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B
B
B
D
A
H
Thank
you,
mr
chair,
and
welcome
everybody
to
louisville,
it's
fantastic
that
we're
finally
able
to
get
back
together
here,
after
hopefully
the
worst
of
this
virus
last
year.
I
know
where,
obviously
we're
working
through
the
delta
variant
right
now
and
hopefully
it
will
be
gone
soon
and
we'll
get
back
to
some
sense
of
normal
that
we
had
before
all
this
happened.
I
just
want
to
give
you
a
brief
update
on
what
we're
going
to
be
doing
with
our
arp
funds.
Here
in
louisville,
we've
been
a
beneficiary
of
about
165
million
dollars.
H
First
off
with
the
cares
act
that
went
to
about
25
cities
that
had
populations
over
500
thousand,
so
our
population
is
over
500
000
because
we
merged
our
city
and
county
governments
and
about
20
years
ago.
So
that
was
a
good
result
of
that.
We've
got
about
388
million
dollars
in
arp
funds,
we're
going
to
put
those
to
work
in
the
five
primary
areas.
The
first
is
to
address
our
affordable
housing
in
homelessness
situation.
H
Here
in
louisville,
we've
got
about
300
people
that
are
chronically
street
homeless,
that
you
see
primarily
downtown
we're
kind
of
a
microcosm
or
an
example
of
what
you
see
in
cities
all
over
the
country
and
we
hope
to
make
a
really
good
improvement
with
both
that
and
the
need
that
we
have
for
affordable
housing,
particularly
at
folks
at
less
than
30
percent.
Ami.
H
The
secondary
of
focus
is
on
workforce
development
and
small
business
support.
We've
been
able
to
come
up
with
some
methods
here
to
transition
people
into
family,
supporting
wages,
whether
it
be
in
the
technology
area
or
healthcare
areas
by
use
of
stipends
and
guaranteed
jobs
with
some
of
our
business
partners
here
in
the
community.
So
we're
excited
about
the
opportunity
to
make
some
significant
work
there
and
and
keeping
our
small
businesses
alive
and
thriving.
We
spent
about
30
million
dollars.
H
We
invested
about
30
million
dollars
in
small
business
grants
during
the
first
wave
of
funding
to
keep
businesses
alive
and
surviving.
Little
did
we
know
that
two
years
ago.
That
would
be
the
strategy
just
to
survive
to
get
through
this
pandemic.
But
we've
been
able
to
do
that
relatively
well,
as
our
economy
is
really
coming
back
nicely
here
in
louisville.
H
Violence,
challenges
that
we're
having
here
in
our
city
and
cities
around
the
country
and
then
fifth
will
be
a
premium
pay
for
some
of
our
frontline
workers
that
were
bearing
the
brunt
of
the
virus
and
to
recognize
the
work
that
they've
been
doing
and
did
so
effectively
during
that
time.
So
we're
excited
about
the
opportunity.
H
H
One
last
comment:
2020
census
data
obviously
has
been
released
in
the
past.
Several
weeks,
the
metro
area
is
growing
about
the
same
rate
as
the
country
is
growing.
The
city
of
louisville
is
growing
a
little
bit
less
rate,
but
I
look
at
his
entire
metro
area,
so
we're
doing
well.
From
that
perspective,
I
do
think-
and
I
want
to-
I
know
you
guys-
have
been
working
on
tax
reform-
any
way
that
we
can
be
helpful
with
that
here
from
louisville.
H
We
certainly
want
to
do
that
as
we
see
sometimes
when
people
move
it's
for
what
they
see
as
more
beneficial
state
taxes,
say:
tax
policy
in
other
areas,
so
any
way
that
we
can
do
that
and
help
we'd
like
to
do
that
and
always
want
to
make
a
plug
for
additional
flexibility
for
local
governments
to
impact
revenues
if
in
concordance
or
in
alliance
with
what
their
citizens
want.
H
So
I
appreciate
charles
work
in
that
area
and
one
last
deal
is
to
update
you
on
our
civilian
review
and
accountability
board
that
you
spent
time
on
in
the
session
this
last
time
that
has
been
created
since
we
last
spoke,
they're
hiring
the
inspector
general
here
in
the
next
couple
months
as
well.
So
that's
well
underway
and
has
been
helping
in
terms
of
both
transparency
and
accountability
and
building
police
community
trust
for
us
here
in
louisville.
So
I
want
to
thank
you
all
for
your
help
with
that.
A
Thank
you
mayor
appreciate
the
welcome
and
appreciate
you
being
here
with
us
in
the
update
on
the
city
of
louisville.
I
also
want
to
say
that
we
do
have
not
on
the
agenda
but
ag
commissioner
ryan
quarles
here
we
want
to
thank
them
for
the
work
that
they've
done,
putting
the
state
fair
on
this
week
with
his
shop
at
the
department
of
agriculture,
as
well
as
the
kentucky
state
fair
board
for
hosting
us.
Thank
you,
commissioner.
I
Thank
you,
sir
good
morning,
everyone,
my
name,
is
brian
o'neill,
I'm
the
legislative
director
for
the
kentucky
professional
firefighters.
Thank
you
very
much
co-chair
meredith
and
co-chair
mills
for
inviting
us
here
today
and
to
everyone
else
on
this
hot
august
day
to
talk
to
this
august
body.
Let
my
friend
introduce
himself
as
well.
J
I
Here,
so
what
I'm
here
to
talk
about
today
is
the
impending
crisis
that
we're
going
to
be
looking
at
for
retiree
health
insurance,
specifically
anyone
that
has
been
hired
in
this
state
after
july.
1
of
2003,
though
I'll
be
using
mostly
firefighters
as
an
example.
Since
that's
who
we
are,
this
is
a
problem.
That's
going
to,
in
fact
affect
any
employee,
whether
they
be
police,
fire,
ems,
state,
county
city
throughout
the
cers
and
kers
system.
I
So
in
2003
the
state
legislature
made
a
change
in
the
retiree
health
insurance
program
rather
than
providing
a
health
insurance
plan.
New
employees
hired
after
july
1
2003
would
get
a
monthly
credit
towards
purchasing
the
state
health
care
plan.
This
is
not
money
that
they
could
use
on
the
open
market.
Rather,
this
is
a
stipend
that
can
only
be
used
at
the
company
store
to
purchase
a
plan
through
the
state
system
so
for
hazardous
duty
employees
is
there
a
tech
person?
I
don't
know
if
I'm
doing
this
right
to
pull
up
this
powerpoint.
I
Oh
there,
it
is
all
right.
Thank
you.
So
it's
rather
interesting
response,
like
I
said
they
get
the
small
stipend
for
hazardous
duty.
I
Employees
that
credit
is
fifteen
dollars
a
month
and
that
is
multiplied
by
the
number
of
years
of
service
has
a
non-hazardous
at
ten
dollars
and
then
there's
a
built-in
cost
of
living
adjustment
of
one
point:
five
percent
per
year,
so
in
2023
that
first
affected
group
of
hazardous
duty
employees
when
they
are
eligible
to
retire
they're,
going
to
get
a
credit
of
21
and
30
cents
per
month,
multiplied
by
20
years
of
service,
which
equals
to
426
dollars
per
month
to
be
used
towards
a
health
care
plan.
I
So
in
2003
legislators
believed-
and
it
was
there
was.
This
was
an
innocuous
event
that
what
they
were
doing
would
keep
up
with
the
cost
of
health
care.
But
unfortunately
it
just
has
not,
as
the
the
stipend
has
moved
forward
with
that
cola,
like
the
proverbial
tortoise,
slow
and
steady
and
moving
forward.
