Paramedic Unit being shut down. Will effect Cranbury residents.
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Stop this-25p1
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PostPosted: Tue, Apr 16 2013, 5:17 am EDT    Post subject: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

http://www.nj.com/mercer/index.ssf/2013/04/capital_healths_reduction_of_a.html
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anon-sp08
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PostPosted: Tue, Apr 16 2013, 10:49 am EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

Stop this-25p1 wrote:
http://www.nj.com/mercer/index.ssf/2013/04/capital_healths_reduction_of_a.html


It sounds unfortunate. But can someone explain why we would have the right to force a company to maintain a money losing operation? Are they getting something from the Township or county in value that implies a quid pro quo on providing distributed service even if it costs them more than they make for it? I'm not baiting, I really want to know.

If so, we should address. If not, and if our region feels the new arrangement doesn't adequately protect us, isn't it up to taxpayers to foot the bill if we want it?
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anon-p829
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PostPosted: Tue, Apr 16 2013, 4:20 pm EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

The answer to your question as to why the hospital should be forced to keep a paramedic unit in service that is allegedly loosing money is simple. The EMS system in NJ is composed of two seperate entities. Basic Life Support (BLS/EMTs) and Advanced Life Support(A.L.S./Paramedics/MICU). The BLS portion is provided by the local municipalities, volunteer rescue squads etc. The paid or volunteer EMTs(Emergency Medical Technichians) have 120-220 hours of training. They staff the ambulances and respond regardless of the nature of the emergency. In addition to supplying the ambulance they provide basic care such as oxygen, CPR, AED, bandaging etc.. The ALS portion is provided by the hospital. This has been state law which was lobbied for by the hospitals themselves. The hospitals wanted and maintain total control of ALS. ALS units are typically suburbans or other SUV's. They are staffed by two state certified paramedics or specially trained RN's. They are paid profesionals. Paramedic training is typically around 2000 hours and takes about 2 1/2 years. Paramedics carry a variety of specialized equipment and medication. They communicate directly with an emergency room physician. They essentially " bring the emergency room to the patient." ALS units are only sent on "life threatening emergencies"( heart attacks, strokes, serious injuries etc..) The paramedics will typically provide care to stabilize critically ill patients in the field and in the ambulance while enroute to the hospital. The paramedics do not transport in their SUVs. Typically one of the paramedics will accompany the patient in the ambulance to the hospital while the second paramedic will follow behind in the SUV. In certain critical cases both paramedics might ride in the ambulance and an EMT or police officer might drive the paramedic SUV.

The shorter answer to the question " why should the hospital be forced to be forced to keep a paramedic in service that is loosing money?" Because the hospitals established a system where they are the only entities permitted to provide this service. Make no mistake over the years that paramedic unit that is being taken out of service in east Windsor has saved numerous lives in Cranbury. If it is allowed to be taken out of service lives of residents will be in jeopardy.
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anon-8670
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PostPosted: Tue, Apr 16 2013, 8:22 pm EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents Reply with quote

I agree. God forbid one has a family member suffer a major event such as a heart attack off hours. How do you explain a father or mother passed because there was no longer an appropriate resource close enough.
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anon-97on
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PostPosted: Tue, Apr 16 2013, 9:11 pm EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

So cutting through the details, if the core argument for why they can be required to provide it even if they are losing money is because they lobbied for a law that gives them exclusive responsibility for this service, it seems like either the law should be specific on their obligations or we should lobby our state representatives to hold them accountable or to revise the law.

Saying lives will be lost without it isn't enough -- we need to get to the legal basis for obligating them to be responsible.
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anon-p82p
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PostPosted: Tue, Apr 16 2013, 11:12 pm EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

Well there kind of is a legal basis but it is complicated. Not every hospital is allowed to run MICU's( paramedic units). Most cannot. In order to have MICU's a hospital must be designated by NJ State Department of Health. In this area the only hospitals that are designated to have paramedic units are capital health and Robert Wood in New Brunswick. Princeton does not have a state designation to run an MICU(paramedic). The state has had a moratorium on granting of Certificates of Need for paramedic units for over 10 years. The reason for the moratorium is because the existing MICU hospital lobbied for it stating that in order to maintain proficiency there had to be limit on the number of paramedic units. The real reason is because the MICU hospitals saw their paramedic units as advertisement and a draw into their facillities. By shutting down the paramedic unit in east Windsor the hospital will continue to meet their "obligation". The difference is that instead having a paramedic unit responding from One Mile Road, near the border of CranburyTownship, you will have one coming from Clarksville Road, Mercerville, or worse yet New Brunswick or Trenton. Try holding your breath from Clarksville Road to South Main Street.
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anon-63s1
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PostPosted: Wed, Apr 17 2013, 12:10 am EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

