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From YouTube: Emergency Medical Services Task Force (10-18-22)
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A
D
A
Present
next
item
of
business
approval
of
September
minutes
chair
will
entertain
a
motion
for
approval
of
the
minutes.
Second,
second,
all
in
favor
say
aye
aye,
he
opposed
the
eyes.
Have
it
record
will
reflect
at
the
September
minutes
have
been
approved
co-chair?
Would
you
have
any
opening
remarks
you
wish
to
make?
Thank
you.
Vanessa
members,
please
be
advised
we're
moving
rapidly
toward
conclusion.
These
throw
task
forces
are
time
limited
and
we
will
rapidly
be
moving
toward
that
November
meeting
when
we
wish
to
adopt
some
recommendations
so
be
on
the
lookout
for
thoughts.
A
So
please,
when
you
get
an
email
from
staff
over
the
course
of
the
next
few
weeks
with
a
preview
and
a
draft
of
what
recommendations
might
start
to
look
like
I
would
ask
that
you
open
that
email
don't
be
like
me
and
leave
it
in
the
pile
of
emails
that
go
unopened
open,
that
email
spend
some
time
with
it,
be
prepared
to
come
back
and
be
expeditious
and
productive.
At
the
next
meeting,
I
also
want
to
alert
members.
A
There
are
three
documents
in
your
committee
packet
related
to
the
cabinet's
response
to
questions
from
that
September
meeting
appreciate
the
cabinet
providing
those
responses.
Those
are
built
around
questions
that
that
we
had
in
the
course
of
the
meeting
and
responses
to
those
questions.
So
please
review
those,
including
one
that
that
we
had
asked
and
felt
like.
This
would
be
the
case
the
last
time
that
reimbursement
rates
were
changed
and
regulation
was
in
2008.
A
But
what
my
notes
indicate
here,
there's
also
a
conversation
about
if
treatment
in
place
could
be
a
Medicaid
coverage
service
and
ask
about
the
cabinet's
willingness
to
come
back
next
month
and
discuss
that
and
I
think
that's
where
we're
going
to
open
up
today,
if
I'm
not
mistaken,
so,
commissioner
Lee,
if
you'll
come
to
the
table,
we
would
start
there.
A
F
We'll
give
it
a
try,
but
thank
you
for
inviting
me
back
to
discuss
this
very
important
information,
an
issue
that
impacts
Medicaid
members
I
want
to
start
with
a
little
bit
of
level
setting
with
the
Medicaid
Program
just
at
a
glance.
What
Medicaid
is
what
we
do.
Of
course
we
are
a
joint
program.
We're
federally
funded
and
state
funded
in
general
federal
funds
provide
about
70
percent
of
the
funding
for
the
Medicaid
Program.
We
currently
cover
approximately
1.6
million
members.
F
We
do
cover
over
half
of
Kentucky's
children.
In
our
medicator
chip
program.
We
have
approximately
625
000
individuals
covered
in
our
expansion
program
and
one
million
individuals
in
our
non.
In
our
traditional
Medicaid
Program.
We
have
over
60
000
enrolled
providers.
We
do
have
six
Managed
Care
organizations
that
provide
services
to
approximately
90
percent
of
our
population
in
state
fiscal
year
2022
we
had
a
14.8
billion
dollar
budget
and
we
had
a
78.5
million
dollars
in
capitation
payments
for
non-emergency
transportation
and
I
know.
This
is
about
emergency
medical
transportation,
but
I.
F
Think
as
we
have
this
conversation,
we
need
to
see
how
we
can
better
collaborate
with
our
emergency
medical
providers
and
our
non-emergency
transportation.
Based
on
some
of
the
conversation
that
I
heard
at
the
last
task
force
meeting.
This
is
just
a
map
showing
you
where
our
Medicaid
members
are.
F
The
counties
colored
in
Orange
is
the
highest
concentration
of
Medicaid
members,
and
you
can
see
that
as
we
move
from
the
East
to
the
West,
the
concentration
of
Medicaid
members
drops
slightest
and
basic
life
support
our
Emergency
Services,
currently
ambulance
services
are
covered
to
and
from
a
hospital
emergency
room
example.
The
waiver
that
the
other
state
had
was
specific
to
Suds
specific
to
individuals
with
substance,
use
disorder
treatment
and
they
could
limit
that
that
group
of
individuals,
because
it
was
an
1115
waiver.
We
also
cannot
waive
the
choice
of
providers.
F
We
are
in
any
willing
provider
State
all
providers
that
can
deliver.
That
service
would
be
allowed
to
deliver,
carve
that
out
and
11
15
research
and
demonstration
project.
It
requests
to
bypass
certain
federal
Medicaid
requirements
so,
for
example,
the
substance
use
disorder
is
a
really
good
example.
If
we
wanted
to
create
some
sort
of
a
waiver
specific
to
the
substance
use
disorder,
we
would
carve
that
population
out
or
any
population
that
we
wanted
to
has
to
be
budget
neutral.
F
So
what
would
a
waiver
look
like
I?
Think?
That's
the
question.
Center
Givens
that
you
asked
we
would
have
to
Define
what
we
would
want
to
waive.
For
example,
would
we
want
to
do
some
pilot
programs
and
specific
Geographic
areas
when
we
want
to
do
something
in
an
urban
area
versus
a
rural
area
or
one
in
each?
