Much more to the ambulance story
To the editor:
As many are aware by now, the collaborative agreement between TAMC’s Crown Emergency Care and the City of Presque Isle expired on September 15 after having been extended from the initial end of the contract in July. Crown is still providing quality care for city residents and will continue to do so until the City has their own 9-1-1 service in place.
What you may not know are some of the concerns regarding this change and what it may mean to residents in the future. There has been no public discussion regarding the City’s decision to make this change. TAMC has not had the opportunity to voice concerns to the council, nor have residents had the opportunity to hear both sides of the issue. Sadly, a great deal of misinformation is being played out in social media, with no real opportunity to get a full picture of the issue.
Here are three key areas of importance we would like to share.
Quality
Crown Emergency Care is fully integrated with hospital emergency services and is licensed at the paramedic level, meaning that a paramedic responds to all 9-1-1 calls in Presque Isle, no matter what their nature. Crown has been recognized statewide for its quality service on more than one occasion.
TAMC has invested in our crews to make sure they have the skills needed to best help those who need our services. Crown is also part of a monthly Quality Improvement Peer Review involving TAMC’s entire emergency care process, from when a call comes in through to the patient’s care in the emergency department. This is a unique quality control measure not found in non-hospital based services.
Commitment
We operate Crown not for financial reasons but because we are committed to the health care of the region. That’s why we often provide services at no charge. Our crews can be found at local school sporting events, 5Ks, parades, community festivals and many other events standing at the ready should medical assistance be needed. We perform a “tuck in” service, where we bring patients, who have the need, home from the hospital and get them settled safely in their home. We do “lift assists” for people who have fallen in their homes and need help getting up.
As a non-profit, mission driven health care organization, we understand that we need to provide certain services without payment in order to ensure the health of our friends and neighbors.
Sustainability
Crown includes coverage to 18 other towns and unorganized territories in addition to Presque Isle, as well as provides interfacility transfers, coverage of community events and more. We are able to provide this extensive coverage due to our staffing resources. By taking away the core of Crown’s service area, Crown’s ability to continue to provide service to all of our surrounding communities is compromised.
If the City considers the total costs involved in operating a service, which include the lack of reimbursement for a number of those costs (due to bad debt by those with poor or no insurance, low reimbursement rates by government payors and non-billable community support), they may also find themselves at risk of not being able to sustain their service.
We were satisfied with the agreement that had been in place between TAMC and the City for the past two years. Our crews worked well together, and ultimately everyone benefited from the arrangement. We had been paying $100,000 to the City as part of that agreement and during the most recent negotiations offered to increase our payment to $130,000 annually. This fee paid for the housing of an ambulance at the PIFD, as well as for the services of a firefighter to drive the ambulance.
In the end, the most important point is that good decisions come from good information and looking at all perspectives of a situation. We believe this has not happened in this case. We hope the City Council will offer an opportunity for TAMC representatives, as well as other members of the public, to share their feedback and also learn more about the City’s planned 9-1-1 endeavor.
Steven St. Pierre, chair
TAMC Board of Trustees
Glenda Dwyer,
TAMC interim president
Dr. Sergio Lema, president
TAMC Medical Staff
