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County to receive certificate of need

SALYERSVILLE – Magoffin County officials received notice last week that the county will be awarded a certificate of need for ambulance services after waiting for close to two years just to get a hearing.

In January 2020 Magoffin County Judge/Executive Matt Wireman submitted an application for a certificate of need through the Cabinet of Health and Family Services after having some concerns with the current ambulance service.

Lifeguard Ambulance Service bought Tran-Star in April 2019, and the license through the Kentucky Board of Emergency Medical Services covering Magoffin and Pike counties.

Six months into the transition, Magoffin County Judge/Executive Matt Wireman voiced his concerns about ambulance services in the county, noting in public meetings the number of times the county was in a “level zero” situation, or not having a staffed ambulance in the county when one is needed.

A few months after applying for the certificate of need, Wireman was notified that there would be a hearing scheduled because Lifeguard had requested one regarding the county’s application.

Then, COVID-19 hit.

“That put everything on a delay,” Wireman said. “We were contacted a couple times over the span of a year after we called and asked, stating the hearing would be scheduled in the near future.”

Wireman said only recently did he actually start to see some progress after getting the media, a local pastor, and even the governor’s office involved.

“We were finally able to get a pre-hearing date scheduled,” Wireman told Mortimer Media Group on September 14. “Once that happened, the parent company of Lifeguard withdrew their request for a hearing and today we got the news we would be receiving a written certificate of need after 40 days.”

Wireman explained that the certificate of need (CON) will basically allow them to establish a Class I ground ambulance service with a basic life support (BLS) unit and an advanced life support (ALS) unit, which is what they had included in the application for the CON.

“That’s what as a county government, working with the city, that we would be able to own and operate,” Wireman said.

He said he is looking into the possibility of contracting out the service to third party services.

“We’re going to weigh all of our options and do what’s best for Magoffin County, both on providing the service and financially,” Wireman said.

When asked, Wireman noted that starting an ambulance service was never the plan when he ran for office.

“Absolutely not,” Wireman said. “I don’t think anyone would want to take that challenge on in my role, knowing financially what it costs. As a financial analyst and an accountant by trade, I know what it’s going to cost and it could cost more. We’re looking at $1 million a year to run two ambulances 24/7 and have the staff there. Will that be enough? Will we have to have more ambulances?”

Wireman also noted that their application only covered emergency runs to prevent other “level zero” incidents, explaining that as it stands, they would not be able to do non-emergency runs or medical transports.

“Being in the ambulance business is not what I ran for judge for, but it’s a need and I’m here to serve and protect as much as we possibly and financially can,” Wireman said.

In his research, talking to other county governments that have taken on the task of operating an ambulance service, he said some barely break even and some are doing quite well, but he expects to need an influx of cash to get the project off the ground.

“Just the timing and things falling into place, we have been able to free up a significant amount of coal severance dollars that were tied up for the industrial park for water, where there are now public funds that came down from the administration and Congress, which is enough to cover the bids that come in and it we will have some residual funds there. In addition to that money that is now freed up and coal severance, we will be able to get the capital needs – the ambulances and equipment – and we’ll be able to buy those and have those out of the way, not having to be making payments on it and that kind of thing, so it will just be the reoccurring expenses of payroll, fuel, supplies and maintenance of the equipment where all the costs are hopefully offset through billing.”

Wireman also noted they will use a third-party billing vendor to bill for the services.

Furthermore, while this is a huge win for the county, the CON is not a license to operate a heath service, and such a license must be applied for separately through the Kentucky Board of Emergency Medical Services.

This is an ongoing matter and the Independent will release updates as they are made available.


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