Rural ambulance plan in limbo
A compromise plan to address staffing challenges for rural ambulance service was tossed out last week by Kansas lawmakers, leaving in doubt how the Legislature will address the issue.
At issue is a regulatory requirement that ambulances operate with two medically credentialed attendants, which poses challenges for rural services.
"This is a bill that allows ambulances, particularly in rural areas, to move with only one EMT and one certified driver," Rep. Fred Gardner, R-Garnett, said of Senate Bill 384. "Current regulation requires two EMTs. As we all know, rural health care is a problem. We're short of people, and we struggle to keep our hospitals and our emergency medical services properly staffed."
Gardner said the profession has lost workers in the wake of the COVID-19 pandemic. Additionally, services are stressed when ambulances need two EMTs to transfer a patient from a rural hospital to a metro area that can provide more specialized services.
After the League of Kansas Municipalities brought the bill request, legislators largely agreed that addressing the issue was necessary. But the House and Senate took different approaches that will likely have to be negotiated in a conference committee.
The plan favored by the Senate was touted as a compromise with industry professionals. The version favored by the House was derided as "dangerous" by Joseph House, executive director of the Kansas Board of Emergency Medical Services.
"SB 384 is not a policy the state of Kansas wants to enact," House said in written testimony about the version of the bill favored by the House. "It unintentionally enables bad actors, unnecessarily places EMS providers at increased risk, and would prove to be nearly impossible to implement successfully."
He urged lawmakers to support the board's existing variance program, which is relatively new. The compromise language passed by the Senate would have authorized the board to grant permanent variances.
Rep. Stephen Owens, R-Hesston, didn't like the idea of allowing but not requiring the board to grant variances.
"The board of EMS is being empowered to further regulate our EMS departments when what we need now is less regulation," Owens said.
He urged the House to reject the compromise version of the bill. He blamed the problem on the state board and took issue with giving them more power.
"This codifies in statute a tremendous amount of authority in the board of EMS," Owens said. "It's important to understand that this problem exists because of decisions made by the board of EMS. It is a decision by the board of EMS to require two EMTs or higher certifications on ambulances. State statute only requires one."
The version favored by the House would block the state board from requiring an ambulance in a city or county with a population of less than 50,000 people to have more than the statutory minimum.
Industry officials said that language appeared to eliminate the twoperson requirement entirely, which could leave patients unattended in the back of an ambulance.
If there were a driver, they wouldn't have to have any specialized training in driving an emergency vehicle.
"The Kansas EMS Association understands and acknowledges there are struggles in the smaller counties and communities due to monetary constraints as well as the ability to recruit and retain volunteers and employees," wrote David Adams, president of the Kansas Emergency Medical Services Association. "This bill will lead to unnecessary and needless suffering and deaths of our citizens."
Jason Alatidd is a Statehouse reporter for the Topeka Capital-Journal. He can be reached by email at jalatidd@gannett.com. Follow him on X @Jason_Alatidd .