Lookahead 2025: New Jersey Chief "Cautiously Optimistic” About New Year

When he spoke with EMS World in September 2024, Chief James Mazza of the Montclair Ambulance Unit in Montclair, New Jersey, was deeply worried about the condition of EMS in his state. Looking forward to 2025, “I am cautiously optimistic,” he said. “I would be lying if I said I was 100% optimistic. I feel that there are still systemic issues to EMS systems as well as to the funding mechanisms that have not been addressed, and without meaningful support from tax dollars, many systems are still going to fail or be at risk for failure.”

“We face several major challenges in New Jersey,” Mazza said of 2025.  “They include essential service designation: In New Jersey and 35 other states, EMS is not designated as an essential service. Municipalities must provide police, fire, a health department and animal control, but are not required to provide or fund EMS. In our case, we responded to 5,700 9-1-1 EMS jobs this year, but received no capital funding from our municipality or residents’ taxes. We had to take out a vehicle loan to replace an ambulance this year and scramble to raise the funds to make the payments.”

Increased call volume is another major challenge. “Our call volume increases up to 20% every single year, but our funding doesn’t,” he said.

Then there’s the demise of volunteer EMS departments in New Jersey. “Back in the day, every town had its own volunteer agency,” Mazza said. “Today, municipalities that operate EMS as volunteer agencies around the clock are few and far between. Call volume and costs are way up, donations are down and volunteer EMTs have day jobs, whether they’re in EMS or other fields.”

“When volunteer agencies around us have trouble staffing trucks with volunteers, they reach out to us for help,” he added. “We are carefully developing an expansion strategy that supports the needs of our neighbors and provides enough billing revenue to justify staffing trucks in another town. Since 2023, when we began staffing a daytime truck in a neighboring town, numerous other municipalities have reached out to discuss partnerships and even mergers to support expansion. If we do it right, and expand strategically based on call volume, payor mix, and logistics, it’s a win/win for everyone, especially for the patients.”

Mazza is hoping to see similar positive results for New Jersey EMS in 2025. A case in point: “We’re seeing a small uptick in reimbursement for some Medicaid jobs, likely because insurers are hoping the state legislature won’t mandate a dramatic increase,” he said. “Gone are the days of every small town having its own EMS squad. We see a future where we combine our resources to ensure that every community has the emergency medical services they expect and deserve. We’re talking with legislators and local leaders about the future and every conversation gets us closer to the goal­­­­­—a regionalized EMS system that’s appropriately staffed and adequately funded.”

When it comes to designating EMS as an essential service, Mazza said, “We would like to see a federal essential service designation with associated funding, but we would settle for it in New Jersey. Then we could aid other states in advocating for appropriate resources at the state level.”

Mazza did have some positive insights into the coming year. “Improvements in equipment are making our job safer and somewhat easier,” he said. “For example, power loaders and stretchers have been a game changer for us, reducing injuries for our personnel and actually giving us a hiring advantage in a competitive space. [But], with every improvement comes a great deal of expense. Manual stretchers could be had for less than $10,000. Now we’re looking at nearly $100,000 to upgrade an ambulance from manual to fully powered stretchers and loaders. All the technological advancements, expansion of scope and safety improvements in the world don’t improve anything if agencies can’t afford to implement them.”

Mazza is also looking further into the future as a new generation steps into leadership. “The new generation of leaders are vocal,” he said. “They are going out and educating their communities and elected officials as to the needs of EMS. They are striving for true recognition of a third service as well as essential service designation.”