If you’ve read or heard about the Maine EMS Lawsuit in the news, you may have wondered about the sources for some of the information Health Choice Maine has been sharing. We’ll keep adding resources to this page as time goes on.
Hospitals Understaffed and Closing Departments
We have seen an exodus of experienced healthcare professionals that have left already understaffed hospitals struggling to maintain appropriate standards of care. Any arbitrary employment search on job sites will bring up never-ending advertisements for hospital positions, offering increasing benefit and bonus packages in an attempt to fill positions. Billboards dot interstates throughout Texas, advertising Maine hospital positions, trying desperately to attract travel nurses. Meanwhile, countless Maine locals with impressive credentials and years of experience are barred from working in their own community hospital. Hundreds of stories from both healthcare professionals, and patients have poured into our inbox across the last year.
The Mills Administration continues to claim the mandate didn’t hurt Maine. But by their own numbers:
- When the mandate took effect in October 2021, Maine Health reported that 69 staffers resigned, Central Maine Healthcare reported 70 resignations and 500 open positions, and another 89 staffers left at Northern Light Health over their refusal to take the vaccine.
- Oct 12, 2021 – The Central Maine Medical Center in Lewiston admitted the closure of their Neonatal ICU was due to staff resignation. Maine hospital to close neonatal ICU after staff resign over vaccination mandate (Becker’s Hospital Review)
- Oct 13, 2021 – The Central Maine Medical Center in Lewiston suspended pediatric and trauma admissions. Central Maine Medical Center suspends pediatric, trauma admissions (WMTW News 8)
- Oct 22, 2021 – The Central Maine Medical Center in Lewiston reported that more than 250 employees were terminated. As a result, the hospital had to cut ICU beds by 50% and reduce the number of medical-surgical beds by 40%. Maine Hospital Fired so Many Unvaccinated Employees They Had to Close the ICU (The Exposé) and Lewiston hospital’s staffing troubles prompt calls for Janet Mills to ease vaccine mandate (Bangor Daily News)
- Oct 25, 2021 – York Hospital suspended emergency services due to staffing shortages. York Hospital in Wells temporarily suspends emergency services due to staffing shortages (News Center Maine)
- May 12, 2022 – St. Mary’s Regional Medical Center in Lewiston closed their maternity and women’s health services. Lewiston, Maine’s St Mary’s hospital to close maternity services (News Center Maine)
- Dec 15, 2022- Northern Light Eastern Maine Medical Center in Bangor closed their inpatient acute rehabilitation program. Bangor hospital to close acute inpatient rehab program (News Center Maine)
How Many First Responders Did Maine Lose Because of the Mandate?
So, how many first responders did Maine actually lose? The simple answer is that we just do not know. The number that the State is boasting is 3% or less. Yet that isn’t even close to accurate, as we have interviewed nearly four times that many. We have been told by analysts that it could be as high as 30%.
However, a large reason for the discrepancy here could be the methodology used to determine that number. What is being counted as a mandated-related termination? As we have worked our way through interviews with first responders, we have come across everything you might imagine and more. Very few first responders were actually terminated with the mandate given as the reason. The circumstances around termination included:
- Many were simply terminated without a specific reason given.
- A concerning number were simply moved to “inactive status.”
- Another group had valid medical exemptions that they were unable or unwilling to renew after Maine EMS updated the medical exemption form in August 2022.
- Another smaller group of EMTs that took the vaccine in order to keep their jobs, have since been suffering from a range of health issues. Some were so serious that they ended up losing their jobs anyway, because they could no longer work.
All of the above scenarios are “mandate-related” but likely were not counted as such.
The impact, while felt throughout the State, was not spread evenly. Some small EMS Departments may have lost one or two people, which sounds nominal until you factor in that they were already running short staffed and on fumes. Meanwhile, some Departments lost nearly their entire staff. This is more the case as you get further Downeast. During the research phase leading to this lawsuit, we came across multiple examples where neighboring Departments Downeast, now covering wider regions of territory, are simply unable to get to some calls in the time they need to.
During the radio show on Monday morning, Tiffany used the 90-minute heart attack call as an example, which is something that actually happened. It didn’t happen just because Maine is a large state and the EMTs had to travel a good distance, but because the Department that should have been responding to that call was out of service because of vaccine-related terminations.
