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Med-Care vote may be pivotal

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Monday, May 5, 2008
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MEXICO - Less than 38 days from Monday, the fate of Med-Care Ambulance Service should be decided. But whether or not its 11 member towns continue to keep the 20-year-old company as their emergency medical services provider by approving another decade-long contract is anyone's guess.

To continue operations, 80 percent of the total population for all the towns must vote to approve the contract, according to Med-Care Board of Directors President Steve Brown of Carthage.

At town meetings last month, Canton, Carthage, Newry, Peru and Roxbury residents overwhelmingly voted to keep Med-Care operating.

But those five towns only total 23 percent of the population served by Med-Care. Andover rejected the contract last month at town meeting reserving the right to revote the issue pending new information gathered by a committee tasked with researching the town's options.

At a committee meeting last week, committee members fine-tuned a request for proposals for coverage to be sent - when finalized - to Med-Care; Paramedic Alliance for Community Emergencies, or PACE Paramedic Service, a division of Stephens Memorial Hospital in Norway; Bethel Rescue; Tri-Town Ambulance Service of West Paris; and NorthStar Emergency Medical Services, a division of Franklin Memorial Hospital in Farmington.

Once that information is gathered and given to town officials, Andover selectmen intend to hold a special town meeting to decide whether to stay with Med-Care or try someone else.

The committee has also asked selectmen from any of the other 10 towns to meet with them at 6:30 p.m. Thursday, May 8, in the Andover town hall to discuss potential updates for the interlocal agreement, Andover Selectman Susan Merrow, also a committee member, said.

Byron, Dixfield, Hanover, Mexico and Rumford have yet to vote on the issue.

"If we don't get 80 percent, then the interlocal expires," Brown said Friday at the station.

"I don't know what happens then. We've had our attorneys look at it, but we've never been faced with that. There is no language in the interlocal that says we can still operate after June 7. So, that's a serious concern about whether or not we can legally continue after midnight on June 7 even if we need to."

That's why Brown, Med-Care's board and Med-Care Director of Operations/Chief of Services Dean Milligan have turned their efforts toward getting the agreement signed rather than lobbying for a planned $2 million station expansion.

They've also just set up a Web site that's packed with information: www.med-careambulance.com/facility/.

Med-Care's Board of Directors OK'd the building project in September, but a funding mechanism has yet to be decided. One option is to take out a 30- to 40-year federal loan.

Failure to get the needed 80 percent would dissolve Med-Care. Its $900,000 in assets would then be liquidated, Brown said.

If the service dissolves, so, too, do jobs of its 60 employees, 15 of which are full time, Milligan said.

Other losses would include 24/7 paramedic or advance life-support care, community outreach work, education programs in schools, CPR and first-aid classes in communities, and ambulance coverage at all sporting events, fires and accidents.

Additionally, New Page Inc.'s regional response team would lose its medical component, and Rumford Hospital would lose its critical-access hospital accreditation.

"That's why it's not just about an ambulance service," Milligan said.

And then, there would be trickle-down effects since many Med-Care employees live and shop in the area.

"Med-Care has a payroll of just under $1 million, and I imagine a large percentage of that gets turned back into these communities. So, to me, to lose Med-Care, it would be devastating and it would be for what? Trading it for what? There's no other ambulance service that can come in here and do it for free.

"These towns have an ambulance service now that provides the highest level of service in the state, and they're only paying 17 percent of its overall cost, including the facility, and that cost is divided among 11 communities. My question back to the citizens is, 'What do you think's going to replace Med-Care that's more efficient and effective?'" Milligan asked.

CLICK HERE To Show/Hide Discussion Thread - (28 Comments)
Comments
Posted By:droppings at May 5, 2008 5:23 AM (Suggest Removal)
Milligan has allowed his ego to get in the way for this project and he should step back and let Steve Brown lead it and then it might make some sense.

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Posted By:Debtof$2.2Mil at May 5, 2008 6:45 AM (Suggest Removal)
This is just wrong. They are planning on buying something 4 times the value or more of the company! Dean has said its worth almost a million, but add it up. It just doesn't make sense. My guess is that its worth $500K tops. If Med-Care was listening, they would have gotten together and rethought this. They hadn't even met since Andover voted no, don't you thing they might have called a special meeting in the face of that issue?

