N.J. bills would give Cooper control of Camden's paramedic services

TRENTON - South Jersey Democrats are fast-tracking a bill that would give Cooper University Hospital control over paramedic services in Camden, currently run by a rival hospital, in a move that critics say circumvents state regulations.

Committees in the Assembly and Senate on Monday each advanced the legislation, sponsored by two Camden County Democrats, Assemblyman Gilbert "Whip" Wilson and Sen. Nilsa Cruz-Perez.

The legislation, introduced last week, is expected to reach the floor of each house for a vote before lawmakers break for summer at the end of the fiscal year, June 30, by which time they must pass a balanced budget.

Advanced life support, or paramedic, services in Camden are currently provided by Virtua Health System, which is 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 in New Jersey select their providers of basic life support, while paramedic services must be hospital-based and approved by the Department of Health, a spokeswoman said.

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

Wilson told lawmakers he wanted to bring these services "all under one umbrella" at Cooper, a Level 1 trauma center.

He noted that the state's other two Level 1 trauma centers, Robert Wood Johnson in New Brunswick and University Hospital in Newark, provide both services to those municipalities.

He said Cooper should be able to do the same, and argued that new paramedics would follow up with patients and check up on them in their homes, and thus help drive down costs by reducing emergency room visits.

Opponents countered these goals could be accomplished under existing law. "You don't need to be a paramedic to do home safety checks," said Scott Kasper, assistant vice president for emergency services at Virtua.

Moreover, critics argue, the bill seeks to bypass the regulatory process by which hospitals and other organizations obtain a "certificate of need" from the Department of Health to provide services.

Virtua said it applied for and obtained a certificate more than 30 years ago to operate in Camden.

"It's a dangerous public policy to circumvent the process, even though proponents of the bill propose to enhance what is already provided in the City of Camden," said Sen. Joseph Vitale (D., Middlesex), chairman of the Health, Human Services, and Senior Citizens Committee.

Vitale voted against the bill, but it cleared his committee, 5-3, with one abstention. Cooper could seek to challenge Virtua's certificate with the state, Vitale said.

Paramedic services are not profitable; Kasper said Virtua spent $1.2 million annually on its Camden operation. Another Virtua representative said the hospital did not receive state subsidies or payments from Camden, though it does bill patients' insurance.

Cooper's clout has grown considerably under the leadership of George E. Norcross III, chairman of the board of trustees and a Democratic power broker.

Asked whether Norcross had played a role in pushing the legislation, Wilson replied, "Read my lips: I have not talked to George Norcross about this bill."

A spokesman for Norcross declined to comment.

The Department of Health does not comment on pending legislation, a spokeswoman said. A Cooper spokeswoman declined to comment.

Christie A. Stearns, a lawyer with Gibbons P.C. who represents Cooper, told lawmakers that the bill would help Cooper "fulfill its mission in Camden City and provide the highest quality of care to patients."

Virtua protested that the bill would deny the hospital due process under the law.

"Why are we here? This bill proposes a major change to state health policy that dates to 1977," Fred Hipp Jr., Virtua's senior vice president for government relations, told the Assembly Health and Senior Services Committee.

"You're being asked to vote on a bill that was introduced just last week," he added. "Is this the time, in the middle of June, with that kind of notice, to make a major policy decision like this without input from the Department of Health?"

Jeff Behm, vice president of the New Jersey Association of Paramedic Programs, echoed that reservation.

"There seems to be a sense of urgency with this bill, but I'm not aware of any public emergency," he told the Assembly panel.

The committee passed the bill on a 9-2 vote.

Virtua operates 12 paramedic units in Camden and Burlington Counties. One is designated for the City of Camden, and up to four serve the city at a given time, Kasper said.

Kasper said Virtua's paramedics deliver 69 percent of its Camden patients to Cooper. Some are taken to Our Lady of Lourdes Medical Center, and 1.7 percent to Virtua, he said.

Critics also said that Newark, New Brunswick, and Camden would not be able to freely select their basic life services providers, since the bill would give the trauma centers the right of first refusal to provide EMS services.

All other municipalities are subject to procurement laws, Kasper said.

He said the bill would "gut" Virtua's regional model. Assemblyman Herb Conaway (D., Burlington), chairman of his chamber's health committee, was skeptical of that claim, noting that Virtua served 77 towns.

But Camden accounts for a significant portion of Virtua's call volume, Kasper said, and to stop servicing the city would force the hospital to reallocate its resources.

This would have an impact on surrounding towns and cities and "our ability to serve once we take a look at how existing units need to be redeployed if they're not needed to handle volume in the City of Camden," Kasper told the Senate panel.