EMS System Review - State of New Jersey

State of New Jersey, DHSS, OEMSConsulting Services: EMS System ReviewRecommendation 5: All EMS provider agencies should be licensed by NJOEMS.All of these topics will be discussed in the Legislation and Regulation chapter of thisreport. Regardless of specific issues, each focus group believed that the current legislation andregulation of EMS are outdated.Recommendation 6: There should be a comprehensive overhaul of the current stateEMS legislation and regulations.System Finance – This has been identified as one of the weakest components of theNew Jersey EMS system. The focus groups identified 25 ideas concerning system financing. Thetop 6 include:1. Identify dedicated sources of funding – It is difficult to determine additional sourcesthat do not already exist. Reimbursement of services is covered by government orinsurance funds with the major issue being adequate reimbursement. For otherservices, different sources may include soliciting benefactors from the businesscommunity and the public. This is likely more successful for local volunteer services.2. Enable all to use volunteer training fund – This is a logical idea that will be furtheraddressed in the legislative and regulation section.3. Increase funding for ground EMS (reduce competition) – This idea involves theincrease in reimbursement from federal Medicare and Medicaid programs. As statedearlier, the GAO recently identified that relying on Medicare reimbursement may leadto a loss of between 6 – 17 percent. While this may lead to changes, it is unrealistic tobelieve that this will be significant.4. Economies of scale for EMS – Part of system finance is assuring the public that thesystem is working smarter instead of working harder. Economies of scale includedetermining just how many units are needed and what organizational models areused. In New Jersey, there are 507 volunteer first aid squads, many covering limitedareas in small towns. Many of the squads appear to provide excellent service, whileothers are struggling to stay in service or stay completely volunteer squads.By 1979, the NJSFAC realized that the number of volunteers was beginning to fall. In1984, volunteers answered almost 90 percent of the BLS calls for the state. By 2004, that numberwas down to 60 percent. 34 In 2004, the percentage of ALS patients transported by licensed34 Aberger, J. 75 Years of Volunteer EMS: A History of the New Jersey State First Aid Council. The Gold CrossMagazine, p. 21.TriData, a Division of 52September 2007System Planning Corporation