We
would
have
to
define
the
specific
providers,
for
example
in
our
1915b
waiver.
We
waive
that
freedom
of
choice
and
the
members
have
to
go
to
the
providers
who
participate
in
that
waiver.
F
We
would
also
have
to
define
the
population
such
as
the
sud
in
West
Virginia,
for
example,
and
we
would
also
have
to
develop
budget
neutrality
and
Reporting
requirements
so
going
on
to
the
next
steps,
if
we're
directed
to
cover
treat
without
transport,
we
should
enter
into
conversations
with
CMS.
We
would
create
a
spa
or
a
waiver
and,
as
noted
in
Indiana
treatment
without
transport
could
be
accomplished
through
a
state
plan
Amendment,
which
is
a
little
bit
simpler
than
an
1115
waiver.
F
If
we
wanted
to
explore
the
treat
triage
and
transport,
we
would
most
likely
have
to
explore
an
1115
waiver,
because
we
would
ask
to
waive
the
location
to
which
those
emergency
providers
could
transport
an
individual.
So,
for
example,
if
we
wanted
to
allow
the
treat
triage
and
transport
to
a
an
urgent
care
center
or
a
physician's
office,
that
would
require
a
waiver,
because
that
service,
providing
being
provided
by
an
emergency
transportation
provider
is
no
longer
an
emergency
when
it
is
transported
to
a
physician's
office
or
an
urgent
care.
F
So
that's
where
the
waiver
would
come
in,
we
would
also
have
to
amend
Transportation
regulations
based
on
Indiana's
experience,
thus
far.
We
would
anticipate
the
need
for
additional
funding.
We
have
guessed
at
approximately
5
million
or
we've
anticipated
5
million,
based
on
Indiana's
experience.
Of
course,
Kentucky's
experience
is
going
to
be
completely
different
than
Indiana's,
but
that's
the
information
that
we
had
to
go
on.
A
Well
done
truly,
thank
you
for
your
your
commitment
to
this
conversation.
Thank
you
for
your
willingness
to
engage
in
it
in
your
next.
The
last
slide
next
steps.
You
started
with
the
statement.
If
directed
to
cover
your
statement,
if
directed
to
cover
indicates
you
would
prefer
the
legislative
body
in
coordination
with
you,
provide
you
direction
to
cover
these
services
or
or
are
there
other,
or
we
must
provide
you
that
direction.
I
presume
you
tell
me.
F
I
think
that
we
can
continue
to
explore
all
these
Opera
all
of
the
the
logistics
of
it.
I
again
would
like
to
stay
in
conversation
with
this
committee.
Sometimes
legislation
if
we
draft
a
specific
legislation,
sometimes
it
ties
our
hands
and
we
can't
be
as
flexible,
but
we
do
want
to
maintain
flexibility
and
would
definitely
continue
to
work
with
this
committee
as
we
move
forward
to
to
formally
formulate
a
plan
since.
F
A
Your
preference
would
be
through
a
state
plan,
Amendment
from
what
I
heard
you
say
because
of
the
flexibility
there
or
you
really
would
like
you.
Would
you
like
to
say
that
today,
based
on
what
you
know,
your
desire
is
a
state
plan
Amendment,
but
you
reserve
the
right
to
go
another
route.
Tell
me
again
what
you're
thinking.
F
A
state
plan
amendment
is
a
little
bit
simpler.
We
pretty
much
tell
CMS
what
we
would
like
to
do.
They
have
90
days
to
review
that
state
plan
Amendment
and
get
back
with
us,
sometimes
depending
on
the
questions
that
they
have
to
ask.
It
can
take
a
little
bit
of
a
time,
but
once
a
state
plan
amendment
is
in
place,
it's
easier
to
administer
because
it
we
don't
have
to
do
the
reporting.
F
We
don't
have
to
renew
it
every
five
years
and
the,
but
it
would
be
for
treat
without
transport
if
we
wanted
to
explore
tree
triage
and
transport
to
a
different
location,
that
would
be
an
11
15
waiver,
so
simply
covering
treatment
without
transport
would
be
simpler
through
estate
plan
Amendment.
F
It's
based
on
Indiana's
state
plan
amendment
that
they
have
related
to
treat
and
not
transport
and
again
we.
You
know
that
5
million
would
not
be
immediately
up
front
over
a
period
of
time.
We
would.
We
would
anticipate
those
costs
to
continue
to
increase
at
some
point
until
they
leveled
out
so.
A
A
F
The
5
million
would
just
be
how,
when
we
pay
the
Managed
Care
organizations,
we
do
pay
them
a
capitated
payment,
we
pay
them
a
per
member
per
month.
Those
rates
have
to
be
actuarially
sound
and
when
we
add
services
to
their
contract.
Naturally
it's
going
to
cost
services
to
go
up
at
first,
so
I
think
that
would
have
saved
the
Managed
Care
organizations
I'm,
not
sure
about
that
would
have
to
just
monitor.
My
biggest
concern
is,
what's
best
for
the
member
the
Medicaid
Program
was
created
for
the
Medicaid
member.
