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From YouTube: Emergency Medical Services Task Force (7-14-22)
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B
C
A
The
first
meeting
today
is
going
to
be
more
of
a
foundational
to
set
the
framework
to
have
an
understanding
of
how
different
things
work,
so
this
will
serve
as
a
foundation
for
us
to
go
forward
in
terms
of
providing
some
good
recommendations
at
the
end
of
the
road
in
which
we
will
hope
to
in
turn
these
recommendations
into
bills.
So
it
can
change
the
some
of
the
dynamics
of
going
over
the
ems
in
a
very
positive
way.
A
The
senator
gibbons
and
I
have
gone
through
those
priorities.
We've
sort
of
we
didn't
rank
them,
but
we
just
put
them
down
and
we're
trying
to
cover
as
many
as
possible
as
we
can
over
the
next
several
months.
So
I
do
appreciate
y'all's
participation
of
providing
that,
as
I
mentioned,
this
is
this-
is
more
of
an
information
gathering.
We're
gonna
try
to
get
as
much
information
as
we
can
as
possible
from
various
aspects
of
the
ems
community
turn.
A
I
wanna
stress
that,
while
we,
which
we
did
during
the
discussions
with
house
bill,
777
it's
at
least
in
my
mind's
primary-
that
we
keep
the
patient
the
the
citizens
of
the
commonwealth
in
our
mind
and
foremost
in
our
mind,
because
that's
what
we're
here
to
do,
that's
what
we'll
get
paid
to
do.
That's
what
you
are
a
lot
of
y'all
get
paid
to
do.
I
know
if
you're
in
a
private
or
public
sector,
to
make
sure
we
provide
that
service
in
the
best
possible
way
and
also
the
the
highest
quality
as
well.
A
I
just
want
to
discover
just
a
couple
of
themes
that
we
that
came
out
of
the
requests
of
some
emails,
that
y'all
sent
some
of
those
themes,
and
I
think
probably
the
one,
the
main
one
is-
is
workforce
from
an
education
standpoint.
Looking
the
pipeline
of
that
the
attraction
retention
of
individuals
that
will
come
into
the
field
certificate
of
need
is
another
issue,
another
is
behavioral
transportations
and
how
to
handle
that,
and
also
inner
facility
transports,
and
also
reimbursements.
A
That
seems
to
be
a
lot
of
hang
up
across
the
board
when
it
comes
to
health,
health
services
in
general.
So
so
with
that,
like
I
said,
I
will
look
for
a
really
really
good,
robust
conversation
that
we've
been
able
to
go
through
and
and
decipher
and
come
up
with
some
good
information.
So
we
can
take
a
proactive,
positive
actions
in
the
next
upcoming
session.
So
with
that,
I'm
going
to
ask
senator
gibbs
to
make
some
open
comments.
D
D
D
A
Thank
you
senator
gibbons,
and
I
just
wanted
to
underline
what
the
senator
said
that
we
are
here
and
we're
here
to
serve
you
all
and
make
sure
that
your
information
and
your
comments
are
here,
so
you
can
contact
any
one
of
us
on
this
committee,
like
I
said
we're.
We
want
to
make
sure
we
get
the
best
possible
product
after
through
going
through
this
process
with
that.
A
Mr
sloan,
if
you
wouldn't
mind
making
yourself
off
available
up
to
the
up
the
table
you're
the
interim
director-
and
I
appreciate
you
coming
on
board
in
the
interim.
I
know
you've
come
into
in
a
transitional
period
and
I've
gone
through
quite
a
few
of
those
and
it's
not
easy
to
go
through
and
take
an
inventory
of
things
and
see
where
we
are
and
and
try
to
abide
by
the
new
laws
that
we
just
passed
recently.
So
thank
you
very
much
for
stepping
up
and
helping
helping
out.
A
E
To
you
all
right
there
we
go
all
right
again.
My
name
is
eddie
sloane,
I'm
the
interim
executive
director
for
about
five
or
six
days
now.
But
thank
you
for
the
opportunity
today.
I
think
what
you
were
looking
for
is
a
kind
of
a
broad
overview
of
ems
in
the
state
of
kentucky
and
maybe
find
out
a
little
about
our
education
system
for
and
personnel
and
and
how
ems
is
run
in
the
state
in
the
interest
of
time.
A
few
of
these
slides
I'll
kind
of
jump
over.
E
But
we
made
it
quite
lengthy
so
that
you
would
have
the
information
later
if
you
come
back
and
look
at
the
powerpoint
in
a
handout
or
such.
But
we'll
talk
a
little
about
the
service
models,
the
classifications
which
will
be
key
going
forward
as
we
look
at
the
new
regulations
and
how
to
make
sure
that
each
of
the
classes
are
met
and,
and
the
folks
end
up
in
the
the
services
end
up
in
the
right
classification
and
able
to
make
they're
not
restricted
on
the
runs.
E
They
need
to
do
the
diverse
regions
in
the
state
of
kentucky
and
the
als
versus
the
bls
model,
just
to
make
sure
that
everyone
is
pretty
clear
on
what
each
of
those
mean.
There
are
221
services
in
the
state.
They
they
go
under
seven
classifications,
but
only
four
classifications
are
are
ground,
ambulance
and
in
reality,
there's
only
the
large,
the
largest
class
is
a
class
one
and
that's
what
we
think
about
as
the
as
a
traditional
service.
E
E
Those
are
the
the
services
that
go
to
your
house
go
to
the
hospital.
