By Jeremy D. Wells
Carter County Times
Emergency Ambulance director Rick Loperfido said that he is moving forward with preparations to contest a certificate of need (CON) from King’s Daughters Medical Center (KDMC) that would place two more KDMC-run ambulances in the county. It’s a move that could result in enough lost revenue for the county to have to lay off employees and remove just as many trucks from service, Loperfido said. But because KDMC aren’t mandated to respond to emergencies and non-paying calls the way the county is, he feels it could result in less emergency coverage for the county overall.
During the regular meeting of the ambulance board on Monday, Loperfido told the board he was moving forward on plans to continue contesting the KDMC CON filing.
“At this point it appears we will need to contest the CON application in Frankfort sometime in late summer or early fall,” Loperfido told the board.
He told the board he had approached the county and received a resolution from fiscal court in opposition to the KDMC move. He has also approached Grayson city council, but mayor George Steele wanted to look into the issue more closely before supporting a resolution.
Loperfido said because they plan to contest it, KDMC could delay their filing again, or they could amend it or file a new CON.
No matter what route they plan to pursue, Loperfido said, he has been keeping track of the number of emergency calls received from KDMC’s urgent care and primary care facilities. This includes calls he sees as frivolous, non-emergency calls that potentially distract from actual emergency responses. For instance, he noted, one of the emergency calls from Urgent Care involved an individual with an ulcer on his chin that had been lanced, but continued to swell when the individual failed to take his antibiotics. While undoubtedly painful, he noted, it was hardly an emergency. Another individual, reported by KDMC staff as having shortness of breath, was found to be waiting outside the facility, calmly smoking a cigarette, when ambulance staff arrived on scene.
While both of those individuals may have required transport to KDMC facilities in Ashland, Loperfido said, neither were what he considered an emergency and both could have waited if necessary.
Board member Kara Johnson had strong words for KDMC staff who considered such issues emergencies and use the ambulance services triage as an excuse for their CON filing. She said it was “ethically wrong” to “put a burden on the taxpayers” for business profit.
“What if someone else is dying of cardiac arrest while we’re transporting (someone with a non-emergency issue)?” she asked.
She described it as a “slap in the face” of county taxpayers who could lose service while continuing to pay their taxes on a diminished county service.
The KDMC CON filing is based on a contention that the county is unable to respond in a timely manner to emergency calls from the healthcare provider.
In other news, Loperfido reported that the county saw a decline in COVID calls over the past month, but that the total number of runs was up over March of last year – with 428 calls and a year-to-date total of 1,461 calls.
Loperfido also gave an update on vehicle maintenance and repairs, and discussed a problem with birds getting into the ambulance bay and building at their east end location. Since the previous meeting, he said, they have reached out to Joe Skeens who is assisting with sealing up the Grayson station around the gutters, where most birds appear to be gaining entry to the building. He also reported hiring a company to strip and wax the tile floors at the west base in Olive Hill, and on department participation in an Air National Guard training exercise featuring 25 parachuters over the county.
He also gave an update on the service’s ongoing problems with their oxygen refill system. Loperfido reported on a fiscal court award earmarked for the purchase of a new oxygen refill system and radio systems. He said the $150,000 in American Rescue Plan (ARPA) funds awarded to the ambulance service during the last meeting of fiscal court would go toward replacing their faulty oxygen refill system with a “larger (and) more appropriate oxygen refill system from OGSI. In addition, he said, a portion of the funds would be used to provide six new mobile radios and 14 portable radios for use in all ambulances, helping improve emergency communications.
The ambulance board moved to accept Loperfido’s report as presented, accept the financial report, and approve the meeting minutes of their previous regular meeting. The board also discussed insurance plan options for ambulance personnel, and held the first reading of their budget.
Loperfido also discussed an issue with “limited allocation” and the impact on supplies for the ambulance service. Many providers are limiting orders based on previous order history in order to determine how to distribute limited supplies in a tight market. As a result, he said, necessary supplies like D10, a ten percent solution of dextrose used to boost the blood sugar of diabetics, are in short supply. The reason the Carter County service is experiencing this issue, in part, is because the service has utilized multiple providers to secure the best price. Because of this, they don’t have enough order history with some distributors to put in a claim large enough to meet their needs. While this wasn’t a problem when there were plenty of supplies available, it now puts the service at risk of running short.
However, he said, they have worked out a deal with KDMC, despite disagreements over their CON application, to make sure they have access to purchase the lifesaving medicines they need.
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