We still have robert wood johnson's paramedic units from Monroe(Medrescue 3) and from Monmouth Junction(Medrescue 6). These units respond to calls in cranbury as well, but in only half of the town. The unit stationed in East Windsor (794) is a great help to the residents of cranbury. We need to have them stationed there, as they also respond to the turnpike for calls as well (motor vehicle accident rescue assignments, or other major calls). If we want to keep 794 in East Windsor, then we need to figure out the cost and split it between East Windsor, Hightstown, and Cranbury. Having a unit respond from Hamilton is absurd and puts peoples lives in jeopardy.
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Really bad-p81q
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PostPosted: Wed, Apr 17 2013, 6:47 am EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

Actually through what is most likely a conspired effort Med Rescue 6 is also being shut down. Med Rescue 3 is stationed at South Brunswick Police- which is not close. Additionally Med Rescue 3 is frequently pulled to the other side of route 27(Somerset) and frequently into New Brunswick. This area is being stripped of this vital service.
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anon-8670
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PostPosted: Wed, Apr 17 2013, 8:02 am EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

I believe our Mayor is in charge of EMS services. I wonder of he has an update or if the TC is sending any letters of concern? I don't see anything on the agendas.
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Concerned-25p1
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PostPosted: Sun, Apr 21 2013, 12:40 pm EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

Are there any updates?
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anon-25p1
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PostPosted: Tue, Apr 30 2013, 6:53 pm EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

As of 5/1/2013 this paramedic unit will go out of service between 7pm and 7am Tuesday through Sunday. On Monday it will be taken out of service at 3pm until 7am Tuesday morning. God help you if you or someone in
your family if you have a life threatening emergency.
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More info-p990
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PostPosted: Thu, May 2 2013, 7:57 am EDT    Post subject: Re: Paramedic Unit being shut down. Will effect Cranbury residents. Reply with quote

April 30, 2013
To All Interested Parties:
Paramedics - Public Safety or Revenue-Generating-Based Hospital Entity
Is a Paramedic a public safety official or a private sector employee? Under the current laws of New Jersey a paramedic may only operate through a bonafide Certificate of Need sanctioned Hospital.
This creates quite a dilemma for municipalities that are located on the opposite side of a geographic region from where the licensed hospital might be located. As an example: East Windsor Township, Mercer County and Capital Health System.
Currently, there is a Capital Health Systems Paramedic Unit serving the area of East Windsor, Hightstown, Robbinsville, West Windsor, Princeton and other communities within Mercer County; along with Cranbury, Plainsboro, and Monroe in Middlesex County. This unit is designated as “794” and is currently stationed in the East Windsor Township Rescue Squad District 1’s building (“the squad”). “The squad” has no management or oversight of the unit; it is simply positioned there in order to provide a timely response to these and surrounding communities.
At this time, the management of Capital Health Systems has surmised that this unit is not generating enough revenue to maintain its operation unit after 7:00 P.M. (except for Mondays when the unit will go out of service at 3:00 P.M.). This is simply abysmal! Is there truly a quantitative cost that can be justified for an individual’s life? Do other public safety sectors generate enough revenue to totally fund themselves? Law Enforcement and Fire Service certainly do not; why must a paramedic unit be self sufficient?
How do “predictive dispatching analytics” work for sick people? Predictive methodologies can be used in many industries as there are similar occurrences that include common denominators. Unfortunately there are few common denominators in emergency services. The EMS system is tasked greater in the spring/summer/fall months than in the winter months. Why, at this specific time would Capital Health choose to remove a paramedic unit when their own statistics would reveal an upturn in call volume? This is quite perplexing!
As the paramedic units are now abridged, what will happen when someone becomes critically ill after 3:00 P.M. on Mondays or after 7:00 P.M. the rest of the week? Why is Monday different than any other day of the week? Could there be other work schedules that might be prudent to the industry?
There will be radical delays in response times, as a unit, if available, will be coming from a greater distance. These response times, identified in the chart below, are expected to increase 111% to 467% to the key areas of East Windsor.



