An EMS system in Letcher County, Kentucky, could serve as a warning for other struggling rural emergency services

When rural fire departments struggle to make ends meet, taking out a loan to cover costs may make sense. But as emergency services in Letcher County, Kentucky, discovered, that can lead to serious problems. 

"Letcher Emergency Medical Service is deep in debt and hemorrhaging money, with some employees saying they have missed paydays and a Chicago area lender with a history of lawsuits against it threatening to repossess everything the service owns," reports Sam Adams of The Mountain Eagle in Whitesburg, Kentucky. "Employees say most if not all of those who missed checks have now been paid, but some have left the ambulance service for other pursuits, worried there won't be any money to pay them."

A natural disaster followed by missteps that hurt Medicaid reimbursements is partly blamed for Letcher EMS's financial woes. "After the 2022 flood, Letcher EMS changed its mailing address from the destroyed firehouse and ambulance station to a board member's home," Adams explains. "When Medicaid figured out it was a residential address, it stopped sending checks. That problem ballooned into another one. No checks from Medicaid, no checks to employees and no money to pay debts."

Shawn Gilley, executive director of the service, agreed that the "service has had financial difficulties, but said he has partnered with an unnamed financial backer to pay off debts and try to keep the service open," Adams reports. "Beginning earlier this year, a man identifying himself as Paul Graver of First Government Lease in Northfield, Illinois, began calling The Mountain Eagle asking for information about Letcher Volunteer Fire Department and Kingscreek Volunteer Fire Department and trying to get the newspaper to write a story saying Letcher owed him money."