In Their Own Words: EMS Departments Spoke Out Against the Mandate
Prior to the mandate, EMS department leaders strongly stated how badly a mandate would impair their ability to meet their responsibilities.
- August 17, 2021: In Washington County, Eddie Morseide, director of Downeast EMS, said the October 1 deadline will make wait times worse for residents. “You’ve already got a short-staffed EMS service in Washington County, and it’ll get a lot shorter,” he said. He estimated that 40% of his staff would not consent to receive the vaccine. Moosabec Ambulance Service, which covers the towns of Jonesport and Beals, said roughly 50% of their staff would not get the vaccine. Renee Gray, who runs Moosabec Ambulance Service, said the vaccine requirement was a nonstarter for her agency. “This mandate will not work for us,” she said. “We need this to be reversed.” Washington County EMS services want vaccine mandate reversed (News Center Maine)
- August 18, 2021: City officials in Auburn, Maine, are worried they could lose 14 or more employees in the Fire Department and dispatch center if they don’t agree to receive COVID-19 vaccinations by mid-September. Fire Chief Robert Chase said some unvaccinated firefighters are “very, very passionate” about the issue and likely won’t get jabbed, a choice that would require their departure. That will remove decades of experience from his force, he said, and leave his already stressed, short-handed department to cope with even more forced overtime since new hiring is so difficult. ME Fire Chief: Vaccine Mandate Could Lead to Departures (Firehouse.com)
- August 24, 2021: After the Maine EMS Board heard testimony from agencies fearful of losing staff to the mandate, they agreed to extend the mandate deadline by two weeks. The meeting had to be rescheduled from the previous week after the EMS Board’s streaming cap of 200 people was exceeded. Dozens of EMS workers spoke in opposition to mandatory vaccinations and shared their concerns in regards to staffing and making an already struggling system buckle. (What is most notable is that the Board essentially seemed to push blame onto DHHS. However, we now know that when the DHHS avenue to this mandate didn’t quite pan out, Maine EMS did in fact take it upon themselves to move forward with their own mandate.) Maine extends EMS vaccine mandate by 2 weeks (EMS1)
- October 16, 2021: The vaccine mandate, most EMS officials agree, has brought an already bad situation to a head, and the result will be felt directly by those who require emergency medical attention. ‘Nightmare scenarios’ Emergency medical responders contend with vaccine mandates (Sun Journal)
- October 25, 2021: Julie Keizer, Waldoboro Town Manager, explains. “If I lose three people who were putting in 40 hours or over, that’s 120 hours I can’t cover. In Lincoln County, we already have a stressed system.” According to Deputy Fire Chief Cody Fenderson in Fort Fairfield, eight workers have quit over the mandate. Now Fort Fairfield only has five full-time staffers available to fill 10 slots. In Portland, the union president for firefighters reports that 8 are expected to quit. Those are full-time positions, and those vacancies will have to be covered by other employees who are already exhausted by the pandemic and working overtime. In Maine, Vaccine Mandate for EMTs Stresses Small-Town Ambulance Crews | Kaiser Health News (KHN and Maine Public Radio)
The Shifting Mandate Narrative
The shift in the narrative since the mandate was implemented is stark. Since the mandate, it seems to have become the taboo topic. The same folks that were previously predicting the mandate being the straw that would break EMS in Maine, are now all but pretending it isn’t a problem and focusing on money. Yet, everything they predicted would happen, is happening.
- April 30, 2022: In this article, Jay Bradshaw implies that it’s only about reimbursement. Maine Voices: Insurance payment delays highlight deepening crisis for Maine EMS providers (Portland Press Herald)
- January 6, 2023: “The staffing issues that all of the services are experiencing right now are already having a significant effect. We have long-term care patients that need transfers, behavioral health patients that need transfers, and patients that need a higher level of care,” said Lail. “The reduction in [ambulance services’] ability to provide transfers means we wind up with ER beds filled with these patients, which backs up the rest of the ER, and patients have longer wait times.” According to Down East Community Hospital and Calais Regional Hospital CEO Steve Lail, “I think it is time for the legislature and DHHS to come up with some kind of plan to make sure that these organizations are funded properly. It needs to be on their radar.” Washington County Hospital CEO: Ambulance shortage ‘backs up the entire system’ (Machias Valley News Observer)
- Currently available on the Atlantic Partners EMS website, is a Workforce Shortage plea. They state that Maine EMS is experiencing a critical EMS shortage that is impacting their ability to respond to emergency calls. Yet they specifically sidestep any culpability of the mandate. They claim that “there may be those that blame the vaccine mandate” — and they’re right. As in all of the trained, credentialed and experienced EMTs that were terminated! We wonder how they feel, each time they read one of these stories about how critical the EMS shortage is becoming. APEMS does go on to explain that the workforce problem has been developing for many years, and we would certainly agree. APEMS goes on to explain that because of the staffing shortages:
- Many EMS providers are routinely working 80 – 100 hours per week, many times 48 – 72 hours consecutively.
