For the last 12 years, Camden has had no ambulance based in town. That is changing July 1, when, courtesy of a new public-private initiative, a North East Mobile Health Services (NEMHS) ambulance will be stationed at the Camden Fire Department on Washington Street, ready to roll to emergencies, as needed.

That ambulance will be staffed with two EMS personnel, one representing Camden Fire Dept., the other, NEMHS. It will start out on a 6 a.m. to 6 p.m. schedule; but in the fall, the ambulance is to be at the fire station on a 24-hour, seven-day-per-week schedule.

Unanimously, the Camden Select Board cemented the deal June 17 at a regularly scheduled meeting after members discussed the, “Agreement By and Between Inhabitants of the Town of Camden and NEMHS for Emergency Medical Services.”

NEMHS is based in Saco and has operated a station in Rockport, providing EMS service to Camden, Hope, Lincolnville and Rockport since 2013. Last winter, Rockport formally established its own municipal EMS service, with ambulances headquartered at the new West Rockport Fire Station.

The three remaining towns — Camden, Hope and Lincolnville — concerned about increased EMS costs with the departure of Rockport from the former arrangement, explored the proposal of Camden and NEMHS teaming up to provide ambulance service.

As talks continued over the winter and spring, an outline developed. At the same time, the Camden Fire Department furthered its own goals of transitioning from a traditional volunteer department to a fulltime firefighter system employing 24-hour schedules. That is due to begin in October.

In a June 13 pre-meeting memo to the Select Board, Camden Fire Chief Chris Farley said Camden Town Manager Audra Caler, North East’s Chief Executive Officer Rick Petrie and Rockport base manager Cory Major, Hope Town Administrator Samantha Mank and Lincolnville Town Administrator David Kinney, as well as Farley, all met to review the agreement.

“Our consensus is that the Agreement will meet the needs of Camden, Hope and Lincolnville in the delivery of emergency medical services,” Farley said. “This agreement includes the proposal as discussed during the FY26 budget process for Camden Fire and NEMHS to work collaboratively in the delivery of these services.”

Lincolnville's Select Board will be considering the agreement (see attached PDF) when it convenes June 23 for a regularly scheduled meeting.

"Although the make-up of the staff on the ambulance may change some under the new agreement, we anticipate that the service level to the residents and visitors to Lincolnville will not change from previous years," said Lincolnville Town Administrator David Kinney, on June 18. "The professional, efficient, caring, skilled, and reliable service will continue."

Likewise, Hope's Select Board will consider the agreement (see attached PDF) on June 24 at its regularly scheduled meeting.

"There are some changes from the previous agreement," said Hope Town Administrator Samantha Mank. "Most notable to me is the new composition of the Review Committee. I don’t anticipate any disruption in service and I believe the residents in Hope will continue to receive the same quality care they have come to rely on for the past several years."

The agreements are based on a three-year term, with NEMHS providing “Advanced Life Support and Basic Life Support (ALS & BLS-Paramedic) Life Support and Basic Life Support (ALS & BLS-Paramedic) emergency ambulance services at the request of the Town 24 hours daily, seven days a week.”

The agreement (see the Camden Select Board meeting packet for the full document) includes monetary penalties for insufficient response levels and response time standards. It stipulates average response time performance requirements (when a call is dispatched from Knox Regional Communications Center to NEMHS to the time when an ambulance arrives at the scene) of 12 minutes.

Fees will be charged by a system that bills the patient, “or such other person as may be responsible for the patient.” North East will bill insurance carriers, Medicare and MaineCare.

“The town shall not be responsible for any payment or collection of a patient’s bill,” the agreement said.

How much will towns pay?

Camden, Hope and Lincolnville will each pay their own subsidy for the ambulance service to North East. The payments are due on a quarterly basis.

The table below outlines those costs. The 12-hour per day fee schedule is in accordance with the current practice of North East, whose staff work 12-hour shifts, responding to calls on shifts of 6 a.m. to 6 p.m., and 6 p.m. to 6 a.m.

