@courierpublicationsllc.com.