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911 Emergency Care Bill to Get a Second Look

Christie conditionally vetoes licenses and criminal checks for EMS workers -- lawmakers say they will look at costs in new session.

A bill that would provide first aid to the state's emergency medical services was conditionally vetoed on Monday by Gov. Chris Christie. The measure would require licenses and criminal background checks for all EMS workers and seeks to improve 911 care and response times.

Sen. Joseph F. Vitale (D-Middlesex), incoming chairman of the Senate's health committee, let the measure expire and said lawmakers would retool it in the new session. "I think we're almost there," Vitale said.

Christie cited the bill's potential cost and directed the NJ Department of Health to study the licensure issue. "While this legislation is well-intentioned and suggests several potential changes that seek to create a more coherent regulatory structure for the state's EMS system, I am advised that implementation of the requirements and commitments provided for in the bill would cost the state and municipalities across the state millions of dollars," the governor said.

The bill grew out of efforts to revamp the state's emergency services that began in 2007, and included input from the state health department, local ambulance squads and the Legislature, according to Scott Kasper, corporate director of EMS for Virtua, the southern New Jersey healthcare and hospital system.

Known as the EMS Redesign Bill, the measure would require "that every 911 provider delivers the same standards of care, has been trained, and has had a criminal background check and [is using] safe equipment," said Francis Pagurek, chief of the Mount Laurel Township Emergency Medical Service and president of the Burlington County First Aid Council.

Volunteer first aid, ambulance or rescue squads would be exempt from having to pay any costs associated with licensure, or for the cost of the criminal background checks. The bill also creates a new position in state government, a State Medical Director for Emergency Medical Services who would be a New Jersey-licensed physician with experience in the medical oversight of emergency medical services delivery.

"While this bill is an important step in highlighting the need for certain improvements in our EMS system, the changes in this bill raise a multitude of new issues that need to be thoughtfully considered before our current system of emergency care is disturbed," Christie said.

Kasper said the bill addresses concerns about the potential cost. "The bill requires licensures of all ambulance services, and the Department of Health would waive all the fees for volunteer rescue squads," he said.

This "is a pro patient bill" that will strengthen volunteer rescue squads, added Pagurek. The governor's conditional veto is a movement in the right direction, and signals that the administration agrees with improving standard for 911 care.

"This issue has been studied for many years, with extensive, expert input having been received from both volunteer and paid providers," Pagurek said. "We are firmly convinced that a legislative consensus on how best to strengthen what works, and fix what is clearly broken, will soon be reached in a bill that the governor will sign."

Vitale said he will look into the cost of licensure. "It all depends on who is paying for it and how they are paying for it," he said. Opponents of the bill had argued that the cost of implementation would fall on the state government, or on the municipalities.

"Licensure costs money. The background checks to ensure that everyone who enters a home has had an appropriate background check, that cost will be borne either by the individuals or the squad, or the town or the state or a combination thereof," Vitale said. "It costs money but we have to make sure that every ambulance has an EMT on board and that the response time is cut as much as possible. It is all about quality, and there is a cost associated with quality, there always is. This is a matter of life and death in some cases, and we should do all we can to make sure the right processes are in place."

Vitale said that "many of the volunteers who are EMTs have come to me and said 'we want to be licensed, we want to be treated as professional and be licensed.' They are professionals, and they want their professionalism to be recognized by having them be licensed."

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