The
cost
of
health
care
has
skyrocketed
and
it
has
not
kept
up
at
all.
I
If
we
look
at
the
numbers
right
now
and
that's
for
20
20
21,
the
cost
of
a
health
insurance
plan
through
the
state
system
is
around
for
a
family
plan.
It's
around
1500
to
1600
a
month
for
the
middle
of
the
road
plan
and
for
an
employee
plus
spouse
for
someone
with
their
the
spouse.
It's
about
thirteen
hundred
dollars
per
month,
so
they
would
have
that
426
dollars
per
month
towards
that
the
family
plan,
like
I
said,
1518
they're,
going
to
be
left
with
very
little
of
their
pension.
I
If
you
look
at
say
an
average
player,
let's
compare
just
two
hypothetical
people
they've
been
given
a
career
they've,
given
the
career
to
their
community
they've,
given
20
years
of
their
life,
one
was
hired
in
june
of
20
2003
and
one
was
hired
in
august
of
2003.,
both
planned
to
retire
in
2023.
Both
of
them
were
hired
into
a
similar
department.
They
took
the
same
risks
exposed
to
the
same
tragedies
and
hazards,
and
they
carry
those
same
physical
and
emotional
scars
with
them.
They
earned
a
similar
salary.
I
They're
retiring
with
a
similar
pension
benefit
we'll
say
about
three
thousand
dollars
a
month.
There's
some
people
that'll
make
more
there's
some
people
that'll
make
less,
but
I'm
not
gonna.
Give
you
a
worst-case
scenario:
I'm
giving
you
real
numbers
so
that
three
thousand
one
person
will
have
their
choice
of
health
insurance
plans,
whether
single
married
family
and
the
monthly
premiums
will
be
covered.
The
other
person
will
get
426
a
month
towards
that
health
care
plan
and
again
with
a
plan
that
ranges
from
15
to
1840
for
a
family
plan.
I
I
So
if
we
pick
that
middle
of
the
road
plan,
sixteen
hundred
and
seventy
three
dollars
per
month
apply
the
426
dollar
credit
they're
going
to
have
to
pay
1247
a
month
just
to
have
the
plan,
that's
if
they
never
get
sick
if
they
never
get
injured
and
they
never
have
to
use
the
plan
at
all,
they're
still
going
to
be
out
1247
a
month
that
is
14
964
dollars
a
year
just
to
have
that
health
insurance
plan,
and
you
see
the
numbers
there
for
a
a
married
person
1075
per
month,
12
900
a
year
that
they're
going
to
have
to
come
up
with
just
to
have
the
plan
and
that
doesn't
even
consider
if
they
get
injured
if
they
get
sick.
I
I
I
So
people
deserve
a
well-deserved
retirement
after
they've,
given
that
service
after
they've,
given
so
much
of
their
life,
we
need
to
be
able
to
retire
with
dignity.
So
I
want
you
to
take
a
look
at
some
of
these
pictures,
whether
ems,
whether
fire
police,
some
of
those
people,
will
have
the
better
insurance
plan.
Some
will
not.
How
do
you
pick
that
person
out
those
police
officers
right
there?
That's
after
the
nashville
bombing?
I
I
This
is
the
good
news
is
that
the
first
crop
of
people
that
will
become
eligible
is
in
2023,
because
those
people
is
anybody
hired
after
july
1,
2003
20
years
later,
2023
and
as
we
go
further
down
the
road
to
the
tier
two
people
and
the
tier
three
people.
They
have
a
25
year
before
they're
eligible
to
retire,
so
there's
a
little
bit
of
time
to
help
them.
I
This
is
going
to
be
almost
their
entire
pension
check,
because
their
pension
benefit
is
so
much
less
than
what
the
tier
1
into
tier
2
enjoy.
So
we're
going
to
be
coming
up
against
a
very
serious
problem.
You
know
we
joined
this
obviously
for
service
to
the
community.
That's
how
I've
spent
my
entire
adult
life.
I
spent
eight
years
in
the
marine
corps
in
the
last
20
with
the
fire
department.
I've
wanted
to
serve
the
community
and
serve
the
the
betterment
of
society.
All
I
ask
is
a
little
bit
of
dignity
and
retirement.
I
J
Okay,
I
was
asked
to
be
here
today
to
discuss
increased
tier
1,
b2
and
3
retired,
firefighter
health
insurance
costs
and
the
associated
impact
on
the
fire
service
in
kentucky,
as
my
friend
brian
described,
the
retiree
health
insurance
costs,
which
will
start
being
felt
by
some
public
employees.
Retirees
as
soon
as
2023
are
significant,
so
significant.
J
Over
the
years
it
has
been
widely
expressed
that
public
employees
typically
receive
lower
pay
in
comparison
to
similar
professions
in
the
private
sector,
but
that
the
lower
pay
was
balanced
by
what
many
considered
a
better
defined
benefit
pension
program
for
those
public
employees
hired
prior
to
july.
First
2003.
I
agree
with
this
at
the
intent
of
those
statements.
J
J
Earlier
this
morning,
you
may
have
heard
a
presentation
by
the
kentucky
hospital
association
during
the
interim
joint
committee
on
health,
welfare
and
family
services.
That
association
is
rightfully
concerned
about
the
critical
problem
facing
kentuckians,
as
they
point
out
on
the
information
sheet
they
have
distributed
quote
on
an
all
too
frequent
basis.
Ambulance
service
is
not
available
to
meet
the
needs
of
kentucky's
critically
ill
patients.
J
Out
of
all
the
information
they
will
present.
I
suggest
you
notice.
The
data
from
surveys
of
ems
professionals
conducted
by
k-beams
will
once
again
come
back
to
low
pay
and
lack
of
good
pension
plan.
It
will
be
noted
that
number
one
of
the
top
five
reasons
survey
participants
left
their
ems
license.
Certification
to
to
lapse
was
retirement.
J
The
main
reason
we
could
entice
these
two
trained
firefighters
to
relocate
to
our
community
was
due
to
a
better
pay
and
a
top-notch
work
environment.
Developed
by
an
awesome
fire
chief,
the
firefighter
was
the
firefighter
we
hired
out
of
ohio
was
a
volunteer
firefighter
and
graduated
from
eksu
eku's
fire
service
program.
J
Looking
for
a
career
position,
the
madison
county
firefighter
located
to
us
mainly
due
to
increased
pay
and
a
more
active
service
area
pension
was
not
a
factor
in
his
situation
because
he
was
in
state
thus
making
the
pension
portable,
because
we
could
pay
more
the
whole
the
whole
because
we
could
pay
more
what
hole
did
that
make
in
their
former
communities,
unfortunately,
for
the
real
communities
in
kentucky.
This
goes
on
regularly.
The
urban
suburban
areas
near
our
largest
cities
in
northern
kentucky,
due
to
larger.
J
J
As
an
administrator
of
a
public
agency,
I
understand
that
any
change
or
adjustment
to
any
kppa
plan
could
result
in
an
increase
in
our
actuarial
required
contribution,
but
I
also
know
we
cannot
continue
to
sit
back
and
do
nothing.
Therefore,
I
urge
this
legislative
committee
to
study
what
can
be
done
to
at
least
adjust
the
health
insurance
credit
system
for
all
public
employees
who
began
serving
our
commonwealth
on
or
before
on
or
after
july,
1st
2003..
A
A
The
next
issue
is
ems
recruitment
retention.
I'm
going
to
split
this
up
kind
of
in
three
ways.
As
far
as
the
group
of
presenters
go,
we
will
start
with
keith
sanders
the
director
of
the
edinson
county
ems
service
and
then
we'll
go
with
the
klc
representatives
in
the
second
part
of
this
part
of
the
the
program
and
finish
up
with
our
folks
from
k-beams
as
the
last
part
of
this
segment
keith.
