NJ-EMS

Making municipalities responsible for emergency medical services Making municipalities responsible for emergency medical services -- just as they are for police and fire protection -- along with standardizing 911 service and declaring one set of training and certification rules for all EMS personnel, including volunteers, is an agenda that New Jersey should have attended to long ago.

Legislation drafted last month by a state EMS advisory committee lays out a good blueprint for reforming the state's disjointed EMS system. Now someone must provide the blueprint for paying for it all.

State Sen. Joseph Vitale, chairman of the Senate Health, Human Services and Senior Citizens Committee, has promised to hold hearings on the EMS legislation early next year and says it could cost $10 million to $14 million to implement comprehensive change. The data make it clear, however, that the human cost will be dear if New Jersey delays a much-needed EMS restructuring.

According to a study commissioned by the Legislature and released last year, nearly 14,000 people a year in this state never get the paramedic care their conditions require on the way to the hospital. There are too few paramedic units, and 911 systems, which vary from one municipal or regional operation to another, often affect whether the best unit is dispatched to a call and how quickly.

Moreover, the volunteer squads on which many areas depend are increasingly hard-pressed to recruit and retain personnel and secure enough money to operate.

Although many volunteers stay current with training and equipment, they are not regulated by the state, so there is wide variation in quality among squads. That problem must be addressed.New Jersey must find a way to organize services for the maximum recovery of federal Medicare and Medicaid dollars as well as private insurance funding for EMS and find ways to subsidize the rest.

Rather than try to operate their own unique municipal EMS systems, towns may have to join county or regional programs to meet a new EMS mandate. Those configurations, if properly coordinated, are the most efficient and effective. The positive experience in other states provides the evidence. Regionalization of EMS could point the way to a more logical configuration for other public safety systems.