Vineland Emergency Medical Service History

Several large-scale changes over the last 40 have resulted in the way emergency medical service is delivered in the City of Vineland, New Jersey.

Into the early 1960's, the ill an injured that had no other means, were delivered to the local hospital by ambulance. Typically someone would call Newcomb Hospital and request the ambulance. A taxi dispatcher would alert one of the local cab company drivers to go to the hospital and get the ambulance for the emergency. Witnesses to this process often speak in their stories, about the use of jumper cables and other mechanical hurdles the driver had before him. A police officer often helped the driver complete his mission of grabbing the sick and wounded and moving them toward the hospital.

In 1963 a way of helping those in emergency need was put to work. The Vineland Police Department assigned two of its on duty police officers to the police emergency unit. The emergency unit was a Chevrolet Suburban that carried a stretcher and first aid supplies. This unit did double duty. The officers aboard were able to enforce the law, respond to police emergencies and now respond to medical emergencies. This plan shortened the time from the patient's illness or injury to the time the patient reached the hospital emergency department.

Also to join the existing EMS system was a volunteer rescue squad and a transport ambulance. The rescue squad mostly performed vehicle extrication and a support function to the Fire Department but was capable of more. An ambulance driver staffed the transport ambulance via the Police Department. The out-of-town, Cadillac ambulance was most often used to take patients from the local hospital to tertiary care centers. The hospital provided all additional staffing that was required. Usually this was a single nurse with equipment and medications.

The level of training up to this point, which moved into the 1980's, varied in all components. Most of the police officers that regularly staffed the police emergency units were certified as Emergency Medical Technicians and in CPR. With the increasing number of EMS and police calls it was difficult to staff the emergency unit with currently certified EMTs. This was particularly true when circumstances required more than one police emergency unit be deployed. This was becoming more frequent. The volunteer rescue squad was mostly Emergency Medical Technician trained. Other training and competencies were tested and improved within the group. The transport ambulance driver was a paramedic who often took temporary assignment in the police emergency unit.

Equipment and supplies gradually improved in the Police emergency units and the Rescue Squad. Most of the EMS supplies aboard the Police emergency units were from the hospital. For instance, a fractured wrist would be splinted with a metal cock up splint and ace bandage rather than the typical board splint and cravats used by most rescue squads at this time. Portable resuscitation equipment and suction was added in the 1980's. The rescue squad obtained the "Jaws of Life," Hurst tool prior to this.

In 1985 NJAC 8:40 ET seq. became law. It was a portion of the New Jersey Administrative Code that required a standard of non-volunteer ambulance agencies. The City of Vineland was notified it should comply.

Vineland responded in a limited fashion. The police emergency units became Chevrolet vans. More equipment could be carried and patients could be positioned at 90 degrees on the stretcher. This improved patient care. The added room of the van also facilitated additional equipment and even room for a second supine patient. Vineland was still far short of the new standard but carried on a system that exceeded the performance of many unregulated areas of the state. The wait for help in Vineland was clearly less than in other areas. The equipment that responded to the emergency was also less than that which could be found in other areas.

In 1988 the new Mayor, Harry Curley saw the need to change. He appointed a study committee. This committee consisted of the following people.

• Dr. Joseph Bernardini - a local orthopedic surgeon and physician leader.
• Mr. Tom Rayner - the Chief Operating Officer of Newcomb Hospital.
• Mr. Leon Mazzochi - a long time local business man with a role in the volunteer fire service.
• Mayor Curley - a former Sergeant in the Vineland Police Department and former Board of Education President.
• Director Louis Cresci, Jr. - the City's Director of Health and Health Officer who was part of the volunteer fire service.
• Mr. Si Solazzo - along time City Council representative and Council President. Mr. Solazzo was also an advocate of the 1963 upgrade to police emergency units.
• Director Biaggio Ciulla - Director of Fire and Fire Chief
• Director Jack Carr - Director of Emergency Management which oversaw the Rescue Squad and a full time Fire Captain with the Vineland Fire Department.
• Chief Joseph Cassisi - Chief of the Vineland Police Department and a police veteran that saw the implementation of the police emergency units.

The committee was charged with finding the best way to improve the City's EMS system. Their foremost goals were the provision of quality patient care and compliance with the state regulations. They viewed other systems including private, paid, volunteer, large community, and small community systems.

The result was a separate and distinct Emergency Medical Service Division to be within the structure of the Fire Department but located separately. Jack Carr a paid Fire Captain that rotated shifts with a platoon was removed from the platoon and assigned to a day shift to work with this program. Alfred Lincks, the City Police Department ambulance driver provided research and information as an internal resource during the committee's process. He was appointed to supervise the new unit. The Police Department was not downsized. This freed more police officers to handle the ever-increasing volume in police calls. The 24 hour on / 48 hour off schedule of the Fire Department looked like a fit for the Emergency Medical Service Division. The Fair Labor Standards Act rulings at the time made this appear as an economical way to staff. The new Division answered its first call, June 4, 1990.

The new Division was compliant with the state regulations. As more personnel were brought on the City of Vineland Emergency Medical Service Division assumed its 24 per day / 7 day per week role of providing state of the art pre-hospital care and transportation. Under aggressive management the Division moved quickly to implement a defibrillation program as the regulations began to make it possible. Mayor Curley was recognized by the NJ Department of Health for his efforts in the implementation of this system.

The City's Health Department and in particular Louis Cresci, Jr., Director of Health remained strong advocates for the system. The local Health Department had experience with third party billing as a revenue source through its Nursing, Home Health Care Division. The new Emergency Medical Service Division was implemented as cost effectively as possible. Ambulances were mostly parked outside with heaters to help melt frost and snow. Personnel were hired at lower salaries than police officers. The primary station was a house the hospital loaned to the City (still in use today). Another unit was stationed at a volunteer fire House in South Vineland (also still in use today). In spite of these efforts there was a fiscal impact. The Police Department had more officers for patrol and the Fire Department had a new captain promoted. The Emergency Medical Service Division began cost recovery efforts through third party billing and became a Division of the Health Department.

When needed, the growth of this Division has been supported. Several new vehicles were purchased under the administration of Mayor Romano. When internal quality improvement research showed a lagging response time in north Vineland was worsening, Mayor Campanella's administration provided for the expansion of the service and the construction of its first new building. Under Mayor Barse, an examination of the service was commissioned. Carroll Buracker and Associates, Inc. submitted recommendations for improvement of the service that are now under review.

Today the Emergency Medical Service Division operates three ambulances around the clock. A forth ambulance was added under Mayor Barse's administration. It works during the 12 heaviest call volume hours. This is called a power shift. A field supervision component is strong in ongoing quality improvement. It exceeds minimum state standards and aptly answers calls at the national standard for response times. The community views Vineland EMS as an asset. VEMS has the support of the governing body when needed to carry out its mission of providing pre-hospital emergency medical care.

In 2003 the State of New Jersey Department of Health and Senior Services recognized Vineland EMS as the Public Provider of the year. Several of Vineland's EMTs have received personal nominations for state recognition as well. Millard Hahn was recognized by the state as EMT of the year. Vineland's Chief Lincks continually active with several initiatives at the state level in improving Emergency Medical Services.