EMS Task Force Meets for First Time

The Emergency Medical Services (EMS) Task Force met in Frankfort for the first time on Thursday. Rep. Ken Fleming (R-Louisville) sponsored House Bill 777, a KLC initiative, in the 2022 session to address certificates of need (CON) and create the task force to study other EMS concerns.

“I look forward to a good, robust conversation that we will be able to go through and decipher information and come up with proactive efforts in the coming session,” said Fleming, who serves as task force co-chair.

The first meeting was informational. Members heard from Kentucky Board of Emergency Medical Services (KBEMS) Interim Executive Director Eddie Slone. On his fifth day in his current role, Slone outlined EMS in Kentucky. He explained that the state has 221 services within seven classifications.

Ground ambulances – Class I – comprise the largest segment. They respond to emergency scenes and provide interfacility transfers. He said some communities could only support a single agency, but cities such as Lexington, Louisville, and those in northern Kentucky have multiple providers.

Resources and geography greatly affect response and turnaround times. Slone said there might only be one or two ambulances available in an entire county at any given moment. Due to their large coverage area, resources are typically centrally located. That does not guarantee response times near the 4-to-5-minute range that larger cities experience. Slone explained it could take multiple hours from the start of a run until the ambulance returned to service.

Slone highlighted the struggle EMS providers have recruiting and retaining personnel. The KLC Board of Directors voted last month to pursue legislation in the 2023 session that will help train and certify paramedics and emergency medical technicians (EMTs) to make it easier to hire first responders. Slone also noted compensation challenges and said paramedics might start out earning just $14 per hour in rural areas.

KBEMS statistics show 1,135 ambulances operate in Kentucky. Inspectors must approve the vehicle’s use each year, and supply chain issues have delayed new ambulance orders by as much as three years.

Legislators questioned how many licensed EMTs are currently working in Kentucky. Slone reported the state has 9,335 licensed EMTs; 3,663 are employed.

Rep. Fleming asked why so few EMTs are in the workforce. Slone said it was a complicated answer. “It’s a hard job, a dirty job, and a low-paying job,” he responded.

Task force members thanked Slone for his testimony and asked him to compile other helpful statistics including pay range, type and total number of service providers, and training opportunities by region.

Cabinet for Health and Family Services Inspector General Adam Mather testified before the task force. Mather outlined the CON process and the impact of House Bill 777, which took effect Thursday. The bill allows a city or county to operate an emergency ambulance transport service without a CON if the local government determines a need exists after holding a public hearing. It also allows hospitals to transport patients to and from their facility and other health care providers. Additionally, the bill grants non-substantive review status to a city- or county-owned ambulance provider that seeks to provide non-911 transport and hospitals that want to provide ambulance service from a location that is not a health facility.

When asked whether he thought the current CON system worked, Mather replied, “It is a very contentious topic. We have very talented people working in that office, and they work closely with those applying. I don’t want perfection to be the enemy of good; it is a system that works in Kentucky.”

Co-chairs Fleming and Sen. David Givens (R-Greensburg) committed to gather as much information as possible from stakeholders to cover various aspects of the EMS community. “In my mind, it is primary that we keep the patient, the citizens of the commonwealth, in the foremost of our mind,” said Fleming. “That is what we are paid to do. That is what you are paid to do.”

Givens told stakeholders, “Over the course of the next few months, as you hear us engage in challenging questions that may seem like they are threatening to your turf, try to set aside those personal interests.” He encouraged everyone to have the same goal: to improve emergency medical services for Kentuckians.