Legislature Takes Second Look at Regulating Emergency Medical Services

Opponents argue that bill would put excessive financial burden on volunteer EMT squads.

For the second time since taking office, Gov Chris Christie may have a chance to sign a bill that increases state oversight of emergency medical technicians and paramedics.

The measure (A-2463), requires that ambulance workers be licensed by the state and undergo criminal background checks.

The legislation comes at a time when the state’s longtime reliance on volunteer ambulance squads is under threat from several quarters, including increased regulation, tougher training requirements, and a general decline in volunteerism.

“EMS is in crisis in New Jersey,” said Mary Daley, president of the state EMS union. -- the Professional Emergency Medical Services Association. “A lot of the volunteers are falling by the wayside, a lot of it is going commercial and paid.”

Supporters of the bill argue it makes much-needed changes, adding that the current state of affairs -- in which volunteer squads don’t even have to register with the state -- must end. They also say the state must take action now to ensure that local departments maintain necessary standards.

Opponents maintain that the bill will force more volunteer units to shut their doors..

Christie conditionally vetoed an earlier version of the bill two years ago, saying it needed further study.

The volunteers who oppose the bill are hoping that the governor again calls for further study. Supporters contend that Christie’s staff didn’t have time to study the issue then, and that now is the time to move forward with more state oversight.

The state’s largest emergency medical volunteer organization is the chief critic of the proposal. Howard Meyer, president of the New Jersey State First Aid Council, said the increased costs from state licensing and background checks put too much financial strain on volunteer squads.

“On top of Sandy and everything else, I don’t think it’s any secret that New Jersey has financial issues,” said Meyer, a volunteer with the Berkeley Heights Volunteer Rescue Squad and Hoboken Volunteer Ambulance Corps. He has 40 years experience and has instructed volunteer EMTs for more than 20 years.

The nonpartisan Office of Legislative Services forecasts that the bill will increase costs, but didn’t put a price tag on the increase. The legislation specifies that the costs won’t be borne by the volunteers themselves, but opponents said costs could be pushed onto cash-strapped squads.

“Where’s the money coming from?” Meyer asked, adding that his organization estimates that the bill will cost $30 million to $50 million annually.

That number is disputed by bill supporters, who noted that the State Police already conduct background checks for police and firefighters, as well as for emergency squads that request them.

Meyer said Christie took the correct approach in his 2011 conditional veto, in which he called for a review by state officials of the financial impact of the measure. The Legislature did not act on the veto before the end of this past session.

“That would have been a very reasonable thing to sit down and do,” Meyer said.

Meyer said ambulance services do need changes, including adding a requirement that all ambulances receive inspections and that all patients be guaranteed that an EMT is traveling with them in an ambulance.

“There’s ways of doing that without costing millions, that would be of little or no additional cost to volunteer squads,” Meyer said. He said private ambulance agencies and hospitals are pushing out volunteer squads.

“We believe it’s going to make it more difficult for volunteer squads be able to recruit, to be able to provide services,” Meyer said of the bill.

First-aid training programs have increased their requirements in recent years, while the state fund for this training has been exhausted. Meyer added that shifting the state from certifying to licensing EMS is a means of raising costs.

“I think the goal here is to make it more difficult and bureaucratic for volunteer squads until the people who run the squads say, ‘You know what? We’ve had enough,’” Meyer said.

Meyer noted that volunteer emergency responders have been crucial in responding to large-scale disasters.

Not all volunteers agree with the first-aid council’s position, including Michael Bascom, a volunteer captain with the Shark River Hills First Aid Squad for 20 years. Bascom is also chief financial officer for Neptune and Sea Bright and EMS coordinator for Monmouth County and Neptune.

“There’s been a lack of direction of EMS in general and there’s a need for standardization across the board, for volunteer and career [services]," Bascom said.

Continue reading on NJSpotlight.com.

