HOULTON, Maine — The town’s longtime ambulance director pulled no punches about a controversial analysis report of his department during a Wednesday, Jan. 11 workshop with members of the Houlton Town Council.
Milton Cone, who also serves as the town’s fire chief and cemetery director, blasted the 118-page document prepared by Municipal Resources Inc. of Meredith, New Hampshire that was the culmination of a seven-month review of the town’s ambulance department.
The study was made at the request of the town council, which was looking for ways the town could increase efficiencies.
“I am pleased to have the opportunity to finally respond to some of the recommendations in the report from Municipal Resources,” Cone said. “We had two individuals who were here [in Houlton] for a day and a half. Unfortunately, I didn’t realize how much of this report was going to involve the fire department. I don’t believe these people spoke to anyone on the fire side to gather information there.
“I’m insulted with the statement that was made on Page 12 of this report,” he continued. “I have been the ambulance director for 24 years and served multiple times as the president of the Aroostook County Ambulance Directors Association.”
The section of the report that Cone referred to reads, “‘It was evident to the MRI team that the fire chief without an EMS management background and having not worked for a transportation service, has had limitations in providing leadership, management and change to the ambulance department.”
“I feel that I know the service and the needs better than they [MRI] do based on their day-and-a-half here,” Cone added.
Back in December, town councilors first reviewed the document, which cited numerous items needing to be addressed. The report cost the town $17,350 to compile and took a critical look at the ambulance department, citing issues with the billing process for reimbursement and questioned the need for separate fire and ambulance departments.
The report also stated greater management was needed for the ambulance service and suggested additional cross-training between the fire and ambulance departments would be beneficial to both groups.
Reviewing the fire department was not part of the initial scope of the study, but since the two are so closely connected, examining one department without looking at both proved difficult. Chief Cone said there has been talks about cross-training staff from the two departments for many years, but because of the high costs associated with that training, it has not taken place.
Houlton offers paramedic services for 450 square miles and has projected revenues that are $685,000 higher than projected expenses, Cone added.
Aside from providing coverage to Houlton, the ambulance department also contracts with Amity, Cary, Dyer Brook, Hammond, Hodgdon, Linneus, Littleton, Ludlow, Merrill, Monticello, New Limerick, Oakfield and Smyrna.
In 2015, the department responded to 1,958 calls, up from 1,874 the previous year. Those calls also involved transporting patients to hospitals other than Houlton Regional Hospital, such as transferring a patient to Eastern Maine Medical Center in Bangor. The department has taken patients as far as Boston for care.
Some of those calls, however, are for things that do not require ambulance personnel to transport a person to the hospital.
Cone said it was not uncommon for people to call for an ambulance to help lift someone who had fallen out of bed and could not get up without assistance.
One area of the report that was particularly of interest to the council focused on the billing and collections being done by the department. The report revealed that in 2015, $114,160 was sent to collections, but only $2,036 (1.78 percent) was recovered. In 2014, those numbers were $95,545 with $5,097 collected, while in 2013, the outstanding bills amounted to $62,291, with $5,375 paid.
Council Chairman Bill McCluskey suggested the town consider updating the language in the contracts it has with neighboring communities so that if an individual did not pay their bill, the town of Houlton could send the bill to the municipality for payment.
Chief Cone expressed hesitation in pursuing this course of action as it could very well lead to a drop in revenue as towns would likely drop Houlton and go with a different ambulance service such as Island Falls.
Cone stated his department has worked to correct errors in the billing reports that have delayed payments to the town and would continue to look at ways to improve the collection rate for outstanding bills.
No action was taken by the council at the workshop session.
