GOULDSBORO — Whether it’s a fall or heart arrhythmia, many Schoodic Peninsula residents take comfort that an ambulance can be at their home in minutes. They may even know or recognize the first responder. To sustain Schoodic EMS, the Board of Selectmen is taking a hard look at how much should be budgeted annually and how long it will take for the valued service to break even and continue serving Gouldsboro, Winter Harbor and Township 7 in years to come.
At a related workshop last Thursday night, selectmen discussed whether Schoodic EMS’s geographic reach should be extended or be confined to strictly serving the current communities. Founded after County Ambulance closed in 2018, Schoodic EMS was formed by the two Schoodic Peninsula towns to provide ambulance service locally rather than contract with Ellsworth-based Northern Light Medical Transport & Emergency Care. At the time, a reserve account was set up for the squad.
“In my opinion, we are not in this as a business. We are in it to provide a service,” said Dana Rice, chairman of the Gouldsboro Board of Selectmen. He noted Schoodic EMS’s reason for being is to serve Gouldsboro and Winter Harbor. He worried the original intent could get lost in an effort to generate more revenue from outside the squad’s priority service area in order to break even or make it a profitable operation. Later in the workshop, Rice said, “I am very supportive of Schoodic EMS and what it does for the community. One of the questions for me is the dollar-and-cents part of it. Are we going to make sure Schoodic EMS is going to serve the area if we try to reach out and generate more funds?”
The selectmen’s focus on Schoodic EMS arose last spring when Gouldsboro and Winter Harbor Fire Chief Tate McLean and the squad’s office manager, Ken McCartney, presented a draft Emergency Medical Services for Billing and Collections Ordinance for their review. At the time, they explained that the state required the town to have such an ordinance in place in order for the ambulance service to collect revenue. “It clearly communicates to residents how the billing and collection are going to work,” they said back then. The proposed ordinance sets forth procedures for billing insurers and individuals for co-pay, among other things. A late word change kept the proposed ordinance from being voted on at the 2020 annual Town Meeting on Aug. 26.
At present, McLean and McCartney are Schoodic EMS’s only full-time employees. McLean is an advanced EMT and McCartney is a paramedic and both regularly go out on calls. The rest of the nine-member crew includes another advanced EMT, three paramedics and three EMTs. The first responders are paid a per-call stipend that varies depending on their training and skill level. Paramedics are the highest paid and earn $150 per call. Advanced EMTs earn $100 per call while EMTs receive $75 per call. All are paid $2 per hour when on call and ready to roll during a 12-hour shift. An emergency vehicle driver is paid $50 per call and $2 per hour when on call during a 12-hour shift.
“Since we started this service, I am proud that we have provided 24/7 coverage,” McLean told selectmen.
Schoodic EMS, depending on the level of medical care required, has a rate scale for transporting patients. The fees range widely from $806 for an ambulance run with a paramedic to $330 for a non-emergency call in which an EMT administers basic life support. The squad also charges $13 per mile. Emergency vehicles average 50 miles per call and annually log a total of 15,000 miles. A contracted bookkeeper handles the proper medical coding and electronic billing to insurers. That person’s compensation is derived from 6 percent of the funds collected for each call. The bookkeeper issues a quarterly revenue report for the department.
In 2019, Schoodic EMS’s crew responded to 231 calls compared to 250 in 2020. So far this year, the ambulance service has collected $60,000 in revenue from transports. Except for a few, most of the patients generally are insured and able to meet their co-pay or arrange a payment plan, according to the fire chief.
While Schoodic EMS is licensed through the Gouldsboro Fire Department, McLean said the ambulance service’s annual budget is separated out. In its first year of operation in 2019, a total of $121,000 was budgeted. However, one of its three emergency transport vehicles unexpectedly broke down, costing $30,000 in repairs and raising expenditures to $155,269.
McLean said it may take 5 to 10 years before Schoodic EMS breaks even. One positive development, he noted, is the Maine Legislature’s recent passage of legislation authorizing MaineCare and Medicare to fully cover ambulance bills.
“Like anything [in its infancy], we are starting to bring in some revenue now,” he said.
Through the Hancock County Fire Association, McLean said Schoodic EMS does observe a countywide mutual aid agreement with other Hancock County towns. When able, the ambulance service has assisted other Downeast towns outside its immediate service area. That assistance included a transport from Machias to Fort Kent in Aroostook County. “We can respond, but we have the right to say no,” McCartney stressed.
Budget Committee Chairman Dwight Rodgers suggested Schoodic EMS not only log all its transport calls, but also those requests it turns down from outside its immediate coverage area.
“I think that would be to both our advantage” knowing, he said.
While they are scrutinizing the operation, Rice and other selectmen reiterated their commitment and appreciation for the Schoodic EMS crew’s work. They plan to finetune the ordinance before it is put on the warrant for townspeople to consider at the 2021 annual Town Meeting in June.
“I must say, the thought of having a Gouldsboro ambulance nearby is a lot more comforting than having one come from Harrington or Machias,” Selectman Chris Urquhart said.