KLC and city representatives testified on Thursday about the ongoing struggle cities face finding and retaining trained paramedics. KLC Director of Public Affairs Bryanna L. Carroll, Prestonsburg Mayor Les Stapleton, and Anchorage Middletown Fire and Emergency Medical Services (EMS) Deputy Chief of Fire Operations Lt. Colonel Mike Sutt testified to the Interim Joint Committee on Local Government.
“Cities often pay for the cost of training only to have a newly certified paramedic leave for a higher paying job in the private sector,” Carroll noted. “To exacerbate that issue, the state has shifted that training into more of a college setting rather than the previous vocational focus.”
Limited training programs, time, and cost of accreditation have combined to create the problem. Sutt told the committee that only four local governments currently train their own EMS personnel, and there are only 13 such sites statewide.
It takes 2,000 hours of training for an emergency medical responder to become a paramedic. Working EMTs often struggle to find the time to attend paramedic school. But it’s more than just time; the cost can also be a deterrent. An 18-month paramedic program costs $9,000 at the Kentucky Community and Technical College System (KCTCS).
Sutt described the alarming statistic that between 2016 and 2018, Kentucky only produced 448 paramedics. There are 120 counties in the commonwealth, which equates to 3.7 paramedics per county over that time.
Once paramedics are certified, many chose to move off the ambulance for increased pay, better retirement, and career advancement. This can skew Kentucky’s numbers because many certified paramedics do not work on an ambulance. KLC data shows that only around 9% of paramedics employed by cities outside of Louisville do not also serve as a firefighter.
Sutt called for an assessment of Kentucky’s current educational infrastructure to determine if the current system of training and certifying paramedics can keep up with demand, serve Kentucky’s needs, and work for the public’s overall safety. “Having college institutions do the training does us no good if paramedics are not available for 911 calls and other emergency response when the public needs them,” he said.
Mayor Stapleton testified about Prestonsburg citizens who have waited 45 minutes for an ambulance. In January 2020, the city applied for a certificate of need to provide its own ambulance service because of the staffing struggle faced by the community’s current ambulance provider. However, Prestonsburg cannot get a hearing on its application. The Cabinet for Health and Family Services (CHFS) takes the applications in order, with no emergency process.
Stapleton, who serves on the KLC Board of Directors, pointed out that 28 members of the city’s fire department are already EMTs or paramedics and could help staff a city ambulance. He said the city’s retirement plan, benefits, and pay help with retention. “We literally have people dying out there right now,” Stapleton said.
While his crews can arrive on a scene in three minutes, they cannot transport a patient to the hospital. “So, in three minutes they are on the scene extricating, triaging, and packaging,” Stapleton explained. “Then we’re sitting in the middle of the road with a 70-year-old woman’s head in your lap in 40-degree weather and her laying there waiting on an ambulance to come pick her up.”
Stapleton urged legislators to establish an emergency certificate of need process for communities suffering because of inadequate response time.