If
you'll
introduce
yourself
for
the
record
and
then
you
can
proceed
with
your
comments.
K
K
K
K
Currently,
we
minimally
staff
at
124
hour,
truck
and
116
air
truck
that
one
24-hour
truck
is
a
paramedic
level
truck
that
the
16-hour
truck
is
usually
an
amt
truck
or
a
bls
emt
only
truck,
depending
on
what
staffing
I
can
get,
we
have
a
total
of
eight
full-time
employees.
K
The
rest
of
them
are
prn
or
part-time
of
those,
eight
that
work
regularly,
prn
and
part-time
those
folks
over
half
of
them
work.
Other
ems
agencies.
Again
we
get
back
to
the
topic
of
low
pay,
so
they
have
to
right.
Now.
Staffing
is
one
of
the
greatest
challenges
we
face,
partly
because
of
the
strain.
K
Of
the
of
the
job
itself,
it's
a
physically
demanding
job.
It
is
a
stressful
job.
It
is
a
very
rewarding
job.
If
you
want
to
do
that.
When
I
started
an
ems,
I
started
through
the
fire
department
and
to
give
you
an
idea
of
how
things
has
changed.
My
emt
tuition
didn't
cost
me
anything
because
I
was
in
the
fire
department.
I
was
able
to
go
to
emt
class.
All
that
was
required
was
me,
was
to
pay
for
my
books
and
go
to
the
class.
K
K
Now,
an
emt
class
is
about
eight
nine
hundred
to
a
thousand
dollars,
depending
on
tuition
and
books.
An
aemt
class
is
about
two
thousand
dollars
plus
or
minus
and
books.
A
paramedic
class
when
I
went
through
paramedic
class
started
in
2005.
My
paramedic
tuition
at
western
kentucky
university
was
three
thousand
dollars.
K
Now,
one
of
the
things
that
really
hinders
is
because
most
of
the
paramedic
or
a
lot
of
the
paramedic
and
emt
programs
are
not
taught
through
the
university
and
college
system.
Keys.
Money
cannot
be
used
for
that
tuition.
So
we
have
a
student
that
gets
their
emt
certification
wants
to
go
to
paramedic
school.
K
They
cannot
use
any
of
their
keys
money
if
they're
not
going
to
a
university
or
community
college
system
program
and
the
way
the
education
system
is
run.
If,
if
it's
an
improved,
kbeams
tei
program,
the
licensure
for
paramedic
is
the
same
regardless.
If
they're
going
through
hopkinsville
fire
department,
frankfort
fire
department
or
sky
community
college
in
bowling
green,
the
licensure
is
the
same.
K
Is
that
necessary?
Today
we
see
a
lot
of
paramedics
coming
out
that
they,
the
programs
today,
in
my
opinion,
are
geared
to
make
sure
you
pass.
The
test
functioning
is
a
little
bit
different,
but
to
recruit
people
first
off
you're
you're,
causing
them
to
pay
a
tremendous
tuition
out
of
their
pocket
to
make
barely
above
minimum
wage.
K
Why
would
you
spend
a
thousand
dollars
to
go?
Take
a
class
to
make
11
an
hour
when
you
go
serve
fast
food
and
make
15.
same
thing
with
paramedic.
It
costs
you
as
much
to
go
to
paramedic
schools.
It
does
to
go
to
nursing
school,
but
the
pay
is
probably
ten
dollars
or
better
an
hour.
Less
there's
not
a
lot
of
incentive
to
move
people
into
ems
because
the
money's
not
there.
Why
is
the
money?
Not
there
there's
no
the
reimbursement.
It's
and,
like
I
said
it's,
it's
a
tied
together
thing.
K
One
of
the
things
that
we're
going
to
have
to
do
is
is
get
the
pay
level
up
and
k
beams
will
say
you
know
they're
trying
to
move
the
education
to
raise
the
level
of
education
to
drive
the
wages
up.
Well,
that
in
theory,
I
can
I
understand
that
concept
but
by
the
same
token,
it's
really
hard
to
entice
people
to
take
the
education
if
they
cannot
be
shown
that
the
money
is
going
to
be
there
when
they've
completed.
K
K
K
They
have
to
love
what
they
do,
because
the
money
won't
keep
them
there.
Now,
how
do
we
solve
that?
If
I
had
to
answer
that
question,
I
would
probably
be
in
a
lot
better
position
than
than
I
am
today.
K
K
It
discourages
folks
from
pursuing
it.
There
is
a
lot
of
misconception
of
what
ems
can
and
and
does
do
you
know.
A
lot
of
people
are
still
under
the
notion
that
we
show
up
throw
a
patient
in
the
back
of
the
truck
hauling
the
hospital
and
that's
the
end
of
it.
You
know
we
are
for
most
places
if
you're
running
an
als
service,
you're,
basically
a
rolling
emergency
room
and
we
can
do
a
lot
of
the
same
things
short
of
surgery.
K
K
K
We
are
part
of
the
healthcare
program
we're
the
beginning
of
it
during
the
pandemic.
K
K
If
something
is
not
done
to
address
staffing
and
draw
people
into
this
and
keep
them
there,
the
ems
system
in
kentucky
is
is
in
danger
of
collapsing.
In
my
opinion,
it's
it's
a
dire
situation
right
now.
Our
in
our
region,
agencies
are
stretched
to
the
point
I've
talked
to
my
fellow
directors.
We
have
no
cushion
for
error.
K
If
we,
if
we
run
out
of
trucks,
regs
current
rigs,
we
call
for
mutual
aid
from
surrounding
county
we're
required
to
have
mutual
aid
agreements.
We
have
them
with
every
county
that
touches
us,
but
just
because
I
have
those
agreements
does
not
mean
that
trump,
that
county
is
going
to
have
a
truck
to
send
me.
K
K
K
The
one
thing
is
we
could
bridge
between
advanced
emt
and
paramedic
right
now
you
can
go
to
emt
school,
you
go
to
paramedic
school
or
you
can
go
to
emt
school.
You
can
go
to
advanced
emt
school,
but
you
can't
once
you
go
to
from
emt
to
advanced.
You
have
to
back
up
and
go
from
the
base
back
through
to
go
to
paramedic.
K
That
training
that
you
take
in
the
course
work
you
go
through
to
go
from
basic
to
advanced,
doesn't
count
to
get
you
on
into
paramedic.
There
is
no
bridging
there
that
needs
to
be
put
in
place.
I
don't
know
what
how
that
needs
to
work.
That
would
be
a
job
for
k-beams
to
figure
out,
but
that
needs
to
be
done
that
would
allow
you
could
show
a
pathway,
then,
to
perfect
perspective
employees
to
students
in
high
school
we'd.
K
K
There
could
be
something
set
up
similar
in
the
state
of
kentucky
that
would
allow
paramedics
that
have
retired
that
want
to
come
back
and
work
a
truck
to
do
that
without
any
penalty
they
wouldn't
have
to
be
put
it
back
in
the
retirement
system.
Let
them
just
come
staff,
a
truck
payment,
be
on
the
truck
and
let
them
take
care
of
patients.
K
There's
a
need
out
there
for
patient,
for
paramedics
to
be
in
a
truck
and
for
when
we
have
people
out
there
that
could
do
that,
but
because
of
some
of
these
laws
and
restrictions
that
we
have
we're
not
allowed
to
use
them.
That's
a
problem.
It's
a
problem
and
to
me
it's
an
obvious
problem.
I
don't
know
what
it
takes
to
get
that
addressed,
but
it's
something
that
needs
to
be
looked
at
the
problem
we
have
with
getting
people
in
it.
