Apr 17, 2017
Read my Open Letter to Mr John Bendel here.
For today’s post, we are going to continue to analyze the saga of the Asbury Park Press editorial battle regarding EMS in New Jersey. The EMS Council of New Jersey has sounded off. Last week on April 10th, the EMSCNJ’s president, one Mr. Joseph G Walsh, wrote a letter of his own in order to, as he puts it, “correct several points.” So let’s fact check some of Mr. Walsh’s statements, and dig deeper into what the EMSCNJ has said in the past.
“Paid or volunteer, every New Jersey EMT must pass the same certification exam. Volunteers conduct monthly drills, and education and skills sessions to stay current. The misleading editorial might have panicked some readers into falsely thinking their local volunteer squads are not staffed with properly trained responders.”
It is true, indeed, that every EMT must pass the same certification exam. So what? I would dare to say that the ability to study and regurgitate information from a textbook is not the be-all-end-all in evaluating one’s effectiveness as an EMT. I have worked with great EMTs, and I have worked with people who could not be trusted to work on a crew of two because they lacked the ability that they needed to take the knowledge in their head and apply it in a real-life practical setting. They all had one thing in common though, they passed the same test.
Then there is the other statement that Mr. Walsh makes here about proper staffing. While all EMTs take the same test, that fact alone does not mean that every person operating on a volunteer ambulance in New Jersey is a certified EMT. In actuality, many responders might just be certified at a lesser level. How do I know this? Mr. Walsh tells us.
“Every one of our member squads is required to respond to calls with at least one EMT who remains with the patient. On many calls, two or more EMTs respond. The EMS Council of New Jersey (EMSCNJ) is unaware of any squad — member or nonmember — answering calls without such trained responders.”
Currently, when a paid or career ambulance responds to an emergency, they are staffed by two certified EMT’s. When a volunteer service responds, that might not be the case. Why are there two standards?
“Previous EMS “reform” legislation called for a minimum of one EMT to respond, not two, as incorrectly noted in your editorial.”
Back in May of 2010, I wrote about New Jersey Senate Bill S-818. Nearly a year later, we discussed it again, including some of the recommendations made by the EMSCNJ, then known as the NJSFAC. We even discussed the bill a third time, sharing some facts about the EMSCNJ’s views of the bill. Unfortunately, the bill died, and the EMSCNJ’s page regarding the bill was pulled from the web. S-818 asked for mandatory BLS staffing of two EMT’s. In the only mention of the words “patient care” in their position statement, the EMSCNJ stated the following:
““. . . we recommend that at a minimum, a volunteer crew consist of 1 EMT who will be responsible for patient care and 1 certified driver.”
The legislation called for two EMT’s. The EMSCNJ asked for one. They include what they refer to as “nonvolunteer” services in their latest ask of the State Senate. Those are services that provide emergency response on a paid basis.
“Between answering calls, training, community education and events, recruitment and retention efforts, and fund raising, EMS volunteers throughout New Jersey easily dedicate hundreds of thousands of hours annually. Their service saves residents the additional tax burden that would be required to pay for EMS coverage.”
Funding EMS via taxes is just one way to pay for EMS. Let’s not forget that the majority of volunteer EMS departments in New Jersey do not bill for their services. That billing money, for example, is a great way to offset costs. So is contracting with an outside company. Depending on call volume and payer mix, municipalities might actually save money by going to a career EMS department.
“People often assume mandating EMS services for all municipalities, just as police and fire services are required, will fix everything. Who will pay the millions of dollars annually such an endeavor would require?”
Again, we throw huge price tags on everything, when that might not always be the case. This is a scare tactic. I can think of many municipalities off the top of my head who receive EMS coverage that is completely paid for by those who utilize the service.
“EMS responders, whether paid or volunteer, EMT or paramedic, share the same patient-care goals. Attacking and attempting to discourage volunteers, who are the backbone of New Jersey’s EMS system, won’t help attain those goals. “
Volunteers do not get special treatment just because they volunteer their time. Asking for standards to be set and oversight to be provided is not an attack. It’s called accountability. While Mr. Walsh can say that there is no need to overhaul the NJ EMS system, a look to the north, south, or west might just show exactly how far behind the times EMS in New Jersey is. New York, Pennsylvania, Delaware, and Maryland all have very different service models than New Jersey. All of those states also has EMTs, just like New Jersey does. The difference though, is standards.
For example, Mr. Walsh mentions current Bill S-371. I perused the summary of the bill, and welcome you, the reader to do the same. One statement though stood out to me:
“This bill would require that, when adopting a training program, the Council and the Department of Health must take into consideration the national curriculum for emergency medical technicians and other emergency medical responders. In addition, the bill would require that the impact on recruitment and retention of volunteers be considered before adopting and implementing any new or revised training requirements or curricula related to training materials, minimum class hours, training hours, or the availability of training programs.”
Emphasis is mine. Before the state system would be allowed to move forward, the state would have to weigh the benefits of the patient with the benefits of the provider. I hate to break it to all of my EMS readers out there, but for all intents and purposes, it’s not about you. It’s about the patients. In order to stay current with advancements in medicine, more training is going to be required.
To put it simply: burn your backboards, and throw away your MAST pants.
The volunteer EMTs elsewhere are held to a much higher standard than those in New Jersey. They are asked to answer to neutral, state located departments who provide oversight, not their peers who they pay dues to.
Regardless of the delivery model, everyone who calls 9-1-1 in New Jersey deserves the same level of care and the same level of accountability for their providers. I cannot for the life of me figure out why Mr. Walsh and his organization are so staunchly opposed to this.