Ky. EMS agencies fight statewide personnel shortage
Emergency calls and the need for EMS providers is growing, especially in rural communities, at the same time counties across Kentucky are reporting shortages
By Jacob Dick
FRANKFORT, Ky. — Emergency calls and the need for emergency medical providers is growing, especially in rural communities, at the same time counties across Kentucky are reporting shortages in certified EMS providers.
With nearly 14,000 licensed providers across the state, according to the Kentucky Board of Emergency Medical Services (KBEMS), the problem may be more complicated than a need for more people in ambulances.
Jamie Hardin, director of Yellow Ambulance Service's Owensboro and Daviess County operations, said his service is currently shorthanded, something he said has been constant during his more than 20 years in the emergency medical field, but he's been noticing something different about this latest staffing issue.
"EMTs used to be everywhere," Hardin said." There were lots of them. As an EMT, you would have a hard time getting onto an ambulance service because everyone was looking for paramedics. Now EMTs and paramedics are in short supply."
Hardin said he wasn't sure if there were more emergency medical professionals than there were when he started, but the competition he faces in hiring EMTs has exploded.
"Hypothetically, there may have been 10,000 EMTs out there, but only ambulance services were hiring them," Hardin said. "Now, if there are 15,000 EMTs, you have ambulances, nursing homes, factories, fire departments and so many other places that are hiring. The state numbers might show a few more, but a lot of people are going to EMT school to work just for one job."
Providers of emergency medicine share some strong similarities across their jobs, but they will be the first to point out not all providers are the same.
There are four basic EMS levels that are mostly separated by education level. The most basic level, emergency medical responders (EMS), requires 50 initial training hours and 17 recertification hours while emergency medical technicians (EMT) require 150 initial training hours and 24 hours of recertification. Paramedics are one of the most highly trained levels with 2,000 hours of initial training hours and 60 hours of recertification hours.
Hardin said his service runs eight trucks at its peak time during the day and answers around 19,000 calls a year, 80 percent of which are within the city limits of Owensboro. He said the service manages with around 100 employees with typically one EMT and one paramedic on each truck, but the call volume and stipulations of Yellow Ambulance's contract with local governments means the service pays out a lot of overtime hours to meet its requirements.
Yellow Ambulance isn't the only service providing emergency medicine in the area. They are also backed up by the Owensboro and Daviess County fire departments, which require all of their firefighters to receive EMT certification before being hired.
Dwane Smeathers, chief of the Daviess County Fire Department, said he thought the community was in a better position than others by having several agencies trained in emergency medicine, but even his department has noticed the shortage.
"About 75 or 80 percent of our runs are medical-related runs," Smeathers said. "We are still cognitive of the shortage. I'm on the paramedic advisory board at (Owensboro Community and Technical College), and we go to conferences across the state where we hear of shortages, especially for paramedics."
Volunteer fire departments also receive training, and Smeathers said Daviess County helps facilitate trainings from simple review to emergency delivery of babies. He said every additional professional is necessary as training requirements become more expensive and extensive while volunteer numbers are dwindling.
"It's been harder to sustain volunteer services across the nation because of what they are asked to do," Smeathers said. "In the next 10 years, I could foresee the need for another paid station in Daviess County."
Smeathers said both county stations can average between 1,500 and 1,800 calls each every month.
Tracking the state's needs and performance in emergency service has been difficult because of the lack of sufficient data, but Michael Poynter, executive director of KBEMS, said that all could change. For the past four of his six years in the position, Poynter has been helping to get a pilot project off the ground that can study emergency medicine throughout the state. That project yielded its first round of data last year.
In his opinion, some trends have already jumped out from last year's data.
"I think with any profession, you look at the financial stability of it," Poynter said. "Some counties are only running two paramedics on a truck, but they can't hire anyone. What it really boils down to is probably salary. I think people are making decisions on where else to go."
Thanks to an attrition survey performed by the KBEMS board in 2017, some of the opinions EMS providers have about their job are finally quantified. The survey asked participants to answer some questions about their beliefs about their jobs and explain why they have or might let their credentials expire.
Retirement accounted for 28 percent of the responses for why people leave the industry, followed by 26 percent saying it wasn't their choice to leave. Fourteen percent said low salary or poor benefits was the reason they left, and another 14 percent said they left simply because they had to relocate their family. Only 1 percent said they left because they simply didn't enjoy the job.
While the majority of the participants didn't give negative reasons for leaving the job, EMS providers currently working had some strong opinions about the personal challenges of their industry. In the survey, 89 percent of EMS professionals that responded said they either agree or strongly agree EMS service is a stressful career. When asked about pay and career advancement, 72 percent said they strongly agreed EMS providers needed more pay, but only 19 percent either agreed or strongly agreed there was advancement opportunities in EMS services.
The report didn't breakdown the gender demographics of the state's EMS providers, but 71.6 percent of the 113 participants were male. The majority were EMTs at 76.1 percent, and 19.5 percent were paramedics.
Along with the pilot project, Poynter said KBEMS has been working on exploring solutions that made ease the job of Kentucky's emergency medical providers. He said the board has worked to expand EMT education opportunities into places like high schools, but future EMTs aren't the only ones who need education. He pointed to a community EMT program in Lexington as a possible solution to decreasing the number of calls emergency services face.
"The community paramedic program comes into play so you fill a gap for people that call EMS just for a ride somewhere," Poynter said. "We also need to educate politicians and decision makers on what we do."
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