K
K
Our
budget
runs
almost
a
break
even
between
expenses
and
revenue.
Every
year
we
have
very
little
of
a
contingency
fund.
So
there's
not.
We
can't
compete
with
increasing
salaries
from
surrounding
agencies,
so,
as
everybody
else
can
come
if
they
can
come
up
we're
kind
of
hindered
right
now,
a
paramedic.
If
I'm,
if
I've
got
a
hair,
just
duty
paramedic,
it
cost
me
about
twenty
five
dollars
an
hour
to
pay
that
paramedic
versus
eighteen
twenty
dollars
an
hour
for
comparative
pay
because
of
the
retirement.
K
K
Most
of
the
folks
when
I
started
were
involved
in
volunteer
fire
departments
and
they
lived
and
worked
in
edmondson
county
now,
a
third
of
my
staff
for
more
live
45
minutes
to
an
hour
away,
but
why?
Because
we
can't
get
people
involved,
the
the
gentleman
spoke
about
the
problem
with
volunteer
fire
departments,
chairman
meredith's
dad
and
I've
had
this
discussion
several
times
it's
hard
to
get
volunteers
anymore,
when
our
generation
of
folks
step
out
of
it
kind
of
looking
bleak
for
the
future
of
it.
K
K
K
L
L
I
actually
supplement
to
him.
I
pay
his
tuition.
I
know
all
the
problems
they're
facing
without
you're
not
eligible
for
the
government
funding
for
all
those
programs,
but
we
have
literally
have
to
get
the
pay
up.
We've
got
to
get
the
reimbursement
rate
higher
for
this,
because
when
you
have
a
medical
emergency,
the
bottom
line
is
starts
with
an
emt,
a
paramedic
or
an
ambulance
service.
L
So
you
reach
out
to
me
anytime.
Let
me
know
what
I
can
do
and
you
know
it
is
something
that
we
can't
just
sit
on,
because
this
has
been
going
on
for
far
too
long
and
his
part-time
job.
He
works
60
hours
a
week.
He
goes
in
on
friday
evenings
and
comes
off
on
sunday
evenings
and
if
he's
in
the
middle
of
a
transport
to
mayo,
clinic
or
louisville
or
whatever
you
know,
he
won't
get
off
until
monday
morning.
So
I
know
where
you're
going.
I
know
where
you've
been
you
know.
L
The
hazards
of
the
job
is
is
is
great
too.
It's
not
I'm
almost
thinking
they
probably
should
have
hazardous
duty.
You
know
he
was
recently
his
face
was
spit
his
eyes.
Everything
was
a
bit
full
of
sputum
from
someone
that
was
drug,
impaired,
severely
drug
impaired
and
having
a
seizure,
etc.
L
So
you
know
you're
correct
when
you
say
that
you
know
they
are
a
rolling
emergency
room
because
they
are,
they
have
to
triage
these
people
all
the
time
I
could
go
on
and
on,
but
I'll
stop
for
now,
and
thank
you
for
what
you've
done
for
the
people
we
do
have
to
recruit
and
retain
people
in
this
industry
so
reach
out
to
me
for
anything
that
I
can
do
to
assist
all
of
the
ems
service.
A
F
Thank
you,
mr
chairman,
director
sanders
your
your
presentation
was
very
insightful
and
comprehensive.
I
think
that
goes
from
pay
issues
to
training,
paramedics
and
training
and
re-employment
there.
There
appears
that
there's
some
things
in
there
that
we
may
be
able
to
assist
with
with
legislation.
F
F
Maybe
we
can
address
that
with
legislation
and
get
some
qualified
capable
people
into
the
into
the
field
and,
as
you
said,
and
as
my
colleague
just
mentioned,
that
that
ems
units
are
rolling
emergency
rooms,
I
had
an
experience
with
that
this
summer,
so
it's
personal,
and
I
certainly
would
like
to
get
more
information
as
to
how
we
can
help
with
some
of
the
issues
that
you're
bringing
forward.
Thank
you
very
much
for
your
presentation.
A
C
Alvarado,
thank
you
chairman.
Thank
you,
mr
sanders
for
your
presentation
just
real
quickly.
Just
from
a
practical
standpoint.
I'm
sure
you
guys
make
let's
say
your
service
you're
in
a
small
county.
You
don't
have
a
regional
hospital
inside
your
county.
So
where
do
you
normally
take
your
patient
runs?
To
I
mean
warren
county
is
probably
close
by
in.
C
So
if
you
make
a
run
to
some
of
those
hospitals,
let's
say
one:
for
example:
if
you
go
there,
you
drop
off
a
patient.
If
that
person
has
to
go
back
home,
let's
say:
you've
dropped
them
off
to
the
other.
They've
got
to
go
back
home.
Do
you
get
that
run
to
go
back
to
your
county.
K
K
Right
now
in
medical
center
and
greenville,
both
are
calling
us
we
kind
of
have
an
informal
agreement.
Now
they
are
calling
us
from
the
er.
K
Patients
on
the
floor
most
time
we're
getting
called
now,
if
it's,
for
example,
if
it's
in
warren
county
and
it
is
at
sky
rehab
and
it's
an
edmonton
county
residence
most
of
those
times,
we're
not
getting
called
to
transport
those
folks
back,
even
though
they
pay
taxes
and
support
our
ambulance
service,
the
run
they're
calling
center
dispatch
and
then
that
center
makes
those
transports.
Now,
if
they
caught,
if
medicine
or
dispatch
calls
us,
then
we
will
take
if
we,
if
we
have
staff
available.
K
When
that
doesn't
happen,
well,
to
give
you
a
real
brief
example:
it's
been
about
four
years
ago,
we
extended
a
eight-hour
day
truck
to
a
16-hour
shift,
the
cost
between
the
reduction
in
call-in
for
overtime
and
the
increased
revenue.
By
being
able
to
pick
up
the
return
transports,
pretty
much
netted
out
the
cost
of
adding
that
eight
hour
truck
so,
and
that
was
roughly
around
a
hundred
thousand
dollars
at
that
time.
It's
if
we
do
not
have
the
returns,
it's
a
it's
an
impact
on
them
on
the
bottom
line.
K
Now
that
being
said,
the
ev
everybody
knows
reimbursement
with
medicaid
is
a
challenge
when
especially
non-emergency
medicaid,
you
know
80
bucks
is
is
that,
but
if,
if
my
truck
is
my
truck
cost
me,
the
same
dollar
amount
to
set
there
versus
making
a
run
other
than
the
fuel.
Basically,
so,
if
I
can
have,
if
I
can
be
moving
patients
with
that
truck,
it's
it
reduces
my
cost
per
run.
If
you,
if
that
follows
versus
just
sitting
there
now,
it
does
not
usually
the
way
we
staff
and
the
way
we
run.
K
We
kind
of
coordinate
that
if
we
do
not
send
trucks
out
to
pick
up,
non-emergency
runs
without
another
truck
being
available
for
emergency
calls.
So
we
we
do
staff
to
mitigate
the
impact
on
emergency
response,
but
from
a
bottom
line.
If
we
wasn't
allowed
to
make
those
runs,
it
would
negatively
we
would
probably
be
operating
in
red
most
of
the
time
without
doing
tax
increases
annually.
C
A
L
L
L
Cities
often
pay
the
cost
of
training.
Only
to
have
the
newly
certified
paramedics
leave
for
a
higher
paying
job
in
the
private
sector
to
exasperate
the
issue.
The
state
has
shifted
that
paramedic
training
into
more
of
a
college
setting
rather
than
the
previous
vocational
focus,
anchorage,
middletown
fire
and
ems
deputy
chief
of
operations.
