EMT Concerns

Floyd County Judge-Executive Robbie Williams talks about problems reported with ambulance response times in Floyd County during a special meeting Monday. Also pictured is County Attorney Keith Bartley.

The leaders of four local governments voiced concerns this week about long ambulance response times throughout Floyd County, and the operator of the county’s only ambulance service says there is no quick solution to the problem. 

The Floyd County Fiscal Court talked about the need to address a lag in ambulance response times during a special meeting on Monday, and, in separate interviews, the mayors of Prestonsburg, Wayland and Wheelwright also confirmed the same issue exists in their communities.  

“We’ve got a new company on board and we seem to be getting a lot of calls on the quality of the ambulance service, and I just wanted us to discuss if we as a fiscal court would want to entertain an open discussion with other companies on trying to get another ambulance service in here,” Judge-Executive Robbie Williams told the fiscal court. “We’ve called the new company several times and there just doesn’t, there doesn’t seem to be a sense of urgency on their part in providing the ambulance service that we need.”

Officials in Wheelwright have complained about ambulance response times in southern Floyd County for more than a year now. 

The complaints in that area started surfacing publicly in 2017, after the former Left Beaver Ambulance Service closed and those operations were taken over by the former Transstar Ambulance. 

In January, Lifeguard Ambulance, a subsidiary of a national medical response company, took over operations of Transstar and is currently the only ambulance service in Floyd County. The company’s Eastern Kentucky unit also serves Knott, Magoffin, Pike, Leslie and Harlan counties. 

Williams reported that Lifeguard has “periodically” been staying in the former Left Beaver Ambulance building and operating from the Floyd County annex building “a little more” to serve residents in southern Floyd County, but he said there are still problems with long response times. 

Williams said he had to transport a senior citizen to the emergency room from the Big Sandy Senior Games earlier this year because no ambulance was available. He said officials waited an hour for an ambulance to arrive at Jenny Wiley State Resort Park, and he decided to transport her in his vehicle with an EMT “in the backseat working on her with a defibrillator.”

County Attorney Keith Bartley said he would “certainly support” additional certificates of need for ambulances services in Floyd County, saying that competition could improve services.

The fiscal court took no action on the matter Monday, with Williams reporting that he’ll invite officials from the Lifeguard to address the fiscal court at a future meeting. 

In a separate interview, Prestonsburg Mayor Les Stapleton said he also spoke with Lifeguard officials about the lag in response times, and they “seem to be improving but we’re just watching.”

The problem with ambulance service has been festering for years in Wheelwright and Wayland, officials said. 

In Wheelwright, it took more than an hour for an ambulance to arrive for an emergency on Saturday, Fire Chief Daniel P. Gullett said. He recently suggested that the city commission start its own volunteer ambulance service. 

Mayor Don Hall, who has dealt with this issue several times as mayor, said the call volume in the Left Beaver area is not high enough to support an ambulance service there.

“It’s not the ambulance’s fault when you’ve got one ambulance covering all the areas,” he said.  

Wayland Mayor Jerry Fultz has dealt with similar issues. 

“No matter how quickly they get there, it’s never soon enough,” he said.  

He said Wayland leased the former city hall building to Transstar Ambulance three years before it sold its operations and that Lifeguard Ambulance is now paying that lease monthly, but, he reported, that neither Transstar nor Lifeguard actually staff that building in Wayland. 

Bert Absher, director of operations of Lifeguard’s Eastern Kentucky operations, said the company would staff those facilities if there were enough staff on hand. 

Absher explained that Lifeguard has only been operating in this region for 120 days, and its work here comes as there is also a shortage of EMS personnel across the state and nationally. He reported that Lifeguard needs about 42 full time staff in Floyd County, but it currently only has about 27 people. 

“I have empty trucks, and nobody to put in them,” he said. “And that’s not because of our pay because we have the most competitive benefits package in Eastern Kentucky.”

He said the company offers health insurance, retirement, tuition assistance, 100 percent student loan reimbursement and other benefits for employees, including a $5,000 sign-on bonus for paramedics. To address the staff shortage, Lifeguard is starting a training academy for EMTs in Prestonsburg on Aug. 12. The candidates attended informational sessions and started the process in July. 

“We had over 30 people apply. We’re going to take 20,” Absher said. “That’s a large class, and those students will be placed in an accelerated 12-week program. A normal EMT program is six months.” 

Those students will be paid as full time Lifeguard employees during the class, Absher said, and upon completion, they will meet all requirements to operate an ambulance. He said the majority of those students will work in Floyd County, while a few of them will work in Pike and Magoffin counties. He said Lifeguard will consider hosting another EMT academy here if this one is successful.

Absher said Lifeguard lost at least 26 employees after the company bought Transstar. 

He said some former employees did not want to work a rotating schedule or follow the dress code or other rules. He reported that previously, paramedics and EMTs at Transstar were permitted to work in excess of 100 hours per week, but Lifeguard limited that time for safety reasons, requiring employees to rest for 12 hours after working 48 hours. 

“Left Beaver was one of the most well-respected services in eastern Kentucky when I entered into this service,” Absher said. “But they couldn’t survive based on the call volume that operated out of that area. Now, we’re committed, and through the previous administration, we worked out with the judge here in Floyd County that we will serve the Left Beaver area. I will keep a truck over there every minute that I possibly can, but when that truck goes on a run, I may not have a truck to send back.”

Absher reported that the company’s overall response time is about 20 minutes in Eastern Kentucky and about 17.56 minutes in Floyd County. 

“That’s still slightly above the national average, but Kentucky’s geographical area is not like most of the nation,” Absher said. “We want everybody in Floyd County and all the counties that we serve to know we’re deeply rooted in Eastern Kentucky. We have local management who understands the geographical needs of Eastern Kentucky.”

He said the company will improve its service.

“We’re deeply invested into correcting any deficiencies that we have, but at the same time, if there were 40 EMTs and paramedics to hire today, we would hire them. We would hire them and start them at the most competitive salary that’s available in this area,” he said. 

He said EMTs start at $30,000 a year and paramedics start at $47,900, with benefits.

Absher said Lifeguard, and previously, Transstar, has been working with Big Sandy Community and Technical College for about two years to start a paramedic training program there. The accreditation process takes time, he said. 

“Lifeguard is not a small company. We have the resources of the nation’s largest provider of air and ground services. That’s why we’re able to do these things,” Absher said, talking about student loan forgiveness, tuition assistance and a $5,000 sign-on bonus for paramedics. “I don’t think anyone in eastern Kentucky has hiring incentives going on for paramedics right now, but they’re short too.” 

The shortage of paramedics comes in part, he said, because the course lasts about two years, the same as a nursing degree, and paramedics are often recruited to work in other fields. He also highlighted a problem Bartley mentioned during Monday’s meeting, reporting that federal reimbursement rates for ambulance services from Medicare and Medicaid are not sufficient to fund the cost of services provided. 

Similar concerns about ambulance services were voiced recently by the Pike County Fiscal Court. 

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