They
can
make
inter-facility
transfers
most
in
the
state,
operate
at
an
advanced
level
or
with
paramedics,
but
they
can
also-
and
there
are
some
remaining
basic
life
support
agencies
in
the
state
of
kentucky
again,
they
can
make
inner
facility
transfers
that
are
not
restricted
in
that
manner.
E
The
class
ii
agencies
are
are
bls
only
there
there's
four
services
in
the
entire
state,
two
percent
of
who
of
the
folks.
We
license
it's
bls
only
and
they
cannot
respond
to
the
to
a
to
a
house
to
pick
someone
up
or
take
them.
Someplace
they'll
be
doing,
non-emergent
runs
and
they're,
not
part
of
the
9-1-1
system.
E
E
So
it's
pretty
small
number
that
resides
within
kentucky
we're,
probably
talking
about
seven
or
eight
and
there's
somewhat
of
an
extension
of
the
icu
or
the
er
again
we're
talking
about
patients
that
perhaps
are
on
a
on
ventilators,
though
a
ground
one
may
also
do
ventilators,
but
it's
those
that
are
more
equipped
to
take
them
on
a
normal
basis.
Pre-Acute
patients
class
four
again
we're
talking
about
seven
services
and
those
are
restricted
to
the
confines
of
an
area
and
a
good.
The
best
example.
E
So
you
think
about
who
we're
talking
about
may
be
the
bluegrass
army
depot,
so
at
the
bluegrass
army
depot
they've
got
their
own
annual
service.
They
stay
on
the
on
on
the
depot
they'll
respond
to
calls
on
the
depot,
but
the
only
time
they'll
ever
leave
the
depot
besides
transporting
a
patient
is
maybe
madison
county
has
has
to
use
them
for
mutual
aid
response,
but
they're
again
we're
looking
at
seven
services
and
it's
pretty
isolated.
E
Just
for
your
later
viewing,
there
are
the
rest
of
the
classes,
which
include
aeromedicals
and
a
special
event
type
license
that
we
issue
as
we
look
at
the
service
models
in
the
state.
The
vast
majority
majority
of
them
are
our
community
non-profit
non-fire.
That
would
be
your
your
county
ambulance
service
or
ran
by
a
board
in
a
county.
We
have
54
services,
they're
affiliated
in
some
way:
they're
they're,
a
transport
ambulance
service,
but
they're
affiliated
with
fire
departments,
22
services
that
are
affiliated
with
a
hospital.
E
The
hospital
runs
the
ambulance
service
through
the
through
an
agreement
or
through
having
the
license
themselves
and
that
those
should
not
be
confused
with
the
type
threes
that
we
were
talking
about
before.
There
are
some
hospitals
that
in
fact
run
the
service,
and
then
we
have
56
private
non-hospital
and
that
number
may
be
a.
I
think
that
number
is
a
bit
deceiving.
E
So
when
we
think
about
lexington,
there's
two
class
one
services
in
lexington
in
the
louisville
area,
there
are
several
and,
as
we
look
in
the
northern
kentucky,
I
think
it's
31
services,
I
think
they're
just
in
the
three
counties,
but
when
you
get
outside
of
that,
most
counties
can
only
support
a
single
agency.
Most
of
those,
as
we
saw
earlier,
are
county
county
or
municipal
based.
E
E
During
peak
hours,
some
counties
will
only
have
one
ambulance
in
service
because
that's
all
they
can
afford
or
that's
all
they
can,
staff
and
or
all
the
local
market
will
hold
or
support.
So,
if,
if
that
ambulance
goes
out,
they
rely
on
call
teams,
they
will
call
staff
back
or
rely
on
mutual
aid
from
a
county.
That's
next
to
them.
E
Mutual
aid
required
is
quite
common.
I
spoke
to
someone
on
the
phone
just
this
morning
talking
about
a
mutual
aid
situation
they'd
had
two
days
ago,
but
that's
not
isolated
at
all.
There
are
counties
that
are
probably
utilizing,
or
at
least
will
say
putting
on
standby,
maybe
not
using
the
mutual
aid,
but
at
least
raising
the
the
the
ready
flag
on
a
daily
basis.
E
And
I
think
it's
important
to
remember
that
ems
is
not
a
legislative
essential
all
right.
So
if
the
county
determines
that
they're
not
going
to
run
an
ambulance
service
or
a
city
determines
they're
not
going
to
run
an
ambulance
service
or
if
one
of
the
private
services
that
are
operating
in
a
county
decides
that
they
don't.
They
don't
want
to
operate
today.
E
Speaking
of
so,
we've
spoke
a
bit
of
als
and
bls,
and
when
we
talk
about
bls
we're
talking
about
our
our
emts
that
you
will
see
in
later
numbers
and
the
emts
manage
basic
airway
at
a
basic
level.
They're.
They
you
utilize
an
automated
defibrillator.
They
splint
immobilize,
stop
the
bleeding,
and
there
is
there's
a
limited
range
of
medications
that
they
can
give
some
epinephrine
for,
like
anaphylaxis
or
and
some
breathing
treatments.
E
But
it's
a
relatively
small
scope
of
medication
that
they
give
the
advanced
life
support,
that's
more
when
we're
typically
talking
about
our
paramedics
and
they
can
provide
both
basic
and
advanced
life.
