AUBURN — Both sides in the debate to create a city ambulance service agree that two issues are key — Auburn residents’ safety and money.

Auburn fire Chief Frank Roma said the city can boost medical response time in emergencies, sending a city ambulance to both treat and transport patients. The service will pay for itself, Roma said, letting it bill insurance companies for most of its costs.

“We can provide an enhanced level of service, yet the city can take advantage of a revenue stream that currently goes across the river,” Roma said.

Executive Director Paul Gosselin of United Ambulance counters that there’s not as much money in emergency transport as Auburn seems to think, and he said there’s nothing wrong with the response time Auburn patients would see if United handled all of the city’s medical calls.

“If there is someone doing it and they are doing a great job, if patient care is utmost, if response times are great and it’s not costing the city, then why would you get in it?” Gosselin asked.

City Manager Clinton Deschene said councilors could decide this month if they will pursue a city ambulance service, placing emergency medical response crews and vehicles at the city’s Minot Avenue and Center Street stations.

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“It’s likely I will present best-case, worst-case scenarios for councilors to review,” Deschene said. “Right now, we just have no firm data to utilize from United other than our own well-thought out, professionally accepted projects.”

Councilors last week agreed to have Deschene and Roma hone the response time statistics, potential costs and revenues for a city service.

Auburn currently sends medically-trained firefighters to most medical emergencies reported in the city. Those crews stabilize patients and hand them off to United Ambulance when they arrive. The city cannot bill insurance companies for those costs, however, because they do not transport them. Insurers only pay for transporting patients.

Roma said he’s confident the city could earn enough revenue from billing insurers to cover the cost of the ambulance and then some.

“I’m confident on my numbers,” Roma said. “We are trying to be conservative and not overly optimistic. I would rather come in and perform better than expected, rather than come in not meeting expectations.”

According to projections Roma gave to councilors last week, the city would earn up to $1.2 million annually from insurance company payments with $837,000 in expenses — a $362,000 profit.

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It’s not the first time Auburn has considered the move. The city investigated the idea in 2008. United agreed to pay the city $100,000 per year and to provide medical supplies to fire crews providing medical response.

That deal is scheduled to end and the city and the ambulance company have been working to negotiate a new deal.

“Every few years this idea comes up, and the councilors investigate it and come to the same conclusion,” Gosselin said. “It’s just not worth it to them. It costs them more money than they expected.”

Gosselin said the city’s $1.2 million revenue projection is based on 2012 statistics. The number of calls have declined as insurance companies and new insurance laws try to rein in costs.

“It also assumes that they are going to get every call in the city,” Gosselin said. “If there is a six-car pileup and there are six patients needing transport, they are going to transport every one of them, one by one. We wouldn’t step in to help — that’s what they are predicting.”

He said his projection predicts $980,000 in revenue — minus the $100,000 United no longer would pay the city. The city also assumes uninsured patients would be willing to pay as much as $58,000 out of their own pockets to the city.

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“That’s unrealistic,” he said. “They’d have to write most of that off, and that turns their profit into a $3,000 loss.”

Gosselin said United’s current plan would keep a dedicated ambulance and crew at a station on Rodman Road. That ambulance would only respond to calls in Auburn, and vehicles from the company’s fleet would rotate into that station when it’s out on calls.

That ambulance would respond to calls in most of the southern part of the city. United would send vehicles that are on call at the Russell Street, Lewiston, headquarters to respond to emergencies in the northern part of the city.

“We are already just on the other side of the (Vietnam Veterans Memorial) Bridge,” he said. “We can be there in minutes.”

City crews would no longer be expected to respond to medical-only emergencies.

Gosselin and Joseph LaHood, operations manager for United Ambulance, said the company would adhere to an average eight-minute response time for residents in the outskirts of the city. Auburn Fire currently has a four-minute average response.

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“We know that 80 percent of our call volume comes from one area downtown,” he said. “It’s easier for us to get there because we have trucks down there. And in that area, where 80 percent of the calls come from, response is a couple of minutes.”

Gosselin said he hoped to speak to individual city councilors this week to present his company’s side of the debate.

“We’ve presented our side to councilors before and they’ve come to the same conclusion,” Gosselin said. “Our service, the numbers we offer, make more sense.”

staylor@sunjournal.com

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