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Judge-exec on ambulance services: "This is totally unacceptable"

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MAGOFFIN COUNTY – The county judge-executive is pushing for answers after receiving reports of excessive wait times for ambulances and the repeated need for having ambulances come from other counties to serve Magoffin citizens.

Magoffin County Judge-Executive Matt Wireman told the Independent that he has talked to Lifeguard Ambulance Services, letting them know that their performance since they bought out Trans-Star has not been up to par.

“I told them this is totally unacceptable, poor communications, and I’m well aware and it is logged where we’ve had a lot of ambulances coming from outside of the county for calls from Magoffin,” Wireman said. “I said, ‘I have no desire to get in the ambulance business, but if that’s what it takes to protect our citizens, I will.’”

Wireman said he’s willing to work with Lifeguard to make sure the service to this community is better.

“Magoffin Countians are not second-rate citizens and we deserve the same quality of care as anyone else,” Wireman said. “They’ve assured me that’s what they’re going to do.”

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

Wireman said he’s currently checking with other counties to see how they handle ambulance services to see if there’s a better solution.

“It’s got to get better,” Wireman told the Independent on Monday.

Two people, both of whom are believed to be Lifeguard Ambulance Services employees, have reached out to the Independent, but have asked to remain anonymous. The two have given similar reports, indicating there have been several instances where the Advanced Life Support (ALS) units, which include paramedics, that are supposed to be covering Magoffin County have been used for transfers to hospitals outside of the area, leaving only Basic Life Support (BLS) units, which have two EMTs, to cover 911 emergencies in the county. 

One of the anonymous sources told the Independent, “The paramedic truck and only ambulance covering Magoffin county has been dispatched to Floyd county in the Goble Roberts community while a Floyd county BLS unit was available. According to the laws that is illegal. They then sent the BLS truck to the Floyd-Magoffin line before the Magoffin paramedic made it on scene. The paramedic was stuck “on the wall” at Highlands. This is when there are no rooms available the ambulance crew stays with a patient on their stretcher in the hall, waiting to transfer the patient. While stuck at Highlands, the BLS crew received an emergency run in Magoffin. The patient could have better benefitted from a paramedic on the 20-45 minute ambulance ride to a hospital.”

The anonymous employee also said, “The people of Magoffin County deserve to have at least one paramedic in the county at all times to cover emergencies and at least another BLS crew at all times to cover emergencies and non-emergency scheduled runs.”

On the same day, both sources told the Independent that the paramedic that was supposed to be covering Magoffin was sent to Floyd County, and one of the BLS crews were sent on a non-emergency run, taking a patient to a doctor appointment in Lexington, and leaving only one BLS crew to cover the county. 

Charles O’Neal, the deputy executive director of the Kentucky Board of Emergency Services, explained to the Independent that Lifeguard has a Class 1 license, meaning they provide both advanced life support and basic life support. With the Magoffin/Pike joint license, they legally only have to have one paramedic on duty at all times in either of the two counties. 

“What’s troublesome for your community is there is no ambulance service with a license only covering Magoffin,” O’Neal said. “If there was a license for only Magoffin, you would have to have at least one ambulance based in Magoffin.”

As far as needing mutual aid from other counties, O’Neal said it’s not necessarily a red flag until it happens on a near-daily basis. 

“If they can’t respond in 10 minutes, they have to pass it on to mutual aid, but most ambulances go en route within two to three minutes,” O’Neal said. “It would definitely be a violation if an ALS is out of the area for a non-emergency. Now, if it’s a trauma patient going to die and they need to go to Lexington, they can do that, but they can’t send their last ALS out for a non-emergency.”

O’Neal urged people who believe there has been a violation to the law regarding an ambulance service to file a formal complaint to the Kentucky Board of Emergency Services so they can investigate the matter, by calling KBEMS at (859) 256-3565 or email kbemslegal@kctcs.edu.

