Henry County EMS feels nationwide worker shortage at home

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By Taylor Riley

Henry County is reeling from the effects of a nationwide Emergency Management Services employee shortage.

As the rural EMS workforce has decreased, the responsibilities and educational requirements have increased, according to the Rural Health Information Hub.

Limited funding, expanding coverage areas and a cultural shift in volunteerism have caused quite a problem in the rural areas in the nation, including Henry County.

These days, it’s hard to attract qualified people due to low levels of pay and high requirements, according to Judge-Executive John Logan Brent.

EMT v. Paramedic in Henry County
Henry County has both emergency medical technicians (EMT) and paramedics on staff. Thy have five full-time and 30 part time workers.

An EMT requires the completion of the EMT courses and state license. They provide out of hospital emergency medical care and transportation for critical and emergency patients who use EMS, according to the National Registry of Emergency Medical Technicians (NREMT). EMTs have the basic knowledge and skills necessary to stabilize and safely transport patients ranging from non-emergency and routine medical transports to life threatening emergencies.
In Henry County, EMTs start at $11.76 an hour. After one year of employment, they receive $0.40 an hour raise every January, according to Paige Lucas-Jamiel, EMS director.

A paramedic requires an EMT certification and state license and also the paramedic certification. In contrast to the EMT, a paramedic provides advanced emergency medical care for critical and emergency patients who use EMS, according to NREMT.

In Henry County, paramedics start at $15.65 an hour. After one year of employment, they also receive $0.40 an hour raise every January, said Lucas-Jamiel.

“It just doesn’t pay as much as it used to,” Lucas-Jamiel said.

Full and part time employees are required to work 12-hour shifts.

A shortage in the county
With no hospital in the county, EMS workers are required to spend more time with the patient. Sometimes an hour or more if traveling to a Louisville-area hospital.

On any given day, Henry County, at times, has only two ambulances to respond to emergencies.

If both units are taking residents to hospitals out of the county, Mike Hilliard, Henry County Emergency Management Assistant Director said, “in effect, you have no EMS when that happens.”

Rural counties don’t have the same coverage as urban areas. For one thing, “the county hires EMS workers, who get experience, then leave for a bigger county and higher pay,” Hilliard said. “I don’t blame them. You have to feed your families, but it adds to the need.”

In the past year, Henry County EMS has lost a “few” people due to higher pay at other departments or retirement, according to Lucas.

“We can’t compete with (higher pay), because we are rural,” she said.

Those who work for EMS, don’t typically do it for the money, according to Lucas.

“It’s a calling,” Lucas said. “You have to have compassion for people.”

It’s a family-oriented career, the 29-year-old director said. With only 35 people employed, “friends become family.”
Kentucky and nationwide

Brent said Henry County EMS, headed by the Henry County Fiscal Court are having “trouble finding people” to work for them because of the low wages, but they cannot offer any more money than they do already.

EMS is funded by the state, Brent said at the Pleasureville Commission meeting in August. While Henry County EMS was getting $900,000 a year in reimbursement four years ago, it’s only $700,000 in 2018.

“We’ve been pretty close to breaking even in the last five years, but the insurance reimbursement has really changed,” Brent said.

The federal government has been cutting Medicare and Medicaid payments to ambulance services since 1996, according to the Associated Press.

All of Kentucky’s 257 licensed ambulance services deal with inadequate reimbursement of costs not just from private insurance companies but also from Medicaid and Medicare, said Charles O’Neal, deputy executive director of the Kentucky Board of Emergency Medical Services to the AP.
Judge-Executive Brent said when those who don’t have insurance call on an overdose or other emergency, the expense goes to EMS.

O’Neal agreed. The effects of inadequate reimbursement are more noticeable in the most impoverished areas where more patients are unable to pay. That limits the number of employees working for ambulance services, prevents high salaries and makes it difficult to purchase new ambulances and equipment, O’Neal said.
The result is a lean work force - sometimes too lean, said Larry Allen, director of the Kentucky Office of Rural Health. He said local hospitals sometimes have to send registered nurses along on ambulance rides because of a lack of paramedics.

So, what’s next?
At the Henry County Fiscal Court meeting in last week, Henry County Emergency Services was awarded a $5,000 check by Baptist Health La Grange to purchase a new ambulance.

When asked if Baptist Health would take over Henry County like it did in Oldham in 2015, Brent said “no. “

He assured the Local that it wouldn’t happen because the hospital, or anyone looking to manage Henry County EMS, wouldn’t want to take the loss of upwards of $300,000.

The future of recruitment is up in the air, but Judge-Executive Brent is making his rounds to the city council and commission meetings in Henry County to inform the public on the shortage of EMS workers.

Although Lucas couldn’t confirm whether or not EMS would soon be looking for full-time workers, she said they are “always” looking for part time workers.

Tammy Shaw contributed to this report.