Proposed Changes to NJAC 8:40A
New JerseyState First Aid Council Position Paper on
Proposed Changes to NJAC 8:40A
The New Jersey State First Aid Council has reviewed the proposed changes to NJAC 8:40A regulations.
8:40A-1.3 includes the introduction of the Emergency Preparedness Training Program for EMT-Bs.
The New JerseyState First Aid Council does not support this as a package. Although the introduction of Haz-Mat Awareness, CBRNE Awareness, ICS 100 and IS 700 into the EMT-Basic class is commendable, to require that all recertifying EMT-Bs complete this 12 hour package every 3 years is onerous and excessive. If the regulations insist that 12 hours of continuing education training be restricted to Homeland Security/Emergency Preparedness classes we should be able to make these selections from a pre-approved listing of classes. This would at least provide some variety of material within pre-approved selections. In addition, the economic impact statement explains that providing this training would not cause additional expense or hardship to a TrainingCenter as most (the DHSS statement is “all”) EMT-B Instructors are also Instructors in these specialties. We do not see this. As best as we in the NJSFAC can tell, the majority of EMT-B Instructors in the State of NJ are not certified to teach these courses.
I do not believe that the regs call for an EMT being able to take the 4 courses (700,100, WMD, CBRNE) more then once. Once you’ve taken them, the new required 12 ceus have to be in programs determined to be in the preparedness area by the DHSS. These 4 classes are what I believe comprise what’s referred to below as the “emergency preparedness training program” and are not included in the “emergency preparedness continuing training program” defined below.
"Emergency Preparedness Continuing Training Program" means a training program approved by the Department in accordance with N.J.A.C. 8:40A-9.3 that includes non-introductory level emergency preparedness courses developed by the NJOEM, the NWCG, or the FEMA, but does not include the courses comprising the emergency preparedness training program.
Again, reasonable and intelligent people look at the same thing and arrive at different conclusions. These are the type of issues that need to be answered in writing before we can take concrete positions. Having said that, I believe as does the NJ EMS Educator Association that these 12 elective ceus are better used by EMTs to improve their ability to respond to local emergencies in their communities. All NJ Counties are in the process or have already established teams at the county level to respond to local towns in the event of large scale incidents to provide advice and assistance to local responders as part of the ICS system. These 12 ceus are better spent reinforcing care for those emergencies that EMTs are more likely to encounter on a day to day basis. If any course should be recommended as part of recertification it should be something like the Triage, Treatment and Transportprogram that will help local EMTs deal with the initial response mode to a large scale incident while awaiting the county team’s response. Let’s not also forget that one of the suggestions that has been made concerning the use of the EMT Training Fund is that it be used only to cover the cost of the required 48 ceus needed for recertification. With the financial problem the fund is in and the likelihood that more funding will be found in the near future, that suggestion has to be given serious consideration. If it becomes a reality, do we really want 12 of our currently elective ceus being mandated in preparedness?
8:40A-7.3(a) refers to EMT-B reciprocity.
The New JerseyState First Aid Council does not support this change.
Why is it necessary to make this change? If this is changed then we can no longer utilize neighboring state’s EMTs for emergencies thus limiting ourselves. We feel that there should be a competency testing instead, both of practical skills as well as for didactic knowledge for these EMTs rather than subjecting them to a required recertification class. Additionally, the recertification process as proposed is too cumbersome and the procedure is too complicated.
If OEMS is now going to say that these EMTs can no longer ride with NJ squads without getting a NJ EMT certification, it represents a significant negative policy change on the part of the OEMS and represents a step backwards for the NJ EMS system. This policy change has a significant downside for the NJ EMS system with no upside compensation. A number of EMS organizations have members who ride with EMT certifications from Pennsylvania, New York and other Atlantic EMS Council states. In fact, the other Atlantic EMS Council states all use the same written test NJ does. These are EMTs who live across the border, go to school in these other states and / or have the certification for their jobs which are in one of these states. The one reason I’ve heard that’s been given for the change by members of the OEMS is that this is the only way to track NIMS compliance. This is an inaccurate statement since the OEMS is not even the organization charged with maintaining these records. While the statement has been made that the OEMS LMS system can not assign numbers and input this information for out of state EMT, the same is not true of the state organization charged with maintaining this information. In addition, the other states all must meet the same federal requirements so the records are already being maintained and could be shared with NJ for input if the need ever arose. All this action will do is make it more difficult for paid services to recruit EMTs and create serious problems for many volunteer EMS organizations who now cover their shifts with these EMTS. I’m especially angry since based on a conversation I had with Sue Van Orden, OEMS had told her only a month or so before the regs were issued that this issue wouldn’t be affected by the new regs. Maybe it won’t but again, we have no opportunity to get it in writing.