A
F
A
G
Takes
two
to
tango
for
sure
chairman
committee:
thank
you
all
for
your
commitment
last
session
and
to
all
stakeholders
creating
the
task
force
that
gives
all
of
us
the
chance
away
from
the
hustle
and
bustle
of
a
session
to
try
to
dig
deeper
into
what
is
without
a
question
a
very
complex
Matrix
of
the
provision
of
and
the
need
for
this
vital
service
and
what
Solutions
this
whole
group
can
move
forward.
G
We
look
forward
to
continue
working
with
every
stakeholder
to
ensure
the
highest
level
of
service
for
all
kentuckians
public
safety
is
the
top
priority
for
every
level
of
government
and
counties
are
certainly
on
those
front
lines.
Today,
we
will
share
a
very
brief
overview
of
the
numbers
on
EMS
and
the
models
currently
in
place
to
provide
Ambulance
Service
in
every
County
in
Kentucky.
G
As
you
can
see
on
the
slide,
we
have
broken
this
down
based
on
the
best
numbers
that
that
we
could
find
the
data
that
is
out
there,
there's
about
six
different
categories
that
we've
been
able
to
lump
these
Services
into
based
on
County,
and
so
that
first
section
that
you
see
the
county
operated
where
the
county
owns
and
operates
the
service
out
of
the
county
general
fund
dollars
from
Recruitment
and
Retention
of
employees
and
providing
benefits
to
purchasing
and
maintaining
equipment
and
keeping
pace,
of
course,
with
all
required
training.
G
G
The
third
you'll
see
on
there
is
a
joint
City
County
system,
where
the
Fiscal
Court
and
the
city,
commission,
or
cities
operate
and
fund
that
service.
The
next
one
is
a
regional
you
heard
from
that.
Last
month
there
there
is
one
Regional
from
Barron
and
Metcalf
that
operate
in
the
state
where
two
or
more
counties
operate
the
the
Unified
Service,
whatever
that
that
unification
consists
of
the
fifth
one
is
where
the
county
contracts
with
another
entity
to
provide
service.
G
It
includes
those
counties
who
work
with
either
a
private
company,
a
hospital,
another
County
or
a
city
to
provide
that
service
and
the
county
contributes
tax
dollars
and
to
pay
for
that
service.
The
last
one
is
that
another
entity
completely
and
fully
operates
in
funds
where
a
third
party
again
Hospital
a
city,
a
county,
operates
and
funds
that
service.
So,
as
you
can
see,
there's
really
not
a
comprehensive
answer
when
it
comes
to
solutions
that
will
have
one
solution
that
will
fit
all
120
counties.
G
Some
counties
have
attempted
to
contract
with
private
entities
in
the
past,
but
companies
are
not
in
the
business
of
losing
money,
and
everything
associated
with
this
service
is
very
expensive.
When
a
private
company
pulls
out
of
a
county.
Those
citizens
expect
the
Fiscal
Court
to
find
a
solution
to
that.
G
One
of
the
overarching
challenges
assigned
to
this
task
force
in
the
legislation
and
affecting
all
Employers
in
Kentucky
and
Beyond
was
to
look
at
strategies
for
Recruitment
and
Retention,
and
that
is
certainly
an
across-the-board
urgency
for
all
of
these
services.
To
that
point,
you
can
see
on
that
next
slide.
With
the
again
with
the
data
we
were
able
to
find
the
number
of
EMTs
and
paramedics
working
in
EMS,
Services
versus
other
employment.
G
We
were
not
able
to
deduce
where
those
other
folks
are
employed
if
they're
still
in
that
field
or
not,
but
they
are
licensed
and
ideas
discussed
at
September's
meeting
like
the
treatment
in
place
that
was
just
discussed
or
the
treat
no
transport,
an
overdue
increase
in
the
Medicaid
reimbursement
rate
and
and
other
waivers
like
the
9-1-1
being
approved
as
a
certified
public
expenditure,
as
the
co-chair
so
eloquently
described
last
month
as
being
very
interested
in
that
topic
are
certainly
worth
further
scrutiny
by
all
the
stakeholders
involved.
G
E
Thank
you
Shelley
chairman
Givens,
chairman
Fleming
and
committee
members.
Thank
you.
I
really
appreciate
the
opportunity
to
be
here
and
give
you
just
a
a
really
brief
glimpse
into
the
life
of
rural
EMS
and
what
it
means
in
a
rural
community
as
Jim
Henderson
would
say
and
I
guess,
what's
kind
of
become
our
unadopted
motto.
E
I
guess
is
once
you've
seen
one
County
you've
seen
one
County
we're
all
very
different,
and
not
only
from
geographical
and
Landscape,
but
from
physical
means
and
as
Shelley
pointed
out
in
that
previous
slide,
there
are
counties
like
Owen
County,
which
fund
their
EMS
service
solely
from
their
general
fund
dollars.
While
there
are
a
few
that
have
contracts
with
private
services
and
then
the
remainder,
of
course,
are
funded
through
a
taxing
district.
That's
sole
purpose
as
to
is
to
raise
money
to
or
to
collect
taxes
for
funding
AMS.
E
So
when
we
talk
about
EMS
in
a
rural
community,
it's
important
to
to
get
this
in
your
mind
that
there
are
40
counties
or
40
plus
counties
in
the
state
that
do
not
have
a
hospital.
