Public-private ambulance service marks a decade in Brewer
Friday, February 19, 2010

A decade ago, if somebody got hurt in a car accident on Wilson Street, the advanced life support ambulance would come from Bangor, fighting traffic along the way.

That all changed when city leaders created a then-controversial public-private partnership — the first of its kind in the region — with Eastern Maine Healthcare Systems’ Meridian Mobile Health, which operates Capital Ambulance Service.

“It’s unique because almost nobody in this corner of the country does this,” Brewer Fire Chief Rick Bronson said Thursday.

City councilors signed their first contract with Meridian in August 1999, and just signed a third three-year contract on Feb. 9, retroactive to Jan. 1, 2010.

The service provides the city an ambulance, Capital 309, and a paramedic available 24 hours a day. Both are based at the fire station at no cost. The service also handles billing and pays Brewer for four firefighter-emergency medical technicians to drive the ambulance.

“It really is an experiment that has really gone well,” Chuck McMahan, director of Capital Ambulance in Bangor, said at a Feb. 9 Brewer City Council meeting.

The benefit for Meridian is increased business. Meridian is a member of Affiliated Healthcare Systems, which is a subsidiary of EMHS, and in 1998 purchased Capital Ambulance, according to its Web site.

Over the years, a second ambulance, Capitol 308, has been added and is staffed entirely by Brewer firefighters. The backup ambulance is used for nonemergency transports and as a backup for the advanced life support ambulance, Capital 309.

“By doing this, we have produced distinctively more rapid responses to the person seeking help,” Bronson said. “We reduced travel time to get the medic to them.”

The two Capital ambulances in Brewer operate under different contracts, Bronson said.

For Capital 309, Meridian pays the salary of the paramedics and for all the supplies, which the city gets a fee, which this year was $165,752, to offset the cost of the four firefighter-EMTs who drive the ambulances.

In addition, the city gets 15 percent of net collected revenues for ambulance runs in Brewer, McMahan said.

For the mostly nonemergency Capital 308, Brewer pays for medical supplies and billing, with net earnings split down the middle between the city and Meridian, Bronson said.

“The 308 money comes here, and first we pay [private dispatcher] MedComm [around] 5 percent [for billing], then we take the balance and divide it right down the middle, half to them and half to us,” he said. “At this point, we are netting the city roughly an equal amount” to the Capital 309 fee.

“We’re up over $300,000 in net revenues between the two of them,” Bronson said.

In addition to improving response times, the merger has improved the skills of the city’s firefighters, Bronson said.

“We’ve raised the level of the whole operation, thus we’ve elevated the quality,” he said. “We’ve also elevated what we can do for patients. We’re doing all we can do.”

All of Brewer’s 13 full-time firefighters and five officers have basic EMT licenses, some are intermediates, and one is a paramedic, Bronson said. Of the 19 part-time firefighters, all must have an EMT license or hold a commercial driver’s license to drive the ambulance, he said.

The decision to partner with Meridian a decade ago was controversial at the time, with heated debates at City Council meetings and various letters to the editor of the BDN.

The Maine Labor Relations Board was asked to settle the dispute after Brewer Firefighters Local 2162, the Professional Fire Fighters of Maine, and International Association of Fire Fighters filed a prohibitive practice complaint concerning the partnership.

Local firefighters, during their contract negotiations in 2004, again asked for the contract with Meridian to be scrapped in favor of creating one of their own, but dropped the request when stipends for emergency medical technicians and other changes were added to their contracts.

Over the last couple of years, Capital paramedics have become an inseparable part of the Brewer Fire Department.

“The citizens of Brewer have been very well served here,” City Manager Steve Bost said at last week’s council meeting.

And both parties benefit from the arrangement, McMahan said.

“Everybody wants the Brewer deal,” he said.

A copyright article from the Bangor Daily News by Nok-Noi Ricker, Friday, February 19, 2010.