Lieutenant
colonel
mike
sutt
is
here
with
me
today
to
provide
more
information
on
how
the
training
requirements
work.
E
Thank
you
ma'am.
I
appreciate
y'all's
time
today,
but
basically
want
to
to
enlighten
you
how
this
system
works
and
the
issue
that
it
has
created
for
us.
Currently,
only
local
four
local
governments
are
currently
operating
paramedic
sites
to
train
their
own
ems
personnel.
At
one
time,
that
number
was
25
to
30.
E
E
Working
emts
often
struggle
to
find
the
time
to
attend
paramedic
school
because
of
their
current
jobs
that
they're
working
or
somewhere
else
cost
is
also
a
huge
deterrent
that
we
are.
We
are
coming
into
that
an
18
month,
paramedic
program
cost
approximately
nine
thousand
dollars
currently
at
kctcs
over
a
four-year
period
from
2016
to
2020,
kentucky
programs
document
448
initial
paramedics
from
programs
within
our
current
education
infrastructure.
E
E
E
What
we
are
seeking
is
an
assessment
of
kentucky's
current
educational
infrastructure
to
determine
if
our
current
system
of
training
and
certifying
paramedics
is
truly
serving
our
needs
capable
of
keeping
up
with
our
demand
and
working
for
the
overall
safety
of
the
public.
Having
college
institutions
do
the
training.
Does
us
no
good
if
paramedics
are
not
available
for
9-1-1
calls
and
other
responses
when
the
public
needs
them?
This
time?
I'd
like
to
introduce
mayor
stapleton.
G
My
name
is
les
stapleton
mayor
of
prestonburg
kentucky
and
mr
chairman
committee,
I
appreciate
you
all
giving
me
the
opportunity
to
come
and
and
speak
with
you
all.
You
know
knowledgeable
and
skilled
personnel
is
important.
It's
even
more
important
on
an
ambulance.
G
G
G
So
I
got
to
back
up
and
tell
you,
I'm
retired
state
police,
and
when
I
did
investigations
there
was
four
questions
I
always
answered.
It
was
how
what
when
and
why
and
I'm
here,
to
tell
you
about
the
why,
more
than
anything
in
the
city
of
prestonsburg,
we
have
had
such
a
lack
of
personnel
in
the
private
industry
that
we
cannot
get
service.
Sometimes
we
have
to
actually
call
paintsville,
which
is
20
minutes
down
the
road
and
that's
for
mutual
aid.
Much
like
edmonson
county
does.
G
We've
had
to
ask
for
mutual
aid
from
pipeline
occasions,
which
is
almost
40
minutes
away.
So
when
I
get
when
we
get
a
call,
my
emts
and
my
paramedics
run
our
squad
truck.
Are
there
within
three
minutes
so
in
three
minutes,
they're
on
the
scene
extricating
they're
on
the
scene,
triaging
and
they're
on
the
same
packaging
and
then
we're
sitting
in
the
middle
of
the
road
with
a
70
year
old
woman's
head
in
your
lap
and
40
degree
weather
and
her
laying
there
with
waiting
on
ambus
to
come
pick
her
up.
G
G
So
you
got
to
be
careful
about
that.
Also.
I
suggested
this
to
a
brianna
and
I
really
appreciate
her
and
klc
listed
me
on
this
county
and
city
governments.
Local
governments
should
have
an
opportunity.
If
it's
declared
an
emergency
situation,
they
should
be
able
to
bypass
the
c-o-n
process
and
go
straight
to
the
k-beams
listening
process.
G
If
they
are
licensed
by
k-beam,
then
they
have
the
adequate
needs.
They
can
feel
the
adequate
needs
it
needs
to
be
there.
They
have
the
resources
they
even
have
to
have
the
money
behind
it.
On
january
24th
2020
the
city
of
prestonsburg
applied
for
a
c-o-n
I
have
yet
to
have
a
hearing.
I
have
people
dying.
G
I
didn't
really
feel
like
carrying
that
around
down
here,
so
I
just
went
with
the
last
30
days.
That's
the
last
30
days
when
it
takes
over
10
minutes.
Somebody
get
there
when
my
people
there
are
there
in
three
minutes
and
solving
this
problem
now
on
the
com
process
or
bypass
I
was
discussing,
I
don't
think
it
needs
to
be
for
transports.
G
G
M
Yes,
thank
you
for
being
here,
and
you
know
I'm
a
big
advocate
for
the
fire
departments,
but
in
bullitt
county
our
judge
exec.
He
says:
there's
a
great
need
for
cons.
M
I'm
glad
that
you
say
that
there
is
is
some
need
for
it
that
you
don't
want
to
abolish
them
all
together
the
speed
of
how
you
get
them
the
red
tape.
We
all
agree.
We
need
to
do
away
with
that,
but
in
bullitt
county
we
had
a
problem
just
like
everywhere
else,
not
enough
enough
ambulances.
M
So
I
would
advise
any
judge
exec
to
call
him
and
see
if
maybe
he
can
help
you
out
on
how
to
do
these
things
so
the
c-o-n.
I
think
that
that
is
something
necessary,
because
if
you
start
having
too
many
fire
departments
close,
I
know
most
of
y'all
have
counties
that
are
far
apart
and
are
different.
But
if
you
have
too
many
and
they're
fighting
with
a
government,
a
county
judge
or
the
county
that
has
invested
his
money
in
that
and
then
the
other
ones
come
in
there.
G
G
G
We
have
two
stations,
one
on
each
end
of
town,
so
we
can
access
quickly
and
effectively
the
clm
process,
and
I
you
know
when
I
was
in
the
state
police.
I
literally
remember
two
ambulance
services.
The
drivers
got
out
and
were
fighting
at
the
scene
as
to
who
got
there
first.
So
I
understand
the
com
process.
We
don't
need
that.
G
But
if
a
city
or
county
government
can
look
at
a
situation
say
we're
an
emergency
situation,
we
can
declare
emergency
winners,
a
flood
and
it's
endangering
people's
lives.
We
should
be
able
to
declare
an
emergency
when
people
are
dying
in
their
homes
because
they
can't
get
transported
to
the
hospital
and-
and
I
never
did
say,
do
away
with
the
c.o.m
process.
I
want,
I
think
we
should
be
bypassed
and
allow
us
to
go
to
the
livestream
process
and
then,
if
it
backs
up,
we
go
to
the
c-o-n.
G
Yes,
sir,
I
agree
one
other
statement.
If
I
could
it's
brought
to
my
attention
just
a
little
while
ago,
on
september,
the
30th
beams
came
out
with
a
an
emergency
declaration,
emergency
directive
that
allowed
non-emts
or
paramedics
to
drive
an
ambulance.
That's
just
to
drive
nemesis,
they
help
load
them
up
and
they
drive
them.
I
think
the
re
the
restrictions
was,
they
had
to
have
a
cpr
or
a
basic
first
aid,
so
they
did
not
have
to
be
emt
or
paramedic
and
september
30th.
G
M
Very
good
point:
our
judge
exec
also
mentioned
that
for
the
cost
of
that,
but
I
think
that
what
he's
doing
with
the
apprenticeship
program
and
working
in
the
high
schools
and
that
I
don't
think
I
know
it's
working
and
it
can
help
with
other
counties,
also.
B
An
earlier
speaker
mentioned
about
expanding
the
use
of
keys
money
for
people
that
are
not
going
into
conventional
facility
or
educational
institutions.
Would
you
advocate
for
that.
G
Yes,
sir,
I
would
I
have
two
sons,
one
of
them's
college-educated
and
got
got
a
degree
and
he
went
into
his
field.