E
When
you
look
at
it
from
that
perspective,
it
just
gives
you
an
overarching
view
of
what
we
face
in
the
rural
communities
and
so
in
Owen
County,
we're
30
minutes
away
from
our
closest
hospital
and,
as
you
probably
know,
and
and
some
of
the
far-reaching
rural
areas
in
the
state,
those
those
transport
towns
can
be
even
further
than
that,
some
some
double.
So
it's
very
important,
of
course,
you've
heard
from
every
group.
E
We
have
all
agreed
that
that,
in
order
to
retain
and
recruit
workers
we
have
to,
we
have
to
be
able
to
provide
a
living
wage,
and,
in
my
county
in
particular,
we're
a
rural
County
surrounded
by
urban
areas.
Like
all
counties,
we
constantly
face
an
uphill
battle:
I'm,
recruiting
attention
Workforce
when
competing
with
higher
wages
and
benefits
that
are
able
to
be
provided
by
Urban
counties
and,
in
many
cases,
different
Health
Care
sectors.
E
Since
I've
been
since
I
was
elected
in
2015
we've
more
than
doubled,
our
average
salary
wage
for
EMS.
Unfortunately,
the
Staffing
shortages
is
is
more
critical
today
than
than
ever
before,
even
with
those
increases
and
those
adventure
to
say
that
those
increases
are
similar
Statewide.
E
My
point
in
saying
this
is
just
the
shed
light
that
we
talk.
A
lot
about
reimbursement
rates
and
funding.
Expanded
revenues
alone
is
not
a
one-size-fits-all
solution.
It's
pretty
evident
so
additional
Solutions
just
to
touch
on
briefly
things
that
we're
doing
for
the
sake
of
time.
I'll
keep
it
very
brief,
but
I'd
love
to
have
the
opportunity
to
discuss
further.
E
Yes
in
Allen
County,
we
operate
our
own
public
transit
system
and,
in
some
cases,
they're
able
to
defer
a
potential
ambulance
transports
and
thereby
relieving
some
stress
on
our
EMS
system,
while
providing
those
needed
transports
at
70
percent,
less
the
cost.
In
many
cases
with
Kentucky's,
robust
public
transit
system.
A
few
tweaks
could
allow
for
even
more
use
and
expansion
of
that
service
and
help
EMS
services
and
provide
the
service
to
our
constituents
even
greater.
E
Additionally,
we've
heard
that
several
counties
across
the
state
are
needing
are
they're
thinking
about
the
way
it
used
to
be
when
we
had
localized
training.
We
talked.
We've
talked
a
little
bit
about
that,
so
the
what
the
way
that
EMS
or
the
way
paramedic
classes
are
designed
today,
it's
more
urbanized
and
it
is
very
cumbersome
for
folks
in
the
rural
community.
E
So
I
just
ask
that
when
we
discuss
Solutions,
whether
with
what
comes
from
this
committee
or
in
potential
legislation,
they
would
just
look
toward
a
variety
of
solutions
to
be
additional
tools
to
providing
the
best
emergency
service
possible
for
our
constituents.
Your
constituents
and
all
kentuckians.
B
Thank
you,
chairman,
Givens
and,
and
the
committee
for
allowing
us
to
be
here
today.
I
wanted
to
just
share
with
you.
As
I
stated
earlier,
I
was
one
of
the
newer
appointed
members
of
the
k-beams
board
and
I
wanted
to
make
sure
that
when
I
represent
our
problems
to
the
k-beams
board,
that
I
had
a
representation
from
other
counties.
B
Now,
I'm
fortunate
in
one
way
that
I
have
a
hospital
located
in
our
County,
but
it's
also
not
necessarily
a
blessing,
because
when
the
shortage
of
paramedics
and
the
shortage
of
ambulances
we
ended
up,
do
we
ended
up
doing
a
lot
of
transports
for
the
surrounding
counties
so
for
a
population
of
25
000
folks
we're
doing
about
5
000
runs
a
year
roughly
a
thousand
of
those
are
transports,
but
to
get
back
on
point
of
the
eight
folks
that
the
eight
counties
that
was
represented
there,
there
were
Ms
directors,
there
were
Emergency,
Services,
CEOs
or
chairmans
of
their
boards.
B
Also
we
had
the
hospital
CEO
there
with
us,
and
you
know
we
had
a
two-hour
discussion
and
I
like
to
say
that
at
the
end
of
that
two
hours,
I
could
come
today
and
give
you
the
Magic
Bullet,
but
we
didn't
find
it
in
our
meeting
at
all.
What
we
did
come
down
to
is
we
all
agreed
on
was
Manpower
and
how
do
you
attract
and
how
do
you
recruit
and
I
know
you've
heard
this
over
and
over?
How
do
you
get
these
folks
to
be
able
to
do
this?
B
We
get
a
lot
of
the
transports
and
it's
not
because
the
other
counties
are
shredding
off
their
duties.
They
don't
have
the
people
to
do
it.
They
don't
have
the
number
of
ambulances
to
do
it.
Some
of
those
ambulance,
some
of
those
counties
there's
one
ambulance
up
a
day.
So
if
they
come
to
round
County
to
transport,
a
person
to
a
higher
level
of
care
and
those
transports
are
getting
farther
and
farther
away
used
to
when
you
transported
you
transported
normally
from
Moorhead,
you
would
transport
to
UK.
