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EAST BRUNSWICK, N.J. — A new state report that details a “crisis” in New Jersey’s emergency medical services is, unfortunately, dead-on accurate in both its conclusions and its overall tone. But throwing darts was the easy part.
It has been acknowledged and bemoaned for years that New Jersey’s emergency medical services are a fractured and understaffed safety net, lacking both the dollars and the laws to make all of it work as smoothly and efficiently as it should. What hasn’t been clear is what the state can and should do about the problem. While the Legislature’s review lays out a bunch of possible answers — often in so great a number and variety that one wonders if the entire plan won’t just simply collapse — there are some valuable nuggets to be mined and put into practice almost immediately. In legislative time, that means within the next 12 months.
The overall thrust of the report suggests a movement away from a colloquial structure of smaller, independent units toward a more integrated and regionalized state-driven model. Such a shift in philosophy and mission is probably necessary if geographic coverage and quality of care is to be seamless and ultimately improved.
First, the report notes, the barriers to change must come down.
“The current legislation emphasizes restrictions and political pacification over an effective systems approach for quality EMS care,” the report states.
Among the most beneficial recommendations, several ought to be put on the fast track, including: encouraging small volunteer squads to merge by offering financial incentives; requiring all EMS agencies to be licensed by the state, so that operational standards become uniform; requiring municipalities to provide EMS or “cause it to be provided” — in other words, through an interlocal agreement with another municipality or contract with a vendor; allowing advanced life-support ambulances to be staffed by one emergency medical technician, rather than two paramedics; including EMTs and paramedics in the state pension system, a key financial incentive for attracting new workers, and installing a statewide EMS medical director and three regional directors for broader, more effective oversight and coordination of the network’s many pieces.
The report is voluminous, with 55 recommendations in all — more changes than the state can easily make or necessarily would want to adopt. The state Department of Health and Senior Services is combing through the study to decide what it will advise should be done next. But as was noted by state Sen. Joseph Vitale, D-Middlesex, chairman of the Senate health committee, not all of the pieces will win legislative approval. He also said he expects resistance from some quarters of the EMS community as the Legislature rebuilds the system.
So be it. New Jersey’s emergency medical services are not up to snuff for all of the previously mentioned reasons and some others. It’s time the state implement sweeping changes to ensure that its emergency health services are of a caliber that New Jerseyans can trust and be proud of.