- EMS services are regularly not able to staff the number of ambulances that they normally put in service, or are staffing a lower license level than normal.
- Hospitals in Maine facing tremendous difficulty find ambulances to transport their patients, which backs up their ED’s and doesn’t allow them to put new patients in beds. Hospitals are losing receiving beds because they can’t find an ambulance for transport in a timely fashion. Regularly, we have services traveling 2+ hours to pick up a patient because they were the only ambulance available.
- A recent motor vehicle accident in Maine with 5 patients injured and the closest mutual aid service that had a crew to respond was 1 hour away.
This all begs the question: Why?? Why, at a time when Maine EMS, Legislators, and other figureheads should have been negotiating better reimbursement rates and developing a better long-term plan for sustainability, were they wasting so much time on arbitrary employment requirements that push too many working EMTs out, and prevent future students from entering the field?
Other Resources and References
Here are a few other sources for statements you may have heard from Health Choice Maine.
- Covid-positive healthcare workers allowed to treat patients: The CDC changed their guidance in December 2021 to allow this in times of “crisis capacity”. Strategies to Mitigate Healthcare Personnel Staffing Shortages (CDC)
- Janet Mill’s sister, Dora Mills, is the Chief Health Improvement Officer at MaineHealth. Some of Janet Mills’ earliest pandemic advisers were her family (Maine Public Radio)
- Millinocket wedding outbreak: Documents show Maplecrest employee worked 10-hour shift with COVID-19 symptoms (WMTW)
- Emergency response times: According to a national study, emergency medical service units average 7 minutes from the time of a 911 call to arrival on scene. That median time increases to more than 14 minutes in rural settings, with nearly 1 of 10 encounters waiting almost a half hour for the arrival of EMS personnel. Longer EMS response times have been associated with worse outcomes in trauma patients. In some, albeit rare, emergent conditions (eg, cardiopulmonary arrest, severe bleeding, and airway occlusion), even modest delays can be life threatening. Emergency Medical Services Response Times in Rural, Suburban, and Urban Areas (NIH)
- Emergency response times: The Ellsworth American provided this table in August 2021 which breaks down the reported response times for surrounding rural areas in Hancock County. How long does it take an ambulance to arrive in Hancock County? (Ellsworth American)
- A doctor at Pen Bay Medical Center in Rockport had to transport a patient himself when there were no ambulance drivers available. “A Call For Help:” Maine’s EMS and Paramedic shortage (WABI)
- Blue Ribbon Commission study: EMS in Maine is at the edge of a cliff, if it hasn’t already gone over Report: EMS services in ME are at the edge of a cliff (News Center Maine)
Is Maine EMS Fulfilling Its Mission?
Some of the first responders who were let go lost everything–from their careers to their homes. And for what?
Maine EMS has existed for decades, yet this is the first time there has been a vaccine requirement applied to first responders in Maine.
And yes, some may say “it’s no different than requiring vaccines to attend school.” Except it is. Up until 2021, even to attend school there were religious, philosophical, and medical exemption options for that subset of the population that chose to utilize them. Authoritative State control of a citizen’s medical decisions without exception is still a fairly novel idea, and its benefit is yet to be seen anywhere this control exists now.
In addition, unvaccinated Maine first responders were successfully and safely treating patients for more than a year and a half before the mandate went into effect.
And while Maine EMS was so worried about the personal medical decisions of the adults working in first response across Maine, there really were important issues looming.
How much time did Maine EMS Board spend promulgating this rule, and could that time have been better spent working to address the staffing and funding problems that were approaching on the horizon at the time?
How many young people that may have otherwise gone into first response, will look at the strict vaccine mandates and be deterred?
If this was such an emergency, why then, does the second half of the requirement not go into effect until November 2023? How many more EMTs will we lose when the next vaccine mandate goes into effect? Can we afford to lose any more EMTs?