Returning from a call, one of Gardiner’s ambulances, Rescue 2, left, backs into the station as Rescue 3 pulls out to respond to another call last year at the Gardiner Fire and Rescue station. Many central Maine emergency rescue departments are facing high costs for repairs and replacements to their ambulance fleets as the number of calls are increasing and transport distances are getting longer as some hospitals close. (Joe Phelan/Staff Photographer)

Several central Maine towns and hospitals provide a lifesaving link for residents through their own paramedic or rescue services, often serving several surrounding communities in addition to their own.

But ambulances and their equipment can be extremely expensive, especially for towns without large property tax bases or for nonprofits without built-up reserve funds. When those vehicles need to be replaced or when ambulance services are looking to expand, costs can skyrocket quickly.

And as ambulances are forced to travel longer distances, especially in the Waterville area following the closure of Northern Light’s Inland Hospital earlier this year, those cost burdens can come sooner than expected.

WHICH CENTRAL MAINE SERVICES HAVE AMBULANCES?

Only a few communities in central Maine operate their own emergency paramedic services, and even fewer operate emergency ambulance transport services. Three of Kennebec County’s four cities — Waterville, Augusta and Gardiner — each has a fleet of three to four ambulances and staff. Winthrop and Winslow also have their own ambulance fleets, with Winthrop, like Gardiner, providing services to several other towns in the area.

In Somerset County, Anson, Madison and Starks jointly operate an emergency medical services program. Skowhegan’s Redington-Fairview General Hospital and Pittsfield’s Northern Light Sebasticook Valley Hospital both have ambulance services, and Fairfield and Norridgewock each have nontransporting EMS programs, which means they use the ambulance to treat on-scene, instead of moving a person from the scene to a hospital. Transporting agencies need a different license and can require heftier training.

Most towns with transporting permits have agreements with surrounding communities to respond to emergency calls, and many have agreements for those surrounding communities to reimburse the ambulance service for calls to their towns.

Winthrop, for instance, has a contract requiring Readfield, Wayne, Mount Vernon, Fayette, Manchester and Monmouth to reimburse the Winthrop Ambulance Service based on population and call volume. Gardiner has a similar agreement with Farmingdale, Litchfield, Pittston, Randolph, Richmond, West Gardiner and part of Chelsea — but operates as an enterprise fund and does not take in taxpayer dollars.

Delta Ambulance, a nonprofit ambulance transport company, operates a fleet of 17 ambulances. Delta’s fleet responds to calls in more than a dozen central Maine towns from Albion to Belgrade and often serves as a backup service when other nearby ambulances are unavailable.

HOW EXPENSIVE ARE THESE AMBULANCES TO BUY?

Generally, in the $300,000-$400,000 range.

But many services don’t have that kind of money lying around: Gardiner’s ambulance service has an annual budget of about $2 million and recently had almost $1 million in debt from uncollected fees that it was working to clear up. And ambulance prices are going up.

The Winthrop Town Council approved the purchase of a brand-new Demers brand ambulance from a Bangor-based dealer for $357,000 Monday, using surplus funds left over from previous years. That price tag includes a $72,000 stretcher system. The service will trade in the most run-down of its four ambulances for about $12,500.

And the new ambulance was a bargain, said Councilor Aaron White, who served for 14 years as a Winthrop Ambulance Service EMT. The demo model — a road-ready vehicle — was about $60,000 cheaper than if the town placed an order for a new ambulance, which often takes at least two years to build and deliver, anyway.

“This truck that’s available represents a huge savings to the town if we’re able to get it,” White said Monday. “And if we don’t act on this tonight, this will get sold to someone else. I guarantee it.”

Other ambulances in recent years have hovered around the same cost: Waterville bought an ambulance and related equipment in 2022 for $343,000, and Augusta bought one in 2024 for just under $336,000.

Even maintenance can be expensive. Augusta spent more than $100,000 on maintenance for its four-ambulance fleet in 2024, and Winthrop has spent about $72,000 annually on upkeep for its most run-down ambulance alone.

HOW HAVE CENTRAL MAINE TOWNS PAID FOR RESCUE VEHICLES?

Fairfield’s ambulance service received a special grant in July for a new ambulance, while other communities, including Waterville and Winthrop, have used surplus funds in recent years.

Winthrop officials agreed to use $357,500 in surplus funds to buy their new ambulance. Other municipalities have taken on debt or relied on grants to fund new ambulances. Gardiner bought an ambulance in the aftermath of the COVID-19 pandemic with funds from Kennebec County through the American Rescue Plan Act — a prospect that seems unlikely in the future, given the Trump administration’s decision to freeze or claw back federal grant program funding.

In 2019, Gardiner’s ambulance service chose to combine a fund balance and grants to re-chassis one of its ambulances — a process where the box of the ambulance and all of its equipment is lifted onto new load-bearing machinery. And in its most recent budget, Gardiner used a fund balance to re-chassis another vehicle.

A new ambulance’s lifetime is generally 6-8 years, and it can be re-mounted on a new chassis once or twice, depending on the new model. Each re-mount buys another 6-8 years.

Waterville most recently used surplus funds from its fire department to buy a $343,000 ambulance and related equipment, but required the fire department to pay back the city for the cost of the stretcher and heart monitor equipment.

WHAT IF MY SERVICE CAN’T AFFORD TO REPLACE AN OLDER AMBULANCE?

Ambulances are not immune to maintenance issues — especially older ones. And if those ambulances break down, services can be left scrambling.

Since Winthrop’s new ambulance chief Chris Moretto joined the town in May, he said two of the town’s four ambulances have been in the shop on at least three separate occasions.

“Will that go six to eight months before that ever happens again? Who knows,” Moretto said. “You think you’ve got everything taken care of, we go a week where everything’s going smooth and then all of a sudden an ambulance breaks down.”

The service can afford to staff only two crews at any given time, Moretto said, so having three in the shop would further limit the ability of the town to respond. Just since Jan. 1, both crews have been called out at the same time on 139 occasions. And 28 of those times, a third call has come in, which Winthrop has called another service to respond to. If, say, three older ambulances were out of service, surrounding ambulance services could be overwhelmed, and response times could get dangerously high.

That effect could be especially strong in the Waterville area, where rescue services facing higher-than-ever call volumes may be forced to send crew members to hospitals 20 miles away or farther after Northern Light Inland Hospital’s closure.