Sport
obviously
not
restricted
but
advanced
airway
when
we
think
about
the
innovation,
cardiac,
monitoring
and
intervention
so
with
that
they
have
the
ability
to
recognize
the
rhythms,
treat
their
rhythms
and
they
have
a
really
wide
range
of
emergency
medications
that
they
can
give
to
tree
conditions
and-
and
that's
really
underselling
underselling,
both
the
basic
and
advanced.
E
Of
course
the
advanced
does
much
more
it's.
You
know
we
think
of
anything
from
a
a
surgical
crike
to
decompressing
a
chest,
so
I'm
really
selling
them
short
there.
But
it's
it's
broad.
What
the
als
can
do:
regional,
wise
for
for
inspection
purposes,
only
we've
copied
the
kentucky
health
departments
and
in
their
regions,
but
it's
really
just
for
regional.
E
Only
as
we
pull
data,
we
have
the
ability
to
to
pull
down
on
certain
counties
or
spots
we're
trying
to
get
data,
but
we
really
don't
use
it's
a
state
abroad,
and
sometimes
I
think
we
need
to
remember
that.
Whatever's
going
on
in
pikeville
are
the
same
regulations
that
are
going
on
in
paducah
and
the
same
that
are
going
on
in
covington
and
for
the
most
part,
it's
a
one
size
fit
all.
Once
the
regulations
are
applied
and
we're
pretty
diverse
state.
E
E
Fyi
they're
about
two
two
to
three
years
out
in
ordering
some
ambulances
right
now,
because
supply
obtained
chain
issues.
So
again
I
have
the
luxury:
it's
a
pleasure
to
go
around
talk
to
agencies
on
a
daily
basis.
You
know
so
we'd
love
to
replace
this
truck,
but
we're
we're
18
months
and
we're
getting
a
demo
or
we're
doing
this
and
we're
going
to
remount
this
truck.
So
your
fleet
across
the
state,
I
would
say,
is
a
bit
more
aged
than
than
your
providers
would
prefer,
but
they're
no
different
than
anyone
else.
E
So,
as
you
can
see,
the
majority
of
our
agencies
are
a
level
three
ti
and
and
also
the
ability
to
do
continuing
ed.
So
each
of
those
are
somewhat
self-explanatory,
but
they
go
up
as
to
the
level
that
you
can
teach
or
that
you
can
teach
within
your
facility
within
your
your
license
and
each
of
those
are
licensed
on
their
own.
So,
for
example,
if
you
talk
about
the
frankfurt
fire
and
ems
they
are,
they
have
a
license
to
operate
their
annual
service.
They
have
a
second
license
more
so
to
keep
track
of
them.
E
As
we
look
at
their
tei
most,
everyone
wants
to
be
able
to
especially
do
their
continued
continuing
education
and
those
are
licensed
and
they're
reviewed
every
two
year.
They
have
a
list
of
equipment
that
that
they
must
have
to
be
the
tei
and
and
a
few
other
processes.
They
must
go
through
for
2021
to
give
you
some
insight
as
to
what
the
the
teis
were
doing.
E
I
would
like
to
go
on
that
just
a
bit
again
to
provide
you
some
of
the
insight
when
I'm
out
and
talking
to
especially
on
the
emt
courses.
It's
not
the
number
of
emt
courses
that
I
that
the
providers
are
telling
me.
Perhaps
you
or
something
else,
the
providers
for
me
on
the
emt
courses.
They
can't
get
people
to
fill
the
classes,
they'll
put
a
class
together
and
they're
paying
for
the
class.
E
As
we
go
down
down
the
line,
the
I'll
skip
to
the
paramedic
initial
courses,
there
were
14
initial
paramedic
courses
in
the
state
and,
as
we
were
speaking
earlier
today,
we're
going
to
put
that
number
someplace
around,
probably
about
120
paramedics
that
we
turn
out
each
year
give
or
take
10
or
so
so,
each
county.
If
we
were
to
break
that
out,
gets
a
gets
one.
E
This
is
probably,
I
think
more.
What
most
of
you
want
to
see,
and
this
is
the
location
of
the
paramedic.
Now
the
thumb
tabs
are
different
colors,
but
that's
because
they
have
the
ability
to
teach
multiple
level
of
classes,
but
when
you,
each
of
those
would
represent
a
paramedic
program
or
or
that
has
the
ability
to
teach
a
paramedic
program.
E
I
would
also
like
to
add-
I
don't
think,
there's
a
slight.
There
may
be
a
slide,
but
just
in
case
when
you
talk
about
those
paramedic
programs
to
complete
a
paramedic
program,
you're
talking
someplace
around
1500
hours,
it's
about
750
hours
of
classroom
along
the
way,
there's
about
250
hours
of
clinicals
that
the
student
goes
to.
E
E
They'll
do
about
250
hours
of
that,
while
in
the
the
class
once
completing
the
class
they'll
do
a
ride
time
or
internship,
whichever
term
you,
and
so
that's
about
another
500
hours
that
the
student
will
take
and
in
doing
so
it's
not
just
the
500
hours
there
are.
You
know,
they'll
have
to
see
so
many
and
do
so
many
procedures
and
see
so
many
types
of
patients.
It
may
be
that
they
have
to
have.
E
E
That
doesn't
mean
an
emt,
maybe
couldn't
train
on
basic
airway,
but
you
have
to
be
trained
in
the
subject
that
you're
that
you're
teaching,
if
you're
part
of
a
teaching
institute
for
like
a
level
four
you're,
looking
at
a
class
of
about
40
hours
for
adult
education
to
be
able
to
to
teach
those.
