Critical EMS staffing shortage in Ky. county risks public safety, officials say
An advisory board member for Somerset-Pulaski EMS suggested that the long-term solution is for Pulaski to create a special taxing district
By Carla Slavey
Commonwealth Journal, Somerset, Ky.
SOMERSET, Ky. — Last week, David Sparks sounded out a warning at the Somerset City Council meeting: The personnel problems with Somerset -Pulaski County EMS are getting to be a critical situation.
This Sunday, one of Sparks’ nightmare scenarios almost played out. On a day where the county only had enough people to cover three trucks — with only one of those capable of providing advanced life support — all three crews were on jobs when four other calls came in.
And one of those four was also in need of an advanced crew, Sparks said.
Pulaski ended up having to call surrounding counties for requests for mutual aid, with Wayne County and Lincoln County personnel responding.
The Lincoln County crew ended up taking their patient to the Lake Cumberland Regional Hospital, where the patient had to be flown out to a Lexington hospital, Sparks said.
Sparks is a board member for the Somerset-Pulaski EMS Advisory Board and has recently started leading the charge in asking City Council and Fiscal Court to work together to alleviate the county’s EMS personnel shortage.
At the meeting, Sparks said they were 11 people down. As of this week, he was saying the county was 12 down.
Among those who were working to fill up the three crews Pulaski had on Sunday, Sparks said that a couple of people working were firefighters working overtime.
“So, we didn’t even have all our own personnel on those trucks,” he said.
Even worse, one of the calls for help that came in was a person in the Bronston area who was experiencing seizure activity. The EMS crew that responded didn’t have a paramedic on board, and, therefore, no one qualified to give the patient the medication they required.
Sparks said that off-duty paramedic, Robert Mounce, heard the call on the radio and raced to the scene to administer the medication. It took him only six minutes to get there, but that was six minutes after the ambulance had arrived.
“That’s a lot of lost time,” Sparks said, “especially when you have a patient like that in seizure activity.”
He also noted that it was commendable that the off-duty personnel responded.
Both Sparks and Somerset-Pulaski EMS Chief Steve Eubank said it’s not unheard of for the county to request aid from surrounding EMS departments.
“We call occasionally, but not very often,” Eubank said. “Probably four or five times a year. So to have to call multiple counties in one day, yeah that is quite a bit.”
“Yesterday [Sunday] was an unusually busy run day,” Sparks added. “But nevertheless, we need to be prepared for that.”
The problem didn’t pop up overnight, they said.
“This has been ongoing for years. This didn’t just happen,” Sparks said, adding that EMS employees had contacted Somerset Mayor Alan Keck back in 2021 about having a shortage of manpower in the department.
Eubank said, “It was a bit of a problem prior to COVID, and COVID sped everything up on it. There were some educational programs that we shut down during COVID, which is going to cause a gap. And then one of the more difficult parts of the paramedic process is you spend time working in hospitals, and they had to shut that down for a little while.”
There are other reasons for the staffing shortage, too, Eubank said.
“There’s a lot of causes for it. It’s a difficult job. There’s a lot of stress dealing with the trauma that we see. It’s hard, and the pay is less than what you would make in the hospital.”
Current statistics indicate that the number of paramedics statewide who are retiring or leaving the profession are not being replaced at the same rate, Eubank said. And this isn’t just a state problem. There is a nationwide shortage of EMS professionals, he said.
He agreed with Sparks that the Pulaski situation was getting to a critical point.
Sparks had said at the City Council meeting that there were days in which there were only two crews available.
This Sunday, there were initially three, with Eubank saying a fourth was added during the day.
Sparks said, “We’ve got seven trucks that are fully stocked, but we don’t have the personnel a lot of time.”
“We know with our numbers that three-four trucks is not enough to cover this county with this large of a population. We look at seven trucks, is where we’d like to be. With that, we can generally handle most everything that comes in. and we track the runs that have to wait because there’s not a unit available,” Eubank said.
So what is the solution? Sparks said that the long-term solution is for Pulaski to create a special taxing district, an idea that, he said, when he presented it to Fiscal Court, “went down like a lead balloon.”
“I feel like it would help some,” Eubank said. “Anytime you’re talking about an additional tax — I realize it’s a struggle right now to survive — and so to put more of that on the taxpayers is a difficult decision to make. But we also need to make sure they have ambulance coverage. Most all EMS in Kentucky are affected. The ones that have taxing districts seem to be doing a little better.”
There is a trade off as well. Both Sparks and Eubank pointed out that by initializing a tax to fund EMS, the actual rates one would pay for calling an ambulance would go down.
“When you have an ambulance taxing district — I hate to use the word but that’s what it is — it’s almost like a subscription service, because your runs are very cheap compared to what they are now, because you’re drawing that tax base money in,” Sparks said.
Eubank said that many taxing districts are set up to reduce rates. “That would be something that I would push for if we move that direction,” Eubank said. “You can set a provision in there to decrease or eliminate the balance billing, so you bill the insurance and then the remainder is written off because you pay taxes in this county. There is some legalities with that, as far deductibles and copays. Some of those you can’t really wave. But we would have to get into the legal [aspects] on that if that was something that moved forward.”
To create that tax district, Sparks said it would require a petition that 25% of the county’s voters signed. Then, Fiscal Court would have to pass it.
Sparks said he thinks that one out of the five magistrates would approve it, but it would be “a hard sell” to the other four.
That taxing district would have to go through the county, because the EMS department serves the entirety of Pulaski .
Sparks estimated that Pulaski government pays $1.3 million a year to fund the department, while the City of Somerset pays $720,000.
If correct, that would mean the city is providing around 33% of the funding.
At the previous City Council meeting, Mayor Keck noted that the city only makes up around 20% of the county’s population, which he used as one of the reasons that the county needed to assist more.
While discussing these numbers, Sparks put forward an equally surprising number: Around 51% of EMS’s runs are within the Somerset limits.
That’s not to say that all of the calls are for Somerset residents. As Eubank pointed out, “We’ve got the hospital here, we’ve got three nursing homes, and several assisted living facilities, and so although those runs originate in the city of Somerset , it’s not city taxpaying citizens. It’s residents who have moved from their homes in Science Hill or Burnside [or other areas], either short-term or long-term care. They’re still considered a county resident.”
Sparks also noted that many wrecks take place on roads that have been annexed into the city over the past decade due to corridor annexation. City roads include stretches like East Ky. 80 out to the Ky. 461 industrial park.
In the short term, the best attempt at fixing the problem is to raise pay, Sparks Eubank said. That is something that Somerset government, the entity in charge of funding EMS paycheck, has been trying to do.
The city has given some raises in the past year, and has also implemented an educational incentive. Late on Monday evening, word reached the Commonwealth Journal that more solutions could be forthcoming.
And for those who might be looking towards a career as an EMT or a paramedic, the field nationwide is one that could be easy to get into.
“There is a certification process, we offer those classes,” Eubank said, with classes being held at Somerset Community College , Eastern Kentucky University , and the Lexington -area EMTKY.
But even with the staffing shortage affecting the number of runs EMS personnel can deal with at a time, Chief Eubank said the men and women in his department were working as much as they can to keep Pulaski safe.
“Just know that the people who are here making runs, they are very serving people, and they are working hard. They’re extremely tired, but we’re getting it done.”
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