The Star-Ledger

NEWARK, N.J. — New Jersey's emergency medical response system is limping along on life support. The latest bulletin on its day-to-day status came this week with news that Hackensack has decided to replace professional emergency medical technicians with a private firm or a hospital-based emergency medical service.

It's hard to argue with the decision given a promised savings of $600,000 and assurances that service to the public will not decline. Still, the situation in Hackensack, which understandably has upset those veteran rescue squad employees, reminds us that this is an issue of statewide dimensions that has yet to be appropriately addressed.

Ten months ago, TriData, an Arlington, Va., research company, concluded in a report commissioned by the Legislature that the state's emergency medical response system was in "a state of near crisis." The 171-page report made 55 well-considered recommendations.

Since then, the state has improved helicopter response to accidents, but broader issues of training, staffing levels and volunteers vs. paid staff have yet to be addressed. While it's not always a bad thing that a report sits on a shelf, in this case the recommendations truly are a matter of life and death.

Well-trained, well-coordinated, well-staffed, well-supervised emergency services are crucial to the delivery of health care. Yet such a system is not available throughout New Jersey.

The state Department of Health and Senior Services has asked the Emergency Medical Services Council to draft legislation by November in response to the TriData report. That is none too soon.

The dire nature of the situation is underscored by the number of hospitals that have shut down or are on the brink of doing so. Seven New Jersey hospitals have closed in the past 18 months. An eighth is scheduled to shut down soon. Fifteen years ago, New Jersey had 112 acute-care hospitals. That number has dropped to 75, and half of those are experiencing financial troubles.

The closing of hospitals means, in some cases, that getting to medical help will take longer. For heart attack or stroke patients, time is of the essence. Not only is a well-trained squad critically important, but so is access to good information about the best place to take a patient. All of that requires better statewide and regional coordination.

So far, that is lacking.

In the meantime, local officials are doing what Hackensack has done — coming up with what they consider to be the best solutions for their communities, largely based on economics. Those efforts are reasonable but simply not enough. A coordinated, statewide response is absolutely crucial.