NJ Spotlight is an issue-driven news website that provides critical insight to New Jersey’s communities and businesses. It is non-partisan, independent, policy-centered and community-minded.

raymond Weis January 29, 2013 at 05:38 PM
Unfortunately this bill will do nothing to improve EMS in the State of New Jersey. All vounteer squads that I know of already do background checks of volunteers. All ambulances of State First Aid Council squads are inspected which I know first hand being one of the Middlesex County inspectors and our inspection is a least as stringent as the State inspection and maybe more so. As for the EMT training it is exactly the same for a volunteer EMT as it is for a paid EMT. Getting daytime volunteers is difficult with the state of the economy that is true and we would welcome any volunteers we can find. As far as the EMT course goes iit went from 120 hours to somewhere between 200 and 300 hours and a cost of 500 dollars for the 120 hrs t0 1200 to 1500 dollars for the longer course. It used to be funded by a State training fund which Gov Corzine depleted to try and balance hie budget and has not been replaced. Remember if the volunteer squads are eliminated anytime you need an ambulance you will be billed and the only difference will be that the people on the ambulance will no longer be your neighbors but paid EMTs with exactly the same qulalifications.
Barry Fitzpatrick January 29, 2013 at 09:00 PM
This bill is needed and has been put off for too long already. Mr. Weis lets look at your comments point by point. First you state that all volunteer squads you know of do background checks on their members. I would disagree with you as I know of no volunteer squad that does background checks but more to the point if the checks are already being done, as you say, then why is there such fierce opposition to them? The money is already being spent and peoples privacy is already being invaded so no harm no foul and seeing as though all these volunteer squads are already doing it it must be a good idea. Secondly you state that all ambulances in the First Aide Council are inspected. While this is true not all squads in the state are First Aide Council members. In addition the First Aide Council can do nothing to enforce best practices. Any state licensed ambulance is subject to inspection anytime. In addition to the enforcement power of the state I also refer to your own statements. The council does inspections which are comparable to NJ. So why the resistance to a state agency doing the inspection and having one single standard? I think comments on more training do not even merit discussion. This is medicine there is never too much learning or training. Finally your comments about neighbors and paid EMT's are just silly. I would think that anyone who is sick just wants the most knowledgeable and professional people helping them whether they are paid or volunteer.
Andrew Dahl January 29, 2013 at 11:16 PM
In response to Raymond Weis’s comment above, I find it hard to believe that this legislation won’t have a positive effect on EMS in this state. None of what was stated has to do with what pre-hospital care is all about. EMS is about the patient. Complaining about an increasing amount of training and cost doesn’t sound patient oriented to me whatsoever. Whatever the cost is, it’s going towards patient care and that should be good enough. You’re absolutely right about the amount of training between a volunteer EMT and a paid EMT and how it’s the same. This bill isn’t about getting rid of volunteers, so I’m not sure what place that has here. This bill is about bringing every ambulance in the state of New Jersey to a single standard so a patient receives the same level of care regardless of where they are. Even if it turns to having to be billed for service, the majority of people have insurance for just that reason. Not to mention you now have income to help pay for training and operating costs. You don’t expect to get free care at a hospital, so I don’t understand why there’s a double standard on care provided pre-hospital. Turn to any other state, and you will see EMS services, both paid and volunteer, who are required to be licensed by the state and who bill for services.
ReallySB January 30, 2013 at 06:20 AM
Let's call a spade a spade here, the individuals who put forth this bill to the state multiple times have received multiple campaign donations from for profit EMS service companies. It is all about money and in reading this bill it is very muddled in the sense of how they are grouping Advanced and basic life support in to multiple subsections of this article. However to mr. dahl comment I do not believe you can have the same level of care per ambulance even if you have the same training, there will always be a bell curve of people who are better and worse even meeting the minimum requirements from the state. The question should be asked thou if you state with EMT is Fire next?
Andrew Dahl January 30, 2013 at 05:30 PM
ReallySB, the only two emergency services that a municipality has to provide for their citizens is police protection and fire suppression. EMS is the one service that a township has no obligation to provide. So as to your question about fire being next, I personally have no experience as to what standards are already in place for fire, but I imagine they’re years ahead of EMS. As to your comment about a bell curve of people, sure, you're absolutely right. Like anything else, you have people who do it better then others. Just like an attending in an emergency department providing care to sick people, you get the luck of the draw. But nonetheless, that attending is still board certified and meets a minimum standard of competency. What this bill does, is bring all providers and services to a minimum standard which doesn’t exist today. There is no licensing of volunteer ambulances, and the first aid council has no enforcement rights. It’s all about standards and accountability. Not sure how you believe this bill is supported from profit EMS services, however I can tell you it seems muddled for a few reasons. Along with changes about licensing and standards of care, much of the vocabulary is changed. Vocabulary in the current legislation is out dated, and you will see names of certifications be updated to match the National Registry of EMT’s levels of certification. This is also in a move to license a provider that renders pre-hospital care in the state of New Jersey.


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