So
I
may
be
a
paramedic,
but
I
can't
just
go
in
and
start
teaching
today
in
in
a
ti.
E
I
have
to
make
sure
that
I've
had
training
in
adult
education,
be
able
to
do
my
presentation
and
be
able
to
formulate
the
class
get
together
a
lesson
plan
and
such
but
for
ce,
continuing
education
hours.
That's
a
bit
different.
That
can
be
if
I've
become
an
instructor
in
advanced,
cardiac
life
sport.
If
I'm
a
state
fire
rescue
instructor,
then
I
can
do
continuing
education,
but
I
can't
be
necessarily
a
part
of
the
tei
to
teach
a
paramedic
class.
E
After
doing
so,
if
the
student
comes
along
under
that
way
of
being
an
instructor,
they'll
have
to
have
five
teach
back
classes
that
they're
with
other
instructors
to
make
sure
that
they're
they're
qualified
to
be
an
instructor
kind
of
much
like
the
ride
time
or
internship
that
we
talked
about
earlier.
There's
that
sort
of
internship
they
have
to
instruct
four
hours
in
a
two-year
renewal
period,
so
once
they
achieve
that,
it's
relatively
easy
to
keep
that.
E
Let's
see
I
want
to
go
one
slide
forward,
then
we'll
go
back
a
slide.
I
think.
What's
really
important,
though,
is
we
look
at
those
numbers?
Compare
them
next
to
one
another,
so
we
have
9
300
emts
that
we've
licensed
in
the
state
of
kentucky,
as
as
of
the
data
sometime
this
week.
Having
said
that,
when
we
pulled
the
same
emts
to
see
how
many
of
them
were
affiliated
with
services,
we
only
have
about
3
600
people
in
the
workforce
or
they're
they're
affiliated
with
someone.
E
So
we've
got
6
000
people
that
have
chose
to
get
either
not
work
in
this
line
of
work
move
on
to
something
else.
I
can't
tell
you
why
they're
not
there
for
sure
I
can
take,
tell
you
that
they're
not
the
same
being
true.
When
we
look
at
the
paramedics
again,
it
sounds
like
a
much
better
number
at
4
200,
but
there's
2857
that
that
are
somewhat
affiliated
in
the
state,
and
I
would
tell
you
that
most
of
many
of
those
are
on
two
or
three
different
rosters.
E
E
Okay,
because
they
they
have
the
resources
they
they've
taken
the
time
kudos
to
them
for
developing
a
system
that
they're
able
to
put
that
many
paramedics
through,
but
here's
what
that
does
to
the
numbers?
It's
not
hard
to
remember
now,
there's
2500
people
that
are
not
serving
left
to
serve
the
rest.
Take
in
your
louisville
area.
Take
in
your
your
northern
kentucky
area
that
this
triangle
kind
of
in
between
and
it's
not
uncommon,
I'm
going
to
fall
back.
E
We
can
check
facts
if
we
need
to,
but
it's
not
uncommon
for
me
to
go
south
central
kentucky
and
they
have
one
or
two
paramedics
on
the
roster
in
fact
spoke
to
someone
in
this
room
earlier.
They're
working
36
hour
shifts
just
to
make
the
schedule
work
and
it
gets
the
further
you
get
from
this
region.
C
E
Going
back
one
slide,
I
think
this
will
show
you
a
trend
as
to
the
somewhat
to
the
certifications
over
the
for
each
of
the
agencies
over
the
how
we're
licensing
over
the
last
few
years
there
was
a
bump
in
2020
and
that
can
be
as
part
of
the
emergency
orders.
During
the
it
was
easier
for
someone
that
maybe
gave
up
their
paramedic
or
their
emt
to
come
back.
E
Unfortunately,
I
think
I'm
seeing
I
can't.
I
don't
have
the
data
today
to
tell
you
that,
it's
for
sure,
but
I
think
I'm
seeing
as
you'll
see
we
had
that
bump.
So
we
had
those
licenses
go
back
up,
but
many
of
those
folks
got
it
back
almost
as
a
novelty
per
reason
and
never
really
went
back
into
the
workforce.
There
were
some,
but
many
seems
to
be
the
case.
E
A
And
that's
very
much
appreciated,
mr
salon.
We
we
know
you're
only
been
there
for
a
couple
days.
I
know,
but
you're
you're
familiar
with
the
you
know,
with
the
profession
and
so
forth.
So
I
know
it
was
hard,
but
we'd
sincerely
appreciate
pulling
a
number
of
these
numbers
and
I
and
being
somewhat
of
a
data
geek.
I
would.
I
would
like
to
request
something
from
you.
A
You
provide
a
lot
of
good
information
in
various
categories
and
so
forth
and
help
me
to
help
me
out
and
comes
back
from
my
crazy
business
background.
Can
you
provide
a
matrix
that
will
have
the
service
the
class
number
of
providers
in
the
region,
as
well
as
where,
when
I
say
region
where
the
education
centers
are
as
well
as
where
the
providers
are
that
will
give?
A
A
It's
just
a
workforce
standpoint,
those
sorts
of
things
sort
of
go
through
my
mind.
So
if
you
have
a
matrix,
I
can
get
a
pretty
good
picture
of
how
things
shake
out
in
terms
of
in
terms
of
the
commonwealth.
So
I
know
it
might
take
a
little
bit
of
time.
