Question from our 2026 Annual Open Forum with District Citizens
The following questions were asked:
1. What is an interfacility transfer?
Answer: The District EMS service transports patients from one medical facility to another—sometimes to a higher level of care or a more appropriate facility. Hospitals and other healthcare facilities initiate these requests.
2. What are the different levels of EMT?
Answer: CMHFD has three levels of EMT licensure: Emergency Medical Technician (EMT) — The standard Basic Life Support (BLS) level for ambulance and first-response services.
Includes all Emergency Medical Responder (EMR) skills plus advanced patient assessment, vital signs monitoring, oxygen therapy, bag-valve-mask ventilation, splinting, spinal motion restriction, assisted medication administration (e.g., epinephrine, nitroglycerin, albuterol), and emergency childbirth.
Training: Typically 120–150+ hours.
Advanced Emergency Medical Technician (AEMT) — Intermediate Life Support (ILS) level.
Builds on EMT skills with advanced procedures such as IV/IO access, fluid administration, supraglottic airways, blood glucose monitoring, CPAP, limited medication administration, and some cardiac monitoring.
Training: Roughly 200–470 additional hours beyond EMT.
Paramedic — Advanced Life Support (ALS) level (the highest standard prehospital licensure in Maine).
Includes all lower-level skills plus advanced airway management, medication administration per protocols, cardiac monitoring/defibrillation, and other advanced interventions.
Training: Typically 9 months to 2 years (CAAHEP-accredited programs).
3. What percentage of ambulance calls go unpaid?
Answer: The vast majority are paid by insurance, Medicare, or Medicaid. Only a small percentage of self-pay accounts are never collected.
4. How is the rate for an ambulance call set?
Answer: Rates are set by the District and its billing agent, taking into consideration payor contracts as well as state and federal payment allowances.
5. Is the ambulance revenue reported net or gross?
Answer: It is reported as net payments (after contractual adjustments and write-offs)
6. Regarding the on-duty mechanic position, is there liability insurance?
Answer: Yes.
7. What are the District’s thoughts about the current budget discussion regarding Lincoln Fire Department cuts
Answer: We are taking a “wait and see” approach. Now that the budget has been voted in, we need to address the Mutual Aid Agreement.
8. How did Enfield’s fire costs go from $50,000 to what we now pay?
Answer: Howland Fire was unable to sustain service at that price, which led to the formation of the District. The first budget was intentionally lean to ensure a successful first year. That said, it was the Steering Committee’s position that the coming 2–3 years would include items not in the initial budget. Our goal is to be fully staffed for both efficiency and safety