Harrison and Virginia Cole — Butch and Ginny, to most — won’t miss the police scanner traffic, the drop-everything-at-a-moment’s-notice commitment or the financial headaches.
They will miss the excitement, the personal connection to the communities they serve, “and the trauma,” said Ginny. “All paramedics are trauma junkies, whether they admit it or not.”
Since 1994, the Dixmont couple has operated Community Ambulance out of their Kennebec Road home, serving the people of Dixmont, Etna, Newburgh and Plymouth. Day and night, they respond to medical calls and reports of fires and motor vehicle accidents — more than 450 calls in the last year alone. They have seen death but also have helped save lives.
“They haven’t responded to a call for me personally, but I know they take very good care of people,” Newburgh Town Manager Nancy Hatch said recently. “It’s a service we never had to think about because they were just there. Always there.”
“It’s definitely one of those things we’ve taken for granted,” added Judy Dunn, a selectwoman in Dixmont. “They’ve been so dedicated.”
But as all things must end, so it is with Community Ambulance.
“It’s time,” Ginny said this week, sitting on a desk in a converted office in their home. “I’m 58, my husband is 63. I want to bake a cake. I want to have a sleepover with my grandkids. I want to have an uninterrupted date night with my husband.”
The decision to close Community Ambulance — effective June 30 — was made with heavy and somewhat conflicted hearts. When Butch and Ginny took over the former Dixmont Ambulance Service about 15 years ago, they transformed a nonprofit agency into a for-profit business. Aside from a few part-time ambulance drivers, the work was always done by the husband and wife paramedic team.
The profits never materialized. The Coles said they continued operations because they felt a duty to the communities. Over the years, though, the couple slowly accumulated debts associated with the emergency services they provide. “Diesel prices almost killed us last year,” Ginny said. In recent months, those debts have com-bined with depleted revenues to force the Dixmont couple’s hand.
Jay Bradshaw, director of Maine Emergency Medical Services, a bureau of the Department of Public Safety that oversees ambulance service in Maine, said a majority of the 285 entities licensed in the state are smaller operations like Community Ambulance.
The difference, he said, is that most of those are still nonprofits and have access to grant programs, tax benefits and other revenue streams. Only about five for-profit ambulance services exist in Maine, Bradshaw said.
“There is no standard model for providing emergency services,” he said. “What [the Coles] did fit a need and that’s to be commended.”
Community Ambulance always covered its operational costs — mostly gas, payments on their ambulances and medical supplies — with MaineCare, Medicare and private health insurance reimbursements.
Those reimbursements have shrunk considerably in the last few years, the Coles said. They used to get $700 to $800 for an ambulance call. Now, they get anywhere from $450 to $250 to sometimes nothing at all. If Community Ambulance responds to a call and the patient does not have insurance, for instance, that patient has to pay out of pocket. Ginny said it’s rare that those payments are made in full.
“We’ve turned over stacks and stacks of claims to collection agencies,” she said. “But what are we going to do, not respond to people who may not have insurance?”
The ever-evolving technological components of ambulance service also contributed to the pending closure of the Coles’ business. Beginning April 1, Community Ambulance was required by state law to computerize its calls. It might seem like a small request, Ginny said, but it was a big deal for them.
“The state has to submit statistics in order to get grant funding, but what they’ve done is shift that statistical work to us and it’s created a much bigger workload for a very small operation,” she said. “And, it’s not like we get any of that state money.”
Bradshaw said he sympathized with the Coles’ concerns but doubted the new state requirement was the reason for Community Ambulance’s closure.
“Look at what’s happened in all realms of heath care in terms of computerization,” he said. “It’s easy to blame the state.”
The absence of Community Ambulance will create a hole for the four towns it serves. All Maine municipalities must have an agreement for ambulance services even if they don’t provide any funding. The most likely alternatives in the area are Capital Ambulance and Sebasticook Valley Hospital, both of which are affiliated with Eastern Maine Healthcare Systems, which has much deeper pockets than the mom-and-pop shop run by the Coles.
Hatch in Newburgh said her town likely will approach nearby Hampden for ambulance service, or perhaps Capital.
“We’ll be OK,” she said. “But we’ve had a long relationship with Community Ambulance, so I’m sure some things will be a little different.”
In Dixmont, Dunn said her town has talked to both Capital and Sebasticook Valley but hasn’t made a decision.
“In terms of response time, things are going to change,” she said. “But maybe this is a good time for towns to reassess the services that they have.”
Even with the recent financial struggles, the Coles are thankful for 15 good years and said they are not looking back. Late this year they will celebrate their 35th anniversary. They hope to travel. They hope to spend more time with their grown children, young grandchildren and with each other.
The small office in their home likely will be converted to another use. At the very least, the scanners will be disconnected. The ambulances in their double-bay garage likely will be sold. Someone else will take over the task of worrying about responding to calls at 2 a.m.
“We’ll be able to sit down and watch a movie,” said Butch, looking up at his wife. “Just the two of us.”