As Bowdoinham weighs its emergency medical services options, getting its own ambulance could cost the town more than $1 million just to get started.
During a town meeting Wednesday, Midcoast EMS providers spoke with Bowdoinham residents about the logistics of running an ambulance service now that the town is looking for permanent solutions after its contract with North East Mobile Health Services ends in June.
North East Chief Operating Officer Rick Petrie said the average cost of an ambulance is $350,000, then another $100,000 for equipment and $750,000 to staff the vehicle 24 hours a day. He said for Bowdoinham to break even, that ambulance would need to respond to 1,500-2,000 calls per year. Last year, the town of about 3,000 residents generated just 250 EMS calls.
Right now, Bowdoinham has a $50,000 annual contract with North East, which enlisted Topsham rescue as its backup service in 2022 but switched to Lisbon in January after Topsham grew overwhelmed by the volume of calls. Petrie said due to staffing issues at North East, Topsham responded to 83% of the calls last year and charged North East a $500 fee each time, causing North East to lose money.
In January, North East requested a contract addendum, asking Bowdoinham to pay $67,000 per month or consider their relationship terminated in 90 days. After pushback from the Bowdoinham Select Board, North East backed off and agreed to honor the $50,000-a-year contract until June 30, according to Bowdoinham Town Manager Nicole Briand.
Petrie said at the meeting that his team handled the whole situation “poorly,” but said, “Ultimately, this operation can’t be done at $50,000 a year.”
EMS is losing money — who foots the bill?
Many years ago, EMS operated purely on a volunteer basis, according to Kevin McGinnis, president of Friends of EMS for Maine. The former paramedic said the cost of each call EMS responds to outweighs the reimbursement from insurance companies. He said each call in Bowdoinham costs EMS $2,800, with only a $500 reimbursement through Medicare and Medicaid — an 8% increase from last year. He said 15% of calls are from patients with commercial insurance and 15% are self-pay, whereas EMS only sees payment 35% of the time.
“We need help from our Legislature,” Petrie said.
He said EMS needs $70 million a year from the state to keep ambulance services afloat and suggested the Legislature require Medicaid to pay higher reimbursement rates.
How do you staff an ambulance?
There are many combinations when staffing an ambulance: an EMT plus a driver, two EMTs, an EMT and a paramedic, an advanced EMT and a paramedic; the list goes on. However, the pay grade for each position varies based on experience, so if you want a paramedic who can administer medication, be prepared to pay more money, McGinnis said.
An EMT course is one night a week for four months, an advanced EMT course is two nights a week for six months and a paramedic attends an eight-hour class once a week for two years, plus 500 clinical hours in a hospital.
According to indeed.com, the average annual salary for EMTs is $27,000, for advanced EMTs $34,000 and for paramedics $43,000.
Petrie said it’s hard to draw people to the profession because the pay and benefits aren’t enticing. He said the average age of an EMT in Maine is 45 years old and the rest are retired individuals on a fixed income. He said they could raise wages, but that would require help from taxpayers.
The Bowdoinham Select Board will weigh its options at an ambulance workshop at 6:30 p.m. Monday, April 3, at 13 School St.
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