S4825

An Act concerning the emergency medical services workforce and emergency medical services system capacity, and supplementing Title 26 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. As used in this act:

"Active volunteer emergency medical services personnel" means an individual who:

(1) holds a current certification, license, endorsement, or other credential issued or recognized by the department that authorizes the individual to provide emergency medical services or pre-hospital emergency medical care;

(2) is affiliated with a volunteer emergency medical services agency in a volunteer capacity; and

(3) during a period established by the commissioner, has actively participated in the provision of emergency medical services, including by staffing an emergency medical services unit, responding to or being available for emergency medical services calls, providing pre-hospital emergency medical care, or performing such other operational emergency medical services activities as the commissioner determines appropriate.

"Commissioner" means the Commissioner of Health.

"Credentialed emergency medical services personnel" means individuals holding a current certification, license, endorsement, or other credential issued or recognized by the department that authorizes the individual to provide emergency medical services or pre-hospital emergency medical care.

"Department" means the Department of Health.

"Emergency medical services agency" means an emergency medical services provider, as that term is defined in section 1 of P.L.2017, c.116 (C.26:2K-66), that provides basic life support ambulance services or other pre-hospital emergency medical services.

"Volunteer emergency medical services agency" means an emergency medical services agency that provides emergency medical services wholly or in substantial part through personnel who provide such services on a volunteer basis, and shall include an agency that utilizes both volunteer and paid personnel.

"Volunteer emergency medical services personnel" means credentialed emergency medical services personnel affiliated with a volunteer emergency medical services agency who provide, or are available to provide, emergency medical services on a volunteer basis.

2. a. The department shall establish and maintain a system for determining the number of credentialed emergency medical services personnel in the State who are actively participating in the provision of emergency medical services through volunteer emergency medical services agencies.

b. In implementing the provisions of this section, the department shall distinguish, to the extent practicable, among:

(1) the total number of individuals holding a current emergency medical services certification, license, endorsement, or other credential;

(2) the number of credentialed individuals affiliated with one or more volunteer emergency medical services agencies; and

(3) the number of credentialed individuals who meet the department's criteria for active participation in the provision of emergency medical services through a volunteer emergency medical services agency.

c. The department shall establish objective criteria and a methodology for determining whether an individual is actively participating in the provision of emergency medical services. The methodology may consider, as appropriate:

(1) participation in emergency medical services responses;

(2) staffing of ambulances or other emergency medical services units;

(3) scheduled or documented periods of operational availability;

(4) patient care reports or other records indicating participation in the provision of emergency medical services;

(5) agency membership, affiliation, duty, or staffing records;

(6) information provided in connection with the issuance or renewal of an emergency medical services certification, license, endorsement, or other credential;

(7) attestations by an emergency medical services agency or credentialed individual; and

(8) any other reliable indicator of active participation determined appropriate by the commissioner.

d. The methodology established pursuant to this section shall, to the extent practicable, permit the department to identify and account for individuals affiliated with more than one emergency medical services agency without duplicating those individuals in Statewide workforce totals.

e. Nothing in this section shall require the department to make publicly available the name, credential number, employment or volunteer status, schedule, response history, or other personally identifiable information of an individual emergency medical services provider.

3. a. In addition to the workforce information required pursuant to section 2 of this act, the department shall, to the extent practicable, collect, analyze, or derive information sufficient to evaluate the operational capacity and reliability of volunteer emergency medical services in the State.

b. The information evaluated pursuant to this section may include, but shall not be limited to:

(1) scheduled, available, or actual staffing coverage;

(2) the number of staffed ambulance unit-hours or other appropriate measures of staffed emergency medical services unit availability;

(3) the frequency and duration of periods during which an emergency medical services agency lacks a crew or emergency medical services unit available to respond;

(4) the number and percentage of requests for emergency medical services answered by the emergency medical services agency primarily responsible for responding to the request;

(5) the number and percentage of requests for emergency medical services that are declined, unanswered, unable to be staffed, referred, reassigned, or otherwise handled by another emergency medical services provider, and the cause or circumstances thereof;

(6) the frequency and extent of reliance on mutual aid, automatic aid, contracted services, supplemental coverage, or other emergency medical services providers;

(7) emergency medical services response times;

(8) emergency medical services call volume;

(9) variations in staffing, unit availability, response capability, or response times by time of day, day of week, geographic area, or other relevant factor; and

(10) any other measure of emergency medical services capacity, availability, reliability, or performance determined appropriate by the commissioner.

c. Nothing in this section shall be construed to require the department to collect information specified in subsection b. of this section if the commissioner determines that reliable information is not reasonably available, cannot reasonably be collected without imposing a disproportionate administrative burden, or would not materially assist the department in evaluating emergency medical services capacity and reliability.