B
Now
we're
going
to
Columbus
we're
going
to
Cincinnati,
so
you're
essentially
tying
up
an
ALS
crew
for
a
number
of
hours,
but
it
comes
down
to
Manpower.
So
for
us
and
I
think
that's
one
thing
we
came
away
with
from
that
meeting
in
those
eight
counties
there
and
I.
Think
I
can
certainly
speak
for
those
eight
counties.
That
Manpower
is
the
issue,
and
how
do
we
solve
that?
And
all
these
other
things
without
a
doubt
has
got
to
be
worked
on
part
of
it
is
the
Medicare
the
reimbursement
and
all
of
those
things.
B
You
know
you
can't
continue
to
operate
these
ambulances
at
the
cost
that
this
cost
us
to
operate
without
some
type
of
reimbursement.
So
that's
I
just
wanted
to
share
that
with
you
that
that
I
sit
here
and
I
represent
the
eight
counties
in
my
area
and
I
think
you
know
we're
we're,
certainly
United
we're
willing
to
help
and
we're
willing
to
come
up
with
ideals
or
please
bounce
your
ideals
off
of
us,
because
we're
actually
in
the
trenches
have
to
do
this.
B
C
Thank
you,
Mr
chairman.
This
is
for
all
three
of
you,
because,
especially
you
judge
that
just
had
the
meeting
with
your
eight
surrounding
counties
when
you
all
met
I
mean
we
everybody
sitting
here
knows
that
the
level
pay
in
money
is
definitely
the
disparaging
salaries
is
one
of
the
issues
with
the
Manpower,
but
do
you
all
and
the
people
you've
talked
to
and
been
communicating
with?
C
B
Did
that
was
one
of
the
topics
actually
was
how
to
get
certification.
You
know
back
some
time
ago.
You
could
get
certified
without
and-
and
it
was
before
my
time
but
I-
don't
think
it
was
an
accredited
course
that
you
had
to
go
through
a
two-year
course.
B
You
could
get
certified
with
with
some
probably
a
lot
of
on-the-job,
training
or
some
other
education
in
the
field
and
be
able
to
do
that
training,
but
without
a
doubt
if
we
could
find
a
better
way
to
pipeline
or
more
recruitment
tools
or
some
other
way
to
do
that,
absolutely
we
it
would.
It
would
help
us
tremendously
if
we
could
work
a
way
out
to
get
more
Personnel
in
the
room.
I'd
say
with
the
88
County,
sir,
some
of
them
it
wasn't
a
matter
of
money.
B
It
was
actually
just
a
matter
of
finding
the
bodies
I
mean
in
round
County.
I
would
hire
paramedics
tomorrow.
If
you
know
of
any,
we
just
don't
have
them,
and
it's
not
it's
not
an
issue
of
money.
Maybe
we're
not
paying
paying
us
quite
as
much
but
but
we're
very
comfortable
on
our
on
our
wages.
C
Can't
find
them
one
quick
follow-up,
just
when
you're
looking
when
we're
looking
at
certified
licensed
personnel.
Are
you
having
harder
and
I
realize
paramedics
at
the
top
of
the
of
the
scale
because
of
their
Advanced
Training
and
what
they
perform
in
the
field?
C
But
are
you
having
as
much
trouble
finding
EMTs
BLS
and
advanced
EMTs
as
your
paramedics,
or
is
it
about
the
same
I'm
just
trying
to
get
I
know
in
the
areas
where
I
live
and
where
I've
worked,
what
it
is
but
I'm
trying
to
get
a
feel
what
it
might
be
like
in
like
Eastern
Kentucky,
where
you're
from
is?
Are
we
having
as
much
trouble
getting
EMTs
or
is
it
mainly
paramedics
or
a
combination
of
both
certain.
B
Our
area,
it's
both
it's
just
a
matter
of
getting
either
one
of
them.
We
it's
kind
of
odd.
In
our
in
our
arrangement.
We
share
paramedics
and
EMTs.
You
know
we
share
those
with
probably
five
surrounding
counties,
so
they'll
work
for
us,
one
24-hour
shift
and
take
our
time
off
and
then
they'll
go
to
another
County
and
work.
So
is
the
same
as
EMTs,
so
we're
so
critical
when,
when
one
of
my
EMTs
gets
sick,
they're,
probably
going
to
affect
Three
Counties,
three
County
shifts
around
us
and
that's
just
how
difficult
it
is.
B
E
The
question
if
if
I
could
just
just
to
add
when
we
talk
about
the
TR,
the
availability
of
training,
you
know
this.
The
shortage
has
been
building
for
many
years
and
it's
evident
from
the
numbers
that
you
were
supplied
by
k-beams
and
their
follow-up
presentation
so
that
when
it
as
far
back
as
2018,
where
they
only
graduated
or
certified
just
over
a
hundred
about
20
percent
of
those
were
Lexington.
E
So
that
only
leaves
about
80
folks
and
then
for
120
counties
and
hospitals
that
utilize
them
with
inside
there
for
a
while
as
well.
So
the
lack
of
training
provided
by
kctacs
when
the
program
became
accredited
is
what
is
built
to
this
point.
E
Advanced
EMTs
are
about
four
dollars
less
than
that.
Emts
are
about
four
dollars
less
than
that,
so
graduating
scale.
C
E
E
We're
Treading
Water
because
we're
not
the
only
ones
raising
salaries.
