WATERVILLE — A City Council decision to buy two used ambulances with an eye toward developing a city ambulance service may be reversed, as new information has come to light about the process used to purchase them and a request by Mayor Nick Isgro to slow down the plan, vet the numbers and allow more input.

Councilors voted 6-0 on Oct. 15 to buy two used ambulances for $131,000, a vote Isgro vetoed three days later, saying more time was needed for information gathering by both the council and the public.

The council will consider a resolution Wednesday to override Isgro’s veto. The meeting is scheduled to begin at 7 p.m. in the Chace Community Forum at the Bill & Joan Alfond Main Street Commons at 150 Main St. downtown. The council meeting is Wednesday instead of Tuesday because elections are being held Tuesday.

City Clerk Patti Dubois said the council could vote to override or uphold the mayor’s veto or postpone voting on the override. An override requires the vote of five of six councilors, she said.

“We have to put the (override request) on the agenda because it is required, but they can certainly postpone that vote until the next meeting,” she said.

In his Oct. 18 veto, Isgro said the council formed a committee to study fire department needs, the panel met in closed-door sessions, and less than a month later recommended the council approve the ambulance purchases, and the council voted unanimously to do so.

Considering millions would be spent over the life of an ambulance service, more time should have been spent researching the plan, including having an unbiased, third-party review costs and revenue projections, according to Isgro’s veto.

The city is not licensed as an ambulance service authorized to take patients to hospitals. While the Fire Department’s rescue service responds to accidents and other incidents, only Delta Ambulance, with which the city contracts, may do so. Delta responds to all 911 calls and always has a paramedic on board.

Units from the Waterville Fire Department and Delta Ambulance respond Friday to a medical call on Main Street in downtown Waterville.

As required by city rules, the council Wednesday will consider overriding Isgro’s veto, but Isgro issued a memo to the council, City Manager Michael Roy and fire Chief Shawn Esler dated Oct. 29 recommending the council vote to table the request to override.

Esler and councilors Jay Coelho, D-Ward 5, and Mike Morris, D-Ward 1, are members of the study committee and are pushing to develop a city ambulance transport service, which they say would serve as a backup to Delta, generate revenue for the city and help curb delays in response time.

But in his memo, Isgro wrote that not enough time was dedicated to the process, which was done in an isolated setting. He also wrote that the city has no verifiable numbers to use in making a decision, and the ambulance purchases would violate the city’s competitive bid process. Moving to an ambulance service may be a wise step for the city, but that has not yet been proven, according to Isgro.

“The committee met in isolation from both the community and its relevant partners such as Delta Ambulance, hospital staff and citizens in neighborhoods like Seton Village, all of whom are stakeholders in some fashion and who may bring necessary perspective before making such a large commitment on behalf of Waterville taxpayers,” his memo reads.

He also said it is important to ascertain the viability of such a service.

“For the residents of Waterville, we must be able to say with more certainty than we have now that the rewards — both in financial solvency as well as patient care — of providing ambulance services will outweigh the risks,” Isgro wrote in his memo.

All proposed purchases exceeding $10,000 require a competitive bid process except those rare cases where the items purchased are “unique or non-competitive,” a point Isgro makes in his memo. He quotes an opinion issued by City Solicitor William A. Lee III on the matter:

“In the present situation, there was no publication in the newspaper and only two vendors were contacted. A quick Internet search reveals many vendors of used ambulances between Maine and Massachusetts. It is a competitive market with many possibilities. In my opinion, the proposed purchase of used ambulances does not meet the criteria of ‘unique or non-competitive.’ To determine otherwise would have the narrow exception swallow the rule.”

Isgro also maintains that Roy, the city manager, should have been involved in discussions. Asked at the council’s Oct. 15 meeting for his take on the ambulance service proposal, Roy, a former, 20-year member of Delta’s board of directors, said the most important thing the city could do was bring in 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,” he said.

CONTEMPLATING WEDNESDAY’S VOTE

Coelho said Wednesday he thinks councilors will still vote next week to override the mayor’s veto, but they will wait until the next council meeting to actually vote to purchase ambulances.

Coelho said he believes that when the council voted to buy the two used ambulances, members were under the impression a bid process was not required. But in light of the determination that the ambulances are not unique or noncompetitive items and a bid process is required, the council will follow the appropriate process, he said.

“If there’s a possibility to save some more money out there, let’s do it,” he said. “The end goal is to save taxpayers money in general.”

Coelho said it is possible the council will decide to postpone voting to override the veto.

“It depends on what other information comes to light,” he said.

Council Chairman Sydney Mayhew, R-Ward 4, said he is not sure whether he will vote to override the mayor’s veto, but he leans toward taking more time to study the ambulance issue.

“I’m kind of on the side of caution right now,” Mayhew said. “I’m going to look at more of the figures in the committee’s work and can’t commit to a vote right now, but I am leaning toward being cautious.”

Mayhew said he appreciates the work the Fire Department study committee and fire Chief Shawn Esler and others have done, but the mayor has valid points about the need to take more time to investigate the issue, vet the numbers and be more inclusive about having Delta Ambulance involved in the negotiation process.

Mayhew said he has heard mixed opinions from his constituents about the proposal to have a city-owned ambulance service, with some older residents on fixed incomes saying they are familiar with Delta and want to continue working with it.

“I also know of some business people that have expressed concern as well on the side of how are we going to be able to come up with the money to pay for this,” Mayhew said, adding he agreed with Isgro that Roy, a member of the Fire Department study committee, should be part of the discussion.

Roy is out on medical leave for a few weeks after a recent knee surgery.

“I am in firm belief that he should be included into this discussion based on his administrative knowledge, and he should be involved in this whole entire investigative process,” Mayhew said of Roy.

Mayhew said Esler has been an innovative, creative and frugal department head, and all the numbers he has developed in the ambulance issue should be considered.

“Bottom line is I see this as not a process that needs to be rushed,” he said.

DELTA’S PERSPECTIVE

By all accounts, Delta Ambulance, which has served as the paramedic transport ambulance service for Waterville for more than 40 years, was not included in the fire study committee’s discussions prior to the council vote to buy two used ambulances.

The council voted to buy one ambulance from Autotronics, with addresses in Frenchville, Madawaska and Bangor. It is a 2011 Chevy diesel Osage Ambulance, with 74,160 miles on it, for $55,000.

The other ambulance is a 2012 Chevy diesel P.S. Custom Ambulance, with 95,500 miles, for $47,500. As part of the vote, the council approved buying two used Stryker Power-Cots for $18,000. With discounts, the total cost to the city would be $111,000.

Tim Beals, executive director of Delta Ambulances, has worked at the nonprofit corporation 35 years. Like Roy, Beals said he thinks it is important the city have an independent review of the ambulance service proposal, as such a service is complex and a plan should be fully vetted.

Paramedics from Delta Ambulance transport a victim from a fall on Water Street in August.

At the Morning Sentinel’s request, Beals provided information about the number of 911 calls Delta and Waterville fire responded to, from 2008 to 2018, and for this year, to date. The data was provided to Delta from Maine Emergency Medical Services, according to Beals.

In 2008, Delta responded to 1,001 911 calls in Waterville and the Fire Department responded to 1,387. Those numbers climbed to 3,868 for Delta in 2018 and for the Fire Department to 2,761.

So far this year, Delta has responded to 3,465 911 calls and the Fire Department 2,538, according to the data.

Beals noted the numbers do not reflect patient transports from one facility to another. He also noted that Delta responds to multiple calls within a short period of time whereas the Fire Department can only respond to one at a time.

Delta and the city signed an agreement of understanding in 2013 that states Delta is the ambulance service provider for Waterville and will not charge the city a subsidy, according to Beals. The obligations and commitments to which both sides agreed include that Delta holds the city harmless from all liability resulting from Delta’s actions, Delta reserves the right to bill individuals or their insurance carriers for costs associated with medical care or transport service, and it will absorb all bad debt determined to be uncollectible and not seek reimbursement from the city or charge a subsidy fee.

As part of the agreement, the Fire Department handles all fire suppression, accident extrications or water rescues, and does traffic control at accidents.

The city also provides Delta with classroom space for continuing education, which benefits the city, according to the agreement. That agreement remains in effect until modified by Delta or the city.

Delta, an ambulance service licensed by Maine Emergency Medical Services, was formed in 1972 by three Waterville hospitals to provide transportation services to hospitals and meet surrounding communities’ needs for emergency ambulance service, according to Beals.

Delta employs 130 EMS professionals and support staff, and serves 17 communities, he said. As a full-service ambulance service, Delta also does routine and critical care transfers for MaineGeneral Medical Center’s Thayer Center for Health in Waterville, the Augusta and Alfond Cancer Care Center campuses and Northern Light Inland Hospital in Waterville.

Delta has more than 50 paramedics, 15 advanced EMTs and 35 EMTs. A paramedic is on every 911 call, according to Beals.

“As our call volume increased beyond the capability of our local communication center,” Beals said, “we developed our own communications center which is staffed 24/7/365 to manage our fleet of ambulances and ensure timely dispatch to all requests for service.”

Delta has a department that provides advanced continuing education to employees and other EMS providers in the region, conducts monthly continuing education programs for its first responder partners and offers programs, including a citizens academy, to the general public.

It also has a clinical quality improvement staff and regular feedback is given to Delta paramedics, AEMTs and EMTs to ensure best practices are always used to enhance delivery of care to patients, according to Beals.

He said Delta also has a billing office whose staff is certified in ambulance coding, ensuring bills are submitted correctly so insurance companies pay the correct amounts. The staff works with patients to develop payment plans for those who do not have insurance.

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