A few weeks ago, a two-car motor vehicle accident in Woolwich tragically resulted in a fatality to one driver and serious injuries to the other driver. Woolwich Emergency Medical Services as well as several other services responded to the horrific scene and the Sagadahoc Sheriff’s Office is investigating the accident. Because of the townspeople’s decision in recent years to provide and to fund EMS, service in Woolwich is often quick and professional. Our area is lucky to have a combination of paid and unpaid volunteers and professionals working together to keep us safe.

In addition to accident response, our community’s EMS, in conjunction with our local fire departments, respond to 911 calls, provide transport when necessary, coordinate and staff shelters when we lose power, and have recently begun helping Mid Coast Hospital with transporting patients who no longer need to be in the hospital to other facilities (or home), ensuring that the hospital can continue to provide beds for those who need them. EMS personnel are also on scene at fires and other emergency situations.

However, keeping the system going is not without its challenges. A recent Blue Ribbon Commission to Study Emergency Medical Services in the State has concluded that EMS in Maine is at a “breaking point.”

The Commission identified – and quantified – what many of us already know. Maine EMS is experiencing declining volunteerism and an underpaid workforce. The average salary for fulltime EMTs in Maine ranges from $29k to $35k, while paramedics can garner $39k to $53k. However, most of our community EMS services are part-time and operate on an on-call basis. Paid for by municipal budgets, even towns who want to provide adequate compensation often have to compete with fulltime services offered by larger cities or institutions.

Moreover, while some municipalities can afford to pay for the training of their EMS volunteers, many volunteers pay for their own training.

In addition to municipal subsidies that staff these local departments, EMS services statewide rely on public and private insurance reimbursement. Public Medicare and MaineCare are the largest funding sources, and these payments are historically inadequate and based on outdated assumptions about what EMS calls often entail. For instance, currently, calls that do not result in an ambulance transport do not result in payment by Medicare or MaineCare.

Another illustration of the gap between costs and reimbursements is the fact that there’s a certain amount of overhead for EMS services, and most municipal services do not have the call volume to reduce the cost-per-call, which results in an even larger disparity between the cost of service and insurance reimbursements. Municipalities subsidize their EMS service in an effort to reduce that gap, but as the Blue Ribbon report concludes, this funding model is not sufficient.

As a result, the commission has recommended that the state provide an infusion of $50 million per year for the next five years to support EMS services, specifically for currently operating EMS services, to be used primarily for recruitment and retention, and tapping into federal Medicaid match programs to the extent possible.

The commission also recommends that $25 million target EMS services “at immediately risk of failing and leaving residents” without adequate EMS. To increase retention, the commission supports better EMS access to the Maine State Retirement System, as well as fully funding the state Length of Service Award Program so that eligible emergency responders can be covered.

Additional attention also needs to be put into workforce training and education, and the commission recommended that the community college and university system find a way to expand the options available.

Interestingly, the Commission also recognized a program that is already being piloted in Lincoln County, a “community paramedicine” program that covers residents that can be cared for without calling 911. In some ways, it is similar to a public health nursing program, with its emphasis on preventive care. I look forward to learning more about this service.

I represent communities that do their best to provide emergency services to its residents and are also committed to the larger community. We need to find a better way to support these valuable services and I look forward to working on these issues.

Rep. Allison Hepler, D-Woolwich, serves Maine House District 49, which includes Arrowsic, Georgetown, Phippsburg, West Bath and Woolwich.

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