At the beginning of the pandemic, the Lewis County Ambulance Service Authority could only afford to run two ambulances.
Then, in April 2020, West Virginia received $1.25 billion from the federal CARES Act money to help weather the pandemic. A couple of months later, Gov. Jim Justice announced he would designate $200 million of it to reimburse local governments for COVID-19 related expenses. He eventually raised that to $265 million.
Lewis County relied on that federal reimbursement. It allowed Lewis County to run a third ambulance during the busiest times of the day. It paid for COVID-19 supplies like masks and disinfectant products. Ambulance service coordinator James Taylor called the infusion of federal aid “a huge help.”
But soon, that money stopped. And Lewis County, like counties and cities across West Virginia, now face a two- or three-month gap where they can’t get reimbursed for their COVID-19 expenses.
Lewis County Administrator Cindy Whetsell said the county’s request for reimbursement of its December COVID expenses, for more than $176,000, was not approved. She estimated that the county spent similar amounts in January and February.
According to the state auditor’s office, local governments received all of the $265 million set aside for them, plus an extra $416,000. Yet, the governor’s office still has $573 million left of pandemic relief from the CARES Act to spend on needs such as aid to cash-strapped counties seeing another surge in COVID-19 cases.
Taylor said what Lewis County received is helping the ambulance authority even now, as it still runs three ambulances. But with continued reimbursement, they could have done more.
The county’s ambulance service has only one portable ventilator, used to pump oxygen into the lungs of those struggling to breathe, an issue common in severe COVID-19 cases. Taylor said transports of patients on ventilators from the local hospital to larger ones have tripled in the last year.
Taylor said his service has sometimes had to delay transporting a patient to a hospital with more resources and treatment capabilities, as the single ambulance with a ventilator was moving someone else.
If the county had kept getting reimbursed for its COVID expenses, Taylor said, the ambulance service could have bought more portable ventilators.
“You never want to try to delay care, especially when somebody is on a ventilator,” Taylor said.
And, as the Delta variant tightens its grip on West Virginia, the lack of ventilators worries him. And he said the lack of money that can cover costs could create a “big problem.”
Justice has previously indicated most of the remaining CARES Act money is planned to go toward compensating the state’s unemployment trust fund — the governor said this will later reduce taxes on businesses that typically fund unemployment benefits — and to pay off a loan the state had taken from the U.S. Department of Labor during the pandemic to keep the unemployment fund solvent.
Some local government leaders said that they didn’t get reimbursed for requests filed for December. Then, on Jan. 19, they said the governor’s office sent out notices that it would not be giving out more money.
The governor’s office did not respond to questions about this decision.
COVID cases and CARES Act funds
Whetsell said Lewis County ultimately received more than $1.8 million in CARES Act money from the state, and half of the more than $3 million it is set to receive through the American Rescue Plan.
But the American Rescue Plan only allows local governments to be reimbursed for COVID-19 expenses beginning on March 3, 2021, according to its interim guidance. For some West Virginia cities and counties, that leaves a gap of around three months where they don’t have any way to be reimbursed for COVID-related expenses.
“Certainly the CARES Act money and the American Rescue Plan money are very, very helpful and the county is very blessed, but definitely those three months would have been very appreciated and put to good use,” Whetsell said.
“It appears with our [COVID-19] numbers here in Lewis County that things are happening very quickly, numbers are climbing very quickly,” she said. “And so it would be a huge help to have additional funding to be able to put the resources needed to our first responders and our health department and our citizens to make sure that they have the protection and the care that they need during the pandemic.”
Lewis County Commissioner Agnes Queen said county officials had already cut the budget to bare bones before the pandemic.
“COVID has had a catastrophic effect on everyone’s lives, and county government’s not immune,” Whetsell said. “Our expenses have gone up, our revenues have gone down, and we still need to provide the vital services to the constituents.”
Jennifer Piercy, executive director of the County Commissioners’ Association of West Virginia, said reimbursing counties for COVID expenses from the winter months would make a “big difference” for some counties.
“It can have an effect on your budgeting; you’re going to have to now start picking and choosing,” she said. “Do you keep a county park open? Or do you keep sheriff patrols on the road?”
Piercy said the rise in COVID-19 cases makes covering that gap important.
“[Counties] are probably going to want to make additional investments, in PPE and things like that,” she said. “I think it’s going to be very important that they move that date back up, because I think that they need to provide as much assistance as possible to not only counties, but municipalities as well.”
In a comment to the U.S. Treasury on the American Rescue Plan’s interim guidance, Kanawha County officials urged the U.S. Treasury to allow governments to reimburse expenses before March 3, 2021.
Because the state cut off applications for the CARES Act funding, Kanawha officials said they did not receive a reimbursement for more than $550,000 spent on COVID-related expenses in the second half of December.
Kanawha County Commission President Kent Carper said the American Rescue Plan time constraint “makes no sense at all.” He added that the county also spent hundreds of thousands of dollars in January and February, largely for payroll expenses for EMS workers.
Like counties across West Virginia, Kanawha County and its various agencies spent money to transport COVID-19 patients to and from hospitals, to set up test sites and vaccination clinics, and to keep public facilities cleaner than usual.
The commission received $10.6 million of requested reimbursements from the state through the CARES Act.
“I mean, it’s kind of hard to complain about that,” Carper said. “Now, do I believe we should have gotten more? Yes, I really do.”