The
other
one
did
not
want
college
and
he
took
some
training
and
apprenticeship
program
that
I
would
have
loved
to
be
able
to
use
that
keys
program.
Put
him
into
it
now.
The
same
thing
goes
with
emts
and
paramedics.
If
we
can
help
these
people
that
are
interested
in
this
field,
get
that
training
it's
going
to
make
a
substantial
impact
in
our
personnel
across
the
state.
D
Central
wheeler.
Thank
you,
mr
chairman
mayor.
Thank
you
for
coming
down
here
today.
It's
always
good
to
see
you.
You
know.
I
think
you
hit
on
a
subject
that,
as
a
senator
for
a
very
large
rural
district
and
actually
the
largest
county
land
wise
in
the
commonwealth
of
kentucky,
is
really
impacting
the
safety
of
our
rural
citizens.
You
know
my
father-in-law
has
lived
for
you
know,
50
years
in
his
home
in
elkhorn
city.
D
I
know
you're
very
familiar
with
him
being
a
native
of
there,
but
you
know
he's
91
years
old
and
you
know
there's
really
no
ambulance.
That's
I
think.
Currently
in
elkhorn
city,
they
have
to
send
one
from
you
know
another
area
over
there,
and
you
know
it
just
becomes
an
extreme
problem
with
the
expense.
D
At
the
same
time,
I
have
my
health
care
institutions
telling
me
that
there's
a
problem
with
just
basic
transport
because
of
the
need
to
have
a
certain
number
of
people
on
call
for
emergencies
that
they
can't
get
a
transport
from
one
healthcare
facility
to
another.
But
then
you'll
have
the
ambulance,
services
kind
of
say
for
lack
of
a
better
term.
That's
the
easy
money,
whereas
you
know
we,
we
lose
money
when
we
have
to
make
some
emergency
calls.
D
What
are
some
of
the
solutions
that
you
would
see
to
kind
of,
in
addition
to
the
tr,
the
apprenticeship
programs,
which
I
think
are
a
wonderful
idea?
What
are
some
of
the
other
solutions?
Do
you
see
that
we
could
do
to
provide
more
service
for
smaller
rural
communities.
G
G
They
are
most
of
them,
become
emts
through
their
service
and
and
will
work
with
ambulance
services,
because
most
volunteer
agencies
will
help
them
get
the
education
to
help
them
get
the
mt
training.
That's
an
excellent
opportunity.
If
we
can
make
it
at
least
it
doesn't
have
to
be,
they
don't
have
to
make
money,
but
if
we
can
keep
them
having
to
lose
money
for
all
this
time
to
be
able
to
get
that
training
and
be
able
to
work
with
these
volunteer
fire
departments,
I
think
we
could
really
really
move
our
personnel
up.
That
way.
D
And
I
agree
with
you
and
I
think
I'm
familiar
with
that
bill.
In
fact,
I
think
I
filed
it
a
couple
sessions
ago
and
I'm
glad
to
see
that
it's
getting
some
traction
this
time.
I
think
that
the
volunteer
fireman
will
be
a
really
big
assistance
to
providing
some
of
these
emergency
services
to
rural
areas.
C
Senator
alvarado,
thank
you,
mr
chairman,
just
really
quickly.
I
think
we're
one
of
only
four
states
that
actually
has
c-o-n
requirements
period
for
ground
ambulance.
I
think
it's
arizona,
new
york
hawaii,
I
think,
and
us
and
that's
it.
I
don't
know
that
any
of
our
neighboring
states
have
this
requirement.
C
So
I
think
that's
something
for
everybody
on
the
really
in
the
in
the
committee
to
know
that
we're
kind
of
outliers
on
this.
As
far
as
how
this
is
being
handled,
I
know
we
talk
about
cities
making
the
determinations.
If
someone
needs
an
ambulance
service
or
not,
I
mean
a
lot
of
our
hospitals.
Also
need
that
requirement,
I
think
sometimes
too,
and
hospitals.
C
We
have
testimonies
in
the
committee
before
this,
about
difficulties,
they're
having
of
people
sitting
in
hospitals,
waiting
for
someone
to
be
transported
to
another
facility
and
the
doctor
there
who's
more
trained
than
any
of
us
are
right
or
then
most
of
us
at
least
are
to
be
able
to
call
that
shot
to
determine
if
that
person
need.
C
This
is
an
emergency
transfer
to
non-emergency
transport,
whatever
I
think,
there's
a
proposal
being
done
to
have
kind
of
a
non-substantive
review
for
con
to
your
point
that
you've
been
waiting
a
long
time
to
have
this
done
that
if
we
change
the
process
for
that,
it
would
require
a
hearing
within
45
days
mandated
to
be
done
within
that
period
of
time.
It
might
be
something
we
want
to
start
taking
a
look
at
also
another
question.
Just
from
I
think,
k
beams.
C
You
were
mentioning
the
regulation
that
had
gone
away
that
was
kind
of
an
emergency
reg
that
we
allowed
non-emt
people
to
help
drive
those.
I
thought
there
was
a
regulation,
maybe
it's
the
same
one
where
they
would
allow
nurses
to
be
able
to
fill
in
to
help
ride
in
in
a
buggy.
So,
if
someone's
being
transported,
if
a
nurse
was
there-
and
you
didn't
have
enough-
they
could
be
the
ones
to
go
along
just
to
handle
the
shortages.
People
were
being
taken
to
the
next
location.
You
see,
that
was
an
option.
C
C
Might
be
something
for
us
to
talk
to
those
guys
to
see,
because
that's
the
case,
probably
not
a
good
idea
when
we're
running
short
on
personnel,
but
those
are
some
things
for
us
to
consider.
Is
that
there's
a
there's
a
there's,
a
proposal
out
there
that's
floating
around
to
help
expedite
this
process
and
then
the
question
just
becomes.
We
even
need
to
have
this.
You
know
and
it's
always
a
very
touchy
subject
when
it
comes
to
con.
C
Like
you
said,
you
don't
want
people
fighting
on
the
streets
for
the
privilege
of
transporting
somebody,
but
you
know
that's
the
reality
that
we
live
in
really
compared
to
the
rest
of
the
states
and
our
neighboring
states
in
the
country.
G
Mr
chairman,
if
I
may
my
thoughts
on
that,
the
clm
process
does
what
it's
supposed
to
do,
because
if
you
flood
the
market
with
five
or
six
different
agencies
in
these
small
rural
counties,
eventually
everybody's
gonna
start
losing
money,
they're
gonna
start
pulling
back
out
and
then
there's
a
vacuum
left
there
there's
no
personnel
there.
So
I
agree
that
this
there
is
a
use
for
the
con
process,
and
I
I
do
understand
that.
But
we
have
to
expedite
it
or
allow
county
and
city
governments
who
see
emergency
9-1-1
emergencies.
G
A
N
Yes,
sir,
thank
you,
mr
chair,
mike
poynter.
I
am
the
executive
director
for
the
board
of
ems
and
I
will
say
that
I
was
fortunate
to
start
my
career
in
1980
in
barron
county,
which
is
adjacent
to
edmondson
county.
So
I
totally
understand
director
sanders
concerns
with
that,
so
we
apologize
for
not
being
in
person.
We
were
just
notified
by
fema
that
we're
responsible
for
deploying
some
ems
assets
that
we
have
requested
this
week.
So
our
apologies
with
that
and
with
that
I'll
introduce
our
other
speaker,
chuck
o'neill.
O
O
Great,
thank
you.
This
will
just
take
a
few
minutes
here.
