EMS System Review - State of New Jersey

State of New Jersey, DHSS, OEMSConsulting Services: EMS System Review• The temptation to classify ALS personnel into lower paying positions with little roomfor promotion or professional development.• ALS not being a priority, therefore being neglected.• Believing that ALS remunerations will solve municipalities’ financial woes.• Not realizing the training commitment required for ALS.• Municipal public safety leaders sharing their power with medical directors and otherstate regulators.• Cultural changes in organization, as ALS service tends to increase participation bywomen and minorities. The organization must be able to make this advantageous fortheir service.Adding ALS to public or private organizations is not easy. There are many sacrifices andmany changes organizations will have to incur. Above all, if an organization cannot commit tofulfilling the high standards needed, IT SHOULD NOT TAKE ON ALS. The NJOEMS needs toprepare for organizations wishing to provide ALS by:• Refining the application process.• In conjunction with the MICU Advisory Committee and selected organizationalconstituencies, create a clear set of standards that must be met by applyingorganizations. Balance must be maintained to assure strict guidelines without makingit impossible to qualify.• Consider establishing pilot projects for the two years of expansion, with the first yearconcentrating on training, quality management development, establishing appropriatemedical direction and assuring plans for financial survivability. The second yearshould concentrate on implementation and evaluation of services.• ALS projects ready to proceed should not have to wait out an entire year to beoperational.• Financial projections and due diligence should be done before an ALS project isapproved.ALS Financing – It is difficult to predict what needs to be done as the future forreimbursement remains unclear. The Institute of Medicine Report pointed out that there is a $600million shortfall nationwide in EMS reimbursements. A great paradox continues to exists wherean EMS systems cost is based on a readiness capacity, but reimbursement is based onTriData, a Division of 118September 2007System Planning Corporation