It
won't
be
an
easy
task.
Putting
some
matrices
and
spreadsheets
together
is
not
easy,
but
I
think
it'll
really
give
a
good
picture
of
where
things
are.
A
So
I
would
appreciate
that,
if
you
could
do
that,
you
you
mentioned
in
one
of
your
slides.
I
think
it's
on
30,
which
sort
of
struck
me,
and
that
was
the
where
the
the
providers,
my
understanding,
if
I'm
looking
this
correctly
33
percent,
are
working
even
though
you
have
90
or
9
300
that
actually
are
licensed.
A
That's
that's
a
pretty
low
workforce,
given
that
licensing
out
there
now
paramedics
is
around
66
percent.
It
looks
like
to
me:
that's
the
best,
that's
good!
Can
you
can
you
explain?
You
know
why?
Why
that
why
that
dynamic
is
there?
I
know
you
said
that
you
can't
get
people
to
fill
in
to
the
into
these
positions,
but
the
fee
people
are
there,
are
they
even
cause
of
pay?
Is
it
the
conditions?
Could
you
expand.
E
On
that
a
little
bit
well,
what
I
think
what
I
would
expand
on
would
be
somewhat
hearsay
and
simply
by
talking
to
to
the
services,
can
I
give
you
hardcore?
Can
I
give
you
an
answer
that
I
can
go
back
and
hang
my
hat
on
and
say
this
is
my
opinion.
What
I
see
I
can
do
that,
but
you
know
that
when
I
talk
to
providers
or
services,
I
don't
think
ems
has
probably
ever
been
a
harder
job.
E
E
I
could
probably
be
on
board
in
a
week
or
two
or
three
days
when
I
started
the
onboarding
process
is
long
people
tell
me
they
have
our
time
that
a
recruit
a
potential
recruit
may
come
in
today
and
say
I'm
really
interested
in
this
job.
But
if
they
walk
out
that
door
they
lose
them
that
person
doesn't
follow
through,
and
so
those
recruitment
efforts
aren't
quite
as
strong
as
they
are
in
it.
Unfortunately,
perhaps
there's
a
process,
they
go
through
the
pay.
I'm
sorry
and
I.
A
Want
to
put
words
in
your
mouth,
mr
sloan
is:
are
you?
Are
you
referring
to
more
of
a
bureaucracy
process?
You
know
the
heart
is
there
by
the
individual
who
wants
to
serve,
but
once
they
go
through
that?
Well,
we
gotta
fill
out
this.
We
gotta
fill
out
that
didn't
have
the
dynamics
between
the
different
facilities.
I'm
trying
to
I'm
just
trying
to.
E
I
don't
think
that's
I.
I
think
that
many
of
the
providers
think
quite
frankly
and
when
you
look
at
the
many
of
the
services.
Rather
when
you
look
at
the
pay,
that's
offered
the
the
benefits
that
are
offered
that
many
of
the
employees
they're
trying
to
recruit
aren't
the
employees
that
follow
through
they're
willing
to
put
in
perhaps
the
week
of.
E
I
don't
think
that
perhaps
that's
too
much,
not
that's
too
much
red
tape,
but
they
just
simply
don't
follow
through
it's
pretty
astounding
the
number
of
people
that
go
through
an
emt
class
that
never
tests
for
boards
or
never
never
go
to
the
they'll,
go
through
the
entire
class,
it's
120
or
so
hours.
They
never
even
take
the
test,
and
so
I
don't
know
if
it's
that
part
of
the
workforce
that
it's
applying,
but
I
think
it
goes
much
broader.
I
think
you've
got
to
look
at
it's
a
hard
job.
A
E
Absolutely
paramedic
is
that
is
that
the
question
you're
asking
yes,
sir:
oh
I
mean
it
was
paramedic
and
it
was
paramedic.
Five
years
ago
I
mean
it's,
it's
gotten
worse,
unfortunately,
the
the
of
no
fault,
but
the
emergency
regulations
really
somewhat
hit
the
provider
problem
that
we
were
able
to
skirt
around
them
a
bit,
but
recently
in
regulations.
For
example,
there
there's
change
in
regulation
that
will
allow,
before
you
had
to
have
25
percent,
if
you're
an
als
service
25.
E
E
A
E
A
B
E
B
Like
you
said,
folks
are
starting
at
paramedic
at
14
an
hour
and
a
lot
of
services.
If
you
could
see
those
average
pay
rates
across
the
bands,
I
think
that
would
open
a
lot
of
eyes,
because
I
think
people
assume
that
the
pay
rates
are
much
higher
than
what
they
are
and
if
we
could
get
that
information
out
there
and
do
a
statewide
survey
of
that.
I
think
that
would
be
helpful.
Yes,
with
regard
to
that,
the
other
thing-
and
it's
really
probably
more
specific-
to
license
the
class
one
licenses.
B
B
A
B
And
then
I'd
like
to
say,
I
really
appreciate
you
showing
the
the
affiliation
versus
the
licensing
number,
because
that's
something
that
many
of
us
have
talked
about
leading
up
to
this
task
force
and
in
the
prior
year,
as
we
were
working
on
all
the
different
legislation,
because
we
we've
kept
hearing
over
and
over
again
that
we
have
more
licensed
emts
and
more
licensed
paramedics
than
we
ever
have.
But
folks
have
been
wondering
how
many
of
those
people
are
actually
affiliated
with
the
service
and
working
in
the
field.
