Virtua chief on EMS fight: It's like 'communist China'

TRENTON - The dispute over whether Cooper University Hospital should take over emergency medical services in Camden intensified Wednesday, as the CEO of one of the current providers suggested that the legislative process was resembling "communist China."

Cooper quickly shot back, pointing to data released by Camden County claiming that Virtua frequently does not meet industry standards for response times.

At issue is a bill, introduced this month and expected to reach the Legislature for a vote Thursday, that would let Cooper take over paramedic and basic life services in the city.

Paramedic services are now provided by Virtua Health System, and the state-owned, Newark-based University Hospital handles basic life services. Virtua has provided paramedic services to each town in Camden and Burlington Counties for 38 years.

"What in God's name is happening in this state?" Richard P. Miller, Virtua's chief executive and president, said at a Statehouse news conference Wednesday. "What's happening to our process in this state, when one person can want something - I thought I landed in communist China - one person wants something and can take it away from another business, just unilaterally, and get people to agree to it? What in heaven's name is happening to our process?"

Miller was referring to George E. Norcross III, chairman of Cooper's board of trustees and the South Jersey Democratic leader. "The chairman of Cooper obviously feels strongly about taking this program away from Virtua," said Miller, who was flanked by a half-dozen Virtua paramedics.

Dan Fee, a spokesman for Norcross, said: "Mr. Miller's comments crystallize this issue. He's focused on Virtua's profits, and everyone else is focused on the quality of care Camden residents receive.

"If you were seriously injured, would you want your first care to come from the region's only Level 1 trauma center or a community hospital?" Fee added.

The remarks underscore the bitter rivalry between the hospitals. They come as lawmakers prepare to confront a key question on Thursday: What is the best way to serve Camden residents in need of emergency care?

Beyond that, larger issues loom over the bill, such as whether it would be appropriate for the Legislature to circumvent the regulatory process by which Virtua obtained a license to operate in Camden and elsewhere.

The hospitals also argue over Virtua's loyalty to Camden. Steven E. Ross, a Cooper surgeon, wrote in a letter distributed to legislators that Virtua had "violated a commitment" to former Assembly Speaker Joseph Roberts by moving its headquarters out of the city in 2000.

"I viewed that just completely as a betrayal," Roberts recalled Wednesday. "They made a business decision. But they completely violated their commitment to the city of Camden. It was very infuriating, unconscionable."

The move still damages Virtua's credibility today, Roberts said.

Miller said he was "tired of hearing" that Virtua had abandoned Camden. "It's a smokescreen," he said, adding that Virtua wants to build a $10 million primary care center in the city.

Miller said demand for beds at Virtua's acute care center in Camden had dropped by 2000, so the former West Jersey Hospital started offering emergency, primary care, and behavioral health services.

On Thursday, the Legislature is expected to vote on a $35.3 billion budget advanced by Democrats. It includes $2.5 million for Cooper for EMS. Cooper's backers say this one-time expense would be used for start-up costs such as replacing ambulances.

Cooper argues that as South Jersey's only Level 1 trauma center, it is best positioned to provide emergency care. Virtua counters that it has the most experience in providing such care, at no cost to taxpayers.

A Camden County spokesman released aggregate numbers Wednesday, following a request by The Inquirer for data on Virtua's calls and response times.

In the release, the county said it had analyzed all 911 calls for paramedic services in Camden in 2015. "Of 2,961 calls responded, on 788 occasions Virtua paramedics failed to arrive to the individual in need of care within eight minutes from the original dispatch point of contact," Robin Blaker, director of the county's department of public safety, said in a statement.

Thus, paramedics didn't meet the eight-minute industry standard on 27 percent of its calls, Blaker said.

Soon after the county released this information, Norcross blasted an e-mail with an infographic citing that data. "Service matters . . . and every second counts," the e-mail said.

However, the county has not provided the data underlying those aggregate numbers, making it difficult to draw firm conclusions about Virtua's performance.

Providing the data could take a while, county spokesman Dan Keashen said.

The Inquirer last week also requested response-time data from Virtua. The hospital said it maintains the information but declined to disclose it, saying it was proprietary.

On Wednesday, Scott Kasper, assistant vice president for emergency services at Virtua, said through spokeswoman Peggy Leone that he hadn't seen the Camden County data. But he questioned why, after multiple legislative hearings, this was the first time Cooper was questioning Virtua's performance.

Leone said the hospital is reimbursed by insurance, Medicare, and Medicaid for its paramedic services, but would not say how much revenue that generates.

Hospital officials said at the news conference on Wednesday that Virtua loses $1.2 million annually on its Camden operation.

Nevertheless, Miller said Camden was crucial to Virtua's model for paramedic services.

"It's not so much whether it's a gain or a loss from that operation - you're taking 16 percent of the revenue base out of the model," he said.

Camden is a "major base for us in terms of medics and vehicles" that support surrounding towns, Miller said. "How do we balance all of that is going to be the key."

Alexander J. Hatala, president and CEO of Lourdes Health System, said at the news conference that he worried that a Cooper takeover could shut down his medical center in Camden.

Currently, Virtua says, 69 percent of patients in Camden are transported to Cooper; 29 percent to Lourdes; and 2 percent to Virtua.

If Cooper controls EMS, Hatala asked, "are they going to make the right decision on behalf of the patient, or are they going to make a decision that benefits their organization?"

Citing those percentages in an open letter to the Legislature Wednesday, Ross wrote: "If Cooper operates this service, we will work with the other facilities in Camden to assure these standards of care are met."

Ross said current guidelines "require that a patient be brought to the closest, most appropriate facility or the hospital of their choice."

A Department of Health spokeswoman said the state does not regulate patient destinations but "issues guidelines to EMS providers based on clinical presentation and evidence-based practice."