Fort Leavenworth transitions to in-house emergency services, ambulance transport

FORT LEAVENWORTH, Kansas - Fort Leavenworth, Kansas, will have its own emergency medical service beginning May 1, 2026.

Fort Leavenworth Fire and Emergency Services firefighters with EMT certification will be staffing the ambulance service to provide pre-hospital care for approximately the next month until a third-party EMS contract begins in June.

The need for the in-house emergency medical service came about after negotiations with Leavenworth County commissioners failed to arrive at an agreement that maintained the safety of the community while also responsibly using government resources.

For the past several years, Leavenworth County Emergency Medical Service has provided ambulance services to Fort Leavenworth. When the no-cost agreement was up for renewal last year, Leavenworth County commissioners informed installation leaders that the federal government would have to pay $1.2 million to continue the EMS service.

Fort Leavenworth Garrison Commander Col. Todd Sunday said that amount equates to about a quarter of the county's $4 million shortfall, which is disproportionate to the post's actual use. The installation's EMS transports add up to about 2 percent of the more than 12,000 annual EMS runs across the county. Additionally, more than 90 percent of the EMS transports from Fort Leavenworth have been reimbursed by insurance, typically TRICARE, whereas the reimbursement rate across the county is much lower.

Two service extensions were granted in 2025 by the commission as installation leaders worked through the issue, and during that time, post acquired an ambulance and crews began training to be ready regardless of the outcome of the negotiations.

Leavenworth County Commissioner Jeff Culbertson noted in the Dec. 31, 2025, commission meeting that the EMS issue had been broached with previous installation commanders over the past three years. Sunday, who spoke at the meeting to request the final 120-day service extension, assured the commissioners that he and his team were working to resolve the issue. During that meeting, Culbertson stressed that property taxes rather than insurance reimbursement are what enable the county's ambulance service to function.

Ultimately, what the commission wanted and what the government could provide were not in alignment.

"We negotiated in good faith, we tried to get a solution that would be legally acceptable and financially responsible for all parties involved, but we couldn't come to an agreement," Sunday said. "The Garrison and the senior commander worked really hard to come up with a solution, because, ultimately, our primary responsibility is the safety of the community. We exhausted every avenue with the county in order to come up with a solution, but we can't bridge the impasse. Our positions are so far apart, we can't resolve it."

Fort Leavenworth Director of Emergency Services Lt. Col. Anthony Douglass said responsible use of government resources was a priority in making the decision to stand up an in-house EMS in response to the county's demand.

"The bottom line is, based on what the county was demanding, that is not representative of a responsible use of resources," he said. "We owe that to be good stewards, not only to our community, but to taxpayers all over the country."

Douglass said the new EMS service would be a positive change overall, and it should enhance the community's safety with faster response times and more concentrated focus on a much smaller area than was possible with the previous countywide ambulance service.

"The No. 1 priority has always been the well-being of our community," Douglass said. "This is where we live and work - we live on post, we have kids, we have family members - and so it's doubly important to us from the perspective of taking care of our own families, but the No. 1 priority has always been the well-being of everybody on this installation."

Sunday said an installation's firefighters don't typically provide ambulance service, but he reiterated that the solution for FLFD EMTs, and eventually an on-post contracted EMS system, to provide pre-hospital care will mean faster response times, without the wait for an ambulance to be dispatched from off post.

Fort Leavenworth Fire and Emergency Services Assistant Chief of Operations Dustin Hensley said the post's first responders have already been providing basic life support when responding to emergencies and waiting for ambulances to arrive.

Douglass said that redundancy - with firefighters already accustomed to providing basic life support and every fire truck being equipped with emergency supplies - means firefighters are ready to handle any emergency.

With an ambulance, which was acquired from another military installation, already positioned on post and the often single-digit response time of FLFD, Hensley said that will equate to reduced patient transport time to the emergency room. Hensley added that only half of a firefighter's 48-hour shift will be assigned to EMS duties, and the other half will be assigned to a fire truck to provide a schedule with more opportunity to rest.

EMT train-up

Since Munson Army Health Center functions as a Defense Health Agency outpatient clinic, not a hospital, and does not have emergency services, the responsibility of providing emergency care and ambulance transport fell elsewhere.

To ensure the FLFD firefighters taking on this responsibility were prepared, Fort Hood, Texas, Emergency Medical Service personnel recently provided training on standardized emergency medical protocols. Firefighters went through three days of protocol review and hands-on skills validation in March and then worked through difficult and varied scenarios during four more hands-on training days last week.

"We take their knowledge of that protocol and their ability to perform those skills and apply it to a scenario-based response where they assess the patient, determine what protocol is most appropriate to treat that patient, utilize all the tools and skills that we've trained them on and that they've already had training on to further assess and help diagnose the proper treatment and transport decisions for a patient," Fort Hood EMS Training Officer Capt. Christopher Lee said of the training. "(The training continued) all the way up to including simulated transport to facilities, when to use air assets like medevac helicopter services, requesting ground (advanced life support) assistance if they have access to it. (The April training) took all the pieces that we've sorted out in the first month's training, and we're putting them all together in one fluid training scenario."

Currently, 17 FLFD firefighters are fully credentialed as emergency medical technicians and are ready to pick up the EMS duties.

"(Fort Leavenworth EMS) won't be ALS capable, but they will have definitely some trained EMTs that are ready to provide a higher level of care than they used to be able to under their previous protocols with Leavenworth County," Lee said.

Lee said he could see the firefighters gain confidence as their understanding of the protocols increased.

"It really helps them develop the confidence to reassure themselves that they understand the protocols, that they know what the treatments need to be, and that they can formulate that care plan and execute it out in the field when the time comes," Lee said. "And I can say with confidence that those 17 that we credentialed do have the ability to do that."

Fort Hood EMS Paramedic Holly Galiana, who helped provide the training, said she and Lee used several scenarios that were based on real emergency situations that they have encountered in their work.

"We really attempted to put them in some very stressful scenarios, intentionally, to really kind of test their ability to think around obstacles, and they did really, really well," she said. "We intentionally put obstacles in their way and frustrated them as much as we could, and they were able to overcome and continue working and providing that substantial care, and they're ready to go."

Lee said those real-world emergency experiences that challenge every aspect of patient care have equipped him with many learning points that he could impart to the firefighters during the training.

"You see the wheels just turning and it really resorts them back to their fundamentals - what they know, then they build on that," Lee said. "That's the purpose of the training, is to really just rattle them in that way and get them to revert back to their basic EMT-level training, because that's where the life-saving survival chain starts, (with) BLS care."

EMS Director Dr. (Lt. Col.) Reginald Trevino, who is also an internal medicine physician, chief medical officer and deputy commander of clinical services at Munson Army Health Center, will serve as a medical liaison and constant advisor to the EMTs, and he will be available to provide guidance and permissions in cases such as when to continue or suspend CPR.

"My role is overseeing the training and then certifying and ensuring that the EMTs, the firefighters, feel comfortable with the newfound skills that they learned over March and then here again in April," he said. "I will meet with them one on one, assess their confidence level, skill level, and address any questions or concerns they have."

Douglass said the way community members seek emergency care will not change, with 911 calls routing through the same dispatch center. He reiterated that having the on-post ambulance service will be a positive change, equating to faster response and transport times.

"Having (EMS) operate here locally, they don't have to focus on the remainder of the county, so there's zero delay, there's zero break in communication, and the service gets provided in-house," he said.