By Dan Schwester
You couldn’t write a better script: A hastily organized group of people with a common interest, facing off in the state capital against a multi-billion dollar industry and politicians, and coming out on top in an unlikely story of David vs. Goliath.
Only it actually happened. In New Jersey, of all places.
New Jersey has a well-established, high-performing tiered EMS response system anchored by its two-paramedic Mobile Intensive Care Units (MICU). The new legislation introduced by Assemblyman Gary Schaer entitled “The ALS Modernization Act,” provided a lot of great changes to the NJ EMS system. It allows for paramedics to work in other areas of healthcare utilizing their full scope of practice in settings other then 911 prehospital medicine such as in the hospital, primary care, urgent care, ICUs, emergency departments, and even ORs.
It allows them to work within their full scope of practice on interfacility transport units, takes their standing orders out of NJ law, establishes community paramedicine programs, and appoints a state medical director for EMS to establish a better clinical chain of command at the state level. However, one clause was going to endanger the EMS system by permitting “alternate staffing models,” which would allow hospitals to replace one paramedic on each MICU with an EMT.
The potential for this clause to upend New Jersey’s system and potentially impact their paramedics was clear. And up until a few weeks ago, it was a done deal.
Enter the Paramedics for the Advancement of New Jersey EMS (PANJEMS). The organization was founded by paramedic Ben Dafilou, who felt dissatisfied with the lack of a voice that paramedics had in the state capital.
“The law that this bill amends is meant to govern the clinical abilities of paramedics in New Jersey and ensure the care that is delivered is both safe and of the highest quality. The one paramedic one EMT clause was proposed by the hospitals and EMS administrators due to financial reasons, not clinical reasons,” Dafilou testified.
“The reason for the alleged paramedic shortage in NJ is due largely to stagnant wages,” Dafilou continued.
In a matter of a few short weeks, the organization grew rapidly, and got to work; contacting legislators and other professional advocacy organizations in nursing, medicine, and emergency services. They contacted the authors of the law and went to Trenton to testify passionately about the system that they feel provides better patient safety and progressive, high quality care.
“If this was just a clinical question, as it should be, there would be no question about whether or not the dual paramedic system should be maintained,” Dafilou argued.
This view was shared by organizations such as the Professional Firefighters Association of New Jersey, New Jersey Firefighters Mutual Benevolent Association, The New Jersey Emergency Nursing Association, and the Health Professionals and Allied Employees (HPAE). Each of them aided with the changing of the law to maintain a dual-paramedic system.
The results were stunning. PANJEMS was able to get the legislation modified and the provision for alternate staffing changed drastically. Assemblyman Schaer’s office even worked with PANJEMS to develop the exact language of the amendment and now includes PANJEMS in ongoing discussions about the bill. It was a win altogether, rare in this day and age, and unheard of for a group that didn’t exist a month ago. NJ paramedics now have a voice in the NJ legislature. PANJEMS fully supported the legislation after the amendment was made because it will allow NJ paramedics to begin to rapidly progress both as a profession and as clinicians without reducing the quality and safety of care that they provide.
Dafilou states that this is just the beginning for the fledgling organization, which has grown to over 500 members; and anticipates a growing role for the professional organization in the state. The next task is to build out the organization, appoint a board of directors, and continue to move forward. PANJEMS intends to help advocate for better wages for EMS providers, provider mentorship to EMTs and paramedics entering the profession, and to educate the public and the legislature on the EMS system as well as the differences between EMTs and paramedics
The path to paramedic recognition is through public outreach to stakeholders and government. PANJEMS took the first step and found success. This may prove to be a bellwether moment for the profession if this type of activism takes hold.
The bill is expected to be signed into law this summer by Gov. Phil Murphy without issue given the unanimous in-favor votes in both the State Senate and Assembly.
