While they understand the spirit of the move, local nonprofit emergency medical service providers agree a proposed statewide 6% assessment on nonmunicipal services would restrict their functions and raise costs unsustainably.
“It would have a significant negative impact on our service,” said Chris Mitchell, director of operations at Delta Ambulance, which is based in Augusta and provides emergency medical services to central Maine towns, including Whitefield and Somerville in Lincoln County.
A 6% tax on nonmunicipal ambulance services is proposed in Gov. Janet Mills’ biennial budget, which covers fiscal years 2026 and 2027, as a way to increase federal match funds and increase the amount of reimbursement that ambulance services receive from MaineCare for emergency calls.
As proposed, the assessment would be levied on all revenue, including municipal subsidies and donations, said Mitchell.
It would also apply only to private or nonprofit ambulance services, and not municipal services. Multi-town ambulance services are common in rural areas, where the model allows towns to pool their resources to better afford emergency medical services.
However, finances are tight for nonprofit services and municipal services alike, and a tax would increase that burden further, according to Mitchell.
“There’s always a cost,” he said. “Even services that are really efficient don’t break even.”
As a municipal ambulance service, Waldoboro EMS would not be subject to the tax, but Waldoboro service Chief Derek Booker said he shared his colleagues’ concerns about its potential impact.
“This wouldn’t have a direct financial impact on our department, but some of our mutual aid colleagues are facing this tax, and their support helps us,” Booker said. “I share concerns with their ability to sustain service, which would frankly put a strain on the remaining EMS systems around them.”
Another nonmunicipal ambulance service that would be affected as proposed is Central Lincoln County Ambulance Service. From its headquarters in Damariscotta, CLC Ambulance provides emergency medical care to the towns of Bremen, Bristol, Damariscotta, Edgecomb, part of Jefferson, Newcastle, Nobleboro, and South Bristol.
“It would cost us somewhere around $46,000 per year on the average year,” said CLC Ambulance Service Chief Nicholas Bryant. “Unfortunately, there’s no way to cover that cost other than the tax base that covers us … obviously, it isn’t fair to the taxpayers.”
Bryant, Mitchell, and Booker agreed the stated purpose of the tax – increasing the amount of funding ambulance services are reimbursed for providing emergency care to MaineCare-covered patients – is positive.
However, they said, the way the tax is currently envisioned would not be equitable.
“Reimbursement, in general, is a problem,” Booker said. “We operate at a loss, really, in terms
of what we bill out and what we get in return, and that seems to be sort of across the board … Hopefully, MaineCare reimbursement would be significant enough that it actually would improve, but there’s no real promise that would be the case.”
Mitchell said he supported the idea of raising reimbursement amounts, a solution the Maine Ambulance Association, a nonprofit organization, had suggested previously. However, he said, this proposed way of achieving that would harm Delta and other nonprofit ambulance services.
“The concept isn’t bad,” he said. “The way they applied it … is the problem.”
Mitchell took issue with tax dollars from nonmunicipal services being returned to every ambulance service in the state, including municipal services that had not paid the tax to begin with.
Maine had more than 276 licensed EMS services as of January 2021, including 11 hospital-based services, 11 private services, 41 nonprofit services, 35 independent municipal services, and 173 fire and rescue departments that provide emergency medical response, according to the Maine state website.
It is also more common for private ambulance services to carry out patient transfers as well as answering emergency calls, Mitchell said, a detail that he said would further restrict any benefit to nonmunicipal services since, as written, the proposed benefit from the tax would return in the form of reimbursement for emergency calls.
Bryant said he had traveled to the State House to speak against the measure alongside representatives from dozens of other EMS services. He is hopeful the Legislature would take the first responders’ concerns into consideration throughout the budget process.
“What they’re trying to accomplish is good,” Booker said. He added that as written, he did not believe the tax would have the desired outcome. “It is likely to put further strain on an already strained system,” he said.