At the very least I would recommend that the OEMS accept the out of state information for these EMTs and issue a NJ EMT number based on this information. Since the OEMS can enter information manually for those EMTs who have a NJ number, this would enable them to have the information they claim they need while at the same time permitting a valuable resource to continue to be available to the NJ EMS system.
Insofar as requiring a competency testing for those seeking NJ certification from these state, I still don’t see why that would be needed if they are currently riding. However I do not believe I would have an issue with that so long as it was set up in a way that was fair and open. We might want to look at something like the National Ski Patrol’s program.
8:40A-7.5 refers to EMT-B recertification.
The New JerseyState First Aid Council does not support this change. We feel that repeating some of these courses every three years is restrictive and redundant (see comments in 8:40A-1.3 above). If EMT-Bs are restricted to only ICS 100 and IS 700 this is not acceptable; if the scope of classes is expanded to any Homeland Security class this may be acceptable. For recertification students, any class from a pre-approved listing of classes should be accepted. OEMS and the Federal Homeland Security can decide what classes to place onto this pre-approved listing. OEMS can then submit quarterly requests for reimbursement to Federal Homeland Security to replace monies into the Training Fund. Also, classes should be available on-line.
See my comments in 8:40A-1.3 above.
8:40A-7.6 refers to methods of recertification for EMT-Bs whose card has been expired two years or less.
The New JerseyState First Aid Council supports this.
EMT-Bs who are returning to the system need to be brought up to the current levels of competency, including course material which may not have been available at the time their EMT-B certification lapsed.
I believe there should be a “grace period” for EMTs who for reasons beyond their control were unable to complete their EMT recert requirements. Things like illness, military service, etc. should automatically generate a grace period for some length of time comparative to the time the EMT was unable to complete recert requirements.
As far as an EMT who whose card has expired for 2 or more years; in certain cases if they have already taken the required preparedness classes they should not have to take them again. That includes EMTs who have been expired for less then 3 years and those who were still involved in emergency response in some way that they kept current in preparedness training. In addition, if they had the nerve agent training and the epi pen, why must they take it again? There are many of us who will never need to use the training in these 2 classes and we don’t need to recert in them. So why would someone who is working towards their EMT again have to take them? (Granted they will probably get the nerve / epi training as part of the basic course so it’s a mute point.)
However, it’s not a mute point for EMT instructors who let their instructor card lapse but maintained their EMT card. They have already met the requirements and have all the courses. They shouldn’t have to go and take these classes again just to be able to take the instructor class again (to make an EMT who was an instructor take the ITT class again is another issue altogether).
The removal of Cores 1 – 12 may make it more difficult for some EMTs to recertify. These courses were originally set up because of complaints from EMTs of the difficulty in attending what was at that time an EMT recertification program that was run over a weekend or in a short 1 or 2 week period. Some EMTs are not able to attend a Core 13 because of work / family responsibility commitments. Does the DHSS intend to approve Core 13 programs that may stretch over a period of time, say 12 weeks(one night a week) or 24 weeks (1 night every 2 weeks) to assist those EMTs who are unable to complete a program that is given in a much shorter time frame or over a weekend? If not, I would suggest that the OEMS reconsider their removal of the individual core programs.
All the above are likely to exacerbate the problems we all have in recruiting and retaining members. Even the paid services have these same on-going issues that will only continue and likely get worse if the regs go through. When is the DHSS going to get into the 20thcentury (no, that’s not a typo)? Their LMS system is just the latest example of their inability to put common sense systems in place.
8:40A-9.3 refers to notification to OEMS of class cancellations.
The New JerseyState First Aid Council does not support this changeas written.
This section requires that notification of postponed or canceled class be made to OEMS at least 72 hours prior to the scheduled class. This is not acceptable. Much of the time advance notification is possible, but there are times when the things are out of anyone’s control, such as severe weather, illness, accidents, family emergencies, etc.These are unplanned but do occur. It is wrong to impose stringent financial penalties on the instructor for events that may not be in their control.
This should be a no brainer. This is a ridicules reg and hopefully more common sense heads will prevail.
