JAY – Selectmen voted 3 to 2 Tuesday against pursuing a three-year ambulance contract with Community Emergency Services. Instead, the board voted 3 to 0, with two abstentions, to investigate a one-year contract.

CES serves people in Jay, Livermore and Livermore Falls.

The combined subsidy is estimated to be $138,332. The subsidy for each town, based on population, is projected for fiscal year 2005 to be $66,814 for Jay, $28,219 for Livermore and $43,298 for Livermore Falls.

That’s compared to the existing subsidies for fiscal year 2004, which are Jay, $53,562; Livermore, $22,622; and Livermore Falls, $34,710.

Selectmen William Harlow, Rick Simoneau and Barry McDonald opposed entering into a three-year contract with the hospital. The three favored a one-year contract instead.

Selectmen Parker Kinney and Ray Pineau favored the three-year contract.

Olan Johnston, interim emergency medical services administrator for Franklin Memorial Hospital in Farmington, told the board that the hospital is working hard to keep the subsidies as low as possible, but said the ambulance service needs to be self-sustaining.

The hospital continues to receive less reimbursement per call from state and federal government than it costs to provide services, Johnston said.

According to a financial sheet, the hospital projects it won’t be able to collect about $426,750 in fiscal year 2005. That number most likely will fluctuate, Johnston said, because government reimbursements are unknown.

It is projected the hospital won’t be able to collect $448,088 in fiscal year 2006.

The hospital could predict what direct expenses would be, about how many calls it would have but can’t predict what the reimbursement would be, Johnston said.

Johnston gave an overview of a three-year contract proposal that would include language for re-evaluation of reimbursement/revenue issues, expenses and overall operations prior to the beginning of each fiscal year.

It would be a collaborative evaluation, Johnston said, between the towns and the hospital of all aspects of Community Emergency Services operations, including subsidy funding, to allow for changes to occur.

That means if reimbursements to the hospital were more favorable than projected the subsidies from each town could decrease. If reimbursements to the hospital were less than projected, subsidies could increase.

There was also an “out” clause. Town Manager Ruth Marden said that either the towns or the hospital could use if the agreement wasn’t working for either party.

To keep subsidies from skyrocketing, Johnston said, the hospital has proposed altering ambulance service operations.

Now the second ambulance is staffed with an on-call crew and when they get called out they’re automatically paid time-and-a-half, Johnston said.

With a Community Emergency Services doing most of the basic transfers between hospital and other places, such as a nursing home for the hospital, it is typical that the on-call crew is called out.

The plan is to get rid of paid call staffing and to staff the second ambulance from 7 a.m. to 7 p.m. Monday through Friday, Johnston said. This ambulance would also be available as backup for 911 calls.

There would be an on-call emergency medical staff from 7 a.m. to 7 p.m. Saturday and Sunday.

After 7 p.m. and before 7 a.m. each day, there would not be a paid on-call staff for the second truck, he said.

An emergency signal would call out available crew members living in the area to man the ambulance, Johnston said. If no one responded, LifeStar Ambulance service in Farmington would be called out.

Eliminating the paid on-call staff during weekdays and nights is expected to save money, Johnston said, in overtime expenses.

dperry@sunjournal.com

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