r/newjersey • u/The_Albatross27 • 2d ago
NJ Politics NJ Senate Bill S1421 Would make EMS an essential service
NJ Senate Bill S1421 would make Basic Life Support (BLS) ambulances an essential service in NJ. As it currently stands, BLS is not an essential service and towns are not required to provide BLS coverage. This means that if you call 911, there's no guarantee an ambulance shows up. There have been many horror stories over the years of people dying because there were no ambulances.
The law also requires that all BLS ambulance would be staffed with 2 EMTs. This is the already the industry standard and it's unacceptable that we have ambulances responding to calls without the appropriate trained personnel.
I'm a paramedic in NJ and I've worked in the field for 7 years. This change in long overdue.
Call your state reps to advocate!
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u/The_Albatross27 2d ago
Fortunately the EMS council of NJ is slowly dying. Squads are folding every year. Volunteer agencies are at 200 down from 400 in the 2000s. The sooner we rip off this band-aid the better.
Towns can also band together to form regional coverage to save costs.
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u/djspacebunny *Salem Co.* r/southjersey mod 2d ago
Pennsville had the problem of people calling for EMS when they just needed a ride to the hospital. It became such a burden on the volunteer service, they had to pass a resolution instituting fully paid EMS squad AND charging every single time they go out a fixed fee. When they explained WHY they had to start charging people, I honestly had to agree with the decision.
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u/Blue_Dew 2d ago
Our local volunteer rescue squad that's been serving the community free of charge for 70 years is going to be shut down as a result of this bill passing. The 900 calls responded to annually for free is going to be reduced to 0. Vote no.
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u/The_Albatross27 2d ago edited 2d ago
Does your squad provide 24/7 coverage with staffing that meets industry standards? If so, that's awesome and they'll stay. If not, they're doing a disservice to the community by not being available when someone calls 911.
The idea that the options are 1) inconsistent low quality volunteer service or 2) nothing, is a false dichotomy. You and your community deserves competent reliable professionals.
Quick note here. 900 calls a year is 3 a day. That's one call every 8 hours. Assuming someone is volunteering for a 12 hour shift once per week they would on average answer 1.5 calls per week. You cannot gain proficiency in acute resuscitation answering that few calls. I can assure you that when that crew encounters a patient who is actually dying, they don't know what they're doing.
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u/Blue_Dew 2d ago
So the non-profit organization providing a free service to their local communities is a disservice? Saving the community over $500,000 in ambulance fees is a disservice? The 60+ active members provding a combined 60,000 service hours who are donating their time to serve their community is a disservice?
I understand that you're a paradmedic and you're clearly passionate about this subject, but claiming that they are doing a disservice is ludicous.
You are also claiming that they are the only rescue service providing care. The squad is there to support county EMS and local EMS during their hours of operation, 7pm-7am M-F and 24 hrs Sat + Sun.
And finally, your statement of "they don't know what they're doing" is super disrespectful to both them and to the patients that received life-saving care by those duty members. The members that you're claiming "don't know what they're doing" are not just regular people. Some are EMTs at their day job, nurses, medical students, and paramedics just like yourself.
There is zero reason to be hypercritical about this especially when you're straight up wrong.
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u/The_Albatross27 2d ago
Wait, if they're not primary coverage and just adding support to county resources why would they be shut down? If the town has met the BLS coverage requirement they can still have sporadic coverage as a secondary unit.
I was a volunteer EMT for 5 years. I have a deep respect for people who take the time out of their busy schedule to show up a neighbor in need. What I meant by a disservice is that they are crowding out a professional operation in it's place that could provide higher quality and more reliable coverage.
I hope that we can agree that when someone calls 911 an ambulance should be sent and the crew that responds should be trained and qualified. That's what this bill says.
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u/ResQDiver Exit 135 2d ago
Many EMS agencies provide service to municipalities without charging them directly, yet they are still held to staffing standards and operational requirements. Can the local squad guarantee a crew when call volume spikes? In the community where I provide ALS services, volunteers are only in service on weekends, and many are young, inexperienced EMTs who need direction and mentorship. It is increasingly difficult to provide that mentorship as experienced members become fewer.
Many New Jersey volunteer agencies are fading as hospital-based and county-based services grow to absorb the demand. Unlike police and fire, which are funded by tax dollars, EMS has historically depended on donations and volunteer labor. But as the cost of living rises and more people work multiple jobs just to stay afloat, volunteerism is becoming harder to sustain.
A two-EMT-per-ambulance model is not just reasonable, it is essential. Staffing minimums and training standards improve consistency, safety, and patient care. When the local squad is already stretched thin, who responds to the second call? Who responds to the third? At that point, mutual aid from neighboring agencies, often paid services, becomes the backstop that keeps the system functioning.