B
E
B
B
We
didn't
have
a
national
registry
test
requirement
for
years
and
years,
and
then
that
became
a
requirement
for
the
emt
program
and
I
just
wonder
what
the
effect
of
that
is
based
on
pass
fail,
folks
who
can
get
out
of
an
emt
class
and
then
just
can't
pass
that
national
registry
exam
sure,
because
at
the
end
of
the
day
in
this
field,
it's
not
about
what
you
can
pass
on
a
test.
It's
what
you
can
do
in
the
field
when
you're
trying
to
serve
that
patient.
E
D
Thank
you,
mr
chair
and
director
sloan.
Thanks
for
the
information,
the
slot
and
the
slides
and
and
what
you've
put
together
your
staff
put
together.
This
is
exactly
what
we
needed
to
start
the
conversation.
So
thank
you
very
much
for
what
you've
provided
us
here
today
following
representative
meredith's
question,
very
briefly,
I'm
going
to
run
through
a
series
of
questions.
If
I
could,
mr
sir,
what's
the
throttle
on
the
pay
question,
what
what's
the
payer
mix,
private
insurance,
medicare
medicaid
other?
What
what's
the
payer
mix.
E
D
D
D
E
Yes,
there,
so
it's
provided
as
part
of
the
data
sharing
that
as
as
a
so
each
month
or
actually
it's
less
than
each
month,
but
as
run
is
completed,
it's
synchronized
and
it
comes
up
and
it
it
enters
into
a
data
sharing.
There's
a
whole
lot
of
good
terms.
For
that.
I
can't
tell
you,
but
yes
we're
able
to
pull
those
numbers
out
and
tell
you
what
the
average
response
time
is
and
the
number
of
runs
per
break.
Those
runs
down
the
metrics,
pretty
pretty
good.
D
E
Role
is
null
in
the
c-o-m
processor.
All
you
do
is
you,
you
know
if
you're,
if
you're
applying
for
a
license
today
and
you
bring
me
a
c-o-n,
and
I
see
the
c-o-n
and
it
says
for
franklin
county,
I'm
going
to
issue
a
license
for
franklin
county
once
you
meet
all
the
all
of
once.
You've
shown
me
that
you've
got
equipment,
personnel
and
you've
met
those.
I'm
going
to
issue
a
license.
Okay,.
D
As
far
as
the
the
link
between
the
cabinet
issuing
the
c-o-n
and
or
renewing
the
c-o-n
and
k-beam's
collecting
information,
is
there
data
share
between
the
two
and
my
questions
along
these
lines?
If,
if
a
region
is
underserved,
I
would
think
the
quality
metrics
that
you
collect
would
be
an
indicator
in
an
underserved
region.
E
I
think
that
would
be
best
answered
by
the
oig
if
the
information,
so
no
to
my
knowledge
again,
I
want
to
give
the
the
carve
out
here
that
I've
been
doing
this
for
a
brief
time
in
this
role
and
but
most
as
I
understand
it,
on
the
cnon
process.
If
someone
were
to
oppose
the
c-o-n,
they
could
come
get
that
data,
but
there's
not
to
my
knowledge,
there's
no
sharing
of
information
without
a
request,
so
it
would
be
available
if
requested,
but
there's
no
interface.
D
D
D
E
If,
if
they're,
if
they
were
to
come
to
mutual
aid
or
or
do
something
like
that,
then
that
license
would
be
good
if
you
were
on
the
kentucky
tennessee
line.
But
if
I
were
in
nashville
tennessee
today
and
I
wanted
to
go
work
in
lexington
kentucky,
I
would
have
to
obtain
a
kentucky
license
to
work
for
a
kentucky
licensed
service.
D
E
Well,
I
think
really
the
not
so
much
of
what
I
said,
but
what
I'm
getting
ready
to
say
is
that
there's
an
openness
to
to
enter
this
process
with
an
open
mind
and
and
be
willing
to
work
on
the
problems
and
identify
the
problems.
But
I
guess
coming
from
it
is
that
you're
at
least
interested
enough
to
to
drill
down
on
the
information
and
figure
out
where
the
problems
are
as
opposed
to
maybe
your
hometown,
but
looking
at
it
across
the
entire
state
that
I
think
that
you
recognize.
This
is
a
very
broad
problem.
A
You
thank
you
chair.
Thank
you
senator
gibbons.
I
want
to
just
follow
up
on
his
line
of
questioning
and
we
got
two
more
questions
beginning
to
shift
gears
to
our
next
presenter
when
it
comes
to
co
win
and
the
notice
you
mentioned
in
your
presentation
that
there's
really
you
just
get
a
notice
of
somebody's
going
to
stop
providing
service.
A
E
C
E
F
Thank
you,
mr
chairman,
mr
sloan,
and
these
are
this
might
be
directed
or
this
is
direct
towards
you
and
maybe
our
staff.
These
are
some
suggestions.
Listen
to
the
presentation
and
the
questioning
you
know
workforce
is
our
overall
issue
that
could,
if
we
could
better
our
workforce
and
get
more
boots
on
the
ground,
so
to
speak.
We
can
solve
quite
a
few
of
these
problems,
but
I
think
some
data
that
would
be
very
useful
for
this
task
force
as
we
move
forward
in
regards
to
the
workforce
and
do
you
all
have
any?
F
But
one
of
the
things
the
committee
needs
to
probably
look
at
as
we
continue.
