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Quality of Service - Not Money - The Reason Fort Fairfield Council Dumped Crown Ambulance


By:  David Deschesne

Fort Fairfield Journal, May 22, 2019


   Ambulance service in Fort Fairfield was a main topic of discussion at Fort Fairfield town council's May meeting.  Service provided by Crown cease on May 1 when the town and the ambulance service provider were unable to agree to the terms of a new contract.

   “The Town of Fort Fairfield and Crown Ambulance were unable to come to a contract negotiation agreement for ambulance service to the town of Fort Fairfield,” said Fort Fairfield town manager, Andrea Powers.  “Our contract with Crown ended May 1, 2019.  Rather than just stay with 911 service, the council advised me to pursue another service.  I spoke with the City Manager at Caribou and the Town Manager of Presque Isle to see if we could arrange for a short-term contract to provide ambulance service to Fort Fairfield and split the responsibilities of service between the two communities.  The City of Caribou was unable to accommodate us at this time and Presque Isle was able to negotiate a short-term contract with us.”

   The short-term contract with Presque Isle Fire Department - which has been providing ambulance service for the city of Presque Isle for several years now - is for a period of one year.    Ms. Powers said since Presque Isle began providing ambulance service to Fort Fairfield at the beginning of this month, the response time on average has been “ten minutes or less.”

This response time certainly must mean from the time they received the dispatch from the 911 operator until the time they left the building because Presque Isle, at 12 miles away, takes at the very least fifteen to eighteen minutes for even a speeding ambulance to make it into Fort Fairfield. 

   “To maintain service and response times, the town of Fort Fairfield also added our Police Department as trained First Responders for 911 calls,” said Ms. Powers.  “This enables a quick response time and they are equipped with AEDs as well.  The First Aid and life saving measures they can provide to the town's 911 calls is immeasurable.” 

   While the local police are supposed to, in theory, be dispatched to an emergency call to provide care while Presque Isle is en route, this writer has already received one report from a Main Street business who called for an ambulance and waited half an hour for it to arrive, and they had to call the Fort Fairfield police department separately after twenty minutes of waiting to see if an officer could be sent to assist.  So, the 911 dispatching procedure doesn't seem to share a dispatch to FFPD concomitantly with a dispatch to PIFD for ambulance service at this time.

   Barb Ireland, Director of Emergency Services at Northern Light/A.R. Gould hospital (formerly TAMC), who has been overseeing the negotiations with Crown Ambulance and the various communities it still serves, says Fort Fairfield was given the same contract other communities already have agreed to.  “We've been in negotiations with Fort Fairfield.  We've signed two extensions since our contract expired and [former town manager] Jim Risner had signed the first extension.  We had met with all of the communities and we had come up with a price for every community so everybody was treated the same.  The communities asked for a five year contract and I think it was a 240 day notice in case we decided to get out of the business or they didn't want us, everybody had time.  All of the communities at that time had agreed, except for Washburn because they were looking at alternatives.  So we proceeded, and then [town] management changed.  Jim went out and Andrea came in and we continued to work with her.  We couldn't really come up with an agreement.”

   Ireland says the three major points of contention in the contract, from her perspective, were a 1 percent rate hike in the requested stipend from the town, a substantial increase in rent by the Town of Fort Fairfield for the living quarters and ambulance bay at the Fort Fairfield Fire Department, and the ability of Crown to back up the local Fort Fairfield ambulance when it was out on an emergency call.

   The stipend Crown was requesting from the town of Fort Fairfield was increasing to $12.24 per capita, a one percent increase over the previous $12.12 per capita.  The stipend is a fee towns pay for the commitment of an ambulance service in their community.  The increased cost to the town of Fort Fairfield with that 1 percent increase would have been $424 per year.  “[Ms. Powers] had requested the stipend stay at $12.12 per capita.  It was going up to $12.24, she wanted to stay at the $12.12.  We said no,” said Ireland.

   The second point of contention was a rent increase.  Crown had been renting living quarters and an ambulance bay at the Fort Fairfield Fire Department for several years.  The current rent Crown paid to the town for that space was $19,000 per year. Ireland says the town's new contract would have increased that rate to $38,000 per year. “Our rent was increased.  That was fine, we said we can look for other space. In fact we had found another space here in town for the same price that we had been paying here.”

   The third issue neither party could agree to was the consistent availability of an ambulance physically sitting in Fort Fairfield.  From time to time, Crown would be called upon to transport a patient between hospitals and would use the ambulance stationed in Fort Fairfield to provide that service.  They would then “cover” that ambulance by stationing one of their other ambulances in a neighboring community near the town's border in order to respond to emergency calls. 

   “When you have a private ambulance that is trying to make a living, they're doing transports,” said town council member, Scott Smith, who is a retired firefighter from New Hampshire.  “That's why they're not here.  There's money in transports.  There's not a whole lot of money in emergency response.  There [are] some costs that you can recoup, they'll tell you what the percentage is, when you do that research.  We did that where I worked, and they actually hired a company to go and bill collect because the money does not come back.”

   While Crown was covering for their in-town ambulance when it was sent out on a transfer, the town of Fort Fairfield also requested that type of backfill arrangement every time Crown was dispatched on an emergency call in town.   “This was one of the bases that when we sent a crew on transfers we backfilled, we tried to send a crew from one of our other communities to cover,” said Ireland.  “[Ms. Powers] asked if we could cover when we sent it out on an emergency run.  We can't do that.  We cover E. Plantation, Bridgewater, Blaine, Limestone.”

