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Still no hearing for Certificate of Need

*Editor’s Note: This story has been updated to correct a factual error on the Certificate of Need process, with the hearing being required – and subsequently delayed – by the Cabinet of Health and Family Services, not the Kentucky Board of Emergency Medical Services. We apologize for any confusion or inconvenience this error has made.

This story isn’t new, unfortunately, and if you’ve been following the SI for any amount of time, everything below will sound like something that ran last month, six months ago, and yes, even two years ago, but Magoffin is still waiting for not only answers, but a solution to the current and objectively inadequate ambulance service it currently has.

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

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.

From July 1 through August 17 there had been 107 emergency medical calls requiring ambulances and of those calls, 13 were when the county was at a “level zero.”

Lifeguard started their own training programs to produce paramedics, attributing the problems to a lack of staffing, but by January 2020 the complaints were still rolling in, so Wireman applied for a Certificate of Need from the Cabinet for Health and Family Services for the county, which, if granted, would allow Magoffin County to either start its own ambulance service or contract it out, giving the county some control over the situation.

And since January 2020, Magoffin County has remained in limbo.

“We just want a hearing,” Wireman told the Independent. “Whether they side with us or not, we deserve a hearing.”

Wireman said he meets with representatives from Lifeguard semi-regularly, and they sometimes attend the fiscal court meetings, but they continue to tell him it is a staffing problem.

“I understand you can’t hold a gun to people’s heads and make them work, but no one wants to work for them for what they’re paying – which is comparable to McDonald’s,” Wireman said.

“Paramedics can make more at hospitals and nursing homes than they can riding around in an ambulance, so what do you think they will choose?”

Wireman said, as it stands, the county has no control over the situation, and even receiving a certificate of need would put other strains on the county.

“If we take it over, we’re talking about a million-dollar expense and the county and city would have to cover that,” Wireman said. “But we could contract it out and at least have some say in the matter.”

Wireman explained that he knows staffing is a problem, but that’s something Lifeguard should be able to contend with.

“These are the same people that does Nascar races, and they have people there,” Wireman said, explaining that Lifeguard’s a subsidiary of American Medical Response, a national company, and they supply ambulances for those events.

He noted that he asked if they could send staff from other areas of the company, but the paramedics would have to be licensed in Kentucky, something he hopes will be ratified by some upcoming legislature proposals.

“I know of at least two bills that will be introduced in the next legislative session, one to expedite the training process for paramedics and one for reciprocal agreements with other states so that they could have a license from another state and work here,” Wireman said, asking people to let their legislators know how important these bills would be for Magoffin County.

“Our state representative, John Blanton, is on board,” Wireman said. “Les Stapleton, the mayor of Prestonsburg, is trying to eliminate the CON process for city and county governments, which would also help since we wouldn’t have to rely on a private company or individuals.”

Wireman said the local ambulance service historically has not been tied to county government and the system seemed to work pretty well until recently.

Of course, some of the delays can be attributed to the COVID-19 pandemic, which put all Certificate of Need hearings on hold, but he keeps getting the run-around on even when the hearing could be scheduled.

“I keep calling them and complaining, and we have others in the community that are helping, but nothing,” Wireman said. “They’ll tell us we’ll hear something next Tuesday and Tuesday rolls around and we’ve still never heard back from them. We ought to at least get a hearing.”

Wireman said he tells everyone about this problem, hoping someone will eventually listen.

“I tell every single TV station that comes here to cover something,” Wireman said. “No one else has ran anything about this, yet. I told Rocky Adkins when he and the governor comes to town to make sure they have good drivers because our rescue squad will show up and cut them out, but the ambulance may not be coming for quite some time. We paid $1,000 in January 2020 just to apply [for the certificate of need] and they’ve still not given us a hearing.”

Wireman made sure to reiterate that he is not complaining about the men and women who work for Lifeguard, and noted that they have plenty of ambulances, as well, but they just don’t have enough people to fill those seats.

“We had a man die recently where the family was doing CPR and it took the ambulance 45 minutes to get there,” Wireman said. “When you’re in a situation where it’s an emergency and you need critical care right now, you need transported and you shouldn’t have to wait 45 minutes.”

He said last month Lifeguard offered to put a unit at every fire department in the county if they could help find more workers, but until they increase their pay, people are going to continue to pass on the job.

“We’re continuing to inquire about if and when we’ll get a hearing,” Wireman said. “We continue to meet with Lifeguard on their status, but they just don’t pay enough. People here have just accepted this is how it is, and we shouldn’t have to accept it.”

Wireman also commended Mark Campbell, a local pastor, for his help, as well.

After becoming aware that this was still a problem, Campbell recently reached out to Congressman Hal Rogers’ office, the governor’s office, and the inspector general’s office.

“I talked to the assistant general counsel,” Campbell said. “She assured me that this week the hearing in Magoffin Counties CON would be scheduled this week. Nothing can be done about the lack of service until that hearing is complete.”

But over two years since it began, Campbell said he didn’t know this was still a problem.

“I thought this issue was resolved,” Campbell said. “In discussion with other members of the community, they thought it was resolved, also. We see ambulances sitting at the station. But in my discussions with Matt, he says the ambulances are there but no one is available to operate them.”

Wireman said they will continue to push for action until a solution is made.

“If you’re in the southern end of the county and there is an ambulance in town, it’s still a 25-minute drive,” Wireman said. “Hospitals are full, ambulances are often of the county, and it just seems like they don’t have any compassion for people in Eastern Kentucky.”

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

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