EMS System Review - State of New Jersey

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State of New Jersey, DHSS, OEMSConsulting Services: EMS System ReviewFunding for the OEMS in Virginia comes from the state and is divided between twogroups. In FY 2007, the State OEMS received $2,538,678. Each Regional EMS Council receiveda share of $2,954,934 that was split between the eleven councils. This sum was divided based onthe services provided by each council and was not equal across all councils. Grants through bothstate and federal sources are also used to fund OEMS and the operational EMS units in localities.Comparison of State SystemsComparison of the New Jersey State EMS System to five states of similar size orpopulation, found two distinct differences; New Jersey has no state EMS medical director andNew Jersey does not have a regional EMS system within the state. Another important differenceis that in the sample states, local municipalities have legal responsibility for the provision ofEMS. These issues will be discussed extensively throughout the document with directrecommendations for actions. While the differences appear simple, they are having a profoundeffect on how EMS operates in New Jersey. For example, a lack of statewide medical directionleads to fragmentation of EMS medical oversight. Most ALS programs have excellent medicaldirection while BLS programs have little to none. Lack of regionalization constrains the OEMSto manage all regulatory and oversight responsibilities from Trenton. While statewide uniformityis desirable, no state system can be exactly the same. The northern part of New Jersey has adifferent geography and population density than southern New Jersey. The state can maintainproper oversight while allowing for some regional uniqueness. The lack of legal obligation formunicipalities to provide EMS is bewildering at best. Combined with “home-rule” authority, thischallenges providing EMS based on economies of scale and limits the NJOEMS from overseeingoperational situations except by way of strict regulation that demands lock-step conformity.The EMS systems selected for comparison were not selected because they present theperfect model. To the contrary, some have had significant weaknesses that have led to their owncrisis levels. In the 1990s, Connecticut’s EMS system faced a total collapse that requiredsignificant crisis management. Delaware was one of the last states to provide ALS, but in the lastdecade has become an exemplar EMS system. These states have experienced challenges andchanges that have helped them grow. Their experiences may be helpful to New Jersey.ConclusionNo two of the comparison jurisdictions use the same structure or policies in the deliveryof EMS to the public. Different needs, different growth patterns, and different political pressureare only a sample of the factors that result in significantly different systems providing anessential service to the public. Interjurisdictional comparisons are useful in identifyingTriData, a Division of 26September 2007System Planning Corporation
State of New Jersey, DHSS, OEMSConsulting Services: EMS System Reviewtechniques and ideas that are successful elsewhere. Ultimately, decisions must be based onspecific needs and resource availability in the State of New Jersey.Chapter Four looks at the legislative issues involving EMS in New Jersey. This chapterintroduces and compares comparable state EMS systems. Subsequent chapters will explain indetail the current state EMS system and suggestions for modifications that can be successfullyadapted from existing practices in other jurisdictions. New Jersey EMS has many strengths thathave provided its citizens with good prehospital care. This evaluation will continue to provideguidance for NJ EMS.TriData, a Division of 27September 2007System Planning Corporation
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EMS System Review - State of New Jersey

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