Hopefully
this
will
answer
some
of
your
questions,
but
we
do
appreciate
you
all
having
us
in
today
and
again,
as
mr
poynter
described,
we're
expecting
about
three
ambulance
strike
teams
from
fema
to
come
and
assist
us
in
the
state
in
the
next
24
hours
and
we're
kind
of
stuck
in
lexington
and
in
the
louisville
area.
O
As
mayor
stapleton
mentioned
earlier,
his
primary
concern
is
providing
emergency
service
for
the
citizens
and,
if
you
listen
to
members
of
the
kentucky
hospital
association,
their
primary
issue
is
with
inter-facility
transfer,
so
the
lack
of
personnel
is
causing
us
issues
on
on
both
sides.
A
recent
study
by
the
kentucky
board
of
ems
shows
that,
while
we
have
over
14
500
ems
professionals
certified
and
licensed
in
kentucky,
only
approximately
50
percent
of
these
individuals
are
employed
by
a
ground
ambulance
service
in
kentucky.
O
In
2018,
k
beams
in
collaboration
with
the
kbm's
education
committee,
the
kentucky
association
of
fire
chiefs
formed
a
paramedic
accreditation
task
force
to
allow
for
the
flow
of
information
across
paramedic
educational
programs,
one
of
the
work
products.
This
task
force
was
to
survey
certified
emts
in
kentucky
emts
that
are
already
functioning
and
certified
in
kentucky
at
the
emt
level
and
identify
perceived
barriers
to
completing
paramedic
education.
O
The
top
five
barriers
identified
by
those
emts
that
responded
to
the
survey
were
22
percent,
was
a
work
and
schedule
school
schedules.
Conflict
18
percent
was
no
desire
to
become
a
paramedic.
17
was
time
commitment,
length
of
service
14
was
little
increase
or
incentive
pay
and
12
lack
of
financial
aid
availability
for
those
programs.
O
We
also
perform
attrition
reports
annually.
We
haven't
in
the
last
couple
of
years
because
we've
been
staffing
the
state
eoc
as
part
of
covet
19,
so
our
daily
operations
and
our
annual
reports
have
gotten
behind
just
a
little
bit,
but
to
better
understand
provider,
turnover
and
conduct
provider
retention
efforts.
We
began
studying
ems
attrition
in
2016.
O
the
top
five
reasons,
as
the
gentleman
spoke
of
earlier.
The
top
five
reasons
for
allowing
an
ems
license
or
certification
to
expire
in
2016
were
retirement,
26
percent,
which
we
want
through
our
attrition
reports.
We
want
retirement
to
always
be
the
top
level.
We
want
the
highest
percentage
to
always
be
retirement.
That
means
that
individuals
are
staying
in
the
profession
until
retirement,
the
26
percent
of
retirement,
low
salary
and
poor
benefits
package.
O
24
of
the
individuals
that
allow
their
certification
or
lapse
are
licensed
to
lapse
in
2016,
stated
low
salary
and
poor
benefits
package,
16,
relocated,
10,
responded,
external
factors
are
not
their
choice
to
leave
ems
and
10,
reported
poor
management
and
or
hostile
workplace
as
their
reasons,
and
hopefully
you
have
our
16
17
and
18
attrition
reports
in
your
packets.
O
But
just
like
director
sanders
stated,
there's
not
a
silver
bullet
to
fix
the
issue,
but
competition
is
real
and
it
exists
ground
ambulance
services
operated
in
both
the
public
and
private
sector,
having
significant
difficulty
competing
with
hospitals
for
paramedics,
hospitals
are
offering
significant
sign-on
bonuses
and
hazard
pay
that
local
government
simply
cannot
afford
currently,
and
just,
for
instance,
we'll
look
at
some
salaries
in
just
a
second
but
uk
healthcare
on
the
left.
Here.
This
is
from
simply
hired
paying
up
to
thirty
dollars
and
nine
cents.
O
An
hour
for
paramedics,
jenny,
stewart
hospital
in
hopkinsville
down
in
western
kentucky,
offering
a
fifteen
thousand
dollar
sign-on
bonus
for
paramedics
in
the
emergency
room.
Local
governments
are
going
to
have
a
really
hard
time.
City
and
county
local
governments
are
going
to
have
a
really
hard
time
competing
with
that
action
items.
These
are
some
things
that
we
have
done
or
that
we
can
do.
We
believe
to
help
house
bill.
8
was
enacted
by
the
general
assembly
in
2018..
O
This
bill
bolsters
kentucky
medicaid
ground
ambulance
reimbursement
by
generating
an
additional
43
million
dollars
each
year
earmarked
for
kentucky
ground
ambulance
services.
What
we
found
so
far,
this
program
has
started
in
2021,
it's
enacted
in
2018,
but
it
actually
started.
O
We
have,
I
have
meetings
with
a
group
that
runs
the
program
at
medicaid
every
couple
of
weeks
and
the
distribution
has
begun
and
what
happens,
though,
in
in
several
of
these
instances
is
the
county
or
city-operated
ambulance
services
get
these
lump
sums
of
medicaid
money
to
assist
with
operations
and
they
end
up
getting
dumped
into
the
county
or
the
city's
general
fund,
rather
than
reallocated
to
the
ambulance
service.
O
O
O
O
We
have
the
I'm
enrolled
in
the
federal
public
public
services
loan
forgiveness
program,
but
you
have
to
pay
the
loans
for
10
years
before
you
get
any
forgiveness
on
those
threats
to
the
citizens
and
to
our
ems
programs
in
cities
and
counties
across
the
commonwealth.
The
2019
kentucky
ems
salary
survey
produced
the
following
summary
results
for
starting
ems
pay,
and
hopefully
you
all
can
see
these
emt.
The
average
was
11
and
88
cents.
Advanced
emt
was
13
and
30
cents,
paramedic
15.62
cents,
and
that
was
two
years
ago.
O
Those
probably
haven't
moved
a
lot
and
on
a
previous
slide,
you
saw
that,
for
instance,
uk
hospital
emergency
rooms
paying
up
to
double
that,
along
with
sign-on
bonuses
that
hospitals
are
offering
consistent
themes
in
ems
across
the
nation
is
that
they
will.
Our
ems
providers
will
no
longer
do
the
work
for
the
compensation
packages
that
are
available
are
being
offered
local
governments.
O
Bus
must
find
revenue
streams
to
significantly
enhance
ems,
salary
and
benefit
packages
to
remain
competitive
in
the
market,
additional
areas
that
we
might
be
able
to
take
action
on
at
a
local
level
or
assist
at
a
state
level.
Child
care
assistance
for
single
parents
working
24-hour
shifts
ems,
mental
health
services,
wellness
initiatives,
alternative
retirement
plans.
O
I
think
we
definitely
need
to
evaluate
alternatives
to
the
current
accreditation
programs
offered
by
co-a
and
required
by
the
national
registry
for
testing
and
educational
and
financial
incentives
for
continued
work
in
the
ground
ambulance
sector.
We
see
so
many
paramedics
going
to
air
ambulances
into
hospitals,
and
things
like
that
and,
like
the
previous
slide
stated,
only
approximately
48
to
50
percent
of
our
certified
and
licensed
individuals
are
actually
continuing
to
work
on
a
ground
ambulance.
O
So
that's
all
I
have,
and
myself
and
mr
porn
will
be
glad
to
answer
any
questions
that
you
may
have.
Mr
chair.
C
So
the
one
was
with
k
beams.
I
know
there
was
a
regulation
that
was
as
far
as
allowing
other
staff
like
nurses
to
ride
on
buggies
and
that
that
was
removed,
and
I'm
not
sure
why
so
we're
in
a
time
of
shortage,
when
we
have
a
need
to
have
somebody
accompany
a
patient
and
then
somebody's
being
transported
for
some
other
reason
that
there
were
nurses
available
or
a
nurse
willing
to
go
with
the
patient
that
that
could
serve
as
someone.
