An old policy for Jersey City Medical Center ambulance service sparked controversy this week because it seemed to indicate that EMTs bring all patients to Jersey City Medical Center unless a patient specifically directs them to another hospital or there is a specific medical need to go to a hospital other than JCMC.
The 2003 policy seemed to verify claims made over the years that JCMC has steered patients to JCMC when another hospital—specifically Christ Hospital—might be closer at the time.
This claim is not new. Critics of JCMC from the 1990s have suggested that patients picked up by JCMC ambulances have been automatically taken to JCMC.
The current conflict comes at a time when Jersey City Mayor Steven Fulop has asked the city council to give a three-year contract to Bayonne-based McCabe Ambulance, which is being backed by CarePoint Health, a competitor of JCMC.
Officials at JCMC, however, said that the 2003 Transport Destination policy was changed in 2009 when JCMC was last awarded the Jersey City contract.
Mark Rabson, Director of Public Affairs for JCMC, said its ambulances have operated under a different policy since 2009.
Robert Luckritz, director EMS for JCMC, said every ambulance in the JCMC fleet is equipped with a computer into which the details of the current patient are input. Based on that information, the computer recommends what is the best hospital for that patient, whether it is a critical care facility, a general hospital, or one that would deal with cardiac or stroke. Since JCMC is a class II trauma center—the closest to any location in Jersey City—it would receive all trauma cases from Jersey City.
Rabson said the accusations that JCMC ambulances do not bring patients to Christ Hospital simply aren’t true, noting that he recently saw four JCMC ambulances in the Christ Hospital parking lot.
New documents acquired this week show that JCMC ambulances still bring patients to JCMC unless specifically asked not to by the patient.
Although the new printed transportation policy has not changed in the current operating manuals for EMTs, Rabson said that JCMC ambulances operate according to the directions indicated by the computer.
“The computer determines where our ambulances go,” he said. “We spent a lot of money in 2008-2009 updating the software. It is a national company. We take the patient to the hospital that the computer recommends, unless the patient wants to go somewhere else. The city contract says that we have to go to the closest hospital in Jersey City. If it is a trauma case in North Hudson, sometimes we may be directed to take the patient to Hackensack Medical center which is geographically closer.”
According to Rabson, in Jersey City patients go to the nearest hospital unless the computer or patient tells them otherwise. Medical conditions dictate where the patient goes.
Jersey City taxpayers could save money
Jersey City has received two bids for its ambulance contract, one from JCMC, which has had the contract for 130 years, and one from McCabe Ambulance, which is being backed by CarePoint, owner of Christ Hospital in Jersey City, Bayonne Medical Center, and Hoboken University Medical Center.
Last week, Mayor Fulop said he would recommend to the council that it should award the contract to McCabe, claiming the city would save $6.5 million annually, while also increasing healthcare options for residents.
“Saving taxpayer dollars while improving public safety and public health is a priority for our administration,” Fulop said. “The winning ambulance provider will do both by reimbursing the city its costs to provide first-responder services and by offering patients the option to choose the hospital they want to be transported to when their issue is of a non-life-threatening nature.”
The last ambulance contract was awarded in 2009, and the only bidder at that time was JCMC. For the service, the city has been paying on average $3.8 million per year. This year, the city paid $3.9 million. The new contract is for three years, with two, one-year renewal options.
CarePoint Health System-McCabe Ambulance will reimburse the city $2.6 million annually for the cost of using Jersey City firefighters as first responders for any calls to which they cannot respond in a timely manner.
Riaz Wahid, an activist in Jersey City who is expected to speak against awarding the contract to McCabe at the Dec. 18 council meeting, said he is opposed to the use of firefighters, pointing to an increased cost to local taxpayers as well as a disservice to the uninsured and homeless.
“When a for-profit provides services to uninsured the regular payers’ bills go way above what it should be,” Wahid said. “That is one reason why BMC [Bayonne Medical Center] billing is the highest in the nation.”
This goes to the heart of the conflict. CarePoint makes a significant amount of its money through its emergency-room services. Having abolished its contracts with many insurance providers, CarePoint can charge whatever fees it wishes for services provided through the ER and has increased these in order to force insurance companies to offer a higher reimbursement rate.
CarePoint officials claim that JCMC has been unfair in taking patients to JCMC rather than other hospitals such as Christ. The Transport Destination policy of 2003 helps make their case. If patients are diverted, then CarePoint loses a large portion of its revenue.
This is why CarePoint is willing to help McCabe upgrade its fleet to meet the requirements of the Jersey City contract.
Fulop’s reasoning for backing CarePoint
In its bid for the contract, JCMC offered a zero-dollar contract and suggested using some volunteer EMTs instead of full-time Jersey City first responders. Analysis, according to Fulop, showed that during November 2013 there were 69 emergency calls requiring ambulance service to which JCMC was unable to respond within eight minutes. Further, from Jan. 1, 2013 through Sept. 30, 2013, JCMC was unable to respond at all to 121 calls for ambulance service.
“We made the right choice for the taxpayers of Jersey City and equally important we made the right choice for anybody who needs transportation to the hospital,” said Fulop. “This ensures Jersey City residents will receive the highest quality of emergency healthcare.”
In a statement in response, JCMC said it was “extremely disappointed” in the city’s decision not to renew its contract for EMS services with the JCMC.
“Instead of continuing to trust the lives of its residents with a proven nationally recognized EMS provider, this administration has decided to take its chances with an unproven, untested EMS provider associated with a for-profit hospital system from outside of Jersey City,” the release said. “The Jersey City Medical Center operates one of the best EMS systems in the country, and has won numerous awards for innovation, training, and nationally recognized response times. It has been featured in industry magazines, newspapers, and on television as an industry leader.”
The Jersey City Council is expected to hear arguments at its Dec. 18 meeting. Updated information after the meeting can be found in the Jersey City Reporter this weekend or online at hudsonreporter.com.
Al Sullivan may be reached at asullivan@hudsonreporter.com.