Brentwood officials weigh taking on Fremont ambulance coverage after private firms decline

Brentwood officials and staff met to discuss options for providing ambulance coverage to neighboring Fremont after private ambulance companies declined to bid. Participants said AMR told the group it was "not interested" in taking on Fremont as a standalone contract because of insufficient call volume, and the team agreed to invite Fremont representatives and the local billing specialist to the next meeting to review numbers.

The central question was whether Brentwood should absorb Fremont’s ambulance calls under a flat-fee contract or negotiate a staffing- or revenue-sharing arrangement. S5 (Staff member) said AMR “responded back saying, not interested,” and reported that Stewart Ambulance and another Southern New Hampshire operator had also been contacted but had not committed to provide service. S4 (Agency official) told the group that they had previously modeled a $90,000 flat-fee proposal and noted, "They didn't come up with the 90 k. That was me," describing 12 years of experience running similar models.

Why it matters: participants said a low flat fee could shift significant overhead and financial risk to Brentwood taxpayers. S5 raised concerns that overhead costs and uncertain billing revenue would leave Brentwood on the hook for staffing and equipment unless a contract included offsets or revenue protections. S5 described two alternative approaches discussed at the meeting: (1) a staffing-cost model, estimated at about $300,000 to add personnel, in which Fremont would pay direct staffing costs and Brentwood would keep billing revenue; or (2) a model where Brentwood charges a single flat fee and Fremont retains billing revenue to offset the payment. Participants said further analysis is required to see which approach would be feasible and fair.

Numbers and revenue: attendees discussed recent billing performance as a way to estimate how much revenue could offset costs. S5 reported that the department’s recent data averages roughly $4.20–$4.50 per dispatch and that last year’s ambulance billing was in the neighborhood of $290,000 on roughly 600 calls, though participants said the group’s billing specialist should verify those figures. The meeting also included discussion of state-level insurance rules that informed revenue projections; S5 referenced a state calculation (noted in the meeting as the "325%" item) and advised the group to ask the billing specialist for a firm analysis.

Local context and pushback: some members said Brentwood’s tax base and budget profile make it sensitive to any large new expense. Participants compared population and valuation data for Brentwood and Fremont and said that, even with revenue offset, taking on Fremont could change the town’s budget dynamics. S1 (Committee member) emphasized that contract negotiations and any town-level presentation should wait until the group has Fremont’s proposal and verified billing data.

Next steps: the group set a follow-up meeting for next Wednesday at 2:00 p.m. and tasked organizers to invite Fremont representatives, at least one select-board official or the town administrator, and the billing specialist so the committee can review proposals and the underlying billing numbers. Several participants said that if those representatives are not available, they would cancel the meeting rather than proceed without the needed information.

The meeting closed with agreement to gather written proposals and contract language ahead of the next session and to use the billing specialist’s data to test the $90,000 and staffing models before any formal recommendation to the town.