Most residents of Harpswell Neck, Cundy’s Harbor, and Orr’s and Bailey islands drive by a fire and ambulance station every day. But most don’t think about what happens inside — until they need to dial 911.
In a medical emergency, the speed at which first responders arrive can have life-or-death consequences. In the case of a heart attack, medical studies show a victim’s chances of survival drop by 7% to 10% with every minute that passes before CPR and more advanced life support treatments begin.
That urgency is what gets Harpswell’s corps of volunteer and paid responders out the door.
“If the tones go off at 3 in the morning, we’re jumping out of bed and going,” said Sean Hall, who serves as both assistant chief of the volunteer Orr’s and Bailey Islands Fire Department and as one of Harpswell’s small corps of paid firefighters. “To be there for members of the community is huge for me. It’s a comfort for them to see a face they know when things are going badly.”
Despite such dedication from Hall and his colleagues, ambulance response times to medical calls in Harpswell have slowed dramatically over the past eight years, according to state emergency services data analyzed by the Harpswell Anchor.
For Harpswell’s three departments — Harpswell Neck, Cundy’s Harbor, and Orr’s and Bailey Islands — median response times for emergency medical services climbed from 12 to 13 minutes in 2016 to between 16.7 and 18.7 minutes in 2022-23. (During the first five months of 2024, response times have begun to improve for the Harpswell Neck and Orr’s and Bailey departments, while the Cundy’s Harbor times have continued to slow.)
EMS response times in Harpswell are significantly higher than the median response times for volunteer departments across Maine, which slowed in the last decade but have held steady at around 13 minutes since 2021.
Response time is measured as the time that elapses between an EMS unit being notified of a call by a 911 dispatcher and skilled medical help arriving at the door.
Asked about slowing times, leaders of local departments said they do their best to respond quickly to emergency medical calls, but a growing number of challenges gets in the way.
At the same time as Harpswell’s population is increasingly aging at home and the number of 911 calls is swelling, it has become difficult to find volunteers to drive ambulances and provide skilled emergency medical help. The aging population has also changed the nature of EMS responses, with a growing percentage of “fall calls,” when people simply need help getting to their feet and medical crews do not need to rush.
Even when volunteer rosters are at a healthy level, the town’s unique geography — 216 miles of coastline stitched together by bridges and narrow roads susceptible to floods, freezing, and storm-blown trees and power lines — can make it hard to respond as quickly as emergency teams would like.
“Geography does us in,” said David Mercier, Harpswell Neck’s longtime fire chief. “It can take a long time to get from one place to another.”
While troubled by slowing response times, Mercier and other first responders said there’s a bright spot: The speedy response of paramedics who since 2014 have been on call around the clock at a station near the Town Office, along with that of municipal firefighters and emergency medical technicians who are on duty from 6 a.m. to 6 p.m. on weekdays.
When a call for emergency help comes in, those paid responders generally arrive at the scene crucial minutes before an ambulance does — a critical time savings. The paramedics arrive with all the equipment needed for saving a life, including sophisticated heart defibrillators, intubation supplies and a wide range of medicines.
In a report to the Harpswell Select Board last year, Wallace said that in the previous three years, the paramedic “fly car” had typically arrived at calls roughly four to six minutes before ambulances did.
“Everything they can do in the first 10 minutes in the emergency room, we can do immediately,” said David Hudson, EMS director for Mid Coast Hospital and chief of the paramedic squad.
A history of making do
Most towns of 5,000 don’t have three different fire departments. But that decentralized network has its roots in Harpswell’s decentralized geography — three large islands and a jagged quilt of peninsulas, harbors, and homes and small businesses perched at the water’s edge.
Getting from one side of town to another got easier when a bridge was built in 1974 to connect the west and east sides via Mountain Road. But even today, it’s critical to have fire trucks and ambulances stationed in the major villages.
“We’ve had to rely on ourselves,” said Mercier.
But that is changing, particularly as Harpswell’s residents — already among the oldest in the nation’s grayest state — increasingly choose to grow older at home. While there are few fires in town, calls for medical help are rising at a rapid rate.
According to state data for 2010 through May 2024, EMS calls have soared over the last decade and a half — from a low of 99 on Orr’s and Bailey islands to 163 last year; from 101 in Cundy’s Harbor to 167 last year; and from 110 in Harpswell Neck to 272 last year.
Some of those are for life-threatening emergencies, to which EMS responders travel with lights, sirens and a profound sense of urgency. But a growing number are what first responders term “fall calls,” cases in which a person has fallen and simply needs help getting up.
Many people are living alone or without caregivers who can lift them. “When you don’t know who to call, who do you call? The fire department,” said Mercier. “The fire department becomes the caregiver.”
For the Harpswell Neck department, for instance, half of the EMS calls in 2023 were for people who needed hospital treatment, but a full 25% were for those who just needed help getting up.
In such cases, emergency crews are going to drive more slowly to the call, an approach that increases safety on the road but also slows overall response time figures.
“Instead of going lights and sirens, we’ve dialed it back,” said Wallace. Town Fire Administrator Michael Drake added, “We don’t want to put other people in danger for something that’s not life-threatening.”
The road ahead
The core of Harpswell’s emergency response system remains volunteers, people who commit to regular, professional-level training — and responding to calls no matter when.
Phil Taylor is a retired Army and corporate airplane and helicopter pilot and a leading volunteer on the Orr’s and Bailey squad. The Orr’s Island resident practices yoga to stay nimble and has his pager on him at all hours.
“This is a way for me to give back,” said Taylor. “Everybody should be doing something for their community. None of us got here completely by ourselves.”
But with the volunteer corps aging and a limited supply of people willing to take their place, that human resource has stretched thin. Wallace said the Cundy’s Harbor force only has two EMTs, including him.
“We’ve had very few EMS responders. We’re not getting people to replace the ones who leave,” said Wallace. “We’re relying on the paramedics more and more.”
In addition to recruiting a new generation of volunteers, town leaders are exploring two ways to speed response times and ensure high-quality emergency care: a new, centrally located emergency services facility and/or increased paid staffing.
Currently, a paramedic is on duty 24/7 at a small station on Mountain Road. Two paid firefighters are on duty on weekdays from 6 a.m. to 6 p.m., when call volume is highest and volunteer responders are more likely to be at their day jobs. They are based at the Orr’s Island station Monday, Tuesday and Wednesday, and at Harpswell Neck on Thursday and Friday.
A new facility would allow the paid responders to be based in a central location on Mountain Road and respond more quickly to all parts of town. If town taxpayers choose not to invest in that structure, they could consider increasing the budget for firefighters to be on duty at two stations. (The Cundy’s Harbor station is not big enough.)
An architecture firm hired by the town has estimated the cost of a central facility at upward of $6 million. Increasing staffing alone could dramatically increase the town’s $850,000 operating budget for emergency services. At some point, first responders said, Harpswell taxpayers will have to decide if they want to invest more in the help they may one day need.
“Right now, the (town tax) rate is so low because we have virtually no paid services in town,” said Wallace. The wisdom of investing more in emergency services will become clear if people have to wait longer than they like.
“When it’s somebody you care about,” said Wallace, “it seems like it’s taking so much longer.”
