WATERVILLE — The city moved a step toward launching its own ambulance transport service Tuesday when the City Council voted 6-0 to buy two used ambulances for up to $131,000, a move some say could be putting the cart before the horse.

The city for many years has contracted with Delta Ambulance to transport patients to the hospital, with Delta being licensed by the state as a paramedic ambulance service. As such, it must provide a paramedic on every 911 call.

The city’s Fire Department also responds to rescue calls, but is not licensed to transport patients to hospitals. If it runs an ambulance service, it would have to be licensed.

Councilors Jay Coelho, D-Ward 5, and Mike Morris, D-Ward 1, are part of a new city committee studying Fire Department’s needs and, like fire Chief Shawn Esler, are pushing for the city to have and to operate an ambulance service out of the fire station.

Before Tuesday’s vote to buy the ambulances, Coelho said the city had to show it has equipment for such a service before it could petition the federal government to upgrade the equipment to new. He said the committee on which he sits still has a lot of work to do regarding the ambulance plan.

Having an ambulance service will require the city to hire more staff and buy more equipment, and the council would have to vote to approve such purchases in the future. Before the vote, Esler said if councilors approved the ambulance purchases, that would indicate the city intends to move forward with transport service.

Mayor Nick Isgro said he had a lot of questions about financial assumptions and that only committee members have seen the proposed figures.

“There would be a separate (council) vote on whether we offer a transport service,” Isgro said.

He said the city needs to make sure the numbers are reviewed and the plan would not require a municipal subsidy in order to produce revenue.

Travis Barron of Pease Construction Services mixes mortar Wednesday before doing brick work at the historic Waterville firehouse. A Waterville Fire Department ambulance service would be housed at the old station, if such a service is established.

Esler came to Tuesday’s council meeting armed with a thick notebook of statistics and information he said he has been gathering for 10 years regarding an ambulance service. He said the old Central Fire Station, which is attached to the newer one, is designed to house three ambulances and a crew upstairs.

“My mission is to provide the best service to the city of Waterville that we have to offer,” he said.

The ambulances the council voted to buy from Autotronics, with addresses in Frenchville, Madawaska and Bangor, are a used 2011 Chevy diesel Osage Ambulance, with 74,160 miles on it, for $55,000, and a used 2012 Chevy diesel P.S. Custom Ambulance, with 95,500 miles, for $47,500. As part of the vote, the city also will buy two used Stryker Power-Cots for $18,000. With discounts, the total cost to the city is $111,000.

Esler said the funds to make the purchases comes from money the city borrowed for a tower truck, but the price of the truck was less than expected. Esler said the used ambulances should last between 150,000 and 200,000 miles, if maintained properly.

The Maine Municipal Association estimates the Fire Department’s liability insurance coverage would increase from $517 to $1,034 a year if the department were to add ambulance service, he said.

At Tuesday’s meeting, Isgro asked City Manager Michael Roy, a former, 20-year member of the Delta Ambulance board of directors, for his take on the proposal. Roy was not included in the discussions on or planning for a proposed ambulance service.

Roy said he thought the most important thing the city can do is bring someone in from the outside — an unbiased party — to look at the numbers to see if an ambulance service can sustain itself.

“I think we’d be making a big mistake without analysis,” Roy said.

A toy ambulance hangs Wednesday from the rearview mirror of a Delta Ambulance at the company’s facility in Waterville. Delta currently provides ambulance service to Waterville.

Contacted on Wednesday for comment, Tim Beals, executive director of Delta Ambulances, said he first heard last Thursday of the Fire Department’s plan to buy two used ambulances. Beals, who has worked for Delta for 35 years, said he wanted to make sure the residents of Waterville get the best-possible service.

Like Roy, Beals said he thought it important the city have an independent review of the proposal to have a city ambulance service. An ambulance service is complex, and a proposal should be fully vetted, Beals said.

Delta, based on Chase Avenue in Waterville, serves 17 communities, has been in business 47 years and is a not-for profit, 501(c)(3) corporation, according to Beals. He said Wednesday that Delta started covering nine communities and expanded because smaller communities could not afford to support an ambulance service.