These
discussions
over
the
months
is
in
our
rural
areas.
In
in
our
really
underserved
areas,
we
might
have
to
figure
out
a
way
to
maybe
come
up
with
an
idea
to
get
some
funding
out
there
to
where
these
rural
areas
that
are
really
struggling
to
give
them
some
help
to
to
make
a
better
benefits
package.
E
I
would
agree
that
you
that
you're
right
on
the
funding
I
mean,
I
think,
that's
really
important
important-
that
the
funding
is
or
reimbursement
right,
so
be
really
clear.
This
people
do
really
good
job,
but
they
they
are
restricted
to
the
this
kind
of
way.
Insurance
works
right.
You
send
them
a
bill
for
whatever
you
want.
They
send
you
what
they
want
you
to
have
well.
F
E
Ahead,
go
the
first
yeah.
Let
me
let
me
answer
so
I
don't
think
that
I
think
you're
right
that'd
be
really
helpful
to
have
and
really
important
to
have,
and
it's
is
key
to
moving
some
of
this
forward.
I
don't
think
k
beams
is
the
agency
to
pull
that
data.
We
simply
that
that's
a
pretty
large
undertaking
and
we
don't
have
the
staff
or
the
or
at
this
time
to
do
so
and.
C
F
The
other
you
mentioned
reimbursement,
the
other
thing
or
the
other
data,
I
think,
would
be
very
helpful
for
the
committee
is
if
we
could
get
a
comparison
or
a
or
a
survey
or
some
data
that
reflects
what
agencies
do
hard
billing
versus
what
agencies
do
soft
billing
and
maybe
get
a
presentation
to
the
committee.
That
explains
the
difference
between
the
two,
because
that
has
a
bearing
on
some
agencies
have
and-
and
it's
really
it's-
it's
really
a
balancing
act,
because
I
know
some
agencies
have
done
hard.
F
E
I
think
that
we
could
put
together
a
with
this
task
force,
put
together
a
survey
and
certainly
use
our
our
mailing
process
to
put
that
out.
What
do
I
know
that
we
would
get
in
return?
I'm
not
certain,
but
I
think,
if
in
good
faith-
and
I
think
that
this
committee
is
in
good
faith,
that
if
services
saw
that
there
was
maybe
some
help
coming,
then
that
would
be
the
carrot
to
to
increase
participation
in
the
survey.
F
E
D
Had
to
beg
the
chairman
for
one
more
and
I
apologize
for
that
in
listening
to
your
presentation,
you
said
your
tone
indicated
something
a
little
insightful
on
the
service
region
slide.
You
were
talking
about
inspections
and
the
process
that
k
beams
does
for
inspections,
and
I
sensed
in
your
statement
and
I
wrote
it
down
related
to
regulations.
You
said
one
size
fits
all
for
a
pretty
diverse
state.
D
E
E
So
yes,
I
do
think
that
as
we
look
at,
I
don't
have
specific,
but
I
think
a
one
size
fit
all
sometimes
may
be
the
only
choice,
but
it
certainly
makes
it
tougher.
You
know
if,
like
one
agency
may
have
the
ability
to
have
20
ambulances,
all
20
of
them
have
to
be
stocked
to
the
same
level
that
an
agency
that
only
has
two
and
even
though
they
only
maybe
use
10
at
a
time.
But
that's
the
way
the
regulations
are
currently
written.
A
A
Okay,
thank
you.
Thank
you
very
much.
I'd
like
to
have
the
inspector
general
mather
come
up.
Thank
you
very
much
for
being
patient
and
I
want
to
let
let
him
know
that
we
appreciate
his
involvement
toward
the
at
the
end
of
house.
Bill
77
provide
lab,
viable
insight
on
what's
going
on
the
cabinet
and
with
that
sir,
if
you
don't
mind,
go
ahead
and
induce
yourself
and
pre,
please
proceed.
A
A
G
77
will
remain
in
effect,
subject
for
formal
review,
and
so
basically,
what
that
means
is,
if
you're,
a
new
ambulance
service
wanting
to
come
into
the
state
you're
still
going
to
have
to
go
through
that
formal
review
process
like
the
typical
level,
one
ambulance
service
or,
if
you're,
an
existing
service
within
the
state.
And
you
want
a
new
catchment
area,
you
would
still
go
through
that
formal
process
and
then
the
exemptions
777
retains
the
current
con
exemption
for
city-owned
ambulance
services
that
provide
transportation
in
co-terminus
city
outside
of
its
service
area.
G
If
the
governing
body
of
the
co-terminus
city
enters
into
the
agreement
with
city-owned
ambulance
providers,
what
that
means
in
layman's
terms
is
like
for
let's
take
louisville,
for
example,
representative
fleming.
So
all
those
hurts
born
in
all
those
little
areas.
They
count
in
that
area,
and
so
you
would
that
allows
them
to
stay
within
that
catchment
area.
G
I
think
I
miss
and
there's
no
sunset
provision
on
that.
Existing
exemption
and
then
house
bill
777
creates
a
new
co
exemption
for
hospital
owned
ambulances,
services
that
provide
non-emergency
or
emergency
transport
originally
originating
from
the
hospital,
and
so
that
would
be
hospital
hospital
transfers
as
well
as
non-emergency
transfers
from
the
hospital,
and
that
that
provision
does
sunset
on
7-1
of
2026
and
then
it
allows
hospital-owned
ambulance
services,
exemption
from
c-o-n
in
accordance
with
krs
216b
0.020,
subsection
7.
