Timothy Beals is the executive director of Delta Ambulance. Beals says Delta is facing a variety of financial pressures and is looking to impose a service fee on the 14 towns it serves in central Maine that would annually raise more than $600,000. He’s shown Friday in one of the nonprofit company’s ambulances at its headquarters on Chase Street in Waterville. Michael G. Seamans/Morning Sentinel

With various financial pressures eating away at its revenue, Delta Ambulance wants to implement a service fee for the 14 towns it serves in central Maine that would range from $8,500 for a smaller town like Somerville to $97,000 annual bill for Fairfield.

The fee is putting town leaders in the position of determining whether to accept the charge or find another option for 911 emergency services.

Waterville-based Delta, in operation for 50 years, says rising costs and low insurance reimbursements are forcing the nonprofit service to institute the fee. But some municipal officials say they are already facing rising costs of their own in other areas and can’t readily absorb more.

Delta’s fee essentially would be determined by a town’s population; the company would charge $15 for each resident.

The total raised from the service fee across all 14 towns would be more than $600,000.

“It’s not something we wanted to do, it’s just a fact of doing business,” Delta Executive Director Timothy Beals said Thursday.

Beals spoke to the Fairfield Town Council last week and said Delta has been facing rising costs for fuel, and insurance reimbursements have not been keeping up. Further impairing operations are a shortage of qualified personnel, rising expenses related to providing emergency medical care and decisions by some towns such as Waterville to launch their own ambulance service.

When it comes to insurance reimbursements, Delta cannot charge an insurance company for the mileage to the scene of a 911 call, and cannot charge in most cases where a person is not taken to a hospital. So if a call is canceled when the ambulance is already halfway to the scene or if a person refuses medical care or to go to a hospital, Delta cannot charge an insurance company for any of that time or travel, Beals said.

And even when Delta can charge the insurer, it doesn’t mean the full bill will be paid. Mandatory agreements with insurers have meant that if an ambulance service charges, for example, $1,000 for a call, the insurer does not have to agree to pay the entire amount.

In recent years this has meant Delta does not have enough revenue to cover operating costs, Beals said, and the nonprofit has been using reserve funds to make up the difference.

If all towns agree to pay the fee, the money would be used to maintain services and pay for operations, Beals said. Delta is also in conversations with area hospitals to institute a similar fee structure, although Beals declined to expand on those details.

Annual service fees are fairly common with ambulance services around the state, and many of them run much higher than what Delta is proposing, he said.

But those explanations do little for towns already contending with a jump in utility, labor and other costs.

Windsor Town Manager Theresa Haskell said the town is just starting its budget process and leaders are hesitant to agree to the $39,500 Delta fee.

“We all just feel it’s quite a huge cost that these towns would have to incur, that we never had to in the past,” Haskell said.

Like many of the towns served by Delta, Windsor has a firefighting staff and a first responder vehicle but no ambulance, making it unlikely that the town could replace Delta with its own service — like Waterville and Winslow have done in recent years.

As towns proceed through the municipal budget process, it is possible that local officials could agree to pay the Delta fee only to have residents ultimately reject it at the annual Town Meeting.

Lagging insurance reimbursements and rising costs associated with providing emergency medical care are among the reasons Delta Ambulance is seeking to an impose a service fee on the towns it serves in central Maine. Timothy Beals, the executive director of Delta Ambulance, is shown Friday. The largest of those towns, Fairfield, would have to pay $97,000 annually. Michael G. Seamans/Morning Sentinel

Fairfield Town Manager Michelle Flewelling questioned what would happen if one town doesn’t pay or if many towns refuse to pay — what is the impact on Delta and on the rest of the region?

“We absolutely have to weigh everything and what does a change do to the system as a whole,” Flewelling said.

Beals said Thursday if one town declined to pay and chose to discontinue Delta service, the company would likely keep the $15 rate for the other towns for the first year, but may have to increase it later, and would likely have to cut staff.

“Rising costs have sort of forced the issue,” Beals said. “We’re hoping that all of our 14 towns that we serve are willing to support us.”