Delta’s board of directors decided it would be prudent to obtain a comprehensive evaluation of Delta and its regional system, so Delta hired Fitch & Associates of Platte City, Missouri, to conduct the study.

As part of its work, Fitch will talk to stakeholders in the system, town officials, first responder services and public safety answering points, as well as hospitals and other health care facilities, according to Beals.

He said Fitch is the leading EMS system review and system design consulting firm in North America, and has worked with clients in the United States, Canada and other countries for more than 35 years

“We think that the model we have now, the one that we’re using, is good and it has served us well,” Beals said. “But is it the best we want for our whole area? What’s best?”

Coelho said Tuesday an ambulance service would provide revenue for the city, but Mike Monck, a paramedic who has worked for Delta for about 3 1/2 years and who is former director of Waldoboro EMS and a former member of the board of directors for Boothbay Ambulance, issued a word of caution.

“If you think you’re going to make a lot of money on EMS, you’re not,” Monck said.

Monck said he has been involved in emergency medical services 37 years. Delta employees have a great relationship with the Fire Department, he said.

“But I’ve got a question: Why do you want to even think about getting an ambulance, because in my experience, you should be running away from it,” he said. “It’s a thankless job.”

Monck asked Esler what level of service the ambulances would provide in Waterville, whether basic or paramedic.

“I cannot guarantee a paramedic on every truck, like Delta Ambulance,” Esler said.

He said that of 3,000 calls Waterville Rescue responded to in 2018, Rescue had to wait 75 times for Delta to arrive at a call and 19 of those waits were five to nine minutes. Eight of the delays were from 15 to 19 minutes, two delays were 25 to 29 minutes and two delays were for more than 35 minutes, he said.

He said he wanted to be clear the city’s fire-rescue employees were providing care to the patients as they waited for Delta.

Beals, of Delta, said Wednesday the numbers Delta received from the state showed that of the emergency calls to which Delta responded in Waterville, Delta employees were on scene in 12 minutes or less, 96.68% of the time.

He said that from January to September of this year, Delta called for mutual aid 11 times. Delta’s options for mutual aid include using Clinton Fire Department, which has transport service and that Delta uses primarily in the Waterville area. Delta has other options as well, including calling Augusta, Unity and Albion.

 

Residents question the plan

Resident Bob Vear, who has suffered heart attacks, said at Tuesday’s council meeting he has used Delta six times and LifeFlight twice. He asked Esler what would happen if he needed to be taken to Portland for treatment and one of the city’s ambulances, for instance, is somewhere else.

“How is that going to affect these two ambulances, and are we going to be out of town down the road?” Vear asked.

Esler said the city would take care of its residents at all costs and would take him to Portland. If there were a fire, the department’s call firefighters would be called to cover the fire, if necessary, he said.

“I will guarantee you, we will take people to where they need to go,” he said.

Esler said the Fire Department and Delta Ambulance have worked together for some 40 years, and he is open to anything involving Delta to strengthen its position.

Julian Payne, a member of the Waterville Board of Education, wanted to know what Delta’s response was to the ambulance service proposal. He said that when everything appears to look good, “all that sparkles is not gold.” If Delta’s business were cut, Payne said, will it still contract its services with the city?

Monck said city firefighters do a fantastic job, “but at what point will you guys be on a fire call and can’t help us? These are the things you’ve got to talk about.”

He said employees at Delta are stressed, fearing the city will take away its revenue.

“I want to have a team effort,” he said.

Resident Hilary Koch said she loves the firefighters who have responded to her home. She said when she calls for rescue for her child, “I have to have a person with extra training.”

“If the city is not making a commitment to having that paramedic crew,” she said, “it is putting the cart before the horse.”

She said she did not know enough about the numbers but assumed Esler does. When talking about medical care, however, experts are needed, she added.

Esler told her if the Fire Department does not have paramedics available, Delta will cover the call. If Delta is not available, a patient is better off in the hands of an EMT than at home without help, he said.

Cathy Weeks, a member of the Planning Board, said she agreed with Koch’s assessment. Weeks said she has had 12 years’ experience with her ill father and her mother, for whom both Rescue and Delta have responded.

“Delta would come right after your guys would come because these are very critically ill people,” she told Esler. “I do agree you may discuss being an ambulance, but we need to see the whole plan.”

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