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Virtua and Capital Health File Lawsuit to Stop Takeover of EMS Service in Camden and Hamilton

Trenton, NJ - Virtua and Capital Health System announced today that they have filed a lawsuit against the State of New Jersey. The lawsuit asks the court to stop implementation of a recently-enacted controversial emergency medical services (EMS) law that allows Cooper University Hospital to take over the Advanced Life Support (ALS) services that Virtua has been providing to the City of Camden for 38 years, and permits Robert Wood Johnson University Hospital to provide ALS services in Hamilton where Capital Health has provided ALS services since 1977. The basis of the suit is that the EMS law violates the New Jersey Constitution’s prohibition against “special legislation.”

The lawsuit is in response to legislation - introduced on June 8, voted on by the Legislature on June 25 and signed by the Governor on July 6 - that circumvents the New Jersey Department of Health’s longstanding regulation of the delivery of Advanced Life Support emergency services for the exclusive benefit of three hospitals that are Level I trauma centers (Cooper University Hospital in Camden, Robert Wood Johnson University Hospital (RWJUH) in New Brunswick and University Hospital in Newark). Under the law, these three facilities would be the exclusive providers of ALS and Mobile Intensive Care Unit (MICU) services to the municipalities where they are located without the Department of Health’s involvement in that decision. Since RWJUH and University Hospital already provide ALS services for New Brunswick and Newark respectively, Cooper would be the only hospital gaining ALS services from this legislation. Another special provision would permit RWJUH to decide by the end of 2016 whether to provide ALS services in Hamilton.

The State Department of Health designated Virtua 38 years ago as the provider of ALS services to all municipalities in Burlington and Camden counties. Since that time, Virtua has provided high-quality ALS services to the 77 communities in those counties. These services are high-level, often invasive medical services, such as intravenous medication administration, defibrillation and cardioversion, endotracheal intubation and chest decompression. The services are provided by paramedics and nurses certified to render advanced, out-of-the-hospital medical care under the direction of a medical command physician. Virtua has invested significant resources and funds in the development and maintenance of the regional ALS system, including the purchase of advanced medical equipment for its 12 MICUs and the recruitment and training of its 175 paramedics.

“Virtua has longstanding commitments to Camden residents, not only by providing paramedic services, but also by delivering a wide range of health and community services including emergency medical care, pediatric behavioral health, primary care and dental services, to name a few,” said Richard P. Miller, President and Chief Executive Officer of Virtua. “In fact, Virtua’s paramedics are a standard bearer of quality for the state, with faster response times for the City of Camden residents than recommended through New Jersey Department of Health’s EMS Blue Ribbon Panel. Virtua paramedics are the only provider in the state approved to administer medications to assist with intubation in the field without a physician’s order, a reflection of their skill and expertise.”

Capital Health holds the CN to provide ALS services for all of Mercer County. Capital Health’s concern is that carving Hamilton out of the center of its Mercer County ALS program for the benefit of RWJUH will affect the financial viability of the services it provides to the rest of the county which may require a reduction in services.

The complaint asserts that the law violates New Jersey’s Constitution, which prohibits “special” legislation that arbitrarily excludes persons or entities from the benefits of the law without any rational or reasonable basis relevant to the purpose of the act. Article IV, Section VII, paragraph 9 of the New Jersey Constitution provides that “the Legislature shall not pass any private, special, or local laws…[g]ranting to any corporation, association, or individual any exclusive privilege, immunity or franchise whatever.”

According to the complaint, “The legislation is unconstitutional because it excludes without a rational basis all New Jersey health care facilities already providing, or that might seek to provide, ALS services from the privileges that the Act, if made effective, would afford to the current Level I trauma centers, such as an exclusive ALS services area, right of first refusal for Basic Life Support services, state subsidization of its ALS services start-up, and expedited CN review for expanding ALS into other areas.”

“The state has a fair and appropriate process by which to authorize certificates of need for EMS and paramedic services throughout the state, which Virtua and Capital Health received nearly four decades ago,” said Philip H. Lebowitz, attorney for Virtua. “Now through special legislation, their certificates will be gutted for paramedic services Virtua provides to the residents of the City of Camden, and that Capital Health provides in Hamilton, and handed to other hospitals. The New Jersey Constitution is clear that the Legislature cannot grant exclusive privileges such as this and we are calling upon the court to deem them unconstitutional.”

The complaint argues that while the sponsors of the law stated that the law will centralize medical oversight, facilitate high-quality pre-hospital care and support a more cost-effective system, none of these objectives are accomplished by this legislation. In fact, according to the complaint, if enacted, the legislation:

  • Rather than centralize ALS services oversight, if made effective, at least with respect to Camden. Burlington and Mercer counties, the Act would carve up those services municipality by municipality, resulting in the piecemeal delivery of ALS services;
  • Rather than facilitate high-quality pre-hospital care, the Act only provides to Cooper the exclusive right to provide ALS services in Camden, where Virtua has provided uncontested high-quality pre-hospital care for 38 years; and to RWJUH an expedited route to displace Capital Health’s existing program in Hamilton, where it has had responsibility for nearly 40 years; and
  • Rather than support a more cost-efficient system for ALS services, the piecemeal system proposed by the Act, if made effective, would divert taxpayer dollars to subsidize the start-up of Cooper’s ALS services and disrupt the efficiencies gained by the regional approach that resulted in Virtua holding the CNs to provide ALS services to all of the municipalities in Camden and Burlington counties and in Capital Health serving all of Mercer County.

Through this complaint, Virtua and Capital Health are requesting that the court find this EMS law unconstitutional and stop the State from implementing the law. The lawsuit was filed today in the Superior Court of New Jersey, Law Division Mercer County.