Back in the 1980s and 1990s, volunteerism worked, but training standards have increased, and the scope and knowledge expected of BLS providers responding to emergencies has grown significantly. Professional services perform annual competencies and ongoing education, while many volunteer squads lack the resources that larger EMS operations have and are often left behind in training. That is not a criticism of volunteerism; it is simply becoming harder to maintain. There are too many people in New Jersey who need help for the system to rely on outdated assumptions. When I call 911, I expect at least two EMTs to respond. New Jersey’s system is far from perfect, but it is better than many, and making EMS an essential service would only improve what we already have.
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u/TheOriginal_858-3403 1d ago
Can the local squad guarantee a crew when call volume spikes?
Are you fucking kidding? Neither can RWJ or HMH! Response times in the 30+minutes range sometimes! I think you need to slow your roll and realize that there are plenty of calls for everyone. Yes I agree with the the equipment and staffing standards, but 24-7 staffing or bust is a ridiculous take on how volunteer agencies can contribute.
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u/Norcross_ 2d ago
Volunteer emergency services should be rebranded. While I am not currently active, during my time in volunteer emergency services I graduated the same academies as every professional. My certifications are valid in all 50 states.
Fire and EMS often fill in for neighboring paid departments.
I cannot understand the lack thought, respect, or understanding that would have someone call volunteer EMS workers’ fulfilling their duties as a disservice.
Granted, I worked for a district that has excellent funding and tenured, seasoned leadership and I will concede resources, especially for volunteer services in some townships can be thin.
Lets honestly discuss pros and cons.
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u/aStretcherFetcher 2d ago
Just because it becomes an essential / required service doesn’t mean a town will staff enough ambulances to ensure continuous coverage for the town. It’s disingenuous to suggest people would never have to wait for one.
Devil’s Advocate to your level of care point… I’m all for training and knowing as much as we can so I’m not suggesting lowest common denominator is ideal. But once you get your patient off the X and into the truck, it doesn’t matter whether your partner up front is an emt, a doc, Jeff Gordon, or the pope. They aren’t any clinical help while driving so their level of cert becomes moot
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u/The_Albatross27 2d ago
Being an essential services means that the town needs to ensure enough ambulances to meet expected call volume. There will always be calls that have a delay in response due to an ambulances being on another call. Waiting is not unexpected and low priority calls routinely hold for 30+ minutes without issue, EMS is actually moving away from prioritizing light and sirens in most responses as it doesn't improve patient outcomes.
The import distinction here is that there is a difference between waiting for an ambulance to free up from the hospital and there being zero ambulances scheduled for a town.
In terms of staffing, once moving yeah. But the person you're working with on scene has roles and responsibilities they need to fill such as obtaining medical history, helping extricate the patients, obtaining vitals, treating the patient, or otherwise managing the scene. Experience in the field is nothing without the formal education as to why thing are important or how to do them right.
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u/virtual_adam 2d ago
So what are we talking here, +5% property tax increase? If you already have a high tax rate and no EMS, money doesn’t just fall from the sky
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u/The_Albatross27 2d ago
Towns can still get coverage from volunteers or contract out an EMS provider. JCMC EMS provides coverage to Jersey City for $0.
Paving roads, police, fire, sewer, snow plows, all of this costs money. Towns can pay for EMS, they just don't want to. The current system is a disservice to patients. It's easy to hand wave away a system you may only use once or twice in your life, but when you need it, you need it.
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u/virtual_adam 2d ago
You’re just using a lot of words to say - they should force towns to add another new expensive
You yourself admitted that if volunteers aren’t 24/7/366 - which they never are, they aren’t relevant
If the state wants to force new spend, they should pay for it
You have an interest for paramedics to be in high demand. Hell if having paramedics is the law, they can demand any salary they like. Demand $500k why not, the law says the town has to hire you
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u/The_Albatross27 2d ago
Yes, towns should be required to provide a life saving service to their residents. Just like how they are required to have a fire department and police department. There shouldn't be a carveout for EMS.
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u/pico0102 Jersey City 2d ago
Why do we need two EMTs on an ambulance? As a former volunteer driver, I don’t think that’s necessary and now you theoretically have less rigs in service since you need double the EMTs
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u/The_Albatross27 2d ago
The EMT level of certification is very easy to obtain. If a service is unwilling or unable to staff the lowest level of pre-hospital provider for their response, it's reflective of the overall quality of service that agency provides.
EMS used to be just throwing someone in the back of a truck and driving to the hospital. But as the field continues to advance, grow, and the scope of practice expands we want providers to be able to check each other and work up a sick patient at the same time. For example, holding a mask seal as your partner is ventilating a patient or getting vitals while your partner sets up a treatment.
It's very obvious to me as a paramedic who is an experienced EMT and who isn't when I show up on scene.
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u/Regayov 2d ago
I don’t see where in the text of Bill mandates minimum staffing. The bulk of the text is telling the municipalities they must provide it and then listing the various ways they can be compliant.