Two county leaders told lawmakers in Frankfort this week that they’re struggling to recruit and retain emergency medical services personnel. Owen County Judge/Executive Casey Ellis and Rowan County Judge/Executive Harry Clark testified alongside KACo Director of Government Affairs Shellie Hampton before the EMS task force. The special committee is charged with reviewing a variety of issues related to ambulance providers, EMS personnel and reimbursement rates.
“Since I was elected in 2015, we’ve more than doubled our average salary wage for EMS [in Owen County],” Ellis said. “Unfortunately, the staffing shortages are more critical today than ever before, even with those increases.”
Ellis said Owen County is a rural county surrounded by urban areas and competes for personnel, where hazardous duty and fire department-based systems may be more attractive to prospective EMS employees. He added that it’s not uncommon for paramedics and EMTs to work in multiple counties. They may work 24 hours in one county, then use their off days to work in a neighboring county.
“The employee base is regionalized. So we just really are kind of sharing folks. The pool just gets drier and drier and drier,” Ellis said.
Judge Clark, who is also a member of the Kentucky Board of Emergency Medical Services (KBEMS), told task force members that he recently hosted a meeting with stakeholders from eight counties in his region.
“That’s one thing we came away with from the meeting and those eight counties there … manpower is the issue and how do we solve that,” Clark said.
When asked by task force co-chair Rep. Ken Fleming about grassroots efforts to grow the workforce pipeline, Clark said his EMS Director made regular visits to the local high school for presentations and recruitment, but the COVID-19 pandemic put that program on pause. Ellis said the regional technical school in his area, Carroll County Area Technology Center, is working to build up an EMT program for high schoolers.
According to KBEMS, there are around 3,663 licensed EMTs and 2,857 licensed paramedics currently working for EMS providers in Kentucky. Thousands more workers are current on their licensure but not actively employed by an EMS provider.
A KACo analysis of EMS systems across Kentucky found that counties utilize a variety of approaches for service, whether that’s a regional partnership, a joint operation with a city, a county-funded system, taxing district, or an outside entity.
“Some counties have attempted to contract with private entities in the past, but companies are not in the business of losing money. And everything associated with this service is very expensive,” Hampton said. “When a private company pulls out of a county, those citizens expect the fiscal court to find a solution to that.”
To overcome EMS challenges, Judge Ellis said the public transit system is a potential option for some transports, which costs significantly less than an ambulance run.
Possible solutions discussed at the meeting include:
- State regulation changes related to EMT and paramedic training, such as amending current limits on who qualifies as an instructor, and increasing the number of students can be in a class
- Outreach to high school and middle school students to increase awareness about careers in EMS
- Expanding the waiver that would allow use of public transit for non-emergency transports
- Working with the state Medicaid department to request an increase in the Medicaid reimbursement rate, unchanged since 2008
- Researching ways to help potential students pay the class tuition, including public-private partnerships
The EMS task force is continuing to gather input and data from stakeholders. Its next meeting is scheduled for Nov. 1.
