Study: Lisbon Falls EMS operationally strong but needs stable funding and clearer governance

Consultant Chuck McNahan told a public meeting that a six‑month assessment of Lisbon Falls Emergency found the service’s clinical capability, equipment and staff culture are strong, but long‑term planning and funding stability remain unresolved.

McNahan said the review, begun last fall, involved staff interviews and operational data. “We didn’t really see anything broken,” he said, while warning the main vulnerabilities are governance alignment across the three towns and predictable funding to support staffing and programs.

The study highlighted a wide reimbursement gap that affects EMS nationally and locally. McNahan said the national average cost per transport was about $2,673 while average reimbursement was roughly $1,147, leaving a shortfall near $1,500 per transport. “That is something that’s not going to be fixed anytime soon,” he said, noting state and commercial reimbursement policies leave municipalities responsible for subsidies if they want local 911 coverage.

Local leaders and board members focused on steps to reduce that volatility. Several participants pressed for multiyear municipal contracting to help the nonprofit plan and retain staff; one recurrent proposal was a three‑year contract to provide budget predictability and protect recruitment and retention. “Being able to fund out and budget out three‑year contracts is something we could certainly work towards,” a town official said.

Board and staff speakers described rising mandatory costs for training, medications and new protocols and said those increases are squeezing small nonprofit services. Lisbon Emergency representatives said training, DEA‑related compliance and equipment remounts are creating recurring new expenditures and that community paramedicine or treatment‑in‑place programs could help offset some costs if reimbursement policies change.

McNahan and participants reviewed local reliability math: a single daytime ambulance, by his calculations, produces about 75% reliability for responses while adding a second ambulance raises reliability into the high‑90s. He also said call volume has risen substantially in recent years and that longer transports when hospitals reroute or drop designations are lengthening crew time on incidents.

A contentious item in the meeting was a recent budget cut. Participants said the Lisbon council reduced funding for Lisbon Emergency by about $65,000 late in the municipal process; several speakers said some council members later expressed remorse and the board is exploring legal options to restore the funding. “It was basically a four‑minute conversation at council. No warning,” one EMS board member said.

Speakers urged improved communication between the towns and the EMS board. Suggested steps included monthly updates from board representatives to town councils, a short community meeting among the three councils to rebuild trust, and exploring structural options such as a municipal EMS district or an overlapping contract schedule so no single budget cycle leaves the service exposed.

The presenter recommended keeping Lisbon Emergency as a separate nonprofit contractor funded by towns rather than folding it into a municipal department. “We’re recommending that they stay a nonprofit separate entity,” a council member asked; McNahan confirmed that is the study’s recommendation.

Next steps identified at the meeting included a community “heart‑to‑heart” session among elected leaders, consideration of a special town meeting or contract addendum to reach a three‑year funding commitment, and regularized reporting from the EMS board to each town. McNahan said he would share data and resources and remain available to help implement the recommended steps.

No formal vote or motion was recorded at the meeting; participants agreed to pursue follow‑up coordination between the towns and to continue discussions this summer.