Sue Van Orden
President of the New Jersey
State First Aid Council
What if there was an organization whose thousands of associates were willing to work free of charge—and bring with them all the tools necessary to do the job? What if I told you many of your communities already have such an organization working for you?
Volunteer EMS personnel are transparent in our daily activities, as we go about the job of serving our communities. This transparency has come back to haunt us. The public’s complacency is our nemesis. We’ve done such a good job for so long that people simply assume that when the call goes out, someone will respond. Most of the time, the responders are volunteers.
The 80-year-old nonprofit New Jersey State First Aid Council (NJSFAC) represents more than 20,000 EMS volunteers affiliated with 365 first aid and rescue squads throughout the Garden State. New Jersey has the oldest, largest and finest basic life support (BLS) system in the nation. Never in our history have our members billed for service. During the last few decades, for predominantly economic reasons, EMS volunteer rolls and donations decreased, yet call volumes steadily increased.
Keep in mind BLS crews respond to every 911 call. Advanced life support (ALS) and fire crews respond only to calls that require their expertise. Volunteers are the backbone of New Jersey’s EMS response, and must be recognized as such to ensure continued system support. Without volunteers, much like a body without a sturdy musculoskeletal foundation, the system would collapse.
Many BLS squads purchase and maintain their buildings, ambulances and equipment with little or no support from their municipalities. Equipping squads these days entails purchasing not only bandages, but expensive items such as defibrillators, epinephrine pens to combat allergic reactions, $12,000 power-lift and bariatric stretchers. To raise these funds the volunteers turn to bake sales, small auctions, grant applications or simply begging at traffic lights or outside the local grocery store.
Without increased system-wide funding and much greater support of the volunteer BLS community, the changes recommended in the system redesign, collectively, could jeopardize EMS response. Without these, taxes will increase in every community across New Jersey and further burden already-stretched budgets.
Consider these facts. In 2007, volunteer member squads:
- Answered 404,489 calls.
- Traveled 5,643,886 miles.
- Spent more than 2.6 million hours on call, which if billed at the
$12.50 hourly rate of the entry level EMT would have cost more than $32.6 million.
A System at Risk Now, the volunteer EMS system that has worked so successfully is in jeopardy. The proposed system redesign provides a cookie-cutter approach and does not allow the flexibility New Jersey EMS needs, with its mix of rural, suburban and urban areas.
For one thing, NJSFAC-affiliated squads already meet or exceed state regulations for responses, equipment and inspections. Yes, we volunteers have trouble at certain times, such as weekdays, getting ambulances out to answer calls. That is due, however, to lack of volunteers, not lack of regulation or oversight.
Volunteer and commercial EMS differ in the following ways:
Volunteer EMS is a predominately scramble system, with members responding to a call from home or work. Most EMS volunteers return to work or home after responding to calls. Calls typically last one to two hours.
Commercial EMS teams are dedicated crews that are stationed at designated areas, waiting to be called, or do inter-facility transports. Commercial EMS crews typically work 8- or 12-hour shifts.
It makes perfect sense for commercial EMS crews to have two equally qualified members, with each alternately providing patient care and driving.
The NJSFAC minimum operating standard has always recommended and encouraged two emergency medical technicians (EMTs) per call. We feel, however, a prompt response with one volunteer EMT in the patient compartment and another responder with special ambulance-driver training is preferable to waiting 20-40 minutes for mutual aid to get that second EMT. If we were required to provide two EMTs on each ambulance, prompt responses to calls would be even more difficult due to the volunteer shortage.
The proposed regulations do not offer a solution to the shortage of trained EMTs throughout the state, a critical issue for commercial and volunteer agencies. Although recruitment and retention are integral parts of this must-fix issue, they are not adequately addressed in the proposal.
NJSFAC efforts to recruit and retain more volunteers include using grant funding to produce a 14-minute recruitment video and three 30-second public service announcements (PSAs). You can watch the video on our web site, www.njsfac.org. We are revamping our web site and will make the PSAs available on the site later this year. Meanwhile, the PSAs have been airing the past several months on Comcast, Cablevision, Time Warner and Service Electric cable TV, and some local channels. We encourage municipal officials to air the video and PSAs on their own local-access channels, and throughout their communities. Contact me at firstname.lastname@example.org for copies.
Sue Van Orden is President of the New Jersey State First Aid Council from 2004 to present and is a member of Lincoln Park Emergency Services for 27 years. NJSFAC represents volunteer EMS agencies across New Jersey.
This article was originally published in New Jersey Municipalities magazine. Vol. 86, No. 5, May 2009