This emergency administrative regulation is being promulgated in order to meet an imminent threat to public health, safety, and welfare. Specifically, this emergency amendment is necessary to ensure adequate staffing of ambulances.

Senate Bill 150 (Regular Session 2020) (“SB 150”) granted the Kentucky Board of Emergency Medical Services (the “Board”) the authority to waive or modify certain statutes and regulations related to the EMS profession during the State of Emergency declared by the Governor in Executive Order 2020-215. See SB 150 § 1(13). On or about April 14, 2020, the Board filed an emergency waiver and modification of 202 KAR 7:560 with the Secretary of State. The waiver and modification waived (1) the requirement that paramedics staff at least 25% of Class I and Class IV Advanced Life Support (ALS) ambulances and (2) the requirement that ambulances be driven by emergency medical technicians (EMTs), providing instead that ambulances could be driven by “[a] driver certified in CPR and who has had an emergency vehicle operator’s course”. The Board’s modification and waiver of 202 KAR 7:560 was ratified and approved by the General Assembly until April 14, 2022. See House Joint Resolution 1 (Special Session 2021) § 4(29)(k); Senate Bill 25 (Regular Session 2022) § 4(27)(k).

On March 30, 2022, the Board filed emergency and ordinary amendments to 202 KAR 7:560 to allow emergency medical responders (EMRs) to drive ambulances instead of EMTs. (See Section 1, subsections (1)(a), (2)(a), (3)(a), (4)(a), (5)(a), (6)(a)(1), (7)(a)(1), and (8)(a). Section 1(17) is also stricken because under the March 30, 2022 amendments and these amendments, EMRs may be assigned to drive ambulances instead of EMTs and, therefore, Section 1(17) is no longer necessary.) The amendments also waived the requirement that paramedics staff at least 25% of Class I and Class IV ALS ambulances. Under the March 30, 2022 amendments and these amendments, Class I ALS agencies must instead have a paramedic on-duty at all times and all Class IV ALS ambulances must be staffed with either an Advanced EMT or a paramedic. Modifications to the paramedic staffing requirements are necessary because, due to staffing shortages, it is difficult for some agencies – particularly smaller ones – to ensure that they have enough paramedics on-duty to staff 25% of their ambulances.

At a duly called meeting of the Board on April 14, 2022, Judge/Executive Houston Wells, on behalf of the Kentucky County Judge/Executive Association, requested that the Board extend the provision in the Board’s modification and waiver of 202 KAR 7:560 that allowed individuals who are certified in CPR and have completed an emergency vehicle operator’s course to drive ambulances. This request was approved by the Board. At a duly called special meeting of the Board on April 21, 2022, the Board approved this emergency amendment and its companion ordinary amendment. This emergency amendment differs from the emergency amendment filed on March 30, 2022, in that it allows individuals who are certified in CPR and have completed an emergency vehicle operator’s course to drive ambulances until September 1, 2022, after which ambulance drivers must be certified EMRs (as required under the March 30, 2022 emergency amendment). The modifications to the paramedic minimum staffing requirements for Class I and Class IV ALS agencies remain unchanged from the March 30, 2022 amendments.

Emergency medical services across the Commonwealth continue to experience staffing shortages. Therefore, a temporary extension of ambulances services’ ability to assign drivers who are CPR-certified and have completed an emergency vehicle operator’s course is critical to ensuring that agencies can adequately staff ambulances. This extension is intended to allow time for additional personnel to become certified EMRs by September 1, 2022. Additionally, the removal of the requirement that paramedics staff at least 25% of Class I and Class IV ALS ambulances is necessary to ensure that such agencies can satisfy the minimum ambulance staffing requirements and utilize all available ambulances. However, Class I ALS agencies are required to have at least one (1) paramedic on-duty at all times and all Class IV ALS ambulances must be staffed with either an Advanced EMT or a paramedic.

An ordinary administrative regulation is not sufficient to address current EMS staffing shortages, which pose an imminent threat to public health, safety, and welfare. This emergency amendment is necessary to modify the minimum staffing requirements for ambulances to ensure that agencies can utilize their available ambulances. This emergency administrative regulation will be replaced by an ordinary administrative regulation. The ordinary administrative regulation is not identical to this emergency administrative regulation. EMS staffing shortages are expected to continue and, therefore, under the ordinary administrative regulation, agencies will continue to be permitted to assign EMRs as ambulance drivers and Class I and Class IV ALS agencies will not be required to staff at least 25% of their ambulances with paramedics.