As of 4/30/2013*
As of 5/1/2013**
Response Times from East Windsor
To: (location identified below)
Response Time in Minutes as of 4/30/13*
Travel Time Standards Recommended to NJ DHSS, OEMS - By TriData, report issued September, 2007 - Mean***
Travel Time Standards Recommended to NJ DHSS, OEMS - By TriData, report issued September 2007 - 90th Percentile ***
Response Times from West Windsor
Increased Response Time (in minutes)
Increased Response Time Percentage
Response Times from Hamilton
Increased Response Time (in minutes)
Increased Response Time Percentage
47 One Mile Road
20 Lanning Boulevard
3:00
7:34
12:52
13:00
10:00
333%
17:00
14:00
467%
47 One Mile Road
300 Etra Road
9:00
7:34
12:52
19:00
10:00
111%
21:00
12:00
133%
47 One Mile Road
Old Stone Mill Drive
3:00
7:34
12:52
10:00
7:00
233%
15:00
12:00
400%
47 One Mile Road
Squad 146
8:00
7:34
12:52
18:00
10:00
125%
21:00
13:00
163%

* Please note all the response times identified as of 4/30/13 meet or exceed the recommendations set by the independent report.
** Please note, all response times identified as of 5/1/2013 grossly exceed the recommendations set by the independent report
These addresses are simply frequent response locations for demonstration purpose of researched response times. The variables of response times change dramatically from day to day and month to month. For instance, the main access from West Windsor into East Windsor, County Route 571, is currently under construction and will be for a number of months; this is not factored into these time calculations. The reduction of the flow of traffic on this major roadway will significantly increase response times to many areas.

*** this data is provided from a consultant’s report to the State of New Jersey, Division of Health and Senior Services, Office of Emergency Medical Services Consulting Services Report: EMS System Review authored by TriData, a Division of System Planning Corporation, September 2007 and can be found at: http://www.state.nj.us/health/ems/documents/ems_study_report.pdf

As the available paramedic units reduce hours of service for Mercer County: What happens to other surrounding communities when a unit is committed on an assignment? Where does a back up come from? Are these response times increased even more extensively?
What could be inferred by this drastic move? Could it be that critically sick and injured patients from these areas don’t get transported to one of the Capital Health Care Facilities (located in Trenton and Hopewell)?
Is there a problem because the private sector employer cannot garner enough revenue from this area to those hospitals to sustain its existence? Is there another receiving hospital facility in the area that could supplement this region?
There are other medical facilities in the area; though they are not eligible to obtain a Certificate of Need from the New Jersey Department of Health, Office of Emergency Medical Services, as this agency feels having one hospital based paramedic unit per county is enough. Would this not create a monopoly and unfair business practices? In the end, those who will be hurt and potentially die are the residents of a community that are furthest from a prompt emergency care.
Is it time for a Paramedic to become a Municipal or a County employee? If so, allow the various jurisdictional oversights to manage the employees, and a medical board, which is inclusive of the hospitals within that region to provide medical direction and control. This would remove the financial burden from a sole hospital, it would allow a jurisdiction to offset costs by billing for services and it would provide a life saving public safety service to the area.
There are far too many questions that require firm answers and not speculation. The only viable option for the public is to maintain the paramedic unit and work on a resolution through identification of needs, not a hypothesis.
Ultimately, we implore the Commissioner of the New Jersey Department of Health, Office of Emergency Medical Services, to petition other entities for a Certificate of Need for paramedic services in New Jersey, especially areas which have extended transport times to medical facilities.
Further, we seek legislative assistance for our citizenry and for the constituents of our elected representatives, to provide basic and advanced life support treatment and transportation to the critically ill.
Respectfully,

Jeffrey M. Shanker, EMT-B
President
East Windsor Township Rescue Squad District 1
47 One Mile Road
East Windsor, NJ 08520
Jeff.Shanker@Squad142.Com
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