8:40A-9.5 defines recertification training.
The New JerseyState First Aid Council does not support this as a complete package.
The troublesome sections which raise major issues are:
- includes as part of the Core recertification curriculum 24 CORE EMT-B refresher hours, 12 hours of Emergency Preparedness training program and 12 hours of elective CEUs.
- a CEU session or sessions cannot exceed a total of 8 hours on any given date to the same group of students.
- all CEU sessions shall be conducted between the hours of 7 AM and 11 PM.
For the first bullet see our comments in 8:40A-1.3 and 8:40A-7.5. For the second bullet there is no plausible reason why a class cannot take more than 8 hours in one day? People don’t stop learning by a clock. If the course content can support a longer class we should be able to do so. And as for the third bullet which will restrict classes to day/evening shifts, if employees or crews are available on their overnight shift, why not teach a Blood-borne Pathogens or Haz-Mat class during that time frame? Again people don’t stop learning by looking at the time on a clock.
As recertification is concerned why are we still having to go through 48 ceus? There are many EMTs who have gone through recert so many times they could teach the classes. Why isn’t there a rule that once an EMT has successfully recertified say 3 times, the # of ceus they are required to get are reduced by say 50%? I don’t now about the rest of you but before I became an instructor, it was all I could do to pay attention to the instructor in some of these classes. It wasn’t because the instructor wasn’t interesting; it was because I’d gone through the class so many times. We should have a recert program something more like what I understand PA’s is like. There they split all classes into trauma and illness and you need to take a certain number of ceus in both areas. Their LMS system works a heck of a lot better too but that’s a discussion for another time. I have lots more I could say about this subject including the fact that many other health care professionals who are active in their profession don’t have to go through anything near what we do to be able to continue to work in their professions so why do we? Our current recert program costs us EMTs every year. This needs to be addressed but if history is any indication, it won’t be.
8:40A-10.1(c) expands the Scope of Practice for EMT-Bs to include Epinephrine auto-injector training, NAAK training and multi-lumen airway training. The New JerseyState First Aid Council is in support of these. These will go a long way (n) towards improving patient care.
Agree. Having said that, why are we still not able to give aspirin or use glucometer’s and please, this is a rhetorical question so no replys please. And based on history it will probably remain a continuing rhetorical question.
8:40A-10.3 denies an EMT-B to appeal a written warning by OEMS.
The New JerseyState First Aid Council does not support this change.
EMT-Bs should be allowed due process at any point in the procedure, which may also help prevent a full-blown disciplinary procedure.
Agreed
8:40A-11.1 requires a physical address for EMT-Bs and would make these addresses available to the public.
The New JerseyState First Aid Council does not support this change.
The objection is to the part of the regulations which will allow our addresses to be available to the public. What if we have a disgruntled or upset patient or family member, or an emotionally unstable patient who knows our names and looks up our addresses? What would stop them from stalking us?
Very much agree. Let’s not forget possible homeland security issues if this is permitted to remain. In addition, the DHSS should not be permitted to sell our addresses to vendors so the vendor can make a mass mailing. If I want to get more spam mail, I’ll ask for it. We all have the ability to remove our names from these lists but we won’t under the DHSS reg. Finally, the subpoena process should remain as it currently works; the EMT receives it through the EMS organization he or she rides for. The same reasons given above hold true for this as well. The attorney should have to serve the subpoena where I ride again, for my protection. There are already documented cases of EMTs being attacked by members of the public for a variety of reasons. In addition, there are police officers, fire fighters, professional people who have a good reason for not wanting their addresses made public. One squad I know of has a judge as an EMT member. I’m sure that judge will thrilled to find out about this reg. This will cut down on the types of people paid and volunteer squads can recruit for. Should the DHSS not see the light, we need to seriously think about investigating what our legal options will be.
8:40A-12.1 states that EMT-Bs responding to a possible SIDS or SUDC patient would file a specific form.
The New JerseyState First Aid Council supports this.
The form is essentially a benign collection of observations taken at the scene of a SIDS or SUDC, to be submitted to the ME office.
Investigation of these cases rests solely with local law enforcement. They are the ones required to notify the county prosecutor and medical examiner in the event of any suspicious death. Any and all pertinent information should be turned over to law enforcement that in turn will provide the information to the county prosecutor and medical examiner. The EMT should only be required to alert the police in the event that they are not already on the scene and provide all appropriate information to the police.