You
know
we're
a
non-hazard
system
generally
funded,
so
we're
competing
with
Northern
Kentucky
Louisville
Lexington
I'm
speaking
for
Owen
County,
of
course,
mostly
Hazard
Duty
systems,
fire
department
based
systems
with
many
more
resources
and
financial
offerings
than
we
have
and
to
judge
Clark's
Point
earlier
the
the
employee
base
is
regionalized,
so
we
just
really
are
just
kind
of
sharing
folks,
the
the
the
pool
just
keeps
getting
drier
and
drier
and
drier.
H
Thank
you,
Coach
Givens,
I,
just
want
to
judge
us.
I
want
to
get
good
clarification.
What
you
said.
You
said
that
I
can't
I
can't
remember
the
exact
phrase,
but
you
know
each
county
is
unique.
That's
what
I
took
away
from
it
and
I
know.
The
K
beans
have
made
a
presentation,
look
at
Regional
type
of
approach
in
terms
of
providing
certification,
hopefully
awareness
and
so
forth.
H
But
I
got
an
impression
that
you
don't
think
that
might
not
work.
I,
don't
put
words
in
your
mouth,
but
or
you
think
it
would
work
and
I
just
maybe
I'm
missing
I'm
missing
I'm
missing
something
I.
E
Think
there's
opportunities
there.
Okay!
Yes,
you
know
when
you
look
at
Baron
Metcalf,
that's
a
regional,
that's
certified
as
or
classified
I
should
say
as
a
regional
system,
but
really
it's
just
a
cost
share
Regional
system.
They
don't
share
Manpower
resources.
So
it's
not
a
true
Regional
system
in
the
sense
of
what
I've
been
discussing
with
my
colleagues,
for
instance,
I
have
one
County
that
has
a
hospital
judge,
Clark
and
I
talked
about
this
earlier,
so
in
in
that
county,
their
paramedics
and
EMTs
run
when
they
work
a
24-hour
shift.
E
They're
on
the
road
for
24
hours
in
my
County
they
might
work
a
24-hour
shift
and
we
may
not
have
a
call.
We
had
three
days
two
weeks
ago
that
we
did
not
have
a
call
and
then,
when
it
started,
we
had
four
within
an
hour
and
a
half.
So
that's
just
the
way.
Emergencies
go
right.
So
my
sense,
in
my
conversation
with
my
colleagues,
has
been
more
from
a
resource
sharing
than
anything
so
that
we
could
maybe
filter
our
employees
since
we're
all
sharing
resources.
E
Anyway,
we're
you
know
we're
trading
off
Medics
and
EMTs
for
for
different.
For
the
different
days,
so
maybe
we
rotate
those
folks
through,
so
they
work
a
24-hour
shift
and
run
for
24
hours
and
they
could
come
to
a
county
where
we
don't
do
inter-facility
transports
and
and
have
some
downtime
potentially.
So,
when
I
talk
to
my
colleagues
about
a
regional
system,
I'm
looking
at
it
more
from
a
holistic
sharing
right.
E
H
So
when
you
bring
somebody
on
board,
whatever
the
pay
scale,
where
are
they
coming
from
local
or.
E
H
E
No,
we
have,
we
have.
E
Actually,
two
years
ago
started
doing
mailers.
Just
like
you
do
a
campaign
mailer.
We
did
Help
Records
request
for
K
beams
for
addresses
of
certified
Personnel
within
our
region
and
and
did
mailer.
So
we've
done
mailers,
we've
done
email,
blasts,
social
media
campaigns,
the
same
thing
that
our
neighbors
are
doing.
H
Yeah
well
Mr
co-chair
I'm
just
going
to
make
another
statement.
I
had
a
meeting
yesterday
with
the
CEO
Council
and
I
also
had
a
meeting
with
Kentucky
Hospital
Association
yesterday
and
obviously
the
workforce
and
Health
Care
is
is
very
short
and
we
all
realize
that.
But
we
need
to
basically
and
that's
why
I'm
speaking
for
myself
and
anybody
else,
but
we
just
quit
identifying
the
problem,
because
we
know
what
the
problem
is.
H
We
got
to
start
peeling
back
what
the
solution
is
and
part
of
the
process
that
I'm
seeing
is
awareness
and
I.
Think
and
I
appreciate
you
taking
an
aggressive
approach
of
getting
the
message
out,
say:
hey
we're
higher
and
so
forth,
but
also
we
need
to
look
at
increasing
awareness
of
what
health
care,
how
how
much
there
is
a
need
in
terms
of
getting
workers
into
the
health
care,
because
you're
exactly
right.
H
This
has
been
coming
on
for
several
years
and
also
in
the
pandemic,
basically
blew
up
in
our
face
and,
like
oh,
my
gosh,
we
should
have
like
well,
we
should
have
been
more
proactive
because
there's
a
study
back
in
20,
13,
2014
and
stuff
like
that
that
went
through
and
did
some
of
this
announcement.
This
is
more
on
the
nursing
side,
but
there's
a
there's
a
there's,
a
good
foundation
in
terms
of
trying
to
go
after
this.
H
So
my
question
to
you
all
is
what
opportunities
to
get
more
on
a
Grassroots
granular
level
when
it
comes
to
exposing
what
you
have
the
offer,
what
a
what
a
great
pathway
for
to
be
a
paramedic
or
EMT
in
the
high
school
level,
in
terms
of
mentoring
in
terms
of
internships,
those
sorts
of
things
have
y'all
was
that
in
clutch
judge
Clark
was
that
any
did.
