Emergency medical services are no longer free for Swan’s Islanders. In a letter dated May 5, 2012, residents were informed that the Town of Swan’s Island would begin charging for all ambulance runs, a service that was previously covered in the town’s operating budget.

The decision to begin charging for ambulance runs was the result of a discussion at the annual town meeting held in March. In July 2010, the Maine State Ferry Service implemented a new policy—a $600 per-trip fee for after hours emergency runs. The cost is billed directly to the Town of Swan’s Island by the Ferry Service and not to the patient. Vinalhaven, North Haven and Islesboro are charged $650 for an emergency ferry run. Maine State Ferry Service Manager Jim MacLeod explained that the two different charges were based on the operating cost incurred to make the emergency runs. MacLeod stated, “We tried to make it just the actual cost of operating the ferry.”

During the discussion at the Swan’s Island Town Meeting, selectmen proposed that the town continue to absorb the $600 per-trip cost for the emergency ferry trips, a practice the town had been doing since the new policy went into effect in 2010.

In 2011, the Maine State Ferry Service charged the Town of Swan’s Island for 14 nighttime runs, totaling $8,400. Of that amount, only $600 was recovered when the cost of one trip was reimbursed to the town by the user. The additional $7,800 was taken out of the town’s general assistance fund. Residents at town meeting in March expressed to the selectmen that they should do a better job at attempting to recover the $600 cost from the user. Selectman Dexter Lee explained that it was very difficult to get people to pay and that trying to collect from Medicare, MaineCare and private insurance companies was challenging. They will not pay for the ferry run, but will cover some or all of the cost of an ambulance run. In an effort to recover the $600 emergency ferry fee, the Town of Swan’s Island would have to start billing for the ambulance service and not the direct cost of the ferry run.

Shortly after town meeting, the Swan’s Island’s Board of Selectmen, Myron Sprague, Dexter Lee and Jeffrey Ellison, along with Debby Staples, director of the Swan’s Island Ambulance Service met with Tammy and Philip Higgins, of T.G. Higgins Business Services, P.A. after learning that Vinalhaven was using their services. Located in Winterport, T.G. Higgins has over 20 years of combined experience in emergency medical service billing. The selectmen were interesting in learning how they could recoup the $600 per-trip expense from patients. Tammy Higgins informed the group that would have to bill for all ambulance runs and could not just bill for those resulting in the $600 ferry charge.

T.G. Higgins is not a collection agency, but a billing service that currently represents 17 emergency medical services. Tammy Higgins told selectmen that they use a soft approach, sending three invoices, in an effort to collect the ambulance fees. They are experienced in dealing with Medicare, MaineCare and private insurance companies. T.G. Higgins staff will also work with patients to set up payment plans. The Town of Swan’s Island contracted with T. G. Higgins Business Service to handle all of the billing needs for their ambulance service.

Vinalhaven and Islesboro have been charging for ambulance services for a number of years and also are using T.G. Higgins Business Services to handle their billing. Vinalhaven has the added complication of billing for fixed wing air flight as well as ferry transport for emergencies. Burke Lynch, EMS Director on Vinalhaven said, “We have been using Higgins Business Service for three to four years now. I’ve got nothing but good to say about them.” Fred Porter, Public Safety Director for Islesboro confirmed that the Islesboro EMS Department recently switched to T.G. Higgins in April, replacing their former billing agent.

In working with Tammy Higgins, Swan’s Island selectmen came up with a rate of $440 plus $15 per-loaded-mile per-ambulance-run. This will not completely cover the $600 fee charged by the Ferry Service for evening emergency runs, but by charging for the ambulance service during the day as well, the revenue generated will offset the annual cost of the emergency runs being billed to the Town by the Maine State Ferry Service.

In their letter to residents, the Swan’s Island Board of Selectmen expressed their concerns that charging for ambulance services may cause some people to be less likely to call 9-1-1 in the event of a medical emergency. Their message to residents stated, “Special arrangements can be made based upon financial hardship. PLEASE, do not let the letter scare you from making necessary calls to 9-1-1.”

Donna Wiegle is a freelance contributor and a resident of Swan’s Island.