Local leaders are backing a proposal from Pikeville Medical Center to establish a ground ambulance service to serve its hospital in seven Eastern Kentucky counties. 

According to a Certificate of Need application the hospital filed on July 31 with the Kentucky Cabinet for Health and Family Services, PMC plans to invest nearly $221,000 to establish a Class 1 ground ambulance service for emergency and scheduled transportation for its patients in Floyd, Pike, Lawrence, Letcher, Johnson, Knott and Perry counties, with a target completion date for this project in March 2020.

The service will be limited to two ground ambulances that serve hospitals, nursing homes, outpatient clinics, physician offices and other non-acute based healthcare facilities in those counties, the application says. It also states that the ambulance may transfer patients to from PMC to healthcare facilities in other areas, like Fayette, Bourbon and Jefferson counties. 

“This is not an effort to provide emergency scene responses,” the application states. “The response time is expected to be consistent with the regulatory requirements for a licensed ground ambulance service, Class 1.” 

The filing comes as local leaders have been voicing concerns about long ambulance response times in Floyd and other counties. Officials in Wheelwright, Wayland, Prestonsburg and the Floyd County Fiscal Court have highlighted the issue recently. Several of those officials were among physicians and individuals who provided letters of support for the PMC ambulance service. 

Rep. Ashley Tackett Laferty, D-Martin, Floyd County Judge-Executive Robbie Williams and Prestonsburg Mayor Les Stapleton each signed letters of support stating, “Recently, I have become aware of the need for an additional ambulance service provider to provide both emergency and scheduled transports to and from Pikeville Medical Center. Delays in patient transports are unsafe, inconvenient, and financially burdensome on healthcare facilities and providers.”

That statement was also provided in letters submitted to the Cabinet by Rep. John C. Blanton, R-Salyersville, Sen. Phillip Wheeler, R-Pikeville, Pike County Judge-Executive Ray S. Jones, Pike County Attorney Howard Keith Hall, Coal Run Mayor Andrew H. Scott, Coal Run Commissioners Beverly Jo Osborne, Joseph Adkins and Herbert “Trey” Deskins III, Pikeville Mayor Jimmy Carter, Pikeville commissioners Patrick McNamee and Steve Hartsock, Pikeville City Manager Philip Elswick, Pikeville Attorney Russell Davis, American National University Director Tammy Riley and Pike County Schools Superintendent Reed Adkins. 

On Tuesday, Wayland Mayor Jerry Fultz also shared a copy of a similar letter of support he signed on July 29, but that letter was not included in PMC’s application with the state. 

Fultz told commissioners that if PMC is granted this Certificate of Need, it could alleviate long response times in Floyd County.

“They’re not going to respond to 911 calls. That’s not what this is about,” Fultz said. “This is just to come to, if somebody downstairs needed to go to Pikeville Medical, they would send an ambulance to get them. If somebody at Pikeville Medical Center needed to be transferred somewhere, they would send them to them. Which really, it’s going to lessen the burden on the ambulance service that we have.”

According to the application, PMC reported having 1,063 runs either from/to the hospital in 2018, and more than 70 percent of those transfers experienced “long transfer times” of over an hour. PMC also reported having 1,613 non-emergency runs in 2018 and over 70 percent of those patients waited more than an hour for an ambulance. 

The hospital estimates that it will conduct 937 patient runs in the 2020 fiscal year and 1,767 patient runs in the 2021 fiscal year with all of those patients originating from the hospital. The application also says that the hospital will enter into mutual aid agreements with ground ambulance and air ambulance services in the service area. 

The application references ambulance services available in the counties that will be served by the PMC ambulance service. 

“These services cannot and currently do not meet the existing need in the Service Area resulting in slow response times, delayed delivery of care, and additional expense to the health care system and patients in the Service Area,” the application states.

Concerns about ambulance response times in Floyd County have been expressed since the former Left Beaver Ambulance Service closed in 2017. 

This year, the county’s only ground ambulance provider, Trans-Star Ambulance, was sold to Lifeguard Ambulance.

Bert Absher, director of operations for the company’s Eastern Kentucky division, reported recently that the company lost more than 20 employees after it purchased Trans-star, and it needs more than a dozen full time staff in Floyd County. 

In July, the company launched an accelerated 12-week training program for EMTs, and classes started on Aug. 12. 

Absher said that, to recruit employees, the company is offering tuition assistance, 100 percent student loan reimbursement and other benefits for employees, including a $5,000 sign-on bonus for paramedics.

“We’re looking for solutions, but in this industry, solutions don’t come overnight,” Absher said on Aug. 5. “When our nursing homes are frustrated with us, when our dialysis centers are frustrated with us, when the hospitals are frustrated because we can’t get discharges out on time, I want everybody to remember it’s because we’re keeping trucks free for emergencies, which is not only a state mandate, but it’s the morally right thing to do. You can’t send all of your trucks out on doctor’s appointments and discharges and leave no coverage for 911. We want all of our citizens to know that their health and wellbeing is an utmost priority for us. We know we have some issues and we’re combating them every day. We’re throwing everything we can at it to fix this situation, but it’s not an overnight fix.” 

Absher would not comment on the Certificate of Need application filed. He did emphasize, however, that the shortage of EMT and paramedics is a national problem, as fewer people are entering that field. 

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