The Independent requested logs from Magoffin County 911 Dispatch, which show when calls are received for ambulances and when they are en route. 

Going by the months, there were two instances in April (after Lifeguard purchased the local ambulance services) in which an ambulance was not available in the county and had to be dispatched from another area; three in May, with one taking almost two hours for an ambulance to arrive; one in June; three in July, none in August, six in September, four of which happened in a 3-day span; and 13 in October (at press time).

Lifeguard’s Director of Operations for East Kentucky Bert Absher met with the Independent on Tuesday, noting that they have made over 20,000 runs since taking over in April, but people generally never hear about the 19,999 runs that went right. 

He said he has met with Judge Wireman and they understand his concerns, noting that EMS is something everyone expects to have available when they need it. 

In regard to response times and reports of the last paramedic-equipped ambulance being sent out of the county, Absher said, “We would never send our last ambulance out of the county.”

He said that they will answer calls to aid other counties in emergency events, but he keeps at least one truck available in Magoffin.

“Since Lifeguard took over, we’ve experienced a staffing shortage, which is a national crisis right now,” Absher said. “That’s the underlying problem, where people are not going into the field.”

He also boasted that Lifeguard’s national-level resources have allowed them to update their equipment, provide more trainings and incentive packages to employees, and pull ambulances from more areas if there’s not enough staff immediately available here.

“If we go to a level 0, I get one ambulance at the county line just in case,” Absher said. “It can happen anywhere, to have to rely on mutual aid, and in the past, we’ve had to be available for Johnson and Morgan, for example. That just ensures that we have the fastest service available.”

He said they do not have enough employees, but they are “growing” their own, putting them through a 12-week EMT program, noting that they will have approximately 21 people come out of that program within the next month that will go to counties in this area. 

“All non-emergencies will take a second seat, of course, like scheduled appointments, so we can have adequate coverage, but by growing our own, we’ll be able to have additional staff and safe amounts of overtime,” Absher said.

He said they did lose some staff when they capped overtime hours, but he said they had some staff working unsafe amounts of overtime. 

They do have $5,000 sign-on bonuses for paramedics and they are reaching out to fire department volunteers to offer an additional bonus for them to work there.

“We’ve invested $2 million in expenditures on East Kentucky, all on life-saving equipment,” Absher said. “This is state-of-the-art care – the best in the nation – for EMS in Eastern Kentucky. I’m thankful to have a company like AMR to bring these resources to East Kentucky.”

Absher said Lifeguard is a very transparent company and they are doing everything by the standard. He said their education program is nationally recognized, working with Big Sandy Community and Technical College to establish the program. 

He said they will continue to work on increasing their staff, and will work with the Magoffin County Fiscal Court to boost their communications with the community. 

“We want the general public to know we are here to meet their 911 needs, we’re meeting with the 911 services in our communities and we’re always reviewing our action plans,” Absher said.

“If anyone has any questions or concerns, they can call me, Bert Absher at 886-6664, and someone will answer that phone 24/7. We want to take every opportunity to ensure the public is in good hands.”

He reiterated that they always have a paramedic dedicated to Magoffin, with the only way he would take one out of the county would be for an emergency transfer of a Magoffin resident to an out-of-county hospital.

“It’s disheartening to not be able to staff the trucks I have available, but we have the most competitive wages and packages in Eastern Kentucky and tons of benefits,” Absher said. “We know Magoffin has 911 needs met, so we’re working to improve staffing. This is why we’re paying people to train, so we can have adequate staffing.”

While he said they have met an adequate level of care for Magoffin since the buyout, he said, “Part of the biggest failure we’ve had is the staffing shortage and the failure to communicate with the judge,” but said they are taking all steps to fix both of those issues.

“Typically, on an average day, no one thinks about 911, but our trucks are out there 24/7,” Absher said.

The Independent will continue to follow-up on the concerns and the ongoing situation surrounding ambulance services in Magoffin County. 

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