Hospital CEO asks city to consider changing its policy

During the Middlesboro City Council’s regular meeting on Tuesday, the panel heard an issue involving the city’s ambulance service and a local hospital.

Shortly after the council heard reports from the city department heads, Mayor Rick Nelson called Michael Slusher, CEO of Middlesboro ARH Hospital, to present to the council.

“I’m here this evening to respectfully request that Mayor Nelson, with the support of the city council, change the current EMS transport policy,” Slusher said. “The city’s current policy is that if a patient presents to Middlesboro ARH Hospital and requires services that we do not provide the city will transport that patient as far north as London or as far south as Knoxville.”

According to Slusher, part of the issue is it is not always possible to find a bed or an accepting physician within that area.

“Sometimes the closest beds are in Lexington or Hazard,” Slusher explained. “When that occurs, we are left to scramble to find ways to get that patient to the location where they can get the care they need.”

Slusher said that occasionally requires an air ambulance or a private ambulance service from Tennessee.

“My professional advice to the mayor and members of the council and anyone in the audience, if you don’t have air ambulance insurance, you need to buy it, so if your family or loved one needs to be transported to Lexington or to Hazard, they can get there and get the care they need,” Slusher said. “The average cost of air ambulance transport is $40,000. Most of our residents…cannot afford that unless they have the insurance.”

Slusher said he had previously been told the reason for the city’s current policy is it is too hard on the city’s ambulance personnel and equipment to perform the longer transports.

“With that, again I respectfully request that you consider changing your transport policy,” Slusher said.

Nelson called on Middlesboro City Fire Chief Robert England to respond. The Middlesboro Fire Department also houses the city’s ambulance service.

According to England, the city’s ambulance service has performed the longer transports on many occasions.

“I’ve come myself in three times in the last two years and took three, and then another group has taken one to Hazard,” England said. “We’re trying to help.”

England said the longer transports requested have not always been an emergency, citing one transport that involved transporting a patient to Hazard ARH on icy roads and discovering when they arrived the cardiologist would not be in until 10 a.m.

England said the city’s ambulance service has the legal right to set their boundaries.

“I’ve looked at the KRS (Kentucky Revised Statutes) and the KAR (Kentucky Administrative Regulations). We have the right to set those boundaries,” England said. “We’ve got to do this for the eight or 10 guys on duty and the 9,000 residents in the city.”

England explained the city must retain enough on-duty personnel available to respond to all emergency situations that may occur.

“We’ve got a city ordinance that addresses this, no on-duty personnel…are to go out of town,” England said. “I’m trying to be reasonable, and I’m trying to service the city.”

England pointed out that because the longer transports can be refused does not mean that they always should be refused.

Councilmember Corey Eldridge suggested Slusher and England attempt to come up with a plan to address the issue.

“I would implore both of you to sit down with the mayor, and perhaps we can come up with a new protocol,” Eldridge said.

Eldridge offered to attend such a meeting as mediator.

Nelson, England, and Slusher agreed to meet, discuss the issue and search for a solution.