Louisville Metro Emergency Medical Services (also known as LMEMS and known locally as simply Metro EMS) is the primary provider of pre-hospital emergency medical care within Louisville-Jefferson County, Kentucky. With an authorized strength of 250 Paramedics and Emergency Medical Technicians (EMTs), LMEMS is the amalgamation of Jefferson County EMS (JCEMS) and the EMS Bureau of the Louisville Division of Fire (LFR). LMEMS was created early in 2005 and was the last of the major public services in the area able to be combined under the city-county merger of January 6, 2003. LMEMS is a government-administered, third-service EMS provider meaning the agency is not a division or bureau of either the police or fire department but is its own agency. Since its creation LMEMS has averaged 100,000 ca