Discord complicates Calais ambulance decision

CALAIS – If Calais decides to operate its own ambulance service, the decision will have serious consequences for the other member towns of the newly created eastern Washington County ambulance authority, according to the ambulance company that now serves the 19 communities.

Carl Bottorf, the Washington County manager for Meridian Mobile Health of Bangor, said Wednesday that his company would not respond to the Calais City Council’s request for ambulance service proposals.

Bottorf stopped short of saying Meridian wouldn’t submit a proposal, if asked to do so by the new ambulance authority, but he did say that if Calais has its own operation, it will “make it very difficult to provide ambulance service for anyone.”

“Meridian feels that the only solution to ambulance service in this area is a regional approach,” Bottorf said.

Meridian has been providing ambulance service to Calais, Eastport, and 17 other Washington County towns and unorganized territories since Dec. 7, 2000, when McGovern Ambulance of Calais closed its doors.

The communities served by McGovern’s had only a week’s notice of the closure, which followed on the heels of owner Dana McGovern’s indictment on federal charges of defrauding Medicaid and Medicare.

Calais, Eastport and Lubec asked Meridian to step into the breach, and the company agreed to provide ambulance service to the communities for 90 days while Rep. Albion Goodwin, D-Pembroke, introduced emergency legislation to create a quasi-municipal ambulance service.

Gov. Angus King signed the bill into law on Jan. 25. The authority must decide whether to contract as a group with a private company, to maintain ambulance equipment and lease out the operation, or to create a fully owned and operated system.

The Calais City Council met within hours after King signed the bill and continued a previous discussion about starting an ambulance service operated by the Calais Fire Department.

During that meeting, Councilor Ferguson Calder said council members had met with the Bangor fire chief who told them his department netted $900,000 from its ambulance service last year. Calais Fire Chief Danny Carlow said he believed the city could operate an efficient ambulance service at a startup cost of approximately $100,000.

After the discussion, the council asked for proposals from the fire chief and Meridian.

Calais City Manager Jim Porter said Wednesday that the council had not decided whether or not the city should have its own ambulance service.

The councilors want to compare the cost of a city-operated service and one provided by a private company, Porter said. Even though Meridian isn’t submitting a proposal, the company agreed at the beginning of the 90-day contract that it would open its books to member communities, Porter said.

Bottorf said he believes city councilors need to further examine the figures provided by the Bangor fire chief because Washington County is very different from Bangor.

That is something that Meridian is finding out, he said.

Ambulance services, whether for-profit companies or not, make the money they need to operate on “transports,” patients already hospitalized who need to be moved from one medical facility to another, he said.

One of the largest differences between Bangor and Washington County is the percentage of transports that are covered by Medicaid. Of all the forms of coverage, Medicaid pays the least for ambulance service, he said.

“My boss looked at Medicaid in our Bangor operation, and 20 percent of our Bangor transports are Medicaid,” Bottorf said.” Down here, 80 percent of our transports are Medicaid.”

While it is generally true that ambulance services in communities that have hospitals are better off financially than those that operate in communities that don’t have a hospital, that may not be the case in Calais, he said.

Hospitals, such as Calais Regional Hospital, do not automatically call the local ambulance service to transport a patient, he said. They call the ambulance service that serves the community where the patient resides, he explained. That means that a Calais-operated ambulance service won’t be getting all of the transports from the Calais hospital, he said.

Bottorf said Meridian employs 35 people who previously worked for McGovern’s. They are excellent and committed employees who’ve been through a lot in the past year, he said.

“I hope people consider their needs as well,” he said.

Bottorf said Meridian is not trying to elbow into Washington County or underbid anyone. But once the group of new ambulance authority communities breaks up, it will be hard to put the pieces back together, he said.

“This needs to be much more closely examined than the information that has been presented so far,” Bottorf said.

Porter said he agrees that the situation needs more examination, and he expects councilors to do that during their Feb. 8 meeting.

Carlow represents Calais on the new ambulance authority and Porter said he’s sure the situation will be discussed at the authority’s Friday night meeting in Pembroke.