An emergency medical services crisis across Maine

By Sen. Mike Tipping
“EMS services in Maine are at the edge of a cliff, or over it, and changes must occur to ensure that when someone calls with a medical emergency, EMS services are able and ready to assist.”
That’s the conclusion of the final report from the Blue Ribbon Commission on Emergency Medical Services, released to the Legislature on Jan. 12, assessing the state of EMS in Maine and making a series of recommendations to improve the state’s emergency medical systems and outcomes.
The specter it raises, of someone calling 911 and no one being available to respond to their emergency, is unfortunately a very real possibility in the near future, especially in many rural areas of Maine.
The Commission found that EMS in Maine is dramatically underfunded, with $25 million in additional state funds needed to address just the ambulance services that are at immediate risk of failing and leaving their service areas altogether.
Overall, the report recommends allocating $70 million per year for the next five years to help fund the delivery of EMS services. That is a significant amount of money, and highlights the large gap that currently exists between the need and the reality of emergency health services.
The biggest reason these cost gaps exist and why many of Maine’s emergency response systems are stretched to the limit, is that Medicaid and Medicare reimbursement rates, which pay for the majority of emergency service calls, are far below what is necessary to pay for the services. This is especially true in rural areas with lower call volumes that still need to maintain staff and availability.
I’ve heard what this has meant in practice from first responders and municipal officials in towns across this district, as both full-time and volunteer fire and EMS services have been stretched to the limit.
The report also recommends an additional $6 million per year from the General Fund for what are called “non-transporting emergency medical services.” It recommends further study of and regulatory changes to allow and enhance services that fall under this umbrella, including community paramedicine, which it notes “represents an expanded role for EMS providers to assist with both public health and primary healthcare.”
Another key recommendation is funding for the Length of Service Award Program (LOSAP), which rewards EMS workers for dedication to their communities by helping fund their retirement program. Finally, there are recommendations to address differences in licensure requirements, streamlining that process and incentivizing those careers.
Now that the Commission’s final report has been submitted, there have been several legislative proposals to put its recommendations into effect, including bills submitted by EMS Commission co-chairs Sen. Chip Curry and Rep. Rachel Talbott-Ross (who now serves as Speaker of the Maine House).
I have also submitted legislation, titled “An Act to Improve Recruitment and Retention of First Responders” with the aim of addressing some of the issues we’ve seen with frayed fire and EMS services here in Penobscot County.

I’ll continue to monitor these bills and do what I can to make sure EMS services are funded and that, when we call 911, trained professionals will be available to respond.
If you have questions or thoughts on this or any issue, feel free to contact me at (207) 287-1515 or at Mike.Tipping@legislature.maine.gov.