Private or public ambulance service August 31, 2018 on Editorials, Opinion After 45 years serving the greater Ellsworth region with emergency medical technician (EMT) service, County Ambulance has announced it is closing. In the short term, the Aug. 31 departure of County Ambulance will be a challenge. But it’s also an opportunity. Nationally, almost half of all EMT and ambulance service is provided by fire departments or fire department-supported ambulances. Another 15 percent of national ambulance coverage is provided by regional government — county or municipal agencies. Only 18 percent of the country is serviced by private ambulance services such as County Ambulance. The clearest distinction is that fire department ambulance services are largely staffed by full-time employees trained for both fire and EMT functions. Private ambulance companies, existing on service fees and public contributions, employ certified EMTs. Recently, a hybrid ambulance business model has been developed to better serve rural communities. When Penobscot Valley Hospital ended its ambulance service, Howland, a riverside community one-fifth the size of Ellsworth, expanded its fire department’s ambulance service. Howland cut its emergency services budget 48 percent last year and is now earning revenue by answering calls in several nearby communities. Other Maine communities also have found ways to multi-task emergency service assets and staff, while channeling the revenue received to lower local taxes. Capital Ambulance of Brewer is currently tasked with serving Ellsworth’s ambulance needs, parking a vehicle at Maine Coast Memorial Hospital. Needs may soon dictate expansion of both staff and/or ambulances. Or perhaps collective minds will devise a different business model that increases ambulance access, at less cost, while still serving the territory beyond the city limits. Emergency services are a hot topic, yet another spoke in a wheel that points to our aging infrastructure and our aging population. The issue of emergency services brings to the fore the challenges facing rural communities in Hancock County and across Maine. As needs increase and resources shrink, we need to consider the possibilities of centralization and standardization for ambulance services (and, while we’re at it, firefighting and public schooling). All options need to be on the table. From county organized or supported fire and emergency services and police, to larger school districts and fewer rural schools. The crystal ball of city and town planners is showing reduced revenues and growing demands. These are incompatible lines on a chart that does not lie. We encourage full exploration of these topics with a big-picture view before crisis decision making yields hasty and unappealing answers to these vital questions.