Brentwood proposal would charge $90,000 and take billing revenue to cover Fremont ambulance gap

Brentwood’s EMS contract review subcommittee met July 1, 2026, to discuss a proposal for Brentwood to provide contracted ambulance coverage for neighboring Fremont while Raymond Ambulance transitions away next year.

Subcommittee members said the Brentwood proposal under consideration would pay Brentwood about $90,000 a year for contract fee-for-service and would direct billing revenue from Fremont calls to the emergency services revolving fund or to cover a paid duty manager (PDM) slot. Chief Olsson provided the committee with copies of contracts used in nearby towns and described short- and multi‑year contract options he had discussed with Fremont leaders.

Why it matters: Raymond Ambulance has signaled it will stop its current coverage arrangement around March 31, 2027, creating a hard deadline for Fremont and neighboring towns to secure interim or long-term coverage. Committee members said that launching a municipal ambulance service from scratch can be expensive—participants estimated startup costs in the range of $1.2 million to $1.5 million—making short-term contracted coverage an appealing interim option.

What the subcommittee discussed

- Billing and market data: Jeff from NBS offered to brief the subcommittee on ambulance billing and payer mix; members agreed that an independent presentation of billing mechanics and revenue estimates would be useful before recommending terms to select boards. Several participants also said private providers have been reluctant to share utilization and revenue data, complicating market-value estimates.

- Financial terms under review: Committee members summarized the Brentwood proposal as roughly $90,000 in annual contract fees plus Brentwood keeping 100% of billing revenue for Fremont calls, with revenues flowing to an emergency services revolving fund or used to underwrite a paid position to staff additional coverage. Members discussed conservative modeling assumptions (for example, running revenue scenarios on all-Medicare/Medicaid billing to stress-test viability).

- Contract length and protections: The subcommittee favored a three‑ to five‑year contract term with a one‑year probationary or opt‑out clause on Brentwood’s side, and recommended including a substantial “bailout” penalty for partners that withdraw early. Members emphasized the importance of drafting clear notice provisions so a partner town cannot leave immediately after the initial startup costs are sunk.

- Statutory and legal review: Participants noted that cooperative or regional agreements governed by RSA 53A can trigger attorney‑general review and other statutory timelines that may extend the time required to finalize regionalization agreements. The group said they would route any recommended contract through the proper legal channels before select-board consideration.

- Regional context and capacity: Committee members compared Brentwood/Fremont scale with larger towns (for example, Derry and Chester), observing that larger towns can absorb many more calls and spread costs over a bigger tax base. The committee also discussed workforce constraints, noting difficulty recruiting full‑time personnel in smaller towns and the value—and political complexity—of regional consolidation.

Next steps

The subcommittee agreed to add Kevin to the document distribution list, ask Jeff from NBS and Fremont leaders (the TA and the Fremont chief) to attend an upcoming meeting for Q&A, and continue collecting and comparing contracts from Hamstead, Sandown, Derry and Chester. Members also discussed issuing an RFI to private providers to obtain market pricing. Any recommended contract would be finalized through legal review and then presented to the respective select boards; the group noted Fremont’s town meeting/budget cycle means an autumn presentation would fit municipal timelines.

The committee adjourned after agreeing to exchange contract proposals by email and continue data collection.