C
My
understanding
is
that
k
beams
remove
that
reg
all
together,
and
so
I
was
just
inquiring
as
to
why
that
was
in
a
time
when
we're
short
on
staff.
O
Sure
I
can
take
that
senator
alvarado
and
thank
you
for
the
question.
Our
attorneys
actually
reviewed
this
a
few
years
ago
and
we
did
an
advisory
opinion
on
it.
So
it's
our
belief
that
a
nurse
or
a
respiratory,
therapist
or
physician
can
be
the
attendant
on
an
inter-facility
transfer
through
imtala.
So
we
believe
in
our
attorneys
believe
that
federal
regulation
through
imtala
preempts
any
state
regulation
over
allowing
a
physician
who's,
also
who's
already
mandated
through
him
tala
to
ensure
appropriate
staff,
equipment
and
transport
method
for
a
patient,
that's
being
referred
to
another
facility.
O
O
Some
of
the
emergency
orders
that
we
were
discussing
earlier
that
mayor
stapleton
was
discussing
were
part
of
our
authorities
granted
under
senate
bill
150,
which
we
believe
is
part
of
what
the
supreme
court
overturned
on
saturday.
So
those
emergency
orders
are
probably
going
to
be
getting
scaled
back
very
soon.
C
You
know,
and
I
understand
bill
150
and
some
of
the
executive
orders
and
things
we've
extended
in
the
past
with
house
joint
resolution.
77
you're
telling
me
that
your
attorneys
think
that
if
an
er
doctor
wanted
to
accompany
a
patient
on
a
buggy
that
they
think
that
violates
federal
law,
because
I
mean.
O
No
sir,
no
sir,
no
sir,
under
him
towel
the
phys.
The
referring
physician
is
responsible,
obviously
for
the
mode,
this
appropriate
staffing
and
equipment
for
the
patient.
So
we
believe,
and
our
attorneys
believe
that
it
is
not
illegal
in
kentucky
at
all
to
put
any
staff
equipment
or
staff
equipment
or
vehicles
in
place
to
appropriately
transfer
that
patient.
We
believe
that
federal
law
under
him
tala
supersedes
any
state
law
that
we
could
put
in
place
to
say
that
nurses
can
or
cannot
accompany
a
patient
on
an
inner
facility
transfer.
O
We
believe
that
that's
under
federal
law,
that
that
is
the
responsibility
and
the
authority
of
the
referring
physician
under
your
towel.
C
Right
so,
okay,
so
back
to
my
original
questions,
you
had
a
reg.
If
nurses
wanted,
you
know
to
allow
a
nurse
to
accompany
a
patient.
Let's
say
you
guys
were
down
on
staff,
but
a
nurse
is
willing
to
go
from
an
er
who's.
Well
versed
on
running
codes,
administering
emergent
medications,
running
drips
iv
fluids,
an
er
doctor
who
might
be
willing
to
accompany
a
patient
for
some
reason
can
do
procedures
in
route
if
needed.
C
There
was
a
regulation
that
allowed
those
individuals
to
go
with
your
your
emt
folks
on
a
buggy
and
that
reg
from
what
I
understand
has
been
removed.
So
you're
telling
me:
okay,
federal
law
supersedes
I'm
tala,
I'm
very
familiar
with
him
tala
and
that's
all
regarding
transfers
of
someone
going
to
another
facility.
C
Why
would
the
regulator
move
to
allow
staff?
I'm
not
clear
with
your
response,
because
you're
telling
me
in
one
that
it
was
federal
and
you're
saying
well
it
supersedes
our
laws.
Is
that
why
the
reg
was
changed,
because
you
think
that
federal
law
prohibits
those
folks
from
accompanying
somebody
in
route.
O
No
not
at
all,
not
at
all,
and
I'm
not
familiar
with
any
regulation
that
we've
had
regarding
nurses
on
an
ambulance
other
than
class
three
critical
care,
inter-facility
transfers,
but
we
encourage
it.
We
encourage
nurses
or
respiratory
therapists
to
be
utilized
and
I'm
not
aware
of
any
regulation
that
we've
had
since
I've
been
here
in
the
last
eight
or
nine
years.
That
discussed
it,
except
for
specialty
care
transports
and
that's
a
class
three
license.
It's
a
little
bit
different.
O
Specialty
care
transports
are
class,
threes
are
similar,
the
uk
neonatal
and
pediatric
transport
program,
norton
pediatric
and
neonatal
programs.
They
use
specialty,
rns,
usually
they're
from
the
nicu
for
those
programs,
so
adult
critical
care,
transport,
pediatric,
critical
care,
transport
and
neonatal
critical
care
transport
are
all
under
our
class
3
specialty
care
licenses.
O
A
Chuck
one
final
thing:
just
a
couple
of
things
that
were
mentioned
prior
in
the
in
the
presentation
with
regard
to
the
possibility
of
us
looking
at,
because
we've
looked
at
it
across
the
board,
on
other
things:
the
keys
money
being
used
for
programs
that
are
not
in
the
community
college
sitting
or
the
the
university
sitting.
Could
you
all
weigh
in
on
that,
and
also
on
the
re-employment
issue
of
certified
paramedics.
O
Sure
I
think
I
think
chairman,
we
definitely
endorse
the
keys
money
being
used
for
emt
programs,
because
many
of
the
paramedic
programs
are
already
affiliated
with
the
college.
They
can
use
keys
money
for
that,
but
I
think
what
we
were
discussing
is
keys,
money
being
used
for
emt
programs,
and
I
believe
I
may
be
incorrect,
but
some
of
our
emt
programs
or
many
of
our
emt
programs
are
offered
through
state
fire
and
rescue
training
who's
affiliated
with
kctcs.
O
So
there
may
be
a
possibility
where
some
legislation
could
be
written
to
allow
keys
money
to
be
used
through
that,
because
they're
affiliated.
I
believe
that
the
keys
program
requires
that
it
be
through
a
college
or
university
or
an
accredited
technical
school
in
order
for
those
monies
to
be
used,
but
anything
that
we
could
do
to
assist
with
the
power
that
we
have.
We
would
definitely
endorse
and
advocate
for
keys
money
to
be
used
for
ems
programs.
Definitely
what
was
your
second
question,
sir?.
A
N
I
can
take
that
mr
chair
last
year,
in
the
enact
of
the
emergency
regulations
by
the
governor,
they
authorized
us
to
modify
our
regulations.
We
got
together
with
our
leadership
team
and
tried
to
decide
what's
the
best
way
to
do
that.
One
route
that
we
took
was
anybody
that
has
ever
been
certified
or
licensed
as
an
emt,
first
responder
or
paramedic,
or
advanced
emt
in
kentucky
during
the
emergency
regs,
we
allowed
them
to
come
back
full
status
at
no
charge
and
be
fully
reinstated.
N
N
O
O
My
guess
is
that
that
some
of
them
did
and
a
lot
of
them
just
wanted
a
free
certification
or
license
back,
but
we
knew
that
in
order
for
them
to
go
to
work
for
an
ambulance
service
to
be
re-employed
that
that
we
had
to
get
their
certification
or
their
license
back
in
their
hand,
we
kept
that
that
free
period
open
for
about
three
months,
no
continuing
education
was
required
and
it
was
primarily
due
to
the
state
of
emergency
and
we
were
fully
expecting
the
hospitals
and
ems
to
be
offline
due
to
backfills
and
all
our
own
people
getting
coded
and
not
being
able
to
work
so
there's
still
a
reinstatement
process
for
retired
or
expired
emrs,
emts,
advanced
emts
and
paramedics.