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Guest Editorial: EMS should be an essential service

May 17, 2023

By Rick Loperfido, Executive Director of Carter County EMS

When an emergency occurs, and you dial 911 for emergency assistance, you expect to see a response from law enforcement, fire, or emergency medical services to handle your specific emergency.

But did you realize that in the State of Kentucky only two of the first responding agencies that would be responding to your emergency are considered to be essential, by state law? Only the law enforcement officers and firefighters meet that definition. Emergency medical responders are not considered essential in your time of an emergency medical situation.

In the State of Kentucky, the Kentucky Revised Statutes (KRS) do not classify "Emergency Medical Responders" as essential to the citizens of the Commonwealth.

There have been proposals to change this classification, to mirror the same class given to law enforcement and fire protection services across the state. But our legislators have, for some reason, decided not to address this at the state level.

This change would help to make certain each county in the Commonwealth would be guaranteed ambulance transport services, provided through either the county or city governments, to the citizens of each county or city.

Not only would this change by our legislative representatives be an important step in making certain that emergency medical service transports would be available to all state citizens, but it would also open additional financial assistance options to many of these services. This would allow them to acquire needed funding from other resources that are currently not available to service providers who are considered "special purpose taxing districts" rather than "essential."

An example of this would be funds, which were distributed to many first responders like police and fire agencies, who were considered essential during the COVID outbreak.

Ambulance services across the state who were formed as special taxing districts did not qualify for those funds, but they could have if their classification was different. While our local fiscal court did work to make some of their ARPA funds available to our ambulance service, that was done at their discretion. It wasn't a guaranteed amount, and local EMS were not eligible for the state and federal funds these other services were provided.

In addition, all ambulance services across the Commonwealth of Kentucky, who are operating as special taxing districts, are limited by state law to a maximum of $0.10 per $100.00 of property evaluation for income. Private ambulance services and ambulance services operated by cities and counties operate as a budgetary cost to those municipalities. In those circumstances any need to increase budgetary needs is easier done by allocating more funds to those services by a vote of a council or a fiscal court.

Changing the classification could help rural ambulance service providers, many of which struggle with their budgets, with access to the same state and federal funding and grant sources that other first responders enjoy.

Changing the classification of emergency medical services to become an essential service in the Commonwealth of Kentucky would help ensure that ambulance transportation, in an emergency, is just as available to all citizens across the state as police and fire protection are currently.

Editor's note: One of my biggest governmental pet peeves involves what we call "unfunded mandates." This occurs when either the state or federal government – or less commonly a local government – passes laws that require a local government agency or service to provide additional services or coverage, or to upgrade equipment, without providing a source of funding for that service or equipment.

For instance, if a local board of elections is required by state or federal law to purchase new voting machines, but the state or federal agency that requires the replacement of those machines doesn't help pay for them; that's an unfunded mandate.

The same thing happens with equipment for police and fire, and with our ambulance services. As bad as the problem is for fire and police (and it's a problem all governmental service agencies face), as Mr. Loperfido points out above, it can be even worse for rural EMS, who not only have to deal with larger areas and a smaller tax base than their urban counterparts, but due to their status don't qualify for additional funding their colleagues do. It's a problem, and one our legislatures should look at fixing.

– Jeremy

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