16-163-24 Me. Code R. § 3

Current through 2024-36, September 4, 2024

Section 163-24-3 - Applications

1.Eligible Entities. Only eligible EMS entities may apply for stabilization funding from the Program. All eligible EMS entities that apply for funding and meet all the following criteria shall receive funding from the Program:

A. Risk of Imminent Failure. An applicant must demonstrate an immediate risk of failing either by an inability to finance daily operations or due to recruitment and retention issues. All applicants for funding must complete the assessment for their ability to finance daily operations as part of the application even if they do not seek eligibility under that pathway.

I. Assessment of an Applicant's Ability to Finance Daily Operations. If an applicant's Operating Margin is less than or equal to 10% of its Total Revenue it will be considered to be at immediate risk of failing due to an inability to finance daily operations. Each applicant shall provide the following information to determine if its Operating Margin is at or below 10% of its Total Revenue.

a. "Total Expenses" equals the sum of the following expenses.

i. Labor costs.

1. If the eligible EMS entity is staffed with volunteers or a combination of volunteer staff persons, labor costs should be estimated based on a rate of $28.89 for volunteer hours. That amount should also be included as revenue as an in-kind donation of volunteer labor.

2. If the service's average compensation, including benefits, for an actively licensed EMS person, is below $28.89, regardless of licensure level, the actual labor costs should be calculated and disclosed; however, the agency may use the rate of $28.89 for the determination of eligibility calculation.

ii. Non-labor/equipment costs. This includes supplies and materials (e.g., equipment costs, consumables/disposable equipment, and other associated costs).

iii. Purchased services costs. This includes service-level medical director contracting, quality assurance and improvement, training support, etc.

b. "Total Revenue" equals the sum of the following revenues.

i. Transport revenue, if applicable.

ii. Local subsidy or subsidies. This includes any funds generated from tax revenues received by the EMS entity.

iii. Hospital subsidy or subsidies. This includes any funds hospitals or other entities provide for services rendered for that facility or health system outside of transporting revenue. For example, if a hospital reimburses an EMS entity for an interfacility transport and provides a $100,000 contractual fee, only the $100,000 would be represented here.

iv. Subscription services, if applicable.

v. Grant funding, if applicable.

vi. Donations. This includes in-kind donations of labor from volunteers. Volunteer hours should be calculated using the rate of $28.89 per hour, irrespective of the EMS person's licensure level.

vii. Any additional revenue.

c. Calculations

i. For purposes of this rule, Operating Margin is calculated by subtracting Donations and Total Expenses from Total Revenue.

d. Determination

i. If an applicant's Operating Margin is less than or equal to 10% of its Total Revenue, the applicant will have demonstrated an immediate risk of failing due to an inability to finance daily operations and thereby qualify to receive funding.

ii. If an applicant's Operating Margin is greater than 10% of its Total Revenue, the applicant is not eligible for funding based on an inability to finance daily operations. The applicant may still receive funding based on Employee Recruitment and Retention (see II).

II. Employee Recruitment and Retention. If an applicant is not eligible for funding based on its current financial situation, it still may seek funding based on potential workforce recruitment and retention concerns. Such applicants shall provide employee data on a form and in a manner prescribed by the Director.

a. Applicants utilizing a volunteer or augmented voluntary staffing model (i.e., stipend, per call pay, etc.).

i. An applicant with a monthly average of fewer than fourteen (14) actively licensed emergency medical services persons providing clinical care as documented within the Maine EMS and Fire Incident Reporting System (MEFIRS) over the past three years for each response unit (Maine EMS-licensed emergency response vehicle) that is available for at least 60 hours per week shall be considered at immediate risk of failing due to employee recruitment or retention issues and thereby qualify to receive funding.

b. Applicants utilizing a paid staffing model.

i. An applicant with a monthly average of fewer than seven (7) actively licensed emergency medical services persons providing clinical care as documented within the Maine EMS and Fire Incident Reporting System (MEFIRS) over the past three years for each response unit (Maine EMS-licensed emergency response vehicle) that is available for at least 60 hours per week shall be considered at immediate risk of failing due to employee recruitment or retention issues and thereby qualify to receive funding.

B. An applicant must submit financial statements covering the most recent complete fiscal year and the current fiscal year to date as part of its application.

I. These statements must include a balance sheet and income statement from the most recent complete fiscal year and the current fiscal year to date, which may be used to verify financial information provided in the application to demonstrate financial hardship.

C. An applicant must demonstrate that it provided 9-1-1 emergency medical services to its community during the previous calendar year, including as follows;

I. If an applicant underwent a merger in 2022 or 2023, it must also provide proof of consolidation of operations. For such an applicant, the combined volumes of the merged entities will be used for calculations.

D. An applicant must currently provide and intend to continue to provide emergency medical services coverage to the community it serves.

E. If the applicant is a transporting ambulance service, it must participate in the MaineCare Program and maintain an electronic funds account with the Maine Department of Health and Human Services.

2.Announcement of Funding Opportunity

A. The Director shall announce via electronic communication pathways, at a time to be determined by the Director, that the application is available for completion, including instructions on how it can be accessed. The application shall be made available for at least 30 days and can be extended at the discretion of the Director.

3.Application Form

A. The Director shall develop an application to ensure compliance with this rule.

B. All applications for funding must comply with this rule, all instructions provided in the Announcement of Funding Opportunity, and any instructions and formatting requirements within the application.

C. All applicants shall submit the following additional documents to the Director based on instructions provided within the Announcement of Funding Opportunity and Application Form.

I. Current fiscal (year to date) income statement

II. Current fiscal (year to date) balance sheet

III. Most recently completed fiscal year income statement

IV. Most recently completed fiscal year balance sheet

16-163 C.M.R. ch. 24, § 3