January 2010

At the New Jersey State First Aid Council, (NJSFAC) Board of Trustees of meeting on Sunday, January 24, 2010, a formal motion passed unanimously by the voting members. This motion directs the Officers to report this position today to the subcommittee of the EMS Council charged with a system redesign of EMS in NJ.

The NJSFAC cannot support New Jersey State Senate bill S818, sponsored by Senator Joseph Vitale, which revises requirements for emergency medical services delivery, as currently written. The following issues must be reviewed and certain assurances must be given consideration if we are to continue forward.

STATEMENT # 1

The process of reviewing the statewide emergency system began in 2006, when the legislature directed the DHSS and EMS to conduct an objective assessment of the current EMS system in New Jersey. The final report was generated in the fall of 2007. The committee completed the draft and sent the draft to the DOH&SS OEMS where changes were made and not reviewed by the sub committee prior to introduction as S818 to the 214th legislature in January 2010. There was a much different climate when this process of review began as well as a different financial environment than exists today.

STATEMENT # 2

The word volunteer has been removed almost entirely from this document. This is quite a surprise to the volunteer community especially since during discussions there was talk about adding a volunteer BLS section to the New Jersey Department of Health and Senior Services (DHSS) and the Office of Emergency Medical Services (OEMS). The impression given by this exclusion is that volunteer services are excluded from the system. All exclusions of the word Volunteer must be reinserted. In addition, we do not support the changes made to the New Jersey Highway Traffic Safety Act.

STATEMENT # 3

At no time during the discussions was there even a hint that the Emergency Medical Technician Training Fund (EMTTF) would be altered other than the suggestion that the surcharge be raised. The EMTTF must remain as a separate and unique benefit to the volunteer community. The NJSFAC will not accept any other considerations with regards to this fund. The EMTTF was authorized for by the Legislature solely and specifically to support volunteer first aid and rescue services that are provided by volunteers for true emergency response in New Jersey municipalities. NJSFAC supports the EMTTF for its original purpose. Preservation of the EMT Training Fund and increasing emphasis on recruitment and retention of volunteers will preserve the volunteer EMS system at a time when state resources are diminishing and needs are increasing. This would add to the crisis in municipalities that are themselves facing budget cuts, declining tax revenues, and increasing tax appeals.

The funding of training for paid emergency services and medical transportation, which may often be of a non-emergent nature, is a separate issue and should be considered separately. The EMTTF must remain as a separate and unique benefit to the volunteer community. The NJSFAC will not accept any other considerations with regards to this fund.

Individuals seeking employment in the field of emergency services should be required to follow the same path as other healthcare providers. Options might include:

• Individuals pay for their post high school, college or other professional educational programs;
• Tuition assistance programs be implemented for emergency service workers as may be done for nurses and other health professionals;
• Newly created State or federal funds or grants could allocate for continuing education for emergency workers.

STATEMENT # 4

The requirement for two EMTs per ambulance must be directed to the non-volunteer services. None of the contiguous states to NJ require two 2 EMTs.

• As many as 25 other states require one EMT in the patient compartment when a patient is present and one other person to drive the vehicle.
• Most of the NJSFAC agencies have a scramble system and do not require the volunteers to work a 12-hour shift, so there is no need to switch places.
• A non-volunteer agency, even with two EMTs still only has one EMT with the patient, when transporting.

NJSFAC suggests that a sample of language from the NYS Ambulance Regulations be considered.

STATEMENT # 5

The ambulance licensing issue is not portrayed in the final bill as discussed. Were we not to partner and make all ambulances licensed or certified?

STATEMENT # 6

The New Jersey State First Aid Council is deeply concerned that the changes proposed in S818 will result in a decline in the number of volunteers in EMS services throughout the state, and an explosive financial burden to municipalities. This could be avoided by addressing recruitment and retention issues and creating a process to coordinate a blended system of paid and volunteer first aid and rescue. Not only will it effect the day-to-day operations of local EMS agencies, it will also have a significant negative effect on disaster readiness and response if the number of volunteer squads is significantly reduced.

The NJSFAC has demonstrated their importance in mass-casualty incident responses. Faced with our nation's heightened state of alert, it is more critical now than ever for New Jersey to have an established, reliable volunteer EMS base. Non-volunteer services, whether municipal based or private, will not have the resources to call upon in the event of future catastrophic events like September 11, Hurricane Katrina or an event like the Haiti earthquake. On 9/11, New Jersey volunteers responded with over 400 ambulances to the disaster. Simultaneously, volunteer squads staffed over 300 other ambulances to ensure that "regular" 911 emergency response service was not interrupted in local communities.

With an $8.2 Billion dollar budget deficit looming in the 2011 state budget, the fiscal crisis will be worse then in FY2010 when the EMT Training Fund was depleted. If the property tax system were forced to finance paid services in what are now volunteer systems, the impact would have grave consequences to the health and economic well-being of not only municipalities, but also the State as a whole. The impact of adding potentially billions of dollars to New Jersey's property tax base as the result of losing our volunteers is a burden that this State's economy should not have to shoulder.

New Jersey's volunteer EMS system provides three core benefits. Specifically, it:

• Makes available highly trained EMTs for rapid mass-casualty incident response both within the state of New Jersey and throughout the northeast region
• Helps to alleviate an otherwise crippling financial burden on New Jersey municipalities, and
• Provides New Jersey's communities with much-needed, capable, and dependable medical assistance around the clock.

Currently, in more than 80 percent of New Jersey, when someone calls for an ambulance, volunteers respond. The New Jersey State First Aid Council represents more than 20,000 EMS volunteers affiliated with hundreds of first aid and rescue squads throughout the state. According to the Council, NJSFAC-affiliated EMS personnel in 2007 dedicated almost 3 million hours responding to more than 400,000 calls. Without the commitment of these volunteers, the municipalities they serve would have no choice but to foot the bill for emergency services.

The NJSFAC previously distributed a Position Paper which included a Plan of Action with two main goals in mind for maintaining volunteer emergency services- (1) stem the tide of decreasing volunteerism by facilitating the recruitment and retention of qualified and motivated individuals, and (2) enable EMS organizations to become more efficient and maintain or improve their level of effectiveness irrespective of recruitment numbers. The Plan consists of six components:

• Identify Questionable Mandates and Regulations
• Join the Effort to Recruit and Retain Volunteers
• Identify More Options for Producing Revenue
• Share Information on Efficiency and Creative Ideas

Consideration of these and other issues of volunteer first aid would assist in reducing the financial burden on the state and would preserve scarce resources needed to address other important aspects of the "paid" side of emergency services. We must work together toward a blended system that takes advantage of the best facets of both paid and volunteer services so that we can best meet the needs of our residents. The NJSFAC stands ready to work with Governor Christie, the Legislature, New Jersey municipalities and the Department of Health and Senior Services to serve New Jersey citizens.

New Jersey has been the recipient of over 80 years of high quality "free" first aid and rescue (as well as fire services) delivered by citizens willing to donate their time and energy to community service. What volunteer EMTs have received in return, is the satisfaction that comes from saving a life, delivering a baby, or responding to the many crises that have arisen in the past and will continue to occur in the future. NJSFAC members hope that common sense will prevail and we will continue to serve our communities into the future.

We are currently still reviewing the bill and anticipate having additional comments.