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Posted By:concerned resident at May 5, 2008 7:36 AM (Suggest Removal)
This is the greatest line I think Milligan has ever written..."Other losses would include 24/7 paramedic or advance life-support care..."SO, they would lose ALS and medic service, because no other EMS service can provide this, is what I get from this statement. "...Community outreach work, education programs in schools, CPR and first-aid classes in communities..." Because no other service can provide these services to the public? "...and ambulance coverage at all sporting events, fires and accidents." Because any other EMS service won't go and cover sports, go to accidents and definitly won't go to any fire standby's...I don't know what EMS service doesn't go to accidents and fire standby's. I do believe EMS is toned out first for accidents and within the tones for fires. As for sporting and event coverage, I'm sure the next director and service to come in, will cover sporting events. Nothing like being full of ones ego that if he get's canned that the communities wouldn't get EMS coverage.

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Posted By:D at May 5, 2008 8:58 AM (Suggest Removal)
First of all, the first two comments are about the new facility, this is about keeping the existing service. Mr. Milligan may have an inflated ego but you cannot deny the fact that he has brought this service a long way since he has been there. If anyone else comes in to take over, they too will need to have a place to house their equipment and personnel. As stated in the article, noone is going to come in and do it for free. Take a 3 minute response time that feels like 20 minutes when it is for a loved one and stretch that to 25-30 minutes and see how long you tolerate it. I say if it's not broke, don't fix it!!

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Posted By:Concerned at May 5, 2008 9:52 AM (Suggest Removal)
The whole situation is too bad. Maybe Dean and HIS Board of Directors should wait a year to make any decision on the building so that tempers can calm down (and) during that time Milligan can create a more realistic building that isn't so costly and people can look at it differently. Milligan has a very strong "attitude" and controls (manipulates?) the Board of Directors quite well. Back off for awhile - give it a break. It could be healthy for the project and the individuals involved.

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Posted By:Timeout at May 5, 2008 10:28 AM (Suggest Removal)
We can make this about personalities (as usual) but again, show me the cost effective replacement for something that works...please think hard about this...I heard our board of selectmen say that the more they think about this, the more confused they are. It's clear all right, clear as mud. And they don't have an alternative plan in place. Boivin just shrugs that off as unimportant...I don't see it the same way. Buccina says the whole thing confuses him...Rumford voters, you have to make the best decision you can. I know you traditionally look to the board for guidance but they really don't have the answers. I'm voting to keep the interlocal agreement because it makes sense and noone has come up with a viable alternative.

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Posted By:Facts at May 5, 2008 11:17 AM (Suggest Removal)
Debtof$2.2Mil: When someone buys a house, what do they have that is the same value as the house? So what is the big deal if the new building is 4 times the value of Med-care. Oh and if the building is build for $2.2 million. Wouldn't the value of Med-care go up by that too.

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Posted By:Facts at May 5, 2008 11:39 AM (Suggest Removal)
Unknown: If on June 7 Med-care is out then what. Who is going to take over then. It has take years to get all these agreements worked out with all the Fire Departments and sports programs and the hospital. Do you really think that just like that that some other EMS service can step in take all that on, at midnight June 7. When all these other services are asked what their costs would be for service. See if they would work out of the current Med-care facilty. It would be interesting to hear what they say.

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Posted By:Alli at May 5, 2008 12:11 PM (Suggest Removal)
I totally agree with the non-negative people on here. This is a good deal and if you think another service is going to be a knight in shining armor than you are breathing in more mill air than you should be. Like it or not, businesses need to grow in order to keep being successful, and this is one successful business and Dean with the board has done a wonderful job building it up. It may not be perfect, but it aint broke so don't fix it. And if you Rumford people can't see now moronic your selectmen are just by reading the paper over the past several months, than you need to get a clue. It's very clear they don't have the interests of the town at heart and will lead you into deeper doom than they already are. You have your own problems right in your back yard that need fixing before trying to fix a working EMS system. Please see through the garbage and do what you honestly feel is right.