I
enter
your
conversation
at
all
in
terms
of
getting
more
in
a
granular
letter,
because
we
can
look
at
dual
credits.
H
B
Prior
to
covert
sir,
we
we
actually
sent
our
EMS
director,
went
into
the
schools
and
and
worked
with
the
school
system.
They
had
a
very
good
relationship
and
it
was
a
recruiting.
You
know
to
make
folks
aware
of
what
paramedics
did
and
it
was
a
recruiting
tool.
Now
we
hadn't
been
back
since
covered,
but
I
don't
think
you'll
find
it
any
different
than
than
any
other
Workforce.
We
need
I
think
we're
going
to
have
to
go
back
to
the
schools
and
I.
Think
you
make
a
very
good
point.
E
And
that
is
happening
in
our
region.
For
instance,
we
have
a
regional
ATC
so
and
they
are
they're
actually
trying
to
ramp
up
an
EMT
program
so
that
they
would
do
that
in
high
school
and
then
jctcs
is
also
in
that
region
and
they've
started
a
paramedic
class,
the
first
one
there
at
their
new
campus
in
Carroll
County.
So
we
we
have
started
that
Grassroots
effort
in
my
region.
Okay,.
H
Sorry
I
thought
that
was
my
last
comment
a
second
ago
and
now
we're
coming
one
thing
I'd
like
for
this
committee
could
consider
as
well
as
a
Health
and
Family
Services
committee,
as
we
look
for
a
look
at
Workforce
is
the
a
P3,
a
public-private
partnership
that
we
can
go
through
and
do
some
type
of
have
some
type
of
initiative
to
take
private
funds
and
maybe
State
funds
once
again,
that's
another
issue
in
the
budget
and
do
a
match
type
of
approach
to
look
at
those
individuals
that
might
be
interested
and
encourage
them
to
look
at
paramedics
to
look
at
EMTs.
H
Look
at
this!
That's
because
I
tell
you
what,
if
you,
if
you
aren't,
if
we
don't
have
people
there,
you
can't
get
them
Hospital.
You
can't
now
we're
I
mean
which
we
know
right
now.
So
it's
something
I'd
like
for
you
all
to
think
about
and
consider
how
we
can
look
at
this
from
a
different
perspective
from
a
P3
point
of
view,
as
well
as
looking
at
some
type
of
level
in
terms
of
high
school
and
getting
more
exposure
with
that.
But
thank
you
very
much.
H
I
do
appreciate
y'all's
and
I
do
appreciate
y'all's
working
on
777
to
pass
so
so.
Thank
you
very
much.
A
Thank
you
for
the
presentation.
I've
got
a
couple
questions
myself,
if
you'll
flip
to
your
other
slide
that
you
have
in
your
presentation
and
I
feel
confident.
This
is
a
slide
that
kbeans
may
have
brought
to
us
in
one
of
the
early
presentations
as
well,
but
it
still
struck
me
as
I
was
looking
at
it
and
thinking
about
it.
A
G
A
G
A
E
E
So
it's
you
know
it's
you
could
someone
could
easily
say
with
1435
of
them
working
in
hospitals?
That's
not
a
fair
analogy,
but
at
the
same
time
we
don't
know
what
that
number
is.
A
A
If
there's,
if
there
are
some
number
in
that
paramedic
space
that
are
working
in
hospitals,
we'd
like
to
know
the
more
data
we
can
collect
the
more
we
can
get
our
heads
together
and
just
know
where
people
are
working.
That
would
that
would
be
helpful.
Judge,
Clark,
I,
think
that
goes
in
some
ways
to
your
Manpower
question.
A
Judge
Ellis,
I
heard
two
specific
things
from
your
conversation,
the
public
transit
piece
and
then
also
the
localized
training
training
in
the
field
and
the
benefit
potential
benefit
of
being
able
to
do
that.
I
think
those
will
be
some
things
we
address
in
our
final
work
product
as
things
for
us
to
consider
trying
to
help
with
both
the
Manpower
question,
because
the
Manpower
is
the
training
in
the
field.
Localized,
training
piece
that
cost
piece
is
interesting
to
me.
A
E
So
what
we
do
is
it's
you
know:
paramedic
is
charged
with
triaging
a
patient,
so
we
counsel
them
on
the
medical
necessity.
Now,
if
they
want
to
go
to
a
hospital,
we
don't
have
any
choice
but
to
transport
them
to
a
hospital.
But
in
many
cases
just
as
we
talked
about
the
treatment,
no
transport
in
many
cases
we
can
treat
no
transport
or
just
evaluate
them,
triage
them
and
in
many
cases
I,
don't
say
many
cases.
I
don't
have
the
percentage.
E
Maybe
20
I
think
it's
about
20
in
Owen
County
that
probably
don't
meet
the
medical
necessity
for
an
ambulance
and
that
we,
you
know,
make
other
arrangements
for
them.
They
just
need
to
see
a
doctor.
It's
not
emergency.
It's
not
life-threatening.
A
C
It's
not
it's
more
of
a
comment
off
going
off
of
your
question,
one
of
the
things
that
might
be
beneficial
and
I'm,
not
sure.
