EMS System Review - State of New Jersey

State of New Jersey, DHSS, OEMSConsulting Services: EMS System ReviewAir Medical EMS (JEMSTAR)Air medical EMS is provided mainly by a state air medical transport (JEMSTAR)program that is augmented by private agencies. Specifically, air medical EMS response isprovided by a joint venture between the New State Jersey Police (NJSP) and contracted EMSproviders. The NJSP provides the aircraft and two pilots per helicopter and the DHSS providesfunding for two flight nurses or one flight nurse and one flight paramedic. Air medical responseis performed via the use of the two helicopters available. One aircraft called the NorthStarprovides coverage for northern New Jersey while the other, called SouthStar provides coveragefor the southern region. There are three private air medical units that serve as a backup sourcewhen the NorthStar and SouthStar are unavailable.Discipline and safety are of primary concern for organizations with stewardshipresponsibilities for air medical EMS. New Jersey has been fortunate to have maintained a highsafety record during flight transport. JEMSTAR provides approximately 1,700 transports peryear. The number of transports by private air medical agencies is unknown. JEMSTAR isfunded by a $3.00 charge on vehicle registrations and a charge of $1,337 for each transport.Private agencies are not limited as to how much they charge, but receive no state funding.Recommendations were made to adjust the distribution of vehicle registration money andcharges for transport.Advanced Life Support DeliveryNew Jersey’s ALS system provides excellent clinical care by well-trained paramedicsand an active cadre of physicians who provide medical oversight. However, financial issuesthreaten the infrastructure of hospital-based ALS as they are faced with the challenge ofmaintaining adequate staffing and keeping ALS programs profitable. A paradox exists betweenALS care and ALS project viability. Once profitable for hospitals, ALS projects are strugglingto maintain financial stability as non-transportation providers are unable to earn sufficientMedicare/Medicaid funds to assure profitability. Currently, ALS projects must be hospitals orhospital consortium services. ALS provision should be permitted by non-hospital agencies with astrict set of standards in place prior to the commencement of these services. One paramedic andone EMT should be the minimum crew for ALS transport units and one paramedic should be theminimum for non-transport ALS units. Organizations such as the fire service, municipal EMS,commercial EMS, hospital/hospital consortiums, and volunteers could take a larger role inproviding or augmenting ALS services in New Jersey.EMS WorkforceThe workforce is the most critical factor in the provision of effective EMS. It is also the biggestchallenge faced by EMS. The Institute of Medicine report identifies several workforcechallenges that are common to EMS nationwide including recruitment and retention ofTriData, a Division of 5September 2007System Planning Corporation