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Posted By:Steve at May 5, 2008 2:07 PM (Suggest Removal)
Oh Please folks don't let Milligan and his little tribe make you think there is nothing else out there. There is, Rest assured that at Midnight on the 7th the Knight and Shining Armor will show up in the Form of Red and White Ambulances.

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Posted By:tax payer at May 5, 2008 2:13 PM (Suggest Removal)
Ambulance service is a business - it will always be a business. Someone will provide service and that someone should be Medcare. Does medcare need a change in its Director? Did it ever occur to anyone in this debate that the Medcare Director is the one unwilling - or not knowing how - to listen to the stock owners, the voters and owners? We are the stock holders but apparently we do not amount to anything worthy of input. Medcare has told many who will listen - including Andover & Rumford - Medcare is better off without you. That shows a lack of concern and respect for the voters, the taxpayers. Lets face facts, a NO vote on the inter-local will allow for an end to unchecked spending authority by a board that cares not about tax payers. Do you think for a minute another service this size would tell citizens "too bad, we are not dealing with you at any level". Who in this crowd has any corporate experince? Medcare obviously does not. We are dealing with a 20 year old subsidized company that is now making profits on a new business model. They want our tax dollars, they do not want our input. My heart goes out to veterans, active duty personnel, and citizens wanting a voice - apparently all past sacrifice is for not - only self serving corporations know what's best for us. Please Medcare - tell me what is best for me as I do not know any better. tell my parents, my children, tell us all as we can not possible know what is best for us. Who amongst us follows blindly? Who made who? Did Medcare make the voters or did the voters make Medcare? Please answer that - just that.

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Posted By:Facts at May 5, 2008 2:26 PM (Suggest Removal)
Steve: Where are these Knight's and Shining Armor going to house their horses(Ambulances). At their new palace that their going to need to have. Good Luck to them. Also back to the question I asked. Are these services going to use the Med-care facilty? Lets have these committees ask them that question and see their response. Then publish their answers so all can see.

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Posted By:Right On at May 5, 2008 3:21 PM (Suggest Removal)
Maybe in a building already there and fixed up at much less cost ? Our taxes are just gonna keep going and going up if someone doesnt care about our future here. We can't afford new and pretty. we know they need a better place but it doesnt have to cost 2.2 millon dollars.

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Posted By:tax payer at May 5, 2008 3:34 PM (Suggest Removal)
We are arguing for the right to pay a "tax subsidy" for Medcare's growth as a non emergency transport service. They have a contract with CMMC Rumford for transports to CMMC Lewiston. Check the inter-local, it is quoted below: Amendment No. 1. Paragraph 1.1 is amended and restated in its entirety to read as follows: Purpose. The purpose of this agreement is to contract for the provision of paramedic or first aid emergency care or transportation for ill or injured persons and/or non-emergency medical transport services (the “Ambulance Service”) within the geographic territories of the parties (the “Region”) to be provided by a corporation to be established as hereinafter provided. Read closely - non emergency transport services. huh?

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Posted By:D at May 5, 2008 3:51 PM (Suggest Removal)
Sounds like some hard feelings between a few of the writers and Med Care personnel, namely Dean Milligan. You had better gather the real facts and stop letting emotion cloud your judgement.

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Posted By:Mary at May 5, 2008 8:55 PM (Suggest Removal)
get a clue people. How can anyone vote no for Medcare. How can you actually put a price on saving ones life. I hope that any of you idiots that are trashing MedCare dont need an ambulance for yourselves or someone you love, if you vote no thats what is going to happen. Smarten up people.

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Posted By:Timeout at May 5, 2008 10:01 PM (Suggest Removal)
Taxpayer - Read your quote from the interlocal again and tell me how you understand it to only refer to non-emergency services. Your interpretation is not what it says at all. There are two aspects to the service: 911 calls and transports. Transports generate collectible revenue; 911 calls are not so reliable. Transports are what allow the ambulance service to give the low rate on 911 calls. 911 calls contracted separately would absolutely be charged at a higher rate because it is not guaranteed revenue. Anyway, read it again, it refers to both aspects of service.