If
k-beams
could
do
this
or
not
I
know
by
working
in
the
field.
A
lot
of
your
certified
EMTs,
a
lot
of
them
are
police
officers.
Corrections,
Officers,
Camp
counselors,
the
EMT
certification
helps
them
provide
a
level
of
first
aid
and
safety
for
their
organization.
C
So
you're
going
to
find
some
of
the
certified
people
working
for
other
career
pass
and
I
I,
don't
know
if
this
is
even
possible
but
I'm
going
to
throw
it
out
there
since
we're
discussing
things.
If
maybe
when
you
do
the
recertification
process,
it
would
be.
We
couldn't
get
the
information
meatly,
but
maybe
throw
it
out
there
and
ask
them
whether,
if
they're
inactive,
where
they're
currently
employed
or
whether
they're
retired,
because
some
of
the
some
of
the
people
that
are
they're
going
to
retire
but
they'll
maintain
their
licenses
just
okay.
C
So
there
we
want
to
get
back
into
it
and
I'm
kind
of
one
of
them.
People
I've
been
out
of
for
a
while
and
I'm
slowly
getting
back
into
it
because
of
some
of
the
need
for
the
counties
around
me,
but
that
might
be
an
Avenue
to
get
that
data
if
people
recertify
when
they,
when
they
send
in
their
information,
just
ask
them
whether,
if
they're,
if
you're
inactive,
where
are
you
employed
or
are
you
retired
and
out
of
it
or
whatever,.
A
So
I'm
going
to
play
the
roller
connector
now
representative,
Hart
director
Sloan,
both
of
you
know
each
other
post
meeting.
Let's,
let's
have
the
two
of
you
get
together.
If
we
need
legislatively
to
do
anything,
I,
don't
think
we
do.
You
probably
have
authority
to
ask
these
questions
already,
but
get
your
heads
together
after
the
meeting
great
conversation.
Thank
you
all
very
much.
Thank.
A
D
All
right,
thank
you.
I
am
Jim
Musser
I
am
the
senior
vice
president
for
government
relations
and
policy
with
the
Kentucky
Hospital
Association
and
co-chairman
Fleming
co-chairman
Givens.
Thank
you
so
much
for
inviting
us
to
join
you
today.
This
has
really
been
a
great
conversation
that
I've
been
witnessing.
What
I've
got
to
say
to
you
is
probably
going
to
be
a
little
repetitive
of
some
of
the
things
that
you've
already
heard.
D
I'd,
really
like
to
start
out
by
saying
how
happy
I
am
that
we
have
already
been
meeting
with
k-beams
and
how
much
we
appreciate
Mr
Sloan,
the
interim
executive
director
at
the
Kentucky
Board
of
EMS,
because
we've
had
some
some
good
conversations
and
I'm,
anticipating
that
we're
going
distance
that
really
create
some
unnecessary
barriers
to
the
increasing
number
increasing
the
number
of
the
from
getting
the
education
that
we
all
want
them
to
have.
D
D
We
ought
to
be
making
sure
that
we're
not
discouraging
young
people
from
from
these
vital
careers.
We
need
to
be
doing
exactly
the
kinds
of
things
that
your
judge,
Executives
were
talking
about,
doing,
making
sure
that
we're
in
the
high
schools
and
the
hospitals
need
to
do
this
as
well.
We
need
to
make
sure
that
we
have
access
to
the
high
school
students
and,
quite
frankly,
I
would
like
for
it
to
start
at
the
middle
school
level
doing
career
days
and
making
sure
that
they
understand
just
how
important
these
jobs
are.
D
How
exciting
the
jobs
are.
I
mean
you
think
about
you're
saving
people's
lives,
you're
working
as
a
team,
you're,
really
doing
something.
That's
making
a
difference
for
people
and
I
think
that's
very
exciting.
I
can't
imagine
careers.
That
would
be
much
more
rewarding
than
being
the
one
that
says,
nursing
and
and
several
other
partners
to
identify
ways
to
address
these
shortages.
I
think
we
can
do
the
same
thing
on
the
side
with
k-beams
and
are
folks
who
want
to
help
us
to
put
more
paramedics
in
the
field.
Quite
frankly,
more
paramedics
in
the
hospital.
D
Turning
to
Behavioral
Health,
it's
been
such
a
thorny
problem
and
we
would
like
to
suggest
a
minor
change
to
the
way
con
operates,
we're
not
looking
for
rip
it
out
by
the
roots
or
or
some
major
change,
but
we
think
that
we're
Behavioral
Health
is
involved
that
there
can
be
some
tweaks
that
are
made.
That
will
really
benefit
everybody
involved.
D
Patients
would
benefit
if
a
hospital
Ambulance
Service
established
to
transfer
Patients
Out
of
the
facility
under
very
defined
circumstances
could
also
move
patients
in
emergency
departments
waiting
for
transfer
to
another
facility.
It
would
assist
in
meeting
the
behavioral
health.
Patient's
need
and,
quite
frankly,
be
an
efficient
use
of
resources.
As
all
of
you
know,
House
Bill
777
allow
has
a
service.
They
should
be
able
to
pick
up
a
behavioral
health
patient
waiting
in
an
emergency
department
rather
than
just
moving
patients
out
of
the
out
of
the.