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State Department: Kentucky

If you’re a paramedic or EMT who’s thinking of relocating or would just like to learn more about life across the U.S., EMS World’s State Department is worth a look. We start with data-driven “snapshots” of each state, then add a few paragraphs about regional practices and lifestyle. Our goal is to highlight everyday aspects of potential destinations from a prehospital provider’s point of view.

Kentucky Snapshot

  • Link to state EMS website
  • Average straight-time wages: EMT $13.74/hour, paramedic $19.121
  • State area: 40,408 square miles     
  • Approximate state population: 4,468,000
    • Rank (↓): 26
    • Change since 2010: +3%
  • Most populous cities (approximate): Louisville 623,000, Lexington 322,000, Bowling Green 67,000
  • Violent crime one-year change: Louisville N/A, Lexington -11%, Bowling Green N/A2
  • State violent crime rank (↑): 53
  • State property crime rank (↑): 193
  • Health rank (↓): 454
  • Average temperatures: Summer 75ºF, winter 36ºF5
  • Top state income tax: 7.1%6
  • Average sales tax: 6.0%6
  • Average property tax: 0.79%6
  • Median home value: $148,4007
    • One-year change: +5.0%7
  • Median monthly rent: $1,1507
  • Average cost of electricity: $0.11/kwh8
  • Cost of living index: 93.0 (U.S. average = 100)9
  • Unemployment: 4.3% (U.S. average = 3.6%)10
  • Best states rank (↓): 4011
  • Approximate annual retirement cost per household: $57,00012

Reasons to Visit Kentucky

I live just north of Nashville–so close to Kentucky, you can almost see it from my house. But I’d much rather visit the Bluegrass State than stare at it. Here’s why:

Bourbon—If my doctor told me I wasn’t getting enough acetaldehyde, bourbon would be my supplement of choice. Kentucky produces 95% of the world’s supply, including Maker’s Mark, Wild Turkey, and Jim Beam. Jack Daniel’s isn’t on that list because it’s not from Kentucky and it’s not bourbon. More on that when I write about Tennessee.

Taxes—Kentucky has the lowest sales tax in the region, except for Virginia. If I drive 20 minutes north to the Kentucky-Tennessee line, I can save 3.5% on taxable items like shoes and bourbon.

Horses—If you love horse racing or just horses, maybe it’s time to learn a few bars of “My Old Kentucky Home.” The state has hundreds of horse farms, several racetracks, and one huge event at Churchill Downs each May that’s billed as the greatest two minutes in sports. (No, not Miley Cyrus singing the national anthem.)

Caves—Kentucky’s Mammoth Cave is the planet’s largest—53,000 acres, including 400 miles of passageways. If you’re visiting the state and don’t see signs for caves, you’re probably in one.

Connections—Kentucky borders seven states and has six interstate highways. I’ve driven all of them. The only complication is changing time zones while heading north or south on I-65. I don’t think time zones are supposed to work that way.

Finger-Lickin’ Food and Other Attractions

Like most of the mid-South, Kentucky is a mixture of urban and rural. The state has two national parks, dozens of forests, and 90,000 miles of streams. Kentucky also has more mileage of navigable waterways than anywhere in the U.S. outside Alaska.

Louisville, Kentucky’s most populous city, is much more than the baseball-bat center of the universe; it’s also the headquarters of Kentucky Fried Chicken, the second-largest restaurant chain in the world. My family sure put lots of mileage on our old Chevy Bel Air when Greater Boston got its first KFC franchise in the ’60s.

Kentuckians enjoy access to bluegrass music, first-class museums, and nationally ranked college basketball. They also live with a 200-year-old surveying error known as the Kentucky Bend—a 27-square-mile bubble-shaped peninsula separated from the rest of the state by Missouri and Tennessee. That’s like buying a house with a driveway owned by the neighbors.

Kentucky EMS

National registry is a prerequisite for initial EMT, AEMT, and paramedic certification. To get reciprocity from Kentucky for out-of-state licensure, you’ll need an NREMT card and an approved HIV/AIDS course.

Recertification is every two years and requires the following:

  • EMT: CPR, pediatric abusive head trauma training, and either national registry or 24 hours of CME.
  • AEMT: CPR, pediatric abusive head trauma training, and either national registry or 48 hours of CME.
  • Paramedic: CPR, ACLS, pediatric abusive head trauma training, and either national registry or 60 hours of CME.

Unless you’re a much better basketball player than EMS provider, you’ll find this link to local jobs useful.


1. EMS World. EMS World Salary Survey 2018,

2. FBI. Uniform Crime Reporting System, 2018 National Incident Based Reporting System,

3. Public Safety Rankings,

4. America’s Health Rankings, United Health Foundation. 2018 Annual Report,

5. Current Results. Average Annual Temperature for Each U.S. State,

6. Tax Foundation Facts and figures 2019,

7. Zillow. United States Home Prices & Values,

8. Choose Energy. Electricity Rates by State,

9. Missouri Economic Research and Information Center. Cost of Living Data Series, 2019,

10. State Unemployment Rate in the U.S. The Content Marketing Trend Study, 2019,

11. Best States 2019: Ranking Performance Throughout All 50 States. U.S. News & World Report. 2019.

12. Hill C. This is exactly how much it will cost to retire well in every state in America.

Mike Rubin is a paramedic in Nashville and a member of EMS World’s editorial advisory board. Contact him at

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