Maine (WABI) – Current data shows that it takes between 2,000 and 2,500 calls annually for an ambulance service to break even.

But for most rural Maine towns, calls average only about a quarter of that.

Joy Hollowell covered the Maine EMS Crisis this week as part of TV5’s ongoing Investigates coverage.

Last year, the Maine Legislature declared emergency medical services an essential service, just like fire and police.

They also budgeted $31 million for it.

40% was initially given as a tourniquet for the Maine Hemorrhage EMS System.

The rest is focused on support.

But is it enough?

“I think we’re in a very challenging reimbursement system for ambulance services.”

Joe Kellner is the CEO of Life Flight from Maine. He was also a member of Blue Ribbon Commission Tasked with Studying Maine Emergency Medical Services. They determined that $70 million is needed each year for the next five years just for EMS transport services.

“Through the project, the rates that government payers pay, meaning Medicare and Medicaid, increase less than inflation year after year,” Kellner explains. “It’s actually written into the law that way, that it grows less than inflation.”

That’s why some rural Maine departments are now looking more closely at regionalization.

It’s already happening in the Howland area with announcement this summer of Central Maine Highlands Fire & EMS District #1.

Regionalization also has the support of the state.

“Yes, and please do,” says EMS Director Wil O’Neal.

ONeal adds that the collaboration is not only encouraged, but eligible for the $31 million in state funds appropriated by the Maine Legislature last year and then approved in the budget by Governor Mills.

The first phase of payments ended in May.

“We administered $10.85 million of the original $12 million in that pool to nearly 200 agencies out of our 271 licensed agencies in the state of Maine,” says O’Neal.

But some argue that application process in almost 50 steps it is too heavy for the already blocked departments.

Others, like EMS from below of Washington County, note that while applications were due in December-.

“The payment didn’t come until mid-June,” says Eddie Moreside, director of Downeast EMS.

In addition to the grant funding, the Legislature also approved four technical assistance positions — something Lincoln’s compliance officer took full advantage of when he filled out their forms.

“If I emailed them or called them, they were really quick to get back and very helpful in answering any questions I had,” notes Bruce Arnold “And they corrected any misconceptions I had.”

Last month, the Maine EMS Rules Committee met again to determine how the remaining $19 million will be distributed. While some felt emergency transport services were still at the top of the priority list, a proposal was made to direct nearly half of the remaining funds to Maine’s 10 licensed training centers.

“Because we need a sustainable workforce development pipeline,” O’Neal explains. “Right now what we’re seeing is constraints on the training site and then limitations on the final product.”

Lincoln Fire Chief Les Brown agrees with that proposition. However, he believes it will be more cost-effective to have state trainers come to them and other small communities for training.

Meanwhile, a community paramedic program could be approved by the state by the end of this year. This allows specially trained paramedics to provide primary care and other services where needed.

Places like St. George, Blue Hill and Jackman are already using the health care model.

Read part 1 Here.

Read part 2 Here.

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