4. a. In implementing sections 2 and 3 of this act, the department shall, to the maximum extent practicable, use, integrate, match, or derive information from data already reported to or otherwise available to the State or a political subdivision thereof.

b. Sources utilized pursuant to subsection a. of this section may include, but shall not be limited to:

(1) information reported pursuant to sections 2 and 3 of P.L.2017, c.116 (C.26:2K-67 and C.26:2K-68);

(2) electronic patient care reports;

(3) information collected in accordance with the National Emergency Medical Services Information System or any successor national emergency medical services data standard;

(4) computer-aided dispatch records and other emergency medical services dispatch information;

(5) department certification, licensing, registration, and credentialing systems;

(6) emergency medical services agency licensing, registration, roster, or operational records;

(7) State and local mutual aid, dispatch, and emergency communications records; and

(8) any other State or local data source determined by the commissioner to contain reliable information relevant to the purposes of this act.

c. An emergency medical services agency, emergency medical services dispatch center, municipality, county, or other entity shall not be required to separately report information that is already reported to, maintained by, or reasonably accessible to the department or another State agency in a form that permits the department to use the information for the purposes of this act.

d. The department may require supplemental reporting only to the extent the commissioner determines that information necessary to implement this act cannot reasonably be obtained, matched, or derived from existing data sources.

e. Any supplemental reporting requirement established pursuant to this act shall be designed to minimize administrative burdens on volunteer emergency medical services agencies and other reporting entities. The commissioner may establish simplified reporting procedures, reduced reporting frequency, exemptions, alternative reporting methods, or other accommodations for smaller volunteer emergency medical services agencies, agencies with low call volumes, or other classes of agencies for which the commissioner determines such accommodations are appropriate.

f. The department may utilize statistical sampling, data matching, automated data extraction, audits, periodic attestations, credential renewal information, or other reasonable methods to verify or improve the reliability of information collected or derived pursuant to this act.

5. a. The department shall establish and maintain on its Internet website a publicly accessible, searchable repository of volunteer emergency medical services agencies operating in the State.

b. The repository shall, to the extent the information is available to the department, identify each volunteer emergency medical services agency and may include:

(1) the name and principal business address of the agency;

(2) the municipality, municipalities, geographic area, or other service area served by the agency;

(3) publicly available agency contact information;

(4) the name or title and publicly available contact information of the agency's chief, president, captain, director, or other principal officer;

(5) whether the agency operates as an all-volunteer or combination volunteer and paid agency;

(6) the type or types of emergency medical services provided by the agency;

(7) the level or levels of emergency medical services provided;

(8) whether the agency provides primary, mutual aid, supplemental, or other emergency medical services coverage;

(9) the municipalities or other governmental entities with which the agency has an agreement to provide emergency medical services, to the extent such information is available; and

(10) any other non-confidential information the commissioner determines would assist the public, State and local officials, emergency medical services agencies, or policymakers in understanding the availability and organization of volunteer emergency medical services in the State.

c. In developing and maintaining the repository, the department shall seek to identify all volunteer emergency medical services agencies operating in the State, including volunteer first aid, rescue, and ambulance squads and organizations affiliated with or represented by the EMS Council of New Jersey.

d. The department may obtain information for the repository from existing department records, emergency medical services agency registrations and licenses, municipal and county records, information submitted pursuant to P.L.2017, c.116 (C.26:2K-66 et seq.), publicly available sources, or periodic agency attestations or updates.

e. The department shall establish a process through which an emergency medical services agency may review and request correction of information concerning the agency contained in the repository.