G
The
city
or
county
government
has
conducted
a
public
hearing
to
demonstrate
that
an
imperative
need
exists
to
provide
emergency
transport
with
its
within
its
jurisdictional
boundaries,
and
the
city
or
county
will
directly
provide
emergency
transport
within
its
jurisdictional
boundaries
or
enter
into
a
contract
with
a
hospital
located
within
its
jurisdiction
or
in
an
adjacent
county.
If
there
is
no
hospital
in
this
county
and
that
sun
sets
as
well
on
71
2026.
2026,
I
think
the
provision
is
that
we
have
to
once
they
notify
our
office.
G
Non-Stop
non-substantive
review
status
granted
by
krs
sunsets
on
7
1
2026..
The
exception
is,
I
think,
eddie
mentioned
it.
The
industrial
ambulances
like
corning,
I
think,
had
one
they're,
I
think
11
or
so
in
the
state
and
then
the
related
regulations.
So
the
state
health
plan,
obviously
which
kind
of
gives
us
our
guidance
for
what
is
required
in
con
and
not
in
con,
and
then
the
certificate
in
need.
Non-Sub
review
criteria
was
amended
as
well
to
align
with
house
bill
777.
A
Yeah,
the
more
you
get
the
more
you
get
into
it.
Sometimes
you
get
a
little
more
confused,
but
then
again
I
appreciate
you
going
through
and
give
a
little
more
definition
understanding
how
the
process
works.
It
provides
a
little
more
clarity
and
I
guess
it's
just
more
of
a
because
speaking
of
clarity.
Ems
jurisdiction
is
that
defined
in
coin,
or
I.
D
D
Your
second
bullet
indicates
rather
clearly
the
applicant
bears
the
burden
of
showing
that
the
proposed
health
service
meets
all
five
review
criteria
established
by
statute,
including
consistency
with
the
state
health
plan.
As
a
cabinet.
It
does.
Does
this
process
of
con
fall
to
you,
the
inspector
general?
Who
does
it
fall
to.
D
G
D
G
Batching
cycles
and
all
this
stuff
sure
so
someone
puts
in
an
application
for
a
c-o-n
goes
to
our
office.
We
will
deem
it
as
complete
once
it's
all
all
criteria
are
met.
We
send
them
that
notification.
Then
it
goes
into
our
newsletter
where
everyone
has
access
to
it.
That's
in
healthcare
and-
and
it's
shown
when
the
batching
cycle
will
be
for
that
when
the
next
batching
cycle
will
be
for
that
particular
con
application.
G
D
D
G
C
D
So
I've
actually
got
that
pulled
up
here
on
my
phone,
real,
quick,
so
2a
is
consistent.
Consistency
with
plans,
2b
is
need
and
accessibility
in
relationships
and
linkages,
cost
economic
feasibility
and
resources,
availability,
quality
of
services,
hospital-based
skilled
nursing,
that's
if
again
a
layperson
here
so
help
me
understand.
Is
there?
Is
there
a
score
sheet
that
someone
sits
down
with
the
hearing
officer
or
someone
and
says
you
scored
this
many
points
here
this
many
here?
How
does
it
work?
How
do
we,
how
do
we
deem
it?
Yes,
redeem
it?
No
so.
G
D
D
Logic
says
it
would
be
good
to
have
that
woven
into
the
conversation
about
c-o-n
and
whether
or
not
adequate
service
is
provided
in
the
area.
Is
that
up
to
the
entity?
That's
that's
making
the
application
to
say.
Look.
We
want
to
show
you
that
that
current
service
is
inadequate
or
how
does
that
work.
A
Any
other
questions
from
the
committee
all
right
inspector
general.
I
just
want
to
follow
up.
Ask
mr
stone
the
the
question
in
terms
of
the
notice:
do
you
know
of
any
re
or
any
process,
or
anything
that
that
occurs
when
a
nurse
is
given
that
somebody
wants
not
to
provide
service,
even
though
they've
gone
through
the
the
c-o-n.
G
So
the
c-o-n
is
the
easiest
way
it
was
explained
to
me
is
it's
kind
of
your
ticket
for
admission,
so
once
we
give
that
c-o-n
we're
kind
of
out
of
that
that
c-o-n
goes
away,
it
then
becomes
once
you
get
admitted.
You
now
have
a
license,
and
so
so
we
don't
have
any,
because
we
don't
oversee
that
licensure
category.
So
we
don't
have
any
knowledge
of
if
they
are
going
out
of
business
or
not.
D
D
C
C
A
G
C
G
It
is
a
it
is
a
very
contentious
topic.
I
will
put
it
that
way:
yeah
we,
we
have
very
talented
people
that
work
in
that
office
and
they
work
very
closely.
I
think
anybody
that
you
talk
to
that
has
put
in
an
application
would
speak
very
highly
of
those
individuals
and
how
helpful
they
are.
I
think
it
you
know,
I
don't
want
perfection
to
be
the
enemy
of
good,
so
it
is
a
system
that
certainly
works
in
the
state
of
kentucky.
A
C
A
Okay,
well,
we
were,
I
guess
we
like,
but
part
of
the
process
would
probably
bring
some
people
in
they'll
have
that
I
guess
the
national
conference
of
state
legislators
or
some
some
association
come
and
provide
that
that
information
that'll
be
helpful.
So
but
good,
is
there
any
other
questions
for
the
task
force?