It’s official. The City of Prestonsburg is formally seeking to establish an ambulance service.

On Jan. 24, the city filed an application with the Kentucky Cabinet for Health and Family Services for a Certificate of Need to establish a Class 1 ALS/BLS ambulance service in the city.

The city estimates it will cost $96,000 to launch the service, with most of those funds, $60,000, being designated to purchase two ambulances and $30,000 being allotted for equipment.

The application also reports that on Dec. 9, People’s Bank confirmed that the city had a $500,000 line-of-credit and a “zero balance” at that bank.

Lifeguard Ambulance, the only ground ambulance serving Floyd and surrounding counties, has offered to provide an ambulance and pay Prestonsburg monthly to lease Prestonsburg Fire Department EMTs and paramedics to answer ambulance calls in the city. City officials are still considering that contract, Stapleton explained.

“The council has been given a copy of a contract with Lifeguard Ambulance. You know, we’re waiting to see what the council says, but, just so I’m not putting all of our eggs in one basket, we have also filed our CON, our Certificate of Need, for our own ambulance service here in the City of Prestonsburg,” Mayor Les Stapleton said.

Prestonsburg has 13 EMTs, four of whom work part time, as well as three full time paramedics and one part time paramedic. Stapleton said the city may need to hire one full time paramedic to meet requirements. He explained what Prestonsburg will be able to provide residents if the Certificate of Need is granted, reporting that firefighters who are certified as EMTs can treat patients at a scene, but they are not permitted to transport them for emergency medical care.

“We can do emergency runs and everything else, too,” he said. “Our plan, and we have no reason to swerve from our plan, is that we will only do 911 calls, emergency calls.”

In the application, the city reports that it intends provide ambulance services within the city, but that  its services would be “available regionally” when requests for assistance is made.

“The City of Prestonsburg provides its own 911 dispatching center and through the Dispatch center response delays for ambulance request(s) have been identified on several occasions,” the application states.

Stapleton said if the CON is granted, Prestonsburg may respond to calls where a hospital needs ambulance transportation to a helipad to fly a patient out for emergency care, but he said, other than calls like that, the city’s service will not provide routine transfers and doctor’s visits.

“We have no intentions whatsoever of doing that,” he said.

The application states, “The City of Prestonsburg has no intention to provide non-emergency Medical transportation nor to compete with a Private Ambulance Services.”

The city estimates, in its application, that it will provide 690 runs annually. It highlights problems with ambulance response times as one of the reasons for the need to establish a new ambulance service in Prestonsburg.

The application states, “These response delays are very common and Lifeguard Ambulance Service management has acknowledged these delays due to lack of personnel ... It is felt by the City of Prestonsburg that the residents in the described boundaries will benefit from a Governmental based Ambulance Service. The additional Ambulances would allow more Ambulances to be available to the Citizens of Prestonsburg, which would not only benefit the Citizens of Prestonsburg, but all of Floyd County by relieving Lifeguard Ambulance Service of City 911 calls.”

Ambulances response times have been highlighted at local government meetings throughout the county for more than a year. Stapleton attended a special Floyd County Fiscal Court meeting on Friday in which officials talked about the problem of ambulance response times in the county. Firefighters there told fiscal court members that it took Lifeguard Ambulance 45 minutes to respond to a bus wreck in Allen last month, and response times in the southern end of the county are also excessive.

Lifeguard officials have repeatedly explained the problem to local government leaders, reporting that the lack of personnel hinders response times in Floyd and other counties.

The company recently hosted a ceremony to mark the graduation of 21 EMTs who were paid to undergo training at Lifeguard prior to gaining certification to work there.

Stapleton said he thinks that if the CON is granted, the Prestonsburg ambulance service would help alleviate calls and improve service for Lifeguard in Floyd and surrounding counties. Similar comments were made by attendees at the fiscal court meeting last week and in the city’s CON application.

The application notes that the city is in the process of establishing mutual aid agreements with the City of Paintsville and Pikeville Fire Department EMS.

“It is yet to be determined if Lifeguard EMS will participate with a mutual aid agreement and it is anticipated that the agency will contest this process, despite the evidence showing the need,” the application states.

Letters of support for the Prestonsburg ambulance service were submitted by Floyd County Circuit Judge Johnny Ray Harris, District Judge Eric D. Hall, Mountain Comprehensive Care Center President/CEO Promod Bishnoi, Riverview Health Care Center Administrator/CEO Missy Allen, David Volunteer Fire Department Chief Greg Davis, Assistant Chief Michael Tussey and Floyd County Emergency and Rescue Squad Captain Ritchie Schoolcraft, as well as others.

Highlands ARH Regional Medical Center CEO Tim Hatfield wrote in his letter of support that a Prestonsburg ambulance service “would be a good compliment” to services currently provided.

“This new service would take some of the stress off of existing services that find recruiting paramedics a challenge in the State of Kentucky and in particular as it relates to Eastern Kentucky,” Hatfield wrote. “The addition of the ambulance service would provide a very efficient turnaround time within the City limits to get patients to the ER in a timely fashion. It is my understanding the City of Prestonsburg is willing to answer and operate their service to take care of 911 or Emergency calls only. With our region experiencing a lot of challenges in transportation services in general due to financial instability, this new emergency service will definitely meet some current and future needs.”

Floyd County Health Department Director Thursa Slone asked the Cabinet to “strongly consider” the application in her letter of support.

“I serve on different boards and am concerned about the issues I hear related to the response times and availability of emergency related services across the county including within Prestonsburg City Limits,” she wrote. “I feel these concerns are driving the request to apply for this application in order to meet unaddressed needs of this community.”

Rep. John C. Blanton, R-Salyersville, told the Cabinet in his letter that he believes establishing an ambulance service in Prestonsburg will “help alleviate the extended response time” in Magoffin County and surrounding areas.

Rep. Johnny Ray Turner, D-Prestonsburg, also pledged that he would “strongly support” an ambulance service in Prestonsburg, stating that it would provide improved emergency services to Floyd County residents.

Prestonsburg resident Beth Walker told the Cabinet in her letter that her family waited 2.5 hours for an ambulance transfer to Ashland.

Prestonsburg Fire Chief Michael Brown also gave his “full support” for the effort.

“The City is in a dire need of an Ambulance due to extended response times and delays from the current Ambulance provider, the extended response times and delays are well known in the Community and have been documented by the local Media,” Brown wrote.

He also wrote, “The AAOS (American Academy of Orthopaedic Surgeons) recommends that a person experiencing a Traumatic event should be assessed and transport initiated within 10 minutes, and the AHA (American Heart Association) recommends early ALS (Advanced Life Support) intervention in Cardiac related Emergencies to reduce morbidity and mortality rates. The current Ambulance provider is falling short of these goals due (to) the delays and limited number of ALS providers available.”

The city is required to file a public notice about the application on March 19. The Cabinet will make its final decision by June 17.

The application is one of two filed recently to establish an ambulance service in Floyd County. Emergent Care EMS filed an application in October to establish the same type of ambulance service in Floyd County.

The decision in that case is expected to be rendered in March.

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