6. a. No later than 24 months following the effective date of this act, and at least annually thereafter, the department shall prepare and publish on its Internet website a report concerning the emergency medical services workforce and emergency medical services system capacity in the State.

b. Each report shall include, to the extent practicable:

(1) the total number of credentialed emergency medical services personnel in the State, categorized by credential type;

(2) the number of credentialed emergency medical services personnel identified as affiliated with volunteer emergency medical services agencies;

(3) the number and percentage of credentialed emergency medical services personnel determined to be actively participating in the provision of emergency medical services through volunteer emergency medical services agencies;

(4) an explanation of the methodology and criteria used to determine active participation;

(5) information concerning the operational capacity and reliability of volunteer emergency medical services developed pursuant to section 3 of this act;

(6) Statewide and regional trends in emergency medical services workforce participation, staffing, capacity, reliability, call volume, mutual aid utilization, and response performance, as appropriate;

(7) comparisons with prior reporting periods sufficient to identify significant changes or trends;

(8) any significant limitations in the data or methodology used in preparing the report; and

(9) recommendations, if any, for improving the collection of emergency medical services workforce and capacity information or addressing significant workforce or capacity issues identified by the department.

c. The department shall present information in the report on a Statewide basis and, where practicable and statistically appropriate, by county, region, or other geographic area determined appropriate by the commissioner.

d. The department may publish agency-level information concerning system capacity or performance when the commissioner determines such information to be reliable, appropriate for public reporting, and consistent with applicable State and federal privacy laws. Nothing in this act shall require the public disclosure of personally identifiable information, protected health information, confidential personnel information, or information otherwise protected from disclosure by State or federal law.

e. The department shall transmit an electronic copy of each report prepared pursuant to this section to the Governor and, pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), to the Legislature.

7. a. The department may implement the requirements of this act in phases and may establish pilot programs or transitional reporting periods as necessary to develop, validate, and improve the methodology used to measure active emergency medical services workforce participation and system capacity.

b. In implementing this act, the department shall seek to:

(1) minimize duplicative reporting and administrative burdens;

(2) maximize the use of automated reporting and existing data systems;

(3) establish consistent definitions and technical standards;

(4) ensure the reliability and comparability of information reported across agencies and geographic regions;

(5) account for differences among volunteer, combination, municipal, nonprofit, and other emergency medical services delivery models; and

(6) protect patient privacy and the confidentiality of personally identifiable information in accordance with applicable State and federal law.

c. The commissioner may establish definitions, reporting methods, reporting intervals, data standards, validation procedures, exemptions, alternative reporting requirements, reasonable phase-in periods, and other requirements necessary to implement this act.

d. The department may issue guidance, directives, technical specifications, or other administrative materials necessary to implement this act prior to the adoption of rules and regulations.

8. The Commissioner of Health shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as the commissioner deems necessary to effectuate the purposes of this act.

9. This act shall take effect on the first day of the seventh month next following the date of enactment, except that the Commissioner of Health may take any anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.

STATEMENT

This bill requires the Department of Health (DOH) to collect, analyze, and report information concerning the active volunteer emergency medical services (EMS) workforce and the capacity and reliability of volunteer EMS services in the State.

Under the bill, DOH is required to distinguish between the total number of individuals holding current EMS credentials, the number of credentialed individuals affiliated with volunteer EMS agencies, and the number of credentialed individuals who are actively participating in the provision of volunteer EMS services. DOH is to establish objective criteria and a methodology for determining active participation, which may consider participation in EMS responses, ambulance staffing, periods of operational availability, patient care reports, agency records, credentialing information, and agency or individual attestations.

The bill additionally authorizes DOH, to the extent practicable, to evaluate measures of volunteer EMS capacity and reliability, including staffing coverage; staffed ambulance unit-hours; periods when an agency lacks an available crew or unit; calls answered by the primary agency; calls declined, unanswered, referred, reassigned, or handled by another provider; reliance on mutual aid or supplemental coverage; response times; call volume; and other appropriate performance measures.

The bill requires DOH, to the maximum extent practicable, to use information already available to the State or local governments, including information reported under the existing EMS data law, electronic patient care reports, National Emergency Medical Services Information System data, dispatch records, credentialing systems, and agency records. Supplemental reporting may be required only when necessary information cannot reasonably be obtained from existing sources. DOH is authorized to establish simplified or alternative reporting requirements for certain volunteer EMS agencies.

The bill also requires DOH to establish a publicly accessible, searchable online repository of volunteer EMS agencies operating in New Jersey. The repository may include information concerning an agency's service area, contact information, leadership, volunteer or combination status, services provided, and other non-confidential information.

Finally, the bill requires DOH, within 24 months after the bill's effective date and at least annually thereafter, to publish a report concerning the EMS workforce and system capacity. The report is to include statewide and, where practicable, regional information concerning credentialed EMS personnel, active volunteer EMS personnel, workforce participation, staffing, capacity, reliability, mutual aid utilization, and response performance. The bill authorizes DOH to phase in its requirements and establish definitions, reporting methods, technical standards, exemptions, and other implementation requirements.