   Crown will cover for a missing ambulance when it is deployed doing a patient transfer/transport, but not when the ambulance that is in Fort Fairfield is sent out on an emergency call.  “But if you had two calls in Fort Fairfield, we would send a rig from Limestone, Presque Isle or somewhere,” said Ireland.    “When I knew we couldn't come to an agreement, I asked for a meeting with the council so that we could all talk about it in an open forum.  That's when all negotiations broke down and ceased.” 

   During the public comment period of the town council meeting, the town council received a couple of comments regarding their rapid, and seemingly covert and sudden, change to Presque Isle's ambulance service.

   “I'm not familiar with the way in which the dealings went with Crown Ambulance Service and negotiations that could not be met,” said George Knox, who lives on Presque Isle Street.  “However, I think the process in which the citizens of the town were notified - or lack thereof - was lacking.  That was my first concern.  My second concern is the response time from Presque Isle, coming from North Street.   It is important that we try to come to some negotiations with Crown, or at least have some ambulance service stationed here, in the town.  I believe the response time from Presque Isle is inappropriate and as a father of three young children, all under the age of five, that is a big concern of mine.  This is a service that I think a lot of the people in the town were happy to have, having an ambulance stationed here in the building.  As for myself and many of the people I've spoken with, this is a serious concern.” 

   “I will echo my neighbor's comments, said Craig Cormier.  “I am very concerned about having an ambulance based here in town.  I also have concerns about how this was released.  It seems not only were the citizens of Fort Fairfield surprised, but also officials in other communities as well, which is concerning to me.  I know there's been mention of response times and, yes, I'm sure there were times where Crown - or the previous provider - may have had a lot of calls and may not have been sitting directly here, in town, but I do know that they usually move their rigs to the borders so they are accessible and so the times that you wouldn't have an ambulance here in town were far less than we're looking at now.  As a community, we try to be a community of choice, we talk about quality of place, it's very concerning for those with young kids who live here and  I also have concerns for our older residents trying to age in place who now have to face longer wait times for service.”

   Town councilor, Mitch Butler agreed with the need for local ambulance service, but cited some serious shortcomings in the actual service being provided by Crown Ambulance to the town.  “I'd like to have an ambulance service here in the town of Fort Fairfield.  There's been a lot of talk around with the contract that we have not signed, there were things in the contract that were not following the law or the guidelines.” said Butler.  “Until Crown Ambulance can come up with a contract that we can deal with, that focuses on the safety of Fort Fairfield, the response time in Fort Fairfield.  There have been some response times that from this bay down here that took forty minutes or better to get across town and twenty minutes to get to the border.   I've heard stories of, along with that response time, [where] they're toned out they don't immediately leave the building.  One time this summer they were eating supper and they finished their supper before the ambulance left.  I've been in law enforcement most of my life at Caribou Police Department, I remember many suppers that I sat down at the table and started to eat my supper and I get a call and I have to stop and have to leave right there.  When I hear stories about the ambulance crew getting a call at supper time and they sit down and finish eating their supper, there's something wrong with that also.”

   Butler then reiterated his willingness to deal, but he says Crown Ambulance is going to have to commit to stepping up their service, first.  “If Crown Ambulance is hard-fast on servicing the town of Fort Fairfield I'm willing to sit down and contract, but I'm not willing to sit down with somebody, have a call come out and have them sit down and finish their supper, or clean their equipment before they leave the building.  That has happened.  We get people around here that talk about the response time. When you leave the bay in Fort Fairfield and it takes you twenty minutes to get to the border, from this building, there's something wrong.  I don't care what anybody says, there's something wrong with this service when it takes that long to leave this building and get three miles out to the border.” 

   Town Council Chairman, Mark Babin reflected on an unusually long wait time for Crown when they responded from their former location on Brown Street.  “My father-in-law, when we lived on Cogswell Street, the ambulance was down on Brown Street, his son was able to beat the ambulance, from Bridgewater.”

   Bridgewater is around 25 miles from Fort Fairfield.  Brown Street is only a quarter of a mile away from Cogswell Street.

   Butler said the issues of contention with the contract were not really about money.  “When we look at Crown Ambulance and the contract that they want to give us, it had nothing to do with pay, it had nothing to do with budget.  We were looking for safety of the town of Fort Fairfield and response time.  Some of the stuff they asked for was just not legal.  So, I mean if you're going to look at a contract that's not legal and keep submitting the same contract, then there's something wrong with that also.  I think Crown Ambulance, some of the stories that have been put out, I think if they want to sit at the table, they've got to come out with some reasonable type deals.  When we have a contract that's not legal and some of the stuff they ask us to do is not binding and not legal, I can't sign a contract.  The town manager has been taking holy heck for not signing the contract that's not binding.  I'm willing to talk to anybody about any type of service to the town of Fort Fairfield that would be safe to this town.  But when it takes forty minutes to get from this building to the other side of town, with no explanation, there's something wrong. 

   “I'm not sure what they were referring to when they talked about the 'illegal things' because our contract - we even had one of the communities have their lawyer review it,” said Ireland.  “It was written by one of our attorneys so I don't know what they were referring to when they talked about things 'not being legal.'  I don't know what they were told, or what they had seen.”