After Oct. 1, it is anticipated that Camden Fire Dept. will be staffed 24 hours a day. That is when the fee schedule for the 24-hour per day, seven days per week staffing model is to kick in. Until then, NEMHS will be paying for two employees to staff a 6 p.m. to 6 p.m. shift; hence, the differential cost to the towns presented in the table.

Until Oct. 1, the NEMHS amublance will be at the Camden Fire Station from 6 a.m. to 6 p.m. After Oct. 1, the ambulance, and just one NEMHS staff member, will be stationed at the fire station.

Fee schedule for each town that is contracting with North East Mobile Health Services
The 12-hour day, 7-day--week schedule reflects a staffing model by which NEMHS personnel continue providing ambulance service from 6 p.m. to 6 a.m. from the NEMHS base on Route 1 in Rockport. When the Camden Fire Dept. switches to 24-hour firefighter/EMS coverage at it station (Oct. 1), it will half-staff the ambulance that is to be at the fire station 24 hours a day, resulting in less staff position filled by NEMHS; hence the reduction in costs to the municipalities.

As stipulated in the agreement, NEMHS will continue to maintain its base in Rockport, with a dedicated base manager/supervisor, who is qualified as a paramedic. Another ambulance there will also respond to calls.

The NEMHS supervisor is to maintain regular communications with the towns and Knox RCC, “to maintain effective operations and resolve issues that may arise in a timely manner,” the agreement said.

Camden Select Board

At the June 17 Camden Select Board meeting, Town Manager Caler said Camden's mutual aid partner continues to be Rockport. Multiple agencies will respond to calls, as necessary, but she added, "Rockport is our primary back-up."

Select Board member Chris Nolan asked if the former Review Committee, which had been tasked over the years for overseeing EMS performance and costs in the towns, would remain intact.

The Review Committee has not met since January of last year, said Nolan.

"Whose responsibility is it to make sure that happens," he asked.

Camden Town Manager Audra Caler said, "We talked about changing it, and having a different model, now that the service is different."

She said oversight would be the purview of fire chiefs, administrators and town manager, "because that is where any issues start."

"OK, good,” said Nolan. 

The agreements for all three towns outlines the review model: "A review Committee will be formed made up of the Town Administrator and Fire Chief or their designee when applicable from each participating Town, as well as the NEMHS CEO and Base supervisor.

"The review Committee will review Response Level and Response Time performance quarterly and evaluate whether changes are necessary. The review committee understand that topics discussed in these meetings may be confidential and protected. Any Protected Health Information that may be discussed must only be used for the purpose of these meetings and may not be used, discussed or disseminated outside of the meetings."

"We will also see how it goes, and if there is a desire for participation on the Select Board we can have that be something we look at," said Caler. 

"Given the magnitude of this change," suggested Board Chair Susan Dorr, it would be good to see, "every once in a while how it is going."

Farley noted that the dynamics have changed over the past few years between the towns and NEMHS, and that problems are now immediately addressed.

"We do not want problems to fester," he said, adding that he is in close communication with NEMHS leadership.

Farley added that operations and staffing levels have improved at the Knox Regional Communications Center in Rockland.

"They have taken care of some of their long-standing problems and are moving forward," said Farley. "They are better off from where they were about six months ago."

Board member Alison McKellar noted that while the former review committee, "did not serve every purpose, I did like the idea of a group of citizens or select board members [who are] more knowledgeable and help shape the conversation of public safety, in general.... Would it be possible to look at a more of a county-wide public safety regional [approach] so we can keep chugging away at working together more?"

Caler agreed, and said a formalized group would be helpful.

Dorr, Farley and Caler noted the level of professional EMS training within the Camden Fire Dept. has steadily increased, with EMTs, advanced EMTS and paramedics already trained or going to school in September for higher-level certification. Caler commended Farley for the department's work in broadening its EMS service.

Farley, in turn, commended the community for stepping up to support the effort.

Reach Editorial Director Lynda Clancy at lyndaclancy@penbaypilot.com; 207-706-6657