How to fix the mess that is NJ's EMS system

[paramedicmike]

So, If most systems can afford ALS , why not let FAS,'s hire medics if they can.... better to allow them than to prohibit FAS's from running ALS.

Because, unless I'm mistaken, state law only allows medics to be employed through hospitals.

At least that's how it was explained to me by several NJ medics.

-be safe

[Amhet1]

"So, is the answer having paid BLS? To a point yes. But then you're back in a circle to who gets paid. If the BLS transports and the medic is in the back providing care. The BLS gets paid and the ALS gets nothing. How can a medic provider survive like that? "

Medicare and private insurance reimburse for a "Paramedic Intercept".

What is required is a written agreement between the BLS and PI for reimbursement. Only one of the departments can bill for the service. The two services would have to agree how much each service would get.

As far as the rest of NJ..... The system must be torn apart from the top down and completely rebuilt. The legislature has to make the necessary changes before any worthwhile effects will be seen on the streets. Develop county EMS SYSTEMS! Design it in a way that works for that county but as an integral system with the state. Monopolies of ALS has to be disbanded. Any competent service should be able to provide ALS with appropriate oversight. Stop the TAXPAYER GRAVYTRAIN! Why does a small volunteer service need 3-4 ambulances when they clearly cant staff them or have a need for them. Disband those services that cannot or HAVE NOT met response requirements.

Someone compared NJ to other broke systems like Houston, NYC, Phili, etc. It is fair to make the comparison because a broke system is a broke system. CA is broke because because of the top-heaviness. The state has the peices in place, but with any big government is going to be innefficient. The money CA has spent on administration of EMS at the state level could have paid for a paramedic on every ambulance and fire truck.

Does anyone else see a common thread thru problem areas? NJ = Democrat. CA = Democrat. NYC = Democrat. Sorry, overtaxing, taking away personal freedoms and waste just [s:5c48bb2d43]pis [/s:5c48bb2d43]irritate the hell outa me.

Im sure I could come up with more, but I think the other best option is give the entire state back to the atlantic ocean.

[afib]

THANK YOU AMHET !!!!!!

[mediccjh]

Oh, where do I start....

In New Jersey, ALS MUST be hospital-based. By law. That is why you cannot operate an ALS 911 service in New Jersey. Personally, I don't mind it.

Also, by law, there must be 2 medics on the MICU. I like that too.

BANISH THE FIRST GRADE COUNCIL. They are useless. They do nothing. Because of them, volunteer units don't even need to be licensed by the state.

GIVE NJOEMS MORE POWER. More power to inspect the vollies and hold them accountable.

HOLD THE VOLLIES ACCOUNTABLE. I don't even need to explain this.

REGIONALIZE, REGIONALIZE, REGIONALIZE. It's working in Gloucester. Regionalize the 911 centers to be county-wide. Make the BLS county-wide, with ALS fly cars. Hudson, Warren, and Hunterdon do this. It works. Keep certain ones stand-alone, like REMCS for Newark.

To me, the problem is not that there aren't enough medics in NJ; it's that they are abused. There are lots of places where the PD will request ALS on an obvious BLS patient just to baby-sit until the BLS shows up. It sucks.

DISCLAIMER: These are my opinions, and do not represent the organizations in NJ I work for.

[FormerEMSLT297]

Because, unless I'm mistaken, state law only allows medics to be employed through hospitals.

At least that's how it was explained to me by several NJ medics.

-be safe

WTF,, Obviously you did not read my first post on this subject..... What I said was the LAW needs to change to eliminate the MONOPOLY that is hospital based ALS in N.J.

Allow any provider that has can show a need, to run an ALS unit, FD's FAS' PD's,

They also need to reevaluate the 2 medic system, as there is nio evidence to support better patient outcomes.

[paramedicmike]

WTF,, Obviously you did not read my first post on this subject..... What I said was the LAW needs to change to eliminate the MONOPOLY that is hospital based ALS in N.J.

Actually, I did. But since you continued to ask I figured you forgot what you wrote and needed some reminding.

Allow any provider that has can show a need, to run an ALS unit, FD's FAS' PD's,

Police departments have as much business running EMS as does fire. That is to say, neither has any business running EMS. EMS needs to be a stand alone operation. In a sense, it makes sense for the hospitals to run it as hospitals are, by definition, health care facilities. We provide health care. We need to work under the guidance and supervision of a physician. So why not be affiliated with hospitals?

They also need to reevaluate the 2 medic system, as there is nio evidence to support better patient outcomes.

But there is (anecdotal) evidence to support that B/P partnerships lead to faster burnout. This is demonstrated across the country every day. So you would argue that a system promoting burnout is the way to go?

-be safe

[Asysin2leads]

You know, of the Police Department EMS services I know, they run so much better than Fire based EMS. Why do you think that is? Is it because like EMS, cops can actually show up for their job, go home at the end of the night and be done with it?

[FormerEMSLT297]

Look I understand that having a hospital based EMS has it's advantages, but,, when ALS is not getting to people that need it, and the appearent reason is a ALS monopoly that system needs to be reevaluated..

And I agree with hwat Asys said, of the ALS Police systems, they do as good, if not a much better job providing EMS than their FD counterparts.

All I'm saying is opening up more opportunities to run ALS units, hopefully will increase the ALS that is available to arrive at a patients side in a timely manner.

Also ,, I agree, I like to work in a 2 medic system as well, but if you can double the ALS coverage single ALS is something to consider,,,,, CONSIDER being the key word...

[DirtJerZ]

Im a new jersey Paramedic, i work at 2 projects. The problem i see is the volunteer squads, Most are unprofessional and pick and chose calls. This puts a strain on the system because medics are stuck transporting patients or sitting on scene with patients who could have been triaged to BLS. This leaves the medics unable to respond where they are actually needed. Also the volunteers are keeping us on jobs, just to check out the patient. I say down with the first aid council, and make the BLS professional. They show up in my project wearing shorts, sandals, etc.. and a radio. They have no idea of the concept of going to the hospital. They sit and wait on scene for the medics, and usually its a release. Very sad system and we have the first aid council to thank.

[Asysin2leads]

Im a new jersey Paramedic, i work at 2 projects. The problem i see is the volunteer squads, Most are unprofessional and pick and chose calls. This puts a strain on the system because medics are stuck transporting patients or sitting on scene with patients who could have been triaged to BLS. This leaves the medics unable to respond where they are actually needed. Also the volunteers are keeping us on jobs, just to check out the patient. I say down with the first aid council, and make the BLS professional. They show up in my project wearing shorts, sandals, etc.. and a radio. They have no idea of the concept of going to the hospital. They sit and wait on scene for the medics, and usually its a release. Very sad system and we have the first aid council to thank.

So long as you can be in charge of a couple of million depending on whether or not the rest of the squad votes you treasurer, and so long as the "captain" of the squad can send the ambulance out for a $500 transmission tune up billed to the township to his brother the auto mechanic whenever he pleases, and so long as the towns want pretty ambulances with pretty lights and remain the dark about EMS, and so long as the local politicians benefit from it, the Volunteers will exist, the First Aid Council will exist, and people in New Jersey will die needlessly. To fix the the EMS system in NJ you'd first have to fix the corruption in NJ, and well, I think my plan to empty Lake Superior with my trusty pail will have more success.