N.J. Governor Signs Controversial EMS Bill

July 07--Gov. Christie signed legislation Monday allowing Cooper University Hospital to take control of emergency medical services in Camden, a bill that drew criticism from the city's longtime paramedic-services provider.

The measure, which some critics complained was fast-tracked by lawmakers and bypassed regulations, was passed without debate last month in both houses despite opposition from Virtua Health System, which operates the services in every town in Burlington and Camden Counties.

Supporters have said the law will allow better coordination between EMS services and the hospitals that receive those patients, including follow-up care for patients who live in Camden.

Cooper, a Level 1 trauma center in Camden, currently receives 69 percent of such patients; the nearby Our Lady of Lourdes Medical Center gets 29 percent.

The legislation is controversial in part because Cooper's chairman, Democratic power broker George E. Norcross III, has worked with Christie on many Camden-related issues.

Under Norcross, Cooper's profile -- and its political clout -- has grown considerably. Last year the state Economic Development Authority awarded Cooper Health System $40 million in tax incentives to move back-office jobs from Cherry Hill and Mount Laurel to Camden.

A statement released by Cooper on Monday read, "The governor's action today, in addition to the overwhelming, bipartisan support of the Legislature, will allow advanced life support services in Camden to finally be fully integrated within the region's only level 1 trauma center. Camden residents will now receive the same level of care as others in the state."

In a statement Monday evening, Virtua CEO and president Richard P. Miller expressed disappointment at Christie's decision.

"We will explore all options, including the possibility of litigation," he said.

Assembly and Senate committees last month advanced the legislation, sponsored by Assemblyman Gilbert "Whip" Wilson and Sen. Nilsa Cruz-Perez, both Camden County Democrats.

Advanced life support services in Camden, such as for patients requiring cardiac monitoring, are provided now by Virtua Health System, based in Marlton. Virtua operates a regionalized system for each town in Camden and Burlington counties. Basic life support services in Camden are provided by University Hospital in Newark.

Under current law, municipalities select their providers of basic life support, while paramedic services must be hospital-based and approved by the Department of Health.

The bill gives Cooper exclusive authority "to develop and maintain advanced life-support services" in Camden. Cooper also would be best positioned to provide basic life services.

Several lawmakers who voted against the bill last month expressed concerns it would circumvent state regulations that require hospitals to obtain a certificate of need from the state, a license Virtua has held for 38 years.

"It's a dangerous precedent to set," said Sen. Joseph Vitale (D., Middlesex). "And whether this change in EMS is appropriate or not, it opens the door for anyone else to say, 'Well, they did it here.' "

Last month, Virtua's Miller attacked the proposal.

"What in God's name is happening in this state?" he said at a news conference. "What's happening to our process in this state, when one person can want something -- I thought I landed in communist China -- one person wants something and can take it away from another business, just unilaterally, and get people to agree to it? What in heaven's name is happening to our process?"

Before the vote, a state panel of emergency medicine professionals recommended against the move because it never went through the state Health Department process normally involved in vetting such a major change.

A hospital seeking to offer paramedic or other health services in a region ordinarily would have to apply to the state for the certificate of need, demonstrating it was qualified to fulfill an unmet need.

Most patients served by EMS are not suffering from trauma or injuries, but heart attacks, strokes, or other acute ailments. In a recent federal evaluation of non-trauma care, Cooper fared slightly worse than Virtua or Lourdes.

The federal Centers for Medicare and Medicaid Services, which track death rates in hospital patients with five common conditions, found that Cooper's performance on all five was in line with national averages, while Virtua and Lourdes each beat the average on one of the five.

This week, an online petition to preserve Virtua's EMS program had almost 13,000 signatures.

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