The Kentucky Board of Emergency Medical Services (KBEMS) has filed an emergency regulation to prevent Class I agencies from downgrading from an advanced life support (ALS) license to a basic life support (BLS) license due to the current paramedic shortage.
202 KAR 7:560 requires Class I ALS agencies to have at least one paramedic on duty at all times. Many agencies have struggled to find paramedics to fulfill this requirement and are faced with either voluntarily downgrading to BLS service or receiving disciplinary action for violating the requirement.
If an agency downgrades to BLS, they would be required to acquire a new certificate of need to return to ALS service.
KBEMS testified to the Interim Joint Committee on Health Services in July on the paramedic staffing shortage. They provided data that although there are 4,292 certified paramedics in the state, only 2,474 are working for an ambulance service in Kentucky.
While call volumes have increased, the state is losing EMS providers; the number of newly certified paramedics is less than the number leaving the workforce.
KBEMS filed an emergency regulation to create temporary waivers for agencies to continue to operate ALS service with either an advanced EMT (AEMT) or paramedic on duty at all times. This solution is temporary solution while the paramedic shortage persists.
Class I ALS agencies can request a temporary waiver from KBEMS. Agencies are required to provide a sworn and notarized affidavit that includes:
- Why the agency is unable to meet the requirement to have at least one paramedic on duty at all times
- Steps the agency has taken to have at least one paramedic on duty at all times
- Number of paramedics the agency has on staff
- Compensation the agency pays paramedics
- Additional steps the agency will take to hire paramedics
- Number of ambulances the agency has staffed each day
- Certification that the chief local elected official of the agency’s geographic service area has been notified, in writing, that the agency is requesting the temporary waiver
Agencies will be required to submit quarterly reports to KBEMS on their efforts to staff paramedics.
All temporary waivers will expire on Dec. 31, 2026.
