NJ Emergency Medical Services Council “Blue Ribbon Panel”

1. NJ Emergency Medical Services Council“Blue Ribbon Panel” EMS System Design Recommendations

2. NJ Emergency Medical Services Council“Blue Ribbon Panel” Pre-Amble to Change • EMS Coverage be required 24/7 • Health Insurance Coverage pay for EMS 911 Emergencies based on Lay person’s knowledge, with payment sent directly to provider • NJDOHSS Commissioner support Legislative initiative to supplement transportation cost for non-transport MICU’s • EMS should remain multi-tiered (First Responder, BLS, ALS) • EMS Dispatch Compliance Standards • ALS Dispatch must be centralized and the closest unit must be dispatched • ALS System change must be made easier to facilitate • Uniform pre-hospital data collection must occur statewide at all levels • EMS Medical Advisory Council should have both ALS & BLS Sections • Recommended response times must be established in order to improve care

3. NJ Emergency Medical Services Council“Blue Ribbon Panel” • Panel recommendations have been split into three parts • Mild System Change • Moderate System Change • Intense System Change

4. NJ Emergency Medical Services Council“Blue Ribbon Panel” Mild System • Major Components: • First responder program is desired • BLS would consist of paid and Volunteer where available, crew configurations EMT/EMT (phased in bridged training) • ALS Providers remain CN Based, crew configurations MICP/MICP, Medical Protocol driven system with MD contact “as necessary”, Medical changes allowed at commissioner level not in Law, non-transport system remains (transport of last resort OK), Financed by supplemental charges to DMV Violations • Medical Advisory Council would have both ALS & BLS sections • Uniform Data Set collected from ALS & Licensed providers

5. NJ Emergency Medical Services Council“Blue Ribbon Panel” Moderate System • Major Components: • First responder program is desired, MICP permitted • BLS would consist of paid and Volunteer where available, crew configurations EMT/EMT (phased in bridged training) • ALS Providers remain CN Based, crew configurations MICP/MICP, Medical Protocol driven system with MD contact “as necessary”, Medical changes allowed at commissioner level not in Law, non-transport system remains (transport of last resort OK), Financed by supplemental charges to DMV Violations

6. NJ Emergency Medical Services Council“Blue Ribbon Panel” Moderate System (con’t) • Major Components: • Creation of Medical Oversight Board • Medical Advisory Council would have both ALS & BLS sections • Legislation requiring Municipalities to have 24/7 coverage; Insurance coverage mandates; recognize EMS as the third Emergency provider (with Police & Fire); Allow the Paramedic first responder programs • Uniform Data Set collected from all ALS & BLS Providers • Vision and Oversight provided by Board of Oversight appointed by Commissioner/Governor

7. NJ Emergency Medical Services Council“Blue Ribbon Panel” Intense System Change Major Components • Five regional Planning and Oversight Boards (POB) created, consisting of Medical Director, POB Director, Finance Manager, Homeland Security Coordinator, QA/QI person (s) for Field and Dispatch medical care, Pre-Hospital Career and Volunteer Services Coordinators • Regions would be based upon HRSA Regions (population based) • Each of the Five POB Directors would sit on the State POB and serve as the Agency Licensing Board (State Medical Director to serve as State Chair) • Each of the Five POB Medical Directors would sit on the State POB and serve as the Provider Licensing Board State EMS Director to serve as State Chair) • Medical Protocol driven system with MD contact “as necessary;CN based, CN Subletting permitted in urban areas

8. NJ Emergency Medical Services Council“Blue Ribbon Panel” Intense System Change Major Components • BLS would consist of paid and Volunteer where available, crew configurations EMT/EMT (phased in bridged training) • ALS Crew configuration determined by POB recommended MICP/MICP • Uniform Data Set required from ALL EMS Providers • State POB and MAC would be the venue for providing new medical initiatives, changes in scope of practice or procedures • State EMS Director and State Medical Director would also serve on the State POB with Regional Directors and Medical Directors

9. NJ Emergency Medical Services Council“Blue Ribbon Panel” Intense System Change Major Components • A State sponsored Emergency Medical Service Pension System for EMS 911 providers with credit given for volunteer services. • Legislation would be required to; requiring Municipalities to have 24/7 coverage; Insurance coverage mandates; create POB’s at State and Regional Level providing the authority necessary to facilitate it’s roles as outlined; Create necessary funding for program administration and cover uncompensated expenses provided by the EMS Providers; recognize EMS as the third Emergency Service Provider (with police & Fire); Central Dispatch Creation and funding; create and fund an EMS Pension Law

10. NJ Emergency Medical Services Council“Blue Ribbon Panel” System Readiness Each design requires 24/7 coverage at the First Responder, BLS and ALS Levels….Crews shall report their availability at the beginning of each tour, areas uncovered would require automatic mutual aid to the next available unit (s). All EMS Vehicles and Personal will have State issued ID’s for easy and accurate identification.

11. NJ Emergency Medical Services Council“Blue Ribbon Panel” EMS Dispatch Mild & Moderate All Levels must Compliance with EMD As presently configured using statewide dispatch protocols Intense Centralized at county level using statewide dispatch protocols Each Center would be licensed to provide EMS Dispatch by local POB with reimbursement funding available to facilitate QA/QI programs

12. NJ Emergency Medical Services Council“Blue Ribbon Panel” First Responders Mild Desirable at this level (First Responder, EMT, Police etc) Moderate & Intense Required at this level (First Responder, EMT, Police etc) can be Paramedic

13. NJ Emergency Medical Services Council“Blue Ribbon Panel” Response Times • Cardiac Arrest Patients in rural/urban/suburban areas (90% of time) • 1st responder and/or BLS <4 minutes • ALS <10 minutes • All other patients rural areas (90% of time) • 1st responder and/or BLS <30 minutes • ALS <15 minutes • All other patients in urban/suburban areas (90% of time) • 1st responder and/or BLS < 20 minutes • ALS < 10 Minutes

14. NJ Emergency Medical Services Council“Blue Ribbon Panel”

15. NJ Emergency Medical Services Council“Blue Ribbon Panel” Questions????????????? Written Comments should be sent to: Dr. James Pruden, Emergency Department St. Joseph’s Hospital and Medical Center 703 Main St. Paterson NJ 07503 Or email: prudenj@sjhmc.org