CARIBOU, Maine — Caribou Mayor Mark Goughan and City Manager Dennis Marker explained in more detail why the city will charge $100 per capita to surrounding towns for emergency services as opposed to $11.50 in 2020 during the City Council meeting on Monday.
The new EMS rate will affect Caswell, Connor, Limestone, New Sweden, Perham, Stockholm, Wade, Washburn, Westmanland, Woodland and Madawaska Lake Township. Towns without fire departments, such as Woodland, will need to pay a total of $125 per capita for both EMS and fire services.
Caribou is presenting surrounding towns with three options moving forward. The first would have no annual contract or fees, and 911 calls would go to the closest ambulance with an available crew. The town would then receive a $500 bill as a flat rate for each call.
Marker said that while this option would not leave surrounding communities unprotected, it may result in lengthy response times.
The second option would cost towns $100 per capita for EMS services, and the third would charge towns $125 per capita for both fire and ambulance services.
As of Jan. 13, the town of Caswell has agreed to a contract for the second option.
Several outside communities have held public meetings in which officials discussed the rate increase with residents in addition to options for moving forward. Limestone held a public hearing on Jan. 7 in which the town discussed how they may need to pay more than $200,000 for a new ambulance contract with Caribou.
Woodland also held a meeting concerning the new rates on Tuesday.
John Rasmussen, chairman of the Perham Selectboard, spoke during the public comment portion of the Caribou council meeting, telling Caribou officials that Caribou is “holding our elders hostage for a ransom” by significantly increasing the rates.
He added that the town of Perham cannot legally make a decision regarding the new fire and ambulance contract by Caribou’s Jan. 31 deadline as the item would need to be on the town’s annual warrant.
“If you do this, it will force us into a situation in which our residents may not receive emergency services and you are putting their lives on the line,” he said.
Rasmussen strongly recommended that Caribou also contact outside towns and ask when they are “legally able to make this decision.”
While the Perham chairman said he understands the increase is necessary, he felt that bumping the rate to $100 per capita is “fiscally irresponsible,” adding that an extra 10 or 20 dollars per capita annually would be more manageable.
Rasmussen also mentioned that the board had previously discussed this matter in executive session under MRSA 405.6 C, which allows the council to privately discuss matters as they relate to “economic development only if the premature disclosure of the information would prejudice the competitive or bargaining position of the body or agency.”
“This effort to raise this much money from the community’s most rural and vulnerable people — is this economic development,” Rasmussen asked.
Based on feedback from Rasmussen and other surrounding community members, the city has since changed the deadline to March 31.
Caribou resident Wilfred Martin said after Rasmussen that the city has “been talking about this for many years.”
“If [neighboring towns] aren’t satisfied with the ambulance service price, they’ve got the right to refuse and buy their own ambulance,” he said. “Wouldn’t that be the answer to their problem? Then there’d be no argument. And might I remind you people that we’ve been giving the ambulance service to other towns at a cheaper rate than Caribou and assuming all responsibility, and we’re not going to be having any more of this.”
Caribou resident Rep. John DeVeau said that he would like to participate in the city’s discussion of the matter, adding that he may be able to seek out other avenues through which “we could make this a little more fair” for surrounding towns if he has more information concerning the situation.
Goughan said that Caribou wants to be a good neighbor while also fairly representing its own citizens.
“This is a tightrope act and [the city] is trying to balance this to the best of our ability. There are no winners here,” he said. “It’s my personal belief that we ought to get out of the ambulance service, but we want to be good neighbors and we want to do it right.”
The mayor later clarified this comment by saying that no formal decisions would be made concerning the city’s ambulance without first giving surrounding communities a notice well in advance.
He said there are no plans to discontinue Caribou’s ambulance service in 2020.
Goughan then provided a timeline that explained how the city arrived at its current rates, which involved looking at revenue and expenses from the past 25 years. The city found that Caribou was paying close to $140 per capita for the service and that surrounding communities were paying roughly half this rate.
In early May 2019, Goughan said Limestone approached the city about obtaining ambulance services from Caribou after learning that Crown Ambulance would be discontinuing.
“Around this time, the council was dealing with the River Road failure, snow removal from hydrants, the food pantry, labor issues within the ambulance department, street lights, medical marijuana, the public safety building, Sitel’s parking lots and more,” Goughan said.
Marker presented data showing that, over the past two decades, calls within Caribou have been going down while calls to outside communities have been increasing even though the population is declining.
“We know we have an aging population,” Marker said. “The population is going down but overall costs are increasing.”
Looking at the 2020 budget, Marker said costs to run the fire department are about $461,000 and the ambulance costs roughly $2.2 million. With fewer towns using the fire department, Marker said it would cost roughly $47 per person if expenses were evenly distributed, while the ambulance, which serves several outside communities, would cost $190 dollars per person.
Revenues, according to Marker, have also affected the rate increase. He said the city generally receives 100 percent of what they bill from patients with private insurance, 80 percent from patients with federal insurance, 40 percent from those with state insurance, and nothing from uninsured patients.
Marker said there is an increasing number of patients using state and federal insurance, causing the city to lose money on most calls.
With the fire and ambulance services not making enough revenue to match their expenses, he said the cost per person in towns that receive these services would result in roughly $106 per person, adding that the number would be closer to $125 when planning for additional expenses.
Marker said the Caribou Fire and Ambulance Department is looking at roughly a quarter million dollars worth of additional expenses for fixing its roof and ambulance upkeep.
He said Caribou taxpayers are already paying close to $125 per capita.
“We recognize that it’s a steep change in cost from $11.50 per person to $100,” Marker said. “The situation is not unique to Caribou, and because of reimbursements it’s a losing situation for everybody. There’s no way to sugar coat something like this, but we’re hoping we can share this information so everyone has a greater understanding.”