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Posted By:Timeout at May 5, 2008 10:30 PM (Suggest Removal)
One more thing - I just had dinner with some folks from out of town that spent a half hour saying "no way!" when I told them how low the taxes are here in Rumford. The amount of service we have for the little we pay is one of the amazingly wonderful things about this town. I guess it's human nature to want to pay less but really, how about a little gratitude for all that we have?

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Posted By:Mel at May 6, 2008 12:26 AM (Suggest Removal)
I remember when it was just rural EMS and Bill Gates was running the show and it rocked then. Look what has been built up from that. We have top of the line emergency care that doesn't question your ability to pay they just come. These are competent medical professionals who are dedicated to saving lives. I don't care what anyone thinks persoally about Dean or anyone else associated with the Med Care group. You are cutting off your noses to spite your face. If it doesn't go through we will see a definitive change in the care we receive. Think about the big picture and if it was one of your own in trouble. I know who I would call. My experience with the crew at Med Care is one of total trust with my or my loved ones health. I would so much rather pay for this plan than have the government( town or otherwise) spend my money on the welfare programs they are using it for now. I live in an outbound town and I for one hope Med Care and the towns can come to a reasonable compromise to make the majority happy. There will always be some one who complains but when they need help it won't matter to Med Care whether they were for or against this proposal.

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Posted By:trisomethingelse at May 6, 2008 5:47 AM (Suggest Removal)
So Allison Ross, at least I assume that is who you are. Lets sum up what you have said: North Star, Bethel, Tri-Town, Pace, & United all bad. Med-Care good. You speak like you are so well versed on this topic. Do you work for any of these services? Perhaps have family that does? Could you elaborate on what you know about each service and enlighten us all?

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Posted By:Read it Right at May 6, 2008 6:07 AM (Suggest Removal)
trisomethingelse, I don't think I saw anywhere is the comment post that said those services were bad. As far as putting a name to the screen name, be careful. That has caused problems in the past. Unless you are willing to put your own name up there. Yeah. I can do that too.

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Posted By:Right On at May 6, 2008 8:25 AM (Suggest Removal)
I dont know . There have been lots of suggestions. I know they need a better place but cant it be done cheaper then 2.2 ?Thats just scary when everything else around us is sky rocketing too. This is not a good time for any of us.

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Posted By:Right On at May 6, 2008 8:30 AM (Suggest Removal)
Dont get me wrong, i want our ambulance service. I also want to put food in my kids mouth, keep them warm, put gas in my car so I can take them where they need to go and help my ageing mother. Its scary!

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Posted By:Zoloft at May 6, 2008 2:37 PM (Suggest Removal)
I heard from a Rumford resident, that CMMC administration is considering having United step up to the plate in Rumford hospital. I dont know how true this is, but that would really put a twist on things.

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Posted By:Facts at May 6, 2008 3:44 PM (Suggest Removal)
Zoloft: Do you think people are going to believe your comment. When you start by saying "I heard from a Rumford resident". How would they know what CMMC administration is or isn't considering. Seeing it isn't even located in Rumford.

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Posted By:Facts at May 6, 2008 4:00 PM (Suggest Removal)
I still would like all these people that think Med-care doesn't need a new facility. I ask you to go and ask any other service if they would work out of the current Med-care facility. Then post their comments in the papers. See if they would let their hundreds of thousands of dollars worth of equipment sit in huts. How come they haven't been asked this before now? Also where are they going to be based out of? I bet their response times are the same as Med-care. Has this question been asked too? It should have been seeing that it was a huge concern of many in past articles.

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Posted By:Allison R at May 6, 2008 4:54 PM (Suggest Removal)
FYI the person writing under the name ALLI is not Allison Ross I would appreciate not being dragged into this. I did work for MED-CARE and no longer do. For many many reasons, i do how ever work for three of the services trisomethingelse referred to. I dont know who you are but leave me out of this. I am not going to get in the middle of this battle i have my thoughts and i am keeping them to myself. I would ask that you not assume that because of the screen name that you know who it is because you are very wrong.

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Posted By:Read it Right at May 7, 2008 8:16 AM (Suggest Removal)
See what I mean about putting names to screen names, trisomethingelse?

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