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Towns, hospital look at future of ambulance services

By Susan Mustapich | Feb 23, 2021
An in-depth study of emergency ambulance services provided to Camden, Rockport, Hope and Lincolnville recommends extending the current contract with North East Mobile Health Services and augmenting training for local fire departments.

A study on emergency ambulance services in the towns of Camden, Rockport, Hope and Lincolnville is informing officials in those towns what has gone well and what can be improved.

The study reviewed the performance of North East Mobile Health Services, the 911 ambulance service for the four towns. Consultants investigated the company's licensure and oversight procedures and inspected North East's facility in Rockport, vehicles, practices and contracts.

While extensive data reviewed shows North East met or surpassed its contractual obligations to the four towns, the study recommends improving emergency medical response by training local firefighters in the four towns to provide services while waiting for the ambulance to arrive. It also leaves open the door for increasing the regionalization of emergency medical services in the future.

The current cost of the North East contract is around $311,000, which is split among the four towns using a formula. The additional cost of training firefighters is about $100,000, according to the report, also to be apportioned among the four towns.

Fire chiefs in all four towns support training firefighters in emergency medical services, according to the report. Rockport Town Manager Bill Post and Camden Town Manager Audra Caler are proposing to add funding for this purpose in 2022 municipal budgets.

The four towns are about to enter into a new short-term contract with North East, beginning July 1. The study determined there is insufficient time and funding for the four towns to move to fire department-based emergency medical services this year. It recommends entering into another one-year contract with North East in 2022, with a one-year extension.

The costs of a fire department-based service is $1.2 million in startup costs and another $1.2 million in annual operating costs, according to the study.

Over the past few years, the four towns have set new contract requirements for North East, and questioned whether those requirements were met.

One key contract requirement is that a paramedic respond to 95% or more of advanced life support calls. The study reviewed all 911 ambulance calls from July 2019 through June 2020 in the four towns, totaling 1,404 calls. Of those, 623 were considered advanced life support calls. The contract for paramedic service on those calls was met nearly 100% of the time, with the exception of a 97% response in Camden in September 2019.

Another key contract requirement is that North East meet specific response times for 911 calls from each of the towns. Study results show North East delivered faster response times to emergency calls in all four towns than required by the contracts.

Response time to Pen Bay Medical Center's requests for patient transfers to other medical facilities were also evaluated.

Consultant Kevin McGinnis presented the study results Feb. 8 and 9 to elected officials and town managers in the four towns.

One of the reasons McGinnis was brought in to do the study is that he has evaluated ambulance services throughout the state of Maine, Post explained Feb. 8.

McGinnis has served as Maine Emergency Medical Services director. He is credited with coining the term "community paramedicine," and served as CP chief for North East Mobile Health Services and CP program manager for the National Association of State EMS Officials, according to the publication EMSWORLD.

Pen Bay Medical Center and the towns of Camden and Rockport contributed to the cost of the study, and brought McGinnis on as a consultant. Tom Judge, former executive director of LifeFlight of Maine, served as a volunteer coordinator for the study.

In introducing the study Feb. 9, Camden Select Board Chairman Bob Falciani reminded board members that review and improvement of ambulance services is one of their top priorities. Caler has told board members the study would help them make decisions based on a wealth of data and other information.

Camden board members Marc Ratner and Taylor Benzie spoke in support of the report's proposal.

Chairman of the Lincolnville Board of Selectmen Ladleah Dunn asked Feb. 8 if alternatives have been reviewed for how costs are shared among the four towns. She is curious to see options regarding how much Hope and Lincolnville are paying per ambulance call, compared with Camden and Rockport.

Chairman of the Hope Board of Selectmen Sarah Ann Smith asked about getting language in the contract that would improve the quality of service for this coming year. She pointed out that the towns are entering into budget season, and need information now on contract costs from North East.

The study also brought to light the main complaints with North East's services. This came from interviews with 40 stakeholders recommended by a Steering Group of members of all four towns.

Hospital staff, Rockland Fire and EMS and local fire departments had issues with professionalism and some clinical deficiencies, when comparing North East staff with Rockland EMS staff.

Closer communication with North East staff was asked for regarding hospital patient transports.

Lack of consistent supervisory staff at North East's Rockport base office was another complaint. Overuse of mutual aid from the Rockland EMS was another complaint, with 52 mutual aid calls in 2019 and 40 in 2020.

Despite these complaints, the study found overall feedback on North East's service and staff was"'predominantly positive."

McGinnis spoke about how the mutual aid problem has been resolved more recently and there is now a supervisor in place at the Rockport base.

The data review found no serious response reliability issues, but pointed out a need for contractual clarity on measures for accountability. It also found there are no service or licensed personnel performance issues under review or in resolved status.

Part of the study provides educational information, including all of the services that can be performed by emergency medical technicians, advanced EMT's and paramedics.

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