Jonesport selectmen have begun formulating the figures that they will lay before the budget committee this week, and foremost among those accounts is money for the ambulance service. The issue came front and center recently when it became known that an ambulance service in western Washington County was in danger of going out of business for lack of funds and the unwillingness of the towns it serves to fund it adequately.

The potential demise of the Petit Manan Ambulance Service prompted a meeting in Columbia Falls January 12 of western Washington County ambulance service representatives, town officials, and the hierarchy of state officials involved in EMT issues. The participants in that meeting—and the estimated 50 folks who went to listen—agreed to form a committee to look into the problem with an eye toward a regional solution.

In Jonesport and Beals, the picture was already clear: the Moosabec Ambulance Service (MAS), which serves the two towns, had submitted budget requests for 2023 that tripled the amounts sought and raised last year.

Traditionally, the MAS formulates its requests by setting a per capita dollar amount and multiplying that figure by the number of residents in each town. In 2021, that amount was $15 per head, resulting in a request for $20,000 from Jonesport and $7,455 from Beals. In 2022, the per capita fee went up to $25, resulting in a bill of $33,275 for Jonesport and $12,425 for Beals.

For 2023, the MAS is asking for $81 per resident, rendering a bill of $100,850 for Jonesport and $35,883 for Beals. The tripling of the amounts sought from the Moosabec towns prompted discussion among Jonesport selectmen on January 18 as to how to incorporate the request into the recommendations they present to the budget committee this week.

MAS service chief’s take

Renèe Gray is service chief of the Moosabec Ambulance Service, and it was her letter to Jonesport selectmen that prompted worried discussion last week. Contacted after the selectmen’s meeting, she said the sudden increase in requested funds is largely because past requests were kept low because the crew sacrificed to hold the service together—by working for a pittance and dipping into money set aside to replace their 2007 model-year ambulance. “We’ve done everything we could do to keep requests from towns down,” she said.

While the January 12 meeting was prompted by the potential demise of the Petit Manan service, Gray pointed out that other services were managing. The towns covered by Petit Manan contribute very little compared to Moosabec, she said: Steuben pays $5,500 for coverage of its 1,126 citizens, and Milbridge pays $2,500 for 1,265 souls. By contrast, the towns covered by Pleasant River Ambulance service (Addison, Columbia, Columbia Falls, Harrington, and some UTs) already pay $81 a head for a total of $260,000. Lubec, where Gray is town manager, pays $90,000 out of its tax base.

MAS wages

The MAS force consists of four drivers, four local attendants (all EMTs)–all of whom have full-time jobs–and an out-of-town EMT who sleeps over Friday nights in their newly purchased and renovated former filling station next to the ambulance garage and who covers the Saturdays when no local EMTs are available.

Although forced to pay the out-of-towner minimum wage ($13.80 per hour) to secure a person in the post, MAS has been paying the local EMTs much less to help the service survive. After paying $1,000 each for EMT training (in Machias or Calais and including some Saturdays), the MAS attendants earn only $3.75 an hour while on call and approximately $20, depending on license level, while on a run. Most ambulance patients are on Mainecare, which only reimburses 85 percent of approved run costs (and nothing if the patient refuses to be transported to a hospital).

Enticing persons with that level of training for the poor level of pay MAS can offer is difficult, says Gray. Of the latest group to go through EMT training in Machias, not one was a MAS recruit, she said. “Times have changed,” she maintains. “This is a profession. Who [does this kind of] work for $13 an hour when you can earn $17 or $19 at MacDonald’s?” Her goal is an on-call wage of $7 per hour, yielding a pre-tax pay of $168 for a 24-hour shift.

Where to from here?

In Jonesport, when First Selectman Harry Fish read and digested Gray’s $100M+ request, his reaction was to pen a letter to State Senator Marianne Moore, who represents Washington County, urging her to enter a bill in state legislature that would provide money for cash-strapped ambulance services covering rural Maine towns.

Citing the January 12 meeting in Columbia Falls and listing MAS’s requests of his town since 2021, he encouraged her to introduce a bill that would reimburse towns and cities for 70 to 75 percent of the monies they raise for their ambulance services. The percentages, he wrote, were “along the same lines as reimbursement [that towns receive] for General Assistance.”

Fish is a member of the committee that came out of the January 12 meeting, but he is not encouraged by the trend toward regionalization, writing that it “would probably increase waits and travel time without relieving the reimbursement shortfall. At this point, I believe that only financial assistance from the State can resolve this life-or-death situation for our small rural communities.”

A blue ribbon commission at the state level has already been addressing the financial difficulties of rural ambulance services, without coming to a solution. Gray says the message from state EMT officials that she heard January 12 was: “This is a local issue. We can’t wait for the state [to act], or we will be out of business.”

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This article is republished by The Maine Monitor with permission from the Machias Valley News Observer.