Dr. Shaver created a unique first response system staffed by registered nurses who were housed in Medi-cars and operated under the guidance of advanced medical directives.

[1] The EMS bureau of the Louisville Division of Fire utilized firefighters cross-trained as EMTs and paramedics as well as non-firefighting personnel.

JCEMS provided emergency medical services to all areas within Jefferson County outside of the cities of Louisville, Anchorage and Jeffersontown.

The JCEMS Disaster Response Team (DRT) responded to all hazardous materials and technical rescue incidents within Jefferson County outside of the City of Louisville.

After the creation of LMEMS all hazardous materials responsibilities, along with specialized vehicles and equipment, were transferred to the Jefferson County Fire Service.

The executive assistant director of Emergency Management Agency was given ultimate charge of LMEMS and a part-time physician hired to perform medical direction.

LMEMS employs an entirely full-time workforce of Kentucky-licensed Emergency Medical Technicians (EMTs) and paramedics (also known as EMT-Ps).

LMEMS does not return patients home nor does it offer transportation to immediate care centers or hospitals without emergency departments.

EMT-Basics (referred to as technicians or EMTs) and EMT-Paramedics (usually just called paramedics) have drastically different scopes of practice but all exist to provide care and transportation to the sick and injured.

A technician specializes in ambulance operation and basic life support care as well assistance to advanced providers.

Technicians are trained to operate independently of a paramedic, and when such situations arise they are capable of caring for and transporting any medical emergency to the hospital on their own.

The rank insignia of LMEMS is as follows: LMEMS is a long-established "union shop" and all employees beneath the rank of lieutenant colonel can become members of the International Brotherhood of Teamsters (IBT) Local lodge #783, but all employees are required to pay a "Fair Share" contract support fee.

Any employees' first twelve months of service with LMEMS is considered a probationary period where the new hire is subject to dismissal without union representation.

Additional elected shop stewards are on duty at most times to assist members with concerns on a day-to-day basis.

Other, private ambulance agencies such as Rural/Metro Corporation and Yellow EMS provide services for parts of areas near by or within Jefferson County.

Currently a contract exists with Yellow EMS (YEMS) to provide emergency medical services within the Jeffersontown city limits.

In 2012, Ford Motor Company announced they would no longer manufacture the Econoline van ambulance prep package and subsequently LMEMS has opted to begin procuring Type I vehicles based on the F-450 pickup truck chassis.

All crew members are trained and equipped with protective gear to treat patients potentially contaminated with hazardous materials.

Electrocardiographs (EKG) can be transmitted wirelessly from the cardiac monitor to the receiving hospital in the advance of the patient's arrival.

All LMEMS resources are dispatched and tracked by MetroSafe, a unit of Metro Government that coexists within the Emergency Services that handles all public safety communications.

In addition to radio telecommunications MetroSafe is the primary answering point for all 911 calls placed inside Louisville-Jefferson County.

By using voice encryption the chances of protected health information (PHI) being compromised by unauthorized monitoring is greatly reduced.

By department procedure, response requests are assigned to LMEMS resources based on their proximity to the incident and the skill level anticipated by using information gathered from the caller.

If the BLS ambulance crew first arrives and determines that advanced care is not needed the ALS resource may be canceled and ready to respond elsewhere.