LEGISLATIVE FISCAL ESTIMATE
[Second Reprint]
ASSEMBLY, No. 4107
STATE OF NEW JERSEY
220th LEGISLATURE
DATED: JULY 5, 2022
SUMMARY
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Synopsis: |
Makes various changes concerning regulation of emergency medical services; establishes mobile integrated health program and new State Emergency Medical Services Medical Director in DOH. |
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Type of Impact: |
Increased State costs; Potential cost savings for certain hospitals. |
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Agencies Affected: |
Department of Health; University Hospital and Bergen New Bridge Medical Center. |
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Fiscal Impact |
Annual |
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State Cost Increase |
Approximately $0.2 million |
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Potential Cost Savings for University Hospital and Bergen New Bridge Medical Center |
Indeterminate |
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· The Office of Legislative Services (OLS) concludes that the Department of Health (DOH) will incur approximately $0.2 million in annual salary and benefit costs for the State Emergency Medical Services Medical Director to be established under the bill. Additionally, one-time indeterminate expenses will result due to the department’s regulatory responsibilities in establishing a mobile integrated health program.
· The effects of the various changes to the regulation of advance life support emergency medical services (EMS) under the bill generally provide for flexibilities and streamlining in the provision of services. Therefore, the OLS assumes that the bill will lead to certain cost savings for entities that operate EMS Programs, which includes University Hospital, an independent non-profit legal entity that is an instrumentality of the State located in Newark, and Bergen New Bridge Medical Center (formerly the Bergen Regional Medical Center), a county-owned entity in Paramus.
BILL DESCRIPTION
Under the bill, the Commissioner of Health is to appoint a State Emergency Medical Services Medical Director to the Office of Emergency Medical Services. The State Emergency Medical Services Medical Director is to be a licensed physician in this State and board certified in emergency medicine. In selecting the State Emergency Medical Services Medical Director, the commissioner is to give preference to a candidate who is board certified in emergency medical services. The State Emergency Medical Services Medical Director is to be coequal with the Director of Emergency Medical Services.
The DOH is also required to establish a mobile integrated health program. In establishing the program, the department is to consider relevant standards and recommendations from interested stakeholders, and is to develop criteria by which an entity may apply for and receive authorization from the department to participate in the mobile integrated health program. The bill defines "mobile integrated health" to mean health care services delivered with the approval of the department to patients outside of a hospital setting, using mobile resources, and employing team-based and patient-centered care.
The bill provides that the Mobile Intensive Care Advisory Council is to: (1) advise the DOH on all matters of advanced life support, (2) directly provide recommendations to the commissioner for clinical updates; (3) annually review advanced life support scope of practice; (4) be chaired by the State Emergency Medical Services Medical Director; (5) establish new by-laws; and (6) select a vice-chair from among its members.
This bill also makes various changes to the regulation of advance life support EMS, as specified in the bill.
FISCAL ANALYSIS
EXECUTIVE BRANCH
None received.
OFFICE OF LEGISLATIVE SERVICES
The OLS concludes that the DOH will incur approximately $0.2 million in annual salary and benefit costs for the State Emergency Medical Services Medical Director to be established under the bill. Additionally, one-time indeterminate expenses will result due to the department’s regulatory responsibilities in establishing a mobile integrated health program.
The effects of the various changes to the regulation of advance life support EMS under the bill generally provide for flexibilities and streamlining in the provision of services. Therefore, the OLS assumes that the bill will lead to certain cost savings for entities that operate EMS Programs, which includes University Hospital, an independent non-profit legal entity that is an instrumentality of the State located in Newark, and Bergen New Bridge Medical Center (formerly the Bergen Regional Medical Center), a county-owned entity in Paramus.
The OLS notes that the provisions of this bill only affect the second level of the State’s two-tiered EMS response system, usually provided by a paramedic, for critical or life-threatening emergencies, medication administration, and advanced care under the command of a physician. This tier is mandated by State law to be provided by hospitals through a certificate of need. The Commissioner of Health is responsible for designating providers to serve a region, where they interface with the first level of the EMS response system, local agencies which provide basic life support services. As such, the bill does not have an impact on local or county governments.
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Section: |
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Analyst: |
Lead Research Analyst |
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Approved: |
Thomas Koenig Legislative Budget and Finance Officer |
This legislative fiscal estimate has been produced by the Office of Legislative Services due to the failure of the Executive Branch to respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).