And the Kentucky EMS Branch – a small state office that many believe became lost in the complexity and sheer magnitude of the Cabinet for Health Services, will cease to exist.

The new law takes effect on July 15 but will take almost a year to fully phase in.

The Kentucky Board of Emergency Medical Services will replace the Kentucky Cabinet for Health Services’ EMS Branch, which has regulated and administered Kentucky’s statewide EMS program since the 1970s.

And the Kentucky Board of Medical Licensure, which has authority over paramedics, will hand over that authority to the new EMS Board. The KBML began administering Kentucky’s paramedic program in the 1970s but in recent years contracted many of those duties to the state EMS Branch.

The board will also administer and regulate ambulance services and training institutions throughout the state.

Lt. Gov. Henry made the announcement this afternoon at the Kentucky EMT Instructors Conference in Louisville. The announcement took many EMS workers -- who had planned to rally in Frankfort next week for the signing -- by surprise.

"This gives you credibility," Henry told the EMT Instructors. "I congratulate you on this year. This is probably the best year you have had in the legislative process. I challenge you to continue," said the Lieutenant Governor, who is also a practicing surgeon at the University of Louisville and University of Kentucky hospitals.

Thursday's law also changes the authoritative process for paramedics from certification to licensure. New emergency medical technicians shall be initially certified using the requirements and testing of the National Registry of Emergency Medical Technicians, but EMTs seeking recertification will follow new requirements set by the Kentucky EMS Board, which at a minimum will include 24 hours of prescribed continuing education every two years. The law also establishes a new investigative and disciplinary action process, clarifies approved skills, and allows a paramedic to draw blood samples, in certain situations, at the request of a peace officer.

The new board was borne from frustrations, and a lot of hard work, by the Kentucky Ambulance Providers Association and the Central Kentucky EMS Alliance. And for the first time in the history of Kentucky EMS, large groups of EMS workers and administrators traveled to the state capitol and joined forces with the fire and police services to lobby for legislation.

It all began in the Spring of 1999 at a KAPA retreat in eastern Kentucky. Frustrated that the EMS Branch had to compete for limited funding from near the bottom of the state’s largest entity, those attending the retreat agreed that EMS had to be removed from the Cabinet.

A draft of dreams, called "EMS 2000," was born and circulated throughout the state. Like all dreams, it was gradually tempered by reality and negotiation with other groups until it took the form of House Bill 405.

The bill was sponsored by Representatives Stephen R. Nunn, J. C. "Bo" Ausmus III, Jim Callahan, Mike Cherry, Barbara White Colter, Tim Feeley, William U. Scott, Jim Stewart, Johnnie L. Turner, Ken Upchurch, and Brent Yonts. It was introduced into the House on Jan. 19.

It wasn’t the first EMS reform bill introduced to Kentucky’s 2000 General Assembly. House Bill 370, pressed by CKEMSA, had similar dreams and had been introduced five days earlier. But soon both KAPA and CKEMSA joined forces and worked together for the passage of HB 405.

The two biggest obstacles were the composition of the new board and funding.

Field EMS workers felt there were not enough "practicing" emergency medical technicians and paramedics on the board, and that the board was "top heavy" with EMS administrators. Physicians felt that the composition of the new board lacked the necessary physician oversight. Changes were made.

Almost everyone wondered where the funding for the board would come from. The original "EMS 2000" draft called for a vehicle registration fee to fund the board. Although such a fee would have raised almost $10 million annually to fund the board, the reality of passing a bill that included this fee grew bleak.

Hope for additional funding rose with Gov. Patton’s proposed tax revision plan, but that hope was soon lost when the state legislature failed to support it.

At this time, the total funding for the new board is unknown. The House and Senate reconvene next week to work on the budget. It is anticipated that the new board will end up with the same funding that the EMS Branch has been receiving: approximately $850,000, far short of the $10 million originally hoped for.

Poor funding of Kentucky’s EMS program has long been an issue, and was one of the main reasons that KAPA and CKEMSA wanted to remove the EMS Branch from the Cabinet for Health Services. Setting up a complete board and improving the state EMS program without additional funding may prove to be a very difficult task.

The new Kentucky Board of Emergency Medical Services will consist of 16 members selected by the Governor and will include:

• 1 paramedic who works for a government agency but is not serving in an educational, management, or supervisory capacity;
• 1 emergency medical technician-basic who works for a government agency but is not serving in an educational, management, or supervisory capacity;
• 1 emergency medical technical-first responder who is not serving in an educational, management, or supervisory capacity;
• 1 physician licensed in Kentucky having a primary practice in the delivery of emergency medical care selected from a list of three physicians submitted by the Kentucky Medical Association;
• 1 physician licensed in Kentucky serving as medical director of an advanced life support ambulance service, selected from a list of three physicians submitted by the Kentucky Medical Association;
• 1 physician licensed in Kentucky who is routinely involved in the emergency care of ill and injured children selected from a list of three physicians submitted by the Kentucky Medical Association;
• 1 trauma surgeon licensed in Kentucky selected from a list of three physicians submitted by the Kentucky Medical Association;
• 1 citizen having no involvement in the delivery of medical or emergency services;
• 1 emergency medical services educator from a Kentucky college or university that provides an emergency medical services educational program;
• 1 mayor of a city that operates, either directly or through contract services, a licensed Class I ground ambulance service;
• 1 county judge executive from a county that operates, whether directly or through contract services, a licensed Class I ground ambulance service;
• 1 volunteer-staffed, licensed Class I ground ambulance service administrator who is a certified emergency medical technician or a licensed paramedic;
• 1 fire-service-based, licensed Class I ground ambulance service administrator who is a certified emergency medical technician or a licensed paramedic;
• 1 hospital administrator selected from a list of five nominees submitted by the Kentucky Hospital Association;
• 1 basic life support, licensed Class I government-operated ground ambulance service administrator who is a certified emergency medical technician or a licensed paramedic; and
• 1 advanced life support, government-operated ambulance service administrator who is a certified emergency medical technician or a licensed paramedic.

The board will have an executive director, a physician medical advisor, a general counsel, and a staff to carry out its many functions.