>Here are the complete remarks concerning a proposed ordinance to allow billing for Emergency Medical response and transport services made by Ms. Paula Weiler, Northern Area Executive Vice President of the NJ First Aid Council. The remarks were directed to members of the Ridgewood Village Council on Wednesday, January 16.
“Thinking of Changing Your Squad’s Volunteer Status?
THINK AGAIN
New Jersey law defines volunteer and non-volunteer first aid, rescue and ambulance squad as “a first aid, rescue and ambulance squad which provides emergency medical services without receiving payment for those services… Non-volunteer first aid, rescue and ambulance squad” means a first aid, rescue and ambulance squad that provides emergency medical services on a paid basis. The New Jersey Highway Traffic Safety Act of 1987 (“NJHTSA”).
The test for determining whether or not a squad is “volunteer” is applied at the squad level and not the member level. If a squad bills for service it is not a volunteer squad regardless of whether or not its manpower is volunteer.
Once a squad bills for its services, then legally it is considered a non-volunteer squad which automatically loses many benefits given volunteer squads by New Jersey law.
Non-volunteer squads are:
– SUBJECT to NJ Dept. of Health & Senior Services (NJDH&SS) licensure, annual inspection and considerable fees.
– SUBJECT to NJDH&SS unscheduled inspections of ambulances and crews.
– REQUIRED to respond to all calls with two EMTs. Under no circumstances may these squads respond with only 1 EMT and a driver or first responder.
– SUBJECT to federal HIPAA rules and regulations due to the practice of billing.
– SUBJECT to rules and regulations of Medicare and Medicaid billing fraud and abuse. When such fraud is alleged, the billing agent is NOT responsible, but rather a squad officer, or in the case of a municipal squad, the mayor / town administrator is subject to charges and fines. (Reference UMDNJ)
– SUBJECT to Medicare and Medicaid payment practices including holding payments for any reason, sometimes for months (as do insurance companies). Should their claims reviewers find that previous paid claims (up to 3 years prior) were paid in error, they will demand reimbursement be made within 30 days. If it’s not made, the moneys will be withheld from future payments and interest will be charged and added to the amount owed.
– REQUIRED to document additional patient information including Social Security number, diagnosis code and other insurance billing information and keep the information confidential. Squads must also document medical necessity for the use of an ambulance. It is likely that a significant number of calls done by squads will not meet this requirement and will not be eligible for insurance reimbursement.
– LOSE their volunteer LOSAP benefits. The limiting language in this benefit is close to the NJHTSA definitions.
– LOSE all free EMT certification and recertification training provided by the NJ EMT Training Fund Act.
– FORFEIT the use of warning devices, i.e., “blue lights” on their personal vehicles or ask for the right of way in responding to their squad buildings for emergency calls. Non-volunteer squad captains are not entitled to use red light/siren on their personal cars.
– LOSE the benefit of limited immunity from civil lawsuits for actions taken on calls. (“Good Samaritan Act”)
– INCUR increased liability insurance costs, perhaps as much as 2 to 3 times what the squad currently pays.
– LOSE free college education for their child or spouse if killed on duty.
– RISK loss of mutual aid. Non-volunteer squads cannot force other towns to provide mutual aid to their town without a mutual aid contract in place between the towns. Only volunteer squads have the ability to approve or disapprove mutual aid contracts between towns that affect them.
– INELIGIBLE for the special presumption that cardiovascular or cerebrovascular injury or death of their members on a call is the result of the call. Likewise, they do not automatically receive the highest benefit available under the Worker’s Compensation Act.
– EXCLUDED from use of “The Volunteer Emergency Service Organization Loan Fund” by the NJ Division of Consumer Affairs.
– EXCLUDED from NJ State Contract pricing or bidding for goods and services. Non-volunteer squads would no longer be exempt from state licensing of raffles and games of chance. Currently, volunteer squads need only a municipal license.
– LOSE the right to replace supplies from a receiving hospital amounts to increased supply costs for squads.
– RISK a substantial decrease in voluntary contributions made to the squad.
– INCUR increased costs especially if the squad is unable to maintain its volunteer member base. Added costs for paid personnel must then be paid by the town.
– LOST BENEFITS: Non-volunteer squads that are not part of a municipality cannot have the municipality provide insurance coverage for their vehicles, equipment or liability. Non-volunteer squad members are not eligible for municipality provided life insurance; accidental death and dismemberment, hospitalization, medical, surgical, health or accident insurance. They cannot have the municipality provide Workers Compensation.
This represents a listing of what volunteer benefits a squad would lose by being reclassified as non-volunteer. The final decision should be between the squad and the Village Mayor and Council. As I had stated initially, we in the New Jersey First Aid Council would much prefer not to lose our volunteer membership, but the patient’s interest and well-being is of higher concern to us in the NJSFAC. I am merely trying to ensure that all parties are aware of the multiple ramifications of this classification